HomeMy WebLinkAbout06-01-07
-.J
15056041147
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
OFFICIAL USE ONLY
..
County Code Year
INHERITANCE TAX RETURN A1
RESIDENT DECEDENT 2 1 u
File Number
537
Date of Birth
291129886
09142006
02091920
Decedent's Last Name
Suffix
Decedent's First Name
MAJOR
HARRIET
MI
E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
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
[J 4. Limited Estate
'xJ 6. Decedent Died Testete
~-, (Attach Copy of Will)
u
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise
(date of death after 12-12-82)
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
o
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
[J
10 Spousal Poverty Credit (date of death
. between 12-31-91 and 1-1-95)
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
MARIELLE F HAZEN 7175404332
Firm Name (If Applicable)
MARIELLE F HAZEN
REGISTER b~ cV'9LLS US~NL Y
:", (
First line of address
2000 LINGLESTOWN RD.
Second line of address
:,,":~ 'l
SUITE 202
City or Post Office
H.a..RR I SBURG
DATE FILED
State
FA
ZIP Code
17110
Correspondent's e-mail address: M FHa zen@H a zen e Ide r I a w . com
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.
SIGNA RE OF PERS RESPONSIBLE FOR FILING RETURN DATE
Dennis Major
o5/o~/ol
,
1481 South Mountain Road, Dillsburg, PA 17019
SIGNATURE OF PREPARER OT R THAN REPRESENTATIVE
DATE
Marielle F Hazen
ADDRESS
2000 Linglestown Rd., Harrisburg, PA 17110
Side 1
L
15(]5b(]41147
15(]5b041147
-.J
PA Inheritance Tax Return
Signature of Additional Fiduciaries
ESTATE OF FILE NUMBER
Major, Harriet E. 21--
Under penalties of pe~ury, 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 #2
~~
Name
Address1
Address2
City, State, Zip
Debra Kenes
45 West Keller Street
Mechanicsburg, PA 17055
Date
_$$J__
--.J
15056042148
REV-1500 EX
Decedent's Name: H a rri et E. M aj 0 r
RECAPITULATION
Decedent's Social Security Number
291129886
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) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7).......................................................................
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 Governmental 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.
16.
Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X ~ 0 00
Amount of Line 14 taxable
at lineal rate X .045 1,680 86
Amount of Line 14 taxable
at sibling rate X .12 0 00
Amount of Line 14 taxable
at collateral rate X .15 0 00
18.
15.
16.
17.
17.
18.
19. Tax Due....................................................... .....................................................,........ 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
1505b042148
7,249.36
8. 7 , 2 4 9 . 3 6
3,28915
2 279 35
5,568 50
1,680 86
1,680.86
o 00
75 64
o 00
o 00
75 64
D
1505b042148
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Harriet E. Major
STREET ADDRESS
Messiah Village
1---...
File Number 21--
100 Mount Allen Drive
1--.
CITY
Mechanicsburg
I STATE
PA
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
75.64
0.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
0.00
TotallnteresVPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(58)
75.64
75.64
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;.................................................................................. [!]
b. retain the right to designate who shall use the property transferred or its income;.................................... !xl
c. retain a reversionary interest; or.................. ................. ............................................................................... ,lCJ
d. receive the promise for life of either payments, benefits or care?.............................................................. Ix]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................................................................................................... ....... [!J
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?..................................................................................................................... 0 [!]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
, ..., ...m.. il,~'iw_.'..,'!~'.Ulll:ri~Uf~~
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. 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 zero
(0) percent [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 zero (0) percent [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 four and one-half (4.5) percent,
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 twelve (12) percent [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.
Rev.1608 EX+ (6.981
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
C~THOFPENNSYlVAN~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Major, Harriet E.
FILE NUMBER
21--
Include the proceeds of litigation and the date the proceeds were received by the estete.
All property jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Banker's Life - Long-Term Care Insurance 4,400.00
2 Banker's Life - Medigap policy - premium refund 297.57
3 PNC Bank - Checking Account #50-7006-9508 301.79
4 1935 Ford Pick-up Truck - per attached appraisal 2,250.00
TOTAL (Also enter on Line 5, Recapitulation)
7.249.36
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Major, Harriet E.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21--
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 685.70
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Marielle F Hazen 2,364.76
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
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 238.69
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 3,289.15
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H.A
FUNERAL EXPENSES
continued
COMMONWEAl. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Major, Harriet E.
FILE NUMBER
21--
ITEM
NUMBER DESCRIPTION AMOUNT
1 Candace Arnold - Funeral Service Minister 75.00
2 Mabel Stock - Funeral Catering 171.22
3 Malpezzi Funeral Home 169.48
4 Rothermels - Funeral Flowers 220.00
5 Trustees of United Methodist Church - Funeral Service Organist 50.00
Subtotal
685.70
Copyright (c) 2002 fonn software only The Lackner Group, Inc.
Fonn PA.1500 Schedule H-A (Rev. 6-98)
Rev.1602 EX+ (6-981
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Major, Harriet E.
FILE NUMBER
21--
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal - Legal Publication
75.00
2
The Sentinel - Legal Publication
158.81
3
US Postal Service - Certified Mail Postage
4.88
Subtotal
238.69
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev.1512 EX+ (6.96)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEAl. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Major, Harriet E.
FILE NUMBER
21--
Include unrelmbursed medical expenaea.
ITEM
NUMBER DESCRIPTION
1 Messiah Village - Nursing Home Expense
VALUE AT DATE
OF DEATH
2.241.61
2 Philhaven - Medical Expense
37.74
TOTAL (Also enter on Line 10, Recapitulation)
2,279.35
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV.1513 EX+ (9.00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Major, Harriet E.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions,l. and transfers
under Sec. l:I116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trustee's'
FILE NUMBER
21--
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
I.
1
Debra Kenes
45 West Keller Street
Mechanicsburg, PA 17055
Daughter
one-third
2
Dennis Major
1481 South Mountain Road
Dillsburg, PA 17019
Son
one-third
3
Kevin Major
184 Simmons Road
Mechanicsburg, PA 17055
Son
one-third; Ford
Truck specific
bequest
Total
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
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LAST WILL AND TESTAMENT
OF
HARRIET E. MAJOR
FILE CJ?Y
I, HARRIET E. MAJOR, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum which I have handwritten or signed, located with my will or with my valuable
papers and found within 30 days of the probate of my will. Gifts may only be to persons who
survive me or to organizations which exist at my death, and if there is a conflict, the
memorandum having the latest date shall govern. To the extent no such memorandum is found,
or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal
property shall be added to my residuary estate and pass under Article IV hereof.
Article IV
I give and bequeath my 1935 Ford Pick-up Truck to my son, KEVIN E. MAJOR.
Article V
I bequeath unto each of my issue any Note which was executed in my favor, thereby
forgiving to each of them any balance that may be owed thereon at the time of my death; and
direct that my Executor not collect any principal or interest, if any be due, on said Note at my
death. If a Mortgage has been executed by any of my issue to me securing any Notes on said
premises, I authorize my Executor to satisfy those Mortgages of record.
Article VI
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my children: DEBRA R. KENES, of Cumberland
2
County, Pennsylvania, KEVIN E. MAJOR, of Cumberland County, Pennsylvania, and
DENNIS E. MAJOR, of York County, Pennsylvania.
However, if a beneficiary does not survive me by thirty (30) days, but leaves descendants
who survive me by thirty (30) days, those descendants shall receive, per stirpes, the share the
beneficiary would have received had he or she survived me by thirty (30) days.
Article VII
I nominate, constitute and appoint my son, DENNIS E. MAJOR and my daughter,
DEBRA R. KENES, as Co-Executors. I direct that my Co-Executors be permitted to serve
without bond and in addition to those powers granted by law, I grant them power to distribute in
cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I could have filed
if living. My Co-Executors shall receive reasonable compensation for services rendered to my
estate.
Article VIII
In addition to the powers conferred by law, I authorize my Co-Executors, in hislher
absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
3
(e) to compromise claims without court approval and without consent of any
beneficiary,
(t) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
G) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, I, HARRIET E. MAJOR, hereby set my hand to this my
Last Will and Testament, on 0 l! V- mbfJ. r .3/ , 2003, at Harrisburg, Pennsylvania.
.Ak~ ~~. ~h
HARRIET E. MAJOR
In our presence, the above-named HARRIET E. MAJOR signed this and declared this
to be her Last Will and Testament and now at her request, in her presence, and in the presence of
each other, we sign as witnesses.
Name
Address
,.!X'OQ;it jjlj).sfz1~'l1 ?d. I ,If JuS, ~./-NI)II()
~()()() it ~'1 riJjt/)l ~. JiI. StJ11H:g PI/I?/ / D
4
I, HARRIET E. MAJOR, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
HARRIET E. MAJOR, the Testatrix
on }/)~A-- 3/ ,2003.
Lfll:bJ :>J
.~i f. ~(r-
HARRIET E. MAJOR
Notarial Seal
Marielle F. Hazen, Notary Public
City of Harrisburg. Dauphin County
My Commission Eltpires Sept. 23, 2006
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute
this instrument as her Will; that she signed and executed it willingly as her free and voluntary act
for the purposes therein expressed; that each of us in her sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to before ~e
by JeS51 en... +\ . Hb \~V'C\
and J!j WI (}~~~
witnesses, on] ~.?) , 2003.
.
~~
'/la .
No PUD IC
. NOWlal Seal
.Manelle F. Hazen. N~ Public
City of Harrisburg, Dauphin County
My Commission fupil'llS SepL 23, 2006
5