HomeMy WebLinkAbout04-24-14 (2) J
CAf� 15D5610143
REV-1500 EX YT OFFICIAL USE ONLY
PA Department of Revenue pennsylvania countycode Year File Number
Bureau of Individual Taxes pEPPPiMWOF"e'FN°`
PO BOx.28D601 INHERITANCE TAX RETURN 21 14 0006
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Binh
10 06 2013 10 01 1988
Decedent's Last Name Suffix Decedent's First Name MI
HAWKINS PATRICK C
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
HAWKINS BRITTANIE M
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 Return 3. RRemaiinder Setur(Date of Death
El 4, Limited Estate 4a.Future Interest Compromise S. Federal Estate Tax Return Required
(date of death after 12-12-92)
g Decedent Died Testate 7, pAnaddegt Maio neda Living Trust B. Total Number of Safe Deposit Boxes
- (Attach Copy of Wig) ( c%WY nut)
L] 9, Litigation Proceeds Received 10.barn ee�n123191 a t{Da-Ike}tDeatn I1.Election to tax under Sec.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
DAVID J LENOX 717 271 7175
REGISTER Or VgLS USE-J JNLYr c-)
Ire ->_ c cn ;�u
First Line of Address
8 TRISTAN DRIVE SUITE 3 n .x .a v
Second Line of Address t� O - 'V
D*TE*ILED N r rTI
City or Post Office State ZIP Code
DILLSBURG PA 17019 Crt
Correspondent's e-mail address:
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 knovtfedge.
SIGNATURE OF PERSON RESPONSIBLE FOR PILING RETURN - DATE
Brittanie M Hawkins Cn ApnL Q.
ADDRESS
933 Oakmont Drive Lansing, KS 66043
IVE � DATE David J. Lenox
ADDRESS
8 Tristan Drive,Suite 3, Dillsburg, PA
Side 1
15051,10143 1505610143
1505610243
REV-1500 EX Decedent's Social Security Number
De denrsName: Hawkins, Patrick C.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 30, 549. 29
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous IDq-Probate Property
(Schedule G) u Separate Billing Requested............ 7•
g, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 30 , 549 . 29
9. Funeral Expenses and Administrative Costs(Schedule H)..................................
y 4 , 606. 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11• 4 , 606 . 00
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 25 , 943 .29
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. 25 , 943 . 29
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 25 943 . 29 15. 0 . 00
(a)(1.2)X.00 _
16. Amount of Line 14 taxable 0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 00 18. 0 . 00
at collateral rate X.15
19 0 . 00
19. TAX DUE.:..............................................................................................................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2 J
L 1505610243 1505610243
f
REV-1500 EX Page 3 File Number 21.14-0006
Decedent's Complete Address:
DECEDENT'S NAME
Hawkins, Patrick C.
STREETADDRESS
284 Pine Creek Drive
CITY STATE ZiP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (f) 0.00
1 Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
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.
7,
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:..................._...................._.......----....._................. ]F��l x
b. retain the right to designate who shall use the property transferred or its income;............
c. retain a reversionary interest;orr.. ._. x
d. receive the promise for life of either payments,benefits or care?............................................................ x
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?....... ❑ Q
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.2................................-......_....................................................................... ❑
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 far the use of the surviving spouse
is 3 percent 172 P.S.§9116(a)(1.1)(i)j,
For dates of death on or after January 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 172 P.S.§9116(a)(1)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)(13)]. 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.
� Rnytsaa Ex,(I 140)
SCHEDULE E
pennsyivania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hawkins Patrick C 21-14-0006
include she proceeds of etrgatlnn and the date the proceedsvme moeWed by the estate.
All property jo ntli yawned with the right of surAvorahlp must he dlaclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Members 1st FCU Checking Account: 2,089.52
2 Members 1st FCU Savings Account: 22,724.77
3 2006 Harley Davidson Sportster SX120OC: 5,735.00
TOTAL(Also enter on Line 5,Recapitulation) 30,549.29
(if more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
• REV-1611 EX-(10-09)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Hawkins Patrick C. 21-14-0006
Decedent's debts must be reported on Schedule L
ITEM DESCRIPTION AMOUNT
MBE
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Brittanie M. Hawkins
Street Address 933 Oakmont Drive
city _Lansing state KS Zip 66043
Year(s)Commission Paid 2'000'00
21 Attorney's Fees David J. Lenox 2,000.00
3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant-to Decedent
4. Probate Fees 496.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 110'00
See continuation schedule(s) attached
TOTAL(Also enter on line 9,Recapitulation) 4,606.00
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hawkins, Patrick C. 21-14-0006
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Gunn Mowery, LLC(Administrator's Bond): 110.00
H-87 110.00
Copyright(c)2002 form software only The Lackner Group,Inc. Farm PA-1500 Schedule H(Rev.8-98)
REV-1513 EX-(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hawkins, Patrick C. 21-14-0006
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(SI RECEIVING PROPERTY DECEDENT (Words) (55S)
TAXABLE DISTRIBUTIONS [include outright spousal
I. distributions,and transfers
under Sec.9116(8 1.2
1 Brittanie M.Hawkins Wife $30,000.00+50%
933 Oakmont Drive of residuary
Lansing, KS 66043-2226 estate
2 Sheila Hawkins Mother 25%of residuary
284 Pine Creek Drive
Carlisle, PA 17013
3 Hawkins Father 25%of residuary
284 Pine Creek Drive
Carlisle, PA 17013
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as 2DOrODnate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOTTAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
St S$
MEMBERS 11 MEMBERS T!
: ZP,1(A tRTDtrr 1f073ON. :PHf>PftA"I.CH PJ71`r'11N1ON.
Dillsburg Dillsburg
5 Tristan Drive 5 Tristan Drive
Dillsburg PA 17019 Dillsburg PA 17019
Inquiries Call: 717-502-9992 Inquiries Call: 717-502-9992
Acct XXXXXXX58B HAWKINS,PATRICK Acct XKXXXKX588 HAWKINS,PATRICK
Eff: 03/13/14 Date: 03/13/14 Eff: 03/13/14 Date: 03/13/14
Tlr: 1652 Time: 1:55pm Tlr: 1652 Time: 1:54pm
Withdrwl from REGULAR SAVINGS 0000 Withdrwl from CHECKING 0011
Prev Bal: 24,814.29 Prev Bal: 2,089.52
'Amount: 24,814.29 Amount: 2,089.52
New Bal: 0.00 New Bal: 0.00
Seq: #573386 Seq: #572846
Deposit to REGULAR SAVINGS 0000
Prev Bal: 22,724.77
Check Disbursed -24,814.29 Amount: 2,089.52
ESTATE OF PATRICK HAWKINS New Bel: 24,814.29
Ref number: 00 896013 Seq: #572847
Authorized by
ID Source: Authorized by
❑ Dry Lic
❑ SigCard ID Source:
❑ Known ❑ Dry Lic
❑ Other p SigCard
❑ Known
VISA Balance Transfer 1.905 APR NO ❑ Other
balance transfer fees. Ask an associate
for more details. VISA Balance Transfer 1.90% APR NO
balance transfer fees. Ask an associate
for more details.
PATRICK C HAWKINS
PATRICK C HAWKINS
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I of 2 3/17/2014 11:25 AT
David J. Lenox
Attorney At Law
8 Tristan Drive, Suite 3, Dillsburg, PA 17019
717-271-7175 (phone)
717-271-7178 (fax)
April 21, 2014
Register of Wills ti
Cumberland County Courthouse c m
One Courthouse Square C° G3 C>o
_- O
Carlisle PA 17013 M = o
- {
mcm
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In Re: Estate of PATRICK C. HAWKINS
0
File No. 21140006 o c " �= T
m
cn .
Dear Register: -L -
i
Enclosed for filing please find the Inheritance Tax Return in duplicate,the Inventory, and the
Status Report with regard to the above captioned estate.
Please return a filing receipt to my attention. I am enclosing a self-addressed, stamped
envelope for your use.
Si rely,
avid j. Lenox, qui re"
DJL/sdg
Encl
David J. Lenox, Esq: Ext 101, law @davidjlenox.comcastbiz.net
S. Dawn Gladfelter,Office Adm.: Ext. 102, Dawn @davidjlenox.comcastbiz.net
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