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HomeMy WebLinkAbout08-11-15 � 1505614134 EX(03-14)(FI) REV-1500 Bureau of Individual Taxes INHERITANCE TAX RETURN Counry Code Year File Number Po Box 2soso� 2 1 1 5 0 0 2 5 Harrisburq, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDWYY Date of Birth MMDDYYW 1 6 3 4 0 0 1 5 1 1 2 0 4 2 0 1 4 0 3 1 8 1 9 5 2 Name Suffix DecedenYs First Name MI MADFI SCH DANI EL F (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI C 00 P E R J A M I E R 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 Priorto t2-13-82) � 4.Agriculture Exemption � 5. Future Interest Compromise(date of � 6, Federal Estate Tax Return Required (date of death on or after 7-1-2012) death after 12-12-82) � 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 � 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 DAVI D R . GALLOWAY 717 697 4700 First Line of Address WALTERS & GALLOWAY , PLLC Second Line of Address 54 EAST MAI N ST City or Post Office State ZIP Code MEC HA NI CS BU RG PA 1 7 0 5 5 ;..y c> ��� � CorrespondenYs e-mail address: DAVID(a7WALTERSGALLOWAY.COM � c� `� � n -��–�— �� �,� p REGIST,EF�O._1Ntt�S U NLY � � _.. - .. .__ � � m REGISTER OF WILLS USE ONLY � - ,� �-���� � '� 5� DATE FILED MMDDYYYY ` , ; � ; , —t7 -y i -5-� : , � 'rl ; �a .�.:= C7 N �...._ M f DATE FILED STANFF{- �� � PLEASE USE ORIGINAL FORM ONLY Side 1 I IIIIII IIIII IIIII IIIII(IIII IIIII IIIII IIIII II�II IIIII'lll II�I L 1505614134 1505614134 J �_t � � � 1505614234 REV-1500 EX(FI) DecedenYs Social Security Number DecedenYsName: DANIEL F. MADFISCH 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. 5 3 $ 2 • 7 2 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(totai Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 5 3 $ 2 , 7 2 • 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9� 4 6 5 6 9 . 6 7 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. � � 5 2 3 . 2 6 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 5 7 � 9 2 . 9 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. - �'J � 7 � � . 2 � 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. - 5 � 7 � � . 2 � 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 _ � . � O 15. O . � � 16. Amount of Line 14 taxable at lineal rate X.0_ � . � � �g. � . � � 17. Amount of Line 14 taxable at sibling rate X.12 � . � � 17. � . � � 18. Amount of Line 14 taxable at collateral rate X.15 � • � � 1 g. 0 • � � 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. � . 0 � 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 kno edge. N U OF SO E BLE FOR FILIN RETURN DATE � 8/7/2015 DRESS ICHELLE M. MCKEAN 407 NORMAN RD CAMP HILL PA 17011 OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE 8/7/2015 ADDRESS DAVID . ALLOWAY 54 EAST MAIN ST MECHANICSBURG PA 17055 I I'IIII III'I IIIII I'lll'llll IIIII IIIII IIIII II�I�II'II I'll II'I Side 2 � 1505614234 1505614234 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 2� 15 0025 DECEDENT'S NAME DANIEL F. MADFISCH STREET ADDRESS 304 EAST MAIN ST ��n' STATE ZIP SHIREMANSTOWN PA 17011 Tax Payments and Credits: 1� Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (2) 0.00 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWIN� 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 prope�ty transferred ...................................................................... ❑ QX b. retain the right to designate who shall use the property transferred or its income ............................... ❑ ❑X 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? ....................................................................................... ❑ � 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate propeRy,which contains a beneficiary designation?.................................................................................................. ❑ 0 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 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 or for 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. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: DANIEL F. MADFISCH 21 15 0025 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disciosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC BANK 647.72 CHECKING AND SAVINGS 2. 2008 DODGE AVENGER 4,735.00 KELLEY BLUE BOOK VALUE TOTAL(Also enter on Line 5,Recapitulation) $ 5 382.72 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL F. MADFISCH 21 15 0025 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. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY Of THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. PENNSYLVANIA STATE EMPLOYEES 388,783.76 100.00 388,783.76 0.00 RETIREMENT SYSTEM-PENSION EXEMPT TOTAL (Also enter on Line 7,Recapitulation) $ 0.00 if more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(OS-13) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL F. MADFISCH 21 15 0025 DecedenYs debts must be repoRed on Schedule[. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS BUHRIG FUNERAL HOME AND CREMATORY, LTD. 16,933.44 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)ofPersonalRepresentative(s) MICHELLE L. MCKEAN 14,850.00 StreetAddress 407 NORMAN RD City CAMP HILL State PA Z�P 17011 Year(s)Commission Paid: 2015 2. Attomey Fees: WALTERS&GALLOWAY, PLLC 13,350.00 3. Family Exemption:(If decedenPs address is not the same as claimanYs,attach explanation.) Claimant NONE SUeet Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 415.50 5 AccountantFees: MARK L.WETZEL, CPA-FIDUCIARY(RESERVED) 500.00 6. Tax Retum Preparer Fees: MARK L.WETZEL, CPA 175.00 2014 PERSONAL INCOME TAX 7. ESTATE NOTICE-THE PATRIOT NEWS 190.73 8. ESTATE NOTICE-CUMBERLAND COUNTY LAW JOURNAL 75.00 9. FEDERAL EXPRESS DISTRIBUTION TO BENEFICIARIES(RESERVED) 80.00 TOTAL(Also enter on Line 9,Recapitulation) $ 46 569.67 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES 8�LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL F. MADFISCH 21 15 0025 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. CLEANING-CAROL HUBBARD 506.00 APARTMENT 2. AUDREY BEAR, LANDLORD 1,300.00 JANUARY, FEBRUARY RENT 3 AUDREY BEAR, LANDLORD 620.74 DOOR REPAIR 4. PPL ELECTRIC UTILITIES qg,gg 5. COMCAST CABLE 7,89 6. 2014 PENNSY�VANIA INCOME TAX 76.00 7. 2014 FEDERAL INCOME TAX 1,485.00 8. ONEMAIN FINANCIAL 2,678.74 CREDIT CARD 9. DISCOVER BANK 2,300.00 CREDIT CARD 10. CAPTIAL ONE 1,500.00 CREDIT CARD TOTAL(Also enter on Line 10,Recapitulation) $ 10 523.26 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DANIEL F. MADFISCH 21 15 0025 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).] 1. MICHELLE L. MCKEAN Lineal 407 NORMAN ROAD CAMP HILL, PA 17011 2. ANGELA HESSE Lineal 6520 E. LOWELL LARIMER rD SNOHOMISH,WA 98296 3. ELENA MADFISCH Lineal 1304 SHELBY ST HIGGINSVIL�E, MO 64037 4. TARL MADFISCH Lineal 32 FOXTAIL AVE MIDDLEBURG, FL 32068 5. JAMIE COOPER Spousal 304 EAST MAIN ST SHIREMANSTOWN, PA 17011 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. $ If more space is needed,use additional sheets of paper of the same size.