HomeMy WebLinkAbout01-31-08
.
---I
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
.
County Code Year
INHERITANCE TAX RETURN 21 06
RESIDENT DECEDENT
OFFICIAL USE ONLY
File Number
00530
Date of Birth
198 22 9297
06 09 2006
04 27 1911
Decedent's Last Name
Suffix
Decedent's First Name
MARGUERITTE
MI
E
SCHAEFFER
(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
I X"! 1. Original Return [-I 2. Supplemental Return
4. Limited Estate
4a. Future Interest Compromise
(date of death after 12-12-82)
[1
[]
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
[xl
6. Decedent Died Testate
(Attach Copy of Will)
lJ
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
I J 10 Spousal Poverty Credit (date of death
. between 12-31-91 and 1-1-95)
LI
11.Election to tax under Sec. 9113(A)
(Attach Sch. 0)
~ORRESPONDENT . THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
JEFFREY R. BOSWELL ESQUIRE 717 ~~6 9317
c-~ '::',,~
Firm Name (If Applicable)
BOSWELL, TINTNER, PICCOLA &
REGISTEROF:~LS U~ ONLY
315 N. FRONT STREET
-..-,
First line of address
w
Second line of address
<J1
741
DATE FILED
City or Post Office
HARRISBURG
State
PA
ZIP Code
17108-0741
Correspondent's e-mail address:jboswell@att.net
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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which pre parer has any knowledge.
SIGNATURE OF PERSON SPaN BLE FOR Fill RETURN DATE
J
John A. Schaeffer
Jeffrey R. Boswell Esquire
DATE
J~J^,a.,- /(, 200~
ADDRESS
315 N. Front Street, Harrisburg, PA 17108-0741
Side 1
L
15056041147
15056041147
---I
';
-.J
15056042148
REV-1500 EX
Decedent's Social Security Number
198 22 9297
Decedent's Name: Margueritte E. Schaeffer
_........__ ____..__.______________________..___ ________..______.______.___.._______m___ n__
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.
15,794.67
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) [1 Separate Billing Requested............ 7.
___ _____ _____ ___.. _______u____ _'__ -----,---- ----.-----
15,794.67
-- -..---- ---- -- ----
11,947.68
17,165.49
29,113.17
-13,318.50
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.
-13,318.50
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 .00
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 1'"4"taXable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
o .00
15. o . 0 0
16. o .00
17. o . 0 0
18. o . 0 0
19. o . 0 0
o .00
o . 0 0
o .00
19. Tax Due..................................................................................................................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
D
Side 2
L
15056042148
15056042148
-.J
~
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schaeffer, Margueritte E.
FILE NUMBER
21-06-00530
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All properly jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 HCR ManorCare - Personal trust fund
VALUE AT DATE
OF DEATH
326.86
2 Wachovia - Checking Acct. No. 1000661328890
7.545.81
3 John E. Neumyer Funeral Home - prearranged funeral
7.922.00
TOTAL (Also enter on Line 5, Recapitulation)
15.794.67
(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 E (Rev. 6-98)
"
REV-1151 EX+ (12-99)
.~
~
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schaeffer, Margueritte E.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-00530
ESTATE OF
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
8,275.52
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
John A. Schaeffer
Social Security Number(s) / EIN Number of Personal Representative(s):
162-33-7352
Street Address 202 Kraus Drive
City Valparaiso
Year(s) Commission paid 2008
State IN Zip 46383
400.00
2.
Attorney's Fees
Boswell, lintner, Piccola & Alford
1,800.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
83.00
5. Accountant's Fees
6.
Tax Return Preparer's Fees
Boswell, lintner, Piccola & Alford
7.
Other Administrative Costs
1,389.16
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
11,947.68
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schaeffer, Margueritte E.
FILE NUMBER
21-06-00530
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
John E. Neumyer Funeral Home - pallbearers, obituary, organist
353.52
2
John E. Neumyer Funeral Home - Funeral
7.922.00
Subtotal
8.275.52
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schaeffer, Margueritte E.
FILE NUMBER
21-06-00530
ESTATE OF
ITEM
NUMBER DESCRIPTION
5 John A. Schaeffer - reimbursement of costs (travel expense from Valparaiso,
lodging, and funeral meal
AMOUNT
47.55
200.00
8.00
75.00
IN, 865.93
19.35
173.33
1 Boswell, Tintner, Piccola & Alford - disbursements
2 Boswell, Tintner, Piccola & Alford - closing costs
3 Cumberland County Register of Wills - short certificates
4 Cumberland Law Journal - legal advertising
6 Sovereign Bank - check charge fee
7 The Sentinel - legal advertising
Subtotal
1.389.16
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev.1512 EX+ (6.98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Schaeffer, Margueritte E.
FILE NUMBER
21-06-00530
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Department of Public Welfare (Class 3)
VALUE AT DATE
OF DEATH
16.238.35
2 Department of Public Welfare (Class 6)
627.64
3 HCR ManorCare - Services through 06/09/2006 (Class 3)
299.50
TOTAL (Also enter on Line 10, Recapitulation)
17,165.49
(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 I (Rev. 6-98)
.~
REV 1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Schaeffer, Margueritte E.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-06-00530
RELATIONSHIP TO
DECEDENT
Do Not List Trusteels)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
John A. Schaeffer
202 Valparaiso
Valparaiso, IN 46383
Son
Remainder
Total
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 Schedule J (Rev. 6-98)
LAST WILL
OF
MARGUERITTE E. SCHAEFFER
C")
s;:;;;o
-,,~ :.:D
";i~~
.~:~ :'1]
.= c/) ~~'>-,
:;23 ';-~
. ,,':6
Tl--1
.:::;.
Jeffrey R. Boswell, Esquire
Boswell, Tintner, Piccola & Alford
315 N. Front Street
P. O. Box 741
Harrisburg, Pennsylvania 17101-0741
(717) 236-9377
r--:>
=
<=
C'"'
r
~
=~
:D
~~l~
C)
"0
,- i;~
I:::J
,;;:-
-0
(-~)
--T1
,- =':J
:.::::: C")
-:Irl
...-:;.:...
N
w
CJ1
;,.,';- r;;:
LAST WILL AND TESTAMENT
OF
MARGUERlTTE E. SCHAEFFER
Introductory Clause. I, MARGUERlTTE E. SCHAEFFER, a resident of and
domiciled in the City of Harrisburg, County of Dauphin and Commonwealth of Pennsylvania, do
hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all
Wills and Codicils at any time heretofore made by me.
I have One living child: JOHN A. SCHAEFFER.
ITEM I
Direction to Pay Debts. I direct that all my legally enforceable debts, secured and
unsecured, be paid as soon as practicable after my death.
ITEM II
Direction to Pay All Taxes from Residuary Estate. I direct that all estate, inheritance,
succession, death or similar taxes assessed with respect to my estate herein disposed of, or any
part thereof, or on any bequest or devise contained in this my Last Will (which term wherever
used herein shall include any Codicil hereto), or on any insurance upon my life or on any
property held jointly by me with another or on any transfer made by me during my lifetime or on
any other property or interests in property included in my estate for such tax purposes be paid
out of my residuary estate and shall not be charged to or against any recipient, beneficiary,
transferee or owner of any such property or interests in property included in my estate for such
tax purposes.
ITEM III
General Bequest of Personal and Household Effects. I give and bequeath all my
personal and household effects of every kind including but not limited to furniture, appliances,
furnishings, pictures, silverware, china, glass, books, jewelry, wearing apparel, and all policies
of fire, burglary, property damage, and other insurance on or in connection with the use of this
property, to my son if he shall survive me. If my son shall not survive me, the issue of my son
surviving me, shall take per stirpes the share my son would have taken had he survived me. If
my issue do not agree to the division of the property among themselves, my Executor shall make
such division among them, the decision of my Executor to be in all respects binding upon my
issue. If any beneficiary hereunder is a minor, my Executor may distribute such minor's share to
such minor or for such minor's use to any person with whom such minor is residing or who has
the care or control of such minor without further responsibility and the receipt of the person to
whom it is distributed shall be a complete discharge of my Executor.
Last Will and Testament ofMARGUERlTTE E. SCHAEFFER
Page I
ITEM IV
Cash Legacy to Charity. I give and bequeath to the ST. FRANCIS OF ASSISI CATHOLIC
CHURCH, 1439 MARKET STREET, HARRISBURG, PENNSYLVANIA, or its successors, the sum of
One Thousand Dollars ($1,000.00) for such uses and purposes as its governing board shall deem
necessary and advisable.
ITEM V
Outright Gift of All Property to Son, Contingent Gift to Issue of Son, Contingent
Gift to Named Beneficiary. I give, devise and bequeath all the rest, residue and remainder of
my property of every kind and description (including lapsed legacies and devises) wherever
situate and whether acquired before or after the execution of this Will, absolutely in fee simple to
my son, JOHN A. SCHAEFFER, if he shall survive me. If my son shall not survive me, his
surviving issue shall take per stirpes the share he would have taken had he survived me, or in
default of such issue to .
ITEM VI
Naming the Executor, Executor Succession, Executor's Fees and Other Matters.
The provisions for naming the Executor, Executor succession, Executor's fees and other matters
are set forth below:
(1) Naming an Individual Executor. I hereby nominate, constitute and appoint as
Executor of this my Last Will and Testament my son, JOHN A. SCHAEFFER, and direct that
he shall serve without bond.
(2) Naming Individual Successor or Substitute Executor. If my individual Executor
should fail to qualify as Executor hereunder, or for any reason should cease to act in such
capacity, the successor or substitute Executor who shall also serve without bond shall be my
grandson, MARK SCHAEFFER.
(3) Fee Schedule for Individual Executor. For its services as Executor, the individual
Executor shall receive reasonable compensation for the services rendered and reimbursement for
reasonable expenses.
ITEM VII
Definition of Executor. Whenever the word "Executor" or any modifying or substituted
pronoun therefor is used in this my Will, such words and respective pronouns shall include both
the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply
equally to the Executor named herein and to any successor or substitute Executor acting
hereunder, and such successor or substitute Executor shall possess all the rights, powers and
duties, authority and responsibility conferred upon the Executor originally named herein.
Last Will and Testament ofMARGUERITTE E. SCHAEFFER
Page 2
ITEM VIII
Powers for Executor. By way of illustration and not of limitation and in addition to any
inherent, implied or statutory powers granted to Executors generally, my Executor is specifically
authorized and empowered with respect to any property, real or personal, at any time held under
any provision of this my Will: to allot, allocate between principal and income, assign, borrow,
buy, care for, collect, compromise claims, contract with respect to, continue any business of
mine, convey, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate
any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect
to, take possession of, pledge, receive, release, repair, sell, sue for, to make distributions or
divisions in cash or in kind or partly in each without regard to the income tax basis of such asset,
and in general, to exercise all the powers in the management of my Estate which any individual
could exercise in the management of similar property owned in his or her own right, upon such
terms and conditions as to my Executor may seem best, and to execute and deliver any and all
instruments and to do all acts which my Executor may deem proper or necessary to carry out the
purposes of this my Will, without being limited in any way by the specific grants of power made,
and without the necessity of a court order.
ITEM IX
Definitions of Family. The following definitions shall be used to define the family:
(1) Definition of Children. For purposes of this Will, "children" means the lawful blood
descendants in the first degree of the parent designated; and "issue" and "descendants" mean the
lawful blood descendants in any degree of the ancestor designated. The terms "child,"
"children," "issue," "descendant" and "descendants" or those terms preceded by the terms
"living" or "then living" shall include the lawful blood descendant in the first degree of the
parent designated even though such descendant is born after the death of such parent.
(2) Definition of Per Stirpes. The term "per stirpes" as used herein has the identical
meaning as the term "taking by representation" as defined in the Pennsylvania Probate Code.
Testimonium Clause. IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my seal this.Lfl- day of June, 2005.
\ r'\-
, ~ 1
4\ (i.JL~.. (SEAL
MARGU TTE E. SCHAEFFER
Last Will and Testament ofMARGUERlTTE E. SCHAEFFER
Page 3
,
Attestation Clause. The foregoing Will was this ---.ii.- day of June, 2005, signed,
sealed, published and declared by the Testatrix as and for her Last Will and Testament in our
presence, and we, at her request and in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses on the above date.
~
of ~ 1M! fZ;/~
of ,_1k4-iAk1, PI}
12/d/h~", (f'" -.$~;r /
Last Will and Testament of MARGUERITTE E. SCHAEFFER
Page 4
PROOF OF WILL
COMMONWEALTH
PENNSYL VANIA
OF)
COUNTY OF DAUPHIN
) Self-Proving Affidavit
)
We, MARGUERITTE E. SCHAEFFER, and Jeffrey R. Boswell and
Diane E. Grissinger , 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 Testatrix signed and executed the instrument as her Last Will and
that she had signed willingly (or willingly directed another to sign for her), 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, and in the presence of each other, signed the Will as
witness and to the best of our knowledge the Testatrix was at that time eighteen years of age or
older, of sound mind, and under no constraint or undue influence.
r~~'
~
t.,
f?:~; /~ ~-AI~r
ltness
Subscribed, sworn to, and acknowledged before me by MARGUERITTE E.
SCHAEFFER, the Testatrix and subscribed and sworn to before me by
Jeffrey R. Boswell and Diane E. Grissinger , witnesses, this /~
day of June, 2005.
My Commission Expires: CJjo;r?-()() 7
~ALTH OF PENNSYlVANIA
NOTARIAl SEAL
CONNIE t. HARDY, Notlry Pubic
City of HlrrisCNq, Oauphin County
Iltt CoI'IIaS$ian ExpRs Fib. 10, 2007
.... . of HOIIriii
Last Will and Testament of MARGUERlTTE E. SCHAEFFER
Page 5