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Home My WebLink About03-19-15 1505610105 �� m��v OFFICIAL' u��—��mm P^Department ofRevenue pennsyLvaniaCounty Cvde Year. File Number Bureau of Individual.Taxes INHERITANCE TAX RETURN PO BOX 28o6ol ENTER DECEDENT INFORMATION BELOW Social 8��vi v�wu�b� Date of wmooYYYv Date�,8i�x ww_oo_,-Y-r_/----- ... � _ ..............._ \ ' 1Q32 | _~- -____l | "'"�=__.................-................._-__-__| Decedent's Last Name Suffix Decedent's First M| — ' ------- - —' --------i �-- | Klinger | | | Roy E ( (if Applicable) Enter Surviving Spouse's Information Below Spouse's�amwomo Suffix Spouse's rin�wama M| -- ------------------------ -� ----| ...................------- .........-- � — �� ........... ............. ��... ..... �� Social Security ^---------- -----�--- ----'--- THIS RETURN MUST 8EFILED|NDUPLICATE WITH THE � ( REGISTER OF WILLS �� ........... �� FILL|wAPPROPRIATE OVALS BELOW CND 1 Original Return c:D u.Supplemental Return x=:) a. Remainder Return(Date urDeath Prior to 12'13'82) c=) 4. Limited smote c:D 4a Fvmm Interest Compromise(date of x=r n. rnoom|Estate Tax nomm Required death after 1x-1e'ou) c=:) 6. Decedent Died Testate c=D r. Decedent Maintained aLiving Trust o. Total Number mSafe Deposit Boxes (Attach Copy o/Will) (Attach Copy mTmot.> e. Litigation Proceeds Received u=:) 1o. Spousal Poverty Credit(Date n,Death C=D 11. Election mTax under Sec.y11o(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 |Daniel cmmHe/ | (717) 761-8686 } REGISTER OF WILLS LiSrONLY-1 (7) 7-3 First Line of Address .22 Cedar Cliff Drive Second Line ofAddress _1 nm DATE FILED City_orPost Office .________ State � Code _n Camp Hill | | PA ! 117011 ��. � Correspondent's e-mail N 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. OF PERSON—R.LSPO OR FILING RETURN DATE 22 Cedar cliff Drive, Camp Hill PA 17011 SIGNATURE orpnspAusnOTHER THAN REPRESENTATIVE oxrs Aoonsoo PLEASE USE ORIGINAL FORM ONLY Side N N N 1505610105 1505610105 0 ��" �� 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Klinger, Roy E RECAPITULATION 1. Real Estate(Schedule A). .. . .. . . . .. . . . . .. . . . . .. . ..... ...... .. . . .. . . .. 1. 2. Stocks and Bonds(Schedule B) .. . . .. .. . . . ... . .... .. . .. . .. .. . .. .. . .. .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . .. . . 3. 1 0.00 4. Mortgages and Notes Receivable Schedule D 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). .. . .. . 5. 107,378 65 6. Jointly Owned Property(Schedule F) OD Separate Billing Requested . . .. . . . 6. 36,625.00 j 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. .. . .. . 7. f I 8. Total Gross Assets total Lines 1 through 7 8. ; 144,003.65 9. Funeral Expenses and Administrative Costs Schedule H 9. 6,136.10 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . .. . . . .. . .. .. 10. 0.00 i 11. Total Deductions(total Lines 9 and 10). . . . . .. .. .. . . . .. . . .. ... .. . . . .. . .. 11. 6,136.10 12. Net Value of Estate(Line 8 minus Line 11) . . ... . .. .. . .. . . . . .. . .. .. .. . .. . 12. 137,867.55 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . .. ... .. . . ... .. .. . .. .. . 13. `i 14. Net Value Subject to Tax(Line 12 minus Line 13) .. . . .... . . . . .. .. . .. ... . . 14. j 137,867.55 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 .....,,._.-....__.._._..__________........,._vw....w, ,,vv_.. v ------ transfers 2)X.0_ _.. ._._._...___..._ _ 15.? 16. Amount of Line 14 taxable at lineal rate X.0 45 137 867.55 16 3 6,204.04 j 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 _ _.,...............Y_._. 19. TAX DUE ...... . . . .. . . . . . . . . . . . . . . . . . .... . .. . . . .. . .. ... .. . .. . . . . . 19. 6,204 04 __..._._,.......,_..v.. .____.. ._..,.,... . ....._._,... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 REV-1500 EX(Fl) Page 3 Fife Number Decedent's Complete Address: DECEDENT'S NAME Roy E Klinger STREET ADDRESS 4621 S. Clearview Drive CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,204.04 2. Credits/Payments A.Prior Payments B,Discount Total Credits(A+B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 1,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) 6,204.04 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 ............................................ ❑ N 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?.............................................................................................................. ❑ 0 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ 0 ❑ 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 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. REV-1508 EX+(08-12) "i pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Klinger, Roy E 21 13-0538 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 1. Members 1st FCU-Balance 5/2/13$2,115.81 -50%share ownership 1,057.91 2 Members 1st FCU-balance 5/2/13$13,885.47-50%share ownership 6,942.74 3 Members 1st FCU-Balance 5/2/13-100%Ownership 99,378.00 TOTAL(Also enter on Line 5, Recapitulation) $ 107,378.65 If more space is needed, use additional sheets of paper of the same size. REV-15og EX+(oi-io) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE IJOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Klinger, Roy E If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Daniel E Klinger 22 Cedar Cliff Drive Son Camp Hill PA 17011 B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 4621 S Clearview Avenue,Camp Hill PA 17011 73,250.00 50 36,625.00 TOTAL(Also enter on Line 6, Recapitulation) $ 36,625.00 If more space is needed, use additional sheets of paper of the same size. 281-CT—Warranty Doed--Short Farm-4W 1909-40016 Sh••t Henry Hili,inm, Indians,ft MADE THE I day of November in the year Of our Lordtwo thousand three (2003). BETWEEN ROY E. KLINGER AND ANZONETTA J_ KLINGER, his vi.fe, hereinafter referred to as parties of the first part, Grantors , and ROY E. KLINGER .AND ANZONBTTA J. ZLINGiER, his wife and DANIEL EUGENE KLINGER, their son, hereinafter referred to as parties of the second part, Grantees WITNESSETH, that in consideration of One and XX/100 ----------------------- -1-------------------------------($1.00)---------------------- ------------------------------------------------------($1.00)---------------------- Douara, in hand paid,the receipt whereof is hereby acknoaotedged, the said grantor s do hereby grant and convey to the said grantees, as tenants by the entireties as to husband and wife and tenants with the right of survivorship and not as tenants in common as to their son; ALL THAT CERTAIN piece or parcel of land, situate in the Township of Hampden (off the Clearview Farm) , County of Cumberland and Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the North side of Clearview Drive which point is at the Southeastern corner of Lot No. 124; thence Northwardly along Lot No. 124, 110 feet to a point; thence South 83 degrees 34 minutes East, 65.5 feet to Lot No. 126; thence Southwardly along Lot No. 126, 110 feet to Clearview Drive; thence Westwardly along the Northern side of Clearview Drive, 65.5 feet to a point, the place of BEGINNING. IT BEING Lot No. 125 on General Plan of Section 2 and 3 of Clearview Farm, recorded in Cumberland County Plan Book 9, Page 6. RESERVING a 5 foot easement for drainage on the East of the property. HAVING THEREON ERECTED a single dwelling house known and numbered as 4621 South Clearview Drive, Camp Hill, Pa 17011. • BEING THE SAME PREMISES WHICH Nelson Improvement and Development Corporation, a Pennsylvania Corporation, by their Deed dated August 28, 1964 and recorded August 28, 1964 in Cumberland County Deed Book I, Volume 21, page 348, granted and conveyed unto Roy E. Klinger and;An2cSnetta J. Klinger, his wife, Grantors herein. IS A CONVEYANCE FROM PARENTS TO THEMSELVES AND THEIR ONLY afil - t�t�PI'IS PENNSYLVANIA REALTY TRANSFER TAX EXEMPT. faJ C7 Q; Cn Lai = j took 260 PAcc2050 08!29/2014 11:22:19 AM CUMBERLAND COUNTY Inst.#200363764-Page 1 of 2 And the said grantors hereby covenant and agree 04t they will warrant specially the property hereby conveyed. i IN WITNESS WHEREOF, said grantors a hereunto set their hands aril seat s the day and year first above written. ' ,Statab anb trtb --_ _ _ '-'J._.....__........... E. Kli er to �' . AJ.� . ...... ........ '!= nz e a tt ait9ec� : ---- --.,. r.._» ._............. ens State of Pennsylvania 88. County of Cumberland On this, the ! t' day of November, 2003 X0 , before me, a Notary Public the undersigned officer,personalty appeared Roy E. Klinger and Anzonetta J. Klinger, his wife known to me (or satisfactorily proven) to be the person a whose name s are subscribed to the within instrument,and acknowledged that #heyited same the purposes therein contained. IN WITNESS WHEREOF, I hereunto sNa Seal golly eMNotery Public PublicHoondrr Twp. bMand CDu x{106 ......�__....,..... .�._»....._...w............. t�+e +c .�e:tnsy+an+�eAssa�ndonwtwmr�es Title of Officer. Notarial Seat tats b Kelly L Quinn,Notary Public 88. Hampden 1Wp..Cumberland County My Cammisslnn Expires Feb. 16,2006 county Of Member.Penn Orn this, the day of syrvanlaAssaaorNorarlsefore me, the undersigned ofzeer,personalty appeared known to me (or eatiefaetoray proven) to be the person whose name subscribed to the within instrument,and acknowledged that executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto act my hand and ofleiat seat. ---............... ._..Title of OJ]tcer,....,... I do hereby certify that the precise residence and complete post office address of the within named grantee is 4621 South Clearview Drive, Camp Hill, Pa 17011. l .Grantees.. .........._...._...._...... $QpK 260 PAGE`,ZOS�. �. 08(2912014 11:22:18 AM CUMBERLAND COUNTY Inst.#200363764-Page 2 of 2 REV-151.0 EX+ (08-09) - pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Roy E Klinger 21 13-0538 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 INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. FEGLI Group Life Insurance paid to Daniel E Klinger,beneficiary on 17,013.75 100 100.00 0.00 7/23/2013 TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size. 1 w o LD i ¢ ¢ Ln F- fn OOWV'^,r *o •ZZ *Q1 CL Zo,?O=) CD w ¢ M ' h U f ti o �a o hN O 2 O CO C_) Ly_; C' J Lul - V