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Home My WebLink About11-20-0815056041125 REV-'I 5OO EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 28oso1 INHERITANCE TAX RETURN 2 1 0 8 0 2 3 8 _ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 2 1 3 2 0 0 8 0 2 1 5 1 9 1 7 Decedent`s Last Name B E R G Suffix Decedent's First Name E L E A N O R MI R (It' Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FIILL IN APPROPRIATE OVALS BELOW ~~ 1. Original Return ~~ 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) ~~ 9. Litigation Proceeds Received MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS a 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) 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) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: N<3me Daytime Telephone Number U1 I L L I A M P D O U G L A S E S Q 7 1 7 2 4 3 1 7 9 0 Firm Name (If Applicable) -------------- - 'I REGISTER OF WILLS USE ONLY D O U G L A S L A W O F F I C E First line of address C7 -~.7 ~ 4 3 W S O U T H S T `--~ ~ ~ ' ~a ' ~ Second line of address ~ , =E ~~"' -' ' ' -.~ C' ~ Chi ~ ~ . :, _ ~~ ~. r-- -~ ° r~ ~ ~f~`FILED~ - .City or Post Office State ZIP Code I_____ - .___ z_~ 2a. `, C A R L I S L E P A 1 7 0 1 3 . -- = E~ _' ~,_; ~ ~ Correspondent's e-mail address: dOUgIaSIaW@earthllnk net ~ - , _ ., . ,~,~ 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 1:rue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT RSON RESP NS16LE FOR FILING RETURN DATE ADDRESS 130 Parker St., Carlisle PA 17013 SIGIVATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 _J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name. Eleanor R. Berg RECAPITULATION 0 0 0 1. ...................................... Real estate (Schedule A) 1. .. 3 1 0 7 2 1 5 2. ................................ Stocks and Bonds (Schedule B} 2. .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. <1. Mortgages & Notes Receivab{e (Schedule D} .................... .. 4. 1 5 8 8 3 7 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. Ei. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 1. Inter-VivoS Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .... ... 7. 8 4 6 9 5 5 8 5 8. Total Gross Assets (total Lines 1-7) ..:..................... ... . fl. Funeral Expenses & Administrative Costs (Schedule H) .... ... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 1.t , Total Deductions (total Lines 9 & 10) ....................... ... 11. 1 2. ................ Net Value of Estate (Line 8 minus Line 11) .. , .. 12. 4 6 9 5 5 8 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . ... 13. 4 6 9 5 5 8 5 14. ............... Net Value Subject to Tax (Line 12 minus Line 13) ...14. T~4X 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 2 , 113 .00 at lineal rate X .0.045 16. - 1 1. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 1 £). Tax Due ............................................. ... 19. 2 , 113 .00 2C). FILL IN THE OVAL iF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 15056042126 15056042126 REV-1500 EX Page 3 Decedent's Complete Address: File Number 0238 DECEDENT'S NAME Eleanor R. Berg __ STREET ADDRESS 130 Parker St. CITY STATE --- _ ZIP.. - Carlisle PA 17013 Tax Payments and Credits: ~ Tax Due (Page 2 Line 19) (1) 2.113.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) $0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total InteresUPenalty (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) 2 ,113 .00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +SA. This is the BALANCE DUE. (5B) 2 , 11.3 , 00- - Make Check Payab/e to: REG/STER OF W/LL S, 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 "intrust 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. §911 Ei (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 irnposed 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 irnposed 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-1503 EX + (6-98) SCHEDULE B COMMGNWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Eleanor R Berq 0238 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH_ See Attachment Page(s) TOTAL (Also enter on line 2, Recapitulation) ~ $ 31, 072.15 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Eleanor R. Berg Decedent's iVame Page 1 21 08 0238 File Number Schedule B -Stocks 8~ Bonds ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Corrections: # 4. 798 shares Hess Corporation (HES) @90.51 for a tota{ of $72,226.98 $48.151.32 We originally reported this as $24,075.66 for a difference of 2. #29. 2400 shares CSX@$49.67 for a total of $119,208.00 ($24,000.00) We originally reported this as $143,208 for a difference of 3. #31. 200 shares FPL Group, Inc. (FPL) @$64.52 for a total of $12,904.00 $6,452.00 We orgiinally reported this as $6,452. for a difference of 4. #39. 769 shares of Duke Energy @$18.46 for a total of $14,195.74 $30.76 We originally reported this as $14,164.98 for a difference of 5. #40. 100 shares GE @$34.89 for a total of $3,489. .($9.00) We originally reported this as $3,498 for a difference of 6. #42. 100 shares Johnson & Johnson @$63.25 for a total of $6,325.00 ($16.00) We originally reported this as $6,341 for a difference of 7. #43. 15 shares LSI @ $5.19 for a total of $77.85 ($1.05) We originally reported this as $78.90 for a difference of 8. #44. 384 shares Spectra Energy Corp. @$23.43 for a total of $8,997.12 $69.12 We originally reported this as $8,928.00 for a difference of 9. #45. 20 shares Pa Imit @$404.83 for a tota{ of $8,096. $228.60 We originally reported this as $7,867.40 for a difference of 10. NEW ADDITION #76. 10 shares Fairpoint @$8.32 $166.40 SUBTOTAL SCHEDULE B $31,072.15 REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF~ FILE NUMBER Eleanor R. Berq 0238 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. American Express Swiss and U.S. Travelers checks (not discovered by executor until $15,883.70 August, 2008) TOTAL (Also enter on line 5, Recapitulation) ~ $ 15, 883.70 (If more space is needed, insert additional sheets of the same size) ~C- ~;, 2iijg. ~;fiil~'M, l'JACHOVIP, SEA ..u~,..~.._ ~r~th Man_o-------- - - - - . of Wachovia Securities tiVachovia Securities, LLC 3 Lemoyne Drive Lemoyne, PA 1704 Tel 717 761-7344, 500 A68~605 .Fax 717 9753426 ~r~~ Octobez 29, 2005 Douglas La~~T Office William P. Doii~las, Esquire 43 W. South Street PO Box 261 Carlisle, PA 17013 RE: Eleanor R ger~ date of death February 13, 2008 Dear Az~.rl: Listed below are the values for February 13, 2408 11~C. ~ I ~ `w.~cr~ovz.4 5~crn~xT~s Shares Company Per share Total 1636 ATT $ 38.34 $ 62,724.24 800 Abbott Labs $ 56.40 $ 45,120.00 107 Alcatel-Lucent $ 6.15 $ 658.08 120 American Electric Pwr. $ 44.00 $ 5.,280.00 3904 Aqua America Inc. $ ZO.a 1 $ 79,290.24 868 A.utoliv Inc. $ 52.71 $ 45,752.23 328 BP PLC $ 66.42 $ 21,785.76 2400 CSC Corp. $ 49.67 $119,203.00 100 Cicso Systems inc. $ 23.93 $ 2,393.00 378 Citigoup Inc. $ 26.26 $ 9,8x7.50 150 Coz~~cast Cozp A $ 1.7.67 $ 2,650.50 2250 Dow Chemical $ 38.77 $ 87,232.50 769 Duke Enemy $ 18.46 $ 14,195.74 2532 Exxon Ivlobil Corp. $ 85.23 $215,802.36 200 FPL Gxoup Inc. $ 64.52 $ 12,904.00 1711 k'ord Motor Co. $ 6.56 $ 11,224.16 100 Creneral Electric $ 34.$9 $ 3,489.00 11,108.66200 Croldman Sachs Tr $ 10.26 $ 113,974.87 321 I~SBC 1=loldin~s $ 73.62 $ 23,632.02 600 Harsco Corp. $ 55.89 $ 33,534.00 798 Hess Cozp. $ 90.51 $ 72,226,98 80 I-Iospira $ 41.65 $ 3,332.00 Jennifer L, Buehler, MSA E. Yhomas McKee, MBA, CRPC° Senior Vice President - Irnestments Finaneia~ Advisor Financial Advisor tom.mckeemwachovlasec.com jennlfer..bueh lerOwaehoviasec.com lyrtda K. Neff Kondra A. Meyer Tricia M. Mankoski Senior Client Associate Registered Client Associate Registered Client Associate lynda.neif@wachaviasEC.com kendia.meyer@tvaehoviaseacom triCia-mankosl<i@waohoviasec.com ,.-~.+rrr n,~JSG CCT ~!~. 2..08 ~, iiiFi'l~ '~~"Jo,CHOVIA SEC i~!0. ~ l 100 Intel Cozp. $ 21.12 $ 2,112.00 100 J'oku.~son & Johnson $ 63.25 $ 6,325.00 800 Kellogg Co $ 51.08 $ 40,864.00 15 LSI $ 5.19 $ 7755 933 M & T Bank $ 87.80 $ 81,917.40 100 Pepco Holduigs Inc. $ 26.30 $ 2,630.00 1,320 PepsiCo Itlc. $ 71.93 $ 94,947.60 10,320 Pfizer Inc. $ 22.75 $234,780.00 320 Public Service Enterprise ~ 46,91 $ 15,01120 939 Rohm ~: Haas Co. $ 54.68 $ 51,344.52 20 St. Paul's Travelers $ 48.01 $ 960.20 1,311 Sovereign Bancorp,ll~c, $ 12.32 $ 16,J.51.52 384 Spectra Eneztry Corp. $ 23.43 ~ 8,997.12 1,180 Susquehanna Bancshares $ 20.59 $ 24,296.20 400 Teco Energy Inc, $ 15.83 $ 6,332.00 1132 'Verizon Comn.~unications $ 38.40 $ 43,468.80 128 Visteon Coxp. $ 4.14 $ 529.92 300 Washington Real Estate $ 3 7.38 $ 9,414.00 300 Wisconsin 1;nez~gy Corp. $ 45.63 $ 13,b89.00 20 Pennsylvania lnstued $404.83 $ 8,096.60 Money rrxarket fund $1,891.64 r have corrected the amount of shares and the cost per share on sonic of the secuiZtzes,l am sorry for any ineon'vience this has caused. 1f I caz~ be of fuz~her assistance; please let me know. ~Si er ly, ~~ L K. Neff ~cP__„_r C_.Sient Associate ®Rl~STOWN B~~ A Tradition of Excellence 77 East King Street P.O. Box 250 Shippensburg, PA 17257 r~ ~ ~ . (1 r }z °1~~~-. ~. 1 ~ ~ (~,r~ ~ c.-~'~f~ ~ ~ ~ ~~ ~ ~ -S Lf is ~~~-, L ,.j(~ J~ IY v.vuc,t" ~.~ ~~\'~~ L/4f~ ~_ ~'~...1 1 ~~~ ~'~f~ c'i~ l~°~ ~~a.-~~,'~ t,~ I~~~~u ~ l.` ~ ~. ~ ~ ~JfilC~nTi~ ~„---- American Express Check ~or~ TRAUEL Travel Related Services Company, Inc. Number: ~®JSZS~c~S f.- AM6R~CAN 4315 South 2700 West EXPRESS RELATED Salt Lake City, Ut 84184-4030 o SERVICES SEPTEMBER 25, 2008 An American Express company JP MORGAN CHASE HANX DEARBOAN MAILKET P.G. BOX :fAll~ 9-321'720 BATON ROUGE, LOUISIANAIU87bUiLC ~actiy ° Thirteen Thousand, Three Hundred Eighty-Three and 70/100 °i U~ CiC+LCARS ****I3,3~3.7~J{ ~y ESTATE OF ELEANOR R BERG ~ ATTN: THOMAS H BERG EXECUTOR he 130 PARKER STREET ~<~i~-y ~'E rder CARLISLE PA 1701 USA ~ (.~°°° f ~~•80552558~~' s:0724L2927~: 002686L6~~' REC-EMPTION ,,,,,,ER,~,,,,, TRAVEL NON-NEGOTIABLE ~(~55255~ EXPRESS RELATED o SERVICES An American Express company Please retain this receipt for your records. SEPTEMBER 25; 2008 Claim File Number Amount 082505058 ~ * * ~ 13 , 383.70 US DOI,L~RS The attached check reimburses ou for the American bcpress Travelers Cheque(s) which you ~orwarded to us for redemption. The $35(or USD e4uivalent) fee to process the documents has been deducted from this check. Thank you for letting us be of service. Redemption Unit Travelers Cheque Refund Services ESTATE OF ELEANOR R BERG ATTN: THOMAS H BERG EXECUTOR 130 PARKER STREET CARLISLE PA 1701 USA NOtiT-NEGC3T~ABLE