HomeMy WebLinkAbout09-11-06
REV.'SCO EX (6.00)
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'*' COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 05
0699
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Seifert Albert C.
COUNTY CODE
YEAR
NUMBER
DATE OF DEATH (MM.DD.YEAR)
08/04/05
DATE OF BIRTH (MM-DD-YEAR)
03/04/1931
SOCIAL SECURITY NUMBER
177 -24-6892
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
172-24-9350
D 3. Remainder Return (dale of death prior to 12-13..'l2)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach 3ch 0)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
M. Annan Seifert
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[!J 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy ofWdl)
o 9. Litigation Proceeds Received
D 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12-32)
o 7. Decedent Maintained a living Trust (Attach copy olTnJst)
o 10. Spousal Poverty Credit (date of dlllllt> between 12-31-91 and 1.1-95)
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NAME
Andrew C. Sheel , Esquire
FIRM NAME (ff Appficabfe)
Andrew C. Sheely, Attorney at Law
TELEPHONE NUMBER
(717) 697-7050
COMPLETE MAILING ADDRESS
Andrew C. Sheely, Esquire
127 South Market Street
P.O. Box 95
Mechanicsburg, PA 17055
(8)
169,494.55
(1)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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 Properly (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)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (tolal 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)
169,494.55
(11)
(12)
(13)
(14)
0.00
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
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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)
x .0 _ (15)
0.00
(19)
0.00
16. Amount of Line 14 taxable at lineal rate
x .0 _ (16)
x .12 (17)
x .15 (18)
-'~~m. ::t::~~~~~::'n.~l~:.;~..::~...~__~"_ :~.. ~~I' .,.1...."..:"."..':.~~.:.~..:.~:"~~~:..u::.J.t"_ '.(.~' ~,l\ J:1! l.;,H "~"~. ..\ ~ ;" ~"f:r;l~I:::.i~!lt.f."q; j~.J.":].!;~~""' " _ ~,;~:~~a~~\
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Decedent's Complete Address:
STREET ADDRESS
107 Orchard Street
CITY . I STATE I ZIP
Mechanlcsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the lax due.
(SA)
(58)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
0.00
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
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? .....................................................................................................,.................. ~
No
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ADDRESS
M. Annan Seifert, 107 Orchard eet, Mechanicsburg, PA 17055
SIGN~~ PREPARER OTH~ RE E
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A!:l.9.L~~_..g:.._~.~_~_~~y, Esquir~__1..??S. Market Str ,.0. Box 95, Mechanicsburg,PA 17055
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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. ~9116(a)(1.2)J.
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. 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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REV~151O EX, (0.98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
ALBERT C. SEIFERT
FILE NUMBER
21-05-0699
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.
ITEM DESCRIPTION OF PROPERTY
INCLUDE THE NM'E OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A copy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST f1F APPLICABLEl VALUE
1.
Lincoln Insurance Company -
Death Benefit for annuity held
by the decedent in an IRA account
which named Wife, M. Annan Seifert
as beneficiary 169,4
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94.5~
TOTAL (Also enter on line
(If more space is needed, insert additional sheets of the same ~
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REV-1513 EX.,. (9-00)
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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
M. ANNAN ~lttt~Ji' Spouse 100% rest,res.
107 Orchard Street & remainder 0
Mechanicsburg, P A 17055 Estate
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
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B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
ALBERT C. SEIFERT
FILE NUMBER
50-06-0055
ESTATE OF
.due
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(If more space is needed, insert additional sheets of the same size)
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LAST WILL AND TESTAMENT OF ALBERT C. SEIFERT
I, ALBERT C. SEIFERT. of the Borough of Mechanicsburg, Cwnberland County.
Pennsylvania, being of sound and disposing mind, memory and understanding. do make. publish
and declare this my Last Will and Testament, hereby revoking mld making void any and an prior
Wills by me at any time heretofore made.
l.
I direct tbe paymem of all my just debt'l and funeral expenses as SOOI.1 after my decease as
the same can cOl1\'eniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever sitmlte, I give, devise and bequeath to my beloved wife, M. ANNAN SEIFERT. to her
own use and benefit absotutely.
3.
In the event my said wife, M. Annan Seifert, should predecease me or die at about the same
time I do, such as in an accident or disaster common to both of us, I hereby direct that my estate be
divided and distrihuted as follows:
A. Eight and one-third (81/3%) per cent to my son. CHRIS A. SEIFERT. absolutely.
In the event he predeceases me, this share shall go to his two (2) SallS. in trust, as provided for
below.
B. Eight and one-third (8 1/3%) per cent to my daughter. M. ANNAN HOLLINGER,
Trustee, in trust, for the benefit of my grandson, DAVID SEIFERT. upon the tenus and conditions
set forth more fully herein below.
C. Eight and one-third (81/3%) per cent to my daughter, M. ANNAN HOLLINGER.
Trustee, in Ullst, for the benefit of my grandson. DANIEL SEIFERT, upon the tenns aJ.ld
conditions sel fonh more fully herein below.
D. Twenty-five (25%) per cent to my daughter, M. ANNAN HOLLINGER,
absolutely. In the I~vent she predeceases me, her share shall be divided in equal shares, per CqpitJl.
amongst my grat'1dchildren who survive me. Any such shares payable to the said DAVID and/or
DANIEL SEIFERT, shall be in trust as provided for above and below herein.
E. Twenty-five (25%) per cent to my daughter, KIERNA BLACK, absolutely. In the
event she predec~~,..~es me, her share shall go to her children who survive me, in equal shares.
F. Tw'~nty-Jive (25%) per cent to my daughter, TARA JANKOUSKAS, absolutely.
In the event she im~decea.ses me, her share shall go to her children who survive me. in equal shares.
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4.
The tenm and conditions of the trusts to be established for my two (2) grandsons
aforenalned are as follows:
A Each trust shall be separately maintained and administered.
B. The income from each Tnlst Estate, as well as so much of the principal as is needed
according to the discretion of the Trustee, shall be used and expended for the college education, or
other such formal education, such as any internship, apprenticeship, residence, clerkship or the like
of the tnlSt beneficiary. The decision of my Trustee as to the sort or type of educatiOll acceptable
and to the completion thereof shall be absolute and final.
e. Tl1e paymenrs authorized herein may be made by my said Trustee directly to the
beneficiary if he iii, in the sole opinion of my Trustee, of such age and ability to handle properly the
funds so paid to hnn, or may be made by my Trustee directly to any illstitudon or other service
provider entitled to such payment by reason of services rendered or to be rendered to the
beneficiary .
D. To pay the accumulated income and principal then remaining ill the Trustee's hands
to the beneficiary when he has atl.ained the age of twenty-five (25) years.
E. 1 di rect that the interests of the beneficiary in the Trust hereby created, whether in the
principal or income thereof, shall be free from liability to attachment or other legal process issued at
the instance of any creditor or a..lJsignee of the beneficiary, and I direct that no payment shall be
made by way of al1ucipation of sums which may thereafter accrue to any benefichuy.
F. In the event the beneficiary of a trust hereby created predeceases me or dies during
the Lerm of such trust, his share shall go to his surviving children, in equal shares. In the event he is
not survived by children, his share shall go to his brother, in trust. provided his brother has survived
him. In the event that he is 110t survived by lUs brother, then his share shall be divided and
disuibuted in eq~lal shares, rJU ca,pita, amongst my then survi ving grandchildren.
G. hl the event the aforellamed Trustee is unable or unwilling to serve or to continue to
serve for any reason. then I appoint my daughter, KIERNA BLACK, as first successor Trustee.
In the event she is unable or unwilling to serve for any reason, then I appoint my daughter, TARA
JANKOUSKAS. as second successor Trustee. I f\ll'ther direct that my Tnlstee need not file a
bond for her faithful perfonnance in this or any other jurisdiction.
5.
I nominate, constitute and appoint my wife, M. ANNAN SEIFERT, to be the Executrix of
this Il~Y Last Will a11d Testament In the event that Sh:.b~~ me or for any reason be
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unwilling or unable to act as such Executrix, I nomiIUlte, constitute and appoint my daughter. M.
ANNAN HOLLINGER, to be Executrix in her place and stead. In the event that she is unable or
unwilling to serve ill such capacity, I appoint my daughter, KIERNA BLACK. to be Executrix in
her place and stead. In the event that she is 1.111able or unwilling to serve in such capacity. I appoint
my daughter, TARA JANKOUSKAS, 10 be Executrix in her place and stead. I further direct tllat
they shall not bl~ required to file bond or other security in the Office of the Register of Wills for the
purpose of administering my Estate.
IN Wn'NESS WHEREOF, I have hereul1to set my hand and seal this J..!!.fL. day of
(:)...(1~:.__, A.D. 2000.
~n~ ~ .I2(~Y:-'
ALBERT C. SEWER'I'
(SEAL)
Signed, sealed, published and declared by the above-named ALBERT C. SEIFERT, as
and for his Last Will and Testament, ill the presence of us, who at his request and in his presence,
and in me presence of each other, have hereunto subscribed ou ame~ as witnesses.
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