HomeMy WebLinkAbout04-17-08 (2)
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15056051058
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
RESIDENT DECEDENT
al &YJ1
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Date of Birth
201-18-3153
12/05/2007
10/11/1926
Decedent's Last Name
Suffix
Decedent's First Name
MI
Bretz
Betty
A
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
" ',.,..........u......._^._.,.~._.......,
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
ta::l 1. Original Return
2. Supplemental Return
c::> 3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4. Limited Estate
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
8. Total Number of Safe Deposit Boxes
c::., 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
City or Post Office
State
ZIP Code
(717) 737-2033
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! REGISTE'\~aLLS USE tila...Y
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D'A-lt FILED
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Firm Name (If Applicable)
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Attorney At Law
First line of address
352 S. Sporting Hill Rd.
Second line of address
o
u:r
Mechanicsburg
PA
17050
Correspondent's e-mail address:JMB@JamesMBach.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 all information of which preparer has any knowledge.
IBLE F R FII!ING
OAT -,,/,6 -d ~
. Sporting Hill Rd. Mechanicsburg, PA 17050
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051058
15056051058
...J
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15056052059
REV-1500 EX
Decedent's Name:
Betty
A Bretz
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) . . . . . . . . . . . . . . . . .. 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.
9. Funeral Expenses & Administrative Costs (Schedule H). . . . .
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) . . . . . . . . . . . .
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . .
. . . . 12.
. . . . . . 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, or
transfers under Sec. 9116
(a)(1.2) XO_
16. Amount of line 14 taxable
at lineal rate X.O _ 40,865.68
17. Amount of line 14 taxable
at sibling rate X .12 3,000.00
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
15056052059
Side 2
L
Decedent's Social Security Number
201-18-3153
1.
2.
9.
43,865.68
43,865.68
1,838.95
360.00
2,198.95
15056052059
---l
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Betty A Bretz
STREET ADDRESS
440 Sample Bridge Road
File N\lmber .
!
,;
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DECEDENT'S SOCIAL SECURITY NUMBER
201-18-3153
CITY
Enola
I STATE
PA
I ZIP
17025
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C ) (2)
3. Interest/Penally 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 avalon 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. (5)
A. EntElr the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(SA)
(5B)
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 No
a. retain the use or income of the property transferred;.......................................................................................... 0 [!g
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [!g
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ..................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................................................................. 0 [i]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................................... 0 [!g
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 PS. 99116 (a) (1.1) (ii)]. The statute does not exemot 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 oftransfers to or for the use of the decedent's siblings is twelve (12) percent[72 P.S. 99116(a)(13)]. Asibling is defined, under
Section 910:2, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-150B EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS/ & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
=
ESTATE OF
Betty A. Bretz
FILE NUMBER
ITEM I
NUMBER
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.
DESCRIPTION
VALUE AT DATE
OF DEATH
1 PNC Bank checking account. Account No. 50-0351-3488
2 PNC Bank - Money Market Account No. 50-0351-6005
25,443.09
28,126.05
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
53,569.14
REV-'1511 EX+ (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Betty A Bretz
FILE NUMBER
ITEM
NUMBER
A.
Debts of decedent must be reported on Schedule 1.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Sullivan Funeral Home 51 N, Enola Dr, Enola, PA 17025
Funeral Lunch
Additional Death Certificates
1,974,20
200,00
30.00
2
3.
B. ADMINISTRATIVE COSTS:
10
11
Personal Representative's Commissions
Name 01 Personal Representative(s) Donna F. Smith
Social Security Number(s)/EIN Number 01 Personal Representative(s)
Street Address 440 Sample Bridge Road
City Enola
StatePA Zip 17025
Year(s) Commission Paid:
2
Attorney Fees
3,214.14
3
Family Exemption: (II decedent's address is not the same as claimant's, attach explanation)
3,500.00
Claimant Donna F. Smith
Street Address 440 Sample Bridge Road
City Enola
StatePA .Zip 17025
Relationship 01 Claimant to Decedent Daughter
4
Probate Fees
192.00
5. Accountant's Fees
6
Tax Return Preparer's Fees
100.00
7
Patriot News - Legal Advertisement
Cumberland County Law Journal- Legal Advertisement
West Shore EMS & EPT EMS
PHARR America
EPT Ambulance
148.17
75.00
106.97
85.98
77.00
8
9
TOTAL (Also enter on line 9. Recapitulation) $
(II more space is needed, insert additional sheets 01 the same size)
9,703.46
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Betty A. Bretz
SCHEDULE J
BENEFICIARIES
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
~BER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Donna F. Smith - 440 Sample Bridge Rd. Eno/a, PA 17025 Daughter 92%
2. Shirley Kidman - 82 Linda Drive Mechanicsburg, PA 17050. Sister 8%
· Specific Bequest of $3,000.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
I 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 $
NU~
(If more space is needed, insert additional sheets of the same size)
THE LAW OFFICE
of:
JAMES M. BACH
Attorney-At-Law
352 S. Sporting Hill Road
Mechanicsburg, PA 17050
737-2033
LAST WILL AND TESTAMENT
FOR
Betty A.. Bretz
Last Will And Testament Of
Betty A. Bretz
I, BETTY A. BRETZ. of the TOWNSHIP OF SILVER SPRING.
COUNTY OF CUMBERLAND. COMMONWEALTH of PENNSYLVANIA.
being in good bodily health and of sound and disposing mind and memory, and not
acting under duress, menace, fraud, or undue influence of any person whomsoever,
merely calling to mind the frailty of human life, and being desirous of disposing my
worldly goods while I have the strength and capacity so to do, I do make, publish and
declare this my.LAST WILL AND TESTAMENT. I hereby revoke, cancel and annul
all my former Wills and Testaments, including codicils thereto, by me at any time made,
and declare this alone to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE IT HAS PLEASED GOD TO ENTRUST ME WITH IN
THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1.
ITEM 2.
ITEM 3.
ITEM 4.
\
ITEM 5.
ITEM 6.
I direct that my Executrix hereinafter named, pay and discharge aU of my
just debts, funeral and testamentary expenses.
I order and direct that my bodily remains be cremated.
I give, devise and bequeath the sum of $3000.00, free from tax to my
dearly beloved sister Shirley Kidman, provided she survives my death. If
she should not survive my death then this bequest will lapse.
AU the rest, residue and remainder of my entire estate, wheresoever
situate, and whatsoever it may consist of, I give devise and bequeath,
absolutely, and in fee, to My Dearly Beloved Daughter, Donna F.
Smith, per stirpe:
I nominate and appoint Donna F. Smith as Executrix of this my Last
Will. Should the Executor named herein fail to qualify or cease to act as
Executor, then I appoint Diane R. Miller and Sylvia K Morrow, as C-
executrix.
I order and direct that my Personal Representative(s) named herein use
the legal services of JAMES M. BACH, as Attorney for my Estate.
~(!LIf3KPJ
BETTY BRETZ
ITEM 7.
ITEM 8.
ITEM 9.
I direct that my personal representatives, as well as their successors
shall not be required to give bond for the faithful performance of
their duties in any jurisdiction.
I direct that all estate, succession, legacy, inheritance or other transfer
taxes, however designated that shall become payable by reason of my
death in respect of all property comprising my gross estate for tax
purposes, whether or not such ptOperty passes under this LAST
WILL. shall be p"id hy my Executa! out v[ illY residuary estate.
I grant to my personal representatives herein named, in addition to,
but not in limitation of those powers vested by law, to be exercised
without prior application to or approval of any court, the power and
authority to retain indefinitely any property, to invest and reinvest
any assets or the proceeds derived from the sale of assets, although
said investments may not be of the character prescribed by law, to
sell, convey, assign, transfer and encumber any property, to pay,
settle or compromise all claims, to make distribution or divisions in
cash or in kind, and in general to exercise all powers in the
management of any property hereunder which any individual could
exercise in the management of similar property owned in her own
right, and to execute and deliver any and all instruments and to do all
acts, which may be deemed necessary and proper.
~~{Lt~
BEm . BRETZ
.___________________.____________________.____. END----------.-------..-.-------.-----------------
2
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
)
)
ss
I, BETTY A. BRETZ the TESTATRIX, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my LAST WILL; that I signed it willingly; and that I
signed it as my free and voluntary act for the purpose therein expressed. '
Sworn to or affirmed and acknowledged before me, by: the TESTATRIX this fuh day ofJyly:,
2005.
E~ ~ t~~
BETTY BRETZ
NOTARIAL SEAL .
JAMES M. BACH. Notary Public
Hampden Twp., cumberland County
My CommissIon Expires May 13, 2007
The preceding instrument consisting of this and two (2) other typewritten pages,
identified by the signature of the TESTATRIX, was on the date thereof signed, published and
declared by BETTY A. BRETZ the TESTATRIX therein named as and for her LAST Will..
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LEZLI .
Residing at 352 S. Sporting Hill Road
1iechanicsburg.FA 17050
Residing at 352 S. Sporting Hill ROlld
Mechanicsburg, FA 17050
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
)
)
ss
We, LEZLI J. LEAR and MARY CLAYCOMB. the witnesses whose names are signed
to the attached or foregoing instrument, being duly qualified according to law, do depose and say
that we. were present and saw the TESTATRIX sign and execute the instrument as his LAST
WILL; that the TESTATRIX signed it willingly and that he executed it as his free and voluntary
act for the purpose therein expressed; that each witness in the hearing and sight of the
TESTATRIX signed the WILL as witnesses; and that, to the best of our knowledge, the
TESTATRIX was, at the time, 18 or more years of age, of sound min,d and under no constraint
or undue influence.
Sworn to or affirmed and acknowledged before me, by: LEZLI J. LEAR and MARX
~~M;daYOf~~.
~
NOTARIAL SEAL
JAMES M. BACH, Notary Public
Hampden Twp., Cumberland Coun
My ComllllSslon Expires May 13, 20~7
SM. BACH, ESQUIRE
TARY PUBLIC
echanicsburg, PA 17050
My Commission Expires: 05/13/07
3
~
JAMES M. BACH
~>.i..........
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--
We are a Debt Relief Agency
Attorney At Law
We assist people
filing for Bankruptcy
352 S. Sporting Hill Rd., Mechanicsburg, PA 17050, Tel: (717) 737-2033
April 16, 2008
Register of Wills
One Courthouse Square
Carlisle P A 17013
RE: Estate of Betty A Bretz
Dear Register:
Enclosed here with please find an original plus one copy of the Inheritance Tax Return and status report
for the estate of Betty A Bretz.
Kindly process this tax return in normal fashion.
I am also inclosing here with a check in the amount of $15 for the filing fee of the Inheritance tax return,
and another check payable to the register of wills in the amount of$2,198.95 which represents full
payment of inheritance tax.
ReSpeCtfu~ ~
es M. Bach
orney at Law
Encl: Original plus one copy of Inheritance Tax Return,
Check in the amount of$15, and a check in the amount of$2,198.95
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