HomeMy WebLinkAbout09-27-07
--1
15056051058
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
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
File Number
~\ ()l
l5~~~
Date of Birth
206-32-1473
12/29/2006
12/08/1942
Decedent's Last Name
Decker
Suffix
Decedent's First Name
Nancy
MI
L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Securityf'Jumber
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return
4. Limited Estate
<=)
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
c:::::
2. Supplemental Return
c.:;
c::::: 4a. Future Interest Compromise (date of
death after 12-12-82)
c::::;) 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c::::: 10. Spousal Poverty Credit (date of death 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
.J!
8. Total Number of Safe Deposit Boxes
c.:;
c.:;
Tricia D Naylor
Firm Name (If Applicable)
Law Office of John C Os'Z-v STOW I L -z..
First line of address
(717) 243-7437
104 S Hanover ST
REGISTER OF WILLS USE ONLY
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Second line of address
or Post Office
State
ZIP Code
.-:;J~?
DAT-E.!5-ED
-.---1
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vJ
Carlisle
PA
17013
N
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Correspondent's e-mail address:
Under penalties of peljury, 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, correcl and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
DATE
9 - ;<0' 07
1l~,~
Ie, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058
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L
15056051058
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15056052059
REV-1500 EX
Decedent's Name:
RECAPITULATION
Nancy
L Decker
1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . .
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) c::::;; Separate Billing Requested . . . . . " 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::; Separate Billing Requested.. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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, or
transfers under Sec. 9116
(a)(1.2) X .0_
16. Amount of Line 14 taxable
at lineal rate X.O_
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
16.
17.
18.
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052059
Side 2
206-32-1473
Decedent's Social Security Number
1.
8.
3,088.79
62,500.00
65,588.79
5,129.53
121,603.77
126,733.30
-61,144.51
0.00
15056052059
....J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
Nancy L Decker
STREET ADDRESS
317 Hogestown Road
DECEDENTS SOCIAL SECURITY NUMBER
206-32-1473
CITY
Mechanicsburg
STATE
PA
ZIP
17050
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. CreditS/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
Total Credits ( A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
0.00
A. Enter the interest on the tax due.
0.00
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 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments. benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [i]
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
contains a beneficiary designation? ........................................................................................................................ 0 ~
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 exempt 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.
REV-1508 EX+ (6-98) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Decker, Nancy L
FILE NUMBER
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
DESCRIPTION
Members 1 st Federal Credit Union Checking Account #203435
VALUE AT DATE
OF DEATH
563.79
2 Members 1 st Federal Credit Union Savings Account #203435
25.00
3 1997 Ford Explorer in fair condition
2,500.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
3,088.79
REV-1509 EX+ (6-9S*
. COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Decker, Nancy l
FilE NUMBER
If an asset was made Joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURViViNG JOiNT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.'Ronald R Coon, Jr.
317 Hogestown Road
Mechanicsburg, PA 17050
Son
8.
C.
JOINTLY-OWNED PROPERTY:
LETTER
ITEM FOR JOINT
NUMBER TENANT
1. A.
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMIlAR DATE OF DEATH
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTlY.HELD REAL ESTATE VALUE OF ASSET
"s'/..
iResidence Deed #00274-01849 317 Hogestown Road, Mechanicsburg ..1; 125,000.00
,PAt7050 .0 I i
%OF
DECO.S
INTEREST
DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
05/04/06
50
62,500.00
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
62,50000
REV-1511 EX+ (12-99.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Decker, Nancy L
FILE NUMBER
Debts of decedent musl be reported on Schedule 1.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL. EXPENSES:
Funeral bil
1,552.00
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.
Attorney Fees
837.50
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Ronald Coon, Jr
Street Address 317 Hogestown Road
2,725.03
City Mechanicsburg
Relationship of Claimant to Decedent Son
State PA .Zip 17050
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Filing Fees
15.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
5,129.53
REV-I512 EXt (12-03)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Decker, Nancy L
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
FILE NUMBER
1.
Pinnacle Health Emergency 478.00
Nephrology Assoc of Cen PA, Inc 179.00
Intemists of Central PA 290.00
Moffit Heart and Vascular Group 750.00
Capital Area Surgical Assoc 750.00
Riverside Anesthesia Assoc 1,595.00
Silver Springs Ambulance and Rescue 472.50
Pulmonary and Critical Care 765.00
Pinnacle Health Hospital 48,960.94
Pennick Automotive 1,132.09
Geico 41.15
Popular Club 1,064.00
Verizoo Wireless 803.76
Credit Collection Services 36.54
Blair 518.70
Seventh Avenue 1,076.05
ASC Mortgage #1100205993 12,470.25
:ASC Mortgage #1100193910 49,882.03
Tredegar Corp 130.00
Water Guy 29.78
United Water 11.96
PPL 56.57
Figi's 110.45
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
121,603.77
I L( qb (
P (-!cl)
SC.hedule F attachmen
Preoared by and Return to:
Absolute Abstract, LLC
125 West Harrisburg Street
Dillsburg, PA 17019
717-432-7102
File No. 2006042
Parcel ID # 38-21-0291-034
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~bts 3J"nbenture, made the 28th day of April, 2006,
~tttueen
RUTH I. BREWBAKER, WIDOW
(hereinafter called the Grantor), of the one part, and
NANCY L. DECKER, A SINGLE WOMAN, AND RONALD R. COON, JR., A
SINGLE MAN
(hereinafter called the Grantees), of the other part,
Witne..ttb, that the said Grantor for and in consideration of the sum of One Hundred Twenty Five
Tho.....d DoI1an 00/100 ($115,000.00) lawful money of the United States of America, unto her well
and truly paid by the said Grantees, at or before the sealing and delivery hereof, the receipt whereof is
hereby acknowledged, has granted, bargained and sold, released and confIrmed, and by these presents
does grant, bargain and sell, release and conftrm unto the said Grantees, as joint tenants with the right of
survivorship and not as tenants in common
ALL THAT CERTAIN lot of ground situate in the Township of Silver Spring, County
. of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows,
to wit:
BEGINNING at a point in the center of the Hogestown Road comer of lot now or
formerly of Darwin Sadler and wife, being Lot No. 11 in the hereinafter mentioned Plan
of Lots; thence along said Lot, South 34 degrees, 45 minutes West, one hundred fifty
(150) feet to a point at comer of said Lot; thence North 55 degrees, 15 minutes West,
fIfty (50) feet to a point; thence by Lot No. 13 in said Plan of Lots, North 34 degrees, 45
minutes East, one hundred fIfty (150) feet to a point in the center of the Hogestown Road;
thence along said Road, South 55.degrees, 15 minutes East, fifty (50) feet to the place of
BEGINNING.
HAVING erected thereon a five-room frame house.
BEING Lot No. 12 in a Plan of Lots laid out by William G. Rechel, Registered Surveyor,
on November 17, 1949.
800~ 274 PAGr1849
.
BEING THE SAME PREMISES which Edward A. Haegele, widower, by Deed dated
April 27, 1960 and recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Record Book D, Volume 19, Page 49, granted and
conveyed unto Ernest L. Brewbaker and Ruth I. Brewbaker, husband and wife, Grantors
herein.
AND THE SAID Ernest L. Brewbaker died May 11, 2005, whereupon title and fee
vested into Ruth I. Brebaker by right of survivorship.
U:olttber \uitb all and singular the buildings and improvements, ways, streets, alleys, driveways,
passages, waters, water-courses, rights, liberties, privileges, hereditaments.and appurtenances, whatsoever
unto the hereby granted premises belonging, or in anywise appertaining, and the reversions and
remainders, rents, issues, and profits thereof; and all the estate, right, title, interest, property, claim and
demand whatsoever of her, the said grantor, as well at law as in equity, of, in and to the same.
Q::o babe anb to bolb the said lot or piece of ground described above, with the buildings and
improvements thereon erected, hereditaments and premises hereby granted, or mentioned and intended so
to be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only proper
use and behoof of the said Grantees, their heirs and assigns, forever.
~nb the said Grantor, for herself and her heirs, executors and administrators, does, by these presents,
covenant, grant and agree, to and with the said Grantees, their heirs and assigns, that she, the said Grantor,
and her heirS, all and singular the hereditaments and premises herein described and granted, or mentioned
and intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, against her,
the said Grantor, and her heirs, will warrant and defend against the lawful claims of all persons claiming
by, through or under the said Grantor but not otherwise.
in Witness Wbereof, the party of the first part has hereunto set her hand and seal. Dated the day
and year first above written.
&ealeb anb J)elibereb
IN THE PRESENCE OF US:
~~
~~~ ~~~\\.~lt~
Ruth I. Brewbaker
{SEAL}
2
BOOK 274 PACf1850
Commonwealth of Pennsylvania } S8
County of York
On this, the 28th day of April, 2006, before me, the undersigned Notary Public, personally
appeared Ruth L Brewbaker, widow, known to me (or satisfactorily proven) to be the person whose name is
subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my ~~
NOTARIAL SEAl ':A ..
CHRIS DAMRON. NOTARY PUBLIC Notary Public
CITY OF lAHCASTER.lANCASTER COUNTY My commission expires
M'( COMMISSICW EXPIRES MAY 29. 2006
CUlberland County Recorder of Deeds
InstruMent Filin,
The precise residence and the complete post office
address of the above-named Grantees is:
317HogeR~
~~
On behalf of the Grantees
RKeiFtl 605489
Instri 2006-014961 5/0412006 11=00:39
Renrks: ABSOlUTE ABSTRACT
DEClER
DEED
DEED - IlRIT
DEED - RIT STATE
CUttBERlAND VAlLEY
SILVER SPRltIi TlIP
DEED - AIH
.J.C.S. I A. T .J.
CO IHPRlJtJEHOO FHD
REC. IMPRVHT FUND
Checkl 2148
Checkl 2149
Clleckl 2150
Total Received.......
3
8"()OK 274 PACf1851
11.50
.50
1250.00
625.00
625.00
11.50
10.00
2.00
3.00
$1, 2B8.oo
$.50
$17250.00
$2,538.50