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Home My WebLink About12-06-05 (2) REV-1500 EX + (6-00) * COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY w .... lI:::!1I) uQ:lI:: wQ.u ",00 uQ:..J Q.1II Q. 0( [!] 1. Original Return o 4. Limited Estate [!] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received 2. Supplemental Return FilE NUMBER II 05 COUNTY CODE YEAR SOCIAL SECURITY NUM8ER 205-09-9815 T'THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS I SOCIAL SECURITY NUM8ER I o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes 0842 NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Spahr, Charles I. , DATE OF DEATH (MM-DD-YEAR) -, DATE OF BIRTH (MM-DD-YEAR) I 09-14-2005 I 01-20-1920 [(iF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) I- Z W C W o w c 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 SpOusal Pover!)' Credit (date of death between . 12-31-91 and 1-1-95) .... z w c z o Q. II) w Q: Q: o U NAME Gary L. James, Esq. FIRM NAME (If applicable) , James, Smith, Dietterick & Connelly, LLP TELEPHONE NUMBER 717/533-3280 11134 Sipe Avenue Hummelstown, PA ---__L 17036 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested j:: :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) :> (Schedule G or L) 0 Separate Billing Requested l- ii: 8. Total Gross Assets (total Lines 1-7) < 0 9. Funeral Expenses & Administrative Costs (Schedule H) (9) w a: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) None None None None . OFFICIAL~E ONLY _.:!.. c..;;:.) .~ c,n rn [', '--) ,~, S~1 ~ ! 0', .....,.; , ....) :""r-; 16,009.64 None u f'''Ie) 573,252.24 N (J'I 17,226.60 96.05 (8) 589,261.88 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) (11) 17,322.65 (12) 571,939.23 (13) 0.00 (14) 571,939.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 (16) j:: 16.Amount of Line 14 taxable at lineal rate 571,939.23 x .045 ~ :> Q. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) :E 0 0 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18) >< x ~ 19. Tax Due (19) 0.00 25,737.27 0.00 0.00 25,737.27 Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; I<A Decedent's Complete Address: STREET ADDRESS 337 Graham Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 25,737.27 24,450,41 1,286.86 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 25,737.27 TotallnteresUPenalty (D + 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. 8. Enter the total of Line 5 + 5A. This is the8ALANCE DUE (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 8LOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................. [!J il b. retain the right to designate who shall use the property transferred or its income;................................ [!J n c. retain a reversionary interest; or..............................._............................................................................ [!J 0 d. receive the promise for life of either payments, benefits or care?........................................................... [!J 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................. ........... ............................. ..-................................ .................... 0 [!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?..........................................................................................._.................... [!J 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 pe~ury, 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 preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS . . DATE Tim Roney Spahr 538 West Penn Street c.:-;::---' J J Carlisle, PA 17013 ------- Ft~ SIGNATURE OF PERSON RESPONSIB ADDRESS-----' . SIGNC~ Gary L. Jame , E (l...- .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. 99116 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. DATE ADDRESS {1--- 5 r Q-&><..> ,.:-. DATE 134 Sipe Avenue Hummelstown, PA 17036 Rev-15G8 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. FILE NUMBER 21-05-0842 Include the proceeds of litigation and the date the prooaeds were reoaived by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Conseco Senior Health Insurance Company - insurance premium refund VALUE AT DATE OF DEATH 1.765.40 2 Travelers - automobile insurance premium refund 327.00 3 Wachovia Bank Checking Accout No. 1010071397430 - valued per letter dated 9/27/05 5.567.16 4 Wachovia Bank Checking Accout No. 1010071397430, accrued interest _ valued per letter dated 9/27/05 0.08 5 2002 Toyota Camry LE Sedan - valued per Kelly Blue Book 8.350.00 TOTAL (Also enter on Line 5, Recapitulation) 16.009.64 (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-1510 EX+ (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. IFILE NUMBER 21-05-0842 This schedule must be completed and filed ~ the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM OESCRI ..~ r ",vr ...... , OA TE OF OEA TH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. 1 Cash gift - Charles Reisinger on 12/22/04 1.000.00 100.000 1.000.00 0.00 2 Cash gift - Jessica Johnson on 12/22/04 1.000.00 100.000 1.000.00 0.00 3 Cash gift - Suson Akakpo-Martin on 12/22/04 1.000.00 100.000 1.000.00 0.00 4 Cash gift - Angela Spahr Bobb on 12/22/04 1.000.00 100.000 1.000.00 0.00 5 Cash gift - Christopher Spahr on 12/22/04 1.000.00 100.000 1.000.00 0.00 6 Cash gift - Stephanie Falck on 12/22/04 1.000.00 100.000 1.000.00 0.00 7 Cash gift - Tim Spahr on 12/19/04 5.000.00 100.000 3.000.00 2.000.00 8 Cash gift - Margaret Reisinger on 12/19/04 5.000.00 100.000 3.000.00 2.000.00 9 ForeThought Life - prepaid funeral account 12.100.20 100.000 0.00 12.100.20 10 Wachovia Securities Account No. 7667-7621 _ 557.152.04 100.000 0.00 557.152.04 titled in the name of the Charles I. Spahr Living Trust dated 12-14-1995 - valued per statement and public listing TOTAL (Also enter on Line 7, Recapitulation) 573.252.24 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleG (Rev. 6-98) REV-1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-0842 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 13,077.10 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 James, Smith, Dietterick & Connelly, LLP 4,000.00 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 91.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 58.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 17,226.60 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 COMMO~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. FILE NUMBER 21-05-0842 ITEM NUMBER DESCRIPTION AMOUNT 1 Carlisle Memorial Service Inc. - headstone engraving 160.00 2 Department of Veterans Affairs - flat granite marker - estimated costs 400.00 3 Ewing Brothers Funeral Home, Inc. - funeral services 12.517.10 Subtotal 13.077.10 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-87 OTHER ADMINISTRA TIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. FILE NUMBER 21-05-0842 ITEM NUMBER DESCRIPTION AMOUNT 1 Commonwealth of Pennsylvania - title transfer fee 28.50 2 Register of Wills, Cumberland County - filing fee for Return & Inventory 30.00 Subtotal 58.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Spahr, Charles I. FILE NUMBER 21-05-0842 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Bankcard Services - credit card balance VALUE AT DATE OF DEATH 54.18 2 Verizon Wireless - wireless telephone service 41.87 TOTAL (Also enter on Line 10, Recapitulation) 96.05 (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 I (Rev. 6-98) . REV 1513 EX+ (9-00) . SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 1 Spahr, Charles I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Suson E. Akakpo-Martin 1310 Woodridge Drive Middletown, PA 17057 Angela S. Bobb 568 Mountain Road Boiling Springs, PA 17007 Stephanie A. Falck 5526 Hitcher Bend Austin, TX 78749 FILE NUMBER 21-05-0842 NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. Granddaughter 1/18 of Residue 31,552.18 2 Granddaughter 1/18 of Residue 31,552.18 3 Granddaughter 1/18 of Residue 31,552.18 4 Jessica A. Johnson 500 West Royal Towers Drive Irmo, SC 29063 Charles A. Reisinger 27 Pine Drive Manchester, PA 17345 See continuation schedule attached Continuation 414,178.33 Total 571,939.23 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropriate, on Rev 1500 cover sheet Granddaughter 1/18 of Residue 31,552.18 5 Grandson 1/18 of Residue 31,552.18 II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Copyright (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Form PA-1500 ScheduleJ (Rev. 6-98) SCHEDULE .. BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Charles I. Spahr 205-09-9815 09/14/2005 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Margaret B. Reisinger Daughter Gifts & 1/3 of 191,313.08 5767 Waggoners Gap Road Residue Landisburg, PA 17040 7 Christopher C. Spahr Grandson 1/18 of Residue 31,552.17 5 East Springville Road Boiling Springs, PA 17007 8 Tim R. Spahr Son Gifts & 1/3 of 191,313.08 538 West Penn Street Residue Carlisle, PA 17013 Total 414,178.33