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Home My WebLink About08-15-07 (2) 15115611511147 REV-1500 EX (06-05) INHERITANCE TAX RETURN RESIDENT DECEDENT PA Department of Revenue Bureau of Individual Taxes PO Box 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Suffix [IIJ MI o Suffix [IIJ MI G THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .. 1. Original Return c:::> 4. Limited Estate .. c:::> 2. Supplemental Return c:::> c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach a Copy of Trust) 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) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHALL BE DIRECTED TO: Daytime Telephone Number ~ Elill ~ "'.''(J '1" c:::> c:::> c:::> c:::> o 8. Total Number of SOB's CORRESPONDENT - ~ ~.i c: ", \~ - ,~{2 j J ~ ~ C) DATE FILEDW Correspondent's e-mail address: DATE L Side 1 15115611511147 15115611511147 ~ ~ 15D5bD52D4l!l REV-1500 EX Decedent's Name: RECAPITULATION 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested 8. Total Gross Assets total Lines 1.7 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11 Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub"ect to Tax Line 12 minus Line 13 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 _ $0.00 16. Amount of Line 14 taxable at lineal rate x .045 $4,177.55 17. Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19 TAX DUE 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L Side 2 15D5bD52D4l!l 1.1 2.1 3.1 4.1 5.1 6.1 7.1 $0.00 I $0.00 I $0.00 I $17,193.50 I $0.00 I $0.00 I 8. $17,193.50 $13,015.951 $0.00 I $13,015.951 $4,177.551 $0.00 I 9.1 10.1 11.1 12.1 13.1 14. $4,177.55 15 $0.00 16 $187.99 17 $0.00 18 $0.00 191 $187.991 c=::> 15D5bD52D4l!l J . ~ ~~ . . LAST WILL AND TESTAMENT OF PAUL E. MENTZER I, PAUL E. MENTZER, of North Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath all of my guns of every kind and nature to my son, DALE E. MENTZER. TIDRD: I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my Wife, MARTHA D. MENTZER, providing she shall survive me by thirty (30) days. Should my Wife, MARTHA D. MENTZER, predecease me or die on or before the thirtieth day following my death, I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my children, equally, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death, shall be distributed to his or her issue, per stirpes, living on the thirty-fIrst day following my death, and in default of such then living issue, such share shall be added to the share or shares for my other children. FOURTH: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. FIFTH: I nominate, constitute and appoint my Wife, MARTHA D. MENTZER, Executrix of this my Last Will and Testament. Should my Wife, MARTHA D. MENTZER, fail to qualify or cease to act as Executrix, I appoint my son, DALE E. MENTZER and my daughter, DENISE AGAR, or the survivor of them, Co-Executors of this my Last Will and Testament. ... SIXTH: I direct my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two (2) typewritten pages, each identified by my signature, this / I r< day of August, 2000. ~~~~~.~ '(SEAL) aul E. Mentzer Signed, sealed, published and declared by the above-named Testator, Paul E. Mentzer, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~dL~. ~YV .. ~ COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Paul E. Mentzer, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Paul E. Mentzer, the Testator, this /1 day of August, 2000. , NOTARIAL SEAL SHELLY SEXlON, NOTARY PUBLIC CARLISLE BORa, CUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 26, 200~ Member, Pennsylv?r,\g f,~::~(j!:~~_~~~~~,!! " (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, RONALD E. JOHNSON and MI'7e.T#FI). MF/VTZE1f!:..., the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that Paul E. Mentzer, signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON and mA~rHrl 1>. lI1€fJ7. EK, witnesses, this Z"t"l f August, 2000. EAL) NOTABlAl SEAL SHEllY SEXTON, NOTARY PUBLIC CARLISLE BORO, CUMBERLAND COUNTY MY COMMISSiON EXPiRES f;PRll26, 2003 MemheT, PHr.r.Svl."n;., t,H.- ,-"t.,x 0' N I . ---.~._..__,"...". .::.:::~.:.~ 0 anes ) ~ ,Wi' Notary Pub . -~ .. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER ITEM NUMBER Paul E. Mentzer 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 DESCRIPTION VALUE AT DATE OF DEATH 1966 Harley Davidsin SLH electrioglide - proceeds from sale $1,000.00 2 1982 Harley Davidson SLT Model- not driven for 12-13 yrs needs work $7,000.00 3 firearms - rifles and shotguns (see list attached) (All values obtained from AuctionArms.com or Gunbroker.com) $9,193.50 TOTAL (also on line 5, Recapitulation) $17,193.50 1. Marlin model 93, 30-30, serial #6581. 2. Stevens #44, 25-20, serial #11793. 3. Marlin 39A, .22 rimfire serial #71 92195 4. Winchester 1897, 12 Ga., serial #C 234360 5. Marlin 336, 30-30, serial #69 61754 6. Thompson Center Renegade, .54, serial #39034 7. Thompson Center Renegade, .50, serial #97314 8. Thompson Center Renegade, .50, serial #149241 9. Ithaca 37,12 Ga., serial #---- 10. Remington 14,35 Rem, serial #42755 11. Remington 14, 35 Rem, serial #102051 12. Winchester 190, .22 rimfire, serial #529138 13. American gun co., 12 Ga. Knickerbocker, serial #40534 14. Sears Ted Williams, 34, .22 rimfire, serial #------- 15. Savage 65M, .22 Magnum, serial #----- 16. Winchester 1886, 40-82, serial #80228 17. Marlin 1936, 32 special, serial #86919 18. Thompson Center Hawkin, .50, serial #75168 19. Thompson Center Hawkin, .45, serial #44000 20. Remington 760, 30-06, serial #188094 21. Remington 760,30-06, serial #87023113 22. Marlin 1895SS, 45-70, serial #22053340 23. Western Field, .22 rimfire, serial #87003 24. Savage 94, 20 Ga., serial #-------- $325.00 $635.00 $305.00 $282.00 $225.00 $180.00 $180.00 $180.00 $210.00 $285.00 $285.00 $99.00 $79.00 $90.00 $125.00 $1356.00 $355.00 $154.00 $154.00 $263.00 $263.00 $408.00 $39.00 ~dA. ~n 25. Colt 1878, 10 Ga., serial #15204 26. Marlin 1894S, 44 Magnum, Serial #22063110 27. Winchester 1892, 32wcf, Serial #783456 28.'" Charles Daly Hawkin, .50, Serial #630055 29. Traditions Deerhunter, .50, Serial #277094 30. Zoave reproduction flintlock, (Japan), Serial #3344 31. Batavia Leader, 12 Ga., double, Serial #93707 32. Marlin 336, 30-30, Serial #26103925 $1010.00 $348.00 $650.00 $126.00 $116.00 $100.00 $97.00 $225.00 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Paul E. Mentzer Debts of decedent must be reported on Schedule I. A. ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses: I Ronan Funeral Home $8,800.95 2 Administrative Costs: I Personal Representive Commissions Name of Personal Representative(s) Social Security Number of Personal Representative: Street Address: City: State: Zip: Year(s) commissions paid: 2 Attorney fees to Andrews & Johnson $700.00 3 Family Exemption Claimant Martha D. Mentzer Street: 1925 Spring Road City: Carlisle State & Zip Pa 17013 Relationship of Claimant to Decedent: Wife $3,500.00 4 Probate Fees to Register of Wills 5 Accountant Fees to Patricia Rosendale, CPA 6 Tax Return Preparer's Fees 7 Register of Wills - P A Inheritance Tax filing fee $15.00 8 9 10 II 12 13 14 15 16 17 18 19 TOTAL (also on line 9, Recapitulation) $13,015.95 B. SCHEDULE J BENEFICIARIES ESTATE OF Paul E. Mentzer FILE NUMBER ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 91 16(a) (1.2)] I Martha D. Mentzer 1925 Spring Road, Carlisle, P A 17013 wife residue 2 Dale E. Mentzer 323 Sherwood Drive, Carlisle, PA 17015 son guns II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0