The URL can be used to link to this page

Home My WebLink About05-15-14 (3) _ __ J 1505611185 REV-1500 EX(02-11)(FI) PA Department of Revenue OFFICIAL USE ON�Y Bureau of Individual Taxes County Code Year File Number Po sox zsosoi INHERITANCE TAX RETURN 21 13 �9 51 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 189- 08262013 03221920 DecedenYs Last Name Suffix DecedenYs First Name MI BIETSCH TOM H (If Applicabie) 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 BOXES BELOW � 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death � ❑ Priorto 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 � 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 ❑ 1 1. 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 B�IRECTED TO: Name Daytime Telep e Number �, � RICHARD C- SNELBAKER 717-69 28 � `�`:; '..�,/J'a..� Y.._.� �'� t:J�'. _.L' REGIS� ,.1IY]L.LS US"�,�NLY ""! "�7 C/j n; ' V� �,.f�} .;.:.t C7�� t�> -_, First Line of Address Q Ss - �-�=: G.l�: � :'- = 44 WEST MAIN STREET ' �' � � � �"-�i Second Line of Address � � `� G'I C1ty Or POSt OffiCe State ZIP COde DATE FIIED MECHANICSBURG PA 17055 Correspondent's e-mail address: Under penaities of perjury, 1 declare that I have examined this retum,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. SIGNATU`�i/F PERSON RESP NSI LE FOR FILING RETURN DATE l -��,��, ��-�� -�� ADDRESS S `� �o rC�C T • ALLAN BIETSCH , EXECUTOR 5545 EAST EVERGREEN BLVD - , UNIT 6305 SIG UR F P ER OTHER THAN REPRESENTATIVE V N O R� DATE ADDRE S �1�j � RICHARD C • SNELBAKER, ESQUIRE 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA, 17055 Side 1 � �, 1505611185 1505611185 J OM4647 3.000 � 1505611285 REV-1500 EX(FI) DecedenYs Social Security Number 189- Decedent s Name B I E T S C H T�M H RECAPITULATION 1. Real Estate(Schedule A) . . • • • • • • • • • • • • • • • • • • • • • • • � ' ' �� • �� 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2_ 2,2 9 7,5 4 5 •19 3. Closely Heid Corporation,Partnership or Sole-Proprietorship(Schedule C), . , . , 3, 0 • �� 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , 4. 0 •�� 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , . , 5. 3�4 ,6 8 5 • �3 6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , , , g. � • �� 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested . . . . 7. �4,7 8 2 •6 0 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . g, 2,6 7 7,012 • 8 2 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. 6��17 • 5� 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , . , . , , . 10. 4 ,218 • 2 6 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. 1�,2 3 5 •7 6 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . 12. 2,6 6 6,�7 7 • �6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J}. . . . . . . . . . . . . . . . 13. 0 •0 0 14. Net Value Subject to Tax(Line 12 minus Line 13) , , , , , , , , , , , , , , , 14. 2,6 6 6,��7 • �6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers un�er Sec.9116 (a)(1.2)X.0- � • �0 15. � -�� 16. Amount of Line 14t�xab�e 116,4�4 • 9 7 at�inea�ratex.o- 2,586,777 •�6 �s. 17. Amount of Line 14 taxabie at sibiing rate X.12 � • 0� 17. 0- �� 18. Amount of Line 14 taxable ],2,�� -Q� at collateral rate x.15 8 Q,��J 0 • Q 0 18. 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. L�LB,404 •97 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 1505611285 15�5611285 � OM4648 3.000 _ _ _ _ File Number REV-1500 EX(FI) Page 3 Decedent's Complete Address: 21 13 0 9 51 DECEDENT'S NAME BIETSCH TOM H SIREET ADDRESS � BOROUGH CUMBERLAND COUNTY STATE Z1P ciTv CARLISLE PA 17013- Tax Payments and Credits: 12 8,4�4 •9 7 1. Tax Due(Page 2,Line 19) �� 2. Credits/Payments A. Prior Payments 12 0,�� 0 B. Discount 6,0 0� •0 0 12 6��0 0 •0� Total Credits(A+B) (2) 3. Interest � -0� (3) 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMEN7. a.O a Fill in box on Page 2,Line 20 to request a refu�d. �4� 5. If l.ine 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. �5) 2,4�4 •97 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: X 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? . ❑ 0 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.§91 16 (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 decedenYs 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. OM4671 2.000 REV-1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENTOFREVENUE STOCKS 8� BONDS INHERITANCETAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 13 0951 Tom H. Bietsch All property jointly owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ��M OF DEATH NUMBER DESCRIPTION 2,297,545.19 1. Vanguard investment account #20113514 TOTAL (Also enter on Line 2,Recapitulation) S 2,297,545.19 zwasss z.000 If more space is needed,inseR additional sheets of the same size REV-1508 EX+(0&12) pennsylvania SCHEDULE E DEPARTMEMOFREVENUE CASH, BANK DEPOSITS 8� MISC. INHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Tom H. Bietsch 21 13 0951 Include the proceeds of litigation and the date the proceeds were received by the estffie. All property jointly owned with right of survivorship must be disciosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CSO 2,989.00 health insurance premium refund due the decedent 2 Genworth Financial 768.32 long term care insurance premium refund due the decedent 3 M&T Bank 99,923.68 checking account #446920 4 Sarah Todd Nursing Home 1,566.67 refund due the decedent 5 U.S. Treasury 150.00 refund due the decedent on 2013 Final Individual Income Tax return 6 Wells Fargo 190,282.84 savings account ending in 7238 7 Wells Fargo 9,004.52 checking account ending in 5709 TOTAL(Also enter on line 5,Recapitulation) $ 304,685.03 2wasa�z.000 If more space is needed,use additional sheets of paper of the same size. . _ _ REV-1510EX+(08-09) SCHEDULE G pennsylvania DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDEhlT ESTATE OF FILE NUMBER Tom H. Bietsch 21 13 0951 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY EXCLUSION TAXABLE ITEM INCLIAETFEN4MEOFTFETRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD�S NUMBE rrEOnreoFrRn��nrrnct+ncoav oF r�oeeo FoR REnL esTnre VALUE OF ASSET INTEREST IF APPUCABLE VALUE �� Kathy Bietsch 14,000.00 100.0000 3,000.00 11,000.00 $5,000.00 gift made February 6, 2013 and $9,000.00 gift made June 26, 2013 2 T. Allan Bietsch 14,000.00 100.0000 3,000.00 11,000.00 $5,000.00 gift made February 6, 2013 and $9,000.00 gift made June 26, 2013 3 M&T Bank 52,782. 60 100.0000 0.00 52,782.60 IRA account #35004200996811. Designated benefiary was decedent's son, T. Allan Bietsch TOTAL(Also enter on line 7,Recapitulation)$ �q '7$2. 60 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2.000 REV-1511EX+�,ao9> SCHEDULE H pennsylvania DEPARTMEt�fiOF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT FILE NUMBER ESTATE OF Tom H. Bietsch 21 13 0951 DecedenYs debts must be reported on Schedule I. ITEM AMOUNT NUMBER DESCRIPTION A. FUNERALEXPENSES: � None B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State Z�P Year(s)Commission Paid: 2. AttorneyFees: Snelbaker & Brenneman, P.C. 2,862.60 3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach e�lanation.) Claimant Street Address City State Z�P Relationship of Claimant to Decedent 4. Probate Fees: 1,508.50 5. Accountant Fees: 250.00 6. Tax Return Preparer Fees: 7. 1 Cumberland Law Journal 75.00 advertising Executors' Notice 2 Register of Wills additional probate fee 100.00 Total from continuation schedules . . . . . . . . . 1,221.40 TOTAL(Also enter on Line 9,Recapitulation) $ 6 017.50 9W46AG 2.000 If more space is needed, use additional sheets of paper of the same size. 21 13 0951 Estate of: Tom H. Bietsch Schedule H Part 7 (Page 2) 3 The Sentinel 221.40 advertising Executors' Notice 4 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the 1,000.00 administration of the Decedent's estate 1,221.40 Total (Carry forward to main schedule) REV-1512EX+,,Z.,z> SCHEDULE i pennsylvania pEppRlTv1ENTOf REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES 8� LIENS RESIDEMDECEDENT FILE NUMBER ESTATE OF 21 13 0951 Tom H. Bietsch Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed mVALUE A DATE OF DEATH ITEM pESCRIPTION NUMBER �. Milenum Pharmacy 69.26 perscription costs , 2 PA Department of Revenue 1,149.00 2013 Final Individual Income Taxes 3 pA Department of Revenue 200.00 quarterly income tax payment for 3rd quarter 2013 4 U.S. Treasury 2,800.00 quarterly income tax payment for 3rd quarter 2013 TO7AL(Aiso enter on Line 10,Recapitulation) $ 4 218.26 If more space is needed,insert additional sheets of the same size. 2W46AH 2.000 REV-1513EX+(01-10) SCHEDULE J pennsylvania DEPARTMEM OF REVENUE BEN EFI C IARI ES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER: ESTATE OF: 21 13 0951 Tom H. Bietsch RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE � TAXABLE DISTRIBUTIONS[InSeCe 91t16(a)p(1 2��stributions and transfere under i, Jeffrey Whiting 979 North Road North Yarmouth, ME 04097 Bequest per Item Second of Will Nephew 10,000.00 2 Martha Smith 37 Island Avenue Cumberland, ME 04021 gequest per Item Second of Will Niece 10,000.00 3 Grace Bishop 5322 Safe Harbor Way Salisbury, r'ID 21801 Bequest per Item Second of Will Niece 10,000.00 EMER DOLIAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. �� NON-TAXABLEDISTRIBUTIONS A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: t. TOTAL OF PART il-ENTER TOore spa�ce isA needed,luse add tio�naSsOheetsNof paper of Ehe same s'��Ze.ER SHEET. S 0.0� 9 W 46AI 2.000 21 13 0951 Estate of: Tom H. Bietsch Schedule J Part 1 (Page 2) Item Relation Amount No. Description 4 Austin Brizendine 4154 Bosley School Road Glen Rock, PA 17327 Bequest per Item Second of Will Nephew 10,000.00 5 Cathy Tolman 196 Doe Ridge Lane Galax, VA 24333 10,000.00 gequst per Item Second of Will Niece 6 Ernie Gulden 1030 Waterloo Lake Drive Denison, TX 75020 Bequest per Item Second of Will Nephew 10,000.00 7 Wayne Gulden 224 Corry Street Yellow Springs, OH 45387 Bequest per Item Second of Will Nephew 10,000.00 8 Gary Gulden 606 Wingrove Court Tipp City, OH 45371 Bequest per Item Second of Will Nephew 10,000.00 9 T. Allan Bietsch 5545 East Evergreen Blvd Unit #6305 Vancouver, WA 98661 Son 2,566,777.06 All of Residue: 2,586,��•06 ._..... I.:.. . .... ... I I I � � � LAST WILL AND TESTANIGNT � �� I ,'� I I�, I."TOM H. QIETSCH,of the Township of Silver Sprirn,.Lounty of Cumberl�nd��d I I �nwealth oC Penns}�h�ania,bein�of�sound and disposiii,mind_meir�on and unitcrstanding,do � ��CORlllll � ake. �ublish and declare tliis as and for my Last W ill and`I'estament.hereby revuking ancl makin;voi�l � m 1 all former«'ills and codicils by me at a°y time heretotore made. TIRS�C. 1 order and direct that ali my lust ilebts,funeral costs,expenses of estate aciministration and all taxes owir�g b�cause oC my death,e.g.,Federal Estate tax,Fennsylvania Transfer lnheritancc Tax. be paid fi�om my est2te by my Cxecutor,hereinafter named,as s°°°�s P��ssible��er��to each of SECOND. t give,devise and be9ueatli the sum of 1en Thousand Dollars($ � AUSTIN �ny nieces and nephews,namely,JCFFRGY W�IITING,M:��THA SM�DEN aRd GAKY GU�LDEN,�'�� BRIZENDtNE,CnTlIY TOLMAN,ERNIL GULDEN,�"1AYNG GUL suivive me. THLRD. t give,devise and bequeath all tlie rest,residue and remainder of my Gstate,rea, personal and mi�ed,whatsoever and wheresoever situated,uoto my son,namely T.ALLAN [3i�CTSCI I, absolutely and in fee simple if he survives me. ]f my said son shall predecease me,l give,devise and bequeatlt my said residuary estate,w�to my daughter-in-law.namelY,�THY BAILEY BIETSCFI,absolut�l�y�p��a'�f��N BIETSCH,to be the LA__ STLY• 1 nominate,constitute aild appoint my son, Y Esecutor of this,my Last W�i�and Testament,but if for any re�son my said son should fail to qualify as such Esecutor or cease so to serve,then and in thal event,1 nominate,constitute a�d WC�t o�ut b�d or�other i��mely,AUSTIN I3RIZENDINE,to be the Esecutor hereot,each and both to sc,� security as a condition of qua�ific�tion as such fiduciary. �N W ITNESS WHEREOP,l,TOM H.B1C"fSCH,have hereunto set m��l�have�affised i�tY�s �ewritten page to wivc my Last W��a��d TesYament which consists uf one(I)ty� signature this 24°i day of September,Two Thousand T�velve(2012)• l � �sen�) � — --___—�-��„i-�.�;�cs��, r<� on the dale thereof si�ned,sealed,published 1°�the presence o�M The preceding instrutnent,c�onsistin�of lhis and one(1)other typewritten i�e,each idenlil iec by the signature of the Testator,W� ��,QIETSCI�,the Testator therein named,�5 and for his Last W ill and`I estame . who,at his request,in liis presence anci in Che presence of each oCt�er,have subscribed our names`�s �vit�tesses hereto. �%�� nw oF�icES -- j�iELgAI<ER& BRENrJE7sA.N.P.C. /i � � ^ \ `'�— _ �� - I, I� 'i � � �� COMNIONWEALTI-I OF P�NNS1'LVAM.�)SS. �� COUNTY OP CUtVIBERLAND > II I IWe,TOI��t H. B[LTSCH_RICHARD C SNELBAKGR and SANDR�K• SHOW�RS, � the Testator and the witnesses,respectively,��iose uames are signed to the attaehed or foregoin�, I instivment,beiog tirst dti�ly s�vorn,do heceby declare to the uildersigned authority tl�at the T'estator signeci 1nd executed the insri�ument as his Last W ill and Testament and that he had signeci willingly,and tl�at he esecuted it as his free and volunta�y act for tl�e puiposes therein expressed,and tl�at each of the witnesses,in the presence and hearing of the Testator,sianed the Will as a witness and tl�at to the best of his or l�er kuowledge the Testator was at tl�at time eighteen years of abe or older,of sound mind and under no constraint or undue influence. �i4A � � Testator �C^y1�:1;ir:��-�'�i• ' �� w,t,�ess ��i�� — W rtness Subscribed,sworn to and acla�owledged before me by"I'OM H. BIETSCH,tl�e Testator, and stiibseribed�nd sworn to before me by KTCHAP.D C. SNELBAKER and SANDRA K. SHOW�RS,�'iYnesses this 24�'day of Septeuiber,2012. � �' /,,_ Notary Public � COMMONWEALTH OF PENNSYLVANIA NotaAal Seal Susan L.Matrazi,Nobry Pub�ic Medwnlaburg 8oro,Cum6erland County My Commission Expires Nov.24,2015 MEMBER,PENNSYLVANU ASSOC1AT10N OF NOTARIES �qW OFFICG SNELBAhEP.� BRENNEMaN. P.C. � I �I I I