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HomeMy WebLinkAbout04-19-06 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In re: Estate of Michael D. Politzer-Hardy, A minor under the age of fourteen years No. 2005 - 378 PETITION FOR DISTRIBUTION OF PRINCIPAL FOR CARE OF A MINOR IN ACCORDANCE WITH 20 Pa. C. S. & 5164 TO THE HONORABLE, THE JUDGES OF THE SAID COURT: AND NOW COMES the Petitioner, Geneva B. Politzer, by and through her attorneys, Saidis, Flower & Lindsay, and respectfully states as follows: 1. Petitioner is the mother of Michael D. Politzer-Hardy, a minor twelve years of age. 2. Michael D. Politzer-Hardy, the minor, was born on June 6, 1993, and resides with the petitioner, at 42 Kenwood Avenue, Carlisle, Cumberland County, Pennsylvania. 3. By Order of May 6,2005, this Court appointed F&M Trust Company and the petitioner as co- guardians of the estate of the minor, with respect to sixteen thousand ($16,000) dollars of life insurance proceeds of which the minor was beneficiary. 4. Subsequently, the minor was found to be beneficiary of his deceased father's tax-deferred retirement plan, which designated the minor's paternal grandmother, Ann Ripley, of Rutland, VT, as guardian. 5. The tax-deferred retirement account of approximately $12,000 was paid out in a lump sum during 2005, and, after making certain expenditures therefrom on the minor's behalf, Mrs. Ripley added the balance to the minor's guardianship account at F&M Trust. 6. By Order of this Court dated April 28, 2005, principal was disbursed from the guardianship account, as follows: $60 for new mattress; $636.71 for travel expenses; $1,500 for home remodeling; $500 for attorney fees. 7. No other principal disbursements have been made from the account, which has a current balance of$18,827.68. 8. As a result of the lump-sum distribution to Mrs. Ripley of the minor's father's tax-deferred retirement account, the minor has a federal income tax ,liflbility for 2005 of $902. " . I' " WHE~FORE, p~titioner respectfully requests t~at. ffi:tSjG0Urr/~itth6rize the corpor~te co- guardian of the mmor's estate to expend from pnnclpal $962 fot' the purpose of paYing the minor's 2005 federal income tax liability. 9Z ;":' "'., 'J. .,J G I SJ7Z c Respectfully submitted, SAIDIS, FLOWER & LINDSAY Dated: "/t;{7/f; & ~ I I By: ~~ Thomas E. Flower S.Ct. #83993 2109 Market Street Camp Hill, PA 17011 (717) - 737 - 3405 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In re: Estate of Michael D. Politzer-Hardy, A minor under the age of fourteen years No. 2005 - 378 VERIFICATION I, Geneva Politzer, hereby verify that the statements made in the foregoing Petition are true and correct, to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. ~ 4904, relating to unsworn falsification to authorities. DATED: Or / /06 BY:~ nevePa. z d Total number of exam tions claimed , , . . , . 7 Wages, salaries, tips, etc, Attach Form(s) W-2 . Sa Taxable interest. Attach Schedule B if required b Tax-exempt interest. 00 not include on line Sa . 9a Ordinary dividends. Attach Schedule B if required . b Qualified dividends (see instructions) . . , . . . 9b 10 Taxable refunds, credits, or offsets of state and local income taxes (see instructions) . 11 Alimony received . . . , . . , , , , . . . . . . . , , . . . , , . , . . , . 12 Business income or (loss). Attach Schedule Cor C-EZ . . . . . . . . . . . . 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here 14 Other gains or (losses), Attach Form 4797 . . , , , . , ,'. . . . , . . , , 158 IRA distributions . . . . , l...!!!J I b Taxable amount (see instructions) 168 Pensions and annuities . . l..!!!.J b Taxable amount (see instructions) 17 Rental real estate, royalties, partnerships, S corporatiolls, trusts, etc. Attach Schedule E 18 Farm income or (loss). Attach Schedule F , . . . . . , . . , , , , 19 Unemployment compensation . . . . , . . , . , , . , . , . , , , , , . , . . 20a Social security benefits . . I 20a I b Taxable amount (see instructions) 21 Other income. Ust type and amount (see instructions). . . , , . . . . . 22 Add the amounts in the far . ht column for lines 7 throu h 21. This is r total Income . 23 Educator expenses (see instructions) . . . . . , . . . . ., 23 24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ , 25 Health savings account deduction. Attach Form 8889 . 26 Moving expenses. Attach Form 3903 ........ 27 One-half of self-employment tax, Attach Schedule SE . 28 Self-employed SEP, SIMPLE, and qualified plans. . , 29 Self-employed health insurance deduction (see instructions) . 30 Penalty on earty withdrawal of savings 31a Alimony paid b Recipient's SSN . 32 IRA deduction (see instructions). . , 33 Student loan interest deduction (see instructions) . 34 Tuition and fees deduction (see instructions) . . . 35 Domestic production activities deduction. Attach Form 8903 . 36 Add lines 23 through 31a and 32 through 35 . . , . . . . . 37 Subtract line 36 from line 22. This is r ad usted rosa Income . For Disclosure, PrIvacy Act, and Paperwork Reduction Act Notice, see instroctions, UYA Form 1 040 label (See instructions) Use the IRS label. OtherwiSe, please print or type. Presidential Election Campaign Filing Status Check only one box. Exemptions If more than four dependents, see instructions. Income Attach Fonn(s) W-2 here. Also attach Forms W-2G and 1099-R If tax was wtthheld. If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1Q4.0-V. Adjusted Gross Income Department of the Treasury - Internal Rewnue Service U.S. Individual Income Tax Return 2005 IRS Use Only - Do not write or staple in this space. , 2005, ending ,20 OMB No. 1545-0074 Your social security number 188-74-0086 Spouse's social security number Forlhe year Jan. 1-Dec. 31, 2005, or other tax year beginning Your first name and initial Last name olitzer-Bard L A Michael 0 B E L Last name If a joint return, spouse's first name and initial Apt. no. ... You must enter ... .... your SSN(s) above. .... ~ Home address (number and street). If you haw a P.O. box, see instructions. R 42 Ken.ood Ave E City, town or post olIice, state, and ZIP code. If you haw a foreign address, see instructions. Checking a box below wiD not change your tax or refund. ~ Check here if you, or your spouse if filing jointly, want$3 to go to this fund (see instructions). 0 You 0 Spouse 1 iii Single 4 0 Head of household (with qualifying person). (See instructions) If 2 0 Married filing jointly (ENeI1 if only one had income) the qualifying person is a child but not your dependent, enter 3 0 Married fding separately. Enter spouse's SSN abow this child's name here. . and full name here. . 50 Qualifying widow(er) with dependent child (See instructions) ~ ;ou::~. ~fs~~~c~~myouas~~d~t,.d~~~~h~k~X~ '. '. '. " : : : :} :~a::~ JL c Dependents: (3) Dependent's on 6c who: relationship to 1 First name Last name u. lived with you ~ . did not live with you due to divorce or sepal'lltlon 0 (_Instructions) - DeDendents on 6c 0 not entered abov Add numbers on lines above ~ 7 Sa 158. 8b 9a .0 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 15 046. 14 888. 24 25 26 27 28 29 30 31a 32 33 34 35 ~.j C.> O:J ..) "'v t;-..:) '- "J c.,., - l.;:l :..~ 36 . 37 O. 15 046. Form 1040 (2005) Fonn 1040 (2005) Michael D Politzer-Bardv - - Tax and 38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . . . . 38 15.046. Credits 398 Check {O You were born before January 2, 1941, 0 Blind. } Total box.. W if: 0 Spouse was born before January 2, 1941, 0 Blind. checked ~ 39. St8ndard b If your spouse itemizes on a seperate retum or you were a dual-wrtus alien. see instructions and check here ~ 39b 0 Deduction _40 Itemized deductions (from Schedule A) or your standard deduction (see left margin). . . . 40 5.000. for. 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 10.046. . People who 42 If line 38 is over $109,475, or you proWled housing to a person displaced by Hurricane Katrina, checked any box on line see instructions. Otherwise, multiply $3,200 by the total number of exemptions daimed on line 6d . 42 3.200. 39a or 39b or 43 Taxable Income. Subtract line 42 from line 41. If line 42 is more than line 41, enter ..().. 43 6.846. who can be claimed as a 44 Tax (see instructions). Check if any tax is from: a 0 Form(s) 8814 bO Form 4972 . . . . . 44 1.236. dependent, 45 Alternative minimum tax (see instructions). Attach Form 6251 45 1.155. See insll'. . . . . . . . . All others: 46 Add lines 44 and 45 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 46 2.391. Single or 47 Foreign tax credit. Attach Form 1116 if required . . . . . . . . 47 Married filing 48 Credit for child and dependent care expenses. Attach Form 2441 . 48 separately, 49 Credit for the elderly or the disabled. Attach Schedule R . . 49 $5,000 Married filing 50 Education credits. Attach Form 8863 . . . . . . . . . . . . . 50 jointly or 51 Retirement savings contributions credit. Attach Form 8880. . . 51 Qualif)'ing 52 Child tax credit (see instructions). Attach Form 8901 if required . 52 widow(er), $10,000 53 Adoption credit. Attach Form 8839 . . . . . . . . . . . . . 53 Head of 54 Credits from: a 0 Form 8396 b 0 Form 8859. . . . 54 household, 55 Other credits. Check applicable box(es): . 0 Form 3800 $7,300 bO Form 8801 c 0 Form 55 56 Add lines 47 through 55. These are your total credits . . . . . . . 66 O. 57 Subtract line 56 from line 46. If line 56 is more than line 46, enter..().. . . ~ 57 2.391. Other 58 Self-employment tax. Attach Schedule SE. . . . . . . . . . . . . . . . . 58 69 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137. . . . 59 Taxes 60 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 60 61 Advance earned income credit payments from Form(s) W-2 61 62 Household employment taxes. Attach Schedule H . . . 62 63 Add lines 57 throuah 62. This is vour total tax . . . . . . ~ 63 2.391. Payments 64 Federal income tax withheld from Forms W-2 and 1099. . . 64 1,489. - 65 2005 estimated tax payments and amount applied from 2004 retum 65 If you haw a 66a Earned Income credit (Be) NO. i . , i . . . . . . . . . 66a qualifying b Nonl8lcable combat pay election ~ 66b child, attach Schedule EIC. 67 Excess social security and tier 1 RRTA tax withheld (see instr.) . 67 68 Additional child tax credit. Attach Form 8812 . . . . . . . . . . 68 69 Amount paid with request for extension to file (see instructions) . 69 70 Payments from: a 0 Form 2439 bO Form 4136 cD Form 8885 . 70 71 Add lines 64, 65 66a, and 67 throuah 70. These are vour total payments . . . . . . . . . . ~ 71 1.489. Refund 72 If line 71 is more than line 63, subtract line 63 from line 71. This is the amount you overpaid 72 O. Direct deposit? 73& Amount of line 72 you want refunded to you . . . . . . . . . . . . . . . . . . . . . . ~ 73& O. See instructions ~b Routing number I I ~ C Type:O Checking o Sa\1ngs and fill in 73b, ~d Account number I I 73c, and 73d. 74 Amount of line 72 'IOU want applied to your 2006 estimated tax ~ 74 Amount 75 Amount you owe. Subtract line 71 from Une 63. For details on hoN to pay, see instructions ~ 75 902. You Owe 76 Estimated tax oenaltv (see instructions). . . . . . . . . . . . . I 76 I "'T 188 74 0086 Page 2 Third Party Designee Sign Here Do you want to allow another person to discuss this return with the IRS (see instructions)? 0 Yes. Complete the following. Designee's Phone PenIonaI identification name ~ no. ~ number (PIN) ~ I Under penalties of pe~ury, I declare that I haw elCllmined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and comple\B. Declaration of preparer (other than 1lIllpayer) is based on all infonnation ofwhich preparer has any knowledge. ONo Joint return? Your signature Date Your occupation Daytime phone number See instructions .... ldisabled child 717-258-8715 ~r copy ,. Spouse's signature. If a joint return, both must sign. Date Spouse's occupation records. Paid Preparer's ~ I Date I Check if Preparer's SSN or PTIN signature self-employed 0 Preparer's Use Only Firm's name (or ~ EIN yours if seIf-em~oyad), Phone no. address, and ZI code UYA Form 1040 (2005) Foon 8615 Tax for Children Under Age 14 With Invesbnent Income of More Than $1,600 ~ Attach only to the child's Fonn 1040, Form 1040A, or Fonn 1040NR ~ See separate I..tructlo... OMS No. 1545-0074 Department of the Treaswy Internal Rewnue SeNce Child's name shown on retum 2005 =ntNo. 33 Child's social security number ~chael D Politzer-Bard 188-74-0086 Before you begin: If the child, the parent, or any of the parent's other children under age 14 must use the Schedule D Tax Worksheet or has income from farming or fishing, see Pub. 929, Tax Rules for Children and Dependents. It explains how to figure the child's tax using the Schedule D Tax Worksheet or Schedule J (Form 1040). A Parent's name (first, initial, and last). Caution: See inslTucfiOf/$ before completing. B PInnl's soc:IIIl security number Geneva B Politzer 560-96-6237 C Parent's filing status (check one): o Single 0 Married filing jointly 0 Married filing separately iii Head of household 0 Qualifying wid<M(er) Child's Net Investment Income 1 Enter the child's investment income (see instructions) . . . . . . . . . . . . . . . . . . . . . . . 2 If the chid did not itemize deductions on Schedule A (Form 1040 or Form 1040NR), enter $1,600. Otherwise, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Subtract line 2 from line 1. If zero or less, stop; do not complete the rest of this form but do attach it to the child's return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Enter the child's taxable Income from Form 1040, Une 43; Form 1040A, line 27; or Form 1040NR, Iine40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Enter the smaller of line 3 or line 4. If zero, stop; do not complete the rest of this form but do attach it to the child's return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tentative Tax Based on the Tax Rate of the Parent 6 Enter the parent's taxable Income from Form 1040, Hne 43; Form 1040A, line 27; Form 1040EZ, line 6; Form 1040NR, Hne 40; or Form 1040NR-EZ, line 14. If zero or less, enter..{).. . . . . 7 Enter the total, if any, from Forms 8615, Hne 5, of all other children of the parent named above. Do not include the amount from line 5 above. . . . . . . . . . . . . . . . . . . 8 Add lines 5, 6, and 7 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . 9 Enter the tax on the amount on line 8 based on the parent's filng status abcNe (see instructions). If the Qualified Dividends and Capital Gain Tax Worbheet, Schedule D Tax Wor1tsheet, or Schedule J (Form 1040) is used to figure the tax, check here ................. .. 0 10 Enter the parent's tax from Form 1040, line 44; Form 1040A, line 28, minus any alternative minimum tax; Form 1040EZ, line 10; Form 1040NR, line 41; or Form 1040NR-EZ, line 15. Do not include any tax from Fonn 4972 or 8814. If the Qualified Dividends and Capital Gain Tax Worbheet, Schedule D Tax Worksheet, or Schedule J (Form 1040) was used to figure the tax, check here . . . . . . . 0 11 Subtract line 10 from line 9 and enter the result. If line 7 is blank, also enter this amount on line 13 and go to Part III 1 15 046. 1 600. 13 446. 6 846. 6 846. 4 854. 11 700. 1 236. 2 3 4 5 6 7 9 10 o. 11 1 236. . . . . . . . . . .. 12b 13 o to line 16. x 1 236. 14 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . .. 14 15 Enter the tax on the amount on line 14 based on the child's fiUng status (see instructions). If the Qualified Dividends and Capital Gain Tax Worbheet, Schedule D Tax Worksheet, or Schedule J(Form1040)isusedtofigurethetax,checkhere ..................... 16 Add lines 13 and 15 ................................... 17 Enter the tax on the amount on line 4 based on the child's fiUng status (see instructions). If the Qualified Dividends and Capital Gain Tax Worksheet, Schedule D Tax Worksheet, or Schedule J (Form 1040) is used to figure the tax, check here . . . . . . . . . . . . . . . . . . . . . 18 Enter the largerof line 16 or line 17 here and on the child's Form 1040, Hne 44; Form 1040A, line 28' or Form 1040NR line 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For P.lperwortl Reduction Act Notice, see instructions. UYA ~D 15 o. 16 1 236. ~D 17 683. 18 1 236. Foon 8615 (2005) Form 6251 Alternative Minimum Tax-Individuals OMS No. 154~OO74 2005 (Rev. JanU8IY 2006) Deper1ment of the Treasury Intemal Rewnue Sen<ice ~ See separate instructions. ~ Attach to Fonn 1040 or Fonn 1040NR. Name(s) shown on Form 1040 ~chael D Politzer-Hard Alternative Minimum Taxable Income See instructions for how to com If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41 (minus any amount on Form 8914, line 2), aid go to Hne 2. Otherwise, enter the amount from Form 1040, line 38 (minus MY amount on Form 8914, line 2), aid go to line 7. (If less than zero, enter as a negative amount.) . . . . . . . . . . . . . . . Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 21b'Yo of Form 1040, line 38. . . . . . Taxes from Schedule A (Form 1040), line 9 .................................. Enter the home mortgage interest adjustment, if any, from line 6 of the worksheet in the instructions. . . Miscellaneous deductions from Schedule A (Form 1040), line 26 . . . . . . . . . . . . . . . . . . . If Form 1040, line 38, is over $145,950 (over $72,975 if maniecI filing separately), enter the amount from line 9 of the Itemized Deductions Worksheet in the instructions for Schedules A & B (Form 1040) . . Tax refund from Form 1040, line 10 or line 21 . . . . . . . . . . . . Investment interest expense (difference between regular tax aid AMT) . . . . . . . Depletion (difference between regular tax aid AMT) . . . . . . . . . . . . . . . . Net operating loss deduction from Form 1040, line 21. Enter as a positive amount . . Interest from specified private activity bonds exempt from the regular tax . . . . . . Qualified small business stock (7% of gain excluded under section 1202) . . . . . . Exercise of incentive stock options (excess of AMT income over regular tax income) . Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) . Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) . . . Disposition of property (difference between AMT aid regular tax gain or loss) . . . . Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) . . . . . Passiwactivities (difference between AMT aid regular tax income or loss) Loss limitations (difference between AMT aid regular tax income or loss) . Circulation costs (difference between regular tax aid AMT) . . . . . Long-term contracts (difference between AMT aid regular tax income) . . Mining costs (difference between regular tax aid AMT) . . . . . . . . . Research aid experimental costs (difference between regular tax and AMT) Income from certain installment sales before January 1, 1987 . Intangible driUing costs preference . . . . . . . . . . . . . . Other adjustments, including income-based related adjustments AJtematNe tax net operating loss deduction . . . . . . . . . . Alternative minimum tuable Income. Combine Ones 1 through 27. (If married filing separately aid line 28ismorethan$191,ooo,seetheinstructions............................ . Alternative Minimum Tax 29 Exemption. (If this form is for a child under age 14, see the instructions.) 2 3 4 5 6 1 2 3 4 5 15 046. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 6 7 8 9 10 11 12 13 14 15 18 17 18 19 20 21 22 23 24 26 28 27 28 15 046. AND line 28 Is IF your filing status is . . . not over. . . Single or head of household . . . . . . . $112,500 Married filing jointly or qualifying wic:lo.v(er) . . 150,000 . Married filing separately . . . . . . . . . .. 75,000. If line 28 is over the amount shQNJl aboIIe for your filing status, see the instructions. 30 Subtract line 29 from line 28. If zero or less, enter -0- here and on lines 33 and 35 and stop here . . . . . . . . .. 30 31 . If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part III on page 2 aid enter the amount from line 55 here. · All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) aid subtract $3,500 ($1,750 if married filng separately) from the result.. . Alternative minimum tax foreign tax credit (see the instructions) ................... TentatNe minimum tax. Subtract line 32 from line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . Tax from Form 1040, line 44 (minus alY tax from Form 4972 and any foreign tax credit from Form 1040, line 47). If you used Schedule J to figure your tax, the amount for line 44 of Form 1040 must be refigured without using Schedule J (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Alternative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on Form 1040, line 45 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For Paperwort Reduction Act Notice, see Instructions. UYA THEN enter on Iine29... .. $40,250 . . . 58,000 } . . . . .. 29 . . . 29,000 5 850. 9 196. 32 33 34 31 2 391. 32 33 2 391. 34 1 236. 36 1 155. Form 6251 (2005) (Rev. 1-2006)