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HomeMy WebLinkAbout08-21-13 J 1505610140 REV-1500 EX �°,_,°, OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po sox zsosot INHERITANCE TAX RETURN Harrisburq, PA 17128-0601 RESIDENT DECEDENT 2 1 1 2 1 2 0 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDVVYY Date of Birth MMDDm'Y 1 1 1 4 2 0 1 2 1 0 0 7 1 9 2 6 DecedenPs Last Name Suffix Decedenfs First Name MI Y 0 S T T H 0 M A S G (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Su�x 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 � 1.Original Return � 2. Supplemental Retum � 3. Remainder Return(date of death priar to 12-13-82) � 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required death after 12-12-82) ❑X 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust _ 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) � 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(date of death � N. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONfIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 ❑ ..... ONLY_o C) � �� REGISTl1lOFWILLSUSE C �7 �1 First line of address r� 5 4 E A S T M A I N S T R E E T ^= " . ' ; Second line of address � � � �� . I Ciry or Post Office State ZIP Code � ����DASE FILED ' .i. f1 E C H A N I C S B U R G P A 1 7 0 5 5 ' =.� � i Correspondent's e•mail address: Under penalties of perjury,I declare that I have examined Ihis retum,inGuding accompanying schetlules and slatements,antl to Ihe bes!of my knowledge and belief, it is true,correct and complete.Declaretion of preparer olher Ihan the personal representative is basetl on all in(ormalion uf which preparer has any knowledge. SI ATURE OF P SO ESP NSIBLE FOR FII.ING RETURN DATE . / AD SS BENJAMIN J • Y ST, SHERWOOD DRIVE (1ECHANICSBURG PA 17055 SIGNATUR PR A OT RTHAN REPRESENTATIVE DATE 5= i L `� � ADDRE MUR E R• WALTERS, III, 54 E • MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610140 1505610140 J �� _ J 1505610240 REV-1500 EX DecedenPs Social Security Number oecedenrsName: THOMAS G • YOST RECAPITUTATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 1 5 3 6 0 0 , 0 0 2. Stocks and Bonds Schedule 6 p. 1 2 7 0 � . 5 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 Miscellaneous Personal Property(Schedule E). . . . . . . 5. 5 0 5 7 3 . 9 1 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. • 7. Inter-Vrvos Transfers&Miscellaneous N n-Probate Property (Schedule G) � Separate Billing Requested . . . . . . . 7. . 8. Total Gross Assets(total Linas 1 through 7) . . . . .. . .. . . . . . . . . . . . . . . . . . . 8. 2 1 6 8 7 4 . 4 3 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 3 3 3 3 . 6 1 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 1 4 8 6 5 . 5 8 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 8 1 9 9 . 1 9 12. Net Value of Estate(Line B minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 8 8 6 7 5 . 2 4 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. 1 8 8 6 7 5 . 2 4 TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(121X •0 0 . 0 � 75. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X •045 1 8 8 6 7 5 . 2 4 �6. 8 4 9 0 . 3 9 17. Amount of Line 14 ta�ble at sibling rate X.12 � . � 0 17. ❑ . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. � • � 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 8 4 9 0 . 3 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 L 1505610240 150561�240 � ___ _ REV-1500 EX Page 3 File Number DecedenYs Complete Address: 21 12 1207� DECEDENTSNAME THOMAS G . YOST --- - STREETADDRESS �- � - � �- � - 945 HERMAN DRIVE _-- - - _— --- -- - - -- - --- - - CITY STATE Z�p MECHANICSBURG PA 17055 Tax Payments and Credits: t TaxDue�Page2,�ine19) (1) 8,490 .39 2. Credits/Payments — A, Prior Payments 8,5 0 0 • 0 0 B, Discount 425• 00 TotalCredits(A+B) (p) 8,925•�0 3, Interest — (3) 4, If Line 2 is greater than Line 1 +Line 3,enter ihe difference.This is lhe OVERPAYMENT. — Fili in oval on Page 2,Line 20 to request a refund. (4) 4 3 4 • 61 5 If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0 •�0 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 Iransfer and: Yes No a. retain the use or income of the propedy transferred: ...................................................................... ❑ Q b. retain the right to designate who shall use the property transferred or its income: ............................... ❑ Q c. retain a reversionary interest;or ................................................................................................ ❑ 0 d. receive the promise for life of either payments,benefts or care? ....................................................... ❑ QX 2. If death occurred afler December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration? ................................................................ ❑ ❑X ...................... 3. Did decedent own an'in irusl for'or payable-upontieath bank account or security at his or her dealh? ......... ❑ ❑X 4, Did decedent own an individual retirement accowt,annuity or other non-probate propedy,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. For dates of death on or after July t, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers lo 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 percenl [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 fling a tax return are still applicable even if the surviving spouse is the only benefciary. 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 fo or for the use of the decedenPs lineal beneficiaries is 4.5 percent,exrept as noted in �2 Ps. §s��s�iz�p2 Ps. §si�s(a)(�)1. • The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defned,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+(01-10) pennsylvania SCHEDULE A OEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TA%ftETURN RESIDENi DECE�ENT ESTATE OF: FILE NUMBER: THOMAS G . YOST 21 12 1207 All real property ovmed 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 propeRy that is jointlyowned with righl of survivorship must be disclosed on Schedule F. Attach a copy of ihe settlement sheet if the properly has been sold, ITEM Include a copy of the deed showing decedenPs interest if owned as tenant in common. VALUE AT DATE NUMBER OFDEATH DESCRIPTION 1 • 945 HERMAN DRIVE 153,600 . 00 MECHANICSBURG, PA 17055 ASSESSED VALUE TOTAL(Also enter on Line 1,Recapitulation.) S 15 3,6�0 • 0 0 If more space is needed,use additional sheets of paperof the same size. REV-1503 EX+(6-98) SCHEDULE B COMMONWEALTHOFPENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER THOMAS G • YOST 21 12 1207 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SAVINGS BONDS 12,700 . 52 $5,000 EE REDEMPTION VALUE TOTAL(Also enter on line 2,Recapitulationj S 12,70 0 • 5 2 (If more space is needed,insert additional sheeLs of the same size) REV-uoa ex+�>>_�o� pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, 8 MISC. INHERITANCE TAX RETORN aESioENroECEOENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: THOMAS G • YOST 21 12 1207 Include Ne proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with righl of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CHEVROLET VAN 1,000 . �0 2000 VENTURE KELLY BLUE BOOK VALUE 2 • PNC BANK 34 ,327 • 0� MUTUAL FUND 3 • PNC BANK 6,725 • 43 CHECKING 4 • PNC BANK 6 ,4�4 . 68 SAVINGS � 5 . HOUSEHOLD CONTENTS PUBLIC SALE PROCEEDS 1,202 • 01 JONES 6 MARTIN AUCTIONS & APPRAISALS, NEWVILLE, PA 6 • DE ELECTRIC 45 • 41 REFUND 7 . METLIFE DIVISION 35 • 52 REFUND 8 • SENTINEL NEWSPAPER 57 • 49 REFUND 9 • AAA 34 • 61 REFUND 10 • LOWE ' S 2�9 • 88 REFUND — RETURN PEDESTAL SINK & STORAGE CABINET 11. STATE FARM 120 . �0 REFUND — ESTATE TAX ID REGISTRATION 12 • PRINCIPAL FINANCIAL DIVIDENDS 150 • 08 REFUND 13 • GH CREDIT CARD 146 . 00 REFUND 14 . TERMINIX 2 .26 REFUND 15 • VETERANS 100 • 0� REFUND 16 • CONCENTRA 13 • 54 TOTAL(Also enter on Line 5,Recapitulalion) E 5�,57 3 •91 If more space is needed,insert addiUonal sheets of paper of the same size REV-1511 EX+(10-09) pennsylvania SCHEDULE H °EPART"'E"T oF"E�E"�E FUNERAL EXPENSES AND iNHERirnNCEraxREruRN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF F�LE NUMBER THOMAS G • YOST 21 12 12�7 DecedenCs debts must be repoAed on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A FUNER4LEXPENSES: 1. MYERS—BUHRI6 FUNERAL HOME MECHANICSBURG , PA 9,971 • 66 2 • P • METHALIC — FUNERAL LUNCHEON 315. 45 B. ADMINISTR4TIVE COSTS: 1. Personal Representative Commissions: Name�s)ot Personal Representative�s) B E N J A M I N J • Y 0 S T streetaddress 6 SHERWOOD DRIVE City MECHANICSBURG State PA z�P 17055 veaqs�Commission Paid: �R E N 0 U N C E D) p, nttorneyFees, MIJRREL R . WALTERS� III 2� 4�� • 00 3, Family Exemption:Qf decedenPs address is notthe same as claimanMs,attach explanation.) Claimant Street Address City State ZIP Rela�ionship of Claimant to Deceden� 4• ProbateFees: REGI$TER OF WILLS — CUMBERLAND COUNTY 421 • 50 5 AccountantFees: 6. raxrtemmPreparerFees: ALFRED L • WHITCOMB. EA PA 225• 00 7. TOTAL(Also enter on Line 9,RecapiWlation) S 13,3 3 3 . 61 If more space is needed,use additional sheeGs of paDer of the same size. REV-1512 EX+(12-OB) pennsylvania SCHEDULE I oeanarMeNr oF ReveNUe DEBTS OF DECEDENT, wneRirnNCernxReruRN MORTGAGE LIABILITIES, 8� LIENS � RESIDENTDECEDENT ESTATE OF FILE NUMBER THOMAS G • YOST 21 12 1207 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical ezpenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. VERIZON WIRELESS 49 • 93 CELL TELEPHONE 2 • PPL 1,�88 • 53 ELECTRIC 3 • UNITED WATER 125 • 53 WATER 4 • YORK WASTE DISPOSAL 39 • 03 REFUSE 5 • ATBT 66 . 80 HOUSE PHONE 6 • NATIONWIDE INSURANCE 544 • 25 HOME OWNERS 7 � $MAC 771 • 95 TERMINEX CONTRACT 8 • FEHL AWNING COMPANY, INC • 59 • 34 AWNING REPAIR 9 • HSBC CARD SERVICE 146 . 00 CREDIT CARD 10 • CONCENTRA 13 • 54 MEDICAL 11 • MESSIAH LIFEWAYS 14 . 98 MEDICAL — FINAL BILL 12 • WEST SHORE EMS 183 • 14 AMBULANCE 13 • PSERS 715• 64 REIMBURSEMENT OF OVERPAYMENT 14 • FREDERICK LORENZO , MD 10 • 00 MEDICAL 15• WOODCRAFT CABINETS 55 • 79 REPAIR PARTS TOTAL(Also enter on Line 10,Recapitulation) 8 y 4 ,8 6 5 • 58 If more space is needed,insed additionai sheets of Ne same size, Continuation of REV-1500 Inheritance Tax Return Resident Decedent THOMAS G.YOST 21 12 1207 DecedenPs Name Page 1 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, 8� Liens ITEM NUMBER DESCRIPTION AMOUNT 16 • ZIMMERMAN MECHANICAL 751 • 00 PLUMBING 17 • RITTER ' S HARDWARE 120 • 0� 18 • COMMUNITY LIFE TEAM 61 . 40 MEDICAL 19 • HOME DEPOT 793 .74 HOUSE REPAIRS 2� . LOWE ' S 1,818 •?2 HOUSE REPAIRS 21 • UPPER ALLEN TOWNSHIP 336 • 00 SEWER 22 • PINNACLE HEALTH 25• 45 MEDICAL 23 • SCOTT SNYDER 1,790 • �0 PAINTER 24 . INTERNAL REVENUE SERVICE 1,795 • 00 2012 TAXES 25 • PA DEPARTMENT OF REVENUE 27 .00 2012 TAXES 26 • LAWN SERVICE 400 .00 MOWNING 27 • ASHCOMBES 51• 03 FLOWERS & IANDSGAPING 28 • DENNIS ZERBE 2,323 • 11 2013 COUNTY/TOWNSHIP REAL ESTATE TAXES 29 • CARPET CARE SOLUTIONS 106 •00 CARPETS - CLEANED 30 . BBEC 545• 00 ELECTRICAL WORK SUBTOTAL SCHEDULE I 10,9 4 3• 4 5 Continuation of REV-1500 Inheritance Tax Return Resident Decedent THOMAS G. YOST 21 12 1207 Decedent's Name Page 2 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 31 • GIANT 37 •68 CLEANING SUPPLIES SUBTOTAL SCHEDULE I 37 •68 GRANDTOTALSCHEDULEI 5 14,865.58 REV4513 E%�(01-10) pennsylvania SCHEDULE J oEPnarnnErvroF aEVeNUE BENEFICIARIES INHERITnNCE TAX RETURN RESIOENT OECEDENT ESTATE OF: FILE NUMBER: THOMAS G • YOST 21 12 1207 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON�S)RECEIVING PROPERTY Do Not List Trustee�s) OF ESTATE I TAXABLEDISTRIBUTIONS [IncludeouVightspousaldlstnbutionsandtransfersunder Sec.9116(a)(12).] 1. BENJAMIN J • YOST Lineal 50 • 00 6 SHERWOOD DRIVE MECHANICSBIJRG, PA 17055 2 • JENNIFER YOST-LEE Lineal 50 • 00 1112 KARMEL STREET BOAl58URG , PA 16827 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLEDISTRIBUTIONS: 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-ENiER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed,use additional sheels of paper of the same size.