HomeMy WebLinkAbout06-20-14 (2) J 1505610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
Pennsylvania
PA Department of Revenue DEPARW ENT OF REVENUE County Code Year File Number
Bureau Individual INHERITANCE TAX RETURN 2806
Bu BOX 280601
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01302014 07211921
Decedent's Last Name Suffix Decedent's First Name MI
DODD MARY A
(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 BOXES BELOW
0 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Prior to 12-13-82)
0 4. Limited Estate 0 4a. Future Interest Compromise(date of 0 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
[] 9. Litigation Proceeds Received Q 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)
1 ry
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTEDTO: s 7CII
Name Daytime Telephone Nrbmber �_ I o
ROBERT G. FREY 717243583 1 ^ z n a
N � m
REGISTER.OF WILLS USIlimiNNLY ;:-J I-)
C'7 n O
n{�
First Line of Address (.J CD T o C c'J
s — rn
5 SOUTH HANOVER STREE ? C—, Cnn C:I`
Second Line of Address O
DATE FILED
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's e-mail address: RFREY@FREYTILEY . COM
Under penalties of perjury,I dedare that I have examined thi urn, cl ing accompanying schedules and statements,and to the best of my knowledge and belief,
it is true correct and Comdata.Declaration of re aver of r n t ers wl representative is based on all information of which preparer has any knowledge,
SIG T OF PERB ONS R FILIN RE DATE
Iq LLu< �20 -2vY
ADDRESS
1571 ROCKLEDGE DRI E C RLISLE PA 17015 E
SIGNATUR F PREP R R THAN EPR ATIVE
ADDRES
5 SOUTH HANOVER STREET LISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 ��
J 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedents Name: MARY A DODD
RECAPITULATION
1. Real Estate(Schedule A). .. . . . . . .. ... .. . .. . .. . ... . .. .. . ... . ... . .. .. 1. 954725 . 00
2. Stocks and Bonds(Schedule B).. .. . .. . .. . .. ... . ... ... . . ... . .. . .. .. . 2. 116900. 00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . 3. 0• 00
4. Mortgages and Notes Receivable(Schedule D). . .. . . .... ... . . .. . . .. . .. . 4. 0 . 00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. ... 5. 119947. 67
6. Jointly Owned Property(Schedule F) =Separate Billing Requested . . .. . .. 6. o • 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) =Separate Billing Requested.. . .. . . 7, 29669 . 00
8 Total Gross Assets(total Lines 1 through 7) a 12 212 41 .67
9. Funeral Expenses and Administrative Costs(Schedule H)... . ... . ... . .. . .. 9. 1114 4 . 16
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . .. .. . .. . ..10. 5162. 78
11. Total Deductions(total Lines 9 and 10).. . ... . .. . ... ... . ... . .. . ... . .. 11. 16306. 94
12. Net Value of Estate(Line 8 minus Line 11). .. . .. . ... . .... . .. . ... . .. . .. 12. 1204934 . 73
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 Sublect to Tax(Line 12 minus Line 13) . 14. 1204934 . 73
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 0 15. 0 .00
16. Amount of Line 14 taxable
at lineal rate X 45 1204934 . 73 16. 54222. 06
17. Amount of Line 14
taxable at sibling rate x - 12 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X - 15 18. 0 . 0 0
19. TAX DUE. ... . . . . . . .. .. .. .. . . . .. .. . .. . .. . .. . ... ... . .... . .. . ... . .. 19. 54222. 06
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number 183-14-7259
Decedent's Complete Address: 21-14-0113
DECEDENTS NAME
MARYADODD
STREETADDRESS
1571 ROCKLEDGE DRIVE
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (i) 54222.06
2. Credits/Payments
A.Prior Payments 51500.00
B.Discount 2575.00
Total Credits(A+B) (2) 54075.00
3. Interest
(3)
4. If Line 2 is greater than Line 1 +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. (5) 147.06
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
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............................................................................................................................. ❑ El
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑
2. If death occurred after Dec. 12, 1982,did decedent transfer properly 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?............. ❑
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 172 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 disclosure of
assets and fling a lax return are still applicable even if the surviving spouse is the only beneficiary.
For dales 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[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.
3
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MaryADodd 21-14-0113
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that Is Jolntlyowned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. House and land, Rockledge Drive, South Middleton Township, Cumberland County 950,000.00
See appraisal attached.
2. Vacant land, Lycoming County. Assessment of 3750 x common level ratio of 1.26 4,725.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 954,725.00
If more space is needed,use additional sheets of paper of the same size.
�-0
REV-1503 EX-(8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary A Dodd 21-14-0113
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. See Publicly Traded Investments Addendum attached 116,900.00
TOTAL(Also enter on Line 2, Recapitulation) $ 116,900.00
If more space is needed,insert additional sheets of the same size
REV-1508 EX+(08-12) SCHEDULE E
Pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT TAX REVENUE
RETURN INHERITANCE TAX RET PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary A Dodd 21-14-0113
Include the proceeds of litigation and the date 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. Orrstown Bank checking account 404896 1,123.00
2. M&T Bank checking account 28725492 8,497.00
3. Bank of America Money Market account 00571365220 40,741.00
4. Bank of America certificate of Deposit 68100100563015 14,213.00
5. Bank of America certificate of Deposit 68100101835909 8,264.00
6. Bank of America certificate of Deposit 68100403450251 27,212.00
7. Bank of America certificate of Deposit 68100408399750 7,027.00
8. 1906-D$5 gold coin 350.00
9. Bank of America credit balance refund 20.67
10. Toyota Camry 12,500.00
TOTAL(Also enter on line 5, Recapitulation) $ 119,947.67
If more space is needed,use additional sheets of paper of the same size.
W
REV-1510 EX-(08-09) SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary A Dodd 21-14-0113
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
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO OECEDENTAND DATE OF DEATH % DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAPPUCABLO VALUE
1. IRA mutual funds, see Addendum 29,669.00 100.00% 0.00 29,669.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL Also enter on Line 7 Recapitulation) $ 29 669.00
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
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Mary A Dodd 21-14-0113
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1. Ewing Brothers Funeral Home 4,286.00
2. Cumberland Valley Memorial Gardens 1,385.00
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.) 3,500.00
Claimant William H. Dodd, Jr. and Stephen A. Dodd
Street Address 1571 Rockledge Drive
city Carlisle state PA zip 17015
Relationship of Claimant to Decedent Sons
4. Probate Fees: 853.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Bank fees 43.50
8. Advertising fees to Cumberland Law Journal and the Sentinel 276.16
9. Appraisal fee to SW Barrett 800.00
TOTAL(Also enter on Line 9, Recapitulation) $ 11,144.16
If more space is needed, use additional sheets of paper of the same size.
T
REV-1512 EX-(12-121
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT,
RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Mary A Dodd - 21-14-0113
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.
TIAA CREF, return of automatic deposit after death 2,343.29
2. Pa. Department of Revenue, 2013 income tax balance owed 16.00
3. US Treasury, 2013 income tax balance owed 2,740.00
4. Bank ofAmerica, credit card payment 63.49
TOTAL(Also enter on Line 10,Recapitulation) $ 5,162.78
If more space is needed,insert additional sheets of the same size.
se
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary A Dodd 21-14-0113
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).]
William H. Dodd, Jr.
1 1575 Rockledge Drive, Carlisle, PA 17015 Son 40%
Stephen A. Dodd
2 1575 Rockledge Drive, Carlisle, PA 17015 Son 20%
Beverly L. Dougherty
3. 4535 Richmod Hill Drive, Murrell's Inlet, SC 29576 Daughter 20%
4.
David R. Dodd
5154 Lanten Hill Drive, Pittsburgh, PA 15236 Son 20%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,ASAPPROPRIATE.
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. $ 0.00
If more space is needed,use additional sheets of paper of the same size.