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Home My WebLink About12-31-0815056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2aosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 00988 EMTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 083-10-3194 08/09/2008 03/02/1917 Decedent's Last Name Suffix Decedent's First Name MI Barton Constance S (If ~4pplicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Ml Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW c:~% 1. Original Return ~: THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF W{LLS 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received _ 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) _. 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 - 7HI5 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Robert P. Grubb, Esq. ! (717) 238-8187 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY Metzger Wickersham First line of address ;, j r 321! 1 North Front Street - ~~ r.a Second line of address '~~ tTt c- P.G. Box 5300 ..__ '! `~~ City or Post Office State Z{P Code DATE F4L6tJ "7 Harrisburg PA 17110 -~ `:-~ ~' Correspondent's a-mail address: Under penalties of perjury,) declare that I have examined this is ~, correct and complete. D~faration of preparer other -TUBE OF PERSON $J~OJaISI8E~6R AILING I~ w including accompanying schedules and statements, and to the best of my knowledge and belief, e personal representative is based on all information of which preparer has any knowledge. ~ ~ ~~ ~A~ G'd~ Mary Beth(S'hafer, 5 Homestead Road, Newpo , P 17074 SIGNAIrURE O PREP ER OTHER THAN REPRESENTATIVE DATE ss, & Erb, P.C., P.O. Box 5300, Harrisburg, PA 17110 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: C0nSlanCe S Barton 083-10-3194 RECAPITULATION 1. Real estate (Schedule A) . ......................................... ... 1. 2. Stocks and Bonds (Schedule B) .................................... ... 2. 143,555.01 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. 4,049.56 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) ................................. ... 8. 147,604.57 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 18,018.80 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. 2,013.16 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 20,031.96 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 127,572.61 13. Charitable and Governmental BequestslSec 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. 127,572.61 ~w. _ .~ .. _n . ... _ .... 'fAX 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 45 127,572.61 16. 5,740.77 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... .. 19. 5,740.77 20. FILL tN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1 5056052059 Side 2 15056052059 REV-1500 E>: Page 3 File Number Decedent's Complete Address: 21 08 00988 DECEDENT'S NAME Constance S Barton STREETADDRESS 5 Homestead Road CITY Newport DECEDENT'S SOCIAL SECURITY NUMBER 083-10-3194 STATE PA ZIP 17074 Tax Payments and Credits: 1. Tax Duey (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 5, 350.00 281.57 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest _ _ _ E. Penalty ------ 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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT (1) 5, 740.77 5,631.57 109.20 109.20 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 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-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)]. Asibling is defined, under Section 9102, ais an individual who has at least one parent in common with the decedent, whether by blood or adoption. ftEV-1603 EX+ (6-98) 1` ~~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Barton, Constance S. 2108-00988 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ Wachovia Securities Command Account No. 9621349989/1578-0559. Date of death valuation 113,835.83 provided by Wachovia Securities, a copy of which is attached. 2. GE Investments Distributors, Inc., S&S Program Mutual Fund No. 0097 41.75 X 750.154 shares; Account No. 2000456299-001 Statement of valuation attached. 3. MetLife lns. Co. Stock - 28 Shares valued as follows: 8/08/2008 High $53.32. Low $50.63 =Median price of $51.98 per share. 8I11I2008 High $54.60. Low $52.27 =Median price of $53.44 per share. Median of 8/08/2008 + 8/11/2008 = $52.71 per share X 28 shares = $1,457.88 TOTAL (Also enter on line 2, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 28,243.30 1,475.88 143,555.01 REV-1.i08 EX+ (6-98) ~. COMP~10NWEALTH OF PENNSYLVANIA INHERITANCE 7AX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Barton, Constance 2108-00988 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. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barton, Constance S. 2108-00988 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ry~ Funeral Director No. 1 -Edward F. Carter Funeral Home, 41 Grand St., Croton-on-Hudson, NY 10520 6,185.00 2. Funeral Director No.2 -Mark Christ Funeral Home, 31 Mahanoy Avenue, Tamaqua, PA 18252 4,440.80 3. Swanson Florist, Croton, NY -flowers 390.36 4. Black Jack's Restaurant -Montrose, NY -funeral dinner 983.15 5. Asbury United Methodist Church, Croton-on-Hudson, NY -minister's honorarium 250.00 6. Asbury United Methodist Church, Croton-on-Hudson, NY -organist's honorarium 250.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/FIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees z. Cumberland Co. Law Journal -Estate Publication s. Carlisle Sentinel -Estate Publication s. Metzger Wickersham -misc. expenses, copies, postage, etc. ~o. Wachovia Securities -Date of death valuation fee i i . Register of Wills -REV 1500 filing fee TOTAL (Also enter on line 9, Recapitulation) I $ 18,018.80 Zip 5,000.00 Zip 118.00 75.00 190.54 85.95 25.00 25.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (t2-03) ~~ SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barton, Constance S. 2108-00988 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 1 Bonstein and Jefferies doctor's office -medical debt 28.09 2. Kunkle Surgical Center -medical debt 60.45 3. Kenetic Image -medical debt 30.60 4. Azizkhan Internal Medicine Association -medical debt 14.00 `,i. Carlisle Regional Medical Center -medial debt 324.00 E3. Carlisle Diagnostics -medical debt 3.26 r'. Kunkle Surgical Center -medical debt 148.74 8. Carlisle Regional Hospital -medical debt 149.00 ~l. Dr. Baker -medico{ debt 17.43 10. Spring Road Family Practice -medical debt 173.59 11. Sarah Todd Memorial Home -final nursing home bill 1,064.00 TOTAL (Also enter on line 10, Recapitulation) $ 2,013.16 (If more space is needed, insert additional sheets of the same size) REV-'513 EX+ (5-0Oi ~' ~ ' SCHEDULE J COb1t~-10NWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTAI~E OF FILE NUMBER Barton, Constance S. 2108-00988 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE t TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 ~ Mary Beth Shafer, 5 Homestead Road, Newport, PA 17071 daughter 50% 2. Roger E. Barton, P.O. Box 265, Loveland, OH 54140-0265 son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET It 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 I $ (If more space is needed, insert additional sheets of the same size) SINCE 1888 December 30, 2008 Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: The Estate of Constance S. Barton Cumberland County Estate No.: 2008-00988 Our Matter No.: 3-251 Dear Register of Wills: 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax:717-234-978 Other Offices Lancaster Shippensburg 777-431-0138 717-530-7515 Wilkes-Barre York 570-825-7500 717-S~k3-0502 Please find enclosed three (3) copies of the Pennsylvania REV 1500 for the above referenced estate. Kindly file one in your office, one with the Department of Revenue, and date stamp the third copy and return it to my office in the enclosed self addressed envelope. Also enclosed is a check for the required filing fee and a second check for the balance of the Inheritance Tax which is due. Should you have any questions please feel free to contact my office at the above phone number. Thank you for your prompt attention to this matter. Sincerely, METZGER, WICKERSHAM, KNAUSS,_& ERB, P.C. --- l ~, ,? -, __, ~, _ -: ~~ Ro P. Grubb, quire -, ,_, C..., _ ~~ _, _, -, Enclosures: - - ,- -c~ , /~~ _~ W y~ N James F. Carl Edward E. Knauss, N~ Clark Devere' Francis J. Lafferty, N Andrew W. Norfleet Robert P. Grubb Of Counsel ~ `Board Certifn'd in civil ^ "`~ trial lain and adz~ocani ~ ~ j L/IY\ hq Hie Natinr,al Bean!