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HomeMy WebLinkAbout06-13-14 RE V-1-1 5V V EX (02-11)(Ft) 1505610140 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 2 0 2 Harrabum PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 1 1 8 2 0 1 4 0 8 2 4 1 9 6 2 Decedent's Last Name Suffix Decedent's First Name MI B U C K B E E J R R 0 B E R T B (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 © I.Original Return 2.Supplemental Return 3.Remainder Return(Date of Death Prior to 12-13-82) 4.Limited Estate E3 4a.Future Interest Compromise(date of El 5.Federal Estate Tax Return Required t-� death after 12.12-82) LJ 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 C] 10.Spousal Poverty Credit(Date of Death 0 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 M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 0 REGISTE OF WILLS USEMYLY c :�Zl rn First Line of Address = n Z (n c:, W A L T E R S & G A L L 4 W A Y P L L C r— ' ' _t ° K m w r1 m Second Line of Address ^�=' �-' J 5 4 E M A I N S T R E E T City or Post Office State ZIP Code . FILED -= M E C H A N I C S B U R G P A 1 7 0 5 5 w � Correspondent's e-mail address: murrel(a)waltersgialloway.com Under penalties of perl'ury,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. SIG� R N REF 41LNG RETURN DAjrE ADDRESS 1 ROBERT B B C E S , 117 E MAPLEWOOD MECHANICSBURG PA 17055 SIGNATURE O A ER HAN REPRESENTATIVE DATE ADDRESS MURREL WXLTIERI �t I, 54 E• MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 Continuation of REV-1500 Inheritance Tax Return Resident Decedent ROBERT B.BUCKBEE,JR 21 14 0202 Decedents Name Page 2 File Number Correspondents Name Daytime Telephone Number M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 0 First line of address W A L T E R S & G A L L O W A Y P L L C Second line of address 5 4 E - M A I N S T R E E T City or Post Office State ZIP Code M E C H A N I C S B U R G P A 1 7 0 5 5 Correspondents e-mail address:m u r r e 10@ w a l t;e r s g a 11 o as V-C o m Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowedge and belief, it is true,coned and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. siGNA OF PEf}SON R BIESOR FILINGJ2ET)1RN Y"1-2e A R E S S SHIRLEY BUCKBEE 117 E MAPLEWOOD AVE MECHANICSBURG PA 17055 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: ROBERT B. BUCKBEE, JR RECAPITULATION 1, Real Estate(Schedule A) ................................... ........ 1- 2. Stocks and Bonds(Schedule B) . . .. . ... . . . . . .. .. . . . . ..... . .. . . ... . . . . 2. 1 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 Prop" 3 8 5 3 5 . 0 3 po {Schedule E}....... 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . .... 6. 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) b Separate Billing Requested ....... 7. 2 4 5 8 0 . 2 7 8. Total Gross Assets(total Lines 1 through 7) . .. . .. . .. . .. . .... .. . ....... 8. 6 3 1 1 5 . 3 0 9. Funeral Expenses and Administrative Costs(Schedule H) ... .. . . .... .. . .... 9. 1 1 7 0 3 . 6 4 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ..... .... .... 10. 1 5 6 1 0 . 4 2 it. Total Deductions(total Lines 9 and 10) ..... . . .. ...... . ........ ....... 11. 2 7 3 1 4 . 0 6 12. Net Value of Estate(Line 8 minus Line 11) .................. .......... 12. 3 5 8 0 1 . 2 4 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(Une 12 minus Line 13) ........ .............. 14. 3 5 8 0 1 . 2 4 TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (ax1.2)X.0 ^ 0 . 0 0 15, 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x.045 3 5 8 0 1 . 2 4 16. 1 6 1 1 . 0 6 17. Amount of Line 14 taxable at sibling rate X 12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18, 0 . 0 0 19. TAX DUE .. . ............_..................................... 19. 1 6 1 1 • 0 6 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 0202 DECEDENTS NAME ROBERT B. BUCKBEE JR STREET ADDRESS 117 E. MAPLEWOOD AVENUE CRY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,line 19) (1) 1,611.06 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) 1,611.06 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 El 191 a. retain the use or income of the property transferred ................................................................... El b. retain the right to designate who shall use the property transferred or its income ............................ c. retain a reversionary interest ..................................................................................................... El d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 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? ......... ❑ ❑X 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 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 disdosure 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 V2 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. _ 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: ROBERT B. BUCKBEE,JR 21 14 0202 Include the proceeds of litigation and the date the proceeds were received by the estate. All propertyjointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS 1 ST FEDERAL CREDIT UNION 35,997.53 CHECKING 2. MEMBERS 1ST FEDERAL CREDIT UNION 37.50 SAVINGS 3. 2002 DODGE GRAND CARAVAN 2,500.00 NET SALE PRICE TOTAL(Also enter on Line 5,Recapitulation) $ 38 535.03 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ROBERT B. BUCKBEE,JR 21 14 0202 This schedule must be completed and fled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THOR RELATIONSHIPTO DECEDENT AND DATE OF DEATH % DECUS EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH ACOPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST OF NTUCAME) VALUE 1. MEMBERS 1ST FEDERAL CREDIT UNION 27,580.27 100.00 3,000.00 24,580.27 BENEFICIARIES ROBERT B. BUCKBEE, SR. FATHER-50% SHIRLEY B. BUCKBEE MOTHER-50% TOTAL (Also enter on Line 7,Recapitulation E 24 580.27 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX-(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ROBERT B. BUCKBEE, JR 21 14 0202 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. HOLLINGER FUNERAL HOME, MT. HOLLY SPRINGS, PA 3,997.20 2. PASTOR-NAOMISEESECARRIKER 100.00 3. ORGANIST-SUSAN NIEDSWICKI 50.00 4. LUNCHEON-ST. PETER LUTHERAN CHURCH-MECHANICSBURG, PA 500.00 5. FLOWERS-ROYERS 37.94 6. SERVICE-ST. PETER LUTHERAN CHURCH- MECHANICSBURG, PA 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) ROBERT B. BUCKBEE, SR Street Address 117 E. MAPLEWOOD AVENUE City MECHANICSBURG State PA zip 17055 Year(s)Commission Paid: (RENOUNCED) 2, Attorney Fees: MURREL R.WALTERS, III 3,200.00 3, Family Exemption:(If decedent's address is not the same as claimants,attach explanation.) 3,500.00 Claimant ROBERT B. BUCKBEE, SR. Street Address 117 E. MAPLEWOOD AVENUE City MECHANICSBURG State PA ZIP 17055 Relationship of Claimant to Decedent FATHER 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 218.50 6 Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9,Recapitulation) 8 11 703.64 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ROBERT B. BUCKBEE, JR 21 14 0202 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses &Administrative Costs-B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative Commissions: 2. Name(s)of Personal Representative(s) SHIRLEY B. BUCKBEE Street Address 117 E. MAPLEWOOD AVENUE City MECHANICSBURG State PA ZIP 17055 Year(s)Commission Paid: (RENOUNCED) SUBTOTAL SCHEDULE H-B1 REV-1512 EX.(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER ROBERT B. BUCKBEE. JR 21 14 0202 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. WEST SHORE EMS 1,799.84 AMBULANCE 2. QUANTUM IMAGING 844.00 MEDICAL 3. HOLY SPIRIT HOSPITAL 9,422.54 MEDICAL 4. CAPITAL CARDIOVASCULAR ASSOCIATES 55.00 MEDICAL 5. PA GASTROENTEROLOGY CONSULTANTS 290.00 MEDICAL 6. CENTER FOR KIDNEY DISEASE& HYPERTENSION 405.24 MEDICAL 7. SPIRIT PHYSICIANS SERVICES, INC. 1,082.00 MEDICAL 8. CAMP HILL EMERGENCY PHYSICIANS 1,460.00 MEDICAL 9. VERIZON 76.92 TELEPHONE 10. UNCLE BOB'S 174.88 STORAGE TOTAL(Also enter on Line 10,Recapitulation) $ 15 610.42 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: ROBERT B. BUCKBEE JR 21 14 0202 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. EMILY B. BUCKBEE Lineal 210 E.WALNUT STREET SHIREMANSTOWN, PA 17011 2. GARRETT J. BUCKBEE, a minor Lineal 210 E.WALNUT STREET SHIREMANSTOWN, PA 17011 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.