HomeMy WebLinkAbout07-21-05
RE\l.1SOO EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPl 280601
HARRISBURG, PA 17128-0601
REV-1500
<JFrlCIAL USE ONLY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2-L-lL2
COUNTY CODE YEAR
~Q...ll-2..
NUMBER
SOCIAL SECURITY NUMBER
201 - 13
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DECEDENTS N~ME (L~ST, FIRST, ~ND MIDDLE lNITI~L)
CIIi\RT"iT~3 J. \,Trn'T"'EHS
DATE OF DE~TH (MM-DD-YE~R) DATE OF BIRTH (MM-DD-YEAR)
II ril 1) 200 June 10, 192(,
(IF APPLICABLE) SURVIVING SPOUSE'S N~ME (LAST, FIRST, AND MIDDLE INITIALI
Fill
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[i] 1. Original Return
o 4. Um"lled Eslale
o 6. Decedent Died Testate (AlIact1 co~y 01 WillI
o 9. litigation Proceeds Received
68L~3
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCI~ SECURITY NUMBER
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of dealh after 12-12.82)
o 7. Decedent Maintained a living Trus\ (Anach copy ofirusl)
o 10. Spousal Poverty Credit (dateofdeathbetween 12-31-91 and 1-1--95)
o 3. Remainder Retum(dale ofdealhprioflo12-13-82j
o 5. Federal Estate Tax Return Required
8. Total Number 01 Safe Deposit Boxes
o 11. Election to lax under Sec. 9113(A) (AttadI SclI 0)
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~ lleC'I"ClN MU$tElE eOMPlETED. All CORRESPONDENCEANb CONFlb . ,jNIl
N~ME COMPLETE MAILING ADDRESS
J. Hobert Stuufrer, lltty. J\ar1wt Square rHd[i.
FIRMNAME~\_'I lIeclulnicsburg, PI\. 170_[;r,
Clane ./
TELEPHONE NUMBER
717-766-9673
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Joinlly Owned Property (Schedule F)
o Separate BiUing Requested
7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule G or L)
8. Tolal Gross Assets (Iolallines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(1)
(2)
(3)
(4)
(5)
0.00
0.00
0.00
0.00
7.295.33
0.00
(8)
(7)
0.00
(9)
(10)
(8)
9,043.41
0.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estat. (line 8 minus Une 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
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14. Net Value Subject to Tax (Une 12 minus Une 13)
(II)
(12)
(13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
16. Amount of line 14 taxable allineal rate
17. Amount of Une 14 taxable at sibling rate
16. Amount of Une 14 taxable at collateral rate
19. Tax Due
0 x .0 Jl.- (15)
0 x .0 1J5 (16)
0 x .12 (17)
0 x .15 (18)
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
20.0
OFFiCiAL USE ONif
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Decedent's Complete Address:
s mEET ADDRESS
1100 Grandon \lay
CITY
Tax Payments and Credits:
1. Tax Due (Page I Une 19)
2. CreditS/Paymenls
A. Spousal Poverty Credit
B. Prior Paymenls
C. Discount
0.00
3.
InteresYPenalty if applicable
D. Inlerest
E. Penally
0.00
4.
TolallnleresYPenalty ( D + E )
If Une 21s grealer lhan Une 1 + line 3, enler lhe difference. This is lhe OVERPAYMENT.
Check box on Page 1 line 20 to request a refund
0.00
0.00
(3)
(4)
(5)
(5A)
0.00
0.00
0.00
0.00
0.00
5.
If Une 1 + Une 3 is greater than Une 2, enler Ihe difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enler the lotal of Une 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
I. Did decedent make a transfer and: Yes No
a. relain the use or income of the property transferred;.......................................................................................... 0 []I
b. retain Ihe righllo designale who shall use Ihe property Iransferred or its income; ............................................ 0 iii
c. retain a reversionary interest; or........................................................................................................................., 0 r;g
d. receive the promise for life of either payments, benefits or care? ...""................,........."..."..................".......... D G
2. If death occurred after December 12. 1982. did decedent transfer property within one year of dealh
without receiving adequate consideralion? .............................................................................................................. 0 5a
3. Did decedent own an "in trust for" or payable upon dealh bank acoount or security at his or her death? .............. 0 5a
4. Did decedenl own an Individual Retirement Acoounf. annuily. or other non-probale property which
conlains a beneficiary designation? ........................................................................................................................ 0 IX]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare Ihall have e~amined this rel\Jrn, including accompanying schedules and statemenls, and 10 !he Dest of my knowledge and belief, il is lrue, correct and complete.
OecIaralion of preparer olher Ihan the personal representative is based on all information of which preparer has any knowledge.
SI~P~?~l~lRLE FOR FILING RETURN
DATE
~ -/'J'--t:sS-
Road, Mechanicsburg, PA 17055
PRESENTATIVE
DATE
'7 - I ~ - 05
Market Squa e Bldg., Mechanicsburg, PA 17055
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For dates of death on or after July I. 1994 and before January I, 1995. the lax rale imposed on the nel vaiue of transfers 10 or for the use of the surviving spouse is 3%
[72 PS. ~9116 (a) (1.1) (i)].
For dates of death on or after January I. 1995. the tax rale imposed on lhe nel value of Iransfers to or for the use of the surviving spouse is 0% (72 P.S. ~9116 (a) (1.1) (ii)]
The stalute does not exemot a lransfer 10 a sUlViving spouse from tax. and the statulory requirements for disclosure of assets and filing a lax return are 81m applicable even i'
the surviving spouse is the only beneficiary.
For dates of death on or after July 1. 2000:
The tax rale imposad on the nel vaiue of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a nalural paren~ an adoptive parent
or a stepparent of the chitd is 0% (72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the nel value of transfers 10 or for the use of the decedent's lineal beneficiaries is 4.5%, except as noled in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(I)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's Siblings is 12% (72 P.S. ~9116(a)(1.3)]. A sibling is defined. under Section 9102, as ar
individual who has atlaast one parent in common with the deceden~ whether by blood or adoption.
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. , Erica L Schlegel
~ ~\:-:.,;....., 04/281200508:15 AM
To: Marcie L McCardell/ConsumerISCP/PNC@PNC
cc:
Subject: Date of death balance
Estate of Charles J Witters (Deceased)
SS# 201-18-6843
DOD 04-14-2005
ACCOUNT NUMBER * DATE OF DEATH BALANCE + ACCRUED INTEREST
DDA #5003696931
$7,289.33 Non interest bearing account
If you selected the balances to be sent to the "Branch" they will only be sent to
The requestor by Lotus Notes.
Have a great Day!!! :-)
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REV~""""'''J.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESrOEN DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
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.
CHARLES IT. l{I~? i1EnS
FILE NUMBER 21-05-00379
2005-00379
ITEM
NUMBER
1.
2.
VALUE AT DATE
OF DEATH
DESCRIPTION
FEG l3anlr, H. ^., chec!ci.n,; account 110. 50036969''\1.
Donegal Insurance Go., premimll rei'Ulld. . -
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7,269.33
6.00
7.29<;.11
TOTAL (Also enter on line 5, Recapitulation) S
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) .
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
CH,^,--T1T,r~s ,T. '.rT';1'~11i;.n~)
ESTATE OF
Debts of decedent must be reported on Schedule I.
FILE NUMBER 21-05-00379
2005-00379
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hyers Funeral Home, r East I-1a-tn 81;" , I1echanicsbul'g,
- I
Pennsylvania, funeral expenses. $ 8,224.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Represenlalive(s} Charles .J. 'fitters
Social Security Number(s)/EIN Number of Personal Representaliye(s) 167-L;.0-4915
Slreet Address 503 Allendale Road
City I.!echanicsburg, Slale ~ Zip 17055
Year(s) Commission Paid: None 0.00
2. Attorney Fees J. Robert Stauffer, Esq. , attorney fee. 200.00
3. Family Exemption; (If decedent's address is not the same as claimant's, attach explanation)
Claimant IT/A I
Street Address
City St~te ~ Zip
I
,
Relationship of Claimant to Decedent
4. Probate Fees Recister of l/ills of Cumberland County,
Pennsylvanla, Letters Testamentary. 87.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. r,oyal ton at Creekvieu, balance due for care. 112.30
8. Cumberland La,'1 Journal, Estate l'lotice. 75.00
9. The Sentinel, Estate Hotice. 122.51
10. Omnicare, balance due on medical bill. 37.65
11. SuAnn Brenner, reimbursement for T'leCiications. 59.95
12. Keystone Urology, medical bill. 110.00
13. Register of llills, filing Pennsylvania Ineritance
Tax Return. 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 9,043.L;.1
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00) '"
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE ..
BENEFICIARIES
ESTATE OF
CILl\..TILES J. ~!I\;~:?TiJ1S
NUMBER
I
2.
3.
l~ .
FILE NUMBER
21-05-00379
2005-00379
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not usnr.s!..(s)
TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under
Sec. 9116 (a) (12)1
AMOUNT OR SHARE
OF ESTATE
1
'r'HOHAS TI. t, :r:~';_11'TI S
r~03 Allendale Hoad One-1'ourth sh are
Hechanicsburg, PA 1705) Son 01' Estate.
TIMOTHY C. HITTERS
653 Spring Lane One-f"ourth sh are
Boiling Springs, PA 17007 Son of Estate.
LuANN DIEHL
1117 Apple Drive One-1'ourth sh are
11echan 1. csbUJ."[;, PA 170S;5 Da11ghter 01' Estate.
SuAnn Brenner
21 :.:est Simpson St. One-1'ourth sh are
llechanicsbul'[" FA 170,?'7 Daughter of Estate.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1S00 COVER SHEET $
(If more space IS needed, Insert addItIonal sheets of the same size)