HomeMy WebLinkAbout10-21-14 (2) � 15�5610105
REV-1500 EX�°2_1'>`�> �
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvarria County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box zso6oi RESIDENT DECEDENT �I I� � � J�
Harrisburg PA 1'7i28-o601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
10/09/2012 06/26/1936
DecedenYs�ast Name Suffix DecedenYs First Name M�
Stratford Daniel R
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name M�
Stratford Waltraud M
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
197-40-6465 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return O 2.Supplemental Retum O 3. Remainder Retum(Date of Death
Prior to 12-13-82)
p 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Retum Required
death after 12-12-82)
O 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
p 9.Litiga5on Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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 DIRECTED T0:
Name Daytime Telephone Number
DaneRos StratFord (717) 766-9826
REGISTER OF WILLS USE ONLY
First Line of Address -
`:..:✓
27 E Willow Terrace Dr r-� �e
� � �
Second Line of Address � n �� F'� n
"'— �:7 �� c-a e"�
P.-:��, Yi _..._
, � w7
l �F , i _)
City or Post Office State ZIP Code � '�
Mechanicsburg PA 17050 . �_�
, , �-r� :..;� -,-�
� ��..�
� __� C7
CorrespondenYs e-mail address: �-� -
Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,a�to ffi�best of m knowle Qa belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information qf.which preparer any k dwl e.
91 NAT OF PERSO ESPON L F�ILING RETURN DATE
...
(�j 1-- -- 2 ZO .
ADD
z7 � �tu,o�.j�l�.c�'i' �,1�+�:c��csn� '��! f�05�
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 �
� 150561�205
REV-1500 EX(FI) DecedenYs Social Security Number
�ecedent•s Name: Dattiel R. StratfOrd
RECAPITULATION
1. Reai Estate(Schedule A). ........ ..... .... ........... ........ ........ 1. 167,300.00
2. Stocks and Bonds(Schedule B) ... .. ......... . . . . .. ...... ..... . .. . .... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D). ....... ..... .. . .. ... ...... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)... .. . . 5. 3,396.98
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ..... . . 6.
7. Inter-Vvos Transfers&Miscellaneous Non-Probate Property 55,310.55
(Schedule G) � Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7).. .................... ....... 8. 170,696.98
9. Funeral Ex nses and Administrative Costs Schedule H 18,500.00
� ( ). . ............... .. 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10.
11. Total Deductions(totai Lines 9 and 10)....... ........ . ..... ... ....... . . 11. 18,500.00
12. Net Value of Estate(Line 8 minus Line 11) ..... .............. ........... 12. 152,196.98
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ............ ...... ...... 13.
14. Net Value Sub'ect to Tax Line 12 minus Line 13 ............ . 14. 152,196.98
J t ) ....... ... .
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 16. 6,848.86
17. Amount of Line 1A taxable
at sibling rate X.12 ���
18. Amount of Line 14 taxable
at collateral rate X.15 �$•
19. TAX DUE ..... ........ . .. . ..... .. . . .... . ............... ....... .... 19. 6,848.86
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
� 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Daniel R. Stratford _
STREETADDRESS
27 East wllow Terrace Drive _ _
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 6,848.86
2. Credits/Payments
A.Prior Payments —
B.DiscouM
Total Credits(A+g) (z) 0.00
3. Interest
(3) 600.00
4. If Line 2 is greater than Line 1 +Line 3,enter the diiference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 7,448.86
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
containsa beneficiary designation? ........................................................................................................................ � ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE 6 AND FILE R 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 Vansfers 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 suroiving spouse is 0 percent
(72 P.S.§9116(a)(1.1)(ii)].The statute dces not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tau retum 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 perceM[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-1502 EX+ (12-12)
� pennsylvania SCHEDULE A
DEPARTMEN7 OFREVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDEM
ESTATE OF: FILE NUMBER:
Daniel R. StratFord
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 wiliing seller,neither being compelled to buy or sell,both having reasonable knowiedge of the relevant facts.
Reai property that is jointly-owned with right of survivorship must be disciosed 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• 205 South Broad Street,Mechanicsburg,PA 17055 152,900.00
2 22 East Wiliow Terrace Drive,Mechanicsburg,PA 17050 14,400.00
TOTAL(Also enter on Line i, Recapitulation.) � 167,300.00
If more space is needed,use additional sheets of paper of the same size.
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REV-35o8 EX+(o8-1z)
� � pennsylvania SCNEDULE E
DEPARTMENTOFREVENUE CASH� BANK DEPOSITS 8�MISC.
INHERITANCE TAX RETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Daniel R. Stratford
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
�. Americhoice Federal Credit Union-Acct.#�oocxu388 1,396.98
2 1989 Ford 150 Van 500.00
3 1966 Ford Mustang 1,500.00
TOTAL(Also enter on Line 5, Recapitulation) $ 3,396.98
If more space is needed, use additional sheets of paper of the same size.
Statement of Accounts
� AmeriChoice z»s s�mnie Bee H�u�W Road Aug 01, 2014 thru Aug 31, 2014
� Mechanicsburg,PA 17055
F E D E R A L C R E D I T U N I O N µ,W�,dmerichoice.org
Building Relationships For Life Account Number: xxxxxxx388
Address Service Requested Account Balances at a Glance
Share Drafts: 1,396.98
Savings: 5.00
00443
�III�II'��II�I'll�l'll��l�l��l�����1�'I�'I�I�II'�����'�'I��"�I��
DANIEL R.STRATFORD ESTATE
�w•• 27 E WILLOW TERRACE
MECHANICSBURG PA 17050-1802 New Relationship Reward Level is: General
Page 1 of 1
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REGULAR SHARE - 0001
Date Transaction Description Additions Subtractions Balance
08-01 Balance Forward 5.00
08-31 Ending Balance 5.00
Dividends Paid Year to Date 0.00
SHARE DRAFT - 0011
Date Transaction Description Additions Subtractions Balance
08-01 Balance Forward 1,396.98
08-31 Ending Ba/ance 1,396.98
Dividends Paid Year to Date 0.00
YTD SUMMARIES
TOTAL DIVIDENDS PAID
REGULAR SHARE 0.00
SHARE GRAFT 0.00
Total Dividends Paid Year to Date 0.00
Phone: (717) 697-3474 • Toll Free: (800) 240-4364 • Fax Number: (717) 697-3713
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REV-1510 EX+(08-09)
� pennsylvania SCHEDULE G
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Daniel R. Stratford
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.
IfEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
INCLtAE THE NAME OF THE TRAP15FBiff,7HQR RElATIONSHIP TO DECEOH�lT M!D
NUMBER n+e onh aF rn�ws�. nTr,�a coPv oF n+E o�o Foa aeu esrn�. VALUE OF ASSET INTEREST (IF APClIC1�BIE) VALUE
1. Waltraud R.Stratford as beneficiary to Daniel R.Stratford(Decd IRA) 55,310.25 100 55,310.25
JMS LLC Cust FBO-Spouse to Spouse transfer
TOTAL(Also enter on Line 7, Recapitulation) # 55,310.25
If more space is needed,use additionaV sheets of paper of the same size.
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REV-1511 EX+ (OS-13)
� pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Daniel R. StratFord
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
i.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) __
Street Address _
�i�y State ZIP
Year(s)Commission Paid:
2. Attor�ev Fees: Keystone Elder Law (5/31 2012) 15,000.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation.) 3,500.00
ciaimant DaneRos Stratford
Street Address 27 East Willow Terrace Drive
ciry Mechanicsburg __ state PA _z�P 17050
Relationship of Claimant to Decedent SOtI _
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 18,500.00
If more space is needed,use additional sheets of paper of the same size.
�A3�1t�L tZ�WE S�RA�'FE�RD, R.�l. 3-7615-360 9 7 0
PA�L 0322[i137 717-6�!7-9288 � �
'd7 E.`A�iCLOM�TERRACE DR_ ��_u}�
r MECHANICS(3tJRt;, Pr� 1?050-1oU!
Pay To
i � 1'he Order Of������(� ��a�'z L��� ; _J $ I�o-«�,.`;
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^ P�rvsnva�iA
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