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Home My WebLink About04-17-08 (3) ~ 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 *". ' .. I County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 0946 Date of Birth 199 14 5779 07 01 1994 11 09 1923 Decedent's Last Name Suffix Decedent's First Name MI ROTH FRANK H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name ROTH MARION MI W Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (date of death prior to 12-13-82) L 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Return Required (date of death after 12-12-82) [Ki 6. Decedent Died Testale 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) L! 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 Number JAMES D. BOGAR 717 737_.')8761 r" ',. - ':~ ,..-.- {~~ Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES ') "- REGISTER OF yvtb.~ USE ?tjL Y . ~R ~J -...J -';' ::lit First line of address ONE WEST MAIN STREET Second line of address r.....) City or Post Office N DATE FILED 0 '..i ' {~\;~ SHIREMANSTOWN State PA ZIP Code 17011 Correspondent's e-mail address:jbogar@bogarlaw.com 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 allmformatlon of which preparer has any knowledge. SIGNATU E !ERSON RESPONSIBLnO~ FILlNCO URN DATE ' , I ()/U,.,u' L-- LJ-. ~ Marion W. Roth - /:5' - i11 DATE James D. Bogar 4(')'lO~ One West Main Street, Shiremanstown, PA 17011 Side 1 L 15056041147 15056041147 ~ ~ -1 15056042148 REV-1500 EX Decedent's Name F ra n k H. Rot h Decedent's Social Security Number 199 14 5779 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) 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)....................................................................... 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/Sec 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, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .06 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 0.00 16. 0.00 17. 0.00 18. 19. Tax Due. ..... ...... ....... ..... .................. ............................................ ... .... ............. ....... .... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 9,267.14 9,267.14 10,175.50 10,175.50 -908.36 -908.36 0.00 0.00 0.00 0.00 0.00 o 15056042148 -1 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07 -0946 DECEDENT'S NAME Frank H. Roth STREET ADDRESS 302 West Courtland Avenue , CITY I STATE IZIP Shiremanstown PA 17011 I 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 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest'Penalty if applicable D. Interest E. Penalty Totallnterest'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. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) (4) (5) 0.00 (SA) (58) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRJA TE BLOCKS No [!J ~ [!J [!J o [!J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 [!J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... 0 [!J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 1. Did decedent make a transfer and: 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?................................................................................................................... ... Yes ~ 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) peroent [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. 99116 (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. 99116 1.2) [72 P.S. 99116 (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. S9116 (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-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERrrANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Roth, Frank H. SCHEDULE B STOCKS & BONDS All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-07 -0946 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 107.339 shares of AT&T Corporation Share Owner 54.25 5.823.14 Dividend Reinvestment and Stock Purchase Plan - Account Number 016449-40450 2 079860102 56 shares of Bellsouth Corp - Common Stock 61.50 3.444.00 ; TOTAL (Also enter on Line 2, Recapitulation) 9.267.14 (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 B (Rev. 6-98) September 15, 1994 First Chicago Trust Company of New York AT&T Transfer Agent PO Box 2575 Jersey City, NJ 07303-2575 RE: Frank H. Roth, Jr. 01644940450 Request to Re-register Plan Dear Sir/Madame: .-"'----.--~- On July 1, 1994 my husband, Frank H. Roth, J:r:/;j>-aied. He was the shareowner of approximately 107.3390 shares Df AT&T Gommon Stock held in the Reinvestment Plan noted above. I ------ According to his will (enclosed) I am the sole heir to his estate. Please re-register the above referenced account in my name, Marion W. Roth. I have enclosed the required legal papers to authorize this request. If you have any questions regarding this request, please contact my representative, M. Wayne Neff, CFP at (717) 761-0100. sincerely, 1/71 (Jfl-u~ 71 @aJ Mario~W. Roth 302 Courtland Ave. Shiremanstown, PA 17011-6509 Enclosures SIGNATUnE GuARANTEE[) MEDALLION GUARANTEED OAU HIN OEPOSI RJ~~ST ~OMfr~- .J~ (61) A100129H 3-<UAITIES Tn.AN~J:.E=n f..rJj NTS Mf.n"Lllc~~ ('I-4CK3HAM~ cc: M. Wayne Neff, CFP $'(1 HIstorical Stock Data Page 1 of 1 c;:;, ~. ::.. at&t ~;:1 Investor Relations AT&T Corp. Historical Stock Data .~~...~~~..II. i:I~~r~-~.) [GO!I Date High 54.7500 Low Close July 01, 1994 54.0000 54.2500 l?l.2Q.O.3-=-.2O'Q6...AI.&LKnowled.ge....V..enwres,.1..P.. All rights reserved. E[h{.acy--E'.QH~ Historical Stock Data Investor Relations BeJlSouth Historical Stock Data -- Page 1 of 1 :~~~~=jj'l~~!y.=::~.l =~=::.j [i-_~~:=:lIi ~ ~ -J"~ 01, 1,... Close 61.5000 @.2Q.o.~2.QQ6-A.T...&LKnQwledge_VJmtur:es,-L.E'., All rig hts reserved. Eri'laC't.EoJlcy- . ~~;. , ~ u o I- U1 Z o ~ :E o () ru o ....=I ~ ~ o ~ ~g it~ ... ~ z. ~ ~ Z..;i% ~~o ~~~ I->~ "Zw ~=z ~~ .. ~ " ~ w U " ;: ~ .. o g~ ..D ..... <0 :::~ a- a:~ r"- ~~ o ~~ "'", Q.. In ~ H VI ::l V ,j ::s:: u o w ?- m z o ::E ::E o () :c .... t>: w ~ ~ ::> '" o 0: wwO ....:cw ..,;....'" Cl:ll..ll.. ~OO Cl:tfjUJ o~!;;: U..,;t- ~..Jcn c o .- ... .e o Q. ... '0 o .c: ..... :J o en - - CI) CO J" ". "i ~~ ~~ c.~,~ :8'~ .~ e! ,,~ ~ ~~ ~, ()~ ~. " ~ .~ tJ) ., ~ .:::: IJl ~ ;i 3 c,.....,.~~ <( .... .~ ~ ~.".,' " <( ~lt...~ ......'''...;;,.: a. !::t~.. .. "- - ~~ .~"\ ~ ~\~~.. ......~.. '( .. '':'.'"''~''''~''''' '" S .~~~~:" ;i\.~~ . "~""['H.'" . ....,...::<. <5 ~..:.. ..J ~ o :::: ''''.'. \.~ w ~.~~ " ~ ~.~.}:... ,,,.~ 13 ~.<., ~~ 0"' \"t/.~. .. ~ ~",.. .' ,. Ui ~. ~ .~ z t~..,~ ~ ~.~ .,~ ~ ~~Jtf,~, .xl":Nr(::~-"~ <.> ~" .~ w ~. .,,,...~,....~, ~ '~ii.; ..'.:.......'., ~ u.. '" ~ N o ~ N en ~ (") a:;w ~. 3';: r- "'....... '" ro ~~", ~ w~. "'.,~ ,I\~, ...J "-.;:, \..,\ CJ ~.~ ~!f'- ~ ~.'~~' t<i?r~,~. i tX) '. W 'f,j~~ f~.,t ""'; ~ 11~~\r-1 !"-v z (:'~ .')..'" '.," j o ~rJ.:L~ .~..~ ".' M.-.......I~ z ,~ .~. N ~ ~~q~/y.i;~ >- o ~,~ ." \.~ a::: ~ - '~ I;;: ~ "" C': ~ ~ ''"'' " ::> ~ ~ :-.. ..,., ~ "'\.~.~ ~ O! 5~~ ~~ ~ ~ u.. ~ ~~;=:: ~ \ ~ 't-.. ..- ~ ~~\. "\ ~~ Cl It ..= \ai .. Z 0: g '" 1: ~ ~ ~ I- Cl ... ...~.. Cl .. Cl Z U ~ ~ ~ 1.; ; ;c J: ::: r V I- " 0 ! ~' ~li1 t 5 u (yo, In o I.n 0-. r- (1) ~ N N o 0-. r- I"- '" I ~ ..... I '" 0- M ..... ~ -:r .-4 N N rI\ f" dJ f5 ~ ,. II Ii <( >-rr ~~ D.Cl ~w 00: V I- \1) :l ll: l- ll: W > o z <( 1: III ll: 111 ll: :J l- V e~ O::l Wz l-< &~ W 0: i W u iL ... o o "' ... it o C ;:, .. J J ~ OJ Q Ul f- ~ o REV-1151 EX+ (12-99) ,~ ~ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Roth, Frank H. FILE NUMBER 21-07 -0946 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 6,800.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Social Security Number(s) J EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees Bogar & Hipp Law Offices 1 ,127.50 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Marion W. Roth Street Address 302 West Courtland Avenue City Shiremanstown State PA Zip 17011 Relationship of Claimant to Decedent Spouse 2,000.00 4. Probate Fees 248.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs TOTAL (Also enter on line 9, Recapitulation) 10,175.50 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 Roth, Frank H. FILE NUMBER 21-07 -0946 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Dillsburg Cemetery Association - Grave and Grave Opening 1.100.00 2 Gingrich Memorials - Monument 490.00 3 Mt. Olivet United Methodist Church - Funeral Luncheon 200.00 4 Musselman Funeral Home, Inc. - Funeral and Burial 4.710.00 5 Stephenson's Flowers - Flower Arrangements 300.00 Subtotal 6.800.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Roth, Frank H. 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 Ust Trustee(s) I. Marion W. Roth 302 West Courtland Avenue Shiremanstown, PA 17011 Wife FILE NUMBER 21-07 -0946 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) One hundred percent of rest, residue and remainder. Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet ll. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Copyright (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Form PA-1500 Schedule J (Rev. 6-98) 0.00 ~ ) j "~"-l\ ",- -- ifcrs! l[il1 Club QT~slctmtnt OF FRAl\lK H. ROm I, fRp..NK H. Ram, of Shirel1EJlstown, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby re- voking all other Wills and Codicils heretofore made by me. FIRST: I direct the payrrent of all my just debts and funeral expenses, including my grave marker and all expenses of my last illness, shall be paid from my residuary estate as soon as practical after my decease as a part of the ex- penses of the administration of my estate. SECOND: I devise and bequeath all the rest, residue and remainder of my estate of -whatever nature and wherever situate, together with any insurance policies thereon, unto my wife, MARION W. ROlli, provided she survives rne by SL.'<:ty (60) days. THIRD: Should my wife, Marion TrJ. Roth, predecease TIE or die on or be- fore the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and Wherever situate, together with any insurance policies thereon, unto my children, scarr F. Ram and KURI' E. ROlli, in equal shares. FOURTH: Should either of my children predecease me, I direct that their --=-~~( f2 ...~ separate share or shares under this, my Last Will and Testament, pass to their respective issue, share and share alike. In default of issue living at the time I'; \. () of my death, I direct that the share or shares of any child predeceasing me pass '- . .~ "'-.'0 to my surviving child. FIFTH: In addition to all powers granted to them by law and by other pr - visions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and:e~!ectivejuntil ,-. >.~~ "-, actual distribution of all property: (A) To sell at public or private sale, or to lease, for any -reriOd of time, any real or personal property and to give options for sales, e.X~ges:--?r leases, for such prices and upon such terms or conditions as are deerred pro~. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improve.rnent, zoning or managemen of real estate and to impose or extinguish restrictions on real estate. (C) To cornprorrise any c1a1..c'll or controversy and to abandon any property which is of little' or no value. (D) To invest in all foms of property, including stocks, carmon trust funds and lIDrtgage investment :hmds, without restriction to invest:rrents authorized for Permsylvania fiduciaries, as are deemed proper, without regard to any prmcipl of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance ta.'{ laws. (G) To make distributions to my herein named beneficiaries in cash or in kind or partly in each. SE'IH: I direct that all inheritance, estate, transfer, succession and death ta.'{ES, of any kind whatsoever, which may be payable by reason of my death, vmether or not with respect to property passing under this 1;.Jill, shall be paid out of the principal of my residuary estate. SEVENTH: All interes ts hereunder, whether principal or income, while undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distributable, shall not be subject to attachrr:ent, execution or sequestration for any debt, contract, obligation or liability of any beneficiary, and furthe:more, shall not be subject to pledge, assignment, conveyance or anti- cipation. EIGHTH: I nominate and appoint my wife, MARION W. ROIH, Executrh of this, my Last Will and Testament. In the event of the death, resignation or in- ability to serve for any reason whatsoever of the said Marion W. Roth, I nominate and appoint SCOTI F. ROTH and KURT E. Ram, or the survivor thereof, Co-Executors of this, my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection ,-lith her duties as such in any juris- diction in which she may be called upon to act insofar as I am able by law to do so. IN \.JITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Test.arrent, this / -; day of .:::r:.; ,-, ;7 1985. i / j j-/,/, (0'/ ; . >-,~; "'-., - , , i /" ..--\. Ii" / /-J ~~j~J {f-'~:-I!,. (SEAL) Frank H. Roth -2- Signed, sealed, published and declared by the above nam::d Testator as and for his Last Will and Testarrent in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. /,.~ 7.1.'> (~-.~()-r I c//. \,. J \ C"..-vf-t:./ Address Address -3-