HomeMy WebLinkAbout05-16-08
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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
11 19 2007
06 04 1929
Decedent's Last Name
Suffix
Decedent's First Name
OWEN
ROBERT
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
~ 1. Original Retum D 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
LKJ 6. Decedent Died Testate D 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 1 0 Spousal povert~ Credit (date of death D 11. Election to tax under Sec. 9113(A)
. between 12-31- 1 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
RICHARD L. WEBBER, JR., 717 532 7388
SHIPPENSBURG
State
PA
ZIP Code
17257
~
REGISTER O~S USE tilL Y
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Firm Name (If Applicable)
WEIGLE & ASSOCIATES, P.C.
First line of address
126 EAST KING STREET
Second line of address
City or Post Office
Correspondent's e-mail address:rwebber@weigleassociates.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.
"~\""';"''''''' ~OR ""'" "'""'" Michael K. Owen 5 . ';,"'. Q II
~RS~ iy\ f)1 rr ~ u 1+ 0
28 loIighlaRSII itraat, Natick, MA 01760
SIGNATURE OF PREPARER OTHER THAN REPR ENTATIVE
/] r YL-/
Richard L. Webber, Jr. Esquire
DATE ,-,C;/
S- /6 '(A)
126 East King Street, Shippensburg, PA 17257
Side 1
L
15056041147
15056041147
\~ y,J
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15056042148
REV-1500 EX
Decedent's Name: Robert L. Owen
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) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D 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/See 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 .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
0.00
15.
263,543.59
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
14,876.80
2,145.98
252,970.53
269,993.31
6,449.72
6,449.72
263,543.59
263,543.59
o . 0 0
11,859.46
0.00
o . 00
11,859.46
D
15056042148
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-08- oLfqrt
DECEDENT'S NAME
Rob e rt L. Owen
STREET ADDRESS
Green Ridge Village
210 Big Spring Road
CITY I STATE IZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
11,859.46
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty (D + 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)
(4)
(5)
(5A)
(5B)
11,859.46
11,859.46
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:
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
D
D
D
D
D
D
No
[!]
[!]
[!]
[!]
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? ...................................................................................................................... [!] D
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. ~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 zero
(0) percent [72 P.S. ~9116 (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. ~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. ~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-1508 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Owen, Robert L.
FILE NUMBER
21-08- 0 l..-f Cf9
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 M& T Bank Checking Account #85460370
VALUE AT DATE
OF DEATH
11.514.80
2 U.S. Treasury - 2007 Federal income tax refund
3.362.00
TOTAL (Also enter on Line 5, Recapitulation)
14.876.80
(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 E (Rev. 6-9B)
Rev-1509 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHeRITANce TAX ReTURN
ReSIOeNT DeCEDeNT
SCHEDULE F
JOINTl V-OWNED PROPERTY
If an asset was made joint within one year of the decedenfs date of death, it must be reported on schedule G.
IFILE NUMBER
I 21-08- () '1 q 'l
ESTATE OF
Owen, Robert L.
SURVIVING JOINT TENANT(S) NAME
A. Michael K. Owen
ADDRESS
RELATIONSHIP TO DECEDENT
Son
28 Highland Street
Natick, MA 01760
B.
c.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. An ACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 817/2007 M& T Bank Money Market Acct # 4,291.95 0.500% 2,145.98
15004205328435
TOTAL (Also enter on Line 6, Recapitulation) 2.145.98
(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 F (Rev. 6-98)
Rev-1510 EX+ (6-98)
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALlH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Owen, Robert L.
FILE NUMBER
21-08- 0 l{ Cf9
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 DESCRIPTION OF PROPERTY DATE OF DEATH % OF DE CD'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Allstate Annuity GA0845400 115,045.32 100.000 3,000.00 112,045.32
2 Allstate Annuity GA0845401 140.925.21 100.000 140,925.21
TOTAL (Also enter on line 7, Recapitulation) 252,970.53
(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 G (Rev. 6-98)
REV-1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Owen, Robert L.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-08- 0'1 C; 7
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 2,606.27
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Weigle & Associates, P .C. 1,500.00
3. 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 84.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 2,259.45
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 6,449.72
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 RElURN
RESIDENT DECEDENT
Owen, Robert L.
FILE NUMBER
21-08- D L{ q 9
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Egger Funeral Home
AMOUNT
2.606.27
Subtotal
2.606.27
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX" (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Owen, Robert L.
FILE NUMBER
21-08- b 'i~q
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills - Filing fee for inheritance tax return
15.00
2
Marriott Residence Inn - Lodging for (3) trips from Massachusetts
1.818.60
3
Michael K. Owen - Transportation Expense
360.00
4
U-Haul Center - Rental of truck and furniture dolly
65.85
Subtotal
2.259.45
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
REV-1513 EX" (9-00)
*'
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Owen, Robert L.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS ~ndude outright spousal
C1istributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trustee/51
FILE NUMBER
21-08- 0 L(C? q
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
I.
Michael K. Owen
~ llighland Str&et
Natick, MA 01760
:; 5C/~-..'f ;etJJ
Son
One Hundred
Percent
263,543.59
Total 263,543.59
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
ACCOUNT;NO.
~M&T
85460370
CLASSIC CHECKING
FEB.23-HAR.21,2008
1 OF 1
00
o 06128H NH 017
32
ROBERT l OWEN
OR ELIZABETH A OWEN
C/O MICHAEL K OWEN
3 SUMMIT RD
NATICK MA 01760-2114
CARLISLE WEST
8,908.53
. POSTING.
}<DATe;..
ACCOUNT ACTIVITY
......: :...;::::::::::: .,:. .::..: :.::::. :;.:; ;.:;:::::.:.:.::.::; ,;. .;;'::": DEPOSITS,,:lNTEREST. ::: :'CHECKS..&: :OTHER: .:
: :.:: 'T~AMSACT:J:ONI)~SeRIPTiON>:: ..::.:.. ... ':::: &:o'tHER'ADbIf:tOMS : :<Si.iBl'RACfIOMS':
02-23-08 BEGINNING BALANCE
$8,908.53
ENDING BALANCE
$8,908.53
WOW. DOESN"T IT FEEL GOOD TO HAVE A PLAN?
PLANNING YOUR FUTURE CAN SOHETIHES PRESENT DIFFICULT QUESTIONS AND CHOICES. AT
TIHES, IT HAY SEEH A BIT OVERWHELHING. WELL, CLOSE YOUR EYES, TAKE A BREATH,
AND COUNT TO THREE. YOU"RE IN THE COHFORT ZONE. LET"S TALK ABOUT YOUR
CHALLENGES AND GOALS TODAY. CONTACT AN H&T BRANCH REPRESENTATIVE SO WE CAN
BEGIN THE CONVERSATION OR TO LEARN HaRE VISIT WWW.HTB.COH/COHFORTZONE.
LOO8A (6/07)
m M&I'Bank
Manufacturers and Traders Trust Company, 812~ West High Street, Carlisle. PA 17013
7172406717 FAX 7172400020
5/5/2008
To: Whom It May Concern:
From: M&T Bank
Kathy Zengerle
812 ~ West High Street
Carlisle, Pa. 17013
Re: Opening date and titling of Money Market account.
This letter is to confirm that account #15004205328435 was
opened on 8-7-2003. The title of the account, si~ce opening, was
Robert L. Owen or Michael K. Owen.
Any further questions, please feel free to call.
Thank you
~y~
Kathy L. Zengerle
Manager
Phone# 717-240-6717
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Allstate Life Insurance Company
PO Box 80469
Lincoln NE 68501-0469
Telephone: 1-800-755-5275
Fax: 1-866-628-1006
Allstate.
December 17, 2007
MICHAEL OWEN
3 SUMMIT RD
NATlCK MA 01760-2114
HAROLD JOSEPH BESHAW
M & T SECURITIES, INC.
ONE WEST HIGH ST
CARLISLE PA 17013-2951
(717)241-7787
RE: Original Allstate. Performance Plus #GA0845401
Your New Allstate. Performance Plus #AC1038291A
Dear Michael Owen:
Your claim has been processed. A check has been sent to you under separate cover and should arrive within the next
seven to ten business days.
The first table represents the entire benefit value under the original contract as of the date of settlement, as well as any
transactions that may have occurred on that date.
Transaction
Date
Transaction
Type
Investment
Alternative
Units for this
Transaction
Transaction
Unit Value
Transaction
Amount
12/17/07
Total Claim
ALlC FIXED ACCOUNT ONE YEAR
N/A
N/A
$-140,92521
The second table confirms the investment alternatives to which your portion of the benefit value has been allocated.
Please review the information below. If you have any questions concerning these allocations, please contact us at
1-800-755-5275.
Transaction
Date
Transaction
Type
Investment
Alternative
Units for this
Transaction
Transaction
Unit Value
Transaction
Amount
12/17/07
Transfer To
ALlC FIXED ACCOUNT ONE YEAR
N/A
N/A
$140,92521
Your Total Annuity Value as of 12/17/07
$0.00
Distributions taken from non-annuitized contracts are generally considered to come from the gain in the contract first. If
the contract is tax qualified, generally all withdrawals are treated as distributions of gain. Withdrawals of gain are taxed
as ordinary income.
II
DOGSN.y7W.N01
&If&OOO2"","Vn-"'OOO5NY7WOOOOO
02153
~
Allstate Life Insurance Company
PO Box 80469
Lincoln NE 68501-0469
Telephone: 1-800-755-5275
Fax: 1-866-628-1006
Allstate.
December 17, 2007
MICHAEL OWEN
3 SUMMIT ROAD
NA TICK MA 01760
HAROLD JOSEPH BESHAW
M & T SECURITIES, INC.
ONE WEST HIGH ST
CARLISLE PA 17013-2951
(717)241-7787
RE: Original Allstate. Performance Plus #GA0845400
Your New Allstate. Performance Plus #AC1038290A
Dear Michael Owen:
Your claim has been processed. A check has been sent to you under separate cover and should arrive within the next
seven to ten business days.
The first table represents the entire benefit value under the original contract as of the date of settlement, as well as any
transactions that may have occurred on that date.
Transaction
Date
Transaction
Type
Investment
Alternative
Units for this
Transaction
Transaction
Unit Value
Transaction
Amount
12/17/07
Total Claim
ALlC FIXED ACCOUNT ONE YEAR
N/A
N/A
$-115,04532
The second table confirms the investment alternatives to which your portion of the benefit value has been allocated.
Please review the information below. If you have any questions concerning these allocations, please contact us at
1-800-755-5275.
Transaction
Date
Transaction
Type
Investment
Alternative
Units for this
Transaction
Transaction
Unit Value
Transaction
Amount
12/17/07
Transfer To
ALlC FIXED ACCOUNT ONE YEAR
N/A
N/A
$115,04532
Your Total Annuity Value as of 12/17/07
$0.00
Distributions taken from non-annuitized contracts are generally considered to come from the gain in the contract first. If
the contract is tax qualified, generally all withdrawals are treated as distributions of gain. Withdrawals of gain are taxed
as ordinary income.
."0/1
~ -,
.
. .
D06500W7.N01
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02154