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HomeMy WebLinkAbout02-06-06 ... \.. REV. 1500 EX + (S-oOJ - REV-1500 r COMMONWEALTH OF PENNSYLVANIA I INHERITANCE TAX RETURN I~LENUMBER DEPAR~~T2~~~VENUE I RESIDENT DECEDENT 21 05 0231 -----------~~~A_17~":~__L______ ---------_ ___ ...__.___ .___ ___ ---_-.J__ ..9.Ql,JNTY CODJ;_ _ "y~AR ___ NU~_____ I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)------ . ------.--------- SOCIAL SEC-URITY NUMBER----------- _____ ~ I Kline, Gen<ge ~--- -- _ _ __ _ __ __ ______ '___ 192~1~62IL______ _ ~ I DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE i:! 102/1312005 , 01/06/1923 ---L------__-"_"-G~TER_OfWIU.~_ _ __, o I"' ",,,,,,eE,,"",,,,," ",0""', ...." CAS', "'" """'00"'""", i 'O''''''''o"rr ,"M'" --- - -- ~18T 1.-0"'", R,"';'- - - -- ~-O- ',- S""",;;;,;;,a'A"'m ---- - -- - -- -- - - -- b ._"""""_,,.., ,,,,.-. .... ..." ".,,,,, _ W I- ,,<(al ldg:~ :roo ofiil l1. <( OFFICIAL JSE ONl y J 4. limited Estate 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 o 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach copy of Will) 9. litigation Proceeds Received 8. Total Number of Safe Deposit Boxes AME if f'~;:'~;;;~e~;~- -- -- - -- -- ----~I 5521 C"lislePike ~U""ON',".'" - - - - -, - ----- - - --- -- -I Meohani"b",g, PA 17050 -- __I 71 7.1697:.1 8()0 __ _ '_ _ _ ___ ___ _ _ _____ _____,___ _ _ _______ _ ___ _ _ __ _ __ __ __ - - --I'~ R'~IE'<a;;S;;,;;;,; A; -- -- ------ ---(;;----- ,~-N:';;'e--- - --- o,~'''~'',o,,-;-- _ _ I ,. S<oo" aod Boo'" (SoI"do', B) (2) Non e L . I I I I I I I I I 110. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 111. Total Deductions (total Lines 9 & 10) 112. Net Value of Estate (Une 8 minus Line 11) 113. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been I made (Schedule J) __--+-l~..~~~~~lue ~~~~~!~~!~X (Li~El.~ITli~~s:~e_~~ ..... ___. n.... _ _ _. n_ .u__. _ .. I SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES i 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 4. Mortgages & Notes Receivable (Schedule D) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None _.'l z o ~ :5 :> l- ii: 1 w Of: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (4) None -------------- --'-,- 162,154.46 c) (5) (6) None (7) 253,696.17 (8) \.~: 415,850.63 (9) --------._---._-----~------.- 32,509.67 - ----...------------ (10) 2,665.43 (11 ) 35,175.10 (12) -------- --._-~--_._--- 380,675.53 (13) (14) 380,675.53 z o ~ :! :> l1. ~ o o ~ x .00 (15) 16.Amount of Line 14 taxable at lineal rate 380,675.53 x .045 (16) 17. Amount of Line 14 taxable at sibling rate -- -- _.__n____________________ 17,130.40 18. Amount of Line 14 taxable at collateral rate ------- ---------------.- -'-._-._-- x .12 (17) RJ( -- --"-- - _'__.n u_ _ ______ x .15 (18) (19) -___n_.___ __ _ _________ _______ 17,130.40 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) 'Decedent's Complete Address: STREET ADDRESS - 303 East Meadow Drive CITY --- - --- -------------- -- --- Mechanicsburg STATE PA -- - --,-- --._-._-- [ZIP I 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 17,130.40 ------.__..__._----_._-----~-- 16,000.00 ---- --.---------.--.-----..- 842.11 3. InteresVPenally if applicable D. Interest E. Penally Total Credits (A + 8 + C) (2) 16,842.11 --.---------- -. - - - --,- ---- 1.90 TotallnteresVPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPA 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 the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) (4) (5) (SA) (58) 1.90 290.19 --------------- -- ------.--- 290.19 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................... ........... ..................... ................... .................................... 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.................................................................................. ~ s ~. :;~ :":~~;;:~':~~::;;:;.'.h.'"~~el~~".'......:":I:':~~:'::;~ ;:~~~'................................... 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?............ ......................... ................. .................. ..................... ......................... 0 o ~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS IF THE ANSWER TO ANY OF THE ABOVE QUESTTONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. --------------- --- - -._-._-- -- -- --- -.-------- -._-- -.- --------- -- -- ---- -------- ----------. -- ---------- ~ ~ o """'''''''.'''''. ,-.... 'M~ _m..., '"' _m. ""'"' .-._ """OM~' .'_0 M'''",..."" M_~ _... "".... ~"M' ~"",.. '''''."~. ..- -.~........ -~.. ,"uoo ~",.o~'"~. ~~ ..,..,"".~ .~..~_ ~__ _ __~ SIGNATU OF ERSONREsPONSIBLEF-OR FILING REURN------~-,d.DDRESS-..- ----. '.-.. DATE :::,,:0, ,,::~ '-"1'o'''~''a "",,, ~~J~\SP6o/i28 ~ t/~1fo-~- n SlG.. NA~R'OFPREPAREif6.f..HER -THAN REP-RESENT ATIVE---- Th~: A t--- ADDRESS 5521 Carlisle Pike Mechanicsburg, PA 17050 DATE F" d".. <>f d'''h '" ,,,.,, J'~ " 1994 'M bero", J,",,,y " 1995, Ihe la, "'Ie ;mp"ed '" Ihe "et eel" ,ft",""", " " ro"he '" <>f the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)J. F" dole, "de"h '" ,,,.,, J'"",,>, " 1995, the lox "la ;m"'''d '" Ihe "et ee'" 'ft"'""e" I, " ,,, II,. '" 'fth, ,"NM"9 ''''''' ;, 0% (72 P.S. ,9116 (,) (1.1) (;;)). The 'let"", do,,, "<>I eeem<>l , I"'""e", , '""';';"9 """" 'rom la" '"d Ihe 'lal''',>, 'eq';"'m",~ '" d;,o",,, 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 I" "'Ie ;mp"ed '" Ihe "of ee'... <>f I",""", 'rom, d""....d aMd lwe"ly-o"e ye", <>f 'ge "\'0'"9" " de"h I, "ro, Ihe ",e ,', ""''''' parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)J. The"" "la ;mpOeed '" Ihe "of eel,e ,ft"""e~ " "",, Ihe ,.. 'fthe deoed"'f, ;;"..1 be",'o"" ;, 45%, .,"'" " ",lad;" 72 P.S. ,9116 1.2) [72 P.S. 99116 (a) (1)]. The la, "Ie ;mp"ed '" the "of '"'' ,ft"'"'Ie~ ro " ro, Ih, '" 'fthe de"'de"f, ';b';"9' ;, 12% (72 P .S. ,9116 (,) (1.3)J A ';b;;"9 . de'",d. under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Z-{.c-'Oh - . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY --._._---~~-.__.._---- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . KlIne, George E - -- --"---'----- --.- ~_ == .-~__~J:ILE~~~E~02~_~~~~--_ -~~~- ---- --------------------...-----..----- ------._--- ---_._---_..__._-----_._-----~_._._-_._- - -,'---- ---- 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. --------------------------- - ---- ITEM NUMBER ---- --._- ---------.---- 1 Wachovia Checking account DESCRIPTION --- --"'-'--------"-.----.-- -- ------.-- 2 Investment account # 3KH-013727 3 2002 Saab 9-3 SE Convertible 4 Miscellaneous personal items 5 1997 Sea Doo GTX Jet Ski 6 ICHP Refund (Health Insurance) 7 USAA Auto insurance refund 8 USAA - SSA Account 9 Riverside Anesthesia Associates refund VALUE AT DATE OF DEATH --.. ---- -- ----- ---------------.-- 11,282.03 129,347.29 16,750.00 750.00 2,200.00 147.10 162.95 1,486.80 28.29 ~- -- ---~------------ - - - ---~--~- - ~ - - - - - ~- ~ - - ------~------ - ---~ --- -------------- TOTAL (Also enter on Line 5, Recapitulation) 162,154.46 i SCHEDULE G I INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA I INHERITANCE TAX RETURN i MISC. NON-PROBATE PROPERTY ----_ RESI~E/II-r:[)ECED~i'l.-r:_________-L____________ __ __ . _______ . - '------.---.--.-~----.--.--- --------------- _'__n _ _ __'__"_ _'_._ ESTATE OF Kline, George E -j' I FILE NUMBER - - --------- ----..------__._.n_____ - ---._- ---..--.----..----.------- ---------------- -- ---------------- --- 21 - 05 - 0231 This schedule must be completed and filed if the answer to any of questions 1 throu~h 4 on page 2 is }'es. 1------------------------- ---- - -; _ ___ ~_____ _ 1 _ _ __ ___,__ _ ____________ DESCRIPTION OF PROPERTY I I % OF . I ITEM I '","00 ..._" ~ ,.-. .00 ~-''''"...,,''oo ....." ""'"' ,DATE OF DEATH, DECO'S I EXCLUSION TAXABLE VALUE __NUMBER i __ _ __ :0000. ~ "~M ~_.. ",": ___ __ _ IV AlUE_:ASS_E;",~EREST i '" ~'UCA''', 1 I'RA Account # 3 KHO 13479 - benefidaries "'e his chHdren, r 253,696, 17, 1 ()()% 253,696, 17 I equally I I I I I I -- --'-'- - ___n'__.. __'_.__.___ _n _____.__.______________ _ __ 253,696.17 - -.--..--------- "------- -'-'-- -,-- - TOTAL (Also enter on line 7, Recapitulation) - . SCHEouLEH FUNERAL. EXPENses & AllVINIsTRAllVE COSTS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I ----- -----._- ---'- -----..- -- ---.---.-------.- ---- ----.----.----.- ESTATE OF KI' G E me, eorge - -----------.--------------------- - ------.--.----------------- ------.-.---------.-- FILE NUMBER 21 - 05 - 0231 - --'--- -----~---._-----_. --- --..---------------.---------- --- -'-".--- ---------- ITEM NUMBER -/i..-- !FUNERALEXPENSES;----- I Malpezzi Funeral Home B. Debts of decedent must be reported on Schedule I. -- - ----.---..- -- ------..----------------------------- DESCRIPTION ----- -- -- --------.--.---- AMOUNT 2 8,396.60 Funeral luncheon - Pennsylvania (Knights of Columbus) 3 1,367.54 Funeral luncheon - New Jersey (Marco Polo) 2,503.30 ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Christine M. Kline Social Security Number(s) / E/N Number of Personal Representative(s); 144-40-8641 5,000.00 2. Street Address 140 Terrace Drive City Chatham State NJ Year(s) Commission paid 2005 Attorney's Fees Ahrens Law Firm, PC Zip 07928 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 10,000.00 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills of Cumberland County State Zip 464.00 5. Accountant's Fees Valerie J. Knisley , CPA 6. 1,250.00 Tax Return Preparer's Fees 2004 Personal Income Tax return Estimated 2005 Income tax returns (1040 & 1041) 295.00 500.00 7. I Other Administrative Costs Estate notice in the Sentinel 2 100.73 Estate notice in the Cumberland Law JOurnal 75.00 Total of Continuation SChedule(s) 2,557.50 TOTAL (Also enter on line 9, Recapitulation) 32,509.67 --- --"--.._--- ----.---.--.--.------ - .. I Sc:helU.H I COMMONWEALTH OF PENNSYLVANIA I FlIleraI Expellses & ! "'g~'i:i',i~~' _ _ _ L _ _ -- ~~~ ____1_ _________ _ ___ ___ _ ____ ESTATE-OF---- - - - - -- - - - - - - - ---- -- n -- ---- n n ------- -- - -!AlE -"UMSE" _ _ __ _ _ __ _ Klin<, Geo'g' E i 2] _ 05 _ 0231 3 Executrix travel expenses --- ---.-------- --------- -- ----- - -------.-..--.--.--....-- 200.00 4 Misc. expenses (postage, stationery, etc.) 5 Estimated cost to sell Timeshare located in New York city 150.00 6 P A Inheritance Tax filing fee 2,000.00 7 Wire transfer fees - Wachovia 15.00 8 Wire transfer fees - Pershing LLC 18.00 9 Additional short certificates 56.00 10 Register of Wills - Exemp letters, short certificates, photocopies, certif.copies 60.00 58.50 I I I I I I I I I I I I I I I I I I I I I I I I --------L_____________________________________ I I I I I I ---- - ---------- ------------__L_____ ________________ Page 2 of Schedule H '. - SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAlTH OF PENNSYLVANIA I INHERITANCE TAX RETURN I -----_ ___~NT DE:E[)~~________ -_L ______ ESTATE OF -----------.----..---------------- ---------------- - - --'--'---.- Kline, George E L __ ___ _ __ FILE NUMBER 21-05-0231 - -- - -.---.___.._u__.________ ___ - '-'.----.- -- -..---.---.- Include unreimbursed medical expenses. -. --------.--.-----..-.--- --..--.---.---------- ------,.~--_._-----_.._------_._--_._-------- ----------------- ITEM NUMBER 1 USAA Auto Insurance --,- ---..-.- ---'--._- ----- -- --.------.----.----.- DESCRIPTION - ---.----...--..----..----..------------..---- AMOUNT 2 Bank of America credit card balance 337.99 3 Capital One credit card balance 1.00 4 USAA Credit Card balance 1,441.49 5 The Manhattan Club timeshare Maintenance fee 16.95 6 Pershing LLC custodial fee 833.00 35.00 2,665.43 --- -._~----.- --'------- -"-..- -,-- --.-- -----._--- --._----- ----- - TOTAL (Also enter on Line 10, Recapitulation) REV-1513 EX~ (9.00) * - I I COMMONWEALTH OF PENNSYLVANIA I INHERITANCE TAX RETURN I . -- - - _!lESII:)e:NT [)E:~E:~E:~T__ ___ ___ _ .. L -- -----.------ -- ---.-----'------------ SCHEDULE J BENEFICIARIES ESTATE OF Kline, George E .. ~~:~~ r---":~E~~:::';:~~ :::~~~(~) RECEIV'NG PROPERTY --- --.- ------~---------_._._-------_._--------------_._--- -. -- --- ... I. I TAXABLE DISTRIBUTIONS (include outright Spousal distributions) I Christine M. Kline I 140 Terrace Drive, Chatham, NJ 07928 I I RELATIONSHIP TO I DECEDENT I . - -- - - -T- - -.Do.Not.LlstJcuslee(s)_ . FILE NUMBER 21 - 05 - 0231 - -------- - ---"-'----.-- I i Daughter I AMOUNT OR SHARE OF ESTATE ---/----- -.._-- ------ I I I II/8th i 2 I. Stephen G. Kline 140 Terrace Drive, Chatham, NJ 07928 3 I Jane E. McCaddin I 138 Passaic Avenue, Summit, NJ 07901 4 I Kevin E. Kline I 1460 Woodacres Court, Mountainside, NJ 07092 I 5 I Michael J. Kline I 130 Father John Drive, Lake Ariel, PAl 8436 I I I 6 I Mary T. Kelly I Hancock Street, Middlesex, NJ 08846 I I I I S" Conlinuatlon SCh'du'O/s) '''ched I E"", don" ,mou,ls fo' d."'hulIon, 'hown ,ho" 0' "," 15 th,ough 18, .. ,pproP',t" 0' Roe 1500 """', 'hoe' I I Son , I/8th I , I I I Daughter ' I/8th I I Son II/8th Son 'I/8th I , i Daughter II/8th II. NON-TAXABLE DISTRIBUTIONS: I IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I - - ----.-----.--.---------------. ----'- --'--- -- __ n_ __ ~ --- -----.- -__..__.n.__ __,_ _ __ _n_._____ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART" - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET! ---- ----- -----------.-. - -.--..---..- -~--.-.. -..-.-.-- -.. - .-- -.-------- ---- '- .... . I , I SCHEDULE J COMMONWEALTH OF PENNSYLVANIA I BENEFICIARIES t d INHERITANCE TAX RETURN " con inue =-c:==~~=--~-R~~~~~Er-g:~~_-=c:-,-~-=~:c=.==--__ ___---: -C"'-=c:-=-- _ ___ ________ ESTATE OF I I NUMBER , NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY - - ------- _1 _______ ____ ____________ _.___ _____________. ", J rr' AXABLE DISTRIBUTIONS [include outright Spousaldistribl.itions. and transfers under . Sec. 9116(a)(1.2)) 7 Patricia A. Kline 38 Hickson Drive, New Providence, NJ 07974 FILE NUMBER 21 - 05 - 0231 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE --_D_o.No~LI"ITru-"le"is) __ -L- _____OF EST~~~____ Kline, George E --------------------------- ---------------------- 8 Matthew 1. Kline 110 Martel Circle, Di11sburg, P A 17019 I I I I , I , _.'-'~ -..------_ __L - ------ - ------- ----.-___n _____..____ - -- ---- -------- Daughter II/8th I Son : I/8th Page 2 of Schedule J - - -- - -. ------_._-~-._- -- ----------------