The URL can be used to link to this page

Home My WebLink About08-08-14 1505611185 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN 21 14 094 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social,Security Numller Date of Death MMDDYYYV Date of Birth MMDDYYYY 04082014 11071927 Decedent's Last Name Suffix Decedent's First Name M I SMITH DUANE R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I SMITH JOANNE M Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES 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(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) 71 6. Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 0 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) a-: CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATt"SHOULD BE:QRECTED TOL7 Name Daytime Teleph0Mb(Ny amber _u-r-I C Fin C VICKY ANN TRIMMER 717-620rWidPO, REGISTEnMFULS USE07NLY =7' C C_> First Line of Address z 7)31 N rn PERSUN & HEIM, PC D — ` 0 Second Line of Address PO BOX 659 City or Post Office State ZIP Code DATE FILED MECHANICSBURG PA 170550659 CorrespondenVs e-mail address: VATRIMMEREIPERSUNHEIM - 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 O PERSON RESPONSIB,IL�E FOR.FILING RETURN DATE ADDRESS JOAN M - Sn I 680 WILLOW WAY, MECHANICSBURG, PA 1 SIGNA RE PREP E OTHER THAN REPRESENTATIVE - r DAT ADDRESS VICKY ANN TRIMMER PO BOX 659, MECHANICSBURG, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 1505611185 OM6647 3.000 V� 1505611285 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name, SMITH DL1 AN F R 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), , , , , g 0 •00 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , q 0 • 00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5_ 0 • 00 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested , , , , 6. 0 • 00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . 7. 272,939 - 00 8. Total Gross Assets(total Lines 1 through 7) , , , , , , , , , , , , , , , , , , 8 2721939 • 00 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. 0 . 00 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) , , , , , , , . . 10. 0 • 00 11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , 11 0 • 00 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . 12 272,939 . 00 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. 2721939 • 00 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.00 272,939 . 00 15. 0 .00 16. Amount of Line 14 taxable at lineal rate X.0 45 0 .00 16. 0 . 00 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. 0 .00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505611285 1505611285 OM4646 3.000 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 14 DECEDENT'S NAME STREET ADDRESS CUMBERLAND CITY STATE ZIP IMECHANICSBURG PA 17110364" Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0 . 110 2. Credits/Payments A. Prior Payments 0 .00 B.Discount 0 . 0 Q Total Credits(A+8) (2) 0 . 00 3. Interest (3) 0 . 00 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) 0 . 00 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 . . . . . . . . . . . . . . . . . . . . . . . . ❑ FRI b. retain the right to designate who shall use the property transferred or Its income . . . . . . . . . . ❑ ❑X 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 El 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? . . Q ❑ 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 lax 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)(it)).The statute does not exempt a transfer to a surviving spouse from lax,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 lax 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. OM4671 2.000 REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE DECEDENT URN MISC. NON-PROBATE PROPERTY INHERITANCE MDE TAX RE ESTATE OF FILE NUMBER Duane R. Smith 21 14 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 'NIXET .EOFTIETRWSrEREE.T�1a aELATionswe TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBE T�anrE OFTwasFEa AnncNACOavoF TnE DEED FOn aEAi ESTATe. VALUE OF ASSET INTEREST iFnr CABUE VALUE 1. American Funds IRA 272,939 100.0000 0 272,939 Joanne M. Smith, Spouse is beneficiary TOTAL(Also enter on line 7,Recapitulation)$ 272,939 If more space is needed,use additional sheets of paper ofthe same size. 9W46AF 2.000 REV-1573 EX+(01-10) pennsylvania • SCHEDULE J DEPARTMEM OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENTDECEDENT ESTATE OF: . . , Duane R. Smith FILE NUMBER: 21 14 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. Joanne M. Smith 680 Willow Way Mechanicsburg, PA 17055 . American Funds IRA Inventory Value: 272,939 Surviving Spouse 272,939 ENTER DOLLARAMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,M 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. $ 0 9W46Ai 2.000 If more space is needed, use additional sheets of paper of the same size. .1 American Funds-Historical Account Balance Page I of I Historical account balance Retum to Your Portfolio View the historical balance for a different date: j { To view your historical balances,enter a specific date or select a quarter-end period using the drop-down f menu and click Submit. y t� mm / dd/ VM OR I Select a gUaWe-r-end period: v _. As of April 08, 2014 Total value* $272,939.43 Non-retirement accounts: $0.00 Retirement accounts: $272,939.43 Retirement accountb° CBBT OUST IRAIROLLOVER Account: 68112989 DUANE R SMITWOEC'D Fund Name Shares NAV Market Value April 08,2014 April 06, 2014 April 08,2014 AMERICAN BALANCED FUND - A (11) 3,621.715 $24.47 $88,623.37 AMERICAN MUTUAL FUND- A (03) 2,593.398 $34.99 $90,743.00 FUNDAMENTAL INVESTORS - A (10) 1,244.053 $50.42 $63,347.18 THE GROWTH FUND OF AMERICA - A (05) 707.866 $42.70 $30,225.88 Account Total: $272,939.43 As of April 08, 2014 Total value: $272,939.43 Non_retirement accounts: $0.00 ; Retirement accounts. $272,939.43 Coovda Q 2014 American Funds Dlshibutors,Inc. PRIVACY 1 z=lio agreement I Business connnultY I Contact us https://accounts.ameriewifunds.com/tf/FANWeb 5112/2014 View Portfolio Ben'eficiarfes Page] of] AMERICAN FUNDS6 ,FromCaOWGMW Benefioari:es Irrio''dawit'Benetciary Designation Information .AEcountName Value .Accountiype :68112989'CB&TCUSTIRA/ROLLOVER 50400, Retilemerit 'DUANE�R St�iITHtl�EC'D value as 6f'd$/09%20i 4. i Benefitiary,'Informailon HOW io update l RA!accouni,6eneficiary;inforrnation Primary 1 Complete the IRA Benefi iaryChange Form l Designation date;UB%04/200b 2' Have your client sign-and return tNe.forrh to an American`F.unds seruice ccfi_ ter:_ DEFAULT IN THE AGREEMENt, IRA f3engfidaty'Ch.6 Forin, SPQUS&!;HILDRErg - + _ - 6RAN6CHILDREN: OR ESTATE;AS APPLICABLE; ', DOWNLOAD(PDF) Contingem Notprovided i i f COD4dOht 0:2014,Arrencan Funds Distributors;dnc.All Rights'Reserved-. htt"s:/%www.ame"ricanfurids.co'in/advsor7accouritslclieriUpoit{olio P ltiedeficiaries.httn 511014 . Persun & Heim, P.C. Attorneys at Law LLOYD R.PERSUN IRS NO. 26-3786257 GARY J.HEIM 1700 Bent Creek Boulevard JACK M.HARTMAN Suite 160 MATTHEW E.HAMLIN' Mechanicsburg,PA 17050 VICKY ANN TRIMMER** JENNIFER DENCHAK WETZEL Please reply to: (717)620-2440 PO Box 659 - FAX;(717)620-2442 Mechanicsburg,PA 17055-0659 *ALSO NEW YORK BAR **ALSO A CPA HTYP://W Ww.pERSUNHEIM.COM vatrimmer @persunbeim.com August 7, 2014 Cumberland County Register of Wills 1 Courthouse Square, Room 102 Carlisle, PA 17013-3387 Re: Duane R. Smith, Deceased Enclosed for filing are the following: I. Original and one copy of a Pennsylvania Inheritance Tax Return, along with a copy of the first page of the tax return to be time-stamped and returned; 2. A check in the amount of$15.00 to cover the filing fee; and 3. A self-addressed, postage prepaid envelope for return mail. Please return a date-stamped copy of cover page of the tax return to my attention in the enclosed envelope. Please do not hesitate to call with any questions. Thank you for your assistance. Sincerely yours, * �Amw Lao V Vicky�rimmer I AT:kaa c _ � Enclosures t a' Jj 3 rn C D CD n O 39974vl I P _ i Q l cr a C 0 O n a w O pj ' p w C w D y o M � o co Vooa { ysx , N z m 0 N ., z = � p oCC a N c O x N N O C cn u m 37 A _i!al � PR��-- C Cp ""• J D C �oo O N T N V N ()�Qa Op ��