HomeMy WebLinkAbout06-19-08~~~ ~ ~,,,,~x~, R V ~ 15 0 ~0 ~), rt = :~. k r~, . ;, ,
S~`by COMNIONWEALTH OF
~,~~ =`t PENfJSYLVANIA
i` ~~~DEPARTEPTT8060EVENUE fNHER1TANCE TAX RETURN F12ENiMBEO
~ ~ ;
;,~,~,;~,~~~ VIARRISBURG,PA1712a-osol REST®ENT ®ECEDENT - ? 0 2 6 6
COUNTYGODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ Scarford, Frankalene Jeanette
_ _____
~ DATE OF UEATH (NIM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
w 02-03-2007 03-16-1935
L j (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
L'9
SOCIAL SECURITY NUMBER
233 - 52 - 8372
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ C°J 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date or dean,Priorm iz-r3sr~
a ~,
w a ~
~ 4. Limited Estate ~ 4a. Future Interest Compromise (dace of Beam seer 12-~z-sz)
~ 5. Federal Estate Tax Return Required
~ a ~ ~ 6. Decedent Diad Testate (AUacn copy or wiu) ~ 7. Decedent Maintained a Living Trust (Aeacn cony or Tmsq
~ ` 8. Total Number of Safe Deposit Boxes
a
a _
~~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (dare or seam between is-3i-si ana r-i-9s)
~ 11. Election to tax under Sec. 9113(A) (Attach scn o)
~. 'ft-II'; SICTIC~N MUST [3E COMPLETED: AI.I* CGIRRESP(3NDfNG~ AN[} CQ.NFIp,~NT1Ai T~#X INFOFi<,MATION SHOULD;.f3E DIRECTED TO:
w NA~vIE ~~ COMPLETE MAILING ADDRESS
~ Shawn D. Meyers
°
o. ---~---
FIRM NAME Ot npu~icabie) 120 N. Main Street
Stei~er___Stei er & Me ers Mercersburg, PA 17236
a
° TELEPHONE NUMBER
° (717) 328-3525 ~
(31"!'IC~ Gi~i ~~9a L,~
1. Real Estate (Schedule A) (1) O)
C
~
`L. Stocks and Bonds (Schedule B) (2) _'
~ ,_?~ <- ? ~= - s
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) _ ,i_ ~ ~ -
~~r~
-:
~ ~~
,
r
4, Mortgages & Notes Receivable (Schedule D) (4) r ? ~ ~ !,~ `
I
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 67 , 369.74 ~t.-_ I
~-
~ ~ _ '-} f
~ (Schedule E) _
~J ~-
r
® 6. Jointly Owned Property (Schedule F) (6) ~
Q ~ Separate Billing Requested
J
~
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
_ .~
F- (Schedule G or L)
Q.
Q 8. Total Gross Assets (total Linos 1-7) (8) 67 , 369.7 4
W 9. Funeral Expenses &Administrative Costs (Schedule H) (9) 9 , 289' 76
~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 214, 784.43
11. Total Deductions (total Lines 9 & 10) 11 224,074.19
( )
12. Net Value of Estate (line 8 minus Line 11) (12) 0.00
13. Chartable and Governmental Bequests/sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 0.00
SEE INSTRUCTfONS ON REVERSE SIDE FOR APPLICABLE RATES
~ 15. Amount of Line 14 taxable at the spousal tax
x .0
(15)
-
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate x .0 (16) _
a° 17. Arnounl of Line 14 taxable at sibling rate x .12 (17)
® 18. Amount of Line 14 taxable at collateral rate x .15 (18)
~
h
19. lax Due 1 0.00
(9) -
20. ~~ • a • • • • •
.~._- _.. __._. ! > E3F 5Ui'iE TiJ AElSWER ALL QUES f i~NS 4N REVERSESIDE AND RECHECK MATH. ~ c ~°-- ---
__~.-__ .__.._._... ~._.._._.~. _.. - _...~..L..w..
®e~ecie~lf"~ ~~a~~ulr~tr~ A~lcllre~~e
STREET ADDRESS Green Ridge Village
210 Big Spring Road
CITY Newville, STATE PA ZIP 17241
T~~ I~~yt,~~f,tt~ ~~~ c~~~lrs:
1. Tax Due (Page 1 Line 19) (1) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total lnterest(Penalty (D + E } (3)
4. 1f Line 2 is greatef than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check batc on Page 1 Ltne 20 to request a refund (q)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A..Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00
Make Check Payable fo: REGISTEiR GP WILLS, AGENT
...,zux.'~...._ ~ w+i »d° 4~ic~ _'?f acs. ".~sx'~",eaY4~r" ~~ ~~°`'~4..~~{i~ :aEwsia> ~. ;: y, is ;~ ~y~'t ~_ .. .. - -. a-...s--.. ~,,...._ _..._,-,~ ~_.. _ ,~
- PLEASE ANSUVER THE F®LLOVIiING QUESTIONS SY PLACINf~ AN °°X" IN TWE APPROPRIATE RL®CItS
1. Did decedent make a transfier and: Yes No
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? .......................................................................................................... .............. ^
IF THE ANSWER TO ANY OF THE ASOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
Under penalties of perjury, I declare that I have examined this return, including accompany(ng schedules and statements, and to the best of my knowledge and belief, ft is true, correct and complete.
oeclaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FLING RETURN DATE
Newville, ~A 17241
SIGNATURE OF
ADDRESS SLe~ger ~Leiger ik Meyers // -
120 N. Main St., Mercersburg, PA 17236
I ~~ PSes911death 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%
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 exem~ 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 0°!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 ra~i.J vposed on the net value of transfers to or for the use of the decedent's siblings is 12°f° [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an
ir~iu~du as at least one parent in common with the decedent, whether by blood or adoption.
t~~ ~U
SCHEDULE E
CASH, BANK DEPOSITS AND MISCELLANEOUS
PERSONAL PROPERTY
Estate of: File Number:
Frankalene Jeanette Scarford 21-07-0266
ITEM VALUE AT
NUMBER DESCRIPTION DATE OF DEATH
1. Share from the Estate of Dennis Scarford, the decedent's father,
for the sale of 18.659 acres of real estate 12,969.28
2. Share from the Estate of Dennis Scarford for the sale of 10.008
acres of real estate 1,617.93
3. Remainder share of the Estate of Dennis Scarford 51,169.91
4. Clear Mountain Bank -checking account 1,611.62
TOTAL 67,368.74
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE COSTS
AND MISCELLANEOUS EXPENSES
Estate of: File Number
Frankalene Jeannette Scarford 21-07-0266
ITEM
NUMBER DESCRIPTION AMOUNT
A. Funeral Expenses:
1. Hoffman-Roth Funeral Home, Inc.- death certificates 67.00
2. Hoffman-Roth Funeral Home, Inc. -funeral expenses 2,292.90
B. Administrative Costs:
1. Personal Representative Commissions
Social Security Number of Personal
Representative: Cynthia J. Albrecht SS# 163-52-8887
Year Commissions Paid 2008 3,368.43
2. Attorney Fees:
Steiger, Steiger and Meyers 3,368.43
3. Family Exemption:
Claimant:
Relationship:
Address of Claimant at Decedent's death
Street Address: City:
State: Zip Code:
4. Probate Fees:
Cumberland County Register of Wills- fee to open estate 53.00
Cumberland County Register of Wills- fee to file inheritance tax return 120.00
C. Miscellaneous Expenses
1. Sollenbergers Messenger Service -notary fees 5123/07 15.00
2. Sollenbergers Messenger Service- notary fees 2127/08 5.00
TOTAL 9,289.76
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
Estate of: File Number
Frankalene Jeannette Scarford 21-07-0266
ITEM
NUMBER DESCRIPTION AMOUNT
1. Department of Public Welfare- claim #470155509 214,784.43
2. Green Ridge Village
380.29
3. Bronstein Jeffries, PA 49.12
TOTAL 214,784.43
R
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO 80X 8466
HARRISBURG, PA 17105-8486
March 13, 2007
CYNTHIA P,LBRECHT
270 MEADOWS ROAD
NEWVILLE PA 17241
Re: JEANETTE BLIZZARD
CIS #: 470].55509
SSN: 233-52-8375
Date of Death: 2/3/2007
bear Ms. Albrecht:
Please be advised that the Department of Public Welfare is attempting to
recover the monetary value of any and all eligible assets in the subject
estate. Although the amount in the~eatate may be considerably less than that
which is owed to the Department, our claim is against the estate, no one
else. Your responsibilities, as the primary next of
kin/administrator/executor, is to advise the Department of any assets in the
estate and to insure that the remaining money, after all funeral and
administrative costs are deducted, is sent to the Department.
The Department of Public Welfare maintains a claim in the amount of
$214,784.43 against the above-mentioned estate. This claim is for
restitution of medical assistance granted on behalf of the decedent for which
the Probate Estate is now responsible to reimburse the Department according
to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95,
e=_ffective June 30, 1995. Enclosed is the Department's itemized statement of
claim.
A portion of this medical expense, namely $13,711.88, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $201,072.55,
is to be entered as a priority Class ~ claim against the estate.
.S~!
Please acknowledge receipt of this letter and advise when payment may be
expected. If the estate accounting is complete, please provide a copy. Tf
the estate contains real estate, please provide copies of the deed, the
latest tax assessment and a current appraisal, if available.
Sincerely,
A
Barbara I. Aschenbrenner
TPL Program Investigator
717-772-6617
717-772-6553 FAX
Eliclosure
SCHEDULEJ
BENEFICIARIES
ESTATE OF: FILE NUMBER
Frankalene Jeannette Scarford 21-07-0266
Item Name and Address Amount or Share
Number of Beneficiary Relationship of Estate
A. Taxable Bequests:
1. Cynthia J. Albrecht Daughter The estate is insolvent.
270 Meadows Road
Newville, PA 17241
B. Charitable and Governmental Bequests:
None
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS $000.00