HomeMy WebLinkAbout02-04-08
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15056051047
REV-1500 EX (06-05)
PA Department of Revenue *'
Bureau of Individual Taxes
PO BOX 280601
__._ , Harrisburg, PA 17128-~..2,1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1
County Code Year
File Number
o 7
005
8 6
Date of Birth
064284487
200 7
01101 9 3 2
Decedent's Last Name
Suffix
Decedent's First Name
MI
M U 1W A NE
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
G.L 0 R I A
M
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
cp
1. Original Return
c::J
2. Supplemental Return
c;:::)
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
'C=}
4. Limited Estate
C:::J
(1Cj
C:::) 4a. Future Interest Compromise (date of
death after 12-12-82)
Ct 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)
^"""--~---- '^...............~...........^"N.,._.........~
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
o
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
K E I T H
o
B RE N N E MAN
717
(
Firm Name (If Applicable)
S N E L B A K E R
First line of address
&
B R E.N N EM A N
City or Post Office
State
ZIP Code
4 4
W EST
MA I N
S T R E E T
Second line of address
M E C H A N I C S BUR G
P A
C)
1 7 055
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including acc-;mpanYi;;g-sched~;;-;;nd stat;;ents, ;;;dt;;t~';f~^k;;;I;~jg~'~~d'b;li;i:
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knOWledge,
~~~~N~_~~~~
__.._!1J~_~~~QE~en ~tr5:.~wtL.,~~.cha!lic~burg Lf..~_JXQ?"~_____~__^__^_____________"
SIGNAT~~ER THAN REPRESENTATIVE 2./ f.. () I
,__w.,___ .,- ----'----.----.-'------..''.-..--"'______,_.._____._____.,,^--^-.-!i!.---,,-,.--.--,,-~-
ADDRESS
44 West Main Street, Mechanicsburg, PA 17055
--'------'-^---~----.._---.Pi::E'ASElJS-EORIGINAL.FOiMONi y ..."'-'-.---........"'---.--~---.-,..,_..-..--.--.------,-.--
Side 1
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15056051047
15056051047
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15056052048
REV-1500 EX
Decedent's
Gloria M. Mulwane
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.
Decedent's Social Security Number
064284487
8 7 ,0 0 0 .0 0
.
.
1 4 ,7 9 5 .6 6
3, 6 1 6 .5 5
1 05 ,4 1 2 .2 1
9 ,8 43 .6 2
3 9 ,0 9 0 .2 6
4.8 ,9 3 3 .8 8
5 6 ,4 7 8 -3 3
5 6 3
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 Subjectto 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 tRxable
at lineal rate X.o.J!5 5 6 ,4 7 8 .3 3
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
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15056052048
15.
16.
2, 5 4 1 · 5 2
17.
18.
2 ,5 4 1 · 52
c....-:.)
15056052048
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07-00586
DECEDENT'S NAME
Gloria M. Mulwane
STREET ADDRESS
127 East Green Street
CITY : STATE i ZIP
Mechanicsburg I PA I 17055
Tax Payments and Credits:
1. Tax Due (Page 2 line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
2.541.52
Total Credits ( A + B + C ) (2)
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.
2,541.52
8. Enter the total of line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
A. Enter the interest on the tax due.
2.541.52
Make Check Payable to: REGISTER OF WILLS, A GENT
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
:: :::~ :~::i:;sii~t:~~~shall.~~.~~.~~~e:.~n.s~rr~~.~r~i".~:.;.::::::::::::::::::::::::::::::::: B ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 g
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 g
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 g
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ B 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 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. 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-'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
GLORIA M. MULWANE 21-07-00586
All real property owned solely or as a tenant in common must 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 willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
VALUE AT DATE
DESCRIPTION OF DEATH
All that certain tract of land improved with a
residential dwelling located in the Borough of
Mechanicsburg, Cumberland County, Pennsylvania,
commonly known as 127 East Green Street, Mechanicsburg,
Appraised fair market value: $87,000.00
TOTAL (Also enter on line 1, Recapitulation) $ 87,000.00
(If more space is needed, insert additional sheets of the same size)
REV-'SO' EX+ (6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Gloria M. Mulwane
FILE NUMBER
21-07-00586
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
VALUE AT DATE
OF DEATH
1. 2003 Chevrolet Blazer
$10,640.00
2. Miscellaneous personalty, furniture and furnishings
300.00
3. Prescription refund
43.27
4. Health Insurance refund
158.00
5. ManorCare refund
3,654.39
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
14,795.66
REV-150. EX+ (6-...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
Gloria M. Mulwane
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
21-07-00586
ESTATE OF
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Scot Mulwane
127 East Green Street
Mechanicsburg, PA 17055
Son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR OllIE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 18/1/06 Susquehanna Valley Federal Credit
Union, checking account No. 2444-00 $ 493.62 100% 493.62
2. A. 8/1/06 Susquehanna Valley Federal Credit
Union, savings account No. 2444-40 $3,122.93 100% 3,122.93
TOTAL (Also enter on line 6, Recapitulation) $ 3.616.5S
(If more space is needed. insert additional sheets of the same size)
REV-1510 EX- (6-9'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Gloria M. Mulwane
FI LE NUMBER
21-07-00586
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.
ITEM
NUMBER
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
DATE OF DEATH % OF DECO'S EXCLUSION
VALUE OF ASSET INTEREST (IF APPLICABLE)
1. Susquehanna Valley Federal Credit Union Group $255.13
Life Ins. Policy for Account No. 2444-00.
Transferee: Scot Mulwane, son of Decedent.
Date of transfer: May 19, 2007 - date of
death
100%
255. 13
TAXABLE
VALUE
-0-
2.
PSECU life insurance benefit payable
Mulwane, Michael Mulwane and Charles
sons of Decedent. Date of transfer:
2007, date of death
to Scot
Mulwane,
May 19,
$480.00
100%
480.00
-0-
TOTAL (Also enter on line 7 Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
-0-
REV-1511 EX. (10-OS).
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
~loriR M. Mulwane
FILE NUMBER
21-07-00586
ESTATE OF
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Waived
Street Address
City
State _ Zip
Year(s) Commission Paid:
2.
Attorney Fees to Snel baker & Brenneman, P. C .
$4,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Street Address
Michael J. Mulwane
127 East Green Street
3,500.00
Claimant
City
Mechanicsburg
State ~Zip 17055
Relationship of Claimant to Decedent son
4.
Probate Fees to Register of Wills: $140.00; additional probate
fee: $120.00
Accountant's Fees, reserve for miscellaneous costs and expenses
6.
~~~~f~~~~~ Appraisal fee to RSR Real Estate Appraisers
260.00
1 , 000 . 00
350.00
5.
7.
Advertise grant of Letters:
a. Cumberland Law Journal:
b. The Sentinel:
$ 75.00
158.62
233.62
TOTAL (Also enter on line 9, Recapitulation) $ 9, 843.62
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX' (12-OJ) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Gloria M. Mulwane
FILE NUMBER
21-07-00586
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
Balance due on vehicle loan (See Schedule E., Item 1) $12,027.09
to Sovereign Bank, Account No. 681758265
2.
Department of Public Welfare, Third Party Liability,
Estate Recovery Program lien for medical assistance
25,444.70
3.
East Pennsboro Ambulance Service - payment on account
198.00
4.
West Shore EMS - payment on account
622.22
5.
West Shore EMS - payment on account
105.12
6.
Neurology Center, P. C. - payment on account
80.27
7.
Healthcom - payment on account
28.00
8.
Pennsylvania Department of Treasury - payment on account
584.86
TOT AL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
39,090.26
REV-1513 EX- (g~OJ ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
Gloria M. Mulwane
FILE NUMBER
21-07-00586
ESTATE OF
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Michael J. Mulwane
127 E. Green Street
Mechanicsburg, PA 17055
Son
1/3 residue
Scot A. Mulwane
127 E. Green Street
Mechanicsburg, PA 17055
Son
1/3 residue
Charles A. Mulwane
81 Mine Bank Road
Wellsville, PA 17365
Son
1/3 residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 B, AS APPROPRIATE, ON REV-1500 COVER SHEET
n 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)
L.AW OFFICES
5NELBAKER.
3nF:NNEM^N
lJc SPMIC
LAST WILL AND TESTAMENT
OF
GLORIA M. MULWANE
I, GLORIA M. MULWANE, of the Borough of Mechanicsburg,
Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and
declare this as and for my Last will 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 in equal shares to my sons, MICHAEL
J. MULWANE, SCOT A. MULWANE and CHARLES A. MULWANE, absolutely.
In the event any of my sons aforementioned should
predecease me, I direct that the share such deceased son would
have received hereunder shall be given to his issue surviving me
per stirpes and if there shall be no such issue then such share
shall be distributed equally between my surviving sons or given
to my sole surviving son, Whichever the case may be.
3. I hereby nominate, constitute and appoint my son,
MICHAEL J. MULWANE, as Executor of this my Last will and
Testament. In the event he should predecease me or fail to
qualify, I nominate, constitute and appoint my son, SCOT A.
L.AW OFFICES
5NELBAKER.
3RENNEMAN
8: SPARE
MULWANE, as Executor of this my Last will and Testament. I
further direct that no person serving as Executor hereunder shall
be required to post any bond to secure the faithful performance
of his duties in the Commonwealth of Pennsylvania or in any other
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament written on Two (2) pages this
9th day of May, 1997.
JLk-r~."- h1 !nA-(f~>(~L)
Gloria M. Mulwane
signed, sealed, published and declared by GLORIA M. MULWANE,
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.
K RlL'.,(tUu-~
( SEAL)
.7
v:-Ji" C ( L--- ,.,
07fA (SEAL)
(.J'
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-2-
COMMONWEALTH OF PENNSYLVANIA}
55.
COUNTY
OF
CUMBERLAND)
We, GLORIA M. MULWANE, KEITH o. BRENNEMAN, ESQUIRE and SUSAN
L. 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 Testatrix signed and executed the instrument as her Last
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.
~j;i,,~ }~l 2t;/--?..1' L~c '7:2' 7~
Testatrix -
~ ~ttUt~
witness
~/'LJ/H~ ~, '71,-0)/"))
-w 1. tnef}s vi
U
subscribed, sworn to and acknowledged before me by GLORIA M.
MULWANE, Testatrix, and subscribed and sworn to before me by
KEITH o. BRENNEMAN, ESQUIRE and SUSAN L. ZYCH, witnesses, this
9th day of May, 1997.
(SJ:l .' Q,'--! I
~du/'--<t&/ . ~
Not ry Public
.AW OFFICES
NELBAKER.
RENNEMAN
Be SPARE
Notarial Seal
Patrida J. Thomson. Notary Public
M-acha~icsburg Borc. Cumberland County
My Commission Expires Dec. 31. 1998
";.~. P~-It,c:rr.eA~.~m r:I."'~