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HomeMy WebLinkAbout07-23-14 J 1505611185 REV_1500 EX(02-1I)(FI) OFFICIAL USE ONLY PA Department ar Revenue Bureau County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN 21 09 0586 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 06102009 02241948 Decedent's Last Name Suffix Decedent's First Name MI LIPPART, SR . JAMES L (if Applicable) Enter Surviving Spouse's Information Below Spouse's Lost Name Suffix Spouse's First Name MI LIPPART DEBBIE L Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 180-48-9483 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW I. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death Prior t0 12-13-82) ❑ 4. Limited Estate ❑ 40. 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 ❑ 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 RE DIRECTED TO: Name - Daytime Telephone Number CRAIG A . HATCH, ESQ • 717-731-9600 REGISTER OF WILLS USE ONLY _ �t First Line of Addressp tJ 2109 MARKET STREET . i c Second Line of Address w w��:., C7, City or Post Office State ZIP Code DAB D CAMP HILL PA 17011 w Correspondent's e-mail address: C •HATCH@HHGLLP • COM Under penalties of perjury, 1 declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge end belief, it is true,correct and complete.Declaration of preparer other then the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR F9�t�NG R RN ...p DAT DEBBIE L • LIPPART t! 7� J .Y> >A_J- 77p 12-01 4y ADDRESS 115 SOUTH 1ST STREET LEMOYNE, PA 17043 SIGNATURE OF PREPARER OTHER THAN REPR NT .. DATE CRAIG A . MATCH , ESQ . /gyp/Zo/y ADDRESS 2109 MARKET STREET CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 �„� 1505611185 CM46473.000 1505611185 .� 1505611285 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name L I P P A R T CR JAMES L RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 $0 . 00 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2 $0 . 00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , " 3' $0 . 00 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . a. $0 . 00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . 5. $0 . 00 6. Jointly Owned Property(Schedule F) Separate Billing Requested $0 • 110 7. Inter-Vivos Transfers&Miscellaneous N . . . 6.on-Probate Property (Schedule G) 1:1 Separate Billing Requested . . . . 7. $0 • 00 8. Total Grass Assets(total Lines 1 through 7) , , , , , . $0 - 00 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9, $582 - 57 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) $0 - 00 11. Total Deductions(total Lines 9 and 10), . , . . . 11 $582 . 57 12. Net Value of Estate(Line 8 minus Line 11) . 12. ($582 . 57) 13. Charitable and Governmental Bequests/Sec 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. ($582 . -7) 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.o IL $0 . 00 15. $0 . 00 16. Amount of Line 14 taxable at lineal rate X.0 $0 . 00 16. $0 • 0 0 17. Amount of Line 14 taxable at sibling rate X.12 $0 . 00 n. $0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 $0 . 00 18. $0 • 00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. $0 . 00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 OM464e 3.000 REV-1500 EX(R) Page 3 File Number Decedent's Com IeteAddress: 21 04 OS86 DECEDENTS NAME LIPPART if S R • JAM STREET ADDRESS 115 SOL11H 1ST STRFFT CU R CITY STATE ZIP ,L EM YNE PA 1 043 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) $Q .011 2. Credits/Payments A. Prior Payments $n • nn B.Discount $ • p O Total Credits(A+B) (2) $O. 00 3. Interest (3) &n nn 4. If Line 2 is greater than Line I+Line 3,enter the difference.This Is the OVERPAYMENT. Fill in box 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. (6) $O ,nn 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 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? . E] El 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 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 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 172 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(x)(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. CM4871 2.000 REV-1508 EX-(M12) pennsylvania SCHEDULE E CERARTANCET REVENUE CASH, BANK DEPOSITS 8, MISC. RESIDENT DE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: James L. Lippart sr. 21 090586 Include the proceeds of litigation and the dale the proceeds were received by the estate. All proPeq jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. The decedent's spouse, Debbie L. Lippart, opened the Estate because she believed the decedent owned a bank account in his individual name. After the Estate was opened, inquiries were made and no accounts were discovered. $0.00 TOTAL(Also enter on line 5,Recapitulation) E $0.00 2W46AD 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1511 E%+( pe SCHEDULE H nnsylvania DEPARTMEWOF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDEWDECEDENT ESTATE OF FILE NUMBER James L. Lippart, Sr. 21 090586 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FLINERALEXPENSES: 1. None B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: $247.00 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Register of Wills filing fees $15.00 2 Cumberland Law Journal publication fee $75.00 Total from continuation schedules . . . . . . . . . $245.57 TOTAL(Also enter on Line 9,Recapitulation) S $582.57 3W46AG 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX-( SCHEDULE J Pennnsns ylvania DEPPRTMEW OF REVENUE BENEFICIARIES INHERITANCETAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: James L. Li art Sr. 21 090586 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 outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Debbie L. Lippert 115 South 1st Street Lemoyne, PA 17043 Surviving Spouse $0.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. [[ NON-TAXABLE DISTRIBUTIONS A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: r 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ $0.00 9W46AI 2.000 If more space is needed,use additional sheets of paper of the same size.