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Home My WebLink About12-23-13 (2) 1505610105 REV-1500 EX(o2-ii)(R) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number VERARiNEN,UEREVENVE Bureau of Individual,Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg,PA 17128-0601 RESIDENT DECEDENT C 3a ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ............................ ......................................... 1 109/14/2011 11/01/1964 Decedent's Last Name Suffix Decedent's First Name MI ........... ........................................ UNMIRE SCOTT A ............... ........... .............. ...... _J ............ ........................... ........... .......... (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 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW CMD 1.Original Return C=) 2.Supplemental Return C=) 3. Remainder Return(Date of Death Prior to 12-13-82). C=:) 4.Limited Estate C=:) 4a. Future Interest Compromise(date of C=:) 5. Federal Estate Tax Return Required death after 12-12-82) C=:) 6. Decedent Died Testate C=:) 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) C=) 9.Litigation Proceeds Received C=:) 10.Spousal Poverty Credit(Date of Death C=:) 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ;Thomas P. Gleason 532-13270 C:>- C: REGW6,30F WILL"SE ONLY M Ca M First Line of Address C> 49 W. Orange Street CD Second Line of Address . (= ............. .......................-........................ ................ ......... .......... rr r ................................................................. ...................... ........................................ .................... DATE FILE�,-3 City or Post Office State ZIP Code ............- Shippensburg PA 117257 . .....................__............. .. ............................................ ........... Correspondent's e-mail address:tomgleason@tomgleasonlaw.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. SIGNATUR VOF ERS02 SPONS7LE FMING RETURN DATE Au 12/20/2013 ADDRESS 7 W. Fayette Street, Shippensburg, PA 17257 SIGNATURE OF PREPARIER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side I 1505610105 1505610105 10\ 1505610205 REV-1500 EX(Fl) Decedent's Social Security Number ............. .................................................... Decedent's Name: RECAPITULATION ............................... ...................... 1. Real Estate(Schedule A). ............................................ 1 0.00 2. Stocks and Bonds(Schedule B) ....................................... 2. 0.00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 4. Mortgages and Notes Receivable(Schedule D)........................... 4. 0.00 1 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 4,487.17 6. Jointly Owned Property(Schedule F) C= Separate Billing Requested ....... 6. 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C=D Separate Billing Requested........ 7. 0.00 8. Total Gross Assets(total Lines I through 7)............................. 8. 4,487.17 1 9. Funeral Expenses and Administrative Costs(Schedule H)................ ... 9. 5,428.20 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 1,068.31 11. Total Deductions-(total Lines 9 and 10)...... ...... ..................... 11. 6,496.51 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. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 0.00 1 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.i 16. Amount of Line 14 taxable at lineal rate X.0 45 0.00 16.1 0.00 i 17. Amount of Line 14 taxable 0.00 1 at sibling rate X.12 0.00 17. .................... 18. Amount of Line 14 taxable at collateral rate X.15 0.00 18. 0.00 1 19. TAX DUE ............. ................ ........................... 19. 0.00 ............................. ................. ........................... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME SCOTT A. DUNMIRE STREET ADDRESS 310 3RD STREET,APARTMENT 3 CITY STATE ! ZIP NEW CUMBERLAND PA 17070 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 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) 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.12,1982,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? ........................................................................................................................ ❑ 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. REV-15o8 EX+(o8-i2) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SCOTT A. DUNMIRE 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 1.1 M&T Bank Checking Account No.87060814 1,570.79 2. Final pay periods from Analytical Laboratory Services 951.13 3. Unused vacation time from Analytical Laboratory Services 1,065.25 4. 1997 Ford Taurus sold to Matthew Stauffer 400.00 5. Miscellaneous personal effects 500.00 I TOTAL(Also enter on Line 5, Recapitulation) $ 4,487.17 If more space is needed,use additional sheets of paper 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 SCOTT A. DUNMIRE Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Fogelsanger Bricker Funeral Home � 4,335.70 l___t �„ B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: z• Attorney Fees: 1,000.00 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: m...80.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 66 7• Additional short certificates from Cumberland County p 12.00 ❑ F � TOTAL(Also enter on Line 9, R(capitulation) $ 5,428.20 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 t DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER SCOTT A. DUNMIRE 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 Pinnacle Health Hospitals 188.25 F-21 F-- Fiinal Comcast bill for apartment at 310 3rd Street,New Cumberland,PA 231.77 33.( Final PP&L gas bill for apartment at 310 3rd Street,New Cumberland,PA 105.13 -- 4.— AT&T Wireless cell'phone bill 532.16 ( 5—� Tax Collector,Robin Gasperetti for per capita tax —� 1100 F-1 F- F-1 Ei El I F] � rsiwrwrr� F-1 �. .�.�....�. F-1 F-1 TOTAL(Also enter on Line 10, Recapitulation) $ 1,068.31 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) Pennsylvania SCHEDULE r DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SCOTT A. DUNMIRE RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9116(a)(1.2).) .1. Doris Dunmire,9 South Fayette St.,Shippensburg,PA mother 1/3 rrnwrr�r■��wrw Robert W.Dunmire,9 South Fayette St.Shippensburg,PA brother 1/31. F3 Barbara Thompson,7 South Fayette St.Shippensburg,PA sister 1/3 LLJ F-1,L.�.J i�w� ....rr..■■.■■■..ss'■uriwrrw■rwnn —_� L 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: r�r■rr� El F-1 I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: F-1 1 � , �---I _w..�wrrr■i�w� TOTAL OF PART 11—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $�s If more space is needed,use additional sheets of paper of the same size. RECEIPT FOR PAYMENT ------------------- GLENDA FARNER STRASBAUGH Receipt Date : 12/23/2013 Cumberland County - Register Of Wills Receipt Time : 14 :33 :29 One Courthouse Square Receipt No. : 1076565 Carlisle, PA 17613 DUNMIRE SCOTT ALAN Estate File No. : 2012-00324 Paid By Remarks : THOMAS P GLEASON DB1 ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check## 1393 $15 . 00 Total Received. . . . . . . . . $15 . 00 r' CD CD �N (`�D ..0 0 Tr N t CD -J (p O N CD 0 c 0 0 N (D i 1 V� 9.