HomeMy WebLinkAbout04-15-13 REV-1500 EX(02-11) 1505610143
PA Department of Revenue y OFFICIAL USE ONLY
p penns Ivania County Code Year File Number
Bureau of Individual Taxes DEVARTWNT OF REVENUE
PO BOx.280601 INHERITANCE TAX RETURN 21 13
Harrisburg,PA 17128-0601 RESIDENT DECEDENT D °�(O
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
211 26 6576 09 25 2012 02 07 1933
Decedent's Last Name Suffix Decedent's First Name MI
MACKLEY DAVID A
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X❑ 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death
Prior to 12-13-82)
4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
g Decedent Died Testate Decede❑❑t Maintained a Living Trust
(Attach Copy of Will) ❑ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received 10.Spousal Povert Credit(Date of Death E] 11.Election to tax under Sec.9113(A)
between 12-31- and T-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
AMY M MOYA 717 652 7323
c� m
FfPWER OF RLS 'E 1LY
M G'a as.
First Line of Address }� {,i
5 011 LOCUST LANE '
Second Line of Address
City or Post Office State ZIP Code ,C DATE FtQED
HARRISBURG PA 17109
Correspondent's e-mail address: AMY@—Ledererlaw.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
,_/-11, v�� Marion k Mackley 4 J I)
ADDRESS
1104 Baldwin Street Mechanicsburg, PA 17055
G TURE IPREPIER OTHER THAN REPRESENTATIVE DATE
Amy M. Moya C � )
ADDRE
L. O. of Susan E. Lederer, 5011 Locust Lane, Harrisburg, PA 17109
Side 1
L 1505610143 1505610143 J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Mackley, David A 211 26 6576
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 2f146 . 50
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous N Probate Property
(Schedule G) u Separate Billing Requested............ 7. 186, 012 . 83
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 188 , 159. 33
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 8 , 077 . 20
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 8, 077 . 20
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 180 ,082 . 13
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 180 , 082 . 13
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 180 , 082 . 13 15. 0 . 00
16. Amount of Line 14 taxable 0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13
Decedent's Complete Address:
DECEDENT'S NAME
Mackley, David A
STREET ADDRESS
1104 Baldwin Street
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0,00
Make Check Pa able to REGISTER OF WILLS, AGENT
5/11 aMa,
y..,
xw
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;............................................................................... ❑ ❑
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ ❑
c. retain a reversionary interest;or............................................................................................................... ❑ ❑x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑x ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
MOM
For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mackley, David A 21-13
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyownedwith the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Income Tax Refund from US Treasury(1/2 of$4,293.00) 2,146.50
TOTAL(Also enter on Line 5, Recapitulation) 2,146.50
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1510 EX+(08-09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mackley, David A 21-13
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH THEIR A COPY OF THE EED FFOREREAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 1,974.796 shares of Morgan Growth Fund Inv,CUSIP 40,068.61 100.000% 40,068.61
No.921928107, held at Vanguard IRA Account No.
09881774530, David A.Mackley,owner, Marion S.
Mackley, beneficiary($20.29/sh)
2 12,582.216 shares of Total Bond Market Index Adm, 141,166.01 100.000% 141,166.01
CUSIP No.921937603, held at Vanguard IRA Account
No.09881774530, David A. Mackley,owner, Marion S.
Mackley, beneficiary($11.20/sh)(includes accrued
dividend$245.19)
3 330.901 shares of International Explorer Fund, 4,778.21 100.000% 4,778.21
921946208, held at Vanguard IRA Account No.
09881774530, David A.Mackley,owner, Marion S.
Mackley, beneficiary($14.44/sh)
TOTAL(Also enter on Line 7, Recapitulation) 186,012.83
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Mackley, David A 21-13
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 4,715.70
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State ZiD
Year(s)Commission Paid
2. Attornev's Fees L. O. of Susan E. Lederer 1,200.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 2,146.50
Claimant Marion S. Mackley
Street Address 1104 Baldwin Street
city Mechanicsburg State PA ZiD 17055
RelationshiD of Claimant to Decedent Spouse
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 8,077.20
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Mackley, David A 21-13
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Musselman Funeral Home 4,363.00
2 Jeffrey's Flowers 88.88
3 Trinity Evangelical Lutheran Church(funeral luncheon) 263.82
H-A 4,715.70
Other Administrative Costs
4 Cumberland County Register of Wills(filing fee) 15.00
H-B7 15.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mackle , David A 21-13
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trusteels)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions,and transfers
under Sec.9116(a)(1.2)]
Marion S. Mackley Spouse 180,082.13
1104 Baldwin Street
Mechanicsburg, PA 17055
Total 180,082.13
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
Form 1040(2012) MARION L & DAVID A MACKLEY 187-24-0845 Page 2
Tax and 38 Amount from line 37(adjusted gross income) .............................................. 38 64, 669 .
Credits 39a Check You were born before Jan.2,1948, 8 Blind. Total boxes
if: Spouse was born before Jan.2, 1948,H Blind. checked► 39a 2
Standard b if your spouse itemizes on a separate return or you were a dual-status alien,check here ► 39b
Deduction 34 461.
for- 40 Itemized deductions(from Schedule A)or your standard deduction(see left margin).... 40 r
People who 41 Subtract line 40 from line 38 .............................................................. 41 30, 208 .
check any 42 Exemptions.Multiply$3,800 by the number on line 6d ...... 42 7, 6 0 0
box on line ..............................
39a or 39b or 43 Taxable income. Subtract line 42 from line 41, If line 42 is more than line 41,enter-0-...... 43 2 2, 6 0 8 .
who can be
claimed as a 44 Tax(see instructions).Check if any tax is from: a Q Form(s)8814 b F]Form 4972 c F1 962 election 44 2, 134 .
dependent,
see 45 Alternative minimum tax(see instructions). Attach Form 5251 ............................ 45
instructions. . ► d6 2, 13 4 .
• All others: 46 Add lines 44 and 45 ..................................................................
47 Foreign tax credit.Attach Form 1116 if required 101.
Single ar ............ 47 _
Married filing d8 Credit for child and dependent care expenses. Attach Form 2441 48
separately,
55,950 49 Education credits from Form 8863,line 19 .................. 49
Married filing 50 Retirement savings contributions credit,Attach Form 8880 .. 50
jointly or
Qual"'In 51 Child tax credit. Attach Schedule 8812,if required.-...,.... 51
$11,90er}, 52 Residential energy credits.Attach Form 5695 52
$11,900 -
Head of 53 Other credits from Form: a[] 3800 b 11 8801 c 53
household, 101 .
$8,700 54 Add lines 47 through 53. These are your total credits...................................... 54
55 Subtract line 54 from line 46. if line 54 is more than line 46,enter-0- .................. ► 55 2, 033 .
Other 56 Self-employment tax. Attach Schedule SE ................................................ 56
Taxes 57 Unreported social security and Medicare tax from Form: a 11 4137 b 0 8919 57
58 Additional tax on IRAs,other qualified retirement plans,etc. Attach Form 5329 if required .. 58
59a Household employment taxes from Schedule H ............................................ 59a
b First-time homebuyer credit repayment.Attach Form 5405 if required ...................... 59b
60 Other taxes.Enter code(s)from instructions 60
61 Add lines 55 through 60. This is your total tax ........................................ 0, 61 2, 0 3 3.
62 Federal income tax withheld from Forms W-2 and 1099 .. 62 6f 326. FORM 1099
Payments
63 2012 estimated tax payments and amount applied from 2011 retum . 63
If you have a L 64a Earned income credit(EIC) ..................NO........J 64a
qualifying child, Nontaxable combat
attach Schedule b pay election 64b
EIC. 65 Additional child tax credit. Attach Form 8812................ 65
66 American opportunity credit from Form 8863,line 8.......... 66
67 Reserved ................................................ 67
68 Amount paid with request for extension to file ............ 68
69 Excess social security and tier 1 RRTA tax withheld ........ 69
70 Credit for federal tax on fuels.Attach Form 4136 70
Re-
71 Credits from Form: aF12439 b 'Il served c F1 8801 d1 saes 71
72 Add lines 62,63,64a,and 65 through 71.These are your total payments .............. ► 72 6, 326.
Refund 73 If line 72 is more than line 61,subtract line 61 from line 72. This is the amount youoverpaid 73 4, 293.
74a Amount of line 73 You want refunded to you.If Form 8888 is attached,check here► 74a 4, 2 33
► b n�mtier _
► c Tvpe: Checking Savings
Direct deposit? p. d numbe7 --
See instructions 75 Amount of fine 73 you wantapplied to your 2013 estimated tax 0.1_75
Amount 76 Amount you owe.Subtract line 72 from line 61.For details on how to pay,see inst. .... ► 76
You Owe 77 Estimated tax enalt see instructions ... 77
p Y( )
Third Party Do you want to allow another person to discuss this return with the IRS(see instructions)? Yes.Complete below. No
Designee Designee's Phone Personal identification
name ► no. ► number PIN
Sign Under penalties of perjury,I declare that I have examined this return and accompanying schedules and statements,and to the best of my knowledge and
belief,they are true,correct,and complete. Declaration of prepare,(other than taxpayer)is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation Daytime phone number
Joint return? IRETIRED 717-697-2486
See instr. If the IRS sent you an Identity
Kee a co Spouse's signature.lf ajoint return,both must sign. Date Spouse's occupation v y
for your copy Protection PIN,
records. enter it here
DECEASED (see inst.)
Print/Type preparer's name Preparer's signature Date Check f PTIN
Paid AAR p self-emptoyed 5 2 5050813
Preparer's Firm's name ► AARP MECHANICSBURG SENIOR CENTER Firm'sEiN►
Use Only Firm'saddress ► 97 W PORTLAND ST Phone no.
MECHANICSBURG PA 17055-
BCA Us1040$2 Form 1040 (2012)
Page > 1 of 1
V-mguard
David A.Mackley Report for 09125/20112mR ' � ;��
x i.,a v iL�n r.A L,,f,.'Fe u.k..1_R s:Y fa .a.l'�'��.t�.#y.'.•ai.�..�., �:.ua..•�'TL�'#,ri.� 1 �e�.s
1104 Baldwin St Client Services:800-662-2739
Mechanicsburg, PA 17055-3934
Total report value: $186,012.83
(Total report value includes any accrued dividends.)
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..: e._ .L�w.:r,.x a �,.1 i -1.5 yr W x.i�,.•eF fE9 � -x.�,yr ,d � iq=:
Account value summary ix 1 �yau
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Name Fund&Account Date 'A Price Per Accrued
Number Opened Shares Share Value* Dividends
Morgan Growth Fund Inv 0026-09881774530 10/17/2006 1,974.796 $20.29 $40,068.61 -
Total Bond Mkt Index Adm 0584-09881774530 10/17/2006 12,582.216 $11.20 $140,920.82 $245.19
Internatl Explorer Fund 0126-09881774530 03/11/2004 330.901 $14.441 $4,778.21 -
Totals $185,767.64 $245.19
'-D o e s r"t include accrued dividends. --
0746091216 02/26/2013 10:01:12
i
April 12, 2013 µ µ h
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of David A. Mackley
SSN: 211-26-6576
Date of Death: September 25,2012
File Number: Not yet assigned
To Whom It May Concern:
Enclosed for filing with your office please find two(2) completed Forms REV-1500 with the
following attachments:
• Date of death valuations; and,
• Check made payable to Register of Wills in the amount of$15.00 for filing costs.
One (1) additional photocopy of the front-page of the completed REV-1500 form has been
provided. Please time/date stamp these copies as received and return them to me in the envelope
provided.
If there are any questions or further requirements regarding this return, please do not hesitate
to contact me.
Very truly yours,
Cl) w M
a rat
A y M. Mo rr'n � r
M,Enclosures 70
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5011 Locust Lane • Harrisburg,PA 17109 • Phone 717.652.7323 Fax 717.652.7340 • susan @ledererlaw.com
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