HomeMy WebLinkAbout11-04-05 (2)
REV-1500 EX + (6-00)
I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
!z I Brenizer, Helen V.
~ DATE OF DEATH (MM-DD-YEAR) 1 DATE OF BIRTH (MM-DD-YEAR)
~ 08-20-2005 10-05-1913
~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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~ 1, Onglnal Return
~ 4. Limited Estate
D 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFIC!Al USE ONLY
FILE NUMBER
II J..'~~ -: -
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
~\\\ ~.
NUMBER
171-28-4733
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D
D
D
D
D 3. Remainder Return (date of death pnor to 12-13.82)
D 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
2, Supplemental Return
4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Poverty Credit (date of death between
, 12-31-91 and 1-1-95)
NAME
Richard L Webber, Jr., Esquire
FIRM NAME (If applicable)
Weigle & Associates, P.C.
.....
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TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
126 East King Street
Shippensburg, PA 17257
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. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) D Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
11. Total Deductions (total Lines 9 & 10)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(11 )
1,019.50
43,998.53
0.00
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
43,998.53
717-532-7388
1. Real Estate (Schedule A)
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SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
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16.Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
0.00
x .00 (15)
0.00
43,998.53
x .045 (16)
1,979.93
0.00
0.00
x .12 (17)
0.00
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
0.00
1,979.93
(19)
19. Tax Due
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00;
RK
Decedent's Complete Address:
STREET ADDRESS
280 N. Locust Point Road
CITY Mechanicsburg
I STATE P A
i
,
:ZIP 17050
I
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
1,880.93
99.00
Total Credits (A + B + C)
(2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPA YMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE
1,979.93
1,979.93
(3)
(4)
(5) 0.00
(5A)
(58) 0.00
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
a. retain the use or income ofthe property transferred;............................................................................. [J
b. retain the right to designate who shall use the property transferred or its income;................................ [J
c. retain a reversionary interest; or............................................................__............................_................. [J
d. receive the promise for life of either payments, benefits or care?........................................................... []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................ .............................................................. __..................... [J
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 property 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.
Under penalties of perjury, I declare that 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 personal representative is based on all information of which pre parer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
Doris J Brenizer
280 North Locust Point Road
Mechanicsburg, PA 17050
G RETURN
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Richard L Webber, Jr. Esquire
!
ADDRESS
126 East King Street
Shippensburg, PA 17257
No
[!]
[!]
[!]
[!]
[!]
[!]
11-3'05
DATE
DATE
t- 5~ ()~
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 statutedoes 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 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-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlYo.Owned with the right of survi vorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Blue Cross/Blue - Refund
113.08
TOTAL (Also enter on Line 5, Recapitulation)
113.08
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1509 EX+ (6-98)
SCHEDULE F
JOINTL V-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
FILE NUMBER
21..
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
A. Doris J Brenizer
ADDRESS
280 North Locust Point Road
Mechanicsburg, PA 17050
RELATIONSHIP TO DECEDENT
Daughter
B.
C.
JOINTLY OWNED PROPffiTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSE INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 8/8/1996 PNC Bank - Checking Account 5,969.89 0.500% 2,984.95
2 A 8/8/1996 Real estate, together with improvements 83.840.00 0.500% 41,920.00
thereon, situate in Silver Spring
Township, Cumberland County,
Pennsylvania known as 280 N. Locust
Point Road, Mechanicsburg, PA 17050
TOTAL (Also enter on Line 6, Recapitulation) 44,904.95
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
REV.1151 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 504.50
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees 500.00
See continuation schedule(s) attached
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
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 1,019.50
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
FILE NUMBER
ITEM
NUMBER DESCRIPTION
1 Ewing Brothers Funeral Home
AMOUNT
504.50
Subtotal
504.50
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-B2
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
FILE NUMBER
ITEM
NUMBER DESCRIPTION
1 Weigle & Associates, P.C.
AMOUNT
500.00
Subtotal
500.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYL V ANfA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Brenizer, Helen V.
FILE NUMBER
ITEM
NUMBER DESCRIPTION
1 Cumberland County Register of Wills - Filing fee for inhertance tax return
AMOUNT
15.00
Subtotal
15.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B? (Rev. 6-98)
REV-1513 EX+ (9-00)
, SCHEDULE .J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Brenizer, Helen V. 21--
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trusteef;)
I. TAXABLE DISTRIBUTONS [include outright sfrousal
aistributions, and ransfers
under Sec. 9116(a)(1.2)]
Doris J Brenizer Daughter One Hundred 43,998.53
280 North Locust Point Road Percent
Mechanicsburg, PA 17050
Total 43,998.53
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTICNS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION 1) TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIGJS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTICNS ON LINE 13 OFREV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
. .
I
Helen V. Brenizer
I
Date of Death Sat, Aug 20, 2005
3 Months After 000 MOI"I,Nov21,2005
I PA Estate Tax
Optimal Discount Paymentf
Prior Payments
Click here
if Paid
at Discount Date Paid
Total
Tax Paid
Paid at
Discount
Not Paid at
Discount
Discount
181 Wed, Oct 5, 2005 1,880.93 1,880.93
0
0
0
0
0
D. Discount
C.
Tax
1,880.931 x
I x
1,880.9.31 x
5 / 95 =
F.
Discount
99.00 I
I
99.00 I
I
I
I
1,880.9.31 x 5 / 95 = I 99.00 1(1) *
1,979.931 x 5% = I 99.001 (2)*
Lesser of (1) or (2) above I 99.00 I
I 1,979.931
I 1,979.93/
I 0.001
* The calculations in (1) and (2) are intentionally different. Item (1) computes the amount of discount
based upon an assumed NET payment. Item (2) computes the maximum potential discount based upon an
actual GROSS principal tax due. Thus, a discount always equals the NET payment x 5 /95, or the GROSS tax x 5%.
A. Tax Paid at Discount (per above)
B. 0 Tax Due if Entire Balance paid on/before Mon. Nov 21. 2005
5 / 95 =
C. Total NET Tax PaidlTo be Paid at Discount
5 / 95 =
E. Tax Credit (C + D)
F. GROSS Tax Due (Page 1, Line 19)
G. Balance of Tax Due
OCT-04-2005 21:48
PNCB8NK
412 768 3458
P.01/01
o PNCBAN<
October 5,2005
Weigle & Associates PC
Attn: Richard L Webber, Jr., Esq.
126 East King St.
Shippensburg, P A 17257-1397
seplal
RE: Estate of Helen Brenizer (Deceased)
SSN: 171-28-4733
DOD: 08-20-2005
Dear Mr. Webber:
ill response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account #5070103593 Established 03-14-1989
HELEN BRENIZER
DORIS J BRENIZER
DOD balance: $5,969.42 + $0.47 accrued interest
The decedent did not maintain any safe deposit box, loans or mortgages with PNC Bank.
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings acco\Ults). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call1-888-PNC-BANK (1-888-762-2265) Or stop by your local PNC Bank branch
office.
Sincerely,
~ ;<r~
Erica L Schlegel
1-800-762-1775
P7-PFSC-04-F
500 First A vc.
Pittsburgh P A 15219
Member FDIC
.' -
FacetWin Screen Print for recdeeds, from "CAMA_Login" 9/19/2005 10:54:59 AM
DISTRICT: 38 - SILVER SPRING TWP SD:
CUMBERLAND COUNTY ASSESSMENT OFFICE 2004 BASEYEAR
CONTROL # 38002788
NEIGHBORHOOD: 3832
I
I
IShort Name
ILAST NAME
IFIRST NAME
Ic/o NAME
IADDRESS1
IADDRESS2
IpOST OFFICE:
ISTATE & ZIP:
I
4 PARCEL: 38-19-1621-102.
SPEC ID: LOT: L-0005
Tback:
BRENIZER, HELEN V & DORIS J
BRENIZER
HELEN V & DORIS J
PROPERTY TYPE: R
280 NORTH LOCUST POINT ROAD
SALES
DEED BK/PG.....00144-00869
DATE OF SALE...08/23/1996
SELLING PRICE: 1
MECHANICSBURG
PA 17050
Situs: 280 N LOCUST POINT ROAD J CURRENT VALUES I
Prop Descrip.: J Assessed Fair Market L,
LAND DESC: LOT 5 PB 39 PG 61 FMV - 83840 L - 26460 I
LAND USE TYPE: 101 C&G - B - 57380 I
DEEDED ACRES: .25 approved? -> T - 83840 I
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