HomeMy WebLinkAbout04-16-13 REV-1500 EX(W 11)(Fq 1505610105
OFFICIAL USE ONLY
PA Department of Revenue pe^^sylvanta
Bureau of Indtviduat Taxes " County Code Year File Number
PO BOX 2806o1 INHERITANCE TAX RETURN { f �
Harrisburg,PA 17128-0601 RESIDENT DECEDENT f
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMODYYYY Date of Birth __ MMDDYYYY
10111/2012 1112711939
Decedent's Last Name Suffix Decedent's First Name MI
Lunday Donald E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Lunday Patricia
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
415-64-7807 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(� 1.Original Return C1 2.Supplemental Return CM 3. Remainder Return(Date of Death
Prior to 12-13.82)
O 4,Limited Estate C=> 4a.Future Interest Compromise(date of C'.> 5. Federal Estate Tax Return Required
death after 12-12.82)
m 6. Decedent Died Testate CM 7.Decedent Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
C= 9_Litigation Proceeds Received C=D 10.Spousal Poverty Credit(Date of Death t.3 11. Election to Tax under Sec.9113(A)
Between 12-31.91 and 1-1-95) Attach Schedulee1q
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMpC OKSHOULD 9901RECTRIT
Name _.. . . . . .. .. . DaytitrgTQ�phone Ntlfer n
John C Ciszustowicz (717R4S71111I87
(SSTBWOF WILLS USMIIR'
First Line of Address O C
104 S Hanover St �f r1' r '>
Second Line of Address a p -n
City or Post Office _ State ZIP Code DATE FILED
Carlisle PA 17013
Correspondent's e-mail addmss:johno@earlislepalaw.com
Under penaWas of Perjury,I declare Nat I have examined this retum,Including ammpanying schedules and statements,and to the best of my knowledge and belief,
b is true,correct and canplete.Declaration of preparar other than the personal representative Is based on all Information of which preparar has any knowledge.
SIGNA E PERSON RE tBLE A FILING TURN DATE
DRESS
624 DevonstAre Dr., Carlisle, PA 17013
SIGNATURE# REPRESENTATIVE DATE
ADDRESS
104 S Hano r St., Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX(FI) Decedertt's Social Security Number
Decadent's Name:
RECAPITULATION
1. Real Estate(Schedule A). ............................. ............... 1. 267,100.00
2. Stocks and Bonds(Schedule 8) ...... ................................. 2. 3,390.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D). . ......... 4.
S. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 90,609.44
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Ywos Transfers&Misceitaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. . 146,960.17
8. Total Gross Assets(total Lines 1 through 7)........... ... ............... 8. 508,069.61
9. Funeral Expenses and Administrative Costs(Schedule H)...... ....._...... 9. 19,556.90 j
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . ...... 10. 12,000.00
11. Total Deductions(total Lines 9 and 10)........ ........... 31,566.90
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 476,502.71
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which _. .
an election to tax has not been made(Schedule J) ........................ 13.
14. Not Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 476,602.71
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 40761 Z 10
(a)(1.2)X.0� , 15. 0.00
16. Amount of Line 14 taxable
at lineal rata X.0 45 68,885.61 is. 3,100.00
IT Amount of Line 14 taxable ,.,..... .. .. ..
at sibling rate X.12 17.
18. Amount of Line 14 taxable .__ ..._ ......
at collateral rate X.15 1&
19. TAX DUE- ........ 19. ...._ 3,100.00
20. FILL IN THE OVAL IF YOU ARE REOUESTINO A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
REV-1 00 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAM
Donald E Lunday
STREETADDRIEW
624 Devonshire Drive
Cariisie PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,100.00
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+B) (2)
3. Interest
(3)
4. If Line 2 is greater than Line 1+Line 3,enter the ditthrence. This is the OVERPAYMENT,
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. if Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,100.00
Make check payable t0: REGISTER OF WILLS,AGENT.
_ :a ..ml ` h,;:G;i )a,.,'P°.I±..4r.I�L"a'�� _01101`,,�i;€: °5`y. ! .`.:9" rr,':�n('1E?�7 f r� 's.. 3hiygrP=;oh� .a1�.5i a :_Mn, r..:i: 't,.1�:... 6)1 ,,
)ta� r
.f",rF___NZ
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................................._...................,......................,........... ❑ N
b. retain the right to designate who shall use the property transferred or its income.......__.................__........... ❑ ■
c. retain a reversionary interest........._.............._......................___..........._................._.............___............. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ ■
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.....................__....._............................................................................. ❑ ■
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? .................._................................................................................................... E ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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R.n i. ,4d`- 1 e. ^flr. .C.:.,1-'I V11 YI @ f6F ,. P b�I"G , �d xa. e. 1` .' , ..: +"N '.� M I, , N4 Y a,'.+��dCBHj�„�INl enfl i++:11
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)(1)].
For dates of death on or after Jan. 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 A)(4)].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 All 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 p2 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-1502 EX+112-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donald E. Lunday 21-12-1255
All real property owned solely or as a tenant In common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. Residence at 624 Devonshire Drive,Carlisle,PA 17013 PIN 0422-0481-061 267,100.00
TOTAL(Also enter on Line 1,Recapitulation.) 6 267,100.00
If more space is needed,use additional sheets of paper of the same size.
RE ,iSO3 EX-(8-U)
Iffpennsylvanta SCHEDULE B
OePAitlTiENT OF R V&Ntk
INHEWANCETAXRETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
I' 150 shares General Electric Common Stock
3,350.00
TOTAL(Also enter on Line 2, Recapitulation) ¢ 3,390.00
If more space is needed,insert additional sheets of the same size
REV-1508 Ex+(o8-11)
i pennsylvania SCHEDULES
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS &MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donald E. Lunday 21-12-1255
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. USAA Savings Account#038210 6,903.00
2 USAA Checking Account#14976706 3,844.00
3 Onstovm Bank Checking Account#106005250 2,100.00
4 Members list Checking Account#26483 9,782.00
5 American Funds Fundamental Investors Account#67694891 12,861.60
6 2011 Honda Accord 16,055.00
7 USAA Tax Exempt Intermediate Fund 39,063.84
TOTAL(Also enter on Line 5, Recapitulation) $ 90,609.44
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+{08-09}
r pennsytvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INIEFtETANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald E. Lunday 21-12-1255
This schedule must be completed and filed if the answer to any of questions i through 4 on page three of the R£V-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
INUURE THE OF ANTHETRANSFEREE,TNeO THEDpNSHIPTRAEESTATE AND
NUMBER THE DATE OF TRANSFER. ATTAGIADOPY OF THE DEED PER RGLE5TgTE. VALUE OF ASSET INTEREST IF aFFUTAN.EI VALUE
I. Nicholas Limited Edition Account#021-027-2700156050 transferred 2125113 13,540.41 100 13,54041
to sons Mark Lunday,Kevin Lunday and Brian Lunday
2 Franklin Templeton World Fund Account#1024085264299 transferred 2!8113 3,419.76 100 3,419.76
to sons Mark Lunday,Kevin Lunday and Brian Lunday
3 UFinancial IRA Account#HTMI35240 transferred 1114113 to spouse Patricia 130,000.00 100 130,000.00
Lunday
TOTAL(Also enter on Line 7,Recapitulation) $ 146,96017
If more space is needed,use additional sheets of paper of the same size.
REV-1511 Ex+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald E. Lunday 21-12-1255
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
I' Hoffman Roth Funeral Home,Carlisle,PA 12,756.80
2 Food for Memorial Service 577.40
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City___. .._ .- .. _.._—_ ..-_. State-._._-ZIP__..____..._.__. ..
Year(s)Commission Paid: _
2. Attorney Fees:
5,625.00
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
city . .._- -----------._.__State---- ZIP- ---....------
Relationship of Claimant to Decedent
4, Probate Fees: 207.50
5. Accountant Fees:
6, Tax Return Preparer Fees:
7. Legal Advertising-The Sentinel 115.20
B Legal Advertising-Cumberiand Law Journal 75.00
TOTAL(Also enter on Line 9,Recapitulation) # 19,556.90
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald E. Lunday 21-12-1255
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbarsed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Auto loan on 2011 Honda Accord 12,000.00
TOTAL(Also enter on Line 10,Recapitulation) $ 12,000.00
If more space is needed,Insert additional sheets of the same size.
REV-1513 EX+(01.10)
ISpennsylvania SCHEDULE 7
DEPARTMENT OF REVENUE BENEFICIARIES
INHEWANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donald E Lunday 21-12-1255
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustees) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
I. Kevin E Lunday 307 Saint Erie W,Suffolk,VA 23435 Son 22961.87
2 Brian J.Lunday 3234 Meigs Rd.,West Point,NY 10996 Son 22961.87
3 Mark T.Lunday 6186 Bannot Dr.,Greensboro,NC 27455 Son 22961.87
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES SS THROUGH IS OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECr10N TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.