HomeMy WebLinkAbout11-05-08
15056051058
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO Box zaosol INHERITANCE TAX RETURN
Harrisburg, PA1712s-osol RESIDENT DECEDENT 21 08 00377
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03/04/2008 02/02/1914
Decedent's Last Name
Lower
Suffix Decedent's First Name
Marion
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
MI
R
MI
TH!S RETUR!`! FAUST BE FILED !N DUPLICATE WITH THE
REGISTER OF WLLI_S
FILL IN APPROPRIATE OVALS 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 H, ... 7. Decedent Maintained a Living Trust 1 8. Taal Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received C::,;:.;' 10. Spousal Poverty Credit (date of death ... 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (/attach Sch. O)
CORRESPONDENT - THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
John C Oszustowicz (717) 243-7437 n Q
Firm Name (if Applicable) CQ m
REGISTER OF I~15E ONL`F~
Law Office of John C OszVS}ouviCZ ~~>'~
-- -mac
First line of address r
=rT G; ~ ~
.ate ~ ~
104 S Hanover St V~>
~ -n
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Second line of address ~
--{ :.
N
City or Post Office State ZIP Code DATE FILED O~
Cariisle PA 17013
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 knowledge.
SIG TURE OF PE ON RESPONSIBLE FOR FI G RETURN DATE
2 2 Clearbrook Dr., Marietta GA 30068 f
-_ ...
SIGNA, E~~F PR~PAf~ R OTHER T AN PRESENTATIVE GATE
// _~'1. _ _ _ __
ADDRE,
104 Hanover St., Carlisle PA 17013 '
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
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REV-1500 E:K
15056052059
Marion R Lower
Decedent's Name:
RECAPITULATION
1 Real estate (Schedule A) . ............................................ 1
Dec;edent's Social Security Number
2. Stocks and Bonds (Schedule B) .................................... ... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3.
4. Mortgages 8 Notes Receivable (Schedule D) .......................... ... 4.
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ..... ... 5.
6. Jointly Owned Property (Schedule F) :,'.`w Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
chedule G)
~.:~m:m Separate Billing Requested.....
... 7.
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 8 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.
.
_.
_ .
_ _ ~w~ .....~ .. ..-__~e _.
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0 45 932,779.72 16.
17. _. _ . __
Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 1 g,
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
250,000.00
273,791.27
451,256.30
975,047.57
38,663.90
3,103.95
41,767.85
933,279.72
500.00
932,779.72
41,975.09
41,975.09
=;
15056052059
i052059
REV-1500 EX Page 3 File Number
Decedent's Complete Address' 21 ': OS ' 00377
Marion
STREET ADDRESS
231 Glendale St
cITY
Carlisle
STATE ZIP
PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 41,975.09
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 40,500.00
C. Discount 2,098.75
-"""-- Total Credits (A + B + C) (2) 42,598.75
3. InterestlPenalty if applicable
D. Interest _
--- - -__-
E. Penalty
Total Interest/Penalty (D + E) (3) 623.66
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)
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? ........ ...... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a benefciary 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)J. The statute does not exert 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 (O) percent [72 P.S. §9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four arld 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)J. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adopti~~n.
DECEDEN~f'S SOCIAL SECURITY NUMBER
R Lower 167-18-7214
REV-1502 EX+ (6-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
(If more space is needed, insert additional sheets of the same size)
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
~ 144 shares Verizon Common Stock CUSIP 92343V104 5,162.40
2 39 shares Comcast Common Stock CUSIP 20030N101 778.05
3 570 shares PPL Common Stock 26,368.00
4 3.31 shares Alcatel Common Stock 18 72
5 312 shares Wachovia Common Stock 7,971.60
6 10.109 shares AXA Common Stock 314.75
7 2 shares LSI Common Stock CUSIP 502161102 10.21
8 5 shares Fairpoint common Stock CUSIP 305560104 47.35
9 3 shares AT&T Common Stock CUSIP 002068102 103.88
10 14 shares Idearc Common Stock CUSIP 451663108 72.45
11 19 shares Met Life Common Stock 1,086.42
12 181 Series E Savings Bonds (See Attachment A) 31,857.44
13 Treasury Note CUSIP 912795D99 100,000.00
14 Treasury Note CUSIP 912795E64 100,000.00
TOTAL (Also enter on line 2, RecaF~itulation) I $ 273,791.27
(If more space is needed, insert additional sheets of the same size)
REV•1508 EX+(6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
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 M&T Bank Checking Account #425729 19,322.39
2 Accrued interest on i1:em 1 0.03
3 M&T Bank Savings Account #15004200023402 178,621.26
4 Accrued interest on i1em3 5 87
5 M&T Bank CD #31003916163593 10,010.43
6 Accrued interest on item 5 311.48
7 Susquehanna Bank CD #405100004523 10,466.43
8 Sovereign Bank Money Market #3384056795 73,261.02
9 Sovereign Bank Checking Account #2891022769 8 296 27
10 Accrued interest on item 9 0.40
11 Sovereign Bank CD #2895543664 10,229.59
12 Accrued interest on item 11 7 18
13 Sovereign Bank CD #2895543292 10,264.09
14 Accruetl interest on item 13 7 19
15 Sovereign Bank CD #3385171800 10,741.12
16 Accrued interest on item 15 6.73
17 Sovereign Bank CD # 3385172279 5,285.21
18 Accruetl interest on item 17 2 28
19 American Home Bank. CD #290002966 10,510.72
20 American Home Bank CD #290003155 10,446.31
21 American Home Bank CD #290003675 5,351.34
22 American Home Bank CD #290003815 15,162.24
23 American Home Bank CD #290004484 7 272 89
24 American Home Bank CD #2900004529 10,379.99
25 Total from Continuation of Schedule E ~ zc~ ~~
TOTAL (Also enter on line 5, Recapitulation) $ I ~-}51,25(,,.~
(If more space is needed, insert additional sheets of the same size)
Continuation of Schedule E
Estate of Marion R F Lower File 2008-00377
1 American Home Bank CD #290004530 10,379.99
2 American Home Bank CD #290004542 10,364.57
3 American Home Bank CD #290004662 7,694.43
4 Personal property 15,670.00
5 Misc uncashed checks 7,185.40
6 USI Insurance refund 247.89
7 February SS payment 2,028.00
8 February & March PA pension payment 1,202.76
9 Verizon dividends 480.96
10 Met Life dividend 39.84
55,293.84
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES..
~ Hollinger Funeral Home 7,827.00
e. ADMINISTRATIVE COSTS:
1. 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 17,700.00
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 Fees 680.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Legal Advertising (The Sentinel & Cumberland Law Journal) 169.78
a J Rodney Fickel -probate bond 3,820.00
s SERS -reimburse PA retirement for partial month payment 521.20
io Craig Kern, CPA - 2007 tax preparation 225.00
> > IBIS -antique appraisal 180.00
~2 Total from Continuation of Schedule H ~~, q'2,i
TOTAL (Also enter on line 9, RE;capitulation) $ 3sst~1~3.90
(If more space is needed, insert additional sheets of the same size)
Continuation of Schedule H
Estate of Marion RF Lower
12 Bartlett Tree Experts
13 Carlisle Petroleum -furnace cleaning
14 PPL
15 Four Seasons Landscaping
16 Embarq Telephone
17 Sheaffer Lawn & Garden
18 Borough of Carlisle -Sewer & Water
19 Cumberland Valley Tree Service -trimming
20 Doug Gleim Painting
21 Travel Expenses for Jane Majeske
22 Death Certificates for decedent's wife
23 Stephen Hietsch Tax Collector
24 Register of Wills filing fee
25 Cumb Co Recorder of Deeds
File# 2008-00377
195.00
138.45
50.93
300.00
58.04
218.63
87.55
855.00
2,985.00
713.00
17.00
1, 867.82
15.00
39.50
$7,540.92
REV•1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
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
t Walnut Bottom Radiology
2 Pinker & Associates (medical)
3 West Shore EMS
4 PPL
5 Embarq
6 Carlisle Borough Tax Accountant -personal tax
7 Carlisle Borough Tax Accountant -school tax
8 Borough of Carlisle -sewer and water
9 Linda Bupp
10 Joseph Buletza -physical therapy
11 March of Dimes
12 Lana Provazzo -housecleaning
13 Citicard Credit Card
14 Nells Grocery Store
15 US Treasury - 2007 personal income tax
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
218.00
18.53
54.50
71.66
60.40
4.90
764.41
25.05
25.00
100.00
10.00
225.00
100.00
89.50
1,337.00
3,103.95
REV-1513 EX+ (g-DO) ~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANI,4 BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Marion R F Lower 2008-00377
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)j
1 Jane L Majeske 2872 Glearbrook Dr, Marietta GA 30068 Daughter 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIF~TE, 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
Gettysburg College
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVEF2 SHEET $
(If more space is needed, insert additional sheets of the same size)
500.00
500.00
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IMPORTANT NOTICE
NOTICE OF TRUST ADMINISTRATION UNDER PA UNIFORM TRUST ACT
Marjorie Fetter Goossens Trust FBO
Historical Society of Perry County
TO: Historical Society of Perry County
P.O. Box 81
Newport, PA 17074-0081
Please take notice that Marjorie Fetter Goossens established the Marjorie Fetter
Goossens Trust FBO Historical Society of Perry County.
The Trustee is:
John C. Oszustowicz, Trustee
104 S. Hanover Street
Carlisle, PA 17013
(717)243-7437
As a current beneficiary of the Trust, you are entitled to receive a complete copy of the
instrument by which the trust was created. A copy is not enclosed. Please contact the
Trustee for a copy.
You are also entitled to receive (at least annually) a written report which identifies the
assets of the trust and their fair market value, any liabilities of the trust, and a statement
of the receipts and disbursement made in the trust since the date of the last written
report.
Date: November 5, 2008
Signature
Address of Signature
Telephone Number
Capacity: Trustee
Counsel for Trustee