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Home My WebLink About09-11-0815056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2sosol 2 1 0 6 0 8 4 9 Harrisburg, PA 17128-oEio1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 191 40 8907 06 10 2006 Decedent's Last Name HOY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Date of Birth 09 04 1948 Suffix Decedent's First Name MI CAROL L 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 Return 0 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) 8 Decedent Died Testate ~ ~ Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Povertyy Credit (date of death ~ 11.Election to tax under Sec. 9113(A) between 1231-91 and i-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 EDWARD P. SEEBER 717 53~~280~~, Firm Name (If Applicable) ' _~CC~~ tt~~--rr~~ ~, REGISTER OF']Atl~s USEt~NLY > JAMES, SMITH, DIETTERICR & ::.r-r-; _ <-~ -, First line of address `-%~ ~ '.~ 1 ~ :1' ("~, _. SUITE C-400, 555 GETTYSBURG ~-J~ ~' ~ _' Second line of address .} ~ •- .- : "~ ~.J City or Post Office State ZIP Code ~ DATE FILED MECHANICSBURG PA 17055 Correspondent'sa-mail address: epS~jSdC.C017t 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. George W. Hoy 4 1110 E~¢t Coover Street, Mechanicsburg, PA 17055 IIGNATU~~FER OTHER THAN REPRE~.W~ltTIUE DATE Edward P. Seeber a~~~o C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 Side 1 15056041147 15056041147 J M,~ - o' ~Itl) ~o ~~ 15056042148 REV-1500 EX Decedent's Social Security Number Decedent's mama: C a r o I L. Hoy 19 1 4 0 8 9 0 7 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 De osits & Miscellaneous Personal Pro e p p rty (Schedule E) ................ 5. 4 0 0 , 0 0 0 . 0 0 6. Jointly Owned Property (Schedule F) ~ 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, 4 0 0, 0 0 0. 0 0 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 1 2 3, 4 9 2 8 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total lines 9& 10) ...................................................................... 11. 1 2 3, 4 9 2 8 9 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 7 6 , 5 0 7 1 1 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. 2 7 6 , 5 0 7 1 1 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.oo 276, 507.11 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16• 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18• 0. 0 0 19. Tax Due ..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-06-0849 DECEDENT'S NAME Carol L. Hoy STREET ADDRESS 1110 East Coover Street CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A, Spousal Poverty Credit g, Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable p, Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 0.0 0 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g) ~ . 0 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 .................................................................................................................. ^ x^ 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? ....................................................................................................................... ^ x^ 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? ...................................................................................................................... ^ 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. ,~ ., -, E ,..,. .. ~ .. a ~- _ 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 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 )]. 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+ (8.98) SCHEDULE E CASH, BANK DEPOSITS, 81: MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Hoy, Carol L. 21-06-0849 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly Jolntlyowned with fhe right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Civil litigation proceeds -matter docketed to the Court of Common Pleas, Cumberland County, PA at No. 08-3012 -Civil Action Law all attributed to the survival action -settlement proceeds received on or about 8/19/08 400,000.00 TOTAL (Also enter on Line 5, Recapitulation) I 400,000.00 (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 E (Rev. 6-98) REV-1151 EX+(12-99) gC1~lEDULE FI FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Hoy, Carol L. 21-06-0849 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: 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 James, Smith, Dietterick ~ Connelly, LLP 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. I Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 1,000.00 365.00 7. Other Administrative Costs 122,127.89 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 123,492.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1502 EX+ (8.88) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN contl n ue RESIDENT DECEDENT ESTATE OF FILE NUMBER Hoy, Carol L. 21-06-0849 ITEM NUMBER DESCRIPTION AMOUNT 1 Dabney, Carr, Troutman, Sanders, LLP -attorney fees attributed to survival action 12,000.00 2 Edward P. Seeber, Esquire -attorney fees attributed to survival action 36,000.00 3 Register of Wills, Cumberland County -filing fee for supplemental Return & 30.00 Inventory 4 Schmidt Kramer -attorney expenses attributed to survival action 2,097.89 5 Schmidt Kramer -attorney fees to survival action 72,000.00 Subtotal ~ 122,127.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV-1513 EX+ (g.p0) SCHEDULE J COMMNHER TANCE TAX RETURN ANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER noy, carol ~. 21-06-0 849 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not Llst Trus s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal dlstnbutlons, and transfers under Sec. 9116(a)(1.2)] 1 George W. Hoy Spouse Residue 276,507.11 1110 East Coover Street Mechanicsburg, PA 17055 Total 276,507.11 Enter dollar amounts for distributions shown above on lines 1 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 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ,. , ~,; , ~. ~ .. •~a ~`~' ~M ~:.~ ~: w~ .r, O ~, N .~ ~ ..~ ~ ~A O U ~ ~~~~ ~. cis o ~ ° ~ U ~ r" ~ ~ w ~~a ~ i ~ ~~o ~ ~ U C7 U .~ U c ~_ ~ Q c.a a a:. p- September 10, 2008 T ~..w~ Glenda Farner Strasbaugh, Register of Wills ESTATE Cumberland County Courthouse SECURITY 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Carol L. Hoy, deceased File No. 2006-00$49 Cheryl L. Baker, CP Certified Paralegal clb@jsdc.com Dear Ms. Farner Strasbaugh: Enclosed are an original and two (2) copies of the Pennsylvania Inheritance Tax Return and Inventory to be filed in the above-referenced Estate, along with a check for Thirty Dollars ($30.00) representing the filing fee. Please time-stamp the extra copies and return them to me in the enclosed self-addressed, stamped envelope. If you have any questions, please feel free to contact me. Very truly yours, ;-.~ LLP DIETTERICK & CONNELLY .TAMES SMITH ~ ~ - ` ' _` , , , a ~ , ~ _ J --~ ~ '.~ ~ L. er, CP ~, ~ :~ _ c Certi d Paralegal ~~ ~ ~ ~ -~ =" ;~ .-_ ~-; Enclosures ,~ "`~ ~- ~ . 00 cc: George W. Hoy, Executrix 134 SIPE AVENUE HUMMELSTOWN, PA 17036 Reply to: SUlte C-400 MAID ION BOADDROESS 555 Gettysburg Pike HERSHEY, PA 17033 PA 17055 Mechanicsburg roLL PREE 1.aoo eaz 3sso , Direct Dial: 717-298-2094 FAx ~, zs33 i780 Direct Fax: 717-298-2095 ~ ~W.;Sd°.°°m