HomeMy WebLinkAbout03-11-08 (3)
REV-1500 EX ,. (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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HOSTETTER PAULINE
DATE OF DEATH (MM-DD-Year)
E.
DATE OF BIRTH (MM-DD-Year)
01/02/2008 03/30/1908
{IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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[Xl 1. Original Return
o 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy oITrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICIAL USE ONLY
FilE NUMBER
21 -0 8 0 0 5 8
"COUNTYCOOE --YEA~ - - 'NuMBER- -
SOCIAL SECURITY NUMBER
1 74- 0 5 - 0 0 5 6
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death prior to 12- 13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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'THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXINFORMA TIONSHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MARCUS A. McKNIGHT III 60 WEST POMFRET STREET
FIRM NAME (11 Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. ,Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
6. lotal Gross Assets (total Lines 1-7)
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)
12. Net Value of Estate (Line 6 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(8)
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
0.00 X _(15)
0.00 X _(16)
0.00 X .12 (17)
7,371.66 X .15 (18)
(19)
16. Amount of Line 14 taxable at iineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19, Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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OFFICIAL USE ONLY
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14,788.59
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14,788.59
6,467.84
949.09
(11)
(12)
(13)
7,416.93
7,371.66
(14)
7,371.66
0.00
0.00
0.00
1,105.75
1 ,105.75
CITY
STATE
ZIP
Decedent's Com lete Address:
STREET ADDRESS
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
1,105.75
55.29
Total Credits (A + B + C)
(2)
55.29
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 0 + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check AGENT
0.00
0.00
1,050.46
1,050.46
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 IX]
b. retain the right to designate who shall use the property transferred or its income; ........................................ D IX]
c. retain a reversionary interest; or ...................................................................................................... D IX]
d. receive the promise for life of either payments, benefits or care? ............................................................. D IX]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............... ................................ ........................................ ....... D IX]
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D IX]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... D IX]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare that I have examined this return, inciuding 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 per al representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RES E F Fill G RETURN DATE
ADDRESS
ADDRESS
6 T POMFRET STREET
CARLISLE
PA 17013
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 3%
[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 0% [72 P.S. ~9116 (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 step~arent of the child is 0% [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 4.5%, 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 12% [72 P.S. ~9116(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-15GB EX + (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HOSTETTER PAULINE
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
E. 21 08
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.
0058
ITEM
NUMBER
1.
DESCRIPTION
M&T BANK - CERTIFICATE OF DEPOSIT #31003913025150
2.
M& T BANK - CHECKING ACCOUNT #740888
3.
JEWELRY - APPRAISAL ATTACHED
4.
PERSONAL PROPERTY - APPRAISAL ATTACHED
VALUE AT DATE
OF DEATH
5,002.93
9,494.66
86.00
205.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
14 788.59
REV-1511 EX + (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
,INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
HOSTETTER
PAULINE
E.
21
08
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
HOFFMAN-ROTH FUNERAL HOME
1.
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions'
Name of Personal Representative (s)
MARCUS A. McKNIGHT, III
181-38-4874
1.
Social Security Number(s}/EIN Number of Personal Representative(s)
Street Address 60 WEST POMFRET STREET
City CARLISLE
State P A
Zip 17013
Year(s) Commission Paid:
2.
3.
Attorney Fees IRWIN & McKNIGHT
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 REGISTER OF WILLS
5.
Accountant's Fees
6.
Tax Return Preparer's Fees PATRICIA A. ROSENDALE, CPA
FIDUCIARY RETURN AND INCOME TAXES
REGISTER OF WILLS, FILING FEE
NOTARY FEES
CUMBERLAND LAW JOURNAL, ESTATE NOTICE
THE SENTINEL, ESTATE NOTICE
1-800 GOT JUNK, TRASH REMOVAL
HOUSE CLEAN-UP
IRWIN & McKNIGHT, ATTORNEY FEES PRIOR TO DATE OF DEATH
ROY D. GOTTSHALL, APPRAISAL ON PERSONAL PROPERTY
7.
8.
9.
10.
11.
12.
13.
14.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0058
AMOUNT
816.24
750.00
1,050.00
79.00
450.00
30.00
10.00
75.00
166.60
496.00
835.00
1,675.00
35.00
6467.84
REV-1512 EX + (6-98)
'*
SCHEDULE'
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
HOSTETTER
PAULINE
E.
21
08
0058
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. UGI - UTILITY
VALUE AT DATE
OF DEATH
42.10
2. EMBARQ - TELEPHONE
18.75
3. RICHARD NEIDERER - RENT
390.00
4. PPL - ELECTRIC
28.29
5. COMCAST - UTILITY
26.18
6. BAXTER DREW WELLMON - MEDICAL
155.00
7. SHIPPENSBURG HEALTH CARE CENTER - MEDICAL
124.00
8. WEST SHORE EMS - AMBULANCE
1 64.77
TOTAL(Also enteron line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
949.09
~v.""~.[...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
PAl" INF
E
H( lS I t- t-/-oI
NUMBER
1.
1.
NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
MARY LOUISE WYATT
3519 EXETER CT
ORLANDO FL 32812
FILE NUMBER
21 OR
RELA TIONSHIP TO DECEDENT
Do Not List Trustee{s)
Collateral
OOfiH
AMOUNT OR SHARE
OF ESTATE
7,371.66
REMAINDER
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - 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)
LAST WILL AND TESTAMENT
I, PAULINE E. HOSTETTER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
ONE. I direct my Executor to pay all of my debts, funeral and administrative
expenses as soon as convenient after my decease. Furthennore, I direct that all state, inheritance,
succession and other death taxes imposed or payable by reason of my death and interest and
penalties thereon with respect to all property composing of my gross estate for death tax
purposes, whether or not such property passes under this will, shall be paid by the Executor of
my estate.
TWO. My Executor may, at his discretion, compromise claims, borrow money,
retain property for such length of time as he may deem proper; lease and sell property for such
prices, on such terms, at public or private sales, as he may deem proper; and invest estate
property and income without restriction to legal investments unless otherwise provided
hereunder. I authorize and empower my Executor to sell any realty and/or personalty owned by
me at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could
do if living. My Executor is authorized and empowered to engage in any business in which I may
be engaged at my death, for such period of time after my death as seems expedient to said
Executor.
THREE.
I give, devise and bequeath all of my estate wherever situate to my niece,
MARY LOUISE WYATT.
FOUR.
I nominate and appoint MARCUS A. McKNIGHT, III, to be the
Executor of this my Last Will and Testament.
FIVE.
No Executor acting hereunder shall be required to post bond or enter
security in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this II th day of
June 2003.
{5 ~ (,..~ (SEAL)
PAULINE E. HOSTETTER
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
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. ;~"'/:'r._I:'_,' _f ,) ( i~,'., #., .......... 'I"".' ':.,~l: -.......'f'..-'Lm
SHARON L. SCHWALM
ACKNOWLEDGl\tIENT AND AFFIDAVIT
WE, PAULINE E. HOSTETTER, TRACI D. SMITH and SHARON L.
SCHWALM, the testatrix and witnesses respectively, whose names are signed to the 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,
and that she executed it as her free and voluntary act for the purpose herein expressed, and that
each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness
and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or
older, of sound mind and under no constraint or undue influence.
;::P~E- ~
PAD INE E. HOSTETTER
. C<..C~~(::)
- CI D. SMITH
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SHARON L. SCHWALM
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by PAULINE E. HOSTETTER, the
testatrix herein, and subscribed ~~ sworn to before me by TRACI D. SMITH and SHARON L.
SCHWALM, witnesses, this .1.1!: d:ay of June, 2003.
Notarial Seal
Martha L. Noel, Notary Public
Carlisle Born, Cumberland County
My Commission Expires Sept. 18, 2003
Me.mbflr, Pennsylvania Association of Notaries
~M&TBank
499 Mitchell Street, Millsboro, DE 19966
January 16, 2008
RECEIVED
fJAN 1 8 2008
Law Offices
Irwin & McKnight
West Pornfret Professional Building
60 West Pomfret Street
Carlisle, PA 17013-3222
IRWIN & McKNIGHT
LAW OFFICES
RE: Estate of Pauline Hostetter
Date of Death: January 2, 2008
Social Security Number: 174-05-0056
Dear Mr. McKnight:
In response to your request,. please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type........................... Certificate of Deposit
Account Number....................... 31003913025150
Ownership (Names of).............. Pauline Hostetter
Opening Date.......................... .07/26/04
Balance on Date ofDeath.........$5,002.46
Accrued Interest
$
0.47
Total.. '" ..... ................ ......... ....$5,002.93
2. Account Type........................... Checking Account
Account Number.............. ...... ... 740888
Ownership (Names of).......... .... Pauline Hostetter
Opening Date.............. ........ .....09/01/67
Balance on Date of Death.........$9,494.28
Accrued Interest
$
0.38
Total.......... ......................... ....$9,494.66
. Page 2
January 16, 2008
The above named decedent did not have a safe deposit box.
* 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 contact
our High Street Carlisle Branch at 1 West High Street, Carlisle, PA 17013, or # 717-
240-4536.
Sincerely, ".-1-'
{jtvt/ititv )jUYW;ICL;
Charlene Warrington, Records Management
1-888-502-4349
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Hoffman-Roth Funeral Home & Crematory, Inc.
219 North Hanover Street
Carlisle, P A 17013
(717)243-4511
January 17,2008
Laliene McManus
PO Box 284
Boiling Springs, PAl 7007
The Funeral Service for Pauline E. Hostetter
15205-1
RECEIVED
IJAN 1 9 2U08
IRWIN & McKNIGHT
lAW OFFICES
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWfNG IS AN fTEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
OUR SERVICE:
Traditional Funeral Service Package . . . . . .
FUNERAL HOME SERVICE CHARGES
$4150.00
$4150.00
SELECTED MERCHANDISE:
Ventura Casket. . . . . . . . . . . . . . . . . . . . . . .
Monarch Interment Receptacle. . . . . . . . . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . .
$1350.00
$1120.00
$6620.00
Cash Advances
Opening Grave. . . . . . . .
Newspaper Obituary Notice- Sentinel.
Clergy Offering . . . . . . .
Certified Copies of Death Certificates.
Hairdresser. . . . . . . . .
$1210.00
$93.24
$125.00
$48.00
$40.00
$1516.24
TOTAL CASH ADVANCES AND SPECIAL CHARGES.
Total
Total Cost .
. . . . . . . . . . . . . . . . . . . . . . . . .
$8136.24
History
01/17/2008 Homestead Life Company.
01/17/2008 Discount - Pre Arr vs Contract
$-6971. 16
$-348.84
TOT AL AMOUNT DUE. .
$816.24
This statement is net and payable in full within 30 days of receipt.
Please return this portion with your Remittance
- - - - - - - -.. - - - -........................................ ---.......... -...................... -........................
$
Amount Enclosed
Service 10 # 15205-1
Pauline E. Hostetter