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Home My WebLink About05-08-07 REV.1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT to- Z W C w () w c l!! :all: ~Ul U a::alI: w~8 :Z:g:..J u 2tlD 4( DECEDENl'S NAME (LAST, ARST, AND MIDDLE INITIAL) GROSS DAVID DATE OF DEATH (MM.DD-Year) M. DATE OF BIRTH (MM-DD.Year) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 3 0 1 0 6 5 COiiNTv"'iXiiiE -YEAA- - - NuMBER- - SOCIAL SECURITY NUMBER 1 89- 5 2 - 7 2 7 2 THIS RETURN MUST BE ALED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (dateofdealh prior to 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sell 0) z o ~ =:) to- a:: c( () w a: z o !i to- =:) Do :& o () S 08/17/2003 10/27/1957 (IF APPLICABlE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [XJ 1. Original Retum D 4. Limited Estate D 6. Decedent Died Testate (AlIach copy of WlI) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (dale of deaIh alIer 12-12-82) D 7. Decedent Maintained a Living Trust (AlIach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91lW1d 1-1-95) COMPLETE MAILING ADDRESS 60 WEST POMFRET STREET PA 17013 OFFICIAL USE ONLY -I 158,544.90 \.. .: 0.00 X _(15) 0.00 97,480.61 X .045 (16) 4,386.63 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 4.386.63 NAME DOUGLAS G. MILLER ESQUIRE FIRM NAME (If Applicable) IRWIN & McKNIGHT TELEPHONE NUMBER 717 249-2353 CARLISLE I C') -t"""! 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Misoellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Misoellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Deoedent, Mortgage Liabilities, & Liens (Schedule I) (10) 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) 14. Net Value Subject to TIX (Line 12 minus Line 13) 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 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAyr,1ENT .: 1 C) C) U1 158,544.90 (8) 60.125.76 938.53 (11) (12) (13) 61,064.29 97,480.61 (14) 97,480.61 'UO!ldope JO poolq ~q JalflallM 'luapaoap alfllfl!M uowwoo U! luaJed auo lsealle self ollM lenp!^!pu! ue se 'C::0~6 uO!IOas Japun 'pau!lap S! 6u!lq!S V '[(8'~){e)9~ ~69 'S'd U] %c::~ S! s6u!lq!s s,luapaoap alfllo asn alflJOI JO 01 SJalsueJllo anle^ lau elfl uo pasodVJ! eleJ X'el alfl '[(~){e)9~ ~69 'S'd U] (c::' ~)9~ ~69 'S'd U U! palOU se Idaoxe '%S, S! se~e!o!lauaq leaU!1 s,luepaoap alfllo asn alflJol JO 01 SJalsueJllo anle^ lau alfl uo pasodW! eleJ lfEU alfl '[(c::" ~)(e)9 ~ ~69 'S'd c::Ll %0 S! 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PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GROSS DAVID FILE NUMBER M. 21 03 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. 01065 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 156,225.26 PERSONAL INJURY CASE 2. ACCUMULATED INTEREST 2,319.64 TOTAL (Also enteron line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 158.544.90 REV-1511 EX + (12-99) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS GROSS ITEM NUMBER A. 1. B. 1. 2. 3. 4. 5. 6. 7. 8. * FILE NUMBER DAVID M. 21 03 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) BRIAN GROSS Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 1 SPEND-A-BUCK DRIVE City DILLSBURG State PA Zip 17019 Year(s) Commission Paid: Attomey Fees IRWIN & McKNIGHT Family Exemption: (If decedenfs address is notlhe same as claimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip Probate Fees REGISTER OF WILLS Accountanfs Fees Tax Retum Preparer's Fees PATRICIA A. ROSENDALE, CPA REGISTER OF WILLS - FILING FEE POST & SCHELL, P.C. - ATTORNEY FEE * CURRENTLY BEING CHALLENGED BY ADMINISTRATOR OF THE ESTATE TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 01065 AMOUNT 9,000.00 8,100.00 275.00 250.00 30.00 42,470.76 60 125.76 REV-1512 EX + (6-98) . . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GROSS DAVID M. FILE NUMBER 21 03 01065 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. BANK OF AMERICA VALUE AT DATE OF DEATH 938.53 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 938.53 "~.':"a.* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER I. II. SCHEDULE J BENEFICIARIES .......'-....... M. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] THE ESTATE OF RAMONA GROSS ** C/O JOHN KILLIAN, ATTORNEY AT LAW 218 PINE STREET, HARRISBURG, PA 17101 ** MOTHER SURVIVIED MORE THAN SIXTY (60) DAYS FILE NUMBER 21 03 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Lineal n1nFl~ AMOUNT OR SHARE OF ESTATE 97,480.61 REMAINDER ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 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) OF COUNSEL F. LEE SHIPMAN COUNSEL JOSHUA D. LOCK ARNOLD B. KOGAN ARTHUR L. GOLDBERG (1951-2000) HARRY B. GOLDBERG (1961-1998) RONALD M. KATZMAN PAUL J. ESPOSITO NEIL HENDERSHOT J. JAY COOPER THOMAS E. BRENNER JOHN A. STATLER APRIL L. STRANG-KUTAY GUY H. BROOKS JEFFERSON J. SHIPMAN JERRY J. Russo MICHAEL J. CROCENZI THOMAS J. WEBER STEVEN E. GRUBB JOHN DELoRENZO JOHN R. NINOSKY ROYCE L. MORRIS DAVID M. STECKEL HEATHER L. PATERNO BENJAMIN D. ANDREOZZI 320 MARKET STREET. STRAWBERRY SQUARE P.O. Box 1268 · HARRISBURG, PENNSYLVANIA 17108-1268 717.234.4161 · 717.234.6808 (FAX) GOLDBERG, KATZMAN & SHIPMAN, P.C. ATTORNEYS AT LAW September 3, 2004 Fredric S. Eisenberg, Esquire 1634 Spruce Street Philadelphia, P A 19103 Paula McDermott, Esquire 240 Grandview Avenue Camp Hill, P A 17011 J ames Nealon, Esquire 2411 North Front Street Harrisburg, P A 17110 J ohnna J. Kopecky, Esquire 300 North 2nd Street, 8th Floor Harrisburg, P A 17101 RE: David Gross v. Archibald Builders Dear Counsel: I enclose a copy of an Order entered by Judge Hoover approving the setdement of the tort action. I would request that Attorney Eisenberg distnbute the proceeds of the survival action consistent with the Judge's Order. He is to provide the $156,225.26 to Atto~ey Paula McDermott to be deposited in an account with Post & Schell to be held pending the disposition of the claims made by the representatives of the Estate of David Gross and Elizabeth Barth. Consistent with our discussions with Judge Hoover, I enclose a Confirmation of Release document to be signed by Ms. Barth, Brian Gross, Maryellen Andrea Brouse, and Jerome Gross. Please return the signed confirmation document to complete my ftle. I have forwarded a Praecipe to close the docket in the tort action which I will file after confirmation that Fred Eisenberg has made distribution of the setdement proceeds. v t;r!.. truly rurs, / -) Ii.!'\ I ~..~ . , .j ',> \. A"l" / '~mas E. Brenner TEB:ar Enclosures 111742.3 Page 1 of2 .,' . /- Huber, Denise From: Kutz, James Sent: Wednesday. April 12, 2006 2:06 PM To: RXAUTHORITY@aol.com Subject: RE: DAVID GROSS ESTATE Business Law & Litigation Department P,actic* At... 1..4,,&t,I*'i S.t.,.. Pua.llcIUo"& Brian-I always wait a day or two beyond 30 days just to be sure something doesn't filter in by regular mail. It does appear that ,matter is final however. I am asking for my firm's authority to release the funds, and at what amount you, as administrator, and we as a law firm agree is owing to Post and Schell. I think your willingness to let me keep only the sum applied for before the appeal was filed is unfair. However, in an effort to get my fee issue resolved with the Estate, please be advised that I have authority to cut you a check, made payable to you as Administrator of the Estate of David Gross, for the full amount of the funds Post and Schell is holding, less a sum of $4lm. 76 which sum is only $2000 more than the amount we sought in the petition before the court BEFORE we knew an appeal would be filed and before we incurred costs and time far in excess ofS2000 to say the least. In other words, if you simply respond by email, that the payment of Post and Schell's legal fees in the amount of $42,470.76 is acceptable to the Estate, a check will be cut , made payable to you as Administrator of the Estate of David Gross, for the full amount remaining in the escrow account, thus bringing my firm's involvement to an end. I have no intention of sending any monies to Mr. Killian as I concur with you fully that the fimds Post and Schell are holding accroe to the benefit of the estate of David Gross and you are the administrator of that Estate. I ,..... KlItZ 17....... Seamd .... 12th Floor ........ .. PA USA 17101-1"1 jIcuta.,,~"I.CIlIn P~s717~12~3. Fax: 7'11-7S1.1lflS Jr.. r~",,_~~ >> ~... >> lint ..JdIiri' ".C'. _ ~~INo/LCOIII 4/12/2006