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Home My WebLink About06-13-07 . --.J 15056041125 REV-1500 EX (06-05) PA Department of Revenue. =~re:~:~=~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 0 0 7 File Number 00306 Date of Birth 198051397 o 3 172 007 05231919 Decedent's Last Name Suffix Decedent's First Name B EAR J A N E MI H (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 o 4. Limited Estate [:&J 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach Copy of Trust) o 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 INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D D o 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes G ERA L D K M 0 R R ISO N E S Q Firm Name (If Applicable) 717 582 2 3 0 0 First line of address REGISTER O~LLS USE orfiJ C -.I -S~Q ~'~ Second line of address ,....--., ~"._~..C) 6 W EST M A INS T R E E T -;;:" ~, CJ) w -rj ZIP Code _ "_.' :::IJ -l DAT~LED r'0 P 0 BOX 2 3 2 City or Post Office State ) co NEWBLOOMFIELD P A 17068 Correspondent's e-mail address: Under penalties of pe~ulY, 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 F PERSON RESPONSIBLE FOR FILING RETURN DATE ~-' u CARLISLE PA 17015 STREET, PO BOX 232 NEW BLOOMFIELD PLEASE USE ORIGINAL FORM ONLY L 15056041125 15056041125 --.J ~ Side 1 REV-1500 EX Page 3 . t Decedent's Complete Address: DECEDENrs NAME JANE H. BEAR STREET ADDRESS 7 ALLIANCE DRIVE APT. 202 File Number 00306 CITY CARLISLE I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 29;532.8~ 1,4 76.64 Total Credits ( A + B + C ) (2) 1 ,476.6~ 3. InterestJPenalty if applicable D. Interest E. Penalty Total InterestJPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) O.OC 5. If line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. (5) O.OC 28.056.2C A. Enter the interest on the tax due. B. Enter the total of Une 5 + 5A. This. is the BALANCE DUE. (5A) (58) 28.056.2C 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 lXJ b. retain the right to designate who shall use the property transferred or its income; ............................... 0 lXJ c. retain a reversionary interest; or ..... ...... ................ ............... .... ........... ......... .............. ......... ....... 0 lXJ 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 lRJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 00 4. Did decedent own an Individual Retirement Account. annuity. or other non-probate property which contains a beneficiary designation?......... ................. .................. ................. ......... ........ ........ ............ 0 00 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. =or dates of death on or after July 1. 2000: rhe 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 Idoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)]. 'he 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 2 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)). he 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 action 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) . . * SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE H. BEAR FILE NUMBER 00306 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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. DESCRIPTION VALUE AT DATE OF DEATH 20,269.1 ~ M&T BANK CHECKING ACCOUNT ACCOUNT NO. 1247379 M&T BANK CERTIFICATE OF DEPOSIT ACCOUNT NO. 031003912277570 10,920.8~ COMMERCE BANK ACCOUNT NO. 1800358 55,745.6C AMERICAN HOME ACCOUNT NO. 5060-1869 87,550.6~ MEMBERS 1 ST FEDERAL CREDIT UNION SAVINGS ACCOUNT 277096-00 50.5~ MEMBERS 1 ST FEDERAL CREDIT UNION CERTIFICATE OF DEPOSIT 277096-40 10,362.n MEMBERS 1 ST FEDERAL CREDIT UNION CERTIFICATE OF DEPOSIT 277096-46 34,617.H MEMBERS 1ST FEDERAL CREDIT UNION CERTIFICATE OF DEPOSIT 277096-48 31 ,142.1~ PERSONAL PROPERTY - APPRAISED BY ROWE'S AUCTION SERVICE 8,370.0C PATRIOT NEWS ~ REFUND 63.2E PEBIF - REFUND 18.64 EMBARQ - REFUND 6.9; TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 259.117.n REV-1511 EX + (12-99) . . * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE H. BEAR SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 00306 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: BOYER FUNERAL HOME-BALANCE 167.4~ 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 Yea~s) Commission Paid: 2. Attorney Fees GERALD K. MORRISON, ESQUIRE 10,364.0C 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 CUMBERLAND COUNTY REGISTER OF WILLS 383.0C 5. Accountanfs Fees 6. Tax Return Prepare!'s Fees 7. THE SENTINEL - ESTATE ADVERTISING 166.0; 8. CUMBERLAND LAW JOURNAL - ESTATE ADVERTISING 75.0C TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 11 155.4~ REV-1512 E!X + (12-03) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE H. BEAR FILE NUMBER 00306 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. EMBARQ - TELEPHONE ACCOUNT 25.61 2. RICE MEMORIAL WORKS - GRAVESTONE LETTERING 125.0C 3. FOREST PARK HEAL TH CENTER - MEDICAL ACCOUNT 40.5C 4. RUFE CHEVROLET - ACCOUNT 191.OE 5. ROWE'S AUCTION SERVICE - APPRAISAL 85.0C 6. PENNSYLVANIA DEPARTMENT OF REVENUE 303.0C 2006 TAXES 7. COMMONWEALTH OF PENNSYLVANIA 36.0( AUTOMOBILE LICENSE 8. SPRING ROAD FAMILY PRACTICE 23.3( MEDICAL ACCOUNT 9. THE PATRIOT NEWS - SUBSCRIPTION COST 61.7E 10. UNITED STATES TREASURY 964.0C 2006 TAXES TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1.855.2~ 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 pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. GRACE B. STEIGLEMAN Sibling 556 E. SPRINGVILLE ROAD 100 PERCENT CARLISLE PA 17015 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET n. 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ REV.l513 EX: * SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE H BEAR (If more space is needed, insert additional sheets of the same size) FILE NUMBER 00306 ,/~ LAST WILL AND TEST AMENT .QE JANE H. BEAR I, JANE H. BEAR of 7 Alliance Drive, Apt. 202, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding do hereby make publish and declare this my Last Will and Testament, hereby expressly revoking all other writings in nature testamentary by me at any time heretofore made. FIRST: I direct that all my debts and funeral expenses be paid as soon after my decease as may be practicable. SECOND: I direct that inheritance tax on property disposed of herein shall be paid from my residuary estate. THIRD: I hereby give, bequeath and devise all the rest and residue of my estate and property, real, personal and mixed, of whatsoever nature and wheresoever situated of which I may own at the time of my death, or to which I may be entitled or of which I may have the right to dispose at the time of my death, to my sister, Grace B. Steigleman, if she is living at the time of my death. In the event she fails to survive me, then I give, bequeath and devise all my estate to my nephew, M. Douglas Steigleman, ifhe is living at the time of my death. In the event he shall fail to survive me, then I give, bequeath and devise my estate in three equal shares, as follows: A. Mt. Gilead United Methodist Church of Shermans Dale, Pennsylvania(.2 ~-...:c) B. Helen O. Krause Animal Foundation, Inc. of Dills burg, Pennsylvania. ~2 -:-.- -- ..... ::..~ ~..._.) C. Chapel Pointe Home of 770 S. Hanover Street, Carlisle, Pennsylvania. -- ~~ II b-e..a.-V (SEAf}~ J H. BEAR t.....) t........"':: Page one of two FOURTH: I hereby appoint my sister, Grace B. Steigleman as Executrix of this, my Last Will and Testament, but in the event that she is unable or unwilling to serve, I then appoint my nephew, M. Douglas Steigleman. I further direct that they shall not be required to give bond or other security in any jurisdiction wherein proceedings may be . held in connection with my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 17th day of October, 2000. ~t&" fir )!l.A:.A.-z/ (SEAL) :ANE H. BEAR Page two of two . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABilITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG. PA 17105-&486 April 17, 2007 GERALD K MORRISON ESQUIRE CENTER SQUARE PO BOX 232 NEW BLOOMFIELD PA 17068 Re: JANE H BEAR SSN: 198-05-1397 Dear Attorney Morrison: Pursuant to your letter dated April 06, 2007, the Department of Public Welfare (DPW) , Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefor~, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. If you have any questions, please feel free to contact me. Sincerely, Ccwu 9-r~~~ Carole A. Procope Recovery Section Manager (717)772-6604 ._Bank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302) 934-2955 April 24, 2007 Law Offices Gerald K Morrison Center Square - POBox 232 New Bloomfield, Pennsylvania 17068 Re: Estate of: Jane H Bear Social Security: 198-05-1397 Date of Death: March 17. 2007 Dear Sir or Madam: Per fOur inquiry dated April I 0, 2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1247379 Ownership (Names oj) Jane H Bear * Opening Date 02/27/04 Balance on Date of Death $20,268.69 Accrued Interest $ 0.50 Total $20,269.19 2. Type of Account Certificate of Deposit Account Number 031003912277570 Ownership (Names oj) Jane G Bear * Opening Date 02/27/04 Balance on Date of Death $10,400.00 Accrued Interest $ 520.82 Total $10.920.82 Please be advised, there was no safe deposit box fouri<fiorthe"aiX>ve"decedent. . · "Fo'r "fUi1her' account "information, regarding ownership, closures and/or reimbursement of funds, etc., please caD the Spring Garden Office # 717-240- 4525. Sincerely, ~vr~ N'ancy Clagett Record~ Management April 17, 2007 COIIIIIIfII'C8 ~BanIc Gerald K Morrison Center Square PO Box 232 New Bloomfield PA 17068 RE: Estate of: Jane H Bear Tax Identification Number: 198-05-1397 Date of Death: March 17, 2007 Dear Sirs: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Typ$: Time Deposit Account Number: 1800358 Date Opened: 01/24/06 Primary Owner: Jane H Bear Principal Balance: $55,591.26 Accrued Interest: $154.34 Date Of Death Balance: $55,745.60 Please feel free to contact me at (717) 412-6134 if I may be of further assistance. ~~~rz~ Mind], ~rout Levy pecialist/Deposit Services Commerce Bank Commerce Bank I Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com nt=~J\:) I en \Jvr T "~ Remitter GRACE B STEIGLEt1AH, ~IN 5253 60-1869J313 4/9/2007 Pay to ESTRTE OF JANE HI BEAR Eighty-Seven Thousi.nd Five Hundred Fi fty Dollars And 63 Cents ** - 87,550.63 NOT NEGOTIABLE III 0 0 5 2 5 :1 III I: 5 0 2 0 II' lab q I: ~ FEE COLLECTED . DATE PJIlO Z j(dMLL t ~ 0000 ~oo b "". :i b ./ Official Check TIME DEPOS'IT TRANSACTION TICKET DATE AMERICAN HOME BANK CUST. NAME 'Ii~ DEBIT ACCOUNT NUMBER (51) FORCE PAY DEBIT (55) DEBIT MEMO (86) WITHDRAWAL (88) PENALTY FREE WITHDRAWAL (05) CREDIT MEMO (38) TIME DEPOSIT (39) IRA DEPOSIT - PRIOR YEAR * tift! Cd 3(flO AMOUNT $ 07 f6}.5f DESCRIPTION TC APPROVED BY * ff/ TIME DEPOSIT TRANSACTION TICKET DATE 1-( AMERICAN HOME BANK CUST. NAME cfI. ~ DEBIT ACCOUNT NUMBER (51) FORCE PAY DEBIT (55) DEBIT MEMO (86) WITHDRAWAL (88) PENALTY FREE WITHDRAWAL (05) CREDIT MEMO (38) TIME DEPOSIT (39) IRA DEPOSIT. PRIOR YEAR * P-tr t1 c1 cJ ?}5,b AMOUNT $ ! 1 ftr1. or DESCRIPTION APPROVED BY TC * r( SERIAL NUMBER REGULAR SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: AoCountNumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account NumbedSuffix Date Certificate Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner MEMBERS 1st FEDERAL CREDIT UNION 277096 -00 12/27/2005 $50.57 $.02 $50.59 None 277096 -40 11/21/2006* $10,340.13 $22.62 $10,362.75 None 277096 -46 12/27/2005 $34,559.77 $57.42 $34,617.19 None 277096 -48 06/21/2006 $31,072.93 $69.19 $31,142.12 None .Purchased by transfer of funds from matured certificate, 277096-47, originally purchased 4118106 Estate of: JANE H. BEAR Date of Death: 03/17/2007 Social Security Number: 198"()5-1397 ~BE~S. 1ST '?JE~L CREDIT UNION :J1Cd< // /(Jtk D niseA.Wolfe /..- Insurance Services Supervisor April 25. 2007 5000 Louise Drive · l?O. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.memberslst.org