HomeMy WebLinkAbout04-07-15 (2) ' �co,-,o> 1505610143
J REV-1500 ,�
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEVARTMEMOFREVENUE
Po aox.2soso� INHERITANCE TAX RETURN 2 1 14 0 0 6 61
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
05 21 2014 09 10 1931
DecedenYs Last Name Su�x DecedenYs First Name MI
KING PAULINE B
(ff 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 OVALS BELOW
� 1. Original Retum ❑ 2. Supplemental Return � 3.Remainder Retum(date of death
prior to 12-13-82)
� 4. Limited Estate � qa,Future Interest Compromise � 5. Federal Estate Tax Retum Required
(date of death aRer 12-12-82)
� 6 Decedent Died Testate ❑ �• qKa heco��of T�tist a�iving Tn,st _____ 8, Total Number of Safe Deposit Boxes
(Attach Copy of Will) � P1' �
� 9. Litigation Proceeds Received � 10.b�twesenP2 3��J1�and��ltl1 95�death � ��.Election to tax under Sec.9113(A)
(Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
SAMUEL L ANDSS 717 761 5361
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REGISTER��fpLLS USF.,�gNLY� �
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F�?� � � � C1'� .:LJ
First line of address :";�.� �,, �--- ---�
525 NORTH 12TH STRELT � ` pn � �
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Second line of address � � ' � � �r
, e.:� ..�.3 �
� � H ��
�AT�ILED N �
City or Post Office State ZIP Code N � p
LEMOYNL PA 17043 � �
Correspondent�se-ma�iaddress: SamuelAndes168@gmail.com
Under penalties of perjury,1 declare that I have examined this retum,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.
ATURE OF P SON PONSIBLE R FILING RE�URN DA
Daniel G. King - - �' '3�
AD SS
524 Park Avenue, New Cumberland, PA 17070
SIG PR ROTH THAN SENT � DATE _
Samuel L Andes � � ."' R
ADD
525 North 12th Street, Lemoyne, PA 17043
Side 1
L 1505610143 1505610143 �
�
�
� 1505610243
REV-1500 EX
DecedenYs Social Security Number
�oede�t•s Name: K I N G� P A U L I N E B
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................... 2. 4 2 , 7 5 9 . 5 1
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 2 5 , 4 6 0 . 3 5
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 9 , 1 1 1 . 5 0
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested............. 7,
8. Total Gross Assets(total Lines 1-7)....................................................................... g. 7 7 , 3 3 1 . 3 6
9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 9 , 3 4 7 . 8 0
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule I)................................ 10. 4 0 , 3 1 1 . 9 3
11. Total Deductions(total Lines 9&10)...................................................................... ��, 4 9 , 6 5 9 . 7 3
�2• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 2 7 , 6 7 1 . 6 3
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. 2 7 , 6 7 1 . 6 3
TAX COMPUTATION-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.00 ��•
16. Amount of Line 14 taxable
at lineal rate X .045 2 7 , 6 7 1 . 6 3 16. 1 , 2 4 5 . 2 2
17. Amount of Line 14 taxabie
at sibling rate X .12 ��•
18. Amount of Line 14 taxable
at collateral rate X .15 18�
19. Tax Due..................................................................................................................... 19. 1 , 2 4 5 . 2 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21 - 14 - 00661
DecedenYs Complete Address:
DECEDENT'S NAME
King, Pauline B
STREET ADDRESS
524 Park Avenue _
CITY STATE ZIP
New Cumberland PA 17070
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,245.22
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +g) (2) 0.00
3. Interest (3) 0.0 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) � ,245.2 2
Make Check Payable to: REGISTER OF WILLS, AGENT.
III lall�llf��l
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:.................................................................................. ❑ x❑
b. retain the right to designate who shall use the property transferred or its income:.................................... ❑ 0
c. retain a reversionary interest:or.................................................................................................................. ❑ x❑
d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑x
2. If death occurred after December 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?......... � x❑
4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which
containsa beneficiary designation?...................................................................................................................... ❑ X❑
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 January 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 re�urn 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 1.2)[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.69116(a)(1.3)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,w�iether by blood or adoption.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSriVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF King, Pauline B 21 - 14-00661
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
8 Ingersoll Rand stock(349 shares) 57.28 19,990.72
9 Allegion PLC stock(449 shares) 50.71 22,768.79
TOTAL(Also enter on line 2, Recapitulation) 42,759.51
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
COMMONWEALTHOFPENNSriVANIA PERSONAL PROPERTY
INHERRANCETAXRETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF King, Pauline B 21 - 14-00661
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
8 Account in Franklin Templeton Investments Mutual Fund 12,815.33
9 Total Control Account with Metropolitan Life Insurance 1,992.02
10 Investment account with Fidelity Funds 10,453.00
11 Miscellaneous items of clothing and personal effects 200.00
TOTAL(Also enter on Line 5, Recapitulation) 25,460.35
SCHEDULE F
COMMONWEALTHOFPENNSYLVANIA �OINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
King, Pauline B 21 - 14-00661
If an asset was made joint within one year of the decedenYs date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
Daniel G. King 524 Park Avenue Son
q New Cumberland, PA 17070
JOINTLY OWNED PROPERTY:
ITEM LETTER DATE InGude name oT�inanRca�alin�s�itu�on anpd bank account numbe DATE OF DEATH %OF DATE OF DEATH
NUMBER FOR JOINT MADE or similar identi n number.Attach deed for'oinU -held real VALUE OF ASSET DECD'S VALUE OF
TENANT JOINT � 9 � Y INTEREST �CEDENI'S INTEREST
estate. _
1 A 2001 Checking account at PSECU 2.ssa.00 50% 1,442.00
2 A 2001 Savings account at PSECU �s,339.00 50% 7,669.50
TOTAL(Also enter on tine 6, Recapitulation) 9,111.50
' ' SCI-�DUL.E H
FUNERAL EXPENSES�
COMMONWEALTH OF PENNSVLVANIA /���� �w�/�(���
INHERRANCE TAX RETURN /�Y,/�r�INh7 1 f W,,-`wv�v
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF King, Pauline B 21 - 14-00661
Debts of decedent must be reported on Schedule 1.
ITEM AMOUNT
NUMBER FUNERAL EXPENSES: DESCRIPTION
A. 1 Parthemore Funeral Home 3,950.87
2 Rolling Green Cemetary(burial lot) 970.00
3 Rubinics Catering(post-funeral reception) 986.00
4 Fairview Township(reception hall rental) 125.00
5 Royers Flowers 278.75
B. ADMINISTRATIVE COSTS:
�, Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
��ty State Zip
Year(s)Commission paid
2. Attomey's Fees Samuel L.Andes 2,500.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
�ity State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 303.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
8 Cumberland Law Journal (advertising) 75.00
TOTAL(Also enter on line 9,Recapitulation) 9,347.80
Sc�ied��e H
Fur�eral Exper�ses 8�
COMMONWEALTH OF PENNSYLVANIA w��M A_ _,_ ��
INHERITANCE TAX RETURN K,a����auc�uv�1.Q6.i''a
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF King, Pauline B 21 - 14-00661
9 The Sentinel(advertising) 158.68
Page 2 of Schedule H
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTHOFPENNSriVANIA LIABILITIES, 8� LIENS
INHERRANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF King, Pauline B 21 - 14-00661
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
8 Golden Living 1,861.29
9 Messiah Lifeways 38,377.09
10 AlertRx Pharmacy 73.55
TOTAL(Also enter on Line 1�, Recapitulation) 40,311.93
REY�1533 EX+(11-08)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA B E N E FI C IARI ES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF King, Pauline B FILE NUMBER
21 - 14-00661
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY ooNauscTNs�ee�s�
I. TAXABLE DISTRIBUTIONS[include outright spousal
distribuUons,and transfers
under Sec.9116(a)(1.2)J
1 Daniel G. King son /o o�,
524 Park Avenue
New Cumberland, PA 17070
'�
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II� NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET O.00