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HomeMy WebLinkAbout08-27-15 (2) J pennsylvania 1505618403 DEPARTMENT OF REVENU€X(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO 60x.280601 INHERITANCE TAX RETURN 21 15 0545 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 03 11 2015 07 15 1920 Decedent's Last Name Suffix Decedent's First Name MI PARR JOHN R (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 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 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 MUSTBECONNPLEfED.ALLANDCONRDETRIALTAXWORMATi0NSHOULDBEDIRECTEDTO: Name Daytime Telephone Number GERALD J BRINSER 717 838 6348 First Line of Address 6 E MAIN STREET Second Line of Address PO BOX 323 City or Post Office State ZIP Code PALMYRA PA 17078 Correspondent's email address: gibrin@aol.com REGIS'ER OA WILLS US5ONQY .E c: REGISTER OF WILLS USE ONLY DATE FILED MMDD =�„ F'? fV rrs rl I' ­3 , c� DATE FILED STA 00 CD Side 1 1505618403 1505618403 1505618411 REV-1500 EX Decedent's Social Security Number Decedents Name: PARR, JOHN R. 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. 31 , 058 • 69 6. Jointly Owned Property(Schedule F) ❑ 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. 31 , 058 . 69 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 1 , 489 • 69 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 12 , 119 4 5 11. Total Deductions(total Lines 9 and 10).................................................................. 11. 13 , 609 • 1 4 12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 17 , 4 4 9 - 5 5 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. 17 , 4 4 9 55 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 8 , 7 2 4 . 78 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 8 , 7 2 4 . 77 16. 392 161 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................................................................................................................... 19. 392 • •61 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 tiling the return is based on all information of which preparer has any knowledge. SI NATU E OF RJERSOLRESIP SIBLE FOR FI NG E,rtlRa o yn D DATE ADDRESS 2044 eorgian Way,Apt. D21, Lexington, KY 40504-3047 SIGNATURE O REPARER OT R HAN REPRESENTATIVE Gerald J Brinser DATE ADDRESS 11rinser,Wagner&Zimmerman 6 E. Main Street, Palmyra, PA 17078 1111111111111111111111 IN Side 2 1505618411 1505618411 J REV-1500 EX Page 3 File Number 21 - 15 - 0545 Decedent's Complete Address: DECEDENT'S NAME Parr, John R. STREET ADDRESS 100 Mt. Allen Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 392.61 2. Credits/Payments A. Prior Payments _ B. Discount Total Credits(A +B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line I +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) 392.61 Make Check Payable to: REGISTER OF WILLS, AGENT. MOM IN 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;.................................... ❑ a c. retain a reversionary interest;or.................................................................................................................. ❑ 0 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?.........................................................................................:............................. ❑ ❑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 contains a 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 spo 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 F?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 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 21ears 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[72P.S.§9116(a)(' •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. pennsylvania SCHEDULE E ` DEPARTMENT OFANCETA RETURN CASH BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN � RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Parr, John R. 21 - 15-0545 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 OF NUMBER DESCRIPTION DEATH 1 PNC Bank-Checking Account#328710219 25,155.28 (Includes accrued interest of$.11) 2 Long-term Care Insurance 5,761.18 3 Supplemental Insurance- Refund of Premium 142.23 TOTAL(Also enter on Line 5, Recapitulation) 31,058.69 REV-1511 EX+(08-13) ' pennsylvania SCHEDULE DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF Parr, John R. 21 - 15-0545 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Brinser,Wagner&Zimmerman--Gerald J. Brinser 1,044.50 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 Register of Wills (Ltrs. Pd. $60.00 = $10,000 -$25,000) 180.50 Register of Wills- File Bond 15.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Register of Wills-Additional Cost of Letters 30.00 See attached 219.69 TOTAL(Also enter on line 9, Recapitulation) 1,489.69 REV-1511 EX+(08-13) pennsylvania Schedule H DEPARTMENT OF REVENUE INHERITANCE TAX RETURN Funeral Expenses& RESIDENT DECEDENT A,dministraWe Costs Confined ESTATE OF Parr, John R. FILE NUMBER 21 - 15-0545 2 Travelers Casualty and Surety Co. of America - Bond for Out-of-State Executrix 219.69 Page 2 of Schedule H Pennsylvania SCHEDULE I DEPARTMENT OFDEBTS OF DECEDENT MORTGAGE EVENUE RET INHERITANCE TAXAXRETURRNN � RESIDENT DECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF Parr, John R. 21 - 15-0545 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 1 Alert Pharmacy 327.92 2 Messiah Lifeways at Messiah Village 3,326.45 3 Outstanding Checks at Time of Death (Messiah Lifeways$8,144.00; Messiah Lifeways 8,465.08 $135.75; Alert Pharmacy$185.33) TOTAL(Also enter on Line 10, Recapitulation) 12,119.45 REV-1513 EX+(01-10) PennsY Ivania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Parr, John R. 21 - 15-0545 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not ListTrustee(s) I� TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Virginia Parr Spouse 1/2 Residue 8,724.78 742 Oak Oval Messiah Village Mechanicsburg, PA 17055 2 Judy Roberts Daughter 1/10 Residue 1,744.96 940 Village Trail, Unit 7-202 Port Orange, FL 3127 3 Deborah Williams Daughter 1/10 Residue 1,744.96 102 Ash Run Road Louisville, KY 40245-6114 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV-1513 EX+(01-10) %y Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF Parr,John R. I FILE NUMBER 21 - 15-0545 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not ListTrustee(s) I� TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 4 Terri Geddings Daughter 1/10 Residue 1,744.96 P.O. Box 82 Bat Cave, NC 28710 5 Diana Shoop Daughter 1./10 Residue 1,744.96 300 Ferguson Road Lexington, KY 40511-8306 6 Carolyn Danks Daughter 1/10 Residue 1,744.96 2044 Georgian Way,Apt. D21 Lexington,KY 40504 Page 2 of Schedule J Jul. 14. 2015 1 : 13PM PNC BANK 412-705-0057 No. 0337 P. 1/2 IV PN C July 14, 2015 Brinser Wagner&Zimmerman 6EMain St2"'PL East Main& South Railroad St P 0 Dox 323 Palmyra, PA 17078 RE: John R Parr SSN: 134-09-0303 DOD: 03-11-2015 Dear Sir/Madazn: In responsc to your request for Date of Death(DOD)balances fox the custorner noted above, our records show the following: Checking Account Account# 5113677053 w Established: 02-03-2014 ©� JOHN R PARR . DIANA SHOOP DOD balance: $500.00+ 0.00 accrued interest Account# 5114427152 00 ` Established: 05-14-2014 JOHN R PARR VIRGINIA L PARR DOD balance: $500.00+0.00 accrued interest Account#3028710219 Established: 12-08-2014 JOHN R PARR DOD balance: $25,155,17+0.11 accrued interest Page 1 of 2 Jul. 14. 2015 1 : 13PM PNC BANK 412-705-0057 No. 0337 P. 2/2 Please note that this office provides date of death balances for deposit accounts(IRAs, CDs, Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch office_ Sincerely, National Financial Services Center PNC Bank,N.A. Member FDIC This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited. If you have received this communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this faxed document Page 2 of 2 RECEIPT FOR PAYMENT ------------------- ------------------- LISA M. GRAYSON, ESQ. Receipt Date : 5/22/2015 Cumberland County - Register Of Wills Receipt Time : 08 :45 :25 One Courthouse Square Receipt No. : 1081442 Carlisle, PA 17613 PARR JOHN R Estate File No. : 2015-00545 Paid By Remarks : BRINSER WAGNER & ZIMMERMAN HMW ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM 60 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 5 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 35 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN RENUNCIATION 25 . 00 CUMBERLAND COUNTY GENERAL FUN COMMISSION TO TAKE 20 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 5242 $180 . 50 Total Received. . . . . . . . . $180 . 50 RECEIPT FOR PAYMENT ------------------- LISA M. GRAYSON, ESQ. Receipt Date: 6/16/2015 Cumberland County - Register Of Wills Receipt Time : 11 :53 : 07 One Courthouse Square Receipt No. : 1081670 Carlisle, PA 17613 PARR JOHN R Estate File No. : 2015-00545 Paid By Remarks : BRINSER WAGNER & ZIMMERMAN DMB ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name BOND 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check## 5300 $15 . 00 Total Received. . . . . . . . . $15 . 00 Bond No. 106316986 Register of Wills of Cumberland County BOND AND SURETY FOR PERSONAL REPRESENTATIVE Estate of John R Parr No. 21-2015-0545 Also known as Deceased KNOW ALL BY THESE PRESENTS,that Carolyn Danks As principal(s)and Travelers Casualty and Surety Company of America as surety(sureties)are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of Thirty Two Thousand dollars ( $32,000.00 )to be paid to the Commonwealth,for which payment we do bind ourselves,jointly and severally,our heirs,executors,administrators and successors,the condition of this obligation being that if Carolyn Danks as(state fiduciary capacity) Administrator of the estate of John R Parr deceased,or any of them,shall well and truly administer the estate according to law,then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and his or their surety or sureties;but otherwise it shall remain in full force. Signed and sealed this 10 day of June 2015 ------- .each intending to be legally bound hereby. Carolyn Danks 6vldltryll Signatur V1f Persora7kep-resentative Signature of Personal Representative Signature of Personal Representative Travelers Casualty and Surety Company ofAmerica (Sea]) `-�---Sijnatujre of Bonding Agency Lamon Warnock Account Transaction Detail Report Page 1 of 1 El Ascending0❑ Descending Account Transaction Detail Report (QFNC Account Number: 3028710219 Post Date Effect Date Amount Balance DCN Ph Seq/fief# Description 07/01/2015 07/01/2015 $3,326.45 $18,720.04 D N 073058784HEC 116 k MIYL 073058784 06/29/2015 06/29/2015 $219.69 $22,046.49 D N 0773810 117 D)MUk 77382023 06/29/2015 06/29/2015 $327.92 $22,266.18 D N 077454136.CHECJ115 AIS Owwe.1, 077454131 06/23/2015 06/23/2015 $0.05 $22,594'.10 D N INTEREST WITHHOLDING 06/23/2015 06/23/2015 $0.18 $22,594.15 C N INTEREST PAYMENT 05/26/2015 05/26/2015 $0.05 $22,593.97 D N INTEREST WITHHOLDING 05/26/2015 05/26/2015 $0.20 $22,594.02 C N INTEREST PAYMENT I 04/27/2015 04/27/2015 $1,516.10 $22,593.82 C N 03433823 DEPOSIT /� 034338230 https://www.cct.pncbank.com/eaimsg/pp/EaiMessageServlet?SOURCE-CHANNEL=UNK... 7/8/2015