HomeMy WebLinkAbout04-16-14 (2) J 1505610105
REV-1500 EX(oz- ` `
OFFICIAL USE ONLY
PA Department of Revenue penosytvarda
Bureau of Individual Taxes ` County Code Year M Number
INHERITANCE TAX RETURN
PO BOX RESIDENT DECEDENT
Harrisburg, t
PA PA 17128-O6Oa
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01/16/2013 12/28/1931
Decedent's Last Name Suffix Decedents First Name MI
Barker Mildred E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouses anal Security h'u ex
THIS RETURN MUST BE FILED IN DUPLICATE Wrl'!T E
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
CID 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Rehm Required
death after 12-12-82)
O 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust S.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) o
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOU EDIRECTEDTOr- rn r*t
Daytime Telephone ppOnrmr,.__........ .M�... O
Anthony J. Nestico, Esq (717)533-5406M z n a
REGISTER O AlJLi�U VONL �;a
47
First Line of Address C-) O -ri
1135 E.Chocolate Ave s w r- rrt
o
Second line afAddress ;> O -n
Suite 300
._ _ .._........... ...... ._. ...._.._ .... . ........... .. _ .............. ..._.__. DATE FILED
City or Post Office State ZIP Code
Hershey PA 17033
Correspondent's e-mail address:tnest'lco@hersheypalaw.com
Under penalties y.I declare that l have examined this return.including accompanying schedules and statements,and to Me best of my knowiedgeontl belief,
it is We,Lb a te.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN RE O RESPONSIBLE FOR FILING RETURN OATS_ /
/2
DRIES
80 ocust Lane I s u PA 19 e , `
SIGNAT OFPREPA EROTHERT R R E "� — / I LI
AODRES l
1135 E.Chocolate Ave., Ite 300, Hershey, P 17033
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Mildred E. Barker
RECAPITULATION
........ ..... . . .._.._....._._... ..
1. Real Estate(Schedule A). ............................................ i. 110,000.00
2, sacks and 3onds(Schedale B} ....................................... 2.: 0.00
1 Closely Hold Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. V�0.00
,,. _.......
,
4, Mortgages and Notes Receivable(Schedule 0)........................... 4, : 0.00
5, Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)..,.... 5. ryT 1,849.19
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.': 6,595.31
7. Inter-Vivos Transfers S Miscellaneous Non-Probate Property - ......_._...___.._.___:.,____;
(Schedule G) O Separate Billing Requested........ 7. 0.00
S. Total Gross Assets(total Lines 1 through 7)............................. 9.j........_,_.__.____._..__.._..-..-_117,644.50
9. Funeral Expenses and Administrative Costs(Schedule H)................... 91 31,484.19
._...__ _._...,�,..,...__.... ,..,............. .11.,..1..1.__,.
10. Debts of Decedent,Mortgage Liabilities and Lions(Schedule 1)......... ..... 10. 65,241.32
11. Total Deductions(total Lines 9 and 10)............:.................... 11. 96,725.51
_____
12. Net Value of Estate(Lines minus Line 11)........... ..... 12. _....._...._._._....._..,._..._......_,.. 20'91_._..____
13. Charitable and Governmental Be ....____.__...._..�. »...._.____..._.___._._._._
quasi$t5ec 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, 20,916.99
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15, Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 _ . ........... .. _._ _,..,....._. . ., .1...1..11 .__......._._.. ....,...._....,
(a)(1.2)X.0_
16. Amount of Line 14 taxable -_.._..,.._._._._._._.....___�_.._......____.._..,-_._._ ;.___.__�e_.,...._____.,.....,._._._._._.__._..__
at lineal rate X.045 20,915.99 ; 16, 941.36
17. Amount of Line 14 taxable !.."",.'.._.._._,__.,...,_..._...___...,.__....._...._._...„....,; t.____,.___._.._,,...__.._....._.,._._._____..__...._._._._.;
at sibling rate X.12 17.
/S. Amount of Line 14 taxable
at collateral rate X,15 16,
_.... ... .. ._._._.. . .._,._... 111......1. ,._�__
19. TAX DUE......... ......... .... ..... ......... ........ . 19, 941.36 !:
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Mildred E. Barker
STREET ADDRESS
525 Hogestown Road
CITY sTATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 941.36
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+B) (2)
3. Interest
(3) 28.16
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) 969.52
Make check payable to: REGISTER OF WILLS,AGENT.
rS fitM ivus e r �e^Ki"f n-.s� -^e
IM
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.......................................................................................... ❑ N
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 are?...............................................I...................... ❑ N
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 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 lax 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+(1108)
r'LEA
Aipennsylvania SCHEDULE A
OEPART ENT OF REVENUE
INHEMANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred E. Barker 2013-00137
All real property owned solely or as a tenant in common most 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 jointlyowned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet If the property has been sold.
REM Include a copy of the deed showing decedent's Interest if owned as tenant in common. VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 525 Hogestovm Road,Mechanicsburg,PA 17050 110,000.00
TOTAL(Also enter on Line 1,Recapitulation.) $ 110,000.00
If more space is needed,insert additional sheets of the same size.
REV-15o8 EX+(08-12)
T pennsyLvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mildred E. Barker 2013-00137
Indude 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. County Taxes prorated at sate of 525 Hogestown Road,Mechanicsburg,PA 154.05
2. School Taxes prorated at sale of 525 Hogestown Road,Mechanicsburg,PA 895.14
TOTAL(Also enter on Line 5,Recapitulation) $ 1,049.19
If more space is needed,use additional sheets of paper of the same size.
REV-L5og EX+(oiao)
0 e pennsylvania SCHEDULE F
� DEPARTMENT DP REVENUE
INHERFANCETAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mildred E. Barker 2213-00137
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.Beverly Rohrbaugh 180 Locust Lane, Daughter
Dillsburg,PA 17019
B.
L.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
FEM FOR JOINT MADE INCLUDE NAME OF RNANCIAL INSTIIIITION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENT MNG NUMBER.ATTACH DEED FOR JOINRY HELD REAL E5TATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
J. A. 2008 PNC checking(acct.#XXXXX9036) 12,387.15 50% 6,193.58 .
2. A. 2008 PNC savings facet.#XXXXX3532) 803.45 50% 401.73
TOTAL(Also enter on Line 6, Recapitulation) $ 6,595.31
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
SCHEDULE H
pennsylvania
1�T DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred E. Barker 2213-00137
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Malpezzi Funeral Home 13,190.28
2. Ginglich Memorials 1,340.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 0.00
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2,000.00
2. Attorney Fees: .
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.)
Oaimant
Street Address
City
State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
353.50
S. Accountant Fees: - 220.00
6. Tax Return Preparer Fees:
7. The Sentinel-Estate advertising 168.30
a. Cumberland Law Journal-Estate advertising 75.00
9. Rodney Freeman-Drywall at 525 Hogestown Road,Mechanicsburg,PA 17050 1,440.00
10. Dave Witmer-Electrical at 525 Hogestown Road,Mechanicsburg,PA 17050 750.00
11. Drew Petfer-Painting at 525 Hogestown Road,Mechanicsburg,PA 17050 637.25
12. Kirby's-Carpet at 525 Hogestown Road,Mechanicsburg,PA 17050 972.75
TOTAL(Also enter on Line 9,Recapitulation) $ 31,484.19
If more space is needed,use additional sheets of paper or the same size.
Mildred E.Barker
2213-00137
Schedule H
continued
13. PPL $445.32
14.United Water $45.88
15. Penn Waste $96.40
16. Community Life $58.80
17. G. Douglas Rohrbaugh-reimbursement for trash removal $324.40
18. Tina Fullerton(notary) $10.00
19. 1'`Advantage Settlement Services, Inc. fees $30.00
20. State Tax $1,100.00
21. Silver Spring Township Authority Sewer $260.28
22. 2013/2014 School Taxes $985.00
23. 2013 Township Taxes $401.62
24. Seller assist at closing $6.579.41
$10,337.11
REV-1512 EX+(12-12)
ispennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES &LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred E. Barker 2213-00137
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 RMS,Inc. 65,241.32 .
TOTAL(Also enter on Line 10,Recapitulation) $ 65,241.32
If more space Is needed,insert additional sheets of the same size.