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Home My WebLink About06-26-13 _ ._ .. _ _ _ _ . ._ . _ . _ . _ _ . .��. . � 1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO e0x 2sosoi INHERITANCE TAX RETURN 2 � 1 2 1 1 O 1 Harrisburq PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 9 2 6 2 0 1 2 0 6 1 0 1 9 2 6 Decedent's Last Name Suffix DecedenYs First Name MI PETERS JR BENJAMI N S ; (If Applicable}Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THfS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2.Supplemental Return � 3.Remainder Return(date of death prior to 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise(date of � 5. Federal Estate Tax Return Required' ',! death after 12-12-82) Q 6. Decedent Died Testate ❑ 7.Decedent Maintained a Living Trust _ 8.Total Number of Safe Deposit Boxes'I. (Attach Copy of Will) (Attach Copy of Trust) � 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(date of death � 11. Election to tax under Sec. 9113(A) ' between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THfS SEC7fON MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFiDENTIAL TAX INFORMATION SHOULD BE DIRECTED T�f Name Dayt+me Telephone�lumber �o K EN DRA A . MOHR , E SQ . 7� c7 9 � 4 �1r�3 3 3 � �._� �w== � fTYR�(jISTER O�ILLS�N@'iE{�NLY �7 �;.. f`� 1'�) F.:y � t r-- �•M c, ,. :� � ' � , i First line of address �'= :_� �-� � –r, –.•; " ,t P A N N E B A K E R & MOH R , P . C . �- � `. —� � `; Second line of address • • �� - �� 4 0 0 0 V I N E S T � _�,, --i �� ;:, �' y-- --J City Or POSt OffiCe State ZIP COde `___— DA7E FILED J MI DDLETOWN PA 17057 Corcespondent's e-mail address: KENDRA@PANNEBAKERLAW.COM Under penalties of perjury,1 deciare that I have examined this return,inGuding accompanying schedules and statements,and to the best of my knowledge and belief,!I, 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. SIG UR SON PON IBLE FOR FILING RETURN DAT � ZO � AD RE 9 0 Dennis Cir Harrisbur PA 17111 SIGNATUR ER HER THAN REPRESENTATIVE DATE 20 ADDRESS' 4000 Vine St Middletown PA 17057 PLEASE USE QRIGINAL FORM ONLY Side 1 � 1505610140 1505610140 � ''�`� � _ ;�_,�_ _ _ ... ._ _ _ _ . . .. . _ _ _ . . . _ _ .. _ . .�^.� .. __ . � 1505610240 REV-1500 EX DecedenYs Social Security Number DecedenYSName: BENJAMIN S. PETERS, JR RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 3 1 4 0 0 0 , 0 0 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2� ' 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. • 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. • 5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E). . . . . . . 5. 2 � 5 3 3 4 . � � 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. • 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property $ 2 6 2 . 9 9 ' (Schedule G) � Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 5 3 7 5 9 7 , 1 0 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 3 0 5 3 0 . 7 $ 10. Debts of Decedent,Martgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. � 2 3 4' 2 . � 7 ��. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 4' 2 $ 7 2 . 9 5 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . �2� 4 9 4 7 2 4 . � �J 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. 4 9 4 7 2 4 . � 'rJ 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. � . � � 16. Amount of Line 14 taxable at�inea�rate X.045 4 9 4 7 2 4 . 1 5 16. 2 2 2 6 2 . 5 9 17. Amount of Line 14 taxable at sibling rate X.12 � . � � 17. 0 . � � 18. Amount of Line 14 taxable at collateral rate X.15 � • � � 1g, � • � 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 2 2 2 6 2 . J 9 ' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q Side 2 � 1505610240 1505610240 J _ _ _ _ _ �1. ._ - - - - . ,,,�� _ REV-1500 EX Page 3 File Number Decedent's Comptete Address: 2� �2 1101 DECEDENT'S NAME BENJAMIN S. PETERS, JR -----—--- ---- ----- ------ _--—_-- STREET ADDRESS 3814 LAMP POST LN -- — - _ _— ---------- --—_—_—_ —_—__— __ _� ___ —_ CITY STATE ZIP CAMP HILL PA 17011 Tax Payments and Credits: �• Tax Due(Page 2,Line 19) (1) 22q�:62.59 2. CreditslPayments A.Prior Payments 25,000.00 B.Discount 1,309.00 Total Credits(A+B) (2) 26,';�0,9.00 3. Interest S3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT, Fill in oval on Page 2,Line 20 to request a refund. (4) 4,�6.41 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 � ,_ ; � ��..:�A, �� :. �_ n� ��i,. . � ,u��':��.��€;.��f � .��I.I�II��Y.... «. �� 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: ...................................................................... ❑ 0 b. retain the right to designate who shail use the property transferred or its income; ............................... ❑ X c. retain a reversionary interest;or ................................................................................................ ❑ � d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ � 2. If death occurred after December 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�ieath 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?.................................................................................................. 0 ❑ IF THE ANSWER TO ANY OF THE ABOVE QUES?{ONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUf� � a., .. ;, . �.. �..��E��`��= _,. . ; , '� ,�` �;'k�,��k . _ . , . � � 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� pouse 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 [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 as��ts 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in 72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is define�,undE Section 9102, as an individual who has at least one parent in common with the decedent,whether by blood or adoption. _ _ _ _ _ _ _ _ _ _ - - - ,'c. ,. .,�� REV-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANGE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BENJAMIN S. PETERS JR 21 12 1101 AIi reai 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 decedenYs interest if owned as tenant in common. VALUE AT DAfiE NUMBER OF DEAT�i` DESGRIPTION 1. 3025 COLUMBIA AVENUE, CAMP HILL, PA-APPRAISED VALUE 139,�00.00 2. 3814 LAMP POST LANE, HAMPDEN TOWNSHIP, PA-APPRAISED VALUE 175,�QQ.00 TOTAL(Also enter on Line 1,Recapitulation.) $ 314 0 .00 If more space is needed,use addiUonal sheets of paper of the same size. _ _ _ _ _ _ _ - — _ _ _ _ _ __ _ ,'�, ,, __ _ _- - _ - _ - �,�� REV-1508 EX+(08-�2) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS 8� MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: BENJAMIN S. PETERS JR 21 12 1101 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 D�T� NUMBER DESCRIPTION OF DEATf�I 1. 1999 TOY07A CAMRY 3; 00.00 2. PSECU SAVINGS 9,�21.10 3. PSECU-CHECKING 2,q81.15 4. PSECU-CERTIFICATE 41,794.40 5. PSECU-CERTIFICATE 33,'1'83.63 6. PSECU-CERTIFICATE 36,#'',�5�4.37 7. PSECU-CERTIFICATE 1,��5.24 8. PSECU-CERTIFICATE 55,1`13.20 9. PSECU-CERTIFICATE 32,�'�1.86 10. PSECU 5.00 11. NATIONWIDE-CAR INSURANCE REFUND �6.40 12. AAA REFUND 17.76 TOTAL(Also enter on Line 5,Recapitulation) $ 215 3 �.11 If more space is needed,use additional sheets of paper of the same size. i�,,,�_ . . ._ . .. .. _ _ . . . . _ . _. _ _ _ . . .. _ . . .�� . .. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER BENJAMIN S. PETERS JR 21 12 1101 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. DESCRIPTION OF PROPERTY ITEM INCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATEOFDEATH %OFDECD�S EXCLUSION TAXFI�LE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAPPLICABLE) VAI� E 1. PSECU- IRA- PAID TO ESTATE 8,262.99 100.00 8; 62.99 TOTAL (Also enter on Line 7,Recapitulation) $ $2 ,gg if more space is needed,use additional sheets of paper of the same size. _ . . . �a. .. _ _ _�,� REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER BENJAMIN S. PETERS JR 21 12 1101 Decedent's debts must 6e reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT',' A. FUNERAL EXPENSES: 1. MYERS HARNER FUNERAL HOME 3;�96.00 2. ROLLING GREEN CEMETERY 9�5.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address Ciry State ZIP Year(s)Commission Paid: Z AttomeyFees: PANNEBAKER & MOHR, P.C. 18,5��.96 3. Famify Exemption:(If decedenYs address is not the same as claiman�s,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS ��3.50 5 AccountantFees: H&R BLOCK- PERSONAL 2012 TAX RETURNS 3�a.00 6. Tax Return Preparer Fees: H&R BLOCK- FIDUCIARY TAX RETURNS 4(�0.00 7. THE SENTINEL- ESTATE NOTICE 2',�1.40 8. CUMBERLAND LAW JOURNAL- ESTATE NOTICE i�5.00 9. REGISTER OF WILLS-SHORT CERTIFICATES �0.00 10. MAINTENANCE REPAIR MATERIALS �9,97 11. RECORDER OF DEEDS-COPIES OF DEEDS 1!'2.75 12. PSECU- COPIES OF ACCOUNT STATEMENTS 25.00 13. HOME INSPECTION 4f'd.00 14. CLAUSER REAL ESTATE APPRAISERS 75u0.00 15. CITIZENS BANK-CHECK ORDER 4�.64 16. REGISTER OF WILLS-COPIES 18.50 17. REGISTER OF WILLS 1�a.00 18. DONEGAL INSURANCE GROUP- HOMEOWNERS 6�' ;DO TOTAL(Also enter on Line 9,Recapitulation) $ 30 5� .78 If more space is needed,use additional sheets of paper of the same size. _ , _ �V,;„ - _ ,.�,� _ Continuation of REV-1500 Inheritance Tax Return Resident Decedent BENJAMIN S. PETERS, JR 21 12 1101 DecedenYs Name Page 1 File Number Schedule H - Funeral Expenses 8�Administrative Costs-B7. ITEM NUMBER DESCRIPTIQN AMOUNT';: 19. MAINTENANCE EXPENSE 172.05 20. PPL ELECTRIC �86.30 21. COMCAST- NECESSARY FOR SECURITY SYS7EM 669.29 22. VECTOR SECURITY ?57.30 23. PA AMERICAN WATER 164.12 25. TOOLMAN LAWN CARE SERVICE '90.00 26. HAMPDEN TWP UTILITIES 31'�.10 27. PENN WASTE �C4.65 28. BOROUGH OF CAMP HILL SEWER �34.50 29. AMERICAN MODERN INSURANCE GROUP- HOMEOWNERS INSURANCE �36.00 30. YORK WASTE DISPOSAL- DUMPSTER '39.08 31. ERIC MORROW- LAWN CARE 1I!90.00 32. GRAN U LAWN �47.67 SUBTOTAL SCHEDULE H-B7 3,5��1.06 w _ _ - - _ ��, _ . . ��-,� REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF QECEQENT� INHERITANGE TAX RETURN MORTGAGE LIABILITIES 8� LIENS RE5IDENT DECEDENT ES7ATE OF FILE NUMBER BENJAMIN S. PETERS JR 21 12 1101 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medical expenses. ITEM VALUE AT DAT� NUMBER DESCRIPTION OF DEATH ' 1. PPL ELECTRIC �48.23 2. TOOLMAN LAWN CARE SERVICE �60.00 3. HAMPDEN TWP UTILITIES �'S5.05 4. PA AMERICAN WATER ;57.56 5. VECTOR SECURITY 1`20.89 6. PENN WASTE INC �45.75 7. INTERNISTS OF CENTRAL PA �p.00 8. PSECU-VISA 1�.95 9. SOCIAL SECURITY RECLAMATION OF BENEFITS 1,OQ)7.00 10. LEFFLER ENERGY- FURNACE REPLACEMENT 2,0�9.14 11. BOROUGH OF CAMP HILL SEWER 165.00 12. DONEGAL INSURANCE GROUP- HOMEOWNERS INSURANCE 3��.50 13. VERIZON 97.96 14. COMCAST 475.25 15. MICHAEL LANGAN, TREASURER-SCHOOL TAX LAMP POST LANE 2,18�.80 TOTAL(Also enter on Line 10,Recapitulation) $ 12 34 .17 If more space is needed, insert additional sheets of the same size. - - - - - - - �_9. ,� _ _ -'1� Continuation of REV-1500 Inheritance Tax Return Resident Decedent BENJAMIN S. PETERS, JR 21 12 1101 ' DecedenYs Name Page 2 File Number ' Schedule I -Debts of Decedent, Mortgage Liabilities,& Liens ITEM NUMBER DESCRIPTION AMOUNT'i 16. DEBRA K. WALLET, ESQ-AMOUNT OWED BY DECEDENT FOR LEGAL WORK DONE ��r0.00 PR�OR TO DEATH ' 17. LEFFLER ENERGY- FUEL OIL 379.90 18. CUMBERLAND COUNTY TAX CLAIM BUREAU- PAST DUE REAL ESTATE TAXES 2,�10.36 19. MICHAEL LANGAN, TREASURER- REAL ESTATE TAXES 5�59.16 20. PA DEPARTMENT OF REVENUE- PERSONAL INCOME TAX DUE 2012 76.00 21. US TREASURY- PERSONAL INCOME TAX DUE 2012 1,4�0.00 22. GRAN U LAWN �47.67 SUBTOTAL SCHEDULE I 5,01 ;�9 GRAND TOTAL SCHEDULE I $ �2 34 ' '�7 _ _ �4� � _ _ _ _ _ _ _ �+r� REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BENJAMIN S. PETERS JR 21 12 1101 RELATIONSHIP TO DECEDENT AMOUNT OR SM�ARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTAT�. I TAXABLE DISTRIBUTIONS [Include outrightspousal distributions and transfers under Sec.9116(a)(1.2).j 1. JENNIE GOODYEAR Lineal -rjQ °�p 930 DENNIS CIR HARRISBURG, PA 17111 2. STEVEN BORDNER Lineal 5��O 251 SPANGLERS MILL RD NEW CUMBERLAND, PA 17070 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIAT�.!' II. NON-TAXABLE DISTRIBU710NS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. . . _ _ . _ . . _ _. _ . _. _ .. . _ . __. . _. _ . _ _ . ._. .i B,,��.. _ __ _ _ __ _ __ _ �,R,� REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: __ _ 25,000.00 Discount: _.__ ___ 1 309.00 Interest Table _ -- ---- _ __ __- . _ ---� , -- - �---- � Year ' Days Delinquent Balance Due Interest this time period� this year this period � ___ --- _ ---- - -- ---- _ ---- _ � Before 1981 --- -- -_ _ _ _-- --- i 1982 - - -- � — --.- T_-_ -- - -------- I 1983 - , - __- _ - r ---- �1984 ------ - -- --- - -- I -- ; 1985 T --' _ _ _- ----------- � 1986 - — ----- I' 1987 - ----- ---- -- -- 1988 through 1991 �------ - - -------- � ----- -- _1992 �I --- ;I- -- - - ---- -- -_. 1993 throuc�h 1994 ' - ---- - --- i--- -------- 1995 through 1998 --- - -, --__--- 1999 - - - --- - I _ _ -- _-�-- ---- — - _ --- 2000 _ _ _ - - �---- � � 2001 I __ _ � - - - -- 2002 --- - _ ___ _ � _ - -- 2003 ---- -- . - - - ' __. -- - � [ 2004 -- - --- --- - ----- -- - --- -- -- - -- --- - - � 2005 -- - - -h _. __� I__2006_ _- -- ----- — ---- - - - - ----- 2007 -- -I __ -- - --- - -- -- -- �--- --- ,_2008 __ - - __ -----I ',. 2009 ----- --- - - --- � -- - - ------ �2010 - - ----- ------- 2011 through 2013 � ___._-_ �_ _-- _ _ _---- --- t_- _ - ------- I.__--- --- --- ,--.- -- I--- -- ' ,: _-.-.------- ---- ;._- -_--- -- - -- i__ __ _ - __ _ _- '�--- _TOTALS 1 - . -----� ---- - -- -- -- -� Penalty Calculation If the decedenYs date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996:___ Penalry: � - - - - - _ - _ _ ,