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Home My WebLink About03-27-14 REV-1 500 EX (06-05) 15056041125 OFFICIAL USE ONLY PA Department of Ravenue Bureau of Individual Taxes, INHERITANCE TAX RETURN County Code Year File Number PO BOX 280801 2 1 1 3 0 0 3 5 Harrisburg,PA 17128-0861 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 1 0 6 2 0 1 3 0 5 0 7 1 9 4 1 Decedent's Last Name Suffix Decedent's First Name MI H I N K E L M A R I E T (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 1.Original Return n 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) 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 0 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 0 11.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 TO: Name Daytime Telephone Number W I L L I A M P D 0 U G L A S 7 1 7 2 4 3 1 7 9 0 Firm Name(if Applicable) REGISTER OF MILLS USE ONLY D 0 U G L A S L A W 0 F F I C E First line of address c5 2 C M G7 4 3 W S 0 U T H S T m 6 6 Second line of address N r7l rn Ic- cn �, 3 City or Post Office State ZIP Code „_, —.�aATE�itE� -4j k C A R L I S L E P A 1 7 0 1 3 0C= ry r- M 1 GPt (n CS Correspondent's e-mail address:dDUaiaslaWwp_earth link.net D 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, A is true,correct and complete Declaration at preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 3 . a .. SIGNATURE OF PREPARER OTHER THAN REPR ENTATIVE DATE ADDRESS t PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 r 9ZIZ609SOST 9ZTZb0990ST Z ap!S M 1N3WAVd213AO NV d0 014mm !V 014IIS3CIb3N 3)iV lIOA dl'IVAO 3Hl NJ llld 'OZ 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ena xel'64 0 8 b I 0 b 0 0 0 gt 0 0 0 tq alel le aulo;ulnowV 'gL 0 8 b T O b tL 9 9 9 S b E E ZL'X @lei 6upgis le aigexei 4L aull to lunowV 'LL 0 0 0 91, 0 0 0 91,0'x aye,leauli le algexel 4L ouil to lunowV '9L 0 0 0 sl 0 0 0 — x(zOM 91.L6'oaS iapun saalsuell io'ayeit xel lesnods agl le algexel qL ouil lo;unowV 'qL S31VN 319VOIlddV?IOd SNOIlonNISN1 339•NOIltllf1dW00 XVl L 9 9 S b E E bL . .. .. .. . .... .. ... . (£L au!'!snulw Z auri)xel of lOatgnS anleA laN"11 CL . . . ' ' . . . . . . ' .. . . . . 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((3 alnpagoS)algenlaoaa SalON+g sa6e6DOW b '£ " ' ' ' ' (O alnpagoS)dlgsloyaudwd-aIOS to d!0iauV8d'uollelodio0 PJOH SIasOIa .£ "Z .... . .. ... . . . . .. .. ... . . ... . . . .. . . . (S alnpago5)spuog pue goolS Z 6 8 T 9 Z Z T L . . . . ..... . . . ...... . . ..... ... . ... . ... .. .. (V alnpagoS)alelso Ie98 "J, b , NOuv,in11dV032i 7I3?4NIH 'S, 2 IdTdN :aweNS,luaPaoaa lagwnN dllmoaS IelooS s,luopaaaa X3 0096-n3N 9ZTZb09SOST REV-1500 EX Page 3 File Number Decedent's Complete Address: 0035 DECEDENT'S NAME MARIE T. HINKEL _ STREETADDRESS -- - _ 16 Wiltshire East CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2 Line 19) (1) $4,014.80 2. Credits/Payments A.Spousal Poverty Credit B.Prior Payments $8,096.05 C.Discount $200.74 3. Interest/Penally if applicable Tofal Credits(A+B+C) (2) $8,296.79 D.Interest E.Penalty Total Interest/Penalty(D+E) (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) $4,281.99 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $0.00 A.Enter the interest on the tax due. (5A) B.Enter the total of Line 5+5A.This is the BALANCE DUE. (58) $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; ...................................................................... ❑ ❑X b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑ c. retain a reversionary interest;or ................................................................................................ ❑ ❑ d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑X 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an'in trust for"or payable upon death bank account or security at his or her death? ......... ❑ ❑X 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 QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on cr after July 1,1994 and before January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three(3)percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1, 1995,the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero(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 twenty-one 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 zero(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 four and one-half(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 decedent's siblings is twelve(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-1502 EX+(6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARIE T. HINKEL 0035 All real property owned solely ores 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 which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 16 Wiltshire East, South Middleton Township, Cumberland County, PA $122,618.49 Credits for payment of county/township, school and homeowners association dues TOTAL(Also enter on line 1,Recapitulation) $ 122 618.49 (If more space is needed,insert additional sheets of the same size) REV-1608 EX,(6-98) ' SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEECE DENT NT ESTATE OF FILE NUMBER MARIE T. HINKEL 0035 Include the proceeds of litigation and the date the proceeds were received by the estate. All propertyjointlyoLed !h right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sale of Personal Property by Stringfellows $1,100.00 2. Sale of Desk to Ruth Schlusser $50.00 3. Sale of Table to Kathy Holtry $50.00 4. Checking Account with Wells Fargo Bank, N.A. Account Number ending 4862 $3,418.17 5. Refund of Homeowners Insurance Payment from Erie Insurance $185.00 6. Refund from Comcast $8.33 7. Reimbursement of Medicare Part B Insurance $138.00 8. Savings Account with Fulton Bank Account Number 1371-85913 $666.18 9. Checking Account with Fulton Bank Account Number 3621-97928 $3,444.17 10. Prepaid Funeral Expenses $1,595.00 11. 1'5. $4,736.75 12. 2012 State Income Tax Refund $47.00 13. 2012 Federal Income Tax Refund $137.00 14. AT&T Refund $10.00 15. Property Tax Refund (not included on original return) $300.00 TOTAL(Also enter on line 5,Recapitulation) $ 15 885.60 (If more space is needed,insert addifional sheets of the same size) REV-1511 EX+(12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES& INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARIE T. HINKEL 0035 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. AUER Cremation Services of Pennsylvania, Inc. $2,013.78 2. Centerville Memorial Park $200.00 B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative(s) VIOLET LEBO & CLAIR RICE $2,853.84 Social Security Number(s)fEIN Number of Personal Representative(s) 171306098 Street Address Clair Rice: 208244976 City Stale Zip Year(s)Commission Paid: 2013 2, Attorney Fees DOUGLAS LAW OFFICE $2,853.84 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 Register of Wills $148.50 6 Accountant's Fees 6. Tax Return Preparers Fees See Attachment Page(s) TOTAL(Also enter on line 9,Recapitulation) $ 23 930.10 (if more space is needed,insert additional sheets of the same size) REV-1512 EX+(12-e3) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER MARIE T. HINKEL 0035 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Mortgage Payoff to Greentree by Assignment from Bank of America $81,117.32 TOTAL(Also enter on line 10,Recapitulation) $ 81 117.32 (If more space is needed,insert additional sheets of the same size) REV-1513 EX t(9-00) - SCHEDULEJ COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARIE T. HINKEL 0035 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. Clair D. Rice Sibling $16,728.33 2. Violet M. Lebo Sibling $16,728.33 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed,insert additional sheets of the same size) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: $4,108.25 Discount: $200.74 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 1988 through 1991 1992 1993 through 1994 1995 through 1998 1999 2000 2001 _ 2_002 2003 2004 2005 2006 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARIE T. HINKEL 21 13 0035 Decedent's Name Page 1 File Number Schedule H - Funeral Expenses &Administrative Costs -B7. ITEM NUMBER DESCRIPTION AMOUNT 7. AT&T $20.00 8. Seller's Assistance to purchasers of Home, John & Helen Neil $560.00 9. Real Estate Sales Commission to Help U Sell and Prudential Homesale $7,545.00 10. Real Estate Transfer Fee to Recorder of Deeds - $1,220.00 11. ReSale Certificate for Sale of Real Estate $150.00 12. Final Water& Sewer reading to S. Middleton Twp. Municipal Authority $93.80 13. UGI $127.22 14. Homeowners Insurance Payment to Erie Insurance $132.50 15. 2013 County Real Estate Taxes $288.13 16. South Middleton Township Utility Bills $12630 17. Met Ed $103.13 18. Century Link $136.45 19. Recapture of Social Security Payment $1,727.00 20. Family Home Medical Supplies $26.01 21. Forest Park Health Center $3,080.00 22. Guardian LTC Pharmacy $143.35 23. Register of Wills $65.00 24. Pinnacle Health $19.85 25. Advertising to The Sentinel $221.40 26. Advertising to Cumberland Law Journal $75.00 SUBTOTAL SCHEDULE H-B7 $15,860.14