HomeMy WebLinkAbout10-07-14 J 1505610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
pennsylvania
PA Department of Revenue DEPAR7MENTOF REVENUE County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 � � I 1..� �q I„�
Harrisbur9,PA 17128-0601 RESIDENT DECEDENT I � �y
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_ ! �
10232011 01281936
DecedenYs Last Name Suffix DecedenYs First Name MI
HEFELFINGER R . FRED
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
HEFELFINGER SHIRLEY
Spouse's Social Security Number
� � — ��-� THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BEL
XQ 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Priorto 12-13-82)
Q 4. Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 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 BE�ECTED T0: � � �t
Name Daytime�@p�ne Numb'�T � n
ROBERT G. FREY 71724,�,5��, —c'-+ � �
-�- ..� r�
- _..
R�flISKER�WIL�USE b�1�L��
„. .." :' '
.._.. . ,. , q:� �
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First Line ofAddress �, �'� r";j � .�� "T�
- � : �, �- C7
5 S. HANOVER ST. � �.; rv ;-= �
Second Line ofAddress „ N � a
F—►
DATE FILED
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's e-mail address: R F R E Y a�F R E Y T I L E Y. C 0 M
Under penalties of perjury,I deGare 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.
SIGNAT RE OF SPONSIBLE FOR FILING RETURN DATE
t
ADDRESS
15 PLOVER STREET CAPE MAY NEW JERSEY 08204
SIGNAT�1 OF PRE AR f�T AN R SENTATIVE D E
€ �.�er' 'y z o/�
ADDRESS
5 SOUTH HANOVER STREET ARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15D5610105 1505610105 �
J 150561�205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYgNeme: R. FRED HEFELFINGER
RECAPITULATION
1. Real Estate(Schedule A). .. . . . .. . .. . .. . . . . .. .. .. .. . . .. .. .. . .. .. .. . . 1. � •��
2. Stocks and Bonds(Schedule B)... . .. . .. .. .. . . .. .. ... . . .. .. .. .. .. .. . 2. �• �0
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).. . 3. �• ��
4. Mortgages and Notes Receivable(Schedule D)... ... .. . .. .. .. .. .. . .. . . . 4. 0• 0�
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. .. . 5. �•��
6. Jointly Owned Property(Scheduie F) �Separate Billing Requested.. .. .. . 6. 8999.91
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) �Separate Billing Requested. . .. .. . 7, 0. �0
8. Tota1 Gross Assets(total�ines 1 throuQh 7). .. .. .... .. .. ... .. .. .. .. . .. 8. 8999.91
9. Funeral Expenses and Administrative Costs(Schedule H). ... ... .. .. .. ... . 9. � •��
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . . ... ...... .10. 0• 0�
11. Total Deductions(total Lines 9 and 10). . .. .. .. .. ... .. .. .. .. . .. .. .... 11. �•0�
12. Net Value of Estate(Line 8 minus Line 11). .. .. .. ... . . ... .. .. .. . .. .. .. 12. 8 9 9 9. 91
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J). . .. .. .. .. . .... .. .. . . . .13. 0 • 0 0
14. Net Value Subject to Tax(Line 12 minus Line 13).. .. .. .. .. . .. . .. .. .. .. 14. 8`J 9 9. 91
TAX CALCULATION-SEE INSTRUCTIONS FOR APPI.ICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate,or
transfers under Sec.9116
(a)(�.2)x.o 0 8999. 91 15. 0. 00
16. Amount of Line 14 taxable
at iineal rate x.0 4 5 16. 0.0 0
17. Amount of Line 14
taxable at sibling rate X . 12 17. 0 •�0
18. Amount of Line 14 taxable
at collateral rate X . 15 18. 0• ��
19. TAX DUE... .. .. . . . .. . . . .. . . . . .. . . . . .. .. .. .. . . . .. .. .... . . .. .. .. . . 19. 0.�0
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
DecedenYs Complete Address:
DECEDENT'S NAME
R. FRED HEFELFINGER
STREET ADDRESS
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. CreditslPayments
A.Prior Payments
B.Discount
Total Credits(A+g) (2) 0.00
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) 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 ......................................................................................... ❑ �
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?............. � �
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
[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 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 decedenYs 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 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+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE
JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
R. Fred and Shirley A Hefelfinqer
If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. Heirs of Mary Ann Hefelfinger and William Siblings
H. Hefelfinger
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 9/25/80 12.992 Acres, South Middleton Township, Cumberland County, 27,000.00 33.33% 8,999.91
Valuation based on assessment of$27,000. See attached 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 6, Recapitulation) $ g,gg9.91
If more space is needed,use additional sheets of paper of the same size.
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