HomeMy WebLinkAbout02-19-08
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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
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN 21 07
RESIDENT DECEDENT
0818
Date of Birth
180266301
06182007
12161934
Decedent's Last Name
Suffix
Decedent's First Name
ZEGER
DORIS
MI
L
(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
181 1 Original Return 0 2. Supplemental Return 0 3. Remainder Return (date of death
prior to 12-13-82)
0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
0 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death 0 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 Numbe.....'
BRADLEY L G R IFF I E 7 1 7 2 4 3C5 5 5 1 :...
;:_.~;(~ t,;.J
--:-"
Firm IName (If Applicable)
GRIFFIE & ASSOCIATES
REGISTER OF V.I~:S USIfONL Y
-"- ~ :;; ~J
./.'.....
First line of address
200 NORTH HANOVER STREET
~~1
-1'.;.~
Second line of address
City or Post Office
CARLISLE
State
PA
DATE FILED
ZIP Code
17013
C d t' 'I dd b g r iff i e @ g r iff i e 1 a w . com
orrespon en s e-mar a ress:
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 alllf1formatlon of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN. DA1E
-1il~iL t? ~& ./}(..L:.u~ Deborah A. Edmondson /? r-=~,v tJ?'
ADDRESS
17013
DATE
Bradley L Griffie
of)
17013
Side 1
L
15056041147
15056041147
--.J
J
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15056042148
REV-1500 EX
Decedent's Name"
ZEGER, DORIS L
RECAPITULATION
1. Real Estate (Schedule A).
2. Stocks and Bonds (Schedule B)..
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).. 3.
4. Mortgages & Notes Receivable (Schedule D)
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
8 Total Gross Assets (total Lines 1-7).....................
9. Funeral Expenses & Administrative Costs (Schedule H)..............
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)....
1.\ Total Deductions (total Lines 9 & 10)........
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(12) X .00
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
16
17.
18.
19. Tax Due...........
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
Decedent's Social Security Number
180266301
1
- __.__ ______m____
0 00
0 00
0 00
0 00
1 , 266 25
7 , 751.27
0 00
9 , 017 52
2
4.
8.
9.
8,352 08
10.
3,539 04
11.
11,891.12
12.
- 2 , 873 .60
13.
14.
-2,873.60
o . 00
D
15056042148
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT NAME
Zeger, Doris l
STREET ADDRESS
__3~~_~ickory~ Road _~____ ~__ ___ _ ___
File Number 21 - 07 - 0818
Carlisle
--TSTATE- -
I. PA
-iZIP-
1
17013
CITY
Tax Payments and Credits:
1 Tax Due (Page 1 Line 19)
2 Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
Total Credits (A + B + C)
(2)
0.00
3 Interest/Penalty if applicable
O. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 0.00
- ---...- ----
(5A)
(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
a. retain the use or income of the property transferred;..... .
b. retain the right to designate who shall use the property transferred or its income;.
c. retain a reversionary interest; or..... ......................................
d. receive the promise for life of either payments, benefits or care?.............
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....................................................... 1- I
No
x,J
. x I
I;]
\--,
1~1
lX
I x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?..
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.. .. ..................................... ...............
I
IX
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. S9116 (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. S9116 (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. S9116 (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 S9116 1.2) [72 P.S S9116 (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 PS. 99116 (a) (1.3)]. A
sibling ii, defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ReSIDENT DECEDENT
\
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=~ c====.c=c=, .===c==.~l'~ =--=-== 'CC.C-.C='.= -=c=- =C--
I FILE NUMBER
21 - 07 - 0818
ESTATE OF Zeger, Doris L
___ ..________________________. _~_.______.______...__.______. __,___.______~__.______._._____'__.__. _'0' __ __"____ ___.____.__
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorslhlp must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE OF
DEATH
1 Security Plus Refund Rider with Parklawn Memorial Gardens and Mausoleum
1,186.25
2 13 Inch Television
50.00
3 Clock
5.00
4 Chair
25.00
TOTAL (Also enter on Line 5, Recapitulation)
1,266.25
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTAT-e OF -~-----------~-----~-- -~--~fRLENUMBER--- ---
______~___=_~ger,~~L_~_~ ____________~_____ ____~_ _ J____~1_-_0~_-~~~___
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SUR:VIVING JOINT TENANT(S) NAME
-- -,-'---'-'-._- ._.,-~--_.__..-..._----'"~
Deborah A Edmondson
ADDRESS
RELATIONSHIP TO DECEDENT
A
305 Hickory Road
Carlisle, PA 17013
Daughter
JOINTLY OWNED PROPERTY:
- -I~~M---TLETTER~TDATE--Illn~ude name JT~~~n~~nm~31~r~~Olb~~~~~nt num~~iD;;E-()F-D-EATH r%OF----OArE oFmCATH-
'FOR JOINT. MADE . '1 'd t'f' bAtt h d d f .. tl h Id I! VALUE OF ASSET DECD'S, VALUE OF
~U~~E_RJ_!ENANT: . JOINT 1~~t~~1 ar I en lYing num e~___~~~e~~~~ e rea. !~~_~_~~~~~~~_D~~E~E~=~INT~RlC~T_
I A ; 09/03 : Checking Account 19744676 15,502.53: 50%. 7,751.27
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TOTAL (Also enter on line 6, Recapitulation)
7,751.27
SCHEDULE H I
FUNERAL EXPENSES & !I
I ADMINISTRATIVE COSTS I
- --------------------+-----------~------ -----------tFILE-rlfUMBE-R-------- n - --.
:S,-~~~~)~__Ze~-=-r, Doris L _____~_________________________L____~~~ilL=_Q?_1i3_ __
Debts of decedent must be reported on Schedule I.
-" .._--~-.._------ -~~._._---,--_._._-._--- ----~-~,-_.~.__.__._.__.~-_.- ---'--- --- '_'-'---'~-'---'-----_._--
ITEM
NUMBEF~ . FUNERAL EXPENSES:
__ _____,_..___,______,'__._____._.,.___,_...______._.._'_____n_'_______ __ ____,__._ _____ ___' __ __._,____,.__,__,__..._ ___'___"__
A. 1 Thomas L. Geisel Funeral Home, Inc.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DESCRIPTION
AMOUNT
5,449.50
2 ReceptionlWake
1,058.94
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
Attorney's Fees Griffie & Associates
State
Zip
2.
1,500.00
3. I Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
State
Zip
4.
118.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
Estate Notice Advertisement to The Sentinel
150.64
TOTAL (Also enter on line 9, Recapitulation)
8,352.08
I Schedule H
I Funeral Expenses &
COMMONWEALTH OF PENNSYLVANIA I Ad . istJ'a1ive" Cos1s conti ued
INHERITANCE TAX RETURN mln n I
__ ____ ~E~~I'J! DECEDIOr-J~___~~J_________~_~___ _~~__ ______0- ___
ESTA ;~~~F-;e;;r~oris-c--- ------ --- ---~-~---~TFiLE NUMBER---
_,_________ _~___~_________~__ _ __ ______~__~__J~~_~ ~~ - 0~18 _____
1
Estate Notice Advertisement to the Cumberland Law Journal
75,00
Page 2 of Schedule H
SCHEDULE I I
DEBTS OF DECEDENT, MORTGAGE I
LIABILITIES, & LIENS
\ I
_c -=c==== -----~-c--=-I_-_==c===-====-=-= -=c=c===-=========-r,:-======= ==cc,==-c-- --cc =_~c
FILE NUMBER
ESTATE OF Zeger, Doris L 121 - 07 - 0818
____ _____________________~~ _ _____ ______ _____ _ _____1 ___ _____ _nun __ _____ _______
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Include umeimbursed medical expenses.
----------...---..--- -----.--_... -------- ----_..-.-_.. ..-,--....--------. --- ------
ITEM
NUMBER
DESCRIPTION
AMOUNT
335.86
Lutheran Social Services
2 Green Ridge Village
3,203.18
TOTAL (Also enter on Line 10, Recapitulation)
3,539.04
REV-1513 EX+ (ll-00)
I
COMMONWEALTH OF PENNSYLVANIA 1
INHERITANCE TAX RETURN
___~__~RESI[)~NT DECE..lJEOi'J~ ___J__________ ~_ ____ _ _______
SCHEDULE J
BENEFICIARIES
ESTATE OF 1\. FILE NUMBER
Zeger, Doris L
________ ___________________ _ _____~ ____.--L----?2 -~!_=_~~1_~_ _ _ _
RELATIONSHIP TO i SHARE OF ESTATE . AMOUNT OF ESTATE
NUMBEH NAME AND ADDRESS OF PERSON(S) DECEDENT i (Words) ($$$)
___ _________~ RECEI":"IN~PROPERTY ________~ OONotListTrus\lle(S)_______[_______________'--___
I
I.
TAXABLE DISTRIBUTIONS [include outright spousal
distributions. and transfers
under Sec. 9116 (a) (1.2)]
John F. Edmondson
96 Monroe Drive
Chambersburg, PA 17201
Grandson
One Hundred
Percent
0.00
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II.
i NON-TAXABLE DISTRIBUTIONS:
I A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
I NOT BEING MADE
I
13. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
I
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET!
I
0.00
Parklawns Memorial Gardens
& Mausoleum
November 26,2007
This is to verify that the value of the"Security Plus Refund Rider" certificate in the name
of Doris Zeger was valued at $1186.25 at the time of Mrs. Zeger's passing in June of
2007.
//~/~7/'/ ,,//
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'7- _,-~? . ~~
Gail' nderson
General Manager
.121K Philadelphia Avenue · Chamhershur,g, PA 17201 · 717-26.1-9125 · Fax 717 -2()3-9663
DignityMemorial,com
Registration # 107'
N"O
Certificate . .,
{'lilH32
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SECURITY PLUS@ - REFUND RIDER
Attached to and made part of Contract # j' ~ it.) .. ,- 7'7 ;7'. d dated
(Purchaser) r)!)l~ I:"'; L~ "7 P',"6>t lr:t<:?
p/,:Yi4 () 'S I~ (i ill! M j~:;;;Ji.!S idtfNt1;:')" r~' /) ;'
CONSIDE RATION: This rider is made part of the contract with the above named, and payment for this
rider is specified thereon.
) I - '7,-' ;; '-7' with
of !?;; 0:..;/
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EFFECTIVE DATE: This rider shall become effective on, and all times shall be calculated from, the
date the above contract is paid in full.
BENEFITS: The Company shall pay the refund rider benefit, if any, (A) upon proper written request
of the Purchaser, his/her heirs, or assigns at anytime. (Bl on the effective maturity date listed below.
TABLE OF REFUND RIDER PERCENTAGES
The refund benefit of this rider shall be the amount of the net cash sales price of the goods or services
purchased, including the cost of this rider, if any, less any discounts, or trade-ins, and multiplied by the
appropriate percentage listed in the table below. The amount of the benefit from this rider DOES NOT
include, finance charges, exchange plan fees, late charges, or collection charges, if any. V \~
REFUND RIDER PERCENTAGES t ~f
AT COMPLETION AT COMPLETION /
OF YEAR PERCENTAGE OF YEAR PERCENTAGE S
~ ~~ ~; ..'~ ;~~ ~~~
5 7% 14 40% \\~
6 8% 15 45%
7 9% 16 50% A ,
8 10% 17 55% ~
1~ ~~~ ~ ~~p~~~
11 25% 20 100% \ \ I 1
NOTE, No b'n,flt " p"I,b\, until ,ft" th, thl'" ,nnl"""V of th, ,ffe,,,,, d,". \\ \\~ ~
SECURITY PLU~RIGHTS OF OWNERSHIP: Except when noted hereafter, the successor to rights of
ownership of this rider will be the spouse of the Purchaser, and the spouse shall be the recipient of any
and all benefits which the Pu rchaser may have been entitled to hereu nder. If the spouse shall not survive
the Purchaser, all rights of ownership will transfer in equal shares to the issue of the Purchaser.
. certify that of
, rather than my spouse, or issue as pro-
vided above, shall be the designated successor to the rights of ownership of any and all benefits here-
under.
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PURCHASER:"
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WITNES/8:
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VALIDATED:
DATE:
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(Cemetery Off,ii::ial)
REFUND RIDER DOLLAR AMOUNT AT MATURITY: $
rl at
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DATE OF MATURITY:
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flJM&TBank
499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
October 2, 2007
Griffie & Associates
Attorneys and Counselors at Law
200 North Hanover Street
Carlisle, Pennsylvania 17013
Re: Estate of Doris Zeger
Social Security: 180-26-6301
Date of Death: June 18. 2007
Dear Sir or Madam:
Per your inquiry received September 28, 2007, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
19744676
Ownership (Names oj)
Doris Zeger *
Deborah A Edmondson *
Opening Date
01/01/78
Balance on Date of Death
$15,502.53
Accrued Interest
$
0.54
Total
$15,503.07
2.
Type of Account
Savings Account
Account Number
015004204274233
Ownership (Names oj)
Doris Zeger *
Opening Date
09/10/04 Closed 06/11/07
Balance on Date of Death
$ 0.00 * * Closed prior to the date of death
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 Chambersburg Main Office #
717-261-2857.
Sincerely,
/) ~-"~'/?/ ~
{'vvr, -;; .~7'
Nancy Clagett
Records Management
~ M&TBank
3628 Scotland Main Street, Chambersburg, PA 17201
7172677670 FAX 171 2677676
July 24, 2007
To Whom It May Concern:
Account number 19744676 was established as a joint tenant with the right of
survivorship during the statement cycle of August 23 - September 23,2003, between
Mrs. Doris Zeger and Mrs. Deborah A. Edmondson. At the time of establishment, the
account reflected a Relationship Checking product.
Very Truly Yours,
cj(~ bP
Katie L. Hershberger
Branch Sales Associate
M & T Bank - Scotland Office
3628 Scotland Main St.
Chambersburg, Pa 17202
P: 717-267-7670
F: 717-267-7676
M & T Bank - "Understanding What's Important"