HomeMy WebLinkAbout08-31-07
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15056041147
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
INHERITANCE TAX RETURN CounlyCode .i?:J
RESIDENT DECEDENT 2 1
File Number
9--f.tS
Date of Birth
179103832
12252006
01021916
Decedent's Last Name
Suffix
Decedent's First Name
STERRETT
HELEN
MI
B
(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 Retum D 2. Supplemental Retum D 3. Remainder Retum (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Retum Required
(date of death after 12-12-82)
D 6. Decedent Died Testate D 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal povertycredit~date of death D 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
GARY L. JAMES ESQ. 7175333280
Firm Name (If Applicable)
JAMES, SMITH, DIETTERICK &
134 SIPE AVENUE
REGISTE~~LLS U~NLY
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First line of address
Second line of address
City or Post Office
HUMMELSTOWN
State
PA
ZIP Code
17036
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D;qE-~ILED
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Correspondent's e-mail address: 9 Ij @jsdc. com
Under penalties of pe~ury, I declare that I have examined this retum, 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.
IGNATU OF PERSON RES Sl FI NG RETURN DATE
Nancy J. Palovitz
}ec~
1638 Fishburn Road, Hershey, PA 17033
OF PREPARER OTHER THAN REPRE~--
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DATE
Gary L. James Esq.
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elstown, PA 17036
Side 1
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15056041147
15056041147
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15056042148
REV-1500 EX
Decedenl'sName: Helen B. Sterrett
Decedent's Social Security Number
179103832
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) D Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D 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 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.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X ~ 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 12 0 , 8 9 9 . 0 2
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0
15.
16.
17.
18.
19. Tax Due..................................................................... .......................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
69,604.80
64,526.71
134,131.51
13,232.49
13,232.49
120,899.02
120,899.02
0.00
5,440.46
0.00
0.00
5,440.46
D
15056042148
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'REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-06-
DECEDENT'S NAME
Helen B. Sterrett
STREET ADDRESS
824 Lisburn Road
Apt 320
CITY I STATE IZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
5,440.46
5,000.00
263.16
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
5,263.16
TotallnteresUPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is theBALANCE DUE
(3)
(4)
(5) 177.30
(5A)
(58) 177.30
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;............................................................................. D [!]
b. retain the right to designate who shall use the property transferred or its income;................................ D [!]
c. retain a reversionary interest; 0[........................................................................................................... D [!]
d. receive the promise for life of either payments, benefits or care?........................................................... D [!]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?................................................................................................................ D [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death:?....... [!] D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?............................ ................................................................................... [!] D
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 statutedoes not exemota 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-15091;X+ (6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
Sterrett, Helen B.
FILE NUMBER
21-06-
ESTATE OF
If an asset was made Joint wtthln one year of the decedenrs date of death. It must be reported on sChedule G.
SURVIVING JOINT TENANT(S) NAME
A. Nancy J. Palovitz
ADDRESS
RELATIONSHIP TO DECEDENT
Daughter
1638 Fishburn Road
Hershey, PA 17033
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSE INTEREST DECEDENrSINTEREST
JOINTLY-HELD REAL ESTATE.
1 A 10/13/2005 Commerce Bank Checking Account # 11,325.34 50.000% 5,662.67
537061871 - valued per letter dated
March 27, 2007
A 10/13/2005 Accrued interest on Item 1 through date 3.93 50.000% 1.97
of death
2 A 9/16/2004 502.513 shares of Eaton Vance Classic 4,708.55 50.000% 2.354.28
Senior Floating Rate - held in
Susquehanna Financial Advisors
Brokerage Account # FFB-233765 - value
per sales price per share
3 A Midland National - return of funds to 68.000.00 50.000% 34.000.00
Nancy Palovitz surviving joint owner of
Commerce Checking Account
4 A 9/16/2004 Prime Fund - Capital Reserves Class - 55,171.76 50.000% 27,585.88
held in Susquehanna Financial Advisors
Brokerage Account # FFB-233765 -
valued per statement dated 12/31/06
TOTAL (Also enter on Line 6. Recapitulation) 69,604.80
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
Rey.1510 I;X+ (6-98)
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SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sterrett, Helen B.
FILE NUMBER
21-06-
ESTATE OF
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.
ITEM I luN OF PROPERTY DATE OF DEATH % OF DECD'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
1 1994 Jetta - Valued at sales price 3.995.00 3.995.00
2 Adams Electric Cooperative - Patronage capital 399.11 399.11
3 MetLife Bank Annuity Certificate of Deposit # 60,132.60 60,132.60
5002463486 - valued per letter dated March 27,
2007 - beneficiaries are Brenda K. Duffy, Linda L.
Fura, Beverly A. Ickes, and Nancy J. Palovitz
TOTAL (Also enter on Line 7, Recapitulation) 64.526.71
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule G (Rev. 6-98)
REV-1151.EX+ (12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sterrett, Helen B.
FILE NUMBER
21-06-
ESTATE OF
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 9,598.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 3,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 634.49
TOTAL (Also enter on line 9, Recapitulation) 13,232.49
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EJ(+ (6-98)
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SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sterrett, Helen B.
FILE NUMBER
21-06-
ITEM
NUMBER DESCRIPTION AMOUNT
1 Camp Hill United Methodist Church - Luncheon 375.00
2 Eby Granite Works - Headstone 111.00
3 Myers Funeral Home - Funeral 8,537.00
4 Pastor Stephen Gallaher 100.00
5 Spring Hill Cemetery 475.00
Subtotal
9,598.00
Copyright (c) 2002 fonn software only The Lackner Group, Inc.
Fonn PA-1500 Schedule H-A (Rev. 6-98)
REV.1513,EX+ (9-lIO)
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SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Sterrett, Helen B.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not Ust Trustee/al
FILE NUMBER
21-06-
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
I.
See attached schedule
Total 120,910.57
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 ScheduleJ (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Helen B. Sterrett 179-10-3832 12/25/2006
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Brenda K. Duffy Daughter 25% of Schedule G 15,033.15
1111 Sunnyside Drive Item 3
Hagerstown, MD 21742
2 Linda L. Fura Daughter 25% of Schedule G 15,033.15
311 Erford Road Item 3
Camp Hill, PA 17011
3 Beverly A. Ickes Daughter 25% of Schedule G 15,033.15
108 Conodoquinet Road Item 3
Newville, PA 17241
4 Nancy J. Palovitz Daughter 25% of Schedule G 75,811.12
1638 Fishburn Road Item 3 and residue
Hershey, PA 17033 net of expenses
Total 120,910.57
1
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August 30, 2007
Glenda Famer Strausbaugh
Register of Wills &
Clerk of Orphans' Court
1 Courthouse Square
Carlisle, P A 17013
THE
ESTATE
SECURITY
FORMULA""
RE: ESTATE OF HELEN B. STERRETT, DECEASED
SOCIAL SECURITY # 179-10-3832
Denise M. Long
dml@jsdc.com
Dear Ms. Strausbaugh:
Enclosed are the following documents to be filed in the above-referenced Estate:
1. An original and two (2) copies of the Pennsylvania Inheritance Tax
Return.
2. A check made payable to the "Register of Wills, Agent" in the amount of
One Hundred Seventy Seven Dollars and Thirty Cents ($177.30)
representing the Pennsylvania Inheritance Tax due.
3. A check made payable to the "Register of Wills, Cumberland County" in
the amount of Fifteen Dollars ($15.00) representing the filing fee.
We do not anticipate opening a probate estate.
Please time-stamp the additional copy of the Return and return it to me in the enclosed
self-addressed, stamped envelope.
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If you have any questions, please feel free to give me a call.
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JtMi"' SMITH: DIETT. :RICK & CO.N.....N. ELLY, LLP
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Denise M. Long -
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cc: Nancy J. Palovitz
134 SIPE AVENUE
HUMMELSTOWN. PA 17036
MAILING ADDRESS
PO. BOX 650
HERSHEY, PA 17033
TOLL FREE 1800.942.3660
TEL. 717.533.3280
FAX 717.533.7771
www.jsdc.com