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HomeMy WebLinkAbout09-16-05 (2) REV-I500 EX (<><10) REV-1500 '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 . HARRISBURG, PA 17128-0601 W I- ll::!!;Ul ua:ll: wll.U J:oo ua:... II.lD II. < INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 05 0218 COUNTY COOE YEAR NUMBER I- Z W C W o W C DECEDENrs NAME (LAST, FIRST. AND MIDDLE INITIAL) Kuhn, Ronald D. ;;~ ~;;;~H (MM~~YEAR)-~~__l~~~~~;;~ ~~-D~::R) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER i 179-30-4054 _____.L___..._.___.._~_._______ ---. I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I REGISTER OF WILLS , SOCIAL SECURITY NUMBER ~ 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (AIlach copy ofWil) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date 01 dealh an", 12-12-82) D 7. Decedent Maintained a Living Trust (AIlach copy of Trusl) D 10. Spousal Poverty Cred~ (date ofdealh between 12-31-91 and 1-1-95) D 3. Remainder Return (dateoldealh prior to 12-13-82) D 5. Federal Estate Tax Return Required ..!.. 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(Aj (Attach Sell 0) NAME John C. Oszustowicz FIRM NAME (If Applicable) Law Office of John C. Oszustowicz TELEPHONE NUMBER (717) 243-7437 COMPLETE MAILING ADDRESS 104 S. Hanover St. Carlisle, PA 17013 1. Real Estate (Schedule A) (1) 10,272.00 2. Stocks and Bonds (Schedule B) (2) 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 4. Mortgages & Notes Receivable (Schedule Dj (4) 0.00 5. Cash, Bank Depos~s & Miscellaneous Personal Property (5) 8,274.55 Z (Schedule E) 0 6. Jointly Owned Property (Schedule F) (6) 6,250.00 ~ D Separate Billing Requested ...J (7) 0.00 ::) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property !:: (Schedule G or L) I:L <( 8. Total Gross Assets (total Lines 1-7) (8) 0 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10,636.21 W a::: (10) 7,816.17 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES - ..:~ l"./1 ~- -, "J C.J 24,796.55 18,452.38 6,344.17 000 6,344.17 z o ~ ~ =>> ~ :iE o o ~ 15. Amount of Line 14 taxable atlhe 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 _ (16) 12Q.OO x .12 (17) ~_~_____p,g?4, 17 x .15 (18) (19) 948.03 17. Amount of Line 14 taxable at sibling rate 14.40 18. Amount of Line 14 taxable at collateral rate 933 63 19. Tax Due 20.~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS :-<XI vv:::lITnr Avp! CITY I STATE I ZIP Lemovne PA 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CredilslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 948.03 0.00 1,140.00 60.00 Total Credits (A + B + C ) (2) 1,200.00 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 251.97 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the Iotal of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT I 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;.......................................................................................... D ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or.......................................................................................................................... D ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .. ......................... ......................... ......................... ...................... ....... .... D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............ ......................... ......................... ......................... .................. ........... .... D ~ 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 penaties of perjury, I declare that I have lIXlWIIIned 1I1is return, including accompanying schewles and statements, and 10 1he best of my knowledge and belief, n is 1rue, correct and complete. Declaration of preparer o1her 1han 1I1e personal represen1ative is based on all information of which preparer has any knowledge. SIGNATURE OF PERS~ RESPON/Z F~RETU~ ~ -yr; a .1- CL&.- f:.. ':JZf'. " ADDRESS ' / 322 . Walnut St., Mt. Holly S rings, PA 17065 SIG E OF PR OTHE REPRESENTATIVE DATE f/,O/05 / f u- i For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [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% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [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%, except as noted in 72 P,S. ~9116(1.2) [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% [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-1502 EX+ (6-9_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kuhn, Ronald D. 21~05-0218 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which properly would be exchanged between a wilting buyer and a willing seller, neither being compeUed to buy or seM, both having reasonable knowledge of the relevant faels. Real property which is jolntly~ed with right of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION 15.5 acres vacant land, Hill St., Mt. Holly Springs, PA 17065 VALUE AT DATE OF DEATH 10,272.00 Decedent owned a 1/5 interest as tenant in common. Valuation determined by multiplying the common level ratio of 1 by the assessed value. See attached assessment. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,272.00 F TAXES ARE ESCROWED. FORWARD THIS BILL TO YOUR AORTGAGE CO. $1.00 FEE FOR EACH ADDITIONAL RECEIPT 'AVABLE TO: MABLE R. SATTESON, TAX COLLECTOR 3 TRINE AVENUE MT HOLLY SPRINGS,PA 17065 IESC: MAP NO: 23-12-0340-003 HILL STREET ACRES 15.500 DEED 0029M00304 LAND APPROX 15 ACRES Vacant Land . VACANT LAND TAX GARDNER, DENNIS kETAL 'AVER CIO MARLIN HECKERT 322 NORTH WALNUT STREET MOUNT HOLLY SPRINGSPA 17065 )FFICE WED 4-9PM,FRI 3-8PMADDEQHRS ~OURS: LAST 2 WKSAPR&AUG to-t2WED.&FRI APPT ONLYNOV t.30.DEC17cFEB28 CLOSED HOLlDA YS.(717)A8(:l-3486* Cornmon TAXPAYER <.;UPY 1:$111 NO: 242 2005...St8tementof.R8f1IEst8teTax8S Improvement Mineral o 0 BiIICate: Total 51 360 F~ 3/01/2005 Control No: 023 - 000002 AssesSed Land Values 51 360 COUNTY Of CUMBERLAND Rates .00200600 COUNTY R B 103.03 Rates .00018000 COUNTy LIB 9.24 R MT SPRINGS Rates .00139000 MUNIC.RE 71.39 Rates .00028000 MUNST LT 14.38 D1lCOunt 2 \ 100..97 2 \ 9.06 103.03 Penal 10 \ 113.33 10\ 10.16 2 \ 69.96 2 \ 14.09 TAX AMOUNT DUE-> 1213112005 .. SEE REVERSE SIDE OF BILL FOR A BREAKDOWN OF YOUR COUNTY TAX DOLLARS .. Return Bill with Payment. For a Receipt, Enclose Self Addressed Stamped Envelope. _ --._. _~-' ,.- .-.~"...." __ _ "..,~ _..,-_-,,"-'_':'-_'-_'_ ~'t,.~."",.....;.;"~,.~---,.....-,.-""""",,,",'_c';;"""";"~:;;"";..... . level ro.:.-hD' ::. I TRACT NO.1: BEGINNING at a pipe located South 74 degrees 2S minutes 50 seconds West of the Southeastern corner of a certain 20 foot wide private alley (commonly known as Divens Alley), a distance of 18.83 feet; thence along lands now or formerly of Kate C. Gill, more lately Edward T. Scholly, South 17 degrees 15 minutes East, a distance of 98.54 feet to a point: thence along the same, North 73 degrees 57 minutes East, a distance of 170.21 feet to a point in land formerly of Kate C. Gill, more lately of William K. Peffer; thence along said land formerly of Kate C. Gill, more lately of William K. Peffer, and Tom O. Bietsch, South 17 degrees 50 minutes 04 seconds East, a distance of 1590.44 feet to a stone pilei thence along the same, South 73 degrees 21 minutes 56 seconds West, a distance of 398.62 feet to a stone pile in line of lands formerly of Henrietta Harman, more lately of Spero Touloumes; thence along said land, North 17 degress 50 minutes 04 seconds West, a distance of 1695 feet to a point in line of lands formerly of Diven, more lately of Jean Kuykendall; thence along said lands and land of Tract No. 2 hereinafter described, North 74 degrees 25 minutes 50 seconds East, a distance of 229.59 feet to a pipe, the place of BEGINNING. CONTAINING 15.093 Acres. l'i_ TOGETHER with the free and common use, right, liberty and priVilege of a certain angular strip of land on the Northward and Eastward ,sides of the tract berein described, 20 feet in width, as well as of the said Diven's Alley as and for a passageway and water course at all times hereafter forever. TRACT NO.2: BEGINNING at a nail set in Hill Street at corner of lands '~ now or formerly of Arnold, more lately that of William Noel; thence along said lands and land formerly of Arnold, more late of Edward T. Scholly, South 17 degrees 15 minutes East, a distance of 275.63 feet to a point, said line being the Eastern side of a 20 'foot wide,blind alley known as Diven's !l-lley; thence along said, land lately of Scholly and Tract No. 1 hereinbefore described, South 74 degrees 25 minutes 50 seconds vlest, a distance of 133.42 feet to an iron pipe; (', thence along lands formerly of D. Fred Souders, Jr., more lately of Jean Kuykendall, North 22 degrees 37 minutes 39 seconds West, a distance of 122.98 feet to a point in line of lands formerly of Group, more lately of Harold L. Clippinger; thence alo~g said lands North 75 degrees 00 minutes 40 seconds East, a d~stance of 65 fe~t to a point in line of lands formerly of Diven, more la~ely of Lloyd Myers: thence along said land, South 17 degrees 15 m~nutes East a distance of 35 feet to a point: thence continuing along said'lands, North 75 degrees 00 minutes 4~ seconds East, a distance of 60 feet to a point on the Western side of Diven Alley; thence along the Western side of Diven Alley, North 17 degrees 15 minutes West a distance of 190 feet to a point in the bed of Hill Street; then~e in the bed of Hill Street, North 75 degrees 00 minutes 40 seconds East, a distance of 20 feet to a point, the place of BEGINNING. CONTAINING .410 Acres. BEING the same two tracts of land which Pearl E.Myers and William A. Myers, her husband, by deed dated March 31, 1962 and recorded in the Office of the Recorder of Deeds in and for Cumberland County at Carlisle, Pennsylvania, in Deed Book "M", Vol. 20, page 22, granted and conveyed to Theodore A. T~chy ~nd Ann~e Lee Tichy, ~is wife. The said Theodore A. Tichy hav~ng d~ed Apr~127, 1?80, t~tle to the above described premises remained vested by operat~on of law solely in his surviving spouse, Annie Lee TiChy, Grantor herein. ,~..,. . ~"...,.. '. _1, .:-'" . 'r'. I . :,: ':~:!. "f: , I pj),' REV-150B EX+ (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Kuhn, Ronald D. FILE NUMBER 21-05-218 In dude the proceeds of litigation and the dale the proceeds were received by the estate. All property Jolntly-own.d with right of survivorship must b. disclosed on Schedul. F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH M&T Bank Checking Account #45691703 2. M&T Bank Savings Account #25004920151814 3. State Farm Auto Insurance Refund Policy 556 6872-B27-38T 4. United Health Care Refund Membership #064774154 5,323.66 700.19 305.70 5. Monumental Life Insurance Payment 600.00 500.00 6. Federal Tax Refund - 2004 Return 600.00 9 Dishes 25.00 100.00 20.00 7. Computer 8 Misc. furniture 1 0 Gucci watch 75.00 11 Ruby ring (man made ruby) 25.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,274.55 REV-1509 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLy-oWNED PROPERTY ESTATE OF Kuhn, Ronald D. FILE NUMBER 21-05-0218 If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Thomas A. Hosie 387 Walton Ave. , Lemoyne, PA 17043 friend B. C. JOINTLY-owNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 2001 Cadillac VIN 1G6KD54Y31Ul66813 12,500.00 50 6,250.00 TOTAL (Also enter on line 6, Recapitulation) $ 6,250.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12~3) '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RE1URN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUnES, & UENS ESTATE OF FILE NUMBER Kuhn, Ronald D. 21-05-218 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Auto Loan - 2001 Cadillac VIN 1G6KD54Y31U166813 Loan obligation $11,100 Car and loan were 5,750.00 owned jointly (50%) and are being reported as such. . 2 Youngs Medical Equipment 110.00 3 The State Employees' Retirement System. Refund of overpayment for period 2/11/05-2128/05 1,956.17 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,816.17 REV.1511 EX+ (12.99>W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATM COSTS ESTATE OF Kuhn, Ronald D. RLE NUMBER 21-05-218 Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT 2 FUNERAL EXPENSES: Hollinger Funeral Home and Crematory Church Rental and food Engraving on headstone 8,590.00 200.00 247.00 1. 3 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Add ress City State Zip Year(s) Commission Paid: 2. Attorney Fees 1,300.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City Slate .Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanfs Fees 6. Tax Raturn Pre parer's Fees 7. Legal advertising 8 Family SetUement Agreement 118.00 161.21 20.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,636.21 REV-1513 EX+ (!l-OO) '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX REWRN RESIDENT DECEDENT ESTATE OF Kuhn, Ronald D. SCHEDULE J BENEFICIARIES FILE NUMBER 21-05-218 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 Onclude outright spousal distributions, and translern under Sec. 9116 (a) (1.2)] 1 Thomas A. Hosie 387 Walton Ave., Lemoyne, PA 17043 friend 6,224.17 2 Marcia Heckert 322 N. Walnut St., Mt. Holly Springs, PA 17065 sister 100.00 3 Fern Gardner 18 Holly St., Mt. Holly Springs, PA 17065 sister 20.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET n NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (II more space is needed, insert additional sheets of the same size)