HomeMy WebLinkAbout07-12-07
--.J
15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes . INHERITANCE TAX RETURN
PO BOX 280601
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
00309
Date of Birth
159181308
o 3 192 007
06011920
Decedent's Last Name
Suffix
Decedent's First Name
S TIT Z E L
MAR Y
MI
M
(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
[R] 1. Original Return
o 4. Limited Estate
[R]
o
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 INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
G ERA L D K M 0 R R ISO N E S Q
717
5(~ 2
'-,;0
'"
2:3500
-.J
6 W EST M A INS T R E E T
N
Firm Name (If Applicable)
First line of address
I~;
-;:J
Second line of address
"..u
,'j --j
N
gJ'
P 0 BOX 2.3 2
City or Post Office
State
ZIP Code
DATE FILED
NEW B L 0 0 M FIE L D
P A
17068
Correspondent's e-mail address:
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 represent' based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
X X 07/10/2007
ADDRESS
New PA 17068 PA 17013
DATE
07/10/2007
PO Box 232 New Bloomfield
PLEASE USE ORIGINAL FORM ONLY
PA 17068
Side 1
L
15056fl41125
15056041125
-.Jcb
---I
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name MAR Y M. S TIT Z EL
RECAPITULATION
159181308
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,2!l;Probate Property
(Schedule G) U Separate Billing Requested. . . . . .. 7.
3659967
8. Total Gross Assets (total Lines 1-7) 8. 3 6 5 9 9 6 7
.......................... .
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 2 8 5 6 6 1
............... .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 1 6 9 5 2 1
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 4 5 5 1 8 2
12. Net Value of Estate (Line 8 minus Line 11) 12. 2 2 0 4 7 8 5
. . . . . . . . . . . . . . . . . . . . . . . . .
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. 2 2 0 4 7 8 5
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 _ 1 2 1 2 6 3 2 15. 0 0 0
16. Amount of Line 14 taxable
at lineal rate X .0 0 0 0 16. 0 0 0
17. Amount of Line 14 taxable 9 9 2 1 5 3
at sibling rate X .12 17. 1 1 9 0 5 8
18. Amount of Line 14 taxable 1 0 0 0 0 0
at collateral rate X .15 18. 1 5 0 0 0
19. Tax Due 19. 1 3 4 0 5 8
.............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L
15056042126
15056042126
....J
, REV-1500 EX Page 3
,Decedent's Complete Address:
DECEDENrs NAME
MARY M. STITZEL
STREET ADDRESS
APT. 507
File Number
00309
335 WESLEY DRIVE
CITY
MECHANICSBURG
I STATE
PA
I ZIP
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19)
2, CreditslPayments
A, Spousal Poverty Credit
8, Prior Payments
C, Discount
(1)
1.340,5~
Total Credits (A + 8 + C) (2)
o.oe
3. InteresUPenalty if applicable
0, Interest
E. Penalty
. TotallnteresUPenalty ( 0 + 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)
o.oe
5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5)
o.oe
1.340.5~
A, Enter the interest on the tax due,
8, Enter the total of Line 5 + 5A This is the BALANCE DUE.
(5A)
(58)
1.340.5~
. 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 IRI
b, retain the right to designate who shall use the property transferred or its income; ............................... 0 IRI
c, retain a reversionary interest; or ................................................................................................ 0 IRI
d, receive the promise for life of either payments, benefits or care? ....................................................... 0 IRI
2, If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 IRI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 IRI
4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 IRI
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) (ill,
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) (iill. 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)(1.211.
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.1508 EX + (6-98)
*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARY M. STITZEL
FILE NUMBER
00309
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
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
DESCRIPTION
VALUE AT DATE
OF DEATH
CASH ON DECElJENT'S PERSON
91.0C
ROWE'S AUCTION SERVICE - SALE OF ALL PERSONAL PROPERTY
3,064.0C
PNC BANK - CD #00382141
(SEE ATTACHED)
15,785.8€
I?NC BANK - CD #00382131
(SEE ATTACHED)
3,221.6t
PNC BANK - SAVINGS ACCOUNT #00382121
(SEE ATTACHED)
3,839.9~
PNC BANK - CHECKING ACCOUNT #00382111
(SEE ATTACHED)
1,339.1~
ERIE INSURANCE COMPANY - REFUNDS
247.0C
BETHANY TOWERS - REFUND
37.1i
26 SHARES PRUDENTIAL FINANCIAL - REDEMPTION VALUE
(SEE ATTACHED)
2,370.8~
PNC - IRA PROCEEDS
6,603.0~
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
36 599.6;
REV.1511 EX+(12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARY M. STITZEL
FILE NUMBER
00309
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. NICKEL FUNERAL HOME 6,944.2.:1
i
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) ELLSWORTH L. STITZEL 1,830.0C
Social Security Number(s)/EIN Number of Personal Representative(s) 172-32-1763
Street Address 227 PATIO COURT
City NEW BLOOMFIELD State PA Zip 17068
Year(s) Commission Paid: 2007
2. Attorney Fees GERALD K. MORRISON, ESQUIRE 1,830.0C
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant 10 Decedent
4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 145.0C
5. Accountanfs Fees
6. Tax Retum Prepare~s Fees
7. PERSONAL REPRESENTATIVE: DALE F. STITZEL, SSN: 174-20-6283 1,830.0C
118 AMY DRIVE, CARLISLE, PA 17013
8. THE SENTINEL - ESTATE ADVERTISING 202.3i
9. CUMBERLAND LAW JOURNAL - ESTATE ADVERTISING 75.0C
TOTAL (Also enter on line 9, Recapitulation) $ 12,856.61
(If more space is needed, insert additional sheets of the same size)
,
REV.1512 EX + (12.03)
*"
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARY M. STITZEL
FILE NUMBER
00309
Report debtllncurred by the decedent prior to death which remained unpaid as of the date of death, Including un reimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ROWE'S AUCTION SERVICE - SALE COSTS 672.4C
2. MESSIAH LUTHERAN CHURCH - FUNERAL LUNCH 100.0C
3. WE IS PHARMACY - PRESCRIPTIONS 24.3~
4. VERIZON - TELEPHONE ACCOUNT 45.4~
5. ERIE INSURANCE - AUTO INSURANCE PREMIUM 14.0C
6. RICE MEMORIAL WORKS - GRAVESTONE & LETTERING 839.0C
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,695.21
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pndude OU~ht s~usal distributions, and transfers under
Sec. 9116(a (1.)]
1. RAYMOND SCHOTT Collateral 1,000.OC
325 WESLEY DRIVE, APT. 3124
MECHANICSBURG, PA 17055
2. AL T A C. STITZEL Sibling
335 WESLEY DRIVE, APT. 620 7.5 PERCENT
MECHANICSBURG, PA 17055
3. CLARK R. STITZEL Sibling
PO BOX 106 7.5 PERCENT
NEYV BUFFALO, PA 17069
4. ELLSWORTH L. STITZEL Sibling
227 PATIO COURT 15 PERCENT
NEW BLOOMFIELD, PA 17068
5. DALE F. STITZEL Sibling
118 AMY DRIVE 15 PERCENT
CARLISLE, PA 17013
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. AMERICAN CANCER SOCIETY
PO BOX 897
HERSHEY, PA 17033-0897
2. THE PERRY HISTORIANS
RD2
NEWPORT, PA 17074
3. THE SALVATION ARMY
20 EAST POMFRET STREET
CARLISLE, PA 17013
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-l500 COVER SHEET $
.eEV'''''~'*
COMMONWEAl. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARY M. STITZEL
SCHEDULE J
BENEFICIARIES
FILE NUMBER
00309
(If more space is needed, insert additional sheets of the same size)
) ,
LAST WILL AND TESTAMENT
OF
O~', -)
MARY M. STITZEL
"'. )
, -)
I, MARY M. STITZEL, of335 Wesley Drive, Apt. 507, Mechanicsburg, Cumb~iIand
County, Pennsylvania, being of sound and disposing mind, memory and understanding
\D
do hereby make publish and declare this my Last Will and Testament, hereby expressly
~evoking 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 and bequeath the sum of ONE THOUSAND DOLLARS
($1,000.00) to my friend, Raymond Schott of Bethany Village, Mechanicsburg,
Pennsylvania.
FOURTH: 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, as follows:
~~%~
M M. STITZEL
Page one of two
1. TWENTY-FIVE PERCENT (25%) to the American Cancer Society, Pennsylvania
Division, c/o Vicki Haake, P. O. Box 897, Hershey, PAl 7033-0897
2. TEN PERCENT (10%) to Perry Historians
3. TEN PERCENT (10%) to Salvation Army
4. TEN PERCENT (10%) to Bethesda Mission
5. THIRTY PERCENT (30%) to be divided equally between my two brothers,
Ellsworth L.Stitzel and Dale F. Stitzel
. 6. FIFTEEN PERCENT (15%) to be divided equally between my sister, Alta C.
Stitzel and my brother, Clark R. Stitzel.
FIFTH: I hereby appoint my two brothers, Ellsworth L. Stitzel and Dale F. Stitzel, as
Executors of,this, my Last Will and Testament. 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 22nd day of
July, 2005.
X:~9J?~SEAL)
MAR . STITZEL
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 17105-8486
April 17, 2007
GERALD K MORRISON ESQUIRE
CENTER SQUARE PO BOX 232
NEW BLOOMFIELD PA 17068
Re: MARY M STITZEL
SSN: 159-18-1308
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,
~9-rND~~
Carole A. Procope
Recovery Section Manager
(717)772-6604
{~'~'1 ~",,"',~~,f._~-~
-~--------~r ,Yj-':
.; .-l_;~,~ :;;~. _ ~';. '.
~y M STITZEL ..; ... .
335WE$I..EYDR AP"11. ' ,
M~CH~NlcSB(jRG P AI 1055-3565
''''1'1
1...11I'1111111111 ~ .11I1,1~~III'IIIIIIItIlIlI'IIIIII'III.11I1111
.~' , ;'~'
.,{
, .; Holder Account Number
-
II
C 0003199053,
IND
I_II
SSNIT1N Certified
Symbol
Yeti
PRU
OOICS0093.DOMEQSBLUEBG,CIS.64 159.. 21.IIOOOO8J)K~1OO8OIi
>~>~');~ ~ ,,'
. ,;~ntNun1b6r'"
'''~~'lbni5.'
;:~sl=ederalID No.
OMB No.
Stocks.
Bonds, etc. ($)
2,383.93
Gross Proceeds I
Reported to IRS
Yes
PRUDENTIAL FINANCIAL INC
. Transaction
Sale - COl
.i.t.e'.,
Paye(sDetails
COMPUTERSHARE SHAREHOLDER SERVICES INc ,
P.O. sOx 43010 I
PROVIDENCE RI i
II
I
FEDERAL N:OME 7
lAX wirriiiELtf tii ~
0.00
-- Nclrne of Issuer
,NOTE: Computershare wi r8Pori the lIllOUnt in Box 210 the IRS. The dillerence between the gross proceeds amount in Box 2 and the net proceeds
you received replllS8fIts any fees, charges, or withholding taxes you may have paid.
Form 1099-8
(Keep for your records)
Summary
Trade Date
. . . '1 Shares/Units I Price Per I Gross Amount I
Transaction Descnptlon Sold Share/Unit ($) , of Sales ($) I
Deduction I
Amount ($) I
Deduction I
Type
Net Amount
of Sale ($)
05 Apr 2007
Sale
26.o00ooo
91.689612
2,383.93
13.08
Transaction Fee
2,370.85
Computershare Trust Company, NA., as agent, upon written request, will provide the name of the executing broker dealer associated with the transaction(s), and within a reasonable amount of
lime will disclose the source and amount of compensation received from third parties in connection with the Iransaction(s), if any.
.
71UTX
PRU
+
001CD70008
OOHX2E
II
-';':'~'. .
001~j!
,,~',~~:; ,
Cashier's Check
o PNCBAN<
PNC Bank, NatioIlaJ Association
Pay 10 the Order of MARY M STITZEL
One Thousand Three Hundred Thirty-nine Dollars And Fifteen Cents
Non.-Negotiable Customer Copy
5004893689
RerTllttef
Cashier's Check
o PNCBAN<
PNC Bank, National Association
Pay 10 the Order of EST A TE OF MARY M STITZEL
Fifteen Thousand Seven Hundred Eiahty-fiye Dollars And Eiahty-six Cents
Non-Negotiable Customer Copy
3200113771
Remitter
Cashier's Check
o PNCBAN<
PNC Bank, National Association
Pay to the Order of ESTATE OF MARY M STITZEL
Three Thousand Two Hundred Twenty-one Dollars And Sixty-nine Cents
Non-Negotiable Customer Copy
300011:J065
Remine,
Cashier's Check
o PNCBAN<
PNC Bank, National Association
~
q
on
..,
~ Pay 10 the Order of EST ATE OF MARY M STITZEL
i
'"
g T~e Thousand EiQht Hundred Thirty-nine Dollars And Ninety-two Cents
Non-Negotiable Customer Copy
~004413948
Rammer
: No; 00382111'
. ,t">.,
c~(
:.<'Jt. .
!~~~ -~{
"1';' '1;
i~
$ 1,339.15
No. 00382141
Date April 2, 2007
$ 15,785.86
No. 00382131
Date April 2, 2007
$ 3,22] .69
No. 00382121
Date April 2, 2007
$ 3,839.92
.~"