HomeMy WebLinkAbout07-01-15 (2) ` � t+ pennsylvania 15�5 618 4 0 3
� oEPARTMENTOiREVEN
�X(03-14)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes Counry Code Year File Number
Po aox 2soso� INHERITANCE TAX RETURN
HarrisburQ PA 17128-0601 RESIDENT DECEDENT 21 14 10 5 3
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDVWY Date of Birth MMDDYVYv
10 �2 2�14 02 16 1927
DecedenYs Last Name Suffix DecedenYs First Name MI
HUNKA ANNA
(If Appiicab�e)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH TNE
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. Agricultural Exemption(date of � 5. Future Interest Compromise(date of � 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
� 7. Decedent Died Testate � 8. Decedent Maintained a Living Trust 1 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 T0:
Name Daytime Telephone Number
JASON E KELSO 717 263 2121
First Line of Address
79 ST PAUL DRIVE
Second Line of Address
City or Post Office State ZIP Code �
C� � � �
CHAMBERSBURG PA 172�1, � a � m ,�
� C- r? ci'
Corres ondenYs email address: lkelso salzmannhuqhes.com � � r> � �"� �
p i. r-- m
REGIST�sR�VW�LS ONLY'C7 �
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REGISTER OF W ILLS USE ONLY �.
DATE FILED MMDDYYYY :� ,-y -r�, � -��r_ �
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DATE FILED STAMP
Side 1
I �'� �� �I I�'II 'I'� I I I' II I�II� '�I��I I I��
�.� 1505618403 1505618403 �
�„�I I� I .II' 11'11 e
� 1505618411
REV-1500 EX
DecedenYs Social Security Number
DecedenYs Name: HUtII(a, Anna
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. 2 4 0 ,613 - 6 4
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested............ 7, 111 ,8 01 • 8 8
8. Total Gross Assets (total Lines 1 through 7)........................................................ 8. 3 5 2 ,415 • 5 2
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 8 ,6 7 8 - 1 0
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)............................ 1C. 1 ,15 5 • 11
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 9 ,8 3 3 - 2 1
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 3 4 2 ,5 8 2 • 31
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. 3 4 2 ,5 8 2 • 31
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
16. Amount of Line 14 taxable
at�inea� rate X .045 3 4 2 ,5 8 2 • 31 �6� 15 ,416 - 2 0
17. Amount of Line 14 taxable
at sibling rate X.12 0 • 0❑ ��• ❑ • ❑❑
18. Amount of Line 14 taxable
at collateral rate X.15 0 - 0❑ 1�• ❑ • ❑❑
19. TAX DUE................................................................................................................ 19. 15 ,416 - 2❑
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 knowledge.
SIGNATURE OF P����/�vC/PON E FOR ��RETURN Alois Hunka � ATE/,r
.GN p�i��
ADDRESS
8952 Mou Oliv Drive Ch mbersburg, PA 17201
SIGNATUR O PR R R T N REPRESENTATIVE Jason E. Kelso DATE
r
ADDRE
79 . Paul Drive, Chambersburg, PA 17201
� I IIIIII IIII I III�I I I I III II� IIII I II I III II III Side 2
1505618411 1505618411 �
����.�..�.��'1.'�.�� a
REV-1500 EX Page 3 File Number 21-14-1053
Decedent's Complete Address:
DECEDENT'S NAME
Hunka, Anna
- - --_- --
STREET ADDRESS
210 Big Spring Road
_. — _
CITY STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 15,416.20
2. Credits/Payments
A. Prior Payments 14,100.00
B. Discount 742.11
Total Credits(A +g) (2) 14,842.11
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) 574.09
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
b. retain the r ght toldes gnatetwho hal use the property transferred or its income:.................................. � z I
P P Y . .
�
�
c. retain a reversionary interest;or............................................................................ .................................. ❑ �i
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?.................................................................................. .................................
� �
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 f�.�
contains a beneficiary designation?................................................................................ ................................. �� u
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
fling a tax return are still applicable even if the surviving spouse is the only benefciary.
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 ofthe 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(a)(1)].
. The tax rate imposed on the net value of transfers to orfor the use of the decedenYs 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.
e�,l I�,...�II ��II1 .
Rev-1508 EX+(OS-12)
SCHEDULE E
°.� pennsylvania CASH, BANK DEPOSITS, & MISC.
� DEPARTMENT OFREVENUE p E RSO NAL P RO P E RTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hunka, Anna 21-14-1053
Include the proceeds ot litigation and the date the proceeds were received by ihe estate.
All property jointly-owned with tha right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Death benefit payout -Hollow Metal(from pre-deceased spouse's pension) 1,000.00
2 Dividend, New Jersey Manufacturers Insurance Company-policy#F661790-6 previously 47.88
canceled.(one-time special dividend for former customer)
3 Susquehanna Bank checking account#10012633292 99,232.16
4 Susquehanna Bank savings account#10012633193 120,780.97
5 Jewelry Auction, net proceeds -sold by Kenny's Auction 10,920.00
6 Refund,2013 income tax check 5,400.00
7 Refund, 2014 income tax check 311.12
8 Refund, Highmark Freedom Blue 29.97
9 Refund,Werson Funeral Home-overpayment(on pre-paid funeral) 2,891.54
TOTAL (Also enter on Line 5, Recapitulation) 240,613.64
(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)
^�°'7 1il II'l�l'11 °
' �ev-1510 EX+(08-09)
SCHEDULE G
� pennsylvania lNTER-VIVOS TRANSFERS AND
DEPARTMENTOFREVENUE MISC. NON-PROBATE PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hunka, Anna 21-14-1053
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.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °o OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSERSATRAC A COPY OF THE DEED�OR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Annuity,American General Life Insurance Company- 111,801.88 100.000°/a 111,801.88
Contract#FN249385. Beneficiary: Alois Hunka,Jr.
(decedenYs son)
TOTAL (Also enter on Line 7, Recapitulation) 111,801.88
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09)
.�1 11 r,.11''�'llf x
�REV-1511 EX+(OS-13) SCHEDULE H
; pennsylvania
� DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENTDECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Hunka, Anna 21-14-1053
Decedent's debts must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
NUMBER
q, FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees Salzmann Hughes, P.C. 7,500.00
3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 420.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 757.60
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 8,678.10
Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 08-13)
"�'I I I � III 1"I fl °
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hunka, Anna 21-14-1053
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Bank fee for monthly bank statement-(February 2015) 3.00
2 Bank fee for monthly bank statement-(April 2015) 3.00
3 Bank fee for monthly bank statement-(March 2015) 3.00
4 Bank fee for monthly bank statement-(May 2015) 3.00
5 Bank fee for monthly bank statement-(June 2015) 3.00
6 Bank fee for monthly bank statement-(November 2014) 3.00
7 Bank fee for monthly bank statement-(December 2014) 3.00
8 Bank fee for monthly bank statement-(January 2015) 3.00
9 Estate notice advertising -Cumberland Law Journal 75.00
10 Estate notice advertising -The Sentinal newspaper 291.60
11 Leab's Accounting, Inc.-preparation of 2014 personal tax return 80.00
12 Leab's Accounting, Inc. -additional work regarding 2014 personal tax return 12.00
13 Ludwig's Jewelers-appraisal of jewelry 275.00
H-B7 757.60
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev.6-98)
•`*"9 I I ; ll'1`IIf '
Rev-1512 EX+(12-12)
SCHEDULE 1
�; pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hunka, Anna 21-14-1053
RepoR debts incurred by the decedent prior to death that remained unpaid at the date of death,including r�nreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Green Ridge Village-final nursing home invoice 611.08
2 Millennium Pharmacy Systems, Inc. -final pharmacy invoice 544.03
TOTAL (Also enter on Line 10, Recapitulation) 1,155.11
(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 I(Rev. 12-12)
«.�rr; u rnt �
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Anna Hunka 10/02/2014 124-46-6610
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Alois Hunka Son fifty percent of residue
8952 Mount Olivet Dr. as per Item Second-A
Chambersburg, PA 17201 of Will, and Annuity
(Schedule G).
2 Anna Lee Hunka Granddaughter Twelve and one-half
6772 Brant Dr. percent of residue as
Mercersburg, PA 17236 per Item Second, B,of
Will.
3 Jacob Hunka Grandson Twelve and one-half
2978 Loma Place percent of residue as
Boulder,CO 80301 per Item Second, B,of
Will.
4 Joshua Hunka Grandson Twelve and one-half
569 Hill Churches Rd. percent of residue as
Latrobe, PA 15650 per Item Second, B,of
Will.
5 Trevor Hunka Grandson Twelve and one-half
569 Hill Churches Rd. percent of residue as
Latrobe, PA 15650 per Item Second, B,of
Will.
Total 342.582.32
1
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