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Home My WebLink About06-14-07 --.J 15056041125 REV-1500 EX (06-05) PA Department of Revenue '* ~~~~~~~~~~~uaITaxes ' INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year 2 1 0 7 File Number o 2 8 2 Date of Birth 20703 794 7 03192 007 05241917 BANKERT EVELYN MI Z Decedent's Last Name Suffix Decedent's First Name (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 [ZI 1. Original Return o 4. Limited Estate [ZI o 2. Supplemental Return o o 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) 10. Spousal Poverty Credit (date of death 0 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 INFOR~IION SHOULD ~IRECTED TO: Name Daytime Tele~h()~Number :=5 W ILL I AM P D 0 U G LA S 7 1 7 2;-f4 3 1= 7 9 "'0 .--~- {.--:\ 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes - r-- City or Post Office State ZIP Code [ REGISTER?fY.?1J,;.LS U~-oNLY~.. I I I C>J ~TEFILED !"".) Firm Name (If Applicable) D 0 U G LAS LAW 0 F FIe E First line of address 4 3 W SOU T H S T ~~- Second line of address CAR LIS L E P A 17013 Correspondent's e-mail address:douglaslaw@earthlink.net 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 OF PERSON RESPONSIBLE FOR FILING RETURN DATE 5/29/2007 ADDRESS , DATE PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 --.J J --I 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Eve 1 yn Z. Ban ke rt RECAPITULATION 20703 794 7 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) .................................. 2. 34856136 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,Q!l;Probate Property (Schedule G) U Separate Billing Requested. . . . . .. 7. 8466754 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 2044191 45367081 3481152 8. Total Gross Assets (total Lines 1-7) ........................... a 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3481152 41885929 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. 4 1 8 8 5 9 2 9 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 (a)(1.2) X.O _ 0 15. 0 0 0 16. Amount of Line 14 taxable 4 1 8 8 5 9 2 9 1 8 8 4 8 6 at lineal rate X .O~ 16. 7 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18. 19. Tax Due ............ ........................... .........19. 1 8 8 4 8 6 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 L 15056042126 15056042126 --I REY-1500 EX .page 3 Decedent's Complete Address: DECEDENT'S NAME ~v~h'!!bJ:}C!r1kert STREET ADDRESS J Langsdorf Way ~ File Number 0282 - -- . CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1. T ax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 18,848.67 942.43 Total Credits (A + B + C) (2) 942.43 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( 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) 0.00 0.00 17,906.24 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. 17,906.24 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 [ZJ b. retain the right to designate who shall use the property transferred or its income; ............................... 0 [ZJ c. retain a reversionary interest; or ................................................................................................ 0 [ZJ 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 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 t. b f" d' t'? rx: con alns a ene IClary eSlgna Ion. .................................................................................................. ~ 00 00 o 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 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. ~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. R;V-1503 EX.+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Evelyn Z. Bankert FILE NUMBER 0282 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Fidelity I nvestments- Account # X47 -182443 VALUE AT DATE OF DEATH 348,561.36 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 348 561.36 Ri;:V-1508 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn Z. Bankert SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 0282 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. ITEM NUMBER 1. DESCRIPTION AFL Insurance CO., long term insurance, 19 days @$80 VALUE AT DATE OF DEATH 3,680.00 2. Meadows Living Center, refund of reservation deposit 500.00 3. two Series H U.S. savings bonds 10,000.00 4. 2006 Federal Income Tax refund 2,779.00 5. Citizens Bank - date of death balance - see attached 32,389.04 6. Cornerstone Federal Credit Union date of death balance all accounts- see attached 32,895.43 7. Diakon Lutheran Social Ministries, Cumberland Crossings, refund 2,424.07 8. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 84667.54 R~V-1510 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 0282 ESTATE OF Evelyn Z. Bankert 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 DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1. Peoples Benefit Life Insurance Company 20,441.91 100. 20,441.91 Annuity #A100002986A01 TOTAL (Also enter on line 7 Recapitulation) $ 20.441.91 (If more space is needed, insert additional sheets of the same size) R.EV-1511 ". (1. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 0282 ESTATE OF Evelyn Z. Bankert Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home 8,743.20 2. Westminster Cemetery, grave opening 1,440.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees Douglas Law Office 20,430.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 335.00 5. Accountanfs Fees John Klingler Associates, preparation of 1041, Fiduciary Return 600.00 6. Tax Retum Prepare~s Fees Cohick & Associates, preparation 2006 tax returns 305.00 7. Vital Statistics, death ctfs, Robert Bankert 27.00 8. Evening Sentinel, estate ad 151.55 9. Cumberland Law Journal, estate ad 75.00 10. Continuing Care, RX 41.18 11. Pa. Dept. of Revenue, 2006 PA 40 tax due 97.00 12. Register of Wills, filing inventory and appraisement and Family Agreement 65.00 13. PSERS, pension reimbursement 2,448.88 14. Cumberland Crossings, final bill 26.71 15. Dept. of Vital Stats, death ctfs, Robert Bankert 26.00 TOTAL (Also enter on line 9, Recapitulation) $ 34.811.52 (If more space is needed, insert additional sheets of the same size) '''''''',' '" >'* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF E I Z B k SCHEDULE J BENEFICIARIES FILE NUMBER velvn an ert 0282 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. Cordelia L. Kutz Lineal 1/2 of residue 628 W. Old York Rd. Carlisle, PA 17015 1/2 of residue 2. Kathy A. Graff Lineal 1268 Conestoga Dr. Minden, NV 89423 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. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - 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) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 18.84e.67 Discount: 942.43 Interest Table h Year Days Delinquent Balance Due r this time period this year J5efore 1981 =t =1 i 1982 i 1983 ..._._._.~--~ L1984 --- ~ 1986 1987 - 1988 through 1991 --~-- 1992 - i I I ~ .=J ~ I j I -~ -~ ~ ---1 -=J -~ ~-- Interest this period 11~93 t. hro~gh 1994 j.I-. ___ !1995through 1998 _ ~~ - F- ~'2:0~03 _ ~. .~ 2004 2005 I 2006_ r- !-..------- L____ ~_._-- - t~TOTALS t =~ Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: __