HomeMy WebLinkAbout11-19-07 (2)
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15056041125
REV-1500 EX (06-05)
PA Oeparbnent of Revenue '*
~~n:~~~~:~uaITaxes INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
o 8 0 2
Date of Birth
206320747
08222 007
082 9 1 9 4 1
Decedent's Last Name
Suffix
Decedent's First Name
R 0 S E
BONNIE
MI
H
(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
00 1. Original Return
D 4. Limited Estate
00
D
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of
death after 12-12-82)
D 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
D 10. Spousal Poverty Credit (date of death D 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
D
D
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
8. Total Number of Safe Deposit Boxes
WILLIAM
A. DUN CAN
DUNCAN &
HARTMAN,
P C
7 1 7 ~4 9 7~ 8 0
.- =
REGISTE~-Q~LLS US~L Y :7V ,:n
.'J~ B ~ /-N t~iJ
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- . ,.. j C'-')
o -0 (--) i r~~
'jl ~ -':~]
.:..- rl"~,
"" r:)
DATE FILED CO " !
Firm Name (If Applicable)
First line of address
1 IRVINE
ROW
Second line of address
City or Post Office
State ZIP Code
CAR LIS L E
P A
17013
Correspondent's e-mail address:billduncan@planetcable.net
OATh
//-/ '7-0
BOILING SPRINGS
~7
ROAD
NEWBURG
PLEASE USE ORIGINAL FORM ONLY
PA 17240
Side 1
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15056041125
15056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: BONNIE H. ROSE
RECAPITULATION
206320747
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
125098.64
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.
O. 0 0
3 3 0 6.9 3
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 Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
128405.57
14061.74
62158.74
7622 0.48
52185.09
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.
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. 5 2 1 8 5. 0 9
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 _ o . 0 0 15. O. 0 0
16. Amount of Une 14 taxable 5 2 1 8 5 . 0 9
at lineal rate X .012- 16. 2 3 4 8 . 3 3
17. Amount of Line 14 taxable o . 0 0
at sibling rate X .12 17. O. 0 0
18. Amount of Line 14 taxable o . 0 0
at collateral rate X. 15 18. O. 0 0
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 2 3 4 8. 3 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
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15056042126
15056042126
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 07 0802
DECEDENTS NAME
BONNIE H. ROSE
STREET ADDRESS
27 FAIRFIELD STREET
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
2,348.33
117.42
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C) (2)
117.42
Total Interest/Penally (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. (5)
0.00
0.00
2,230.91
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
2,230.91
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 00
b. retain the right to designate who shall use the property transferred or its income; ......... ...................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................................. ..................................................... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................. .................. ............. ................. ..... 0 00
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-1502 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BONNIE H. ROSE 21 07 0802
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is de1ined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is iointlv-owned with riaht of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
125,098.64
27 FAIRFIELD STREET
CARLISLE, PA 17013
[SEE HUD SHEET ATTACHED]
TOTAL (Also enter on line 1, Recapitulation) $
IIf morA "'O:'lf'.A i!:; nAArlArI iMArt :'Irlrlition:'ll ",hAA!.. of \hA "':'ImA "';7A\
125098.64
REV-1508 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BONNIE H. ROSE
FILE NUMBER
21 07 0802
Indude the proceeds of litigation and the date the proceeds were reoeived by the estate.
All property joinUy-owned with right of sUlVivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
DESCRIPTION
VALUE AT DATE
OF DEATH
1,189.23
M&T BANK ACCOUNT # 1357913
DATE OF DEATH VALUATION
[SEE ATTACHED LETTER]
MEMBERS FIRST SAVINGS ACCOUNT # 291486-00
DATE OF DEATH VALUATION
[SEE ATTACHED LETTER]
MEMBERS FIRST MONEY MANAGEMENT ACCOUNT # 291486-11
DATE OF DEATH VALUATION
[SEE ATTACHED LETTER]
ALLSTATE HOMEOWNERS POLICY REFUND
25.00
414.43
21.30
ALLSTATE AUTO POLICY REFUND
236.60
EMBARQ REFUND
13.49
CITI RESIDENTIAL LENDING REFUND
291.88
FURNISHINGS PERSONAL PROPERTY PER APPRAISAL
[SEE APPRAISAL ATTACHED]
1,115.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3306.93
REV-1511 EX + (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BONNIE H. ROSE
FILE NUMBER
21 07 0802
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
2.
3.
FUNERAL EXPENSES:
RONAN FUNERAL HOME
ORGANIST
KATHY'S DELI - FOOD FOR AFTER SERVICE
5,435.30
100.00
229.02
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) CYNTHIA L. DARR & JODI L. WHISTLER
StreetAddress 7 HAMILTON ROAD & 134 HASSINGER ROAD
City BOILING SPRINGS & NEWBURG State PA Zip 17007
3,818.71
Year(s) Commission Paid:
2.
3.
Attorney Fees DUNCAN & HARTMAN, PC
3,818.71
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees REGISTER OF WILLS
330.00
5.
Accountanfs Fees
6.
Tax Retum Prepare(s Fees
7.
8.
9.
CUMBERLAND LAW JOURNAL LEGAL AD
THE SENTINEL LEGAL AD
FILING FEES HELD IN RESERVE
75.00
155.00
100.00
TOTAL (Also enter on line 9, Recapitulation) $
14061.74
(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
BONNIE H. ROSE
FilE NUMBER
21 07 0802
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. EMBARQ - PHONE BILL
VALUE AT DATE
OF DEATH
72.02
2. PPL -ELECTRIC BILL
157.54
3. COMCAST - CABLE BILL
97.00
4. SUBURBAN PROPANE
10.75
5. STRINGFELLOW USED FURNITURE - APPRAISAL OF HOUSEHOLD ITEMS
50.00
6. M&T BANK FIA CARD SERVICES # 4313-0270-7300-7384
1,227.82
7. NATIONAL REHAB BILLING
17.68
8. PPL - ELECTRIC BILL
82.51
9. AMC FIRST MORTGAGE # 0078613429 PAYOFF
[SEE HUD ATTACHED]
58,775.14
10. CLOSING COSTS - ATTORNEY FEE - DUNCAN & HARTMAN, PC
[SEE HUD ATTACHED]
11. CLOSING COSTS-TAXES
[SE HUD ATTACHED]
225.00
1,250.00
12. CLOSING COSTS - FINAL WATER & SEWER
[SEE HUD ATTACHED]
13. CLOSING COSTS - WASTE MANAGEMENT
[SEE HUD ATTACHED]
103.40
44.88
14. CLOSING COSTS - OVERNIGHT FEES - DUNCAN & HARTMAN, PC
[SEE HUD ATTACHED]
45.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
62 158.74
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 [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. CYNTHIA L. DARR Lineal
7 HAMIL TON ROAD 25%
BOILING SPRINGS, PA 17007
2. JODI L. WHISTLER Lineal
134 HASSINGER ROAD 25%
NEWBURG, PA 17240
3. BRENDA L. ROSE Lineal
11 ROBIN LANE 25%
CARLISLE, PA 17013
4. ROBERT L. ROSE, JR. Lineal
4203 OAK HAVEN 25%
NIXA, MO 65714
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 TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
"",.n,,". '.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BONNIE H. ROSE
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 07 0802
(If more space is needed, insert additional sheets of the same size)
\. SETTLEMENT STATEMENT
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
HUD-1
OMB No. 2502-0265
8 Tvoe of Loan
1 0 FHA 2. 0 FmHA 3. 0 Conv. Unins.
4. OVA 5. OConv. Ins.
6. File Number:
RE07-196
7. Loan Number:
8. Mortgage Insurance Case Number:
C NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items
marked "(p.oc.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
D. Name and Address of Borrower(s):
Joshua A. Darr
Melissa L Darr
E. Name and Address of Seller(s):
Estate of Bonnie H. Rose
F. Name and Address of Lender:
First National Bank of Mifflintown
G. Property Location:
27 Fairfield Street, Carlisle, Pennsylvania 17013
South Middleton Township, Cumberland County
40-22-0489-150
2 N. Main Street, Mifflintown, PA 17059
Place of Settlement:
1 Irvine Row, Carlisle, PA 17013
H. Name of Settlement Agent:
Duncan & Hartman, P.C.
I. Settlement Date:
10- 4-2007
Funding Date
10- 4-2007
109. Trash
110
10-4 2007 to 11-30-2207
70.53
to
10- 4-2007 to 12-31-2007
to
10- 4-2007 to 12-31-2007
70.53
28.11
10-4-2007 to 11-30-2207
28.11
112
120. Gross Amount Due From Borrower
504.
58,77514
205.
505. Payoff of second mortgage loan
210.
211 Count taxes
212 Assessments
to
to
to
206.
208.
209.
214.
215.
Paid From
Borrowers
Funds at
Settlement
Paid From
Seller's
Funds at
Settlement
First National Bank of Mifflintown
1 250.00
raisal Fee to Diversified A raisal Services
Flood Certification to United One Resources
300.00
19.50
810.
811
901
902.
903.
to
POC $491.00
er month
er month
Settlement or closin fee to
,Abstract or title search to
Title examination to
Title insurance binder to
Document re aration to
~--.
1107. Attorney's fees to Duncan & Hartman, P.C.
:includes above item numbers: 1101-1104 )
1108. Title Insurance to
62500
225.
1109.
1110.
1111
1112
1113
1200
1201
1202.
1203.
\ \
1_ L
1.1
I 1
I r
L L
l l
105.50 I
11,250001
] r
1204 I 1
1205 "l' \ . .......... I.
1300. AdditionalSettlemehrCnarqesi .,..' . ':c.",',,,,,,,,,,, ''','';; . =:::==t
1301 2007-08 School R E Taxes to Judv Camobell Tax Collector I 1 265 11T~~~~~
1302. Final Water/Sewer to SMTMA Acct.012008 I . r . . '10:
1303. Trash to Waste ManaqementAcct. 611-0135887-0061-0 I I ~.
1304 Overniaht Fees to Duncan & Hartman P C l L~ 4
1305. I -- T'
1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) I 4:8; 511\..
CERTIFICATION: I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and
accurate s.tat ment 0_..1 a II receipts and d!sbu ents made on. my account or by me in this transaction. I furt.her cert. ify that I received a co.p.~ .
of tA~UD/ s.em:im'ert Statemct- ~ /' ~' 'I
/ /' /-'.. ) '-.' /'~' ., 11~" I-I II ;"
( ,,'-/{,;,~/ (A . LV 1" /. 'i r:.' _" . I: I \Ji'. (,Ii /' /) ^;
'./ 1r,V"~/ _;:2 , .,":' ql.. ]- t'l...i'tLf ~ltl1 ~.....XjJL L/l--ltJ11 !L.{(.I (/l--.:;:Jlb't
Ignature 0 /---- Signaturgpf- Signature of Seller .I Signature of Seller/;. "
" C.veL'
(includes above item numbers
Lender's coveraqe
Owner's coveraqe
$
$
Premium $
Premium $
,,...... .......;:..'.. ....>-.;>':::-::"::;!
Government Recordin aanditr;:jn~ferChaoraes"
Recordinq fees: Deed 41.00 Mortqaqe 64.50 Release 0.00
City/county tax/stamps
State tax/stamps:
;,.,;
;:':'>-.,.t:',.~<->"
,.,,;.;,...,
1,_2_~
1,13.6
h I have prepared is a true and accurate account of the funds disbursed or to be disbursed by the
"7 "",,01;00 I () ! If (Or
D te
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction
can include a fine and imprisionment For details see: Title 18 U.S. Code Section 1001 and Section 1010.
11 M&rBank
499 Mitchell Road, MilIsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
October I, 2007
Duncan & Hartman PC
Attorneys At Law
One Irvine Row
Carlisle, Pennsylvania 17013
Re: Estate or Bonnie H Rose
Social Security: 206-32-0747
Date of Death: August 22, 2007
Dear Sir or Madam:
Per your inquiry dated September 24, 2007, please be advised that at the time of death, the above-named decedent had on
deposit \'lith this bank the follo\Ving:
1. Type of Account Checking Account
Account Number 1357913
Ownership (Names of) Bonnie H Rose *
Opening Date 05/16/97 Closed 08/29/07
Balance on Date of Death $1,189.23
Accrued Interest $ 0.00
Total $1,189.23
Please be advised, there was no safe deposit box found for the above decedent.
* If upon reviewing the information above, you believe there are additional accounts not referenced, please provide
us with an account number and/or the name of any possible joint account holder. For any additional information on
the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the
Boiling Springs Office # 717-241-7790-.
Sincerely,
6..>:;
,. - /./I'.-A
Z:/Y .2 ~ /r'/>~. ./ 22;:;<:...
l/J ? ./? l-C/'--t-- /:
./ / (
ancy Clagett
Records Management
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
MONEY MANAGEMENT ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Estate of: BONNIE H. ROSE
Date of Death: 08/22/2007
Social Security Number: 206-32-0747
MEMBERS 1st
FEDERAL CREDIT UNION
291486-00
08/25/2006
$25.00
$.00
$25.00
None
291486-11
08/25/2006
$414.43
$.00
$414.43
None
~~DnLQR;~N
Danielle A. Kline
Insurance Services Specialist
October 4, 2007
5000 Louise Drive. PO Box 40 . Mechanicsburg, Pennsylvania 17055 . (800) 283-2328 . www.memberslst.org
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