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Home My WebLink About12-27-07 , . --.J 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 21 07 0487 Date of Birth 191-18-3535 04/20/2007 04/18/1917 Decedent's Last Name SuffIX Decedent's First Name MI HOOVER Miriam E (If Appllcabl.) Enter Surviving Spou.... Information B.low 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 C) 2. Supplemental Return c::> 3. Remainder Retum (date of death prior to 12-13-82) 5. Feeleral Estate Tax Retum Required C=J 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 Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C~',,) 4. Limited Estate c) C-J David C. Gority, VP Firm Name (If Applicable) M & T Bank, Executor (717) 240-4~ 8 --~*"""::)._-~ --_._,,--_.~-~-,,- REGISTER W.iwJllS USE ORlY -~, rrt .~ 0 (~) r- iJJ First line of address i"-' -..J 1 .._~) 1 j . . r::) . ~ ". 1 West High Street Second line of address :r:;:. - fl .' !I <.. {::=::=) ;";:'1 City or Post Office Carlisle State ZIP Code DATE FilED 0) PA 17013 Correspondent's e-mail address: b GOI2/T'f @ ttt,6. {Oi!1 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true and complete. Declaration of preparer other than the pel1lOnal representative Is based on all information of which preparer has any knowledge. t/ OF R R ~NSlty' FILING RETURN Dtt 2 6 2007 M&T Bank Trust DeDarbnent One West High Street Carlisle, PA 17013 DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 --.J -I 15056052059 REV-1500 EX Decedent's Name: RECAPITULATION Miriam E HOOVER 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 BUling 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 (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_ 15. 16. Amount of Line 14 taxable at lineal rate X.O _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE. . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 Decedent's Social Security Number 191-18-3535 650,184.59 119,462.03 0.00 0.00 489,593.32 0.00 0.00 1,259,239.94 68,874.32 20,057.47 88,931.79 1,170,308.15 1,170,308.15 0.00 0.00 c:::> 15056052059 -I REV-l500 EX Page 3 Flit. NI.!'"btr Decedent's Complete Address: L 21 J L 07 0487 DECEDENrs NAME DECEDENrs SOCIAL SECURITY NUMBER Miriam E HOOVER 191-18-3535 STREET ADDRESS 80 North Dickinson School Road CITY I STATE I ZIP Carlisle, PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit 8. Prior Payments C. Discount 0.00 Total Credits (A + 8 + C ) (2) 0.00 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( 0 + 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, Une 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SA) (58) 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;.......................................................................................... D [iJ b. retain the right to designate who shall use the property transferred or its income; ............................................ D [iJ c. retain a reversionary interest; or.......................................................................................................................... D [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [iJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D [iJ 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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 decedenfs siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)).Asibling 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+ (6-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Miriam E. Hoover FILE NUMBER 21-07-0487 All real property owned lolely or 81 a tenant in common mUlt be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wiling seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which II Jointly-owned with right of lurvivorshlp mUlt be dllclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 25% interest in 80 North Dickinson School Road, Dickinson Twp. Cumberland County, PA VALUE AT DATE OF DEATH 2 25% interest in 80 North Dickinson School Road, Inherited from Catherine P. Hoover Estate 325,092.29 325,092.30 Value shown is proceeds from sale TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 650,184.59 REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Miriam E. Hoover FILE NUMBER 21-07-0487 All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 2 539 shares of M & T Bank Corporation M & T Bank Portfolio Architect Account # 201012969 61,082.18 58,379.85 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 119,462.03 REV-1504 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF Miriam E. Hoover FILE NUMBER 21-07-0487 Schedule C-1 or C-2 (including all supporting infonnation) must be allached for each c1osely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information 10 be submitted for sole-proprietorships. ITEM NUMBER NUMBER DESCRIPTION 1. None VALUE AT DATE OF DEATH 0.00 TOTAL (Also enter on line 3. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 . . REV-1508 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Miriam E. Hoover FILE NUMBER 21-07-0487 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 M & T Bank Savings Account 15004212115049 @ Date of Death 2 M & T Bank Checking Account 836982@ Date of Death VALUE AT DATE OF DEATH 3 Interest to Date of Death of item # 2 38,640.79 33,156.50 1.37 4 Estate of Catherine P. Hoover Income Distribution at Date of Death 5 Western Southern Annuity 3,808.68 66,434.54 39,568.27 35,935.46 31,127.82 6,980.61 150.00 6 Lincoln National Life Insurance Annuity 7 Allstate Advantage Plus Annuity 8 Allstate Advantage Plus Annuity 9 M & T Bank Brokerage Account Money Market 1 0 Lincoln National Life Insurance Annuity payment payable prior to Date of Death 11 Refund - Highmark Blue Shield Premium 258.30 12 Estate of Catherine P. Hoover Final Dsitribution 233,530.98 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 489,593.32 REV-1511 EX+ (12-99>_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-07-0487 ESTATE OF Miriam E. Hoover Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. 1. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Hoffman Roth Funeral Home, Balance due Carlisle Memorial Service, Inc. Gravestone 6,554.90 1,500.00 2 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Manufacturers & Traders Trust Company, Executor Social Security Number(s)/EIN Number of Personal Representative(s) 16-0538020 Street Address 1 West High Street City Carlisle 39,600.00 .State PA Zip 17013 Year(s) Commission Paid: 2008 2. Attomey Fees 20,000.00 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 714.00 5. Accountant's Fees 300.00 6. Tax Return Preparer's Fees 7. Cumberland Law Journal, Advertising Letters Testamentary The Sentinal, Advertising Letters Testamentary 75.00 130.42 8 68,874.32 TOTAL (Also enter on line 9, Recapitulation) $ (II more space is needed, insert additional sheets of the same size) . . REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-07-0487 ESTATE OF Miriam E. Hoover Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Venzon, Balance due for Service 15.73 2 Messiah Village, Balance due for Care for February & March 13,441.20 3,601.00 3 Messiah Village, Balance due for Care for Partial April 4 Alert Pharmacy, Balance due on Account 4.64 5 Capital Area Health Associates, Balance due for Care 131.00 6 Carolyn R. McQuillen, Tax Collector - Balance due 80 North Dickinson School Road, Carlisle, PA 1,072.84 7 Marsh Advantage America, Insurance 1,686.50 52.47 8 9 10 Gilberts Landscaping, LLC. Lawn Care Met-Ed - Balance due for service 5.88 NCO Financial Services - Balance due on Account 46.21 20,057.47 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . . REV-1513 EX+ (9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Miriam E. Hoover FILE NUMBER 21-07-0487 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 ~nclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 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 1 Carlisle Area Health and Wellness Foundation, 274 Wilson Street, Carlisle, PA 17013 $1,170,308.15 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ $1,170,308.15 (If more space is needed, insert additional sheets of the same size)