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HomeMy WebLinkAbout04-22-14 (3) 1505610140 REV-1500 EX (02-11)(FI) OFFICIAL USE ONLY Bu Department of Revenue County Code Year File Number Bureau of 80601 Taxes INHERITANCE TAX RETURN Ha BOX g, PA 1 2 1 1 4 0 1 8 2 Harrisburg. PA 17126-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death ' MMDDYYYY Date of Birth MMODYYYY 1 2 1 2 2 0 1 3 1 1 2 8 1 9 2 1 Decedent's Last Name Suffix Decedent's First Name MI W E I G E L M A R T H A J (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 0 1.Original Return F] 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) © 5.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,) rl 9. Litigation Proceeds Received 10.Spousal Poverty Credit(Date of Death ED 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: N Name Daytime Teleph6ne Number o rn B E N J A M I N J B U T L E R 7 1 7 $5 6 1-4 &x,50 REGiSTE D t USE 6NLY --I� tTI First.Line of Address 2 7S OI O 1 0 0 7 M U M M A R 0 A D � ° - ZE - a c Second Line of Address *,� --I F� HI O S U I T E 1 0 1 n 't City or Post Office State ZIP Code DATE FILED L E M 0 Y N E P A 1 7 0 4 3 Correspondent's e-mail address: LAWYERS 2BUTLERLAWFIRM.COM Under penalties of perjury.I declare that I have examined this relum,including accompanying schedules and statements,and to the best of my knowedge and belief, It is true,correct and complete.Declaration of preparer other than the personal representative is based on all Information of which prepare,has any knowledge. SIGN OF PERSON RE ON L FILING ETURN DATE ADDR SS /' 2601 ARVIN! THE WHEATON MD 20902 SIGNATUU-RE OF E}?'fptVR_O E R ATIVE DATE /P ADDRESS 1007 MUMMA ROAD, SUITE 101 LEMOYNE PA 17043 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505610240 REV-1500 EX(FI) Decedents Social Security Number Decedent's Name. MARTHA J . WEIGEL RECAPITULATION 1. Real Estate(Schedule A) . . ... . ... . .. ... ... . .. . ... ... .. . . .. . 2. Stocks and Bonds(Schedule 8) . . . . . . . . . . . . . .. .. . . . . .. . . . . . .. . . 2. 3- Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) 3. 4. Mortgages and Notes Receivable(Schedule D) . . . .. ... . . . . .. ... . . . . ... . . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E), 5, 1 1 3 ? 2 9 5 6. Jointly Owned Property(Schedule F) F-1 Separate Billing Requested 6, 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) Ej Separate Billing Requested T 8. Total Gross Assets(total Lines I through 7) . . . . . .. . . . . . . . ... .. . . . 8. 1 1 3 ? 2 9 5 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . 9. 1 6 7 2 4 2 8 10- Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .... . . . 10. 3 3 ? 5 . 0 0 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . 11. 2 0 11 9 9 . 2 8 12. Net Value of Estate(Line 8 minus Line 11) .. ... . .. . .. . ... . .. ... . . .. . .. 12. - 8 7 2 6 . 3 3 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. - 8 7 2 6 3 3 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 11 11 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X.O 0 0 0 16, 0 . D 0 17 Amount of Line 14 taxable at sibling rate X.12 0 0 0 17, 0 . 0 0 I& Amount of Line 14 taxable at collateral rate X.15 0 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . .. . .. . . . . . . .. . . . . . . . . .. . . . . .. . ... . . . . .. . 19, 0 . 0 a 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 REV-1500 EX(Fl) Page 3 File Number Decedent's Complete Address: 21 14 olsz DECEDENT'S NAME MARTHA J. WEIGEL STREET ADDRESS 824 Lisburn Road,Apt 220 CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount 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. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 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 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred ...................................................................... ❑❑ 21 b. retain the right to designate who shall use the property transferred or its income. ............................... c. retain a reversionary interest ..................................................................................................... ❑ X❑ d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ I] 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? ......... ❑ I] 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑ x❑ 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)(1)). 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 172 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 lax 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 V2 P.S.§9116(a)(1)I. • 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. REV-1508 EX*(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: MARTHA J. WEIGEL 21 14 0182 Include the proceeds of litigation and the dale 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. Total Control Account-Account No.4051293897 2,506.95 Beneficiary: Estate 2. M&T Bank-Checking Account No. 89436202 8,866.00 TOTAL(Also enter on Line 5,Recapitulation) $ 11 372.95 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX-(08A3) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARTHA J. WEIGEL 21 14 0182 Decedent's debts must be reported on Schedule 1. - ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Musselman Funeral Home and Cremation Services 14,339.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City Stale ZIP Years)Commission Paid: 2. Attorney Fees: Butler Law Firm 1,950.00 3, Family Exemption:(If decedent's address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: includes additional probate of 515.00 148.50 { 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Cumberland Law Journal -Estate Advertising 75.00 8. The Sentinel -Estate Advertising 211.78 TOTAL(Also enter on Line 9,Recapitulation) $ 16,724.28 If more space is needed,use additional sheets of paper of the same Size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT DFREVENUE DEBTS OF DECEDENT, NHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARTHA J. WEIGEL 21 14 0182 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. Hospice of Central Pennsylvania 3,375.00 TOTAL(Also enter on Line 10,Recapitulation) $ 3,375.00 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARTHA J. WEIGEL 21 14 0182 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 outrightspousal distributions and transfers under Sec.9116(a)(1.2).] 1. Insolvent Estate Lineal ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE, II. NON-TAXABLE DISTRIBUTIONS: A,SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. Total Control Account® Account No. 4051293897 Statement Period From 10/01/12 To 12/31/12 Page 1 of 1 SH-094103-TCA1PG03 MARTHA WEIGEL Customer Service: (800) 638-7283 824 LISBURN RD APT 509 CAMP HILL PA 17011-7100 NO BENEFICIARY ON FILE The new year is here, and if you're thinking about making resolutions, you may want to consider going green in 2013. You can start with your Total Control Account, by signing up for eSERVICE if you haven't already, and electing to receive paperless statements and newsletters. You can help the environment, by having less paper printed. Whether you have your own personal computer, or your use one at your local public library or elsewhere, eSERVICE may be beneficial for you. You can begin the registration process by visiting www.eservice.metlife.com. By having access to eSERVICE, you can check your Total Control Account online, without having to wait for your statements to come in the mail. TCA SETTLEMENT OPTION EFFECTIVE ANNUAL YIELD 1.50% AS OF 12131112 Account Summary .............................................................................. Beginning Balaoe $2,497.75 nterest $9.20 . Ending Balance::: $2,506.95 Year Tn Date Interest $36.60 Year_T4 Date:Feieral TaxlNathheid $0.00 ........................................................................... _._..._...._....__._._......._._._......_ _...__. ..-. Transaction Details Trans Dater :i: Activity braft Rio U:escriptlon Amount ........................... _ 10/31 Interest $3.10 11/30 Interest $3.00 12/31 Interest $3.10 II III�II1 III3 I 8 ICI 7 I 0 I2 II M&TBarik PERIOD'........... 894362021 CLASSIC CHECKING DEC.04-JAN.03,2014 1 OF I 00 0 06123M NM 017 MARTHA J WEIGEL 824 LISBURN RD APT 220 CAMP HILL PA 17011 INTEREST EARNED FOR STATEMENT PERIOD 0.00 WEST SHORE PLAZA ACCOUNT SUMMARY BEG INN I'NG DEPOSITS & - ' :' OTHER CURRENT ENDING . .......... :I mst.Tri :CHECKS., PAID.. .. m& 1. SohtIONS NO. AMOUNT I NO. I AMOUNT- NO. AMOUNT 8,866.00 0 0.00 1 0 1 0.00 1 0 0.00 0.00 8,866.00 ACCOUNT ACTIVITY ! POST. DEPQqITSjjINTEk�R EKT CHECKS 4 OTHER ' . DAILY DATE i 'TRANSACTON ES AD ', *DTTIONS� :;�: SUSTPACTIONS'.1 12-04-13 BEGINNING BALANCE $8,866.00 ENDING BALANCE $8,666.00