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HomeMy WebLinkAbout08-19-14 REV-1500 EX(02-11) rr 1505610143 OFFICIAL USE ONLY Department of Revenue pennsy lvania County code Year File Numbar Bureau of Individual Taxes of°^a,wEe*or aaysaua PO 60X.280601 INHERITANCE TAX RETURN 21 14 0124 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 01 14 2014 08 05 1914 Decedent's Last Name Suffix Decedent's First Name MI FRANKLIN SARAH E (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 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) 5 Decedent Died Testate y Decedenpt Maintained a Living Trust 1 8. Total Number Of Safe De 0511 Boxes (Attach Copy of Will ❑ (Attach Gopyof Trust) P ❑ 9. Litigation Proceeds Received ❑ 10.Spousal PovertY creditl(Date of Death lween 12-31-Y land ❑ 11,Election to tax under Sec.9113(-8) b2 -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 JOHN B FOWLER III (717) 243 3341 REGISTER OF WILLS USE ONLY First Line of Address (-) 10 EAST HIGH STREETZ�' rt Second Line of Address- c0 i✓ �Cn City or Post Office DAT ^ED — =_ m State ZIP Code -p " �n CARLISLE PA CD O ca Correspondent's e-mail address: ifowler(cbmartsonlaw.com 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 PDNSIBL OR FILING RETURN DATE Pe-, �A- Roy M. Franklin ADD SS 212 Springlilield Road Newvi a PA 17241 ?SIGNR REPARERO R THANR SENTATIVE DATE John B. Fowler III gh Street, Carlisle, PA 17013 1505610143 Side 1 1505610143 J r(rn PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 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#2 Name M r'or E.Tarner Address1 462 West Main Street Address2 City, State,Zip Walnut Bottom, PA 17266 Date Signature#3 Name Harry C.Franklin c'QO�► Address1 600 Mountain Road Address2 City, State,Zip Boiling Springs,PA 17007 Date J 1505610243 REV-1500 EX Decedent's Social Security Number Deoedenrs Name: Franklin, Sarah E. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 109, 707 . 00 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. 35 , 887 . 84 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 2 , 500 . 94 7. Inter-Vivos Transfers&Miscellaneous h{oq-Probate Property (Schedule G) LJ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8, 148 , 095 . 78 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 19 ,229 . 61 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 1,246 . 08 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 20 , 475 . 69 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 127 , 620 . 09 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. 127 , 620 . 09 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 15 0 . 00 (a)(1.2)X.00 16. AmountX .0 45 taxable rate at lineal rate e X .0 127 , 620 . 09 16. 5 , 742 . 90 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 5 , 742 . 90 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-14-0124 Decedent's Complete Address: DECEDENT'S NAME Franklin, Sarah E. STREET ADDRESS 153 East Main Street CITY STATE ZIP Walnut Bottom PA 17266 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 5,742.90 2. Credits/Payments A. Prior Payments 5,000.00 B. Discount 263.16 Total Credits(A +B) (2) 5,263.16 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 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) 479.74 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;............................................................................... ❑ ❑x 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?............................................................ ❑ ❑x 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?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. ❑ ❑ IF THE ANSWERTO 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 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 lax,and the statutory requirements for disclosure of assets and fling 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 172 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. Rev-0502 EX.(0110) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 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 jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's Interest If owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Residence-Real estate located at 153 East Main Street,South Newton Township, 109,707.00 Cumberland County,PA,known as Tax Parcel No.41-31-2230-061, being described in that certain Deed dated September 21, 1989,and recorded in Deed Book E,Volume 34, page 378, and being conveyed to Sarah E. Franklin. Value is assessed value times the common level ratio(0.97),see attached. TOTAL(Also enter on Line 1, Recapitulation) 109,707.00 (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 A(Rev.01-10) Rev-1SD8 EX.(11-1 e) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Orrstown Bank Certificate of Deposit No.4000025869-Date of death value 51000.81 Accrued interest on Item 1 through date of death 6.37 2 Orrstown Bank Certificate of Deposit No.4000034452-Date of death value 5,005.03 Accrued interest on Item 2 through date of death 0.86 3 Orrstown Bank Certificate of Deposit No.4000038978-Date of death value 17,611.18 Accrued interest on Item 3 through date of death 18.33 4 Orrstown Bank Checking Account No.627518-Date of death value 2,419.96 Accrued interest on Item 4 through date of death 0.00 5 Orrstown Bank Savings Account No. 36734-Date of death value 3,850.08 Accrued interest on Item 5 through date of death 0,22 6 Miscellaneous household items and personal property 1,000.00 7 PA Department of Revenue-Property tax rebate for 2013 975.00 TOTAL(Also enter on Line 5, Recapitulation) 35,887.84 (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 E(Rev. 11-10) REV-1511 EX.(10,09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Franklin Sarah E. 21-14-0124 Decedent's debts must be reported on Schedule 1, ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 10,806.40 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zin Year(s)Commission Paid Waived 2. Attorney's Fees Martson Law Offices 7,665.00 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 348.50 5. Accountant's Fees 6. Tax Return Preparers Fees T Other Administrative Costs 40911 See continuation schedule(s) attached TOTAL(Also enter on line 9,Recapitulation) 19,229.61 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 Franklin, Sarah E. 21-14-0124 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Fogelsanger-Bricker Funeral Home,Inc.-Funeral expenses 10.206.40 2 Newville Cemetery Association-Grave digging service 600.00 H-A 10,806.40 Other Administrative Costs 3 Landex-Title search 0.36 4 Reserve for additional filing fees, releases,accounting,distribution and miscellaneous costs 385.00 and expenses 5 United States Postal Service-Certified mail delivery of Notice to PA Department of Revenue 6.48 regarding Safe Deposit Box Inventory 6 United States Postal Service-Postage to return rescue alert device 17.87 H-137 409.71 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX.(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 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 Chambersburg Imaging Associates, P.C. -Medical bill,account payable 194.00 2 Fayetteville Fire-Outstanding check#1537 payable from Orrstown Bank Checking Account 302.00 No. 627518,posted after date of death 3 Guardian Long Term Care Pharmacy, Inc. -Pharmacy bill,account payable 26.05 4 Robert E.Sheep, M.D., F.A.C.S. -Medical bill,account payable 124.32 5 Roy M.Franklin-Reimbursement for paying decedent's bill for Kough's Oil Service, account 599.71 payable TOTAL(Also enter on Line 10, Recapitulation) 1,246.08 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) Rev-1509 EX.(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 If an asset was made Joint within one yearof the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Marjorie E.Tarner 462 West Main Street Daughter Walnut Bottom, PA 17266 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT %OF VALUE OF ITEM FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH DECEDENT'S INTEREST NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST 1 A 04/24/2009 Orrstown Bank Certificate of Deposit- 5,001.87 50.000% 2,500.94 Account No.4000032790($5,000.00+$1.87 accrued interest),see attached. TOTAL(Also enter on Line 6, Recapitulation) 2,500.94 (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-1513 EX.(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin, Sarah E. 21-14-0124 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT Do Not L151 s (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.91 16 a 1.2 Harry C. Franklin Son One-third of 42,540.03 600 Mountain Road estate Boiling Springs, PA 17007 Roy M. Franklin Son One-third of 42,540.03 212 Springfield Road estate Newville, PA 17241 Marjorie E. Tanner Daughter One-third of 42,540.03 462 West Main Street estate Walnut Bottom, PA 17266 Total 127,620.09 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet,as appropr iate. 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)