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Home My WebLink About05-17-07 D 2. Supplemental Retum D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach Copy of Trust) D 10. Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPlETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number .....J 15056041125 REV -1500 EX (06-05) PA Department of Revenue. Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 1712~1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year 2 1 0 6 File Number loa 1 Date of Birth 176347664 1119200 6 042 9 1 9 2 2 Decedenfs Last Name SuffIX Decedenfs First Name REA G E R GWENDOLEN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name REAGER F RED E R I C K Spouse's Social Security Number 178050884 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW 00 1. Original Return o 4. Limited Estate 00 o o o 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required MI MI W 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes S USA N E SQ. 717 763 138 3 H CONFAIR, Firm Name (If Applicable) REGISTER OF WILLS ~ ONLY o = ~Q ~ ':j ;:g JCl>o \;;TO -< 1'5:93 en ~ -.J .~~) C") C'") -0 ->(~...:rl 3 '-~"l -J.ll: FILED -::- __" ..r::- c.n REAGER A D L E R , P C & First line of address 233 1 MARKET STREET Second line of address City or Post Office State ZIP Code C AMP 17011 H ILL P A Correspondent's e-mail address: CAMP HILL PA 17011 DATE ADDRESS ~ 2?7/ ~ ~- c~r~ %7?Jf( PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 .....J ..-I 15056042126 REV-1500 EX Decedenfs Name: GWEN DOLEN REAGER RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) .................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested. . . . . .. 6. 7. Inter-VIVos Transfers & Miscellaneous N,Qn,-Probate Property (Schedule G) U Separate Billing Requested. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .. . . ..... ... 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 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.O _ 16. Amount of Line 14 taxable at lineal rate X .0 _ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 443076.71 o . 0 0 15. 16. o . 0 0 17. o . 0 0 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042126 Decedenfs Social Security Number 176347664 4 4 6 8 3 6.7 1 4 4 6 8 3 6.7 1 3760.00 3760.00 443076.71 O. 0 0 443076.71 O. 0 0 O. 0 0 O. 0 0 O. 0 0 O. 0 0 o 15056042126 ---1 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENrs NAME GWEN DOLEN REAGER STREET ADDRESS 17 South 24th Street File Number 21 06 1081 CITY Camp Hill I STATE PA I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E) (3) 4. If Line 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Fill In oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5) 0.00 0.00 0.00 B. Enter the total of Une 5 + 5A. This is the BALANCE DUE. (5A) (5B) 0.00 A. Enter the interest on the tax 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; ...................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00 c. retain a reversionary interest; or ................................................................................................ 0 00 d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 l&I 3. Did decedent own an .in trust for" or payable upon death bank account or security at his or her death? ......... 0 l&I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. 0 l&I 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 exemDt a transferto a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 decedenfs lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~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. REV-1508 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GWEN DOLEN REAGER SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 06 1081 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joInt1y-owned with right of lurvlvOlllhlp must be dlscloHd on Sdledule F. ITEM NUMBER 1. DESCRIPTION Vehicle -1987 Pontiac Grand Am - VIN 1G2NE11U4HC828713 VALUE AT DATE OF DEATH 1,000.00 3. PNC Bank -IRA Account #75100014636 (No named beneficiary) 500 First Avenue Pittsburgh, PA 15219 Commerce Bank - Savings Account #626220248 3801 Paxton Street Harrisburg, PA 17111-0999 27,070.61 2. 413,876.30 4. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 446836.71 REV-1510 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GWEN DOLEN REAGER SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 06 1081 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 DECO'S EXCLUSION TAXABLE NUMBER THE DATE Of ~ ATTACH A COPY OF THE DEED FOR REAl. ESTATE. VALUE OF ASSET INTEREST VALUE OF APl'\JCABLE) 1. TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed. insert additional sheels of the same size) REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GWEN DOLEN REAGER SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 06 1081 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers-Hamer Funeral Home, Inc. 2,234.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s)IEIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. Attorney Feas Reager & Adler, PC 900.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Feas Cumberland County Register of Wills 440.00 5. Accountanfs Feas 6. Tax Retum Prepare(s Feas 7. Short Certificates 32.00 8. Advertisement - Cumberland Law Journal 75.00 9. Advertisement - Central Penn Business Journal 79.00 TOTAL (Also enter on line 9, Recapitulation) $ 3 760.00 (If more spaoe is needed, Insert additional sheets of the same size) OEV-"" "'.. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GWEN DOLEN REAGER SCHEDULE J BENEFICIARIES RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tnlltee(l) OF ESTATE I. TAXABLE DISTRIBUTIONS pnclude =ht ~I distributions. and transfers under Sec. 9116 (a (1. )) 1. Frederick W. Reager Spousal 443,076.71 17 South 24th Street Camp Hill, PA 17011 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 1. 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 0.00 TOTAl OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 FILE NUMBER 21 06 1081 (If more space is needed, insert additional sheets of the same size) INVENTORY , Deceased No. 21 06 1081 Date of Death 11/19/2006 Social Security No. 176347664 Estate of Gwendolen Reager also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attomey: Susan H. Confair 1.0. No.: 70241 Address: 2331 Market Street Camp Hill Telephone: (717) 763-1383 Dated ~ I) ,07 PA 17011 Description Value PNC Bank - IRA 27,070.61 Commerce Bank - Savings Account 413,876.30 1987 Pontiac Grand Am 1,000.00 N I.J") <>- f-- u::: cr: -...., lL. C' (:)0 esr:' :::J ~? r u.:r: . &c 0:5 C.) ~I ~.,.... a: r- :>- -.r ~"....; ~ r-- = = <:'--.J Total 446,836.71 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figUres should not be extended into the total of the Inventory. RW-4