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Home My WebLink About10-02-07 . , ...J 15056051047 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 Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 2 1 07 00469 Date of Birth Decedent's Last Name SuffIX Decedent's First Name MI L (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW gp 1. Original Retum c:::> 2. Supplemental Return c:::> 3. Remainder Retum (dale of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::> 4, Limited Estate c:::> c'f> 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 c:::> 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 ~aytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9, Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes c:::> K Firm Name (If Applicable) SN E L EMAN 7 1 ' 7 6 9 7 8 ,5:,<2 8 r--..__'m'.'m.........__mmm.m....._..,........_c;..:~...............'. I REGISTEr{Q): WILLS USEJJBL\' .h .. ,~ 0 -T.l Second line of address -0 -'-1 , ,'"j . ..- ,'Tl :'J ~ I N First line of address City or Post Office State ZIP Code L_n_ ~.:I ,i:l~[.!~Il.-ED .".,.".c....."L CO f'1 M E C H A N I C S BUR G P A 1 7 0 5 5 , Executor Center Road, Newville, PA 17241 REPARER OTHER THAN REPRESENTATIVE , pATE /0/ ~ 'I & 7 ADDRESS 44 West Main Street, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.J Cz5 ---' 15056052048 REV-1500 EX Ann L. Boust Decedent's Name: 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) 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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Scl:1edule 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 tc!xable at lineal rate X.O 3.-2 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FiLL iN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 Decedent's Social Secu rity Number 205 12 7 9.7 .7 5,9 9 5 .6 9 '+ 23. .,8 3 0 .6 7 . 4 1 1 ,39 7 .9 5 15. o 16. 17. . 18. 8,69 8 .0 4 1, 6 0 1.5 '+ tB 15056052048 -.J " REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME File Number 21-07-00469 Ann L. Boust STREET ADDRESS 210 Big Spring Road CITY Newville I STATE PA I ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 31,601. 54 33.300.00 1.580 00 Total Credits ( A + B + C ) (2) 34,880.00 3. Interest/Penalty jf 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) 3.278.46 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) A. Enter the interest on the tax due. 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 [] 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 []I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ n 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. 99116 (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. 99116 (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. 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. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(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-1503 EX+ (6-9S. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 All property jolntly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE OF DEATH 2. 3. 4. 5. 6. 7. 8. 9. DESCRIPTION Exelon Corporation, 332 shares common stock at 76.86 per share 25,517.52 Public Storage, Inc., 206 shares common stock at 91.36 per share 18,820.16 Praxair, Inc., 100 shares common stock at 65.48 per share 6,548.00 The Dow Chemical Company, 80 shares common stock at 44.3 0 per share 3,544.00 PPL Corporation, 2,172.29 shares common stock at 44.27 per share 96,167.28 J. P. Morgan, Chase & Co., 102 shares common stock at 52.39 per share 5,343.78 Members 1 st Investment Services, Brokerage Account No. 5FN475886 138,163.00 Fidelity Investment Account No. Z43-302376 11,591.95 ShareBuilder Securities Corporation investment account 300.00 TOTAL (Also enter on line 2, Recapitulation) $305,995.69 (If more space is needed, Insert additional sheets of the same size) : ., REV-1508 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 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 DESCRIPTION VALUE AT DATE OF DEATH 1. Members 1st Federal Credit Union a. Savings account No. 104052-00 b. Checking account No. 104052-11 c. Money Management account No. 104052-05 d. VISA Credit Card account (credit balance) No. 4287590011040520 $ 4,373.03 11,773.41 16,331.74 21.15 Total: 32,499.33 2. Miscellaneous personal property, furniture and furnishings 500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 32,999.33 : " REV-1510 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 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. DESCRIPTION OF PROPERTY INClUDE THE NAME OF lliE TRANSFEREE, lliBR RELATIONSHIP TO DECEOENT AND THE DATE OF TRANSFER. ATTACH A COPY OF lliE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPlICABLE' TAXABLE VALUE ITEM NUMBER 1. Ameriprise Financial Annuity account No. 93002396564 1 004. Transferees: Charles' M. Boust (son), Robert A. Boust (son), Diane J. Boust (former daughter-in-law). Date of Transfer: May 2, 2007 (date of death) 46,520.2C 100% 46,520.20 2. Fidelity Investment account No. 344-789658-IRA. Beneficiaries/ Transferees: Charles M. Boust, Robert A. )/ Boust and Timothy Boust, all sons of Decedent. Date of Transfer: May 2, 2007 (date of death) 38,315.34 100% 38,315.45 3. New York Life Insurance Policy 20623272. Beneficiaries: Robert A. Boust, Charles M. Boust and Timothy Boust, all sons of Decedent. Date of Transfer: May 2, 2007 (date of death) 3,002.2E 100% 100% -0- TOTAL (Also enter on line 7 Recapitulation) $ AI. Q~" f.." (If more space is needed, insert additional sheets of the same size) ,. " REV-1511 EX+ (10-06. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 ITEM NUMBER A. Debts of decedent must be reported on Schedule L DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Parthemore Fun~ral.1 Home & Cremation Services, Inc. $4,125.52 ;.9 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions WAIVED Name of Personal Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attomey Fees to Snel baker & Brenneman, P. C . 5,000.00 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 to Register of Wills ($150.00) addtiional fee ($300.00) Accountant's Fees, miscellaneous probate fees and reserve 450.00 5. 2,000.00 6. Tax Retum Preparer's Fees 7. Advertise grant of Letters Testamentary: a. Cumberland Law Journal b. The Sentinel $ 75.00 152.20 227.20 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 11 802.72 : REV-1512 EX+ (12-03) *' COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medica I expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Graham Medical - payment on account 20.44 2. Spirit Physicians - payment on account 100.00 3. Green Ridge Village - payment on account 439.81 4. Continuing Rx - payment on account 69.75 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 630.00 : REV-1513 EX+ (9-00) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Ann L. Boust FILE NUMBER 21-07-00469 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Charles M. Boust 290 Center Road Newville, PA 17241 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE Son 1/3 of residue 2. Robert A. Boust 8014 Fawnridge Circle Tampa, FL 33610 Son 1/3 of residue 3. Diane Boust 777-A Schoolhouse Lane Lewisberry, PA 17339 None. Former daughter-in-law 1/3 of residue 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 $ (If more space is needed, insert additional sheets of the same size) --- LAW OFFICII:S SNELBAKER. BRENNEMAN Be SPARE ~ - LAST WILL AND TEST.AM:E#Ff. '( ! ! .:). .... f'., i\" ....; OF ORFi- . I", ."" p', f'~~T ANN L. BODST I, ANN 1. BODST, of Mechanics burg, Cumberland County, Pennsylvania, being of Round and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Wtll and Testament, hereby revoking and making void any and all wills by me at any time heretofore made. 1. I direct that all my debts and funeral expenses be paid as soon as practical after my death by my Executor hereinafter named. I direct that all taxes that may be assessed as a consequence of my death shall be paid from my residuary estate as part of the expenses of the administration of my estate. 2. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: (A) One-Third (1/3) to my son, ROBERT A. BODST, of Dublin, California; (B) One-Third (1/3) to my son, CHARLES M. BODST, of Newville, Pennsylvania; (C) One-Third (1/3) to my daughter-in-law, DIANE J. BODST, of Dillsburg, Pennsylvania. 3. In the event my son, ROBERT A. BODST, shall predecease me, I give, devise and bequeath the share my said son, ROBERT A. BODST, would have received hereunder in equal shares to his sons namely, ANDREW BODST and BRYAN BODST, now or formerly of Dublin, California. 4. In the event my son, CHARLES M. BODST, shall predecease me, I give, devise and bequeath the share my said son, CHARLES M. BODST, would have received hereunder to his wife, LETIIA PODST, of Newville, Pennsylvania. 5. In the event my daughter-in-law, DIANE J. BODST, shall predecease me, I give, -----.-- --'---;--"--"-'- li[b. ,'!: I!.~.: ~;, '11 l\Ul f~ ...- . . . LAw OPFICES SNELBAKER. BRENNEMAN Be SPARE devise and bequeath the share my said daughter-in-law, DIANE 1. BOUST, would have received hereunder in equal shares to her children namely, JENNlFER KOHLER, RYAN BOUST and MICHAEL A. BOUST, ofDiIlsburg, Pennsylvania. 6. In the event any beneficiary of my Estate has not attained the age of eighteen (18) at the time of my death, I order and direct that the distributive portion of my Estate attributable to said beneficiary shall be paid over and delivered unto my son, CHARLES M. BOUST, as my testamentary Trustee, IN TRUST, NEVERTIffiLESS, to hold, manage, invest and reinvest for the use and benefit of said beneficiary upon the following terms and conditions: A. I authorize my said Trustee to pay so much of the income arising thereon together with so much of the principal thereof as in the opinion of said Trustee is necessary or desirable to be expended for the support, maintenance, health and education of said beneficiary to the proper payee, including any Guardian of said beneficiary, for such purposes. B. When said beneficiary attains the age of eighteen (18) years, I order a..l1d direct that the Trust shall terminate and the then remaining net balance of principal and accumulated income shall be distributed to said beneficiary, absolutely. C. During the existence of the said Ttust, I order and direct that the beneficiary thereof shall be prohibited from pledging or assigning any assets in said Trust or from otherwise anticipating any distribution hereunder and that no creditor of said beneficiary shall have the right to levy upon, attach or otherwise obtain any assets in said Trust. . . ShOuld tho prinCipal of the Trust herein be or become too small in the Trustee's discretion so as to make establishment or continuance of the Trust inadvisable, the Trustee may make iinmediate distribution ofthe remaining net principal and accumulated income outright to the beneficiary and if the beneficiary is a minor, distribution may be made to the appropriate -2- . - . LAW OP'f'lca SNELBAKER. BRENNEMAN & SPARE Guardian, at which time the Trust shall terminate. I hereby nominate, constitute and appoint my son, ROBERT A. BOUST, as an alternate Trust~ hereunder in the event CHARLES M. BOUST shall predecease me or fail to qualifY or serve in such capacity. 7. I hereby nominate, constitute and appoint my son, CHARLES M. BOUST, as Executor under this my Last Will and Testament. In the event he should predecease me or fail to qualifY, I nominate, cOnstitute and appoint my son, ROBERT A. BOUST, as Executor under this my Last Will and Testament. I m~er direct that no Executor or Trustee appointed hereunder shall be required to post bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania or in any other jurisdiction. 8. I am not unmindful of my son, TIMOTHY L. BOUST. It is my express intent that TIMOTHY L. BOUST not share as a beneficiary in my estate. In the event any portion of my property should pass by intestate succession, I expressly exclude TIMOTHY L. BOUST from a share of such property. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on three (3) pages this 27th day of June, 2000. ~ -J.~//.1~ Ann L. Boust (SEAL) Signed, sealed, published and declared by ANN L. BOUST, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. f?-a# Q~ e (SEAL) SEAL) -3- LAW OFFICES SNELBAKER. BRENNEMAN & SPARE . , COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) We, ANN L. BOUST, PIDLIP H. SPARE, ESQUIRE and SUSANL. ZYCH, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the 1'estatrix.signed and executed the instrument as her tast Will and Testament and that she had signed Willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ 7. '7J~ Testatrix ~~~ ~'W~~ Subscn"bed, sworn to and acknowledged before me by ANN L. BOUST, Testatrix, and subscribed and sworn to before me by PIDLIP H. SPARE, ESQUIRE and ANN L. BOUST, witnesses, this 27th day ofJune,2000. _-t~l._;t. ~ Notary P c NolIirfaI Seal d.......~li:sb- L ~a eli, Notary Pubnc """""':lll IUrg oro,CumbBrland County My Commission EilpIriIs Nnv. 24, 2003 ~embar; . - IlvaJiIa ASBOclal!bil of Nolarles -_._---------~ ..-.----.---.--.--..--