HomeMy WebLinkAbout05-19-06
REV-1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
BENNER WILLIE C.
DATE OF DEATH (MM-DD-YEAR)
[j 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
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REV-1500
OFFICIAL USE ONLY
FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
L 1_ - --.0..2 .JL L a.....9_ _
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-YEAR)
17
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
--.0.. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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)
NAME
TELEPHONE NUMBER
717-533-7130
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
12. Net Value of Estate (Line 8 minus Line 11)
14. Net Value Subject to Tax (Line 12 minus Line 13)
Au ust 23 2005 A ril 2
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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COMPLETE MAILING ADDRESS
Geor e W. Porter Es uire
FIRM NAME (If Applicable)
909 East Chocolate Avenue
Hershey, PA 17033
(1 )
(2)
(3)
(4)
(5)
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20,642.82
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CD
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(8)
20,642.R?
(9)
(10)
17,700.25
40,OlQ 4c;
Insolvent estate
(11 )
(12)
(13)
c;7.71Q 70
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13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
Insolvent estate (14)
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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)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
x .0 _ (15)
x .O~ (16)
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x .12 (17)
x .15 (18)
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CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19)
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Decedent's Complete Address:
STREET ADDRESS
CITY
willie C. Benner
1 Windsor ourt
Mechanicsbur
PA
STATE
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
Total Credits ( A + 8 + C ) (2)
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3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
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5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
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A. Enter the interest on the tax due.
(SA)
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8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN IIXII IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income; ............................................ D
c. retain a reversionary interest; or .......................... .......................................................................... .............. ........ D
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D
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
No
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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 preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
ADDRESS
226 East Glenn Road, Hershey, PA 17033
SIGNATU E OF PI1EPA.vF~HER THAN REPRESENTATIVE
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ADDRESS
909 East Chocolate Avenue. Hershey. PA 17033
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. 99116 (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. 99116 (a) (1.1) (ii)].
The statute does not exemot 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. 99116(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 PS. 99116(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. 99116(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.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
WILLIE C. BENNER
21-05-0789
FILE NUMBER
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.
2.
3.
4.
5.
6.
7.
8.
9.
10.
VALUE AT DATE
OF DEATH
DESCRIPTION
Progressive Insurance - cash value of automobilef
minus deductible - salvage value of 1995 Lincoln
Mark VIII
Blue Chip FCU #8931
Blue Chip FCU - vacation club
EIC - last paycheck
Members 1st FCU - savings
Mustang automobile
1992 Ford Ranger truck - sold for
1968 Camero Race Car - sold
IRS - income tax refund
Miscellaneous personal property, household
furnishings.
4,965.89
416.79
165.07
1,518.07
25.00
no value
500.00
10,000.00
2[752.09
300.00
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TOTAL (Also enter on line 5, Recapitulation) $ 20 ,642. 82
(If more space is needed, insert additional sheets of the sam~ size)
REV-1511 EX+ (12-99) ,
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
WILLIE C. BENNER
FILE NUMBER
21-05-0789
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Hoover Funeral Home
James Gingerich Memorials
3,570.00
3,830.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
2.
Name of Personal Representative(s) Joshua C. Benner
Social Security Number(s)/EIN Number of Personal Representative(s)
3,500.00
Street Address 226 East Glenn Avenue
City Hershey State~Zip 17033
Year(s) Commission Paid:
Attorney Fees: George W. Porter, Esquire
6,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant N / A
4.
5.
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
Probate Fees: Register of wills of Cumberland County -
Letters
Accountant's Fees: Dale Auchenbach - income tax return
100.00
95.00
6. Tax Return Preparer's Fees N / A
7.
8.
9.
10.
11.
12.
13.
Register of wills of Cumberland County - file
inventory and inheritance tax returns.
Baum's notary service - re motor vehicles
The sentinel - advertise letters
Cumberland County Law Journal - advertise letters
Cumberland County Register of wills - File First &
Final Account
Cumberland County Register of Wills - advertise
First and Final Account
Georqe W. Porter - Miscellaneous expenses
30.00
105.00
115.25
75.00
50.00
80.00
150.00
TOTAL (Also enter on line 9, Recapitulation) $ 1 7 , 700 . 25
(If more space is needed, insert additional sheets of the same size)
R,V 1512,EX" (19/) .' . .~. .... .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
FILE NUMBER
21-05-0789
WILLIE C. BENNER
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Sears (Citibank USA N.A.) account #6035253010283696
Nicholas Ortega A-claim for balance of lease contract.
Members 1st Federal Credit Union - #4287590002507503
Gordon's Jewelers (Citicorp Credit Association)
Capital One Acct. #4121741505119078
Omnium Worldwide Inc. for HSBC Bank
PPL Electric Utilities
West Shore School District - per capita tax
Verizon Wireless
Comcast Cable
2,198.87
5,150.00
17,934.60
2,045.22
1,737.04
10,671.38
142.68
31.00
95.41
13.25
TOTAL (Also enter on line 10, Recapitulation) $ 40,019.45
(If more space is needed, insert additional sheets of the same size)
REV-ISI3 EX. (1-91)
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
IDENT DE NT
ESTATE OF
FILE NUMBER
WILLIE C. BENNER
21-05-0789
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not Lilt Trustee(I} OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I . TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. Joshua C. Benner
226 East Glenn Road
Hershey, PA 17033
son
residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
" A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n . ENT~ TOTAL NON- TA2<ABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space Is needed, insert additional. sheets d the same size)