HomeMy WebLinkAbout05-11-06
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15056051058
REV-1500 EX (06-05)
PA Department of Revenue ~"
Bureau of Individual Taxes .
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Vear
File Number
21 05
0771
MINICH
SR.
Date of Birth
02/20/1943
Decedent's First Name MI
CHARLES N
Spouse's First Name MI
PATRICIA L
186-34-0034
08/16/2005
Decedent's Last Name
Suffix
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
MINICH
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
. 1. Original Return
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
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 12-31-91 and 1-1-95)
o
8. Total Number of Safe Deposit Boxes
. 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
CHARLENEFEUCHTENBERGER
(717) 530-2614
Finm Name (If Applicable)
REGISTEF or WILLS USE ONLY
First line of address
129 BEETEM HOLLOW ROAD
Second line of address
City or Post Office
State
ZI P Code
DATE FILED
NEWVILLE
PA
17241
.-.-,
J
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, .11
Correspondent's e-mail address:CFEUCHTENBERGER@ORRSTOWN.COM
Under penalties of perJury, I declare that I have examined thiS return, including accompanying schedules and statements, and to the besi.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 knO~E}qge.
mTURE ~F .~ERSO~ ~SPONSIBL~ FOR ,FILING RETURN .~ /.
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PLEASE USE ORIGINAL FORM 0
. ,
Side 1
L
15056051058
15056051058
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-.--J
15056052059
REV-1500 EX
Decedent's Name'
RECAPITULATION
Real estate (Schedule A).
2. Stocks and Bonds (Schedule B) .
3 Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
4. Mortgages & Notes Receivable (Schedule D).
5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) Separate Billing Requested .
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested. .
8. Total Gross Assets (total Lines 1-7). .
9 Funeral Expenses & Administrative Costs (Schedule H).
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I).
11 Total Deductions (total Lines 9 & 10).
12. Net Value of Estate (Line 8 minus Line 11) .
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)
10.
11.
. . . . 12
13.
14 Net Value Subject to Tax (Line 12 minus Line 13) . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15 Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X 0_ 137,258.11 15.
16. Amount of Line 14 taxable
at lineal rate XO 45
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
100.00
19. TAX DUE.
.19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
L
Decedent's Social Security Number
1.
35,663.25
2
3
88,528.00
4.
5
14,43947
6
100.00
7.
8,339.84
8.
147,070.56
9
9,71245
9,712.45
137,358.11
000
16.
500
17.
18.
5.00
15056052059
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REV-1500 EX Page 3
File Number
Decedent's Complete Address:
DECEDENT'S NAME
CHARLES N MINICH
STREET ADDRESS
1200 MCCLURES GAP ROAD
21
05 0771
DECEDENT'S SOCIAL SECURITY NUMBER
186-34-0034
CITY
CARLISLE,
STATE
PA
ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5.00
Total Credits ( A + B + C ) (2)
000
3 Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, 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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
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 No
a. retain the use or income of the property transferred; ........................... ......... D [K]
b. retain the right to designate who shall use the property transferred or its income; ................... ............ D [K]
c. retain a reversionary interest; or....... . ..................................... ...................... ............... D [i]
d receive the promise for life of either payments, benefits or care? ...... ................. ............ D 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . ...................... ........ D 00
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.
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 three (3) percent [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 zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)]. The statute does 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in
72 PS. ~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 twelve (12) percent [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.
REViS02 EX+ (6-98; .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
CHARLES N. MINICH, SR.
FILE NUMBER
21-05-0771
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 property would be
exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. REAL ESTATE-306 EAST LOUTHER STREET, CARLISLE, PA 17013
1/2 SHARE INTEREST VALUED @ $71,326.50
35.663.25
TOTAL (Also enter on line 1, Recapitulation) $
35,66325
(If more space is needed, insert additional sheets of the same size)
REV-1504 EX+ (6-98)
_Si..: :.Jt: t",~...
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ESTATE OF
CHARLES N. MINICH, SR.
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-05-0771
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships
ITEM NUMBER
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1/3 SHARE OF CORPORATION REAL PROPERTY-730 NORTH COLLEGE STREET,
2
CARLISLE, PA 17013 VALUED@CORPORATEASSET@ $131,775
4700 SHARES CORPORATE STOCK VALUED @ $9,49/SHARE
43,92500
44,60300
TOTAL (Also enter on line 3, Recapitulation) $
88,52800
(If more space is needed, insert additional sheets of the same size)
REV-1505 EX + (6-98)
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLES N MINICH, SR.
Name of Corporation N.L. MINICH (a) SONS, INCORPORATED
Address 730 NORTH COLLEGE STREET
FILE NUMBER
21-05-0771
State of Incorporation PJNNSYLVANIA_
City CARLISLE,
State~ Zip Code 17013
Date of Incorporation ~2 / 30/813___
Total Number of Shareholders 4
2. Federal Employer 10. Number
3 Type of Business CONCRETE/EXCAVATION
Business Reporting Year 2005
Product/Service CONCRETE/EXCA VA TION
STOCK
4
TOTAL NUMBER OF
SHARES OUTSTANDING
PAR VALUE
NUMBER OF SHARES
OWNED BY THE DECEDENT
VALUE OF THE
DECEDENT'S STOCK
Common
9.49
4700 $
$
44,60300
Preferred
Provide all rights and restrictions pretaining to each class of stock
5 Was the decedent employed by the Corporation?
If yes. Position OWNER/OPERATOR
45,000
Annual Salary S
KI Yes 0 No
Time Devoted to Business
40 HRS/Wf\..
6 Was the Corporation indebted to the decedent?
If yes, provide amount of indebtedness S
DYes Kl No
7. Was there life insurance payable to the corporation upon the death of the decedent? 0 Yes Kl No
If yes, Cash Surrender Value S Net proceeds payable S
Owner of the policy
8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years
if the date of death was prior to 12.31.82?
DYes J[] No If yes. 0 Transfer 0 Sale Number of Shares
Transferee or Purchaser
Attach a separate sheet for additional transfers and/or sales
Consideration S
Date
9 Was there a written shareholder's agreement in effect at the time of the decedent's death?
If yes. provide a copy of the agreement.
IXI Yes 0 No
10 Was the decedent's stock sold?
If yes, provide a copy of the agreement of sale etc.
iiCl Yes 0 No
11 Was the corporation dissolved or liquidated after the decedent's death? 0 Yes KJ No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received
12 Old the corporation have an IIlterest in other corporations or partnerships? 0 Yes KJ No
If yes. report the necessary information on a separate sheet. including a Schedule C.1 or C.2 for each interest
THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years
C If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have
been secured, attach copies.
o List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F Statement of dividends paid each year. List those declared and unpaid
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
REV-15G8 EX+ (6-98) _~_"lt,R.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISe.
PERSONAL PROPERTY
ESTATE OF
CHARLES N. MINICH, SR.
FILE NUMBER
21-05-0771
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
MEMBERS FIRST CHECKING ACCOUNT
2,57861
2 CASH BONUS FROM EMPLOYER
6,00000
3 1996 DODGE INTREPID ES SEDAN
4,40000
4 WAGES OWED TO DATE OF DEATH FROM EMPLOYER
830.86
5 VACATION/SICK TIME EARNED
630.00
TOTAL (Also enter on line 5, Recapitulation) $
14,43947
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX + !6-98 i
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COMMONWEALTH OF PENNSYLVANIA
II~HERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
CHARLES N. MINICH, SR
FILE NUMBER
21-05-0771
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. CHARLES N. MINICH, JR
411 EASY ROAD, CARLISLE, PA 17013
SON
B.
C.
JOINTLY-OWNED PROPERTY:
LUTlcri
ITEf" FUR JUINT
NUMBER TENI~.NT
DME
Mf...DE
JOINT
DESCRIPTION OF PROPERTY
INCUJDE NP,ME OF FINANCIAllNsnrUTION AND 8t<.NK ACCOUNT Nur'.18ER OR Slr,/lILP,R DATE OF DE/;fH
_______.~~~iyING ~~iMBER. fI..TTACH D~J~[:?!--2.~.2!!.~TLY-~~~~~.~.L ESTATE _______ _.___~~~i..~~~~?2~-!..._..._.._. INT ERE ~_: y
Gf- ~ED[Nl S j"jTf::Pf"~
A
09/05/00
1978 HAULETTE TRAILER
200.00
50
10000
2
TOTAL (Also enter on line 6, Recapitulation) $
10000
(If more space IS needed, insert additional sheets of the same size)
r<eV-l~lO eX+ (5-98) ~
~jn
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLES N. MINICH, SR.
SCHEDULE G J
INTER-VIVOS TRANSFERS &
MISe. NON-PROBATE PROPERTY
. -., ',- -
FILE NUMBER
21-05-0771
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET IS yes
._~
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECDS EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST {IF APPLICABLE I VALUE
1. ING ANNUITY; CONTRACT # 90063578 8,33984 100 8.339.84
TOTAL (Also enter on line 7 Recapitulation) $ 8,339.84
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) f
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
CHARLES N. MINICH, SR.
FILE NUMBER
21-05-0771
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
HOFFMAN-ROTH FUNERAL HOME
CUMBERLAND VALLEY MEMORIAL GARDENS, PRE-PAID CASKET
5.66960
3,501.60
2
B. ADMINISTRATIVE COSTS
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
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 314.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. CUMBERLAND LAW JOURNAL, ADVERTISING LETTERS 7500
8 THE SENTINEL, ADVERTISING LETTERS 11525
9 MICHAEL BANGS LAW OFFICE, PREPARING DEED 3700
TOTAL (Also enter on line 9, Recapitulation) $
9.71245
(If more space IS needed, Insert additional sheets of the same size)
RE\I-1513 EX-+- (9-0m
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLES N. MINICH, SR.
FILE NUMBER
21-05-0771
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 [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
PATRICIA L. MINICH SPOUSE 100% ESTATE
1200 MCCLURES GAP ROAD, CARLISLE, PA 17013 RESIDUE
2 CHARLES N. MINICH, JR SON 1978 HAULETTE
411 EASY ROAD, CARLISLE, PA 17013 TRAILER
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
m
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
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)