HomeMy WebLinkAbout12-23-13 (2) 1505610105
REV-1500 Ex(m-n)(Fn
OFFICIAL USE ONLY
PA Department of Revenue pennsytvania
Bureau of Individual Taxes _�"� IN Co Code Year File Number
PO BOX 28o6o1 HERITANCE TAX RETURN
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
!� 03/27/2013 08/16/1920
Decedent's Last Name Suffix First Name MI
Sprague L Frances W I
(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
L REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
Q 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Deborah M. Sprague =(717) 3558
REGISTER OF WILLS USE ONLY
First Line of Address
119Pine St
Second Line of Address
'City or Post Office State ZIP Code DATE FILED
Mt Holly Springs [EA F17065
Correspondent's e-mail address:dmS44 @juno.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:217A N BLE F FILING RETURN D TE
ADDRESS
198 W Pine St, Mt Holly Springs, PA 17065
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's name: Frances W. Sprague
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. 37,000.00
2. Stocks and Bonds(Schedule B) ....................................... 2. 10,200.00
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.
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 86,887.51
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7)............................. 8. 134,087.51
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 8,912.49
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 2,059.21
11. Total Deductions(total Lines 9 and 10)................................. 11. 10,971.70
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 123,115.81
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. 123,115.81
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- 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 123,115.81 16. 5,540.21
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE......................................................... 19. 5,540.21
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=)
Side 2
1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Frances W Sprague
STREET ADDRESS
770 S Hanover St
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 5,540.21
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 difference. 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) 5,540.21
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ N
c. retain a reversionary interest .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ E
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ N
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? ........................................................................................................................ ❑
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 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 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 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.
' ' w
REV-1502 EX+(12-12)
pennsytvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Frances W Sprague 21-13-428
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 Former Home at 133 Fulton St,Olean,NY-sold 10118113 37,000.00
i
TOTAL(Also enter on Line 1, Recapitulation.) $ 37,000.00
If more space is needed,use additional sheets of paper of the same size.
BRODERICK LEGAL SUVVLT INC,PUBLISHER
PO. BOX 1624, BINGHAMTON. NEW YORK 13902.1624
STATEMENT OF SALE .
Dated---October 18,-201
Seller ESTATE OF FR�INCES_ W:__SpRAG-ur--_--_---_ Buyer__EDWARD A.
F
ISAAC S__a___all iQOD 1N. '
No.----------13-3 Fulton
---------------------------------------------------------------------.Sheet
JCMIMIM, YAeX
X0 City -----------------------------Olean-------------------------County--99tt9rAUgM5------ State---New -York -
Purchase Price___________
--
--------------------------------------------------------------------------------------------
$ 37,000.00
Insurance Adjustment
------------ ----------------------------
-----------------------------------------------------------------------------------------------------------------------------
--------------------------------- ------------------------------------
------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------- $----------------------------
-------------------------------
Fuel
- - ---- - - -- - - $ - - -
---------------------------------------------------------------------------
City Taxes (Adjusted) 695:497365 = I:9055__per__diem_x__195_days______________ $____ _ 371:57______
County Taxes (Adjusted) $629.17_ = 1.7238__per__them x 75 days_______ ____________ $ ________12929_____
VillageTaxes (Adjusted) -------------------–----------------------–------------------------------------------------------ $----------------------------
SewerTaxes (Adjusted) ------------------------------------------------------------------------------------------------------ $---------------------------
School Taxes (Adjusted) $80.29/365 = .22__per__diem-x 256 $___________56,_32______
FireTaxes (Adjusted) -------------------------------------------------------------------------------------------------------- $--------------------------
---------------------------------------------------------------------------------------------------------------------------------------------- $
Total Amount Due Seller – - -- - - --- --- - - --- $ -
Credits to Purchaser:
Amount Paid Down ------------------------------------------------------------------ $----- 750.00--------
FirstMortgage -------------------------------------------------------------------------- $ ----------------------------
Interest From ---------------------------------- To - -- -- -- -- $ - - -
SecondMortgage --------------------------------------------------------------------- $---------------------------
Interest From ---------------------------------- To - - - - --- $ -- -
-------------------------------------------------------------------------------------------------- $ ----------------------------
--------------------------------------------------------------------------------------------------- $----------------------------
Village Taxes (Assumed) -------------------------------------------------------- $----------------------------
CityTaxes (Assumed) -------------------------------------------------------------- $----------------------------
CountyTaxes (Assumed) --------------------------------------------------------_ $ ____________________________
Local Assessment (Assumed) --------------------------------------------------- $----------------------------
School Taxes (Assumed)__________________ ___�—
BACKHAUS & SIMON, P.C.
710-715 COMMUNITY BANK BLDG.
OLEAN, NEW YORK 14760
(716) 372-4164
ESTATE OF FRANCES W. SPRAGUE
to
EDWARD A. ISAACS and MELINDA R. GOODWIN
SALE OF 133 FULTON STREET, OLEAN, NEW YORK
CLOSING DATE—OCTOBER 11, 2013
Closing proceeds per statement of sale $36,807.18
LESS:
Jones Realty Group—balance of commissions ( 1,470.00)
Michael A. Roeske—survey fee ( 550.00)
Empire Search Company—search update ( 378.00)
Backhaus & Simon, P.C.:
Services rendered in connection with ancillary probate
and sale of residence $1,500.00 -
Disbursements:
Olean City Clerk—local tax search 10.00
Cattaraugus County Clerk—deed stamps 148.00
Cattaraugus County Clerk—file TP-584 5.00
Cattaraugus County Clerk—record affidavit that
estate is not subject to New York estate tax or
Federal estate tax 50.00
Toll calls, faxes,postage, copies 15.00 ( 1,728.00)
BALANCE OF CLOSING PROCEEDS TO THE
ESTATE OF FRANCES W. SPRAGUE $32,681.18
report of distribution3\report of distiibution.sprague estate to isaacs and goodwin
REV-1503 EX+(8-12)
pennsylvania SCHEDULE B
DEPARTMENT Of REVENUE'
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Frances W. Sprague 21-13-428
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. :12 American&Foreign Power Co Debenture;5%series due 2030(bearer bonds) 10,200.00
II
TOTAL(Also enter on Line 2, Recapitulation) $ 10,200.00
If more space is needed,insert additional sheets of the same size
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Frances W. Sprague 21-13428
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Spink Funeral Home 564.48
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:
1,728.00
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: 399.50
5. Accountant Fees:
6. Tax Return Preparer Fees: 111.28
7. 2012 Federal Income Tax-$135.00 and 2012 NY State Tax-$239.00 374.00
8 Prorated Property Tax-City of Olean-$323.92 and Olean Board of Education-$23.97 347.89
9. 2013 Quarterly Estimated Federal Income Tax 318.00
10. Home Closing Costs-Realtor-$1,470;Survey-$550;Title Search-$378 2,398.00
11. Home Utility Costs-3/27/13-10/18/13 1,439.46
12. Home maintenance and repairs to prepare to sell 1,231.88
TOTAL(Also enter on Line 9, Recapitulation) $ 8,912.49
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 RESIDENT D EDEN TURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Frances W. Sprague 21-13-428
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Cumberland Goodwill Fire Rescue(Ambulance) 1,092.61
2. City of Olean Ambulance 427.80
3. Chapel Pointe at Carlisle-Nursing Home 448.80
4. Olean General Hospital 50.00
5. Appalachian Orthopedic Center 30.00
6. Dr.George Branscum 10.00
TOTAL(Also enter on Line 10,Recapitulation) $ 2,059.21
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
i pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Frances W. Sprague 21-13-428
NUMBER NAME AND ADDRESS OF PERSON RELATIONSHIP TO DECEDENT AMOUNT OR SHARE S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS f Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. Sharon Beyer,1216 Harding Blvd.,Norristown,PA 19401 Daughter 25%
2. Shirley Ziegler,770 Freemansville Rd.,Reading,PA 19607 Daughter 25%
3. Ruth Sprague, 139 2nd Ave.,Royersford,PA 19468 Daughter 25%
4. Deborah Sprague, 198 W.Pine St.,Mt Holly Springs,PA 19065 Daughter 25%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 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:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART H— 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.