HomeMy WebLinkAbout10-30-08 15056041125
06
05
REV-1500 EX
(
-
) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PoBOx28oso1 INHERITANCE TAX RETURN 2 1 0 8 0 9 0 5
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 6 8 2 6 4 4 6 7 0 8 2 7 2 0 0 8 0 7 0 1 1 9 1 5
Decedent's Last Name Suffix Decedent's First Narne MI
P O T T E I G E R E L I Z A B E T H M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First NamE; MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
1. Original Return
4. Limited Estate
QX 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82) O
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)
3. Remainder Return (date of death
prior to 12-13-82)
!5. Federal Estate Tax Return Required
r3. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
J I L L M W I N E K A , E S Q U I R E 7 1 7 2_, 3 4 4~=:'1 7 8
..,
Firm Name (If Applicable)
P U R C E L L, K R U G & H A L L E R
First line of address
1 7 1 9 N O R T H F R O N T S T R E E T
Second line of address
City or Post Office
H A R R I S B U R G
Correspondent's a-mail address: jWlf1@ka(C7!_Dkh.COf11
State ZIP Code
P A 1 7 1 0 2
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END
DATE FILED
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, anti to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative rs based on all information of which preparer has any knowledge.
SIGNAT E F PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDR SS
Linda M. Wagner, 1111 Country Club Rd Camp Hill PA 17011
SIG~AQTURE OF PREPARFR QTHFq~THAN REPRESENTATIVE f14TF
JiY1vM. Wineka, 1719 N. Front St. Harrisburg PA 17102
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 1.5056041125 J
15056042126
REV-1500 EX
Decedent's Social Security Number
Oecedent'sName: ELIZABETH M. POTTEIGER .L 6 8 2 6 4 4 6 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.
8 9 1 2
7 7
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. .
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, 8 9 1 2 • ~ 7
9. Funeral Ex enses & Administrative Costs Schedule H
P ( ) ........... g.
..... 6 7 4 3 ~ 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) ....... ..... 10. 2 3 ~ 2 3
11. Total Deductions (total Lines 9 & 10) ...................... ..... 11. 6 7 6 6 • 2 3
12. Net Value of Estate (Line 8 minus Line 11) .................... ..... 12. 2 1 4 6 , 5 4
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 1 4 6 . 5 4
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.0 ~ 0 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X..045 2 1 4 6, 5 4 1s
17. Amount of Line 14 taxable
0
0
0
at sibling rate X .12 17
18. Amount of Line 14 taxable
0
0
0
at collateral rate X .15 18
19. Tax Due ............... ........................ .. ..... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056042126
Side 2
1`056042126
0. 0 0
9 6. 5 9
0. 0 0
0. 0 0
9 6. 5 9
REV-15001=X Page 3
Decedent's Complete Address:
File Number
21 08 0905
DECEDENT'S NAME
ELIZABETH M. POTTEIGER
STREET ADDRESS
1111 Count Club Road
CITY
Camp Hill STATE
PA ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments _
C. Discount
3. InteresUPenalty if applicable
D. Interest
E. Penalty
5.08
(1) 96.59
Total Credits (A + B + C:) (2) 5.08
Total Interest/Penalty (D + E:) (3) 0.00
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) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 91.51
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 91.51
Make Check Payable fo: 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 : ................................................................ ...... ^ ^X
b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^ ^X
c. retain a reversionary interest; or .......................................................................................... ...... ^ 0
d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ ^X
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? ............................................................................................ ...... ^
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-hall(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)]. 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-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH M. POTTEIGER 21 08 0905
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Citizens Bank, Checking Acct. No. 6100759490 8,738.56
(See attached letter from Citizens Bank dated 10/3/08)
2. Hoover Funeral Homes & Crematory, Inc. -refund from Burial Trust 172.76
3. Citibank -credit card refund 1.45
TOTAL (Also enter on line ;i, Recapitulation) I S 8 912 77
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
ELIZABETH M. POTTEIGER 21 08 0905
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Sheraton -post funeral luncheon 1,625.00
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City
Year(s) Commission Paid:
State Zip
2. Attorney Fees Purcell, Krug & Haller
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Linda M. Wagner
Street address 1111 Country Club Road
city Camp Hill state PA zip 17C111
Relationship of Claimant to Decedent Daughter
4. Probate Fees Cumberland County Register of Wills
5 Accountant's Fees
6. Tax Return Preparer's Fees
7. Register of Wills -Fee to fiile Will; Short Certs; Automation fee; JCP fee
8. Register of Wills -Fee to file PA Inheritance Tax Return
9. Register of Wills -Fee to file Family Settlement Agreement & Final Release
1, 500.00
3, 500.00
45.00
38.00
15.00
20.00
TOTAL (Also enter on line 9, Recapitulation) ~ 3
743.00
(Ii more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT.
ESTATE OF
FILE NUMBER
ELIZABETH M. POTTEIGER 21 08 0905
Report debts incurred by the 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
Verizon -phone services
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
23.23
TOTAL (Also enter on line 10, Recapitulation) I $ 23.23
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
ELIZABETH M. POTTEIGER 21 08 0905
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 [nclude outright spousal distributions, and transfers under All personal proper referenced _in
sec. sets (a) (t2p Items III through I of the Decedent's
Will were gifted to the beneficiaries
during her lifetime.
1.
2.
3.
4.
5.
Linda M. Wagner f/k/a Linda K. Maronic
1111 Country Club Road
Camp Hill, PA 17011
Betsy Ibaugh
P.O. Box 164
Canal Winchester, OH 43110
Samuel Potteiger
153 Needlewood Drive
Harrisburg, PA 17112
Geraldine Hodapp
6223 Ash Court
Raytown, MO 64133
Marlin Potteiger
153 Alma Mater Drive, Toftrees
State College, PA 16803
Lineal
Lineal
Lineal
Lineal
Lineal
20% of residue
20% of residue
of residue
of residue
20% of residue
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COb'ER SHEET
(If more space is needed, insert additional sheets of the same size)
I N RE:
ESTATE OF ELIZABETH M. POTTEIGER
a/k/a MARY ELIZABETH POTTEIGER,
DECEASED
IN THE COURT OF COMMON PLEAS
CUMBERLAND CO., PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 08 0905
TABLE OF CONTENTS
Last Will and Testament of Elizabeth M. Potteiger dated March 7, 1995; and
2. Citizens Bank Statement dated October 3, 2008 providing date of death value for
Decedent's Checking Account No. 6100759490.
LAST WILL AND TESTAMENT
OF
ELIZABETH M. POTTEIGER
I, ELIZABETH M. POTTEIGER, of Harrisburg, Dauphin County,
Pennsylvania, declare this to be my Last Will and Testament,
and revoke any and all Wills and Codicils heretofore made by
me.
ITEM I: I direct that all my just debts and funeral
expenses, including my grave marker and all expenses of my
last illness, shall be paid from my residuary estate as soon
as practicable after my decease, as part of the expense of the
administration of my estate.
ITEM II: All federal, state, and other death taxes
payable because of my death with respect to the property
forming my gross estate for tax purposes, whether or not
passing under this Will, including any interest or penalty
imposed in connection with such tax, shall be considered as a
part of the expense of the administration of my estate, and
shall be paid out of the principal of my e:~tate without
apportiLr:^~nt or right of reimbursement.
ITEM III: I give and bequeath my bedroom set and family
bible to my daughter, GERALDINE HODAPP, of Jackson County,
Missouri.
ITEM IV: I give and bequeath my roll~top desk to my son,
SAMUEL E. POTTEIGER, JR, of Dauphin County, Pennsylvania.
ITEM V: I give and bequeath my grandfather clock, my
dining room set and cemetery lots to my daughter, LINDA K.
MARONIC of Dauphin County, Pennsylvania.
ITEM VI: I give and bequeath my grandmother's chest and
choice of salt and pepper shakers to my daughter, BETSY L.
IBAUGH of Franklin County, Ohio.
ITEM VII: It is my desire that my daug]Zters, GERALDINE
HODAPP, LINDA K. MARONIC AND BETSY L. IBAUGH, have their
choice of any of my jewelry which they desiz-~~ to keep in
remembrance of me.
ITEM VIII: It is my desire that my son, MARLIN E.
POTTEIGER, select whatever item of personalty he desires in
remembrance of me.
ITEM IX: I give, devise and bequeath to my children,
MARLIN E. POTTEIGER, GERALDINE HODAPP, SAMUEL E. POTTEIGER,
JR., LINDA K. MARONIC, AND BETSY L. IBAUGH, or their issue,
,per stirpes, all the rest residue and remainder of my estate
of every nature and wheresoever situate in Equal shares.
ITEM X: I nominate, constitute and appoint LINDA K.
MARONIC as the Executrix of this my Last Wi:11 and Testament.
In the event of renunciation, death, resignation or inability
to act for any reason whatsoever of the said LINDA K. MARONIC,
I nominate, constitute and appoint SAMUEL E. POTTEIGER,
Executor of this my Last Will and Testament.
__ .
ITEM XI: In addition to the powers coizfirmed by aw, I
authorize my Executrix or her successor of any property,
appointed hereunder, in their absolute discretion without
court order:
(a) To retain property in the form received, and to sell
either at public or private sale any real or personal
property;
(b) To manage real estate;
(c) To invest or reinvest all forms of property without
being confined to legal investments, and without regard to the
principal of diversification;
(d) To exercise any options or rights; arising from
ownership of investments;
(e) To compromise claims without court approval, without
contest of any beneficiaries;
(f) To lease any real or personal property, however, not
for a time beyond the date when the minor would obtain age
eighteen;
(g) The right to distribute in cash or kind, or both, at
such evaluations that they may fix.
ITEM XII: I hereby relieve my Executor/trix, or his/her
successors, of the necessity of posting bond in connection
with their duties in any jurisdiction in which he/she may be
called upon to act insofar as I am able to do so by law.
IN~WITINESS WHEREOF, I have hereunto set my hand and sea
this !' v day of ~~(~.r~~ 1995.
ELI ~ ETH M. POPOT7LTVEI~~GE'R
The preceding instrument, consisting o~ this and 3 other
typewritten pages, was on the date thereof signed, published
and declared by ELIZABETH M. POTTEIGER, the' Testatrix therein
named, as and for her Last Will, in the presence of us, who,
at her request, in her presence, and in the' presence of each
other, have subscribed our names as witnes~~es hereto.
fc'~nr~ ~--~()~{~1~~ Residing at ~Y~ ~ Ll/~C ~~'--
~~~. Residing at ~ ~ ~ ~~
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF DAUPHIN
We, ELIZABETH M. POTTEIGER,~~~/"J('Z ~~,(}(~11'C~ and
('%j~l~!;~, (x~~CL1C~ the testatrix and the
witnesses, respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn,
do hereby declare to the undersigned authority that the
testatrix signed and executed the instrument as her last
will, and that she had signed willingly and that she
executed it as her free 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 ~
rtr~r ~ ,~r~~r~~
Witne s
~~n~. ~~1C~~C~
( fitness
Subscribed, sworn to and acknowledged before me by
ELIZABETH M. POTTEIGER,, the testatrix, and subscribed and
sworn to before me by }. 1(}/'r~~ l~l~!}U)(~.~- and
l~f l~V~i i~y'(li~~ witnesses, this ~,~ day of
Gt/~r„ 1995 .
~ . ~~
Notary Public
P~~I,~d~iL SE.~L
~~ Citizens Bane
October 3, 2008
JILL M WINEKA
1719 NORTH FRONT STREET
HARRISBURG PA 17102-2392
Estate of ELIZABETH M POTTEIGER
Date of Death: Aug 27, 2008
SSN: 168-26-4467
Dear Sir/Madam:
525 William Penn Place
Suite 153-2618
Pittsburgh, PA 15219
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of his/her date of death.
For IL or LC accounts, contact our Loam Department at 1-800-708-6680. For a.ll other inquiries, please
call 1-888-999-6884
Sincerely,
Bazbaza Richards
Operations Services
Citizens ~a~k~.
Account Number 6100759490
Account Title ELIZABETH M POT'TEIGER
Date O ened 10/31/1974
Account T e Checkin
Principal Balance as of DOD $8725.99
Interest from Last Postin to DOD
Account Balance as of DOD $8725.99
YTD Interest to DOD $12.57