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Home My WebLink About10-28-08 1,505604],125 ~{~ Y -1500 EX (06-05) OFFICI/~L USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2aosol 2 7. 0 8 0 5 2 4 Harrisbur , PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 2 2 0 6 7 4 2 0 2 1 3 2 0 0 8 0 5 0 6 1 9 0 6 Decedent's Last Name E N G L E Suffix Decedent's First Name E L I Z A F3 E T H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF MILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust _ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST aE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE utKtc l to I u: Name Daytime Telephone Number , M E L A N I E W A L Z S C A R I N G I 7 1 7 6.:~5 , 7 7 ,,'~ 7 0 ,---, Firm Name (If Applicable) S C A R I N G I& S C A R I N G I, P C First line of address 2 0 0 0 L I N G L E S T O W N Second line of address S U I T E 1 0 6 City or Post Office H A R R I S B U R G FILING RETURN R 0 A D State ZIP Code P A 1 7 1 1 0 Correspondent's a-mail address: MELANIE SCARINGILAW.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. SIGNATURE OF MI MI 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) REGISTER OF 1M14t$ ESU ~C ,~ ~:_ J - i .. _~ ~r~ DATE FILED uHit~/~-~~~~G~b ADDRESS V' 51 OLIVER ROAD ENOLA PA 17025 SI ~~ lU¢~E~F PREPARERpT~E T ~i RE; RESENT~A,~IVE ~ i~ ~ I _ ~(~/ ADDR SS 200 LINGLESTOWN ROAD, SUITE 106 HARRISBURG PA 17110 PLEASE USE ORIGINAL FORM ONLY 1,5056041,1,25 Side 1 15056047,],25 J ],50560421,26 REV-1500 EX Dece~jent's Social Security Number 2 0 2 2 0 6 7 4 2 Decedent's Name: ELIZABETH ENGLE 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 Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 9 1 0 6, 1 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 8. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 6 5 0 6 6, 3 7 (Schedule G) ^ Separate Billing Requested ....... 7. 7 4 1 7 2, 5 0 8. Total Gross Assets (total Lines 1-7) ~ ~ ~ • ~ • ~ ~ • ~ ~ ~ ~ • • ~ • ~ ~ ~ • 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 11. Total Deductions (total Lines 9 & 10) ........................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 Q ~ 0 0 15. 16. Amount of Line 14 taxable '] 2 4 4 8 5 1 at lineal rate X .045 16. 17. Amount of Line 14 taxable Q ~ Q 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 Q 18. at collateral rate X .15 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YCU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1,5056042],26 Side 2 1 4 4 3, 9 9 8 0 0 0 2 , 1 7 2 3, 9 9 7 2 4 8, 5 1 7 2 4 4 8, 5 1 0. 0 0 3 2 6 0. 1 8 0, 0 0 0. 0 0 3 2 6 0. 1 8 1,.50560421,26 1~1~9!`Of~."•F:f`?: `.`.t1t"~2inl.^-i',' e~~Clj~"''~"~ir~: F;i2 i~u~•.o2r 21 oB o524 DECEDENT'S NAME ELIZABETH ENGLE -- - -- -- --- STREET ADDRESS 51 Oliver Road -- _ _ _I--_ -- - - ----- - - ------- - --- --- CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 3,137.84 C. Discount 163.01 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 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) 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) (1) 3,260.18 3.300.85 0.00 40.67 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 A~'SWER 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 : ................................................................. ..... X b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ 0 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? ................................................................................ " " ...... 0 ^ ^ ^X or payable upon death bank account or security at his or her death? ... intrust for 3. Did decedert own an ...... 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. 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 fcr 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(x)(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(x)(1.3)]. Asibling 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-1509 E;! + (0-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RFRInFNT nFCFnFNT ~~~~~~~ JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER ELIZABETH ENGLE 21 08 0524 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT q. LOIS J. KEIM B C InIAITI V_nwAIFr1 PRf1PFRTV• 51 OLIVER ROAD ENOLA, PA 17025 DAUGHTER ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK 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. A. 072803 FULTON BANK- CHECKING ACCOUNT; 11,166.65 50. 5,583.33 ACCOUNT NO. 3622-52977. JOINTLY HELD WITH WITH LOTS KEIM -DAUGHTER. 2. A. 122869 M&T BANK -CHECKING ACCOUNT; 7,045.59 50. 3,522.80 ACCOUNT NO. 30825148. JOINTLY HELD WITH V'JITH LOIS KEIM -DAUGHTER. TOTAL (Also enter on line 6, Recapitulation) I $ 9,106.13 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF DATE OF DEATH % OF DECD'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) 16, 795.45 10CI. 3, 000.00 ELIZABETH ENGLE 21 08 0524 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the RE:V-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF' TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. INTER VIVOS TRANSFER INTO JOINT ACCT WITH LOTS KEIM (DAUGHTER) IN DECEMBER 2007-M&T SAVINGS ACCT NO. 015004215199438. D.O.D. VALUE $16,794.99, ACCRUED INTEREST $0.46. EXCLUSION PER 72 P.S. 9107(C)(3). 2. INTER VIVOS TRANSFER INTO JOINT ACCT WITH LOIS KEIM (DAUGHTER) IN AUGUST 2007-MEMBERS 1ST FED. CREDIT UNION SAVINGS ACCT NO. 312147-00. D.O.D. VALUE $5.00, NO ACCRUED INTEREST. INTER VIVOS TRANSFER OPENED ACCOUNT WITH LOTS KEIM (DAUGHTER) IN AUGUST 2007- MEMBERS 1ST FED CREDIT UNION CERTIFICATE OF DEPOSIT ACCT. NO. 312147-40. D.O.D VALUE $51,180.44, ACCRUED INTEREST $85.48. FILE NIUMBER 5.001100. 51,265.92 ~ 10(). TAXABLE VALUE 13,795.45 5.00 51,265.92 TOTAL (Also enter on line 7 Rel,apitulation) ~ $ _ 65, 066.37 e`~iJ'i~ ll~ ~ ~ ~u ~ ~7 INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(12-9S) ' ~ ,fi COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ELIZABETH EN ~~~~~~~~ FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 C18 0524 Debts of decedent must be reported on Schedule I. ITEM AMOUNT NUMBER DESCRIPTION A, FUNERAL EXPENSES: 420.07 1. NEILL FUNERAL HOME-SERVICES g. ADMINISTRATIVE COSTS: ~ Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees SCARINGI &SCARINGI, P.C. (INCLUDING FEES THROUGH 10/20/2008) 951.57 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 FeE:s 5 Accountant's Fees 6. Tax Return Preparers Fees 7. ADMINISTRATIVE FEES PAID TO SCARINGI &SCARINGI, P.C. 57.35 8. FILING FEE TO CUMBERLAND COUNTY REGISTER OF WILLS FOR FILING ITR 15.00 TOTAL (Also enter on line 9, Recapitulation) I $ 1,443.99 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA" RETURN RFCIr1FNT f)FCFnFNT ~CIiEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ELIZABETH ENGLE 21 08 0524 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION 1. DIVERSIFIED DENTAL SERVICES- FOR SERVICES RENDERED IN SEPT. 2007. 2. IOPTHAMOLOGY CONSULTING- FOR SERVICES RENDERED OCTOBER 2007. 3. DR. DAECHER-FOR SERVICE RENDERED JANUARY 2008. BALANCE AFTER REIMBURSEMENT FROM MEDICARE (INDEPENDANT BLUE CROSS). TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 60.00 205.00 15.00 280.00 REV l5' ~ F:; + ~9-C^) I ,~~'`~ ~~HEDUL~ J .COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ELIZABETH ENGLE 21 08 0524 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. LOIS KEIM, 51 OLIVER ROAD, ENOLA, PA 17025 Lineal 72,448.51 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER 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 (If more space is needed, insert additional sheets of the same size) ~:~~,~~'~:~'~~ ~iB^~u~i, ~~itC!°C'St ~~1;~~ i~~raa€ty `~°~~rY.:~9~ar~t Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: _ -__ 3 137,84 Discount: -- 163.01 Interest Table - Year - - ~ --- Days Delinquent this time period Balance Due this year ~ Interest this period Before 1981 ~ -- --- -- ------ - -- -- -1982 - - - -- ----- _ 1983 -- - - --- _ -- ---- 1984 -r ---- - -- 1985 - ---- ~ ---- - ~1986 -_ T 1987 ~ j -------- - - _- --- - -. - - - - - - - ---- - ~ 1988 through_1991 --_ ---- -- '~ 1992 - -- -- - - -- - 1 r---- 1993 through 1994 _1_995 through 1998. 1 -- ---- --._ -- --- --- ------- --- 199 9 - ----- - _ -- - 2000 -- ~ - _ _ - ----- - T - - ------ - -- - - 2001 I ~ -- ----- -- - - _- - -- -- --- - -- - - ---- 2003 -- - 4 200 ~ __ --- - ---- - - --- - - --------. _ --- ------ 2005 _- --- - --- - 12006 --- - ---------- - - -- - --- - - -------- -- 2007 _-_ _- _- __ _-- - ---- - ----- ', _ - --- ---- I -- ----- --- ---- ---- ---- ---- I --- -- ---- -- -- - --------------- - T(1TALS i ~ _ -- Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: