HomeMy WebLinkAbout06-23-14 � 1505610143
REV-1500 Ex`°2_„> �
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes �PARTMEHfOFREVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 14 t�'�(�
Harrisburg, PA 17128-0601 RESIDENT DECEDENT v t�
ENTER DECEDENT INFORMATION BELOW �
Social Security Number Date of Death Date of Birth
04 21 2014 05 25 1921
DecedenYs Last Name Suffix DecedenYs First Name MI
BENDER ROBERT F
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
BENDER FREDA K
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. Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a. Future Interest Compromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
� g Decedent Died Testate � �� qnacheCo aintained a Living Trust � 8. Tot81 Numbef of Safe D@ Sit Boxes
(Attach Copy of Will) py of Trust) PD
� 9. Litigation Proceeds Received � �p.spousal Povert Credit�(Date of Deatn � 11.Election to tax under Sec.9113(A)
between 12-31�31 and -1-95) (AttBCh Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX tNFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDWARD P SEEBER 717 53�., 3280 � �,
c= -�= -." r�
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REGISTER O�NM�LS USE�LY
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First Line of Address ' - � N ' "�
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SUITE C400 ` � � �`y
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Second Line of Address ' `�_'. `�� --�-
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555 GETTYSBURG PIKE ` _.i 'v ,'-- ��
DpCT�FILED !- �' Q
City or Post Office State ZIP Code �
MECHANICSBURG PA 17055
CorrespondenYs e-mail address: eps(aa�sdacom
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 knowledge.
SIGNATURE OF PERSON RE PONSIBLE FOR FILING RETURN DATE
��,�,��, ,a p, �r,� Thomas S. Bender � ���OI �L�
ADDRESS
32 Fieldcrest DrivedVlechanicsbur CPA 17050
SIGNATURE OF PREP ER HER THAN REPRESENTATIVE DATE
Edward P Seeber � �� �c�
ADDRESS
Suite -400❑555 Gettysburg PikedVlechanicsburg�A 17055
Side 1
L 1505610143 1505610143 �
� 1505610243
REV-1500 EX
DecedenYs Social Security Number
DecedenYsName: Ben(�e�� RObe1't F.
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.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 51 , 63 6. 33
7. Inter-Vivos Transfers&Miscellaneous I�nq Probate Property
(Schedule G) Lf Separate Billing Requested............ 7,
g. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 51 63 6. 33
r
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 3, 34 9. 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 3,3 4 9 . ��
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 48,287 . 33
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)............................................... �4. 4$ ,2 8 7 . 33
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 2 4 14 3 . 6 7 15. O . 0 0
(a)(1.2)X.00 �
16. Amount of Line 14 taxable 2 4 , 14 3 . 6 6 16. 1 , 0 8 6. 4 6
at lineal rate X .045
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� 0 8 6. 4 6
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 �
REV-1500 EX Page 3 File Number 21-14
Decedent's Complete Address:
DECEDENT'S NAME
Bender, Robert F.
STREET ADDRESS
32 Fieldcrest Drive
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 1,086.46
2. Credits/Payments
A. Prior Payments 1,032.14
B. Discount 54.32
Total Credits(A +B) (2) 1,086.46
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �q�
Check box on Page 2�ine 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) Q.OQ
Make Check Pa able 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 property transferred:............................................................................... � Q
b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑ ❑X
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ Q
2. If death occurred after Dec. 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?.................................................................................................................. ❑ ❑X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESdYOU 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 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 retum 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)j.
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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-1509 EX+�07-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bender, Robert F. 21-14
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Freda K. Bender 32 Fieldcrest Drive Spouse
Mechanicsburg, PA 17050
B. Thomas S. Bender 32 Fieldcrest Drivee Son
Mechanicsburg, PA 17050
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
NUMBER FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A, B 01/31/2000 Real estate located at 32 Fieldcrest Drive, 154,909.00 33.333% 51,636.33
Silver Spring Township,Cumberland County,
PA-owned as joint tenants with right of
survivorship with spouse and son-valued
per tax assessment*common level ratio/3
(159,700*.97=154,909
TOTAL(Also enter on Line 6, Recapitulation) 51,636.33
(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 F(Rev.01-10)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bender�2obert F. 21-14
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
q, FUNERAL EXPENSES:
Myers 8 Buhrig Funeral Home 8� Crematory-additional funeral services not
prepaid
1 i�34.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney°s Fees JSDC Law Offices 1�00.00
3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9CRecapitulation) 3G349.00
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
Bender, Robert F. 21-14
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Register of Wills,Cumberland County-filing fee for Return 15.00
H-B7 15.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bender, Robert F. 21-14
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
' distributions,and transfers
under Sec.9116 a 1.2
1 Freda K. Bender Spouse 50%of interest in 24,143.67
32 Fieldcrest Drive real estate
Mechanicsburg, PA 17050
2 Thomas S. Bender Son 50%of interest in 24,143.66
32 Fieldcrest Drive real estate
Mechanicsburg, PA 17050
Total 48,287.33
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)