HomeMy WebLinkAbout04-16-14 .I 1505610105
REV-1500 Ex(e1-11)(FI, 2
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individuat Taxes County Code Year File Number
PO Box 28o6a1 INHERITANCE TAX RETURN i
Harrisburg,PA 17128-o6oi RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMODYYYY Date of Birth MMDDYYYY
1 10/08/2013 10/06/1937
Decedent's Last Name Suffix Decedent's First Name MI
i Sanderson j Douglas K
(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 INAPPROPRIATE OVALS BELOW
m 1.Original Return C=3 2.Supplemental Return p 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate C=) 4a,Future Interest Compromise(date of = S. Federal Estate Tax Return Required
death after 12.1282)
C@D 8. Decedent Died Testate C= 7. Decedent Maintained a Living Trust 0 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 CZD 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 jI
Richard L. Placey, Esq. ' (717) 236-9577.
REGISTERGP WtLLS USE(!J�Y z MM r
Go Co
First Line of Address 'b I� ::Q q
fTl .,i C7 C:1
;Placey &Wright M CID C7
Second Line of Address - >i� Cry ;� CO I
C 7 rt T`1 i
3621 North Front St. c7 CD t
City or Post Office _ _ _ State ZIP Code - LEa T fir r
i Harrisburg_ _ __- -,- -.-� PA 117110 y I N </1'
CJa
Correspondent's e•maH address: pwlaw @epix.net
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.
S16NATURE OF PERSQ,NREPO IBLE�FJQR FILING R�yETURNj� DATE
ADDR S
Gordon N. Sanderson, Executor, c/o Placey &Wright, 3621 North Front Street, Harrisburg, PA 17110
SIGNATURE OF PREp[tF.bER R TH AN 13F.5+$ESEN�TATiVE
ADDRESS+
Richad L.w/t/cey,�E(I1 sq II /e/&/W!r J 1 fV T
North Front Street, Harrisburg, PA 17110
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
"lr.�/
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name Douglas K. Sanderson
RECAPITULATION
1. Real Estate(Schedule A). _. . ....... .. . . .. . .... .. .. . .. ... ......... . .. t. 265,000.00
2. Stocks and Bonds(Schedule B) . .. . - 0.00
. .. . .. . .. . . ... . . ..... .. . .. ..... .. .. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . .. .. 3. 0.00
4. Mortgages and Notes Receivable(Schedule D) ........ . . .. ... .... .. .. ... . 4. 0.00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). .. .... 5. 67,971.41
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested...... .. 7. 632,844.86
8. Total Gross Assets(total Lines 1 through 7). .. . . . .. . . .. . ... .. ... .... .... 8. 965,816.27
9. Funeral Expenses and Administrative Costs(Schedule H). . .. ..... .._.. .. . 9. 68,082.14
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). ... .. ..... .. .. 10. 16,229.53 1
11. Total Deductions(total Lines 9 and 10).. .. . . .. .... . .. ..... ... .. ... .. .. 11. 84,311.67
12. Net Value of Estate(Line 8 minus Line 11) . . ... ... . . . ........ .. ... .... .. 12. 881,504.60
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . ..... ..... ... ... ....... 13. 40,000.00
14. Net Value Subject to Tax(Line 12 minus Line 13) ... . . . ..... .. ......... .. 14. 841,504.60
i
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_ 0.00 15. �-_-_-___---__ 0.00
16. Amount of Line 14 taxable
at lineal rate x.0 45 100,000.00 6. 4,500.00
7, at s bI ntg of r to x1 t2 xable 720,492.14 7. _ 86,459.06
18. Amount of Line 14 taxable 21,012.46 t8 3,151.871
at collateral rate X .15
19. TAX DUE ... .. 19. 94,110.93
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT OS)
Side 2
1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Douglas K. Sanderson
STREETADDRESS
3716 Lisburn Road
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 94,110.93
2. Credits/Payments -
A.Prior Payments 91,743.18
B.Discount 4,705.55
3. Interest Total Credits(A+B) (2) 96,448.73
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) 0.00
Fill in oval on Page 2,Line 20 to request a refund. (4) 2,337.80
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
t. 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 dales 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 172 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+ (12-12)
pennsy[vania SCHEDULE A'
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: - FILE NUMBER:
DOUGLAS K,. SANDERSON 2113-1127
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
t Real estate situate In Lower Allen Township Cumberland County,Pennsylvania,more
Iparticularly bounded and described In Cumberland County Recorder of Deeds Office In = )
.Record Book 162,Page 140,known and numbered as 3716 Lisburn Road Mechanicsburg, PA I 265 000.00
li I (Valued at price for which sold See settlement sheet attached,)
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TOTAL(Also enter an line 1, Recapitulation.) $ 265 000-00
If more space is needed,use additional sheets of paper of the same size.
REV-i5og E%+(o&IZ)
�> pennsy[vania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER;
DOUGLAS K. SANDERSON 2113-1127
Include the proceeds of Iitiga on 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
� I'Fulton Bank Checking Account 3622-32711 8 785.14
2
Cordier Auctions&Appraisals gross proceeds public auction sale of vehicles and household goods I 55,665.00
3j jCash on Hand 6520
OFF»n„ .
4 EAAA membership cancellation refund 19.75
5 + 11-ltghmark unused premium refund 47.07
to
t 6 Capital Blue Cross unused premium refund 60275
1 'Cordier Auctions&A raisals net proceeds subsequent household items sold -
7 PP P G � � 78.00�'
g Erie Insurance refund homeowner's policy unused premium & 871.00
9 ` Cordier Auctions&Appraisals net proceeds gun sale j 1 837.50
a„,wµ.,,•. »,�.o�;.,.m ,.,�,�, -.�.. y:. .ro..�-.�.».�: i "s,"^w,9?Ttr.
10 I IVisceraneous Personal Effects
'
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TOTAL(Also enter on Line 5, Recapitulation) $ 67,971:41
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+ (08-09) `
pennsyivania SCHEDULE G
DEPARTMENT CIE REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DOUGLAS K. SANDERSON 2113-1127
This schedule must be completed and filed if the answer to any of questions i through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCUIDE THE NAME or ME TRANSFEREE.THEIR REUnoasHiP TD DECEDENT AND DATE Of DEATH % DECD'S EXCLUSION TAXABLE
NUMBER THE DATE DE TRANSFER. ATTACH A COPY OF THE DEED FOR REU ESTATE. VALUE OF ASSET INTEREST ,EAPEUUEEE, VALUE
L !Wells Fargo Advisors IRA#3522-9588. Beneficiary Patricia A.Sanderson _..12.4.1 _
" 1 21012481 100 000 21012.40€
ax w fe Transferred October 8 2013 I 6
2 !Wells Fargo Advisors IRA#1704-5281. Beneficiary Gordon N Sanderson l 1 f;
!brother. Transferred October 8 2013 611832.40 1 100! 0001 611,832.40E
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632,844.861
TOTAL(Also enter on Line 7, Recapitulation) $ r_
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
topennsy[vania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DOUGLAS K. SANDERSON 2113-1127
Decedent's debts must be reported or Schedule 1,
EM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
NUMBER
I Neill Funeral Home 2 770�00
........... ......-1
.........-------------
B. --------------- —-----
ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
State ZIP
Year(s)Commission Paid:
F-
Attorney Fees: 27,500.00
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; 353.50
S. Accountant Fees:
6. Tax Return Preparer Fees:
7, Woof Appraisal Group-appraisal real estate 3716 Lisburn Road, Mechanicsburg 400.00'r
i 8J ,Corder Auctions&Appraisals-net settlement expenses vehicles and household goods 15,945,65
I q.r :Net settlement expenses sale of 3716 Lisburn Road, Mechanicsburg, PA 17,906.54 11
10- i Estate Advertising-Cumberland Law Journal($75.00) The Patriot-News Company($116.45) 191.45 V
11. Cumberland County Register of Wills-short certificates 15,00 P
12 Reserve for future costs,taxes and expenses 3,000.00 ri
TOTAL(Also enter on Line 9, Recapitulation) 68,082.14
If more space is needed, use additional sheets of paper of the same size.
REV-1512 E%4'(12-12)
i pennsy[vania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX.RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DOUGLAS K. SANDERSON 2113-1127
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 I DESCRIPTION OF DEATH
-,:�-+,.nom.�«.
IPPL Electric Utilities debt of decedent(various billings) 2 247 73 .
iBJ s Card Services credit card debt of decedent 145 95
3.; Ritter's( True Value Hardware debt of decedent ( 26.37 .
4. Erie Insurance Group homeowners Insurance 1,219.00
5.; Nenzon i o
6' fYard Card credit decedent 1
card debt of decedent 72.00
7.; iWells Fargo F.N.B.-credit card debt of decedent 8,345.65 I,
i
I e j' 'Lower Allen Township debt of decedent 115.9
9; kErie insurance Group
p pa personal catastrophe insurance
39 00
:_ 239.00,r
10 s Treasury y 2 873 00
United States Treasur 20131040
t 11.: IPA Department of Revenue-2013 PA40 ,
12.! jCordjer Auctions&Appraisals miscellaneous clean-up at 3716 Lisburn Road Mechancisburg I 300.00 Pry j
# 13 (Folk&Garber water damage repairs 490,00
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TOTAL(Also enter on Line 10, Recapitulation) $ _� L'16.229.53
_
If more space is needed, insert additional sheets of the same size.
REV-1513 EXi (01-10)
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMISER�
DOUGLAS K. 8ANDERSON 2113'1127
RELATIONSHIP TO DECEDENT I AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSOWS)RECEIVING PROPERTY Do Not List Trustei OF ESTATE
I WXABLE DISTRIBUTIONS fInclude outright spousal distributions and transfers under
1, �Pal A.Sanderson,4025 Valley Road,Enola,PA 17025 'No Relation
$21,012.46 i
2. ISean Sanderson, 1601 Lenox Drive, Cleveland,TN 37312
Son $50,000m
I !Bryan Sanderson,2565 Rosstown Road,Wellsville,PA 17365 son $10,000.00
4.i iPatrick Sanderson,8911 Toleman Road,Richmond,VA 23229 1 lson 40,000.00
5., 'Gordon N.Sanderson,42 Geen Holly Drive, Kingston,MA 02364 iBrother e s ii I;' u e"'o f
Estate
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH IS OF REV-1500 COVER SHEET,AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX 15 NOT TAKEN:
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
Shrown University,45 Prospect Street,Providence,RI G2912 $20,000.00
2. Johns Hopkins University School of Medicine,733 North Broadway,Baltimore MID 21205 $20,00000
TOTAL OF PART H- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEETj$j, 40,00000
If more space is needed, use additional sheets of paper of the same size.
----
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PLACEY & W1UGHT
RICHARD L. PLACEY ATTORNEYS AT LAW OF COUNSEL
WILLIAM K. WRIGHT 362 1 NORTH FRONT STREET CHARLES J. DEHART, III
(1943-1999) HARRISBURG, PENNSYLVANIA 17110.1533 STANLEY J.A. LASKOWSKI
(71 7) 236-9577 FAX(71 7) 235-0843
April 15, 2014
Register of Wills
CUMBERLAND COUNTY COURTHOUSE
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Douglas K. Sanderson
Estate No. 21-13-1127
Dear Madam/Sir:
We enclose herewith for filing, in duplicate, Pennsylvania Inheritance Tax Return for the
captioned decedent.
Please time-stamp the additional copy of the first page and return it to me in the enclosed,
stamped, addressed envelope.
Thank you.
Very truly yours,
PLACEY& WRIGHT-
and L. Ptaee�
RLP:hsk
Enclosures
cc: Gordon N. Sanderson
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