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Home My WebLink About10-08-08 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.2soso~ 2 1 0 8 0 10 5 Harrisburg, PA 77128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 191 12 2709 O1 13 2008 12 20 1923 Decedent's Last Name Suffix Decedent's First Name MI PATTON JEAN C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 15056041147 ,' 9. Litigation Proceeds Received ~ 1 p, Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) 1__I 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 MICHAEL L. BANGS 717 730 7319~a -~ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Imo, 1. Original Retum n 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) I 4. Limited Estate ~ 4a. Fuwre Interest Compromise ~ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) 6 Decedent Died Testate ~~ { Decedent Mamtained a Living Trust 8. Total Number of Safe Deposit Boxes -~ (Attach Copy of WiIQ LJ (Attach Copy of Trust) Firm Name (If Applicable) First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office CAMP HILL Corcespondent's a-mail address: Under penalties of perjury, I dec~re that I ADDRESS including accompanying schedules and statements, and to the best of my knowledge and belief, personal representative Is based on all information of which preparre~r has any kn/owledge. David E. Patton iO~~/~ S1 5905 Westover Drive, Mechanicsburg, PA 17055 NATURE OF PREPARER OTHER T R ESENTATIVE DATE ~~„~~ • ;'' Michael L. Bangs ~~ ~~ ~~ f;- ' ADDRESS ~ ~ { ~ 429 South 18th Str ~, Camp Hill, PA 17011 State ZIP Code PA 17011 --, . ~ REGISTER OF~VfIILLS US~'IDNLYr^ - ~"} --~ T'i E~ ....1 ~a ~y `~ r DATE FILED ~'~ ~!..~ ,~~ '~ ..' _? ~--~ _-~ '-~ .,: y Side 1 15056041147 15056041147 J 15056042148 REV-1500 EX Decedent's Social Security Number Decedent's Nerve: Jean C. Patton 1 9 1 12 2 7 0 9 RECAPITULATION 1. Real Estate (Schedule A) ........................................................................................ .. 1. 2. Stocks and Bonds (Schedule B) ............................................................................. .. 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C)........ .. 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ .. 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5. 176,859.99 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) ...................................................................... . g, 1 7 6, 8 5 9 9 9 9. Funeral Expenses & Administrative Costs (Schedule H) ........................................ . 9. 15,933.07 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10. 2,760.24 11. Total Deductions (total Lines 9 & 10) .................................................................... .. 11. 18,693.31 12• Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 1 5 8 , 16 6 . 6 8 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. 158,166.68 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 .00 0. 0 0 15. 0 0 0 16. Amount of Line 14 taxable 15 8 , 1 6 6 6 8 at lineal rate X .045 1s. 7 , 117.5 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. 7 , 1 17.5 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 15056042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0105 DECEDENT'S NAME Jean C. Patton STREET ADDRESS 417 Parkside Road CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 7,117.50 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 6,900.00 C. Discount 355.88 Total Credits (A + B + C) (2) 7, 255.88 3. Interest/Penalty if applicable p. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 1 38.38 Check box on Page 2 Line 20 to request arefund --- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 :.................................... ^ ^ 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?......... ^j ^ 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 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-1506 EX+ (6-98) SCNEDrJLE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Patton, Jean C. 21-08-0105 InGude the proceeds of litigation and the date the proceeds were received by the estate. All propeRy jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Fidelity Mutual Life Insurance -distribution 1,231.79 2 IRS Stimulus payment 600.00 3 Refund -Refund from IRS (2007 individual income taxes) 1,128.00 4 Refund -Refund from Verizon Wireless 140.95 5 Refund from Continental Casualty Company -policy cancellation 154.01 6 Refund from Nationwide Insurance -policy cancellation 111.60 7 Refund from The Woods 1,750.00 8 Sale of 1998 Buick Century 4,300.00 9 Sale of miscellaneous personal property 622.67 10 PA State Employees Credit Union -Money Market Account 164,407.16 11 PA State Employees Credit Union -Savings Account 33.55 12 PNC Bank -Account #5140048658 2,380.26 TOTAL (Also enter on Line 5, Recapitulation) I 176,859.99 (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+t12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Patton, Jean C. 21-08-0105 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 David E. Patton Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 5905 Westover Drive city Mechanicsburg state PA zip 17055 Year(s) Commission paid 3,388.38 7,000.00 2. Attorney's Fees Michael L. Bangs 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 5,000.00 4. Probate Fees 300.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 244.69 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 15,933.07 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (8-98) SCHEDULE H-A FUNERAL EXPENSES continued COMr10NWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Patton, Jean C. 21-08-0105 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1602 E7(~ (6-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMdONWEALTH OF PENNSYLVANIA continued INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Patton, Jean C. 21-08.0105 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1612 E7(+ (8-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Patton, Jean C. 21-08-0105 Include unrelmbunsed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Associated Cardiologists 68.38 2 Chase Cardmember Services 3.36 3 CNA Iltc. CCC 184.31 4 Commonwealth Ann. 10.73 5 John Stewart -miscellaneous services 20.00 6 Kilmore Eye Associates 34.56 7 Nationwide Insurance 65.10 8 PAWC 5.08 9 PNC Bank -cancelled check return fee 2.00 10 PP8~L 6.87 11 Public School Employees Retirement System -Return of January 2008 payment 376.01 12 Refund to State Employees Retirement System 463.13 13 Smart Move Makers, Inc. 965.79 14 Talbots 321.52 15 Verizon 65.43 16 Verizon Wireless 167.97 TOTAL (Also enter on Line 10, Recapitulation) I 2,760.24 (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+ (8.00) SCHEDULE J ANIA COMM TA BENEFICIARIES NHERI NCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Patton, Jean C. 21-08-01 05 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Llst Trustee a I. TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers , under Sec. 9116(a)(1.2)] David E. Patton Son One-half 5905 Westover Drive Mechanicsburg, PA 17050 Edward K. Patton Son One-half 4832 Bass Point Road Orlando, FL 32820 Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet III 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) February 20, 2008 Bangs Law Office 429 South 18''' St Ca-np Hill, PA 17011 Attn: Michael Bangs Re: Jean Patton, Deceased. PSECU Account # 8001075939 Dear Mr. Bangs: The account was opened on October 10, 1985. The Share accounts were held solely by Jean C Patton. Visa loan was held individually by Jean C. Patton. The following are the Date of Death Balances for Ms. Patton's account with PSECU: Account Date of Death Balances Interest (1/1/08 to 1/13/08) Savings (S1) $ 33.55 $ 0.01 Money Market (S7) $ 164,407.16 $ 218.43 Interest (1/1/08 tol/31/08) $ 0.02 $ 495.95 Loans: Visa Loan (L9) $ 218.43 On Januar;• 30, 300R, David E. Patton, Executor, had a meeting with me at the Cameron Street office. The outstanding Visa balance was satisfied by a check from Mr. Patton at that time. The remaining funds, in the amount of $166,670.70, were released to the Estate at that time and Ms. Patron's account was closed. If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237-7328, then press 6, extension 3120. Sincerely, ~. ,, ~~'~Q>L-rJ~ Ate, ~".! Roxann Myers Service Advisor PSECU Pennsylvania State Employees Credit Union i' Main Address. 1 Credit Urnon Place, Harrisburg, PA 171 10 2990 717 234 8484 • 800.237.7328 t Mailing Address: P.O Box 67013, Harrisbur PA 17106 7013 717.777 2100 TDD! .800 472,.,1,967 (TDD~ # m_ This credit union is federally insured by the National Credit Union Administrafion. Equal Opportunity Lender www.psetu.tom ~~ ~~~~~ The fihinldng behind 71te IYlaney Nlazc:~ 24, 2~0~ Bangs i,aw Office ~V11Gj]ae~ liafl~i Attorc~ at Law Camp Hill, PA 17411 RE: Jean C Paxton (Deceased} SSN; 291-22-2749 Dt?D: 0?-1~-2008 Dear AIr. bangs= a ~. ~ ~, - ~ [. ~ .. i In response to your request for Date of Death balances for the customer noted above, our records show the following: Checlting Accannt Account # 514004855$ Established O1-O1-1951 JEAN ~ PA~aN D(?I) balance: ~2--~ 8.0.25 non interest bearing Please Hate that this oi;Fice only provides date of death Vices far deposit accounts (ITtAs, CDs, Checking and Savings a~otunts}, VYe dr- not gra~cean a~ ~nanri~ transactions ar pro~rixle statewents. l~f you geed assistance with any of these hems, please call I-SS$-PNC-SA.I+il~ (1-888-762-2260 ac sbaF by Y~ Local P1VC Bank branch office. Siu'-~eiy, Colleen Crowder 1-800-?6?-1775 P7-PFSG04=F 500 First Ave Pittsburgh, Px 25229 ivlenreber FDIC Page 1 of 1