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HomeMy WebLinkAbout03-16-15 T 1505611185 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN c11 14 01200 Harrisburg,PA 17128-0601 RESIDENT DECEDENT d 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 09132014 05081929 Decedent's Last Name Suffix Decedent's First Name M I LORENZ KATHARINE S (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 BOXES BELOW _vA 11 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 El 5. Federal Estate Tax Return Required death after 12-12-82) El 6. Decedent Died Testate F__17. 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 ❑ 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 INFORMAT49N SHOULD BE'-&RECTED;9: Name Daytime Telephone Number r 70 y� {..n STEVEN T- LORENZ 302-593=2604 =? <D REGISTERO"ILLS Ug"NLYr-- r 1 , CT) ;;J r.7 First Line of Address M '7 _.i 7A 'l 232 BEVERLY ROAD Second Line of Address ^. C� •> City or Post Office State ZIP Code DATE FILED NEWARK DE 19711 Correspondents e-mail address: STEVE - LORENZ @ C O M C A S T-N E T 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. SIGNAAJAE OF4a&RSQ4I RESPONSIBLE FOR FILING RETURN DTE /1 ADDRESS 232 BEVERLY ROAD, NEWARK, DE 19711 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 OM46473.000 1505611185 1505611285 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: LORENZ KATHARINE S 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), , , , , 3, 0• 00 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , 4, 0 .00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5. 187,118 - 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. 0 .00 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . g 187-,118.00 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. 10-1119 - 00 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) , , , , , , , , , 10, 0.00 11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , 11, 10,119 - 00 12. Net Value of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , , , 12. 176,999- 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. 176-,999 - 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.OfL 0 .00 15. 0 .00 16. Amount of Line 14 taxable at lineal rate x.0 '� 176,999 .00 16. 7,965. 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. 71965.00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 14 01200 DECEDENTS NAME LORENZ KATHARINE S STREET ADDRESS ';2-q 11IESLEY DRIVE CUMBERLAND CITY STATE ZIP MECHANI SBURG PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 71965-00 2. Credits/Payments A.Prior Payments 0 . 00 B. Discount 0 . 00 Total Credits(A+B) (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) h965- 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 . . . . . . . . . X c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eil 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? . ❑ EXI 4. Did decedent own an individual retirement account,annuity,or other non-probate property,which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ NJ 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)(1)]. 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 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-1502 EX+(t2-t2) SCHEDULE A pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Katharine S. Lorenz 14 01200 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 fads. Real property that Is jointlyowned with right of survivorship must be disclosed 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 DESCRIPTION OF DEATH 1. None TOTAL (Also enter on Line 1,Recapitulation.) $ 0 2w4695 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(9-12y pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Katharine S. Lorenz 14 01200 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None TOTAL (Also enter on Line 2,Recapitulation) $ 0 2w4696 2.000 If more space is needed,insert additional sheets of the same size REV-150�EX+(9.12) SCHEDULE C pennsylvania DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATION, INHERITANCE TAX RETURN PARTNERSHIP OR RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Katharine S. Lorenz 1401200 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 None TOTAL(Also enter on line 3,Recapitulation) $ 0 2w4697 2.000 (If more space is needed,insert additional sheets of the same size) n ` REV-1507 EX+ (04-13) pennsylvania SCHEDULE D DEPARTMENT OF REVENUE MORTGAGES& NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Katharine S Lorenz 14 01200 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH None TOTAL(Also enter on Line 4,Recapitulation) $ 0 2w46AC 2.000 (If more space is needed,insert additional sheets of the same size.) REV-1508 EX+(0812) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS&MISC. INHERITANCE TAX RESIDENTDECEDENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Katharine S. Lorenz 14 01200 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 I. Fidelity Money Market Acct #xxxx0145 16,768 2 Belco Checking Acct #xxxx506O-0040 20,896 3 Belco Savings Acct #xxxx5060-0001 248 4 Bank of America Checking Acct #xxxx7224 7,608 5 Stifel Money Market Acct #xxxx2586 29,725 6 Ohio National Non-Qualified Contract #xxxxl818 - payable to estate 58,515 7 Ohio National IRA #xxxx7389 - payable to the estate 22,616 8 The Hartford Annuity #xxxx3454 - payable to the estate 19,341 9 The Hartford Annuity #xxxx8678 - payable to the estate 11,401 TOTAL(Also enter on line 5,Recapitulation) $ 187,118 2w46AD 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Katharine S. Lorenz 14 01200 If an asset became jointly owned within one year of the decedents date of death,it must be reported on Schedule a SURVNING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT JOINTLY OWNED PROPERTY: LETTER DATE DESCRITION OF PROPERTY %OF DATE OF DEATH ITT FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND SANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECiEDEWS VALUE OF NLIlYBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST None TOTAL (Also enter on Line 6, Recapitulation) $ 0 9W46AE 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) SCHEDULE G pen nsylvan is DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC.NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Katharine S. Lorenz 14 01200 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 INMDETFENAME OFTHE TRANSFEREE.THEIR RELATIONSHPTO DECEDENT AND DATE OF DEATH %OF DECD'S NUMBER THE DATE OrTRANSFER ATTACHACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IFAPPUCABLE VALUE 1 None TOTAL(Also enter.on line 7,Recapitulation)$ 0 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2.000 REV-1511 EX+(08.13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Katharine S. Lorenz 14 01200 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers Buhring Funeral Home 8,413 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: 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: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Cumberland County Register of Wills 1,706 TOTAL(Also enter on Line 9,Recapitulation) $ 10,119 3W46AG 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Katharine S. Lorenz 14 01200 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 None TOTAL(Also enter on Line 10,Recapitulation) $ 0 2w46AH 2.000 If more space is needed,insert additional sheets of the same size. REV-1 ST3 EX+(01-10) SCHEDULE J pennsylvania DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Katharine S. Lorenz 14 01200 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Steven T. Lorenz 232 Beverly Road Newark, DE 19711 Son $88,499.50 2 Brian R. Lorenz 609 Gatewood Drive Enfield, CT 06082 Son $88,499.50 ENTER 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 9W46Ai 2.000 If more space is needed,use additional sheets of paper of the same size.