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HomeMy WebLinkAbout07-01-15 i' pennsytvania 1505614105 .j °®M.0170`IE"IM EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 02182015 08241917 Decedent's Last Name Suffix Decedent's First Name MI Wetzel Nellie M (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 (gD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Agriculture Exemption(date of C 5.Future Interest Compromise(date of O 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) O 7. Decedent Died Testate O 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) O 10. Litigation Proceeds Received p 11.Non-Probate Transferee Return p 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) © 13.Business Assets O 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 Kenneth Gary Wetzel (610) 857-5267 First Line of Address 808 West Third Avenue Second Line of Address City or Post Office State ZIP Code Parkesburg PA 19365 C rn is1 vedzon.net o c_ rn thewetzeisl@vedzon.net s email address: @ � � r�> Q r— REGISTEII�FIWILLS USE 0" � REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY - QD .Q C:7 i.-.. rn !f1 CD DATE FILED S1=P PLEASE USE ORIGINAL FORM ONLY Side 1 1505614105 J 1505614205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Nellie Mildren Wetzel 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. 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 30,954.20 7. Inter-Vivos Transfers 8,Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets(total Lines 1 through 7)............................. 8. 30,954.20 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 5,159.20 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............. .. 10. 3,567.98 11. Total Deductions(total Lines 9 and 10)................................. 11. 8,727.18 12. Net Value of Estate(Line 8 minus Line 11) ............... ............... 12. 22,227.02 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. 22,227.02 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. 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 22,227.02 16. 1,000.22 .. 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ......... 1,000.22 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O 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. SIGgATURE OF PERSON RESPONSIBLE FOR FII G RETURN DATE 7- ADD ESS ' 08 W� ir�P�✓e . a.r/l2sbyr�, SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS Side 2 1505614205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Nellie Mildred Wetzel STREET ADDRESS Elmcroft Assisted Living 129 Walnut Bottom Road CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1,000.22 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) 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 2,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) 1,000.22 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 ............................................ ❑ 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?.............................................................................................................. ❑ E 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? ........................................................................................................................ ❑ N 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-1509 EX+(02-15) i pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Nellie Mildred Wetzel 21-15-0370 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.Kenneth Gary Wetzel 808 W.Third Ave.,Parkesburg, PA 19365 Son B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR 30INT 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. 08107/13 Orrstown Bank-Checking 518115 19,103.86 50% 9,551.93 2. A 08/07/13 Orrstown Bank-Money Market 804142 32,784.58 50% 16,392.29 3. A 08/07/13 Orrstown Bank-Certificate 20051682 5,012.74 50% 2,506.37 4. A 08/07/13 Orrstown Bank-Certificate 20052402 5,007.22 50% 2,503.61 TOTAL(Also enter on Line 6, Recapitulation) $ 30,954.20 If more space is needed,use additional sheets of paper of the same size. BUREAU INDIVIDUAL TAXES Penns lvania Inheritance Tax peC111SJ/tVal11a 28 PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE --' REV-1543 EX D..EXEC (08-12) And Taxpayer Response FILE N0.2115-0370 ACN 15130600 DATE 06-08-2015 Type of Account Estate of NELLIE M WETZEL Savings SSN X Checking Date of Death 02-18-2015 Trust KENNETH G WETZEL County CUMBERLAND Certificate 808 3RD AVE PARKESBURG PA 19365-1312 ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.804142 Date Established 04-12-1983 REGISTER OF WILLS Account Balance $32,784.58 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $16,392.29 Tax Rate X 0.045 Potential Tax Due $ 0.04 5 NOTE': If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C ❑The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child, grandchild, etc.)of the deceased. (Select correct tax rate at right,and complete Part 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. BUREAU OF INDIVIDUAL TAXES Penns lvania Inheritance Tax 7pennsytvania PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice ; DEPARTMENT OF REVENUE -"' REV-1543 EX DotEXEC (08-12) And Taxpayer Response FILE N0.2115-0370 ACN 15130599 DATE 06-08-2015 Type of Account Estate of NELLIE M WETZEL Savings SSN X Checking Date of Death 02-18-2015 Trust KENNETH G WETZEL County CUMBERLAND Certificate 808 3RD AVE PARKESBURG PA 19365-1312 ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.518115 Remit Payment and Forms to: Date Established 08-01-1983 REGISTER OF WILLS Account Balance $ 19,103.86 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $9,551.93 Tax Rate X 0.045 Potential Tax Due $ 0.045 NOTE': If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART, Step 1 : Please check the appropriate boxes below. 1 A [—]No taxis due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. _ B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C ❑The tax rate is incorrect. F� 4.5% 1 am a lineal beneficiary(parent, child,grandchild, etc.) of the deceased. (Select correct tax rate at right,and complete Part F_� 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F]Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. BUREAU INDIVIDUAL TAXES Penns lvania Inheritance Tax per11'1SJ/LVd111d 28 PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice if DEPARTMENT OF REVENUE -"' REV-1543 EX D-EXEC (08-12) And Taxpayer Response FILE NO.2115-0370 ACN 15130601 DATE 06-08-2015 Type of Account Estate of NELLIE M WETZEL Savings SSN Checking Date of Death 02-18-2015 Trust KENNETH G WETZEL County CUMBERLAND X Certificate 808 3RD AVE PARKESBURG PA 19365-1312 ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.20051682 Remit Payment and Forms to: Date Established 04-20-1995 REGISTER OF WILLS Account Balance $5,012.74 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $2,506.37 Tax Rate X Potential Tax Due $ 0 0.045.045 NOTE*: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 , AF-]No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B 0The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C [--]The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent,child, grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. BUREAU OF INDIVIDUAL TAXES PO BOX 280601 Pennsylvania Inheritance Tax pennsytvania HARRISBURG PA 17128-0601 Information Notice j DEPARTMENT OF REVENUE REV-1543 EX D-EXEC (08-12) And Taxpayer Response FILE NO.2115-0370 ACN 15130602 DATE 06-08-2015 Type of Account Estate of NELLIE M WETZEL Savings SSN Checking Date of Death 02-18-2015 Trust KENNETH G WETZEL County CUMBERLAND X Certificate 808 3RD AVE PARKESBURG PA 19365-1312 ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.20052402 Remit Payment and Forms to: Date Established 05-02-1995 REGISTER OF WILLS Account Balance $5,007.22 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $2,503.61 Tax Rate X 0.045 Potential Tax Due $ 0.045 NOTE*: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A F�No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount _ shown above as Potential Tax Due. B El The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C ❑The tax rate is incorrect. F—] 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part F—] 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ .15% All other relationships (including none). D Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. REV-1511 EX+(02-15) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Nellie Mildred Wetzel 21-15-0370 . Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger-Bricker Funeral 646.30 Premier Events-Luncheon 672.40 Wagner Memorials-Engraving stone 75.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 3,500.00 Name(s)of Personal Representative(s) Kenneth Gary Wetzel Street Address 808 West Third Avenue city Parkesburg State PA ZIP 19365 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: 260.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Notary Fee 5.00 TOTAL(Also enter on Line 9, Recapitulation) $ 5,159.20 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(02-15) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Nellie Mildred Wetzel 21-15-0370 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. Medicine Shoppe 87.20 2. Home Instead Senior Care 2,263.95 3. Shippensburg Area EMS 540.00 4. Grane Hospice 100.00 5. Century Line 10.61 6. Chambersburg Hospital 566.22 TOTAL(Also enter on Line 10, Recapitulation) 3,567.98 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(02-15) pennsylvan Ea SCHEDULE 3 DEPARTMENT OF INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Nellie Mildred Wetzel 21-15-0370 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).] I. Kenneth Gary Wetzel Son 50% 808 W.Third Avenue,Parkesburg,PA 19365 2. Carol Wetzel Daughter-in-Law 50% 195 Frye Farm Rd.,Greensburg,PA 15601 3. Addendum(Copy attached) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 00 If more space is needed,use additional sheets of paper of the same size. ADDENDUM TO MY LAST WILL AND TESTAMENT IN REFERENCE TO THE SALE OF THE PROPERTY ON THE CORNER OF CUMBERLAND AVE.AND FRANKLIN HEIGHTS,PREVIOUSLY OWNED BY ME, N.MILDRED WETZEL,AND PURCHASED BY MY GRANDDAUGHTER,STACEY WETZEL BAYLEY. IF UPON THE SALE OF THE ABOVE MENTIONED PROPERTY, MY GRANDDAUGHTER INCURRS A LOSS (TAKING THE PURCHASE PRICE AND SETTLEMENT EXPENSES PLUS THE COST OF RENOVATIONS WITH PROOF OF ALL EXPENSES),SHE IS TO BE REIMBURSED BEFORE MY ESTATE IS DIVIDED. IN WITNESS WHEREOF, I HEREBY SIGN MY NAME TO THIS ADDENDUM TO MY LAST WILL AND TESTAMENT ON THIS DAY OF L. 2014. s WITNESSES � r �,/ N. MILDRED WETZEL