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HomeMy WebLinkAbout04-04-13 (2) J 1505610105 REV-1500 EX(02-11){Fp OFFICIAL USE ONLY pennsyivania PA Department of Revenue DVAnniExr fte County Code Year File Number POBo i 01 ua1 Taxes INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 01102013 03281946 Decedent's Last Name Suffix Decedent's First Name MI DEVENNEY MIMI A (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffof 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 BOXES BELOW f7j 1. Original Return 2. Supplemental Return © 3. Remainder Return(Date of Death Prior to 12-13-62) (� 4. Limited Estate 0 4a. Future Interest Compromise(date of Q S. Federal Estate Tax Return Required death alter 12-12-82) Q S. Decedent Dad Testate T. Decedent Maintained a Living Trust 0 s. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 0 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT—THIS SECTM MUST BE COMPLETED ALL CORRESPONDENCE AND COMFWEIM&TAX INFORMATION SHOULD BE DIRECTED 10: Name Daytime Telephone N"r i STEPHEN D. TILEY 717-1441-583&- OTER OF VfW First Line of Address ..0 v p -n iq FREY 8 TILEY C.) C> Second Line of Address E] M) 5 SOUTH HANOVER ST. —r, Cj* 4* City or Post Office State ZIP Code DATA RULED CARLISLE PA 17013 Correspondent's e-mail address: Under penalties of per)ury,I declare that I have examined this return,including accompanying schedules and staUmams,and to the best of my knowledge and belief, it is true correct and comolaft,Declaration of preparar other than the Personal reoresent"w is based on all information of which preparar has am,knowledge. SJGNA OF PERSON SPONSIBLE FILIIJG RETURN E' ADDRESS RUTH M. OSBORNE ADMIN. 9 EAST LINDEN DR. CARLISLE PA 17015 SIG R THANAWRESENTATIVE OAT ADDRESS STEPHEN D. TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J 1505610205 REV-1500 EX(Fl) RECAPITULATION 1. Real Estate(Schedule A). ....... ... ... ....... ...... ....... ... ..... 1. NONE 2. Stocks and Bonds(Schedule B).... ....... ...... ....... ... ... ....... 2. NONE 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C). .. 3. NONE 4. Mortgages and Notes Receivable(Schedule D)......................... 4. NONE 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)... .. 5. 1999.00 6. Jointly Owned Property(Schedule F) r__1 Separate Billing Requested....... 6. NONE 7. Inter-V vos Transfers&Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested.. ..... 7, NONE 8. Total Gross Assets(total Lines 1 through 7) 6 1999. 00 9. Funeral Expenses and Administrative Costs(Schedule H).... ... ... ....... 9. 1718 .00 10. Debts of Decadent,Mortgage Liabilities and Liens(Schedule 1).............10. 281.00 11. Total Deductions(total Lines 9 and 10). .......... ... ...... . ... ... ... 11. 1999.00 12. Net Value of Estate(Line 8 minus Line 11)............................12. 0.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)...................... 13. 11 -1113 14. Net Value Subject to Tax(Line 12 minus Line 13)... 14 0.013 TAX CALCULATION-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.0 0 15. 11.110 16. Amount of Line 14 taxable at lineal rate X.0 45 16. 0.00 17. Amount of.Line 14 taxable at sibling rate X .12 0-00 17. 0.0 0 18. Amount of Line 14 taxable at collateral rate X .15 18. 0. 00 19. TAX DUE............... ................ ... ....... ... ... ......... 19. 13. 00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q Side 2 L, 1505610205 1505610205 J REV-1500 EX(FI) Page 3 Fit*Number Decedent's Complete Address: 21-13-0185 DECEDENT'S NAME MIMI A DEVENNEY STREET ADDRESS 1000 CLAREMONT DRIVE CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Una 19) (i) 0.00 2. CreditstPsyments A.Prior Payments B.Discount Total Credits(A+8} (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Una 1+Une 3,enter the difference.This is the OVERPAYMENT. Fill In box on Page 2,Line 20 to request a refund. (4) 0.00 5. if Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. 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............................................................................................................................. ❑ d, receive the promise for life of either payments,benefits or care?.—.............................. ................ ❑ 2. If death occurred after Dec.12,1962,did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................................ ❑ 3. Did decedent own an"in trust far"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?....................................................................................................................... ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN, For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the not 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 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 172 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 Ming 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 decedents 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 decedents 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•1608FX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT REVENUE INHERITANCE TOF AX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Estate of Mimi A. DeVenney 21_13-0185 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 Balance in Personal Checking Account M&T Bank Account No.: 28300483 See Exhibit"A"for DOD Balance Letter 1,672 2 Refund from persoani account at Claremont Nursing&Rehabilitation Center 327 i TOTAL(Also enter on line 5, Recapitulation) $ 1,999 if more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsyivania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Estate of Mimi A.DeVenney 21-13-0185 _ Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1_ Personal Representative CommissJons: 500 Name(s)of Personal Representative(s) Ruth M.Osborne Admin. Street address 9 East Linden Drive city Carlisle state PA zip 17415 Year($)Commission Paid: 2013 2. Attorney Fees: 1,159 1 Family Exemption:(M decedents address is not yte same as rdaunanrs,*tech e> im.) Claimsm Steil Address City State ZIP Relationship of Ciaimaxd to Decedent 4. Probate Fees: 5. Accountant Fees: S. Tax Return Prepare Fees: 7. Register of Will-Filing Fee for Small Estate Petition 44 8. Register of Wills-Filing Fee for Inheritance Tax Return 15 TOTAL(Also enter on Line 9, Recapitulation) $ 1,718 If more space Is needed,use additional sheets of paper of fits saute size. REV 4512 EX+(12.12) pennsylvania SCHEDULE i DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES&LIENS ESTATE OF FILE NUMBER Estate of Mimi A.DeVenneV 21-13-0185 Report debts incurred by the decadent prior to death that remained unpaid at the data of death,including unreimbumed medical"mass. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Reimburse Ruth M.Osborne for UPS Box 281 i TOTAL(Also enter on Line 10,Recapitulation) $ 281 If MM space Is needed,insert addtnonol sheets of the sate size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Estate of Mimi A. DeVenney 21-13-0185 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Tnw"*) OF ESTATE ( TAXABLE DISTRIBUTIONS[Include outright spouse!distributions and trulsfers under Sac.9118(a)(1.2).) Robert DeVenney 1' 100 Burnt House Road,Carlisle,PA 17015 Brother 50% 2. Samuel A.DeVenney 301519th Avenue,N.E.,Hickory,NC 28601 Brother 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 115 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: I 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART 8—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 0.00 If more space is needed,use additional sheets of paper of the same size. MM&T, Bank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888.502-4349 F ax {302}934-2955 March 7,2013 Stephen D.Tiley 5 South Hanover Street Carlisle,PA 17013 Re: Estate of Mimi A.I7gVenney Social SecMgjy:1 4-38-2299 Date of Death:January 10,2013 Dear Sir or Madam: Per your inquiry on March 1,2013,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. TypeofAccarmt ChecktngAeeount Account Number 28300983 Ownership(Names qfl Ruth M Oshorne(POA) Mimi Ann DeYenney Anne L.Hawbaker(POA) Opening Date 0812811974 Balance on Date of Death $1,671.56 Accrued Interest $ .01 Total $1,671.57 For any additioual information as the above accoumb,including owuershlp and any changes,closures and/or rebabursemeat of fonds, piaue call the Spring Garden at 717-2404525. We wen unable to bcate any safe depoalt box for the above-mentioned decedent. This letter does not include any ac aunts in which the decns sd may have been fisted as Power of Attorney,Cmtedlan of UnIforat Traashm Representative Payee,or Tree under a writes Agreement Sincerely, Valarie Mercer Adjustment Services y