The URL can be used to link to this page

Home My WebLink About05-28-08 (2) --.J 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 INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 File Number 1099 Date of Birth 165 26 6067 11 25 2007 10 03 1931 Decedent's Last Name Suffix Decedent's First Name MOSER THERESA (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW [!] 1. Original Return D 2. Supplemental Retum D 3. Remainder Retum (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) [K] 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 Poverty Credit ~ date of death D 11. Election to tax under Sec. 9113(A) . between 12-31-91 and -1-95) (Attach Sch. 0) MI A MI CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BERNARD A. RYAN JR. ESQ. (717) 533 3280 Firm Name (If Applicable) JAMES, SMITH, DIETTERICK & REGISTER O~~LLS USE ~L Y c' C) 0:, ::D ::it ;'2 S:2 ~ "'fTl N ::::! en ......-~..... First line of address 134 SIPE AVENUE Second line of address _;3~ '. )(-- DA 1i Fd:.l:D )> N \.0 -0 :::It City or Post Office State PA ZIP Code 17036 HUMMELSTOWN Correspondent's e-mail address: 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 infomnation of which preparer has any knowledge. SIGNATU OF PERSON RESPONSIBLE FOR Fill G TURN DATE '" Diane M. Noto DATE Bernard A. Ryan Jr. 17036 L Side 1 15056041147 15056041147 '. ,-') ," " --.J 0; --.J 15056042148 REV-1500 EX Decedenl'sName: Theresa A. Moser Decedent's Social Security Number 165 26 6067 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~ 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 4 4 9 , 5 4 2 . 0 6 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 15. 16. 17. 18. 19. Tax Due.... ......... ........ .......................... ...... ....................................._..... ............... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 15056042148 145,000.00 324,724.41 8,464.83 478,189.24 27,515.28 1,131.90 28,647.18 449,542.06 449,542.06 0.00 20,229.39 0.00 0.00 20,229.39 D 15056042148 --.J REV-1500 EX Page 3 File Number 21-07 -1099 Decedent's Complete Address: DECEDENT'S NAME Theresa A. Moser 1----- _________________ _ STREET ADDRESS 20 Courtland Road f----- 1-- CITY I STATE PA IZIP 17011 Camp Hill Tax Payments and Credits: 1_ Tax Due (Page 1 Line 19) 2_ Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount (1) 19,000.00 1,000.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 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. 20,229.39 20,000.00 (3) (4) (5) 229.39 (5A) (5B) 229.39 B. Enter the total of Line 5 + 5A This is the BALANCE DUE. 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?.... ...................... ......... ..................... ......... ... ......... ......... .................... .......... 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?.............................. .......................................................... ...................... ........ Yes o o o o o o No [!] [!] [!] [!] [!] [!] [!] 0 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. g9116 (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. g9116 (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. g9116 (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. g9116 1.2) [72 P .S. g9116 (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. g9116 (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-1502 EX+ (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts. Real property which Is jolntly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Real Estate located at 20 Courtland Road, Camp Hill, Cumberland County, PA- valued per sales price 145,000.00 TOTAL (Also enter on Line 1, Recapitulation) 145,000.00 (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 A (Rev. 6-98) Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolnlly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Commerce Bank Savings Account # 626408967 - valued per letter dated December 10,2007 VALUE AT DATE OF DEATH 3,051.68 Accrued interest on Item 1 through date of death 0.52 2 Members 1st Certificate of Deposit Account Number 80840-40 - valued per letter dated January 9, 2008 10.336.80 Accrued interest on Item 2 through date of death 26.71 3 Members 1st Certificate of Deposit Account Number 80840-41 - valued per letter dated January 9, 2008 12.605.19 Accrued interest on Item 3 through date of death 32.00 4 Members 1st Certificate of Deposit Account Number 80840-42 - valued per letter dated January 9, 2008 37,328.91 Accrued interest on Item 4 through date of death 94.25 5 Members 1st Certificate of Deposit Account Number 80840-43 - valued per letter dated January 9, 2008 27,405.77 Accrued interest on Item 5 through date of death 64.69 6 Members 1st Checking Account #80840-11 - valued per letter dated January 9, 2008 3.683.82 Accrued interest on Item 6 through date of death 0.67 7 Members 1st Investment Savings Account # 80840-05 - valued per letter dated January 9, 2008 61.388.70 Total of Continuation Schedule See attached page . TOTAL (Also enter on Line 5, Recapitulation) 324,724.41 (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. 6-98) Rev.1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Accrued interest on Item 7 through date of death 101.72 8 Members 1st Savings Account # 80840-00 - valued per letter dated January 9, 2008 3.531.17 Accrued interest on Item 8 through date of death 2.32 9 MetLife Total Control Account - valued per letter dated February 4, 2008 11,740.79 10 Navy Federal Credit Union Share Certificate Account Number - valued per letter dated January 31,2008 13.432.35 11 Navy Federal Credit Union Share Savings Account Number 3000468631 - valued per letter dated January 31, 2008 30.373.83 12 New York Life Continued Interest Account # 9370779802 - valued per letter dated January 10, 2008 109,022.52 13 Personal Property - valued per executrix 500.00 TOTAL (Also enter on Line 5, Recapitulation) 324.724.41 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) ReY.1510 EX+ (6-98) . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 This schedule musl be completed and filed ilthe answer to any alqueslians 1lhraugh 4 on the reverse side althe REV-1500 COVER SHEET is yes. ITEM IJESCRIPTION OF ~RUPERTY DATE OF DEATH % OF DECD'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 Members 1st IRA Account # 80840-10 - valued 142.74 142.74 per letter dated January 9, 2008; beneficiaries are Diane Noto and Carol Joerger 2 Members 1st IRA Certificate Account # 80840-15 8.322.09 8.322.09 - valued per letter dated January 9, 2008; beneficiaries are Diane Noto and Carol Joerger TOTAL (Also enter on Line 7, Recapitulation) 8.464.83 (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 ESTATE OF Moser, Theresa A. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07-1099 ITEM NUMBER A. FUNERAL EXPENSES: . DESCRIPTION AMOUNT See continuation schedule(s) attached 11,326.74 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 12,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 380.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 95.00 7. Other Administrative Costs See continuation schedule(s) attached 3,713.54 TOTAL (Also enter on line 9, Recapitulation) 27,515.28 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 ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 ITEM NUMBER DESCRIPTION AMOUNT 1 Holiday Inn - meal after funeral 741.74 2 Myers Funeral Home, Inc - funeral service 10.460.00 3 Office of Catholic Cemetery - headstone 125.00 Subtotal 11.326.74 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-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 ITEM NUMBER DESCRIPTION AMOUNT 1 Clauser Real Estate Appraisals - fee for appraisal of 20 Courtland Road, Camp Hill, PA 350.00 2 Cumberland Law Journal - estate advertisement 75.00 3 James Smith Dietterick & Connelly - reserve for estate administration closing costs 500.00 4 Kelvin Smith - haul trash from residence 275.00 5 Recorder of Deeds - transfer tax 1,450.00 6 Taylor, Bean & Whitaker Mortgage Corp - Tax Service fee per HUD -1 settlement sheet 73.00 7 The Sentinel - estate advertisement 190.54 8 Vladamir Torchilo - painting at 20 Courtland Road, Camp Hill, as required by FHA prior to selling 800.00 Subtotal 3.713.54 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Moser, Theresa A. FILE NUMBER 21-07-1099 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Members 1st Visa Account # 4121449998808401 - valued per letter dated January 9, 2008 VALUE AT DATE OF DEATH 71.90 2 PA Department of Revenue - 2007 tax liability 301.00 3 U.S. Treasury - 2007 tax liability 759.00 TOTAL (Also enter on Line 10, Recapitulation) 1,131.90 (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 I (Rev. 6-98) REV.1513 EX+ (9-lIO) . SCHEDULE ~ BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Moser, Theresa A. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal aistributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-07-1099 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Carol L. Joerger 39 Patton Road Mechanicsburg, PA 17055 Daughter 50% of residue 224,771.04 2 Diane M. Noto 114 East Glenn Road Hershey, PA 17033 Daughter 50% of residue 224,771.03 Total 449,542.07 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)