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Home My WebLink About03-24-15 (2) 1505614134 EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 9 1 2 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 8 2 7 2 0 1 4 0 2 0 8 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI Y E N C H I C K J 0 S E P H J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N 0 N E THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Original Return ❑ 2.Supplemental Return ❑ 3.Remainder Return(date of death Prior to 12=13-82) ❑ 4.Agriculture Exemption ❑ 5.Future Interest Compromise(date of ❑ 6.Federal Estate Tax Return Required (date of death on or after 7-1-2012) death after 12-12-82) ® 7.Decedent Died Testate ❑ 8.Decedent Maintained a Living Trust 0 9.Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust) ❑ 10.Litigation Proceeds Received ❑ 11.Non-Probate Transferee Return ❑ 12.Deferral/Election of Spousal Trusts (Schedule F and G Assets only) ❑ 13.Business Assets ❑ 14.Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT•THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number J 0 H N C Z E P P I I I 7 1 7 5 2 8 8 9 0 0 First Line of Address P - 0 • B 0 X 2 0 4 Second Line of Address 8 4 3 8 C A R L I S L E P I K E City or Post Office State ZIP Code Y 0 R K S P I N G S P A 1 7 3 7 2 M Correspondent's e-mail address: REGIS7ERUF Wr IZLS UrSE ONLY i » f7 REGISTER OF WILLS USE ONLY j L7 DATE FILED MMDDrM _ _ C3 J CO s" rTn 0 DATE FILED STA 1n PLEASE USE ORIGINAL FORM ONLY Side 1 I IIIIII(IIII VIII IIID VIII VIII VIII 1111111111111111111 IIII 1505614134 1505614134 U~ f 1505614234 REV-1500 EX(FI) Decedent's Social Security Number Decedent'SName: JOSEPH J - YENCHICK RECAPITULATION 1. Real Estate(Schedule A) 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. 1 0 4 0 8 ' 2 1 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous N -Probate Property (Schedule G) Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . .. . . . . . . .. . . . . . . . . . 8. 1 0 4 0 8 • 2 1 9. Funeral Expenses and Administrative Costs(Schedule H) 9. 2 2 7 9 • 4 9 . . . . . . . . . . . . . . . . . . 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ... . . . . . . . . . . 10. 8 1 2 8 . 7 2 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 0 4 0 8 . 2 1 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . .. . . . .. . . . . . . . . . .. . . 12• 0 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13• 14, Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . .. . .. . . . . . . . . . . 14. 0 • 0 0 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 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X.045 0 . 0 0 16. 0 . 0 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has any kno I dge. SI AT RE OF PERSON RESPONSIBL FOR FILING RET RN DATE A' ESS O5 EAST R_ 0AD YORK SPRINGS PA 17372 SI TURE RE R N PERSON RESPONSIBLE FOR FILING THE RETURN DATE k Z2 a A DRE P • BOX 204 YORK SPRINGS PA 17372 I IIIIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII Side 2 L 1505614234 1505614234 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 21 14 0912 DECEDENTS NAME JOSEPH J.YENCHICK STREET ADDRESS 1 Lon sdorf Way CITY STATE ZIP Carlisle PA 117015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (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 oval 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. �s:.t».a.«ri?'.�.�}�x�xla=;�."•e`.�'.��'�v �i �.��lwt�Y„'�'c6.' ;�.!� ,:s.aw:'��r.�..-� .,�Z��.$�bait..[..�P,<.:.`.s,iN��.'k 's3z%?wtrw'_..t.��._ 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 .............................................................. ....... 191❑ b. retain the right to designate who shall use the property transferred or its income ❑ c. retain a reversionary interest ........................................................................... ......................... ❑ n d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0 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?.................................................................................................. ElR 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 step-parent 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) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RESIDENTDECEDENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: JOSEPH J. YENCHICK 21 14 0912 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. Refund check from Cumberland Crossing 10,408.21 TOTAL(Also enter on Line 5,Recapitulation) $ 10 408.21 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERRESIDENT EDENAX TURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOSEPH J. YENCHICK 21 14 0912 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home 764.99 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Annmarie Klems-Wonders 350.00 Street Address 505 East Berlin Road City York Springs State PA Zip 17372 Year(s)Commission Paid: 2015 2. Attorney Fees: John C. Zepp, III 1,024.00 3, Family Exemption:(If decedent's address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: Cumberland County Register of Wills 110.50 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Inventory 15.00 8. Return 15.00 TOTAL(Also enter on Line 9,Recapitulation) $ 2,279.49 If more space is needed,use additional sheets of paper of the same size. `C REV-1512 EX+(12-12) pennsylvania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES&LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOSEPH J. YENCHICK 21 14 0912 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. Department of Public Welfare 8,128.72 TOTAL(Also enter on Line 10,Recapitulation) $ 8,128.72 If more space is needed,insert additional sheets of the same size. REV-1513 EX-1(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES RIES INHERITANCE TAX RETURN C'�ICf li/i G�7 RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JOSEPH J. YENCHICK 21 14 0912 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Mary Jean Damiels Lineal 0.50 1512 Parilla Crcle Trinity, Florida 2. AnnMarie Klems aka AnnMarie Klems-Wonders Lineal 0.50 505 East Berlin Road York Springs, PA 17372 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. H. 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, $ If more space is needed,use additional sheets of paper of the same size.