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Home My WebLink About08-04-0815056041147 -~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 8 0119 PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Bifth 196 14 1325 O1 18 2007 09 06 1919 Decedent's Last Name Suffix Decedent's Firsi Name MI STEVENS JEANNETTE H (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 X^ 1. Original Return ^ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ^ qa, Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) X 6 Decedent Died Testate ~ Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes ^ (Attach Copy of Will) ^ (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 1 p, 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 TO: Name Daytime Telephone Number WAYNE M PECHT 717 691 9809 rv Firm Name (If Applicable) PECHT & ASSOCIATES, PC First line of address 1205 MANOR DRIVE, SUITE 200 Second Ilne of address City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent'se-mail address: Wpecht@pechtlaW.COm REGISTER (3F:.LS USE~ILY - } rr t ~_ ~ ., . ' '~' i r- - : is '.; ~ _v ~, --I ~ DATE FILED '~ Under penalties of perjury, 1 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~~~~~~~_ Holly Handley ~ ~3v ~-~ ADDRESS 465 Spruce Road, New Cumberland, PA 17070 SIGNAT RE PREP ~RER OT R TH~f N REPRESENTATIVE DATE w / (// 4.~-/~ Wayne M Pecht 7 ~ 30~OR ADDRESS ~ 1205 Manor Drive, Suite 200, Mechanicsburg, PA 17055 Side 1 15D56041147 15056041147 v. v •`"' ~ <_ ~so~6n4~y4~ REV-1500 Ex t7eeedenPs SOCial Beautify Number oeeoev,i~ar~rrre: Jeannette Huth Stevens 19 6 ~.4 13 2 5 RECAPI'~JLA'TtON 1, Real Estate (Schedute A) .......................................................................................... 1. 2. stocks and sonde (schedule a} ................... ~ 8 7 . 7 0 9.71 3. Closely Held Corporation, Partnership or Sole•Proprietorshfp (Schedule C)........,, 3, 4. Mortgages & Notes Receivable (Schedule Q).....,.,, 4 5. Cash, Bank Deposits 1~ Miscellaneous Personal Property (schedule E) ................ 5, 15,241.$7 8. Jointly Owned Property (Schedule F) Q SeparatQ Billing Requested,,,,,,,,,,,,, 6. ~ r ~ S 8 ' ~ 1 7. Inter-Vivos Transfers & MlsceHanecus Non-Probate Property (Schedule G) ~ Separate Billing Requested,,,,,,,,,,,,, 7- 1 ~ , 6 Z 3 . 0 5 8. 'Total Gross A59ets (total Lines 1-7) ............................................... g 1 2 2 , S ~ ~ . 7 4 9. Funeral t_xpenses & AdministratiVe Casts (schedule N) ......................................... 13. 8,630.83 1Q, petits of Decadent, Mortgage Liabllltle9, & Liens (schedule l) ................................ 10. 2,05D.59 11, Totat Deductions (total Lines $ ~ 10)....°....,, 11 1. ~ r ~ ~ 1 , 4 ~ 12. NetVatue of Estate (Line 8 minus Line 11). 12 1 1 1 , 8 fi ~. , 3 2 13. Charitable and GCnrernmental Beque3t3JSec 9113 Trust3 for which an election to tax has not been made (3chedute J) ................................................. 93, 14. Net Value Su6JeGt to T$x (Line 1~ nlinu3 Line 13) . .......................... .................... 14. TAX trOMPUTgTION • 5EE INSTRUCTIONS FOR APPLICABLE RATF.,S 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.z) x .oo Q , D 0 15 16. Amount of Line 14 taxable ~ ~ 1 1 ~ ~ ~ Z it3 ax meat rate x ,045 ~ • , 17. Amount of Line 14 taxabte at sibling ra6e X .12 D D 0 17. 18, Amount of Liter 14 taxable at oallaterat rate X .15 D ~ p 0 1 t3. 19. Tax Due ..................................................................... ................................................ 19. 20. FILL IN THE OPAL IF YOU AR>; REQUESTING A Rt:FUND OF AM f~VERPAYMENT. 111,861.32 0,00 5,033.7G 0,00 0.00 5.033.76 l~ Side 2 ~, 15175604,~b4l5 Z5tlStal]N2148 J Rev-1503 EX+ (8.98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT pECEDENT ESTATE OF (FILE NUMBER Stevens, Jeannette Hull 21-08-0119 All property Jolntlyvwned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 MidFirst Bank GNMA Pool #33236 CD Certificate 20.85 #522540SF -Per total of checks received from DOD to final check received upon certificate surrender and letter from Midland Mortgage that certificate was paid in full as of 5/15/08 2 670928100 Nuveen Municipal Value Fund Inc -Account 41,635.38 #000000598764 2000 Shares Comon Stock Par Value $0.01 per Stock Certificate DOD Market Value per Nuveen Investments Distribution Statement 3 Oppenheimer Money Market Funds Account 6,258.25 #A09-0261700 -DOD Value calculated per Oppenheimer Statement of Account dated 1/31/08 4 842587107 Southern Company Account #386892 -1043.6725 39,795.23 Shares of Common Stock of unknown Par Value - Mean DOD Market Value per E`Trade and Southnern Company Historic Stock Look Ups TOTAL (Also enter on Line 2, Recapitulation) 87,709.71 (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 B (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 FILE NUMBER Stevens, Jeannette Hull 21-08-0119 Include the proceatls of litigation and the date the proceeds were received by tha estate. All property jolMly-owned with the right of survlvonthlp must be dlaclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Belco Community Credit Union Certificate #53073 -DOD value per letter from Belco 10,074.74 2 Belco Community Credit Union Certificate #53074 -DOD value per letter from Belco 5,036.47 3 Genworth Financial Long Term Care Policy #HFN6439271 -Return of unearned 130.26 premium per letter from Genworth and ck #1300106098 TOTAL (Also enter on Line 5, Recapitulation) I 15,241.47 (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-7509 E7(+ (6-98) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Stevens, Jeannette Hull 21-08-0119 If an asset was made joint within one year of tha decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Holly Handley ADDRESS 465 Spruce Road New Cumberland, PA 17070 RELATIONSHIP TO DECEDENT B. C JOINTLY OWNED PROPERTY: Child ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND HANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 Belco Community Credit Union Jt 13,934.42 50.000% 6,967.21 Checking Account #830620 -Established jointly w/daughter, Holly Handley, 10/2000 DOD total value of $27,868.84 per letter from Belco 2 Belco Community Credit Union Jt 2.60 50.000% 1.30 Savings Account #830620 - Estabished jointly w/daughter, Holly Handley, 9/7/2000 with DOD total value of $5.19 pe letter from Belco TOTAL (Also enter on Line 6, Recapitulation) I 6,968.51 (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+ (5.981 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Stevens, Jeannette Hull 21-08-0119 This schedule must be completed and filed it the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER R P N F INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Belco Community Credit Union Certificate 15,120.73 100.000 3,000.00 12,120.73 #53075 -Established jointly w/ daughter, Holly Handley 11/2007 DOD total value per letter from Belco 2 Belco Community Credit Union Money Market 502.32 100.000 502.32 Account #830620 -Established jointly w/daughter, Holly Handley, 7/2007 DOD total value per letter from Belco TOTAL (Also enter on Line 7, Recapitulation) I 12,623.05 (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) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Stevens, Jeannette Hull 21-08-0119 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached 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 Pecht 8~ Associates, PC 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 2,837.31 5,000.00 4. Probate Fees 330.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 190.00 See continuation schedule(s) attached 7. Other Administrative Costs 273.52 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 8,630.83 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (8.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-A FUNERAL EXPENSES continued ESTATE OF FILE NUMBER Stevens, Jeannette Hull 21-08-0119 ITEM NUMBER DESCRIPTION AMOUNT 1 Auer Memorial Home 8~ Cremation Services, Inc. -Cremation and related fees 1.380.00 2 Holly Handley -Reimbursement for expenses incurred for Celebration of Life 773.33 3 Mike Sim -Reimbursement for expenses incurred and services performed for 188.66 Celebration of Life 4 Robert Sim -Reimbursement for expenses incurred and services performed for 495.32 Celebration of Life Subtotal ~ 2,837.31 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-15U2 EX+ (6-98t SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Stevens, Jeannette Hull 21-08-0119 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills -Petition, Will, Short Certificates, Inventory, 280.00 Renunciation, and other fees 2 Cumberland County Register of Wills -Filing fees for Pa1T, Inventory @ $20 each 30.00 3 Cumberland County Register of Wills -Family Settlement Agreement filing fee 20.00 Subtotal ~ 330.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev-1502 EXt {6-98) SCHEDULE H-B6 TAX RETURN PREPARER'S FEES COM~AONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF (FILE NUMBER Stevens, Jeannette Hull 21-08-0119 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B5 (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continue RESIDENT DECEDENT ESTATE OF FILE NUMBER Stevens, Jeannette Hull 21-08-0119 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-67 (Rev. 6-98) Rev-1572 EX+ (8.98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF (FILE NUMBER Stevens, Jeannette Hull 21-08-0119 Include unn3imbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Alert Pharmacy -Prescriptions 89.01 2 Capital Area Health Associates - Medical bill 75.18 3 Community Life Team EMS -Emergency transport to Harrisburg Hospital 12/28/08 60.00 4 Discover Card -Outstanding charges on credit card 74.20 5 Messiah Village -Final rent payment 1,741.57 6 Verizon -final telephone bill 10.63 TOTAL (Also enter on Line 10, Recapitulation) 1 2,050.59 (If more space is needed, additional pages of the same size) 1 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) SCHEDULE J COMMNHER TANCE TAX RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Stevens, Jeannette Hull 21-08-0119 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trustee s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Holly Handley Daughter 55,742.29 465 Spruce Road New Cumberland, PA 17070 George M Stevens Son 55,742.29 9ti07Cain Drive NE Warren, OH 44484 Total 111,484.58 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropri ate, on Rev 1500 cove r 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ U.Uu Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF JEANNETTE HULL STEVENS I, JEANNETTE HULL STEVENS of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I - T direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. IT - I bequeath my tangible personal property, not including cash and securities, to my daughter, Holly Stevens Handley. Should my said daughter predecease me, I bequeath my tangible personal property to my son, George Myron Stevens. III - I devise any interest in real estate which I own at the time of my death to my daughter, Holly Stevens Handley, if living; and if not, to my son, George Myron Stevens. IV - T devise and bequeath all the rest, residue and SAIDIS, GUIDO, SHUFF & MASLAND 2109 Mazket Street Camp Hili, PA remainder of my estate of whatever nature and wherever situate unto my two children, Holly Stevens Handley and George Myron Stevens, in equal shares. Should either- of them be deceased, his or her share shall be paid to the one who is living. If both of my children are deceased, then I direct that the residue shall be divided among my grandchildren who are living at the time of my death. ~___ Page 1 V - I appoint my children, George Myron Stevens and Holly Stevens Handley, Co-executors of this, my Last Will and Testament. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the l ~ ~ day of ~ , 1996. Jeannette Hull Stevens Signed, sealed, published and declared by JEANNETTE HULL STEVENS, Testatrix therein named, on this and one (1) other sheet of paper as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address SAIDIS, GUIDO, SIIUFF & MASLAND 2109 Market Street Camp Hill, PA Page 2 COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. /~ Testatrix SAIDIS, GUIDO, SIiUFF & MASLAND 2109 Market Street Camp Hill, PA G~?bscribed, sworn to and acknowledged before me by the testatrix,-and sub cribed and savor to before me by both wit- nesses, this /,Z~ day of , 1996. otary Public Nt)TARlAt. SEAL THELMA S. McCAt15UPV, Motary Public Camp bill, Cumberland County My Commission Expires July 3,1996 H b a (~ N O }}~~ «~ N V ~ ( l D o t ~.,~ xry~, N x ~~~r.~ ~ )~ ~. tJ2 ~- ~ ~ , U1 ~ { ' -~- ~ C~ `T'`` ~1''l'' `~ `~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } :v COUNTY OF Cumberland } SS File Number 0119 ~ ~~ Holly Handley ~ ~ ~~ -~:, Personal Representative(s) of the Estate of Jeannette Hull Stevens - _~ ~-~ ~~ :,_~ :- _ .ilk ~ deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personaC'as~e~ wherelver situate and all of the real estate in the Commonwealth of Pennsylvania of saki Decedent, that the valluation'p!Q'eed'dpposlte~each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owne~jo real es,~t~te outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of th{s~ inventory. I verify that the statements made in this Inven- ~ ~ N tory are true and correct. I understand that false state- ments herein are made subject to the penalties of ~ Holly andley 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Firm) (Address) (Telephone) Wayne M Pecht Pecht 8~ Associates, PC 1205 Manor Drive, Suite 200, Mechanicsburg, PA 17055 717-691-9809 (Supreme Court I.D. No.) 38904 DATE OF DEATH I LAST RESIDENCE 317 Messiah Circle DECEDENTS SOC. SEC. NO. 01/18/2007 Mechanicsburg, PA 17055 196-14-1325 FIGURES MUST BE TOTALED Personal Prouerty Cash ............................................................................................... 15,241.47 Personal Property ......................................................................... Stocks/Listed ................................................................................. 87,709.71 Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... 102,951.18 Totat Real Property ................................................ Total Personal and Real Property ......................... 102,951.18 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-09 Rey. ~a~s-zoos V/v~