HomeMy WebLinkAbout06-07-07
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15056051058
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~e Year
INHERITANCE TAX RETURN ,"/
RESIDENT DECEDENT C7 07
File Number
90
Date of Birth
01/08/2007
11/17/1907
Decedent's Last Name
Suffix
Decedent's First Name
MI
Roberts
Grace
C
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
~p()U~~'s..~O~illl..S~~urity..~urTll>Etr.
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
IS> 1. Original Retum
4. Limited Estate
c:::J
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
c::>
2. Supplemental Retum
C"::)
c:::>
C"::) 4a. Future Interest Compromise (date of
death after 12-12-82)
c:::> 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c:::J 10. Spousal Poverty Credit (date of death c:::> 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~urTlber
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
~
c:::J
Jeffrey C. Munnell, Esq
FirrT1NarT1l3(lfp.ppli~ble). .
(412) 751-2770
REGISTER OF
First line of address
Second line of address
or Post Office
State
ZIP Code
DAT.f: FILED
PA 15132
Correspondent's e-mail address:
.. ~..~._--~~{{j~1I-l27
iejo. CA 92692
SENTATIVE
DATE I
.... _____.u_.______~u__,_ .Y..W7 _
3 Long Run Road. McKee sport, PA 15132
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051058
15056051058
.-J
15056052059
REV-1500 EX
Decedent's Name:
Grace
C Roberts
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) c.:::J Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::> 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 .0_
16. Amount of Line 14 taxable
at lineal rate X.O 45 5,690.26
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15 51,212.39
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052059
Side 2
Decedent's Social
Number
27,640.00
115,470.59
143,110.59
29,305.28
29,305.28
113,805.31
56,902.65
56,902.66
15.
16.
256.06
17.
18.
7,681.86
7,937.92
.,
15056052059
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
Grace C Roberts
STREET ADDRESS
,En'~J!J!m~!L"._w,_w",,___,__~
:.'.90 i
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"m..^'~"~^,"'^~,W_ w= ,vmm,wmm ='M~'-~
DECEDENTS SOCIAL SECURITY NUMBER
172-07-2633
One Alliance Road 303
CITY
Carlisle
'T'STATE'~---------I-ZTp-------'----
I PA , 17013
I
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
7,937.92
8,000.00
u....___.__..___._
400.00
Total Credits ( A + B + C ) (2)
8,400.00
3. Interest/Penalty if applicable
D.lnterest
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.
Fill in oval on Page 2, Line 20 to request a refund. (4)
462.08
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(58)
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 (iJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 (iJ
c. retain a reversionary interest; or.......................................................................................................................... 0 (iJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 (iJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 (iJ
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.
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 exempt 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. ~9116(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. ~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-1503 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Grace C. Roberts
FILE NUMBER
90 of 2007
ITEM
NUMBER
1.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
Series HH Bond #D5311167HH dated 7/2000
Series HH Bond #M7645214HH dated 10/2000
HH Bond #M7645215HH dated 10/2000
HH Bond #V1491479HH dated 7/2000
HH Bond #V1505092HH dated 10/2000
HH Bond #V1531006HH dated 1/2001
VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed. insert additional sheets of the same size)
REV-1508 EX+ (6-98) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
5C:HIDULI I
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Grace C. Roberts
FILE NUMBER
90 of 2007
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 Personal Effects
1,000.00
1,000.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
115,470.59
Refund from Chapel Pointe - Balance in personal account
Savings Acct. #15004198282540 M & T Bank
9 Checking Acct. #3741612547 M & T Bank
10 Certificate of Deposit #31003908164517 M & T Bank
*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEAl.1lf OF PENNSYLVANIA
INtERlTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GRACE C. ROBERTS
FILE NUMBER
90 of 2007
Debts of decedent must be reported on ScbeduIe L
ITEM
NUMBER
A.
B.
1 .
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Willig Funeral Home
Buono Brothers - Grave Marker
$ 1, 1 62.00
235.00
2.
ADMINISTRATIVE CDSTS
Ethel Karabin
SS#
21395 Carabela
Mission Viejo, CA 92692
3,550.00
B. ADMINISTRATIVE COSTS:
~ . Pe/SOllal Representative's Commissions
Name of Personal Aepresenlalive(s) Linda L. Snider
8.
9.
10.
11 .
12.
3,550.00
Social Sea.rity Number(s)IEJN Nt.mberof Personal Representallve(s)
StreetAddress 408 Timothy Dr.
Elizabeth
164-34-4948
City
S~~~ 15037
Year(s) Commission Paid: Undetermined
2.
AUomey Fees
7,000.00
3. FamIy Ex~ (If decedenl's address is not 1he same as cIainanl's. attach explanation)
CIaimaIi
Street Address
City
Aelatiooship of Claimant to Decedent
Slate _Zip
1 20 . 00
4.
Probate Fees
5. Accountanrs Fees
6. Tax Return Preparer's Fees
7.
McKeesport Christian Missionary Alliance Church
Hospice Center of PA
Reimbursement - Ethel Karabin - Expenses paid on behalf of
Decedent through 2006 and not previously reimbursed
Reimbursement - Ethel Karabin - Trip to attend funeral, etc.
Advertisement - Cumberland Legal Journal
Advertisement - The Sentinel
200.00
200.00
11,476.91
751.80
75.00
166.07
TOTAL (Also enter on 1i1e9, Recapitulation) $ COntinued
Of more spa:e is needed. insert addtionaI sheets of the same size)
RfV.151l EX + 17.181 SCHEDULE H
~i'~
.....-' ~
COMMONWEALTH OF PENNSYLVANIA MISCELLANEOUS EXPENSES
INHERITANCE TAX RETURN Please Print or Type
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GRACE C. ROBERTS 90'of 2007
.- - . -
ITEM DESCRIPTION' AMOUNT
NUMBER
13. Register of Wills - File Inventory 1 5 . 00
14. Chapel pointe - Final Services Rendered 788.50
15. File Inheritance Tax Return 1 5. 00
TOTAL (Also enter on line 9, Recapitulation) S 29,305.28
REV-1513 EX+ (9-00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
NUMBER
I
1.
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Ethel Karabin Cousin
21395 Carabela
Mission Viejo, CA 92692
Linda L. Snider 2nd Cousin
408 Tirrothy Dr.
Elizabeth, PA 15037
Heidi J. Smith Niece
575 Williams Ave., #B
Seaside, CA 93955
Jerry Roberts Stepson
2873 Pine Haven Dr.
Sevierville, TN 37862
AMOUNT OR SHARE
OF ESTATE
10%
10%
2
25%
3
5%
4
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.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Chapel pointe at Car lisle
770 S. Hanover st.
Carlisle, PA 17013
Christian & Missionary Alliance Church
938 surrroit st.
McKeesport, PA 15132
25%
25%
2
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF AEV-1500 COVEA SHEET $ 56,902.65
(If more space is needed, insert additional sheets of the same size)
-"-~--.....-.~,
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2007-00090 PA No. 21-07-0090
Es ta te Of: GRA CE C ROBERTS
IFirst. Middle. Last!
Late Of:
CARLISLE BOROUGH
CUMBERLAND COUNTY
Deceased
Social Securi ty No:
WHEREAS, on the 29th day of January 2007 an instrument dated
July 25th 2000 was admitted to probate as the last will of
GRA CE C ROBERTS
IFirst. Middle. Last)
1 a te of CARLISLE BOROUGH, CUMBERLAND County,
who died on the 8th day of January 2007 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
ETHEL KARABIN and LINDA L SNIDER
who have duly qualified as EXECUTOR(RIX)
and have agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 29th day of January 2007.
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_," / Register 0 / 'IS Ii
· dMdilffjs-tir
'.-.. -~, / ..fJeputy
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* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
LAST WILL AND TESTAMENT
OF
GRACE C. ROBERTS
JEFFREY C. MUNNELL, ESQUIRE
633 Long Run Road
McKeesport, PA 15132
(412) 751 - 2770
LAST WILL AND TESTAMENT
I, GRACE C. ROBERTS, ef the City ef McKeespert, Ceunty
ef Allegheny and Cemmenwealth ef Pennsylvania, being ef seund
mind and memery, de hereby make, publish and declare this to. be
, .
my LAST WILL AND TESTAMENT in manner and ferm fellewing:
FIRST: I direct that all my just debts and funeral
expenses be fully paid and satisfied as seen as cenveniently may
be after my death.
SECOND: All the rest, residue and remainder ef my
estate, whether real, persenal er mixed, and whereseever situate,
I will, give, devise and bequeath as fellews:
(A) TWENTY FIVE (25%) per cent to. CHAPEL POINTE,
presently located at 1770 Seuth Hanever street, Carli.sle, PA 17013;
(B) TWENTY FIVE (25%) per cent to. the CHRISTIAN &
MISSIONARY ALLIANCE CHURCH ef McKeespert to. be distributed equally
ameng their Great Cemmissien Fund, the Church Missienaries and
the Church General Budget;
(C) TWENTY FIVE (25%) per cent to. my niece, HEIDI J.
SMITH, ef Menterey, Califernia;
(D) FIVE (5%) per cent to. my step-sen, JERRY ROBERTS,
ef Sieverville, Tennessee;
(E) TEN (10%) per cent to my secend ceusin, LINDA L.
SNIDER, ef Elizabeth Tewnship; and
(F) TEN (10%) per cent to. my ceusin, ETHEL K~RABIN,
ef Missien Viejo., Califernia.
. "
PROVIDED, HOWEVER, if any of the individually named
beneficiaries should pre-decease me, then his, her or their share
is to be given to CHAPEL POINTE.
THIRD: I hereby nominate, constitute and appoint LINDA
L. SNIDER and ETHEL KA~ABIN, jointly or the survivor of them, Co-
Executrices of this my Last Will and Testament, to serve without
bond.
IN WITNESS WHEREOF, I, GRACE C. ROBERTS, the Testatrix
above named, have hereunto set my hand and seal this .~Ii day of
Ji,/. I}
, 2000.
., /~. n~
// /' _/i' .
/'~-...:J
,.)/_ IA Jl A!f -" c It c.v~
Grace C. Roberts
SIGNED, SEALED, PUBLISHED AND DECLARED by the Testatrix,
GRACE C. ROBERTS, as and for her Last Will and Testament, in the
presence of us, who have hereunto subscribed our names at her request
as witnesses thereunto, in the presence of said Testatrix and each
other.
WITNESS:
~~~
Jeffrey C. Munnell
Attorney at Law
633 Long Run Road
McKeesport, Pennsylvania 15132
412-751-2770
Fax 412-751-2913
June 4, 2007
Register of Wills
Cumberland County
1 Courthouse Square
Carlisle, PA 17013-3387
RE: Estate of Grace C. Roberts
No. 90 of 2007
GentlemenlLadies:
Please find enclosed herewith an original and one copy of the Inheritance Tax Return
executed by the Co-Executrices, together with a check in the amount of$15.00. Kindly file same
and return the receipt to me in the enclosed envelope.
Thank you for your cooperation in this matter.
.......~
JEFFREY C. MUNNELL
JCM/cm
Enclosures
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