HomeMy WebLinkAbout06-18-08 (2)1505605105$
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 21 O8 0486
_ Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
04/10/2008 ' 01/22/1920
__ _.._
Decedent's Last Name Suffix Decedent's First Name MI
HEDGES MARGARET
(IF Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
E~pouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
__ _ _ REGISTER OF WILLS
FULL IN APPROPRIATE OVALS BELOW
N~ 1. Original Retum """ ~+ 2. Supplemental Return ;~i 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ,_~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
"Yµ- 6. Decedent Died Testate ~s 7. Decedent Maintained a Living Trust _. .............. B. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
;;;„;= 9. Litigation Proceeds Received ~.~ 10. Spousal Poverty Credit (date of death ~,,...., 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
1•HOMAS E. FLOWER ', (717) 737-3405
__ _
Firm Name (If Applicable)
.. _ _ _ ___ _. _ __ _ _c.~ _
_ c-~ _..._...._ _._._c.-.7
REGISTER OFiIV S USE Ot~
•
SAIDIS, FLOWER
LINDSAY ~~
r
First line of address
__ _..
2109 MARKET STREET --? C.J
f., e
Second line of address
_. _.. _ __
__.._. _._
.,
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I -' ~ W
I DAi~FILEO
Ci1:y or Post Office State ZIP Code ~------ - -----~- ------------[!€~
_. _....._.__ _ _........... _ .. .. .......... __.._._ _......_.._..._ G17
CAMP HILL ' PA ` 17011
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Correspondent's a-mail address: tflOWef@Sfl-12W.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.
SIGG~t~BT,IJ~ OF PARSON R~ ONSIBL`E FOR FILING RETURN ~j~ / D~AjTE//
Af1flO CCC / TT
ELIZABETH BULOTA, 325 WESLEY DR., APT. 3209, MECHANICSBURG, PA 17055
SI'1 /nn~ARE~R O~THEg~'/~4~yREPRESE~NT•ATIVE ~ ,pqt'~
SAIDIS, FLOWER & LINDSAY, 2109 MARKET STREET, CAMP HILL, PA 17011
PLEASE USE ORIGINAL FORM ONLY
15056051058
Side 1
15056051058•
`7~
REV-1500 EX
Decedent's Name: MARGARET
RECAPITULATION ~~~ ~~~~
15056052059
1.
Real estate (Schedule A) ..........................................
... 1. __
2. Stocks and Bonds (Schedule B) .................................... ... 2. 35,592.62
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3.
4. Mortgages 8 Notes Receivable (Schedule D) .......................... ... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 73,155.40
6. Jointly Owned Property (Schedule F) ~.__.3'" Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property `~ ° -'._~ ' -" "
(Schedule G) ~ Separate Billing Requested..... ... 7.
8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 108,748.02
9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 9,008.56
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. I 1,360.39
11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 10,368.95
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 98,379.07
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. 98,379.07
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) X .0_ 15.
16.
Amount of Line 14 taxable ". .___ -_ _ __.,_.._. ~._ ".~"... . .,._.."a _.,...,
'""""
at lineal rate X .0 _ 16. ~I
17. Amount of Line 14 taxable
at sibling rate X .12 9$,379.07
17, 11,805.49
18. Amount of Line 14 taxable
at collateral race X .15 18. I
19. TAX DUE ........................... .............................. 19. ! 11,8
VAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
C
15056052059
REV-1500 LX Page 3 Ffle Number
Decedent's Complete Address: 21 08 o48s
DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER
MARGARET HEDGES
STREETADDRESS
325 4NESLEY DRIVE
CITY ~ STATE I Zip
MECHANICSBURG ~ PA I 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 11,805.49
2. Credit:slPayments
A. Spousal Poverty Credit
B. Prier Payments 11,215.23
C. Discount 590.26
Total Credits (A + B + C) (2) 11,805.49
3. Interest/Penalty if applicable
D. Interest '`
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4} 0.00
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) 0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (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 :.......................................................................................... ^
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ ^x
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ ^x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................
................................................................. ^ ^x
3. Did decedent own an "intrust fora or payable upon death bank account or security at his or her death? .............. ^ ^x
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 ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after Juiy 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 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. §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)J.
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)]. Asibling is defined, under
Section 9102, as an individual who has at feast one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX+ (6-98) ~
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NtlMBER
MARGARET HEDGES 21-08-0486
All property jointly-owned with right of survivorship must be disclosed on Schedule f.
(If more space is needed, insert additional sheets of the same size)
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REV-1508 EX+ (6-98) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FfLE NUMBER
MARGARET HEDGES 21-08-0486
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.
ITEM VALUE AT DATE
NUN~BER DESCRIPTION OF DEATH
1 REFUND, ASBURY COMMUNITIES, INC. -UNEARNED ROOM & BOARD CHARGES 18,191.45
2 M&T BANK CHECKING ACCT. N0.65406370 18,583.05
3 M&T BANK CHECKING ACCT. N0. 950205958 36,380.90
TOTAL (Also enter on line 5, Recapitulation) $ 73,155.40 ;
(If more space is needed, insert additional sheets of the same size)
r -~~ NI&T Banlc
STATEMENT PERIOD PAGE
MAR.22-APR.22,2008 1 OF 3
00 0 06123M NM I17
6038
MARGARET HEDGES
2800 RUSSELL RD
CAMP HILL PA 17011-2140
SELECTED ACCOUNT-SUMMARY
ACCOUNT' ACCOUNT INTEREST EARNED MATURITY ENDING
TYPE NUMBER YEAR-TO-DATE DATE BALANCE
RELATIONSFfIP CHECKING WITH INTEREST 000000065406370 2.g4
M8T PREMIUM INTEREST 000000950205958 13.93
TOTAL DEPOSITS
18,570.13
26,906.42
45,476,55
ACCOUNT MARGARET HEDGES
RELATIONSHIP CHECKING WITH INTEREST TITHE
ACCOUNT N0. 65406370 WEST SHORE PLAZA
INTEREST EARNED FOR STATEMENT PERIOD 0.79
ACf'f111NT CIIMMARV
$EGINNING
BALANCE DEPOSITS '8
OTHER ADDITIONS
CHECKS PAID OTHER
SUBTRACTIONS CURRENT.
INTEREST PD ENDING
BALANCE
N0. AMOUNT N0. AMOUNT N0. AMOUNT
17,613.83 2 979.02 2 23.52 D 0.00 0.80 18,570.13
ACCf111NT ACTTVTTV
POSTZNL'
DATE
TRANSACTION DESCRIPTION DEPOSITS,ZNTEREST
8 OTHER ADDITIONS CHECKS 8 OTHER
- SUBTRACTIONS - DATLY
BALANCE
03-22-08 BEGINNING BALANCE 517,613.83
03-25-08 CHECK NUMBER 1800 9.80 17,604.03
04-02-08 DEPOSIT 93.02 17,697.05
04-03-OS US TREASURY 303 SOC SEC 886.00 18,583.05
04-21-OS CHEECK NUMBER 1802 13.72 18,569.33
04-22-08 INTEREST PAYMENT 0.80 18,570.13
ENDING BALANCE 518,570.13
CHECKS PAID SUMMARY
1800 Oii-25-08 9.80 1802* 04-21-08 13.72
ANNUAL PERCENTAGE YIELD EARNED = 0.04
LOOBA (6/07)
I~1 ~/I&T Banlc
STATEMENT PERIOD PAGE
MAR.22-APR.22,2008 2 OF 3
MARGARET HEDGES
ACCOUNT MARGARET HEDGES
M&T PREMIUM INTEREST TITLE.
ACCOUNT N0. 950205958 WEST SHORE PLAZA
Af'f'f1111JT CIIMMAI~V
BEGINNING
BALANCE DEPOSITS $
OTHER ADDITIDNS
CHECKS=PAID OTHER
SUBTRACTIONS CURRENT
INTEREST PD ENDING
BALANCE
N0. AMOUNT N0. AMOUNT N0. AMOUNT
58,1556.11 1 1,652.99 5 33,404.55 0 0.00 1.87 26,906.42
Af'f f111NT Af TT\/TTY
POSTING
DATE
TRANSACTION DESCRIPTION DEPOSITS,INTEREST
8 OTHER ADDITIONS- CHECKS & OTHER
SUBTRACTIONS DAILY
BALANCE
03-22-08 BEGINNING BALANCE 558,656.11
03-26-08 CHECK NUMBER 0344 9,792.70 48,863.41
03-31-08 PA TREASURY DEPT ANNUITANT 1,652.99 50,516.40
04-08-08 CHECK NUMBER 0347 1,000.00
04-08-08 CHECK NUMBER 0346 500.00 49,016.40
04-09-08 CHECK NUMBER 0349 12,635.50 36,380.90
04-15-08 CHECK NUMBER 0350 9,476.35 26,904.55
04-22-OS INTEREST PAYMENT 1.87 26,906.42
ENDING BALANCE 526,906.42
- CHECKS PAID. SUMMARY
344 ID3-26-08 9,792.70 346* 04-08-08 500.00 347 04-OS-08 1,000.00
349* ID4-09-08 12,635.50 350 04-15-08 9,476.35
ANNUAL PERCENTAGE YIELD EARNED = 0.04
~* END OF STATEMENT ~*
L008A (8/07)
1V!&1 ~IlK
ACCOUNT PAGE
000000065406370 3 OF 3
MARGARETHEOGES a~6 1800 MARGARET NEOGES oa-se 1802
,2e WESLEY OFi. NO. Z] a
IYEC:MANIC5911fl0. PA 1]065 Da]-~ ~- ~d ~' ~('/ ~~Snl~ ]ZS WESLEY DR NO. 2r
MECNADrIL$BUAG. PA 11055 Bltf~ ' // ~/ / U
U= _7-. _ ~ W'N~IUI]
LLL Sl]t
~I
P,u iomEl 17lYyr„(~~/1 =~ I $ 9 SO
oxnut u~ +~ Q
_ 4~KUi.xnti Gc1~Iil~n~\J'-~~~i= $ /
- 7` ---- 3• 7~
! / "`~~-` 3'~3L Df1LL /lLi 8 .~
AllFrsc Bank
al}first ~~>;~~
IIF.acrnm
0 3 1 3008 3 41: 654o637Du• ~i800 - ~~,.. IhnLtn~ 8
All[ c Bank
®al}first ",`w°,~~«~
w Il finaau
~ /:0313DD83~.1: 654D637D~~' ,~180z r'OOpOg0;~72.~'
Check 1i18DD Paid :03/25/2008 9.BOCheck M1802 paid :09/21/2008 13.72
REV-1511 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~c
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MAF:GARET HEDGES 21-08-0486
Debts of decedent must be reported on Schedule I.
ITEM
NUf,ABER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' BETHANY VILLAGE MEMORIAL SERVICE 40.00
2 WEST LAUREL HILL CEMETERY CO, MONUMENT AND BASE 2,150.00
s. WEST LAUREN HILL -BURIAL CONTAINER 525.00
a. WEST LAUREL HILL -GRAVE OPENING AND CLOSING 900.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)IEIN Number of Personal Representative(s)
Street Address
City .state Zip
Year(s) Commission Paid:
2. Attorney Fees 5,000.00
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 136.00
5. Accountant's Fees
6. Tax Retum Preparer's Fees
~. :PUBLISH EXEC'S NOTICES, SENTINEL (182.56); CUMBERLAND LAW JOURNAL (75) 257.56
TOTAL (A{so enter on line 9, Recapitulation) $ 9,008.56
(If more space is needed, insert additional sheets of the same size)
REV-1!i12 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
sc~EDU~E ~
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
MAI~GARET HEDGES 21-08-0486
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
(1f more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARGARET HEDGES 21-08-0486
i RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER 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 ELIZABETH BULOTA, 325 WESLEY DR., #3209, MECHANICSBURG, PA 'SISTER 100°!°
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LONE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
;~t„~
I, MARGARET HEDGES, do make this my Last Wiil and
Testament, hereby revoking all Wills and Codicils which I have
heretofore made.
FIRST: I give, devise and bequeath my entire
estate, real and personal, to my parents, WILLIAM E. HEDGES and
ELIZABETH HEDGES, share and share ali~;.e or to the survivor of
them.
SECOND: If both of my parents predecease me, or if
neither is living on the thirty-first day after my death, I give,
devise and bequeath my entire estate, as aforesaid, to my sister,
ELIZABETH HEDGES BULOTA. If my said sister predeceases me; I
give, devise and bequeath tree same to her descendants, per stirDes
_r F,D: I nominate; constitute and appoint my niece,
GAT-, r1\TT\ W'j~LDE~v aS E~ecutrl~_ O-~ ti"11S ~i~? last ii ~ ~ 1 and 1eStalent
and I d=reef than She shall not be ~eauired to enter recur-~~v ~_~
any jurisdiction i?7 which she riay act .
IId W~ ESS WHEREOF, I have hereunto set ~y hand
and seal this ,~ ~- day of ~~~~, A.D. 1980.
(SEAL)
SIGNED, SEALED, PUBLIS~iED AND DECLARED as and for
the last Will. and Testament of the above named Testatrix, in the
presence of us, who; at her request, in h:er presence, and in the
presence of each other, have hereunto .subscribed our names as
at jesting witnesses.
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