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Home My WebLink About09-30-08S v J C 15056D41158 REV-~ 5U~ EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes 21, Q 8 ~ 1, 0 2 Po Box zsasol INHERITANCE TAX RETURN Harrisburg, F'A 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 195-16-3026 01052008 11051922 .a Decedent's Last Name Suffix Decedent's First Name MI LAUVER JOHN R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST SE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 2. Supplemental Return ^ 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) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ],~ 8. Total Number of Safe Deposit Boxes ^ (Attach Copy of Will) ^ 10 (Attach Copy of Trust) of death dit d t l P t C S 9113(A) ^ 11 Election to tax under Sec 9. Litigation Proceeds (Received . re ( a e over y pousa . . 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 RICHARD C• SNELBAKER, ESQUIRE 77,7-697-8528 Firm Name (If Applicable) SNELBAKER & BRENNEMAN, P•C• First line of address 44 WEST ~1AIN STREET Second line of address P • 0 • BOX 31,8 City or Post Office State ZIP Code ^, , ~. ,_- ''. _,- r ~. ; F MECHANICSBURG PA 17055 w ' Correspondent's a-mail address: 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 knowVedge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS ~' JOHN R. L ER, J -, EXECUTOR LOIS LAUVER ZIMt1ERf1AN, EXECUTOR SIGNATURE OF PR A REPRESENTATIVE D TE ADDRESS ` RICHARD C• SNELBAKER, ESQUIRE 44 WEST MAIN STREET, MECHANTCSBURG PLEASE USE ORIGINAL FORM ONLY 17055 Side 1 15056041158 6M46473.OD0 15056041158 15056042159 REV-1500 EX Decedent's Social Security Number 195-16-3026 Decedent's Name:L A 0 V E R JOHN R RECAPITULATION 1. Real estate (Schedule A) 1. 0 • 0 0 2. Stocks and Bonds (:ichedule B) . 2. 0 • 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. 0 , 0 0 4. Mortgages & Notes Receivable (Schedule D). 4. 0 • 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 3 5 4 8 2 8 • 7 2 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 0 • 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 2 9 2 0 8 6 •5 3 8. Total Gross Assets (total Lines 1-7). 8. 6 4 6 915 • 2 5 9. Funeral Expenses & Administrative Costs (Schedule H) . g. ], 3 4 3 0 • 7 2 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I). 10. 9 0 71 • 5 5 11. Total Deductions (total Lines 9 & 10) . 11. 2 2 5 0 2 • 2 7 12. 13. 14. Net value of Estate (Line 8 minus Line 11) Charitable and Govt;rnmental Bequests/Sec 9113 Trusts for which an election to tax h2is not been made (Schedule J) . Net Value Subject to Tax (Line 12 minus Line 13) 12. 13. 14. 6 2 4 412 • 9 8 0 • 0 0 6 2 4 412 • 9 8 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.OIL 0,00 15. 0.00 16. Amount of Line 14 taxable at lineal ratex.oli5 624412 •98 1s. 28098.58 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 . . . ................................ 1s. 28098.58 20. FILL IN THE BOX IF' YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 sMasas2.ooo 15056042159 J ' REV-1500 EX Page 3 File Number ~i nn n~na DECEDENTS NAME LAUVER JOHN R STREET ADDRESS UPPER A N TWP, C MBERLA D COUNTY CITY STATE ZIP MECHANICSBURG Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments 2 5 0 0 0 •0 0 C. Discount 12 5 0 • 0 0 (1) 28098.58 Total Credits (A + g + C) (2) 2 6 2 5 0.0 0 3. Interest/Penalty if applicable D. Interest 0 • 00 E. Penalty 0 ' 0 0 Total Interest/PenaHy (D + E) (3) 0 • 0 0 4. If Line 2 is greater than Line 1' + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0 • 0 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 18 4 8 • 58 A. Enter the interest on they tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 18 4 8.5 8 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: a. retain the use or income of the property transferred; ^ a b. retain the right t:o designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . ~ a d. receive the promise for life of either payments, benefits or care? . 2. If death occurred <~fter December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . ~ 0 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 l"HE 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 'I, 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 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. §91161;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. 6M4671 1.000 REV-1508 EX+ (8-98) COMMONWEALTH OF PENN:~YLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEI~ff SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER John R. Lauver 21 08 0102 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 1986 Liberty ;Half Dollar 0.50 Statue of Liberty/Ellis Island Commerative Coin 2 Ameriprise Financial 326,313.11 investment account, #00030707228 0 021 3 Capital Blue Cross 269.80 refund unused premium 4 Commonwealth Annuity and Life Insurance Comapny 4,830.70 policy #09853.55 insuring the life of Lois Lauver Zimmerman 5 Commonwealth ;Annuity and Life Insurance Comapny 5,702.97 policy #09630.58, insuring the life of John R. Lauver, Jr. 6 Pennsylvania 1Department of Revenue 64.00 refund on 200'7 Individual Income Tax Return 7 Pennsylvania State Bank 12,274.70 checking account, #10212819 Interest accrued to 1/5/2008 7.31 8 Pennsylvania State Bank 3,459.34 checking account, #10214294 Interest accrued to 1/5/2008 2.04 9 United States Treasury 1,397.00 refund on 200'7 Individual Income Tax Return 10 United States Treasury 300.00 2008 Economic Stimulus Payment 11 Wachovia Bank, N.A. 207.25 checking account, #51490750 3W46AD 1.000 TOTAL (Also enter on line 5, Recap; (If more space is needed, insert additional sheets of the same size) 354,828.72 ' REV-1510 EX+I~g6) COMMONWEALTH OF PENNSYL`/ANIA INHERITANCE TAX RETURN RESIDEM DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER John R. Lauver 21 08 0102 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBS DESCRIPTION OF PROPERTY INCLIDE TFE NAME OFTif TRANSFEREE, THEIR RELATIONSHIP TO DECEDEM AND 7FE DATE OF TRAPiSFER. ATTACHACOPY OF 7HE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION IF PPPLICABLE TAXABLE VALUE ~ Ameriprise Financial 93,566.72 100.0000 0.00 93,566.72 annuity, account #93007284893 8 004. Beneficiaries are Lois Lauver Zimmerman and John R. Lauver, Jr. 2 Jackson National Life 30,320.46 100.0000 0.00 30,320.46 annuity, account #0039482420. Beneficiary is John R. Lauver, Jr. 3 Jackson National Life 30,320.46 100.0000 0.00 30,320.46 annuity, account #0039482410. Beneficiary is Lois Lauver Zimmerman 4 Protective Life Insurance Company 32,146.47 100.0000 0.00 32,146.47 annuity, account #FK4052422. Beneficiaries .are Lois Lauver Zimmerman and John R.Lauver, Jr. 5 Sovereign Bank 5,726.40 100.0000 0.00 5,726.40 IRA, account #0578114357. Beneficiaries .are Lois Lauver Zimmerman and John R. Lauver, Jr. Interest accru~ad to 1/5/2008 4.26 100.0000 4.26 6 Wachovia Bank, N.A. 34,078.96 100.0000 0.00 34,078.96 IRA account, #25-702-009-0528668. Beneficiaries .are Lois Lauver Zimmerman and John R. Lauver, Jr. Interest accrued to 1/5/2008 34.31 100.0000 34.31 Total from continuation sched les 65,888.49 TOTAL (Also enter on line 7, Recapitulation) ~ $ 292.086.53 (If more space is needed, insert additional sheets of the same size) 3 W46AF 1.000 Estate of: John R. Lauver Schedule G (Page 2) 21 08 0102 Item DOD Value Taxable X10. Description of Asset ~ Interest Exclusion Value 7 Wachovia Bank, N.A. 65,822.22 100.0000 0.00 65,822.22 IRA account, # 25-702-009-9905987. Beneficiaries <sre Lois Lauver Zimmerman and ~7ohn R. Lauver, Jr. Interest accrued to 1/5/2008 66.27 100.0000 66.27 Total (Carry forward to main schedule) 65,888.49 . REV-1511 EX+i,a~' SCHEDULE H COMMONWEALTH OF PENNSYL`JANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER John R. Lauver 21 08 0102 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Neumyer Funeral Home, Inc. funeral services 8,102.97 Total from continuation schedules 130.00 B. 1 ADMINISTRATIVE. COSTS: Personal Represt;ntative's Commissions Name of Personal Representative(s) Street Addres:> City State Zip 2. Attorney Fees Snelbaker & Brenneman, P.C. 3. Family Exemptioin: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. 5. 6. 7. 1 2 Year(s) Commission Paid: City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Prepairer's Fees Cumberland Law Journal Advertising Executors notice Patriot News advertising Executors notice Total from continuation schedules 3,400.00 314.00 188.00 75.00 189.75 1,031.00 TOTAL (Also enter on line 9, Recapitulation) ~ $ 13 , 430.72 7W46AG 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: John R. Lauver Schedule H Part 1 (Page 2) Item No. Description 2 Gingrich Memorials engraving an marker 21 08 0102 Amount 130.00 Total (Carry forward to main schedule) 130.00 Estate of: John R. Lauver 21 08 0102 Schedule H Part 7 (Page 2) 3 Register of Wills short certificates 16.00 4 Register of Wills filing fee for Inheritance Tax Return 15.00 5 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the Decedent's estate 1,000.00 Total (Carry forward to main schedule) 1,031.00 REV-1512 EX + (12-03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA ~ DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ~ ESTATE OF FILE NUAABER John R. Lauver 21 08 0102 Report debts incurred by tFie decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Alert Pharmacy prescription expense 159.05 2 Messiah Village resident care 8,912.50 TOTAL (Also enter on line 10, Recapitulation) $ ~ 9 , 071.55 3wasaH z.ooo (lf more space is needed, insert additional sheets of the same size) REV-151,~EX+(g-00) SCHEDULE J COMMONWEALTH OF PENNSYLVAPJIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT cairait~r FILE NUMBER John R. Lauver 21 08 0102 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 John R. Lauver, Jr. 70 Black Walnut Drive Valley Green Heights Etters, PA 17319 Ameriprise Financial Inventory Value: 46,783.36 Commonwealth Annuity and Life Insurance Comaany Inventory Value: 5,702.97 Jackson National Life Inventory Value: 30,320.46 Protective :Life Insurance Company Inventory Value: 16,073.24 Sovereign Bank Inventory Value: 2,863.20 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS 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 3W46AI 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: John R. Lauver Schedule J Part 1 (Page 2) 21 08 0102 Item No. Descriptior.~ Relation Amount 1 Accrued: 2.13 Wachovia Bank, N.A. Inventory Value: 32,911.11 Accrued: 33.14 Wachovia Bank, N.A. Inventory Value: 17,039.48 Accrued: 17.16 One Half of Residue: 160,896.39 Son 312,642.62 2 Lois Lauver Zimmerman 7345 Fishing Creek Valley Road Harrisburg, PA 17112 Ameriprise Financial Inventory Value: 46,783.36 Commonwealth Annuity and Life Insurance C'.omapny Inventory Value: 4,830.70 Jackson National Life Inventory Value: 30,320.46 Protective Life Insurance Company Inventory Value: 16,073.24 Sovereign Bank Inventory Value: 2,863.20 Accrued: 2.13 Wachovia Bank, N.A. Inventory Value: 32,911.11 Accrued: 33'.14 Wachovia Bank, N.A. Inventory Value: 17,039.48 Accrued: 17'.16 One Half of Residue: 160,896.39 Daughter 311,770.35 LAST WILL AND'TESTAMLNT L, JOHN IZ,. LAUVLR, of the Township of Hampden, County of Cumberland and State of ?'ennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be I;1y Last ??ill and Testament, hereby revoking and making void all for:~er wills, codicils and other testamentary dispositions by me at any time heretofore made. 1. I direct my executors, hereinafter named, to nay as soon as practicable after my .decease all my just debts a.nd the expenses of my last illness and burial. 2. I give, devise and bequeath all of my estate - real, personal and mixed, unto my wife, Betty J. Lauver, absolutely. 3. Should my said wife predecease me, then and in that event, I give, devise and bequeath all of my said estate unto my children, John R. Lauver, Jr., and Lois Lauver, equally, share and share alike. 4. I nominate, constitute and appoint my said wife, Betty J. Lauver, and my two children, John R. Lauver, Jr., and Lois Lauver, and the surviors or survivor of them, executors of this my Last Will. 5. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. I~1?FITNESS WHEREOF, I, JOHN R. LAUVER, the Testator, have hereunto set my hand and seal to this my Last Tn1ill and Testament on ,~ this ~C~` day of ~~L ~~ ~°f~~ l,~ ~_ 1°84. ~ ..~ .. ~,, ,- "~~ ~~ ,,`_ ;; ' ,,~ ~ { _~. .._ ( SEAL ) 5 ~ Signed, sealed, published and declared by the ~ti~ithin na~t!ed John R. Lauver as and for his Last Will and Testament in the presence of us, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our na:aes as witnesses thereto. a i o... S~ .f~'.: i :. ~ ,'~l .. ' / ,1 ` .: /~.~i-T~% ~ --~ -2."~ iXj_ _ _,%'