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Home My WebLink About10-14-14 (2) � 1505611185 REV-1500 EX(02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po eox zsoso� INHERITANCE TAX RETURN 21 14 0303 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY D8t@ Of Blfth MMDDYYYY 159-38-9627 011D2014 10311953 DecedenYs Last Name Suffix DecedenYs First Name M I NEUSBAUM ALAN T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I NEUSBAUM NANCY E Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW � 1. Originai 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) � 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 ❑ 1 1. 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 DIRECTED TO: Name Daytime Telephone Number ,-.,,,, �_� JEFFREY A - ERNICO , ESQ • 717-232-5�0 � �^� rn :: Q c� �'ic> REGISTEROF�YL1 L'$j1SEONL� r—� � �' ;_i, f,� .�-� �. ..._ 4_::7 � ,� "�� First Line of Address - � . ��_'., c�� 3401 N • FRONT STREET ��:� ; � �..' �ri Second Line of Address � � W E"' � . ' � {�i �. y�r PO BOX 5950 � '� �' �'' City or Post Office State ZIP Code DATE FILED � � HARRISBURG PA 171100950 CorrespondenYs e-mail address: J A E R N I C O a�M E T T E - C 0 M 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 RESPONSIBLE FOR F RETURN AT NANCY E • NEUSBAUM �. 0 ADDRESS 1115 MUSKET LANE MECHANICSBURG, PA ],7050 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIV � D E METTE, EVANS & WOODSIDE �� G�� ADDRESS 34�1 N FRONT STREET PO BO 5950 HARRISBURG PA 17110-0950 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505611185 OM46473000 1505611185 � .\ \ 1 1505611285 J REV-1500 EX(FI) DecedenYs Social Security Number Decedent'sName NEUSBAUM ALAN T 159-38-9627 RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . � � • �� 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2 � - Q Q 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , 3. 111,0 3 3 • 3 3 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , q. � - �� 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5. � - �� 6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , _ , g. � - 0� 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested . . . . 7. 7],4 ,12 4 • 8 0 8. Total Gross Assets(total Lines 1 through 7) , , , , , , , , , , , , , , , , , , g 825,158 • 13 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. 2 5,6 7 8 - 5� 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , . . . 10. 9,917 • �5 1 1. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , ��. 3 S,5 9 5 • 5 5 12. Net Vatue of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , , , �2. 7 8 9,5 6 2 • 5 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3. � - Q Q 14. Net Value Subject to Tax(Line 12 minus Line 13) , , , , , , , , , , , , , , , �q. 789,562 • 58 TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(�.z)x.o� 714 ,12 4 - 80 15. O • 00 16. Amount of Line 14 taxabte at�inea�ratex.o�5 75,437 • 78 �s. 3,394 - 7� 17. Amount of Line 14 taxable at sibling rate X.12 D • D 0 ��. 0 • 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 • �� 18. � • �0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3,3 9 4 • �� 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ $IC�@ 2 � 15�5611285 1505611285 � OM4648 3.000 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 14 0 3 0 3 DECEDENTS NAME NEUSBAUf1 ALAN T STREET ADDRESS CUf1BERLAND COUNTY CITY STATE ZiP f1ECHANICSBURG PA 17050 Tax Payments and Credits: 1 Tax Due(Page 2, �ine 19) (1) 3�3 9 4 • 7� 2 Credits/Payments A. Prior Payments � • �� B. Discount � • �� Total Credits(A+g) (2) � • 0� 3. Interest (3) � • 0� 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 5. If Line 1 + Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3�3 9 4 - 7� 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 consideration7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ 0 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.g9116(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 2A00 �`=�-,5°'Ex'`9_,z, SCHEDULE C pennsylvania CLOSELY-HELD CORPORATION, DEPARTMENTOF REVENUE INHERITANCETAX RETURN PARTNERSHIP OR RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Alan T Neusbaum 21140303 Schedule C-1 or C-2 (including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH � An undivided 2/3 interest in North Development Company, a Pennsylvania general partnership 111,033.33 The valuation of the decedent's partnership interest is based upon the following: Real Estate: The partnership owns a rental property located in the Borough of Carlisle, Cumberland County, Pennsylvania, known as 344 E. North Street; TPN 02-21-0318-133. The assessed value of the property is $148,200; multiplied by the applicable Common Level Ratio factor of 0.97, the fair market value is $143,754. The decedent's interest is 2/3, or $95,836. Cash: As of 12/31/2013, the total cash held by the partnership was $27,796. The decedent's interest is 2/3, or $15,197.33. The total value of the decedent's partnership interest is $95,836 + $15,197.33 = $111,03.33 See copies of attached 2013 Form 1065 and partnership agreement, as amended TOTAL(Also enter on line 3,Recapitulation) $ 111,033.33 - (If more space is needed,insert additional sheets of the same size) zwass�2 000 HE�,5°6 Ex'"z_,,, SCHEDULE C-2 pennsylvania DEPARTMENTOF REVENUE PARTNERSHIP INHERITANCE TAX RETURN INFORMATION REPORT RESIDENT DECEDENT ESTATE OF FILE NUMBER Alan T Neusbaum 21 14 0303 1. Name of Partnership NORTH DEVELOPMENT COMPANY Date Business Commenced 2/15/1984 Address 1116 GUNSTOCK LANE Business Reporting Year 12/3�f 2013 City MECHANICSBURG State PA Zip Code 17050 2. Federal Employer ID Number23-2290488 3. Type of BusinessREAL ESTATE Product/Service RENTALS 4. Decedent was a � General ❑ Limited partner. If decedent was a limited partner, provide initial investment $ 0.00 5 PARTNER NAME PERCENT PERCENT BALANCE OF OF INCOME OF OWNERSHIP CAPITAL ACCOUNT A. ALAN T. NEUSBAUM 67.0000 67.0000 27 560.00 B. JAMES E. DONNELLY 33.0000 33.0000 19 404.00 C. D. 6. Value of the decedenYs interest $ 111,033.33 7. Was the partnership indebted to the decedent?, , , , , , , , , , , , , , , , , , , , , , ❑ Yes � No If yes, provide amount of indebtedness $ 0.00 8. Was there life insurance payable to the partnership upon the death of the decedent? . ❑ Yes � No If yes, Cash Surrender Value$ 0.00 Net proceeds payable $ 0.00 Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? ❑ Yes �X No Ifyes, ❑ Transfer ❑ Sale Percentage transferred/sold 0.0000 Transferee or Purchaser Consideration $ 0.00 Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedenYs death? , , , , , , X� Yes ❑ No If yes, provide a copy of the agreement. 1 1. Was the decedenYs partnership interest sold?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ Yes ❑X No If yes, provide a copy of the agreement of sale,etc. 12. Was the partnership dissolved or liquidated after the decedenYs death?. . . . . . . . . . . . . . . . ❑ Yes � No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners?. . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ Yes � No If yes, explain 14. Did the partnership have an interest in other corporations or partnerships? . . . . . . . . . . . . . . ❑ Yes � No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE A. Detailed calculations used in the valuation of the decedenYs partnership interest. B. Complete copies of financial statements or federal partnership income tax returns(Form 1065)for the year of death and four preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market valuels. If real estate appraisals have been secured,attach copies. D. Any other information relating to the valuation of the decedenYs partnership interest. iwnsss 2 000 REV-1510EX+(OS-09) SCHEDULE G pennsylvania DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Alan T Neusbaum 21 14 0303 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 EXCLUSION TAXABLE ITEM iniaweTr�nw,nEOFT�Tr�nrrsFeReE.rHeiRRevnonrs�arooeceoeivrnr� DATEOFDEATH %OFDECD'S NUMBE TFEDATEOFTRNSFFRATTACHACOPVOFTHEDEEDFORREALESTATE VALUEOFASSET INTEREST IFAPPLICABLE VALUE � IRA, Merrill Lynch Account #872-79363 201,794.95 100.0000 0.00 201,794.95 Beneficiary was Nancy E. Neusbaum. See attached for itemization of assets and valuation. 2 IRA, Merrill Lynch Account #872-78681 204,335.34 100.0000 0.00 204,335.34 Beneficiary was Nancy E. Neusbaum. See attached for itemization of assets and valuation. 3 IRA, Merrill Lynch Account #872-74335 307,994.51 100.0000 0.00 307,994.51 Beneficiary was Nancy E. Neusbaum. See attached for itemization of assets and valuation TOTAI.(Also enter on line 7, Recapitulation)$ 714,124.80 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2A00 F�E_�,5„Ex.(OB-13) SCHEDULE H pennsylvania DEPARTMENTOF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Alan T Neusbaum 21 14 0303 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: � Hollinger Funeral Home & Crematory 5,300.00 2 Grave marker 3,855.00 Total from continuation schedules . . . . . . . . . 2,400.00 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: 10,0 0 0.0 0 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation.) 3,500.00 Claimant NANCY E. NEUSBAUM Street Address 1115 MUSKET LANE City MECAANICSBURG State PA ZIP 17050 Relationship of Claimant to Decedent SURVIVING SPOUSE 4. Probate Fees: 3 4 8.5 0 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Cumberland Law Journal Legal advertisement 75.00 2 The Patriot News Legal advertisement 200.00 TOTAL(Also enter on Line 9,Recapitulation) $ 2 5,67 8.5 0 sw4snc z o0o If more space is needed, use additional sheets of paper of the same size. Estate of: Alan T Neusbaum 21 14 0303 Schedule H Part 1 (Page 2) ztem No. Description Amount 3 Burial plot 400.00 4 Memorial service 2,000.00 Total (Carry forward to main schedule) 2,400.00 �`�,S,zEX�"z_,Z, SCHEDULE I pennsylvania DEPARTMENTOF REVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Alan T Neusbaum 21 14 0303 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 � 9,917.05 Par Fulton Bank Line of Credit 9,917.05 Line of credit secured by condominium located at 312 Harbour House, Sea Colony East, Bethany Beach, DE. Co-debtors are James E. and Donna M. Donnelly, husband and wife, and Alan T. Neusbaum and Nancy E. Neusbaum, husband and wife. The total principal balance owed is $39,668.18. The decedent's fractional interest is 25�, or $9,917.05. TOTAL(Also enter on Line 10,Recapitulation) $ 9,917.05 zwnsnH z o0o If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) SCHEDULE J pennsylvania DEPARTMENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Alan T Neusbaum 21 14 0303 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec. 9116(a)(1.2).] i. Nancy E. Neusbaum 1115 Musket Lane Mechanicsburg, PA 17050 IRA, Merrill Lynch Account #872- 74335 Inventory Value: 307,994.51 IRA, Merrill Lynch Account #872- 78681 Inventory Value: 204,335.34 IRA, Merrill Lynch Account #872- 79363 Inventory Value: 201,794.95 Surviving Spouse 714,124.80 Ef�ffER 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: 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 swasni z o0o If more space is needed,use additional sheets of paper of the same size. Estate of: Alan T Neusbaum 21 14 0303 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 2 Jennifer L. Neusbaum 6359 Stanford Court Mechanicsburg, PA 17050 One Half of Residue: 37,718.89 Daughter 37,718.89 3 Erin E. Neusbaum 140 Pennsylvania Avenue, Apt. 2B Centreville, NID 21617 One Half of Residue: 37,718.89 Daughter 37,718.89