HomeMy WebLinkAbout04-06-15 een1505618403
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REV-1500 OFFICIAL USE ONLY
County Code Year File Number
Bureau of Individual Taxes ANCE TAX RETURN
PO BOX 280601 INHERIT
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 14 0162
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01 06 21114 07 10 1930
Decedent's Last Name Suffix Decedent's First Name MI
HUNSBERGER SR . FORREST P
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
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
1 11prior to 12-13-82)
4. Agricultural Exemption(date of 5. Future Interest Compromise(date of S. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
rX 7. Decedent Died Testate 8. Decedent Maintained a Living Trust ❑ 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
10. Litigation Proceeds Received 11. Non-Probate Transferee Return D 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
J13.,Business Assets El 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
BRADLEY J LEBER ESQ 717 845 3674
First Line of Address
17 EAST MARKET STREET
Second Line of Address
City or-Post Office State ZIP Code
YORK PA 17401
A'
Correspondent's email address: bleber(a)biakeyyost.com
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REGISTER 0 Vii-S USE ON F0
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY a � t?� m,,
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ze
DATE-81 ESTAMP � f"': ,17;
W
Side 1
�IIIII�II�II�IIIII'ISIIOIII�IIIIIIIIIIIIiII�IIII�IIIIIII�II�I 1505618403
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150561843.1
REV-1500 EX Decedent's Social Security Number
Decedent's Name: Hunsberger, Forrest P. Sr.
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. 185,457 -19
6, Jointly Owned Property(Schedule F) El Separate Billing Requested......,,.... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested.:....,.,,.. 7.
8. Total Gross Assets(total Lines 1 through 7)......._....,,......................................... 8. 185-1457 -19
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9, 391213-36
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)..............____... 10. 18 1 2114 .8 4
11. Total Deductions(total Lines 9 and 10)................................................i.............. 11. 57,418 ..20
12. Net Value of Estate(Line 8 minus Line 11)..................................4....................... 111 128,038 -99
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. 128,038-99
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.00 15. 0.1111
116. Amount of Line 14 taxable
at lineal rate X .045 128A38 -99 5 7 61-7 5
'17. Amount of Line 14 taxable
at sibling rate X.12 0 .1111 17. 0 .00
18. Amount of Line 14 taxable
at collateral rate X.15 0 .00 18, 0 .011
19, TAX DUE........................_.._........................................;...................................... 19. 5 -1 761 -75
20; FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1:1
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 knowledge.
SIGNATURE OF PEPDNSIB R ft ING RETURN Forrest P.Hunsberger,Jr. DATE
Lit
ADDRESS
12 Powers Roa U U - MA 011776
SIGNATURE OF PRJA THAN REPRESENTATIVE Bradley J.Leber Esquire DATE
ADDRESS
17 East Market Street4, ork,PA 17401
1111111 VIII 11111 lllli Illil hill illli illil hill Ifilll 0111111 Side 2
150SL18411 1505618411
REV-1500 EX Page 3 File Number 21-14-0162
Decedent's Complete Address:
DECEDENT'S NAME
Hunsberger, Forrest P. Sr.
STREET ADDRESS
1000 West South Street
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 5,761.75
2. Credits/Payments
A. Prior Payments 5,736.26
B. Discount 0.00
Total Credits(A +B) (2) 5,736.26
3. Interest (3)
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) 25.49
Make Check Payable to: REGISTER OF WILLS, AGENT.
grl1. F.''`1"+i. i j l}:I',?i'�[.i�f•,�?7.ij';7' ?�..j• f � n Rr' �^.t. ?f. ri'i�`E' .:• al i Ug t:�IJII 'I,i'SP
Iltilrnlli,~tl,!G I;s tt� ; �u li ;l � !t I !{ I ii1(i�I��11 11 i ;t:is�l�tsi� N 11 MI
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;..................................
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 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?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?..................................................................................... El ❑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.
' . 0, ill' ' 1j f ` ` Il ss.r' ns', ,tiMl «. � t
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 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 172 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)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hunsber ,er, Forrest P.Sr. 21-14-0162
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Constitution Life Insurance Company FBO Nationwide Life Insurance-unearned premium 185.41
refund
2 Johnson Controls-pension payments deposited post death 1.856.20
3 Metro Bank Acct. No.2137 9,717.22
Accrued Interest on Item 3 through date of death 0.35
4 Metro Bank Acct. No.2923 49.964.48
Accrued interest on item 4 through date of death 11.54
5 Metro Bank Acct. No.4071 107,816.27
Accrued interest on Item 5 through date of death 30.65
6 Metro Bank Acct. No.9207 3,495.66
Accrued interest on Item 6 through date of death 0.20
7 PA Bureau of Unclaimed Property-Fidelity Mutual Life Insurance dividends 87.22
8 U.S. Department of Treasury-social security payments deposited post death 5,076.00
9 U.S. Department of Veteran Affairs-veteran's aid and attendance payment received post 1,758.00
death
10 Wells Fargo CD Account No.4344 5,158.44
Accrued interest on Item 10 through date of death 0.05
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 5,Recapitulation) 185,457.19
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12)
Rev-1508 EX+(08.12)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT continued
ESTATE OF FILE NUMBER
Hunsber ,er, Forrest P.Sr. 21-14-0162
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
11 Miscellaneous personal property -as sold through Mt. Royal Furniture and Auction,Inc. 299.50
TOTAL(Also enter on Line 5,Recapitulation) 185,457.19
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12)
REV-1511 EX+(08.13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECED NTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Hunsberger, Forrest P.Sr. 21-140162
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Etzweiier Funeral Home-funeral expenses
16,319.30
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Forrest P.Hunsberger,
Street Address 12 Powers Road
City Sudbury State MA Zio 01776
Year(s)Commission Paid 2015 8,418.29
2. Attorney's Fees Blakey,Yost, Supp& Rausch, LLP 11,750.00
3, Family Exemption: (If decedent's address is not the same as Claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 383.50
5, Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 2,342.27
See continuation schedule(s)attached
TOTAL(Also enter on line 9,Recapitulation) 39,213.36
Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hunsber ,er, Forrest P.Sr. 21-14-0162
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Blakey,Yost, Bupp&Rausch, LLP-notary/copy fee 4.00
2 Blakey, Yost, Bupp&Rausch, LLP-notary 3.00
3 Blakey,Yost,Bupp&Rausch, LLP-federal express charges for 4129114 and 5/8114 29.82
4 Coliens-Wagner Agency,Inc. -Executor's Bond fee 888.00
5 Cotlens-Wagner Agency,Inc. -Executor's Bond renewal fee 888.00
6 Cumberland County Sheriffs Department-processing fee to deputize York County Sheriff to 37.00
serve citation
7 Cumberland Law Journal-estate advertisement 75.00
8 Mt. Royal Furniture and Auction, Inc.-fees charged for sale of personalty 124.83
9 Register of Wills-bond filing fee 15.00
10 Register of Wills-filing fee for Petitions,Citations,JCS fee,Automation fee 63.50
11 The Sentinel-estate advertisement 179.92
12 York County Sheriffs Department -processing fee to serve citation 34.20
H-B7 2,342.27
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1612 EX+(12-12)
SCHEDULE I
pennsylvania DEBTS OF DECEDENT,
,DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Huntsberger, Forrest P.Sr. 21-14-0162
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
I Johnson Controls-reimbursement of pension overpayments 464.05
2 Sarah A.Todd Memorial Home-unreimbursed medical expense 1,867.08
3 Sarah A.Todd Memorial Home-unreimbursed medical expense(uncleared check) 7.307.71
4 Sarah A.Todd Memorial Home-unreimbursed medical expense(uncleared check) 1,732.00
5 U.S. Department of Treasury-social security overpayment 5,076.00
6 U.S. Department of Veteran Affairs-veteran's aid and attendance overpayments 1,758.00
TOTAL(Also enter on Line 10, Recapitulation) 18,204.84
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA4600 Schedule I(Rev. 12-12)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hunsber ,er, Forrest P. Sr. 21-14-0162
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Not S 6 8 S
TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 Diane Bscherer Daughter 1/3 of residual
2611 Crestview Drive estate
York, PA 17402
2 Forrest P.Hunsberger,Jr. Son 113 of residual
12 Powers Road estate
Sudbury, MA 01776
3 Debra Yocum (formerly Steele) Daughter 113 of residual
1464 Pine Road estate
Carlisle, PA 17013
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS: .
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)