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HomeMy WebLinkAbout03-04-0915056041114 REV-1500 I_x (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN ~ I V I `~-~ PO BO:X 280601 `~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 189-09-4214 11282008 Decedent's Last Name Suffix Decedent's First Name MI STEIGLEMAN GEORGE F (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WELLS FILL INAPPROPRIATE OVALS BELOW 1. Original Retum ~ 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) 0 4. Limited Estate ~ 4a. Future Interest Compromise (date of ,~ 5. Federal Estate Tax Retum Required death after 12-12-82) 0 8. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Totai Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G. FREY 717-243-5838 Firm Name (If Applicable) FREY & TILEY First line of address 5 SOUTH HANOVER STREET Second line of address City or Post OfFce CARLISLE State ZIP Code PA 17013 REGISTER WILLS USE ~Y Q .r' V ~~ ~ ~ © -~ g 3 G? DA D . ~. ~,. ) t r~Z •:, E . ;-r ~ _...: ,w, C~:' C_> .` ~ _ _ ,..:~ `; i'X`i r.. 4i Q Correspondent's a-mail address: RFREY@ FREYTILEY . COM Under penalties o perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, R is true, correct and complete. Declaration of preparer other than the personal representative is based on ali information of which preparer has anv knowledce. SI UR~E/OF SON RP PONSIBLI1,E~ FOR FILING RETURN / DATE ~~ o S ~~r! ~r vi , C~r1 i1L~ , ~ 170/3 SI RE OF REP OTtjFER R PRESENTATIVE ~ ~/DAT v T ADDRESS ~ Se .~ f'~, ~~-it-w ~: S f' C ~ ~ ~ ~ ~ 2 (~ I ~ d f PLEASE USE ORIGINAL FORM NLY Side 1 15056041114 15056041114 J J REV• 1500 EX 15056042115 Decedent's Social Security Number Decedent's Name: GEORGE F STEIGLEMAN 189-09-4214 RECAPITULATION 1. Real estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) ............................ ......... 2: NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages & Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 7115 . O 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested . ....... 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested . ....... 7 NONE 8. Total Gross Assets (total Lines 1-7) ........................... ....... 8. 7115.0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ............ ........ 9. 317 4 8 . 0 O 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........ ....... 10. 3 4 2 5 6.0 0 11. Total Deductdons (total Lines 9 & 10) .......................... ....... 11. 6 6 O 0 4 . 0 O 12. Net Value of Estate (Line 8 minus Line 11) ...................... ....... 12. - 5 8 8 8 9 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ ....... 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) .. ...... 14 - 5 8 8 8 9 0 0 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. O. 0 0 16. Amount of Line 14 taxable at lineal rate X .0 4 5 16. 0.0 0 17. Amount of Line 14 taxable at sibling rate X • 12 17, 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X , 15 18. 0 . O 0 19. TAX DUE ................................................ ....... 19. O . O 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 L 15056042115 15056042115 J REv-~soo ER Page 3 189-09-4214 Decedent's Complete Address: File Number 21-09-0158 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER GEORGE F STEIGLEMAN 189-09-4214 STREET ADDRESS 375 CLAREMONT DRIVE CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due-(Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits (A + B + C) (2) 0.00 0.00 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. Fili 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) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 0.00 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 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)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 adoption. 217 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER. George F SteiQleman 21-09-0158 Include the proceeds of litigation and the date the proceeds were received by the estate • • •~,.. ~..u..G ,~ i iccucu, .. ~~~~ ~ aaaiuvnai sneers or the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER George F Steigleman 21-09-0158 Debts of decedent must be re orted on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: AMOUNT ~. Hetrick Cemation Service 291 2. Georges Flowers 109 3. Honorarium 20 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative(s) John W. Steigleman Street Address 1810 Suncrest Drive city Carlisle state PA zip 17013 Year(s) Commission Paid: 2009 500 2• Attorney Fees 500 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. 5. 6. 7. Zip Probate Fees Accountant's Fees Tax Return Preparer's Fees dical expenses incurred within 6 months of the date of death 94 50 30,184 TOTAL (Also enter on line 9 Recapitulation) I ~ 31 748 (If more space Is needed, Insert addltlonal sheets of the same size) REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF George F Steigleman FILE NUMBER 21-09-0158 Report debts Incurred by the decedent ~rtor to death rtiar .em~i~ea ,..,...,~a ....~_ ~_._ _. ,_ _.,_ .. CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent GEORGE F. STEIGLEMAN Date of Death: NOVEMBER 28, 2009 Estate Number: 21-09-0158 Date Letters Granted: FEBRUARY 17, 2009 To the Register: I certify that Notice of Estate Administration by Pa. O.C. Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on FEBRUARY 26, 2009: Name: First Church of The Brethren Deborah Campbell David Steigleman Dennis B. Steigleman Gerald R. Steigleman Dawn Gamer Bernice Hibbard Sharon Holtz Jaynee Hubble John W. Steigleman June Martin Pauline McCart Peggy Stoner Donna Kay Phelan Judy Poist Leonard Stoner Barbara Johnson Edward Steigleman Address: 1340 Forge Road, Carlisle, PA 17013 N. Bedford Street, Carlisle, PA 17013 4 Peach Orchard Road, Newville, PA 17241 Box 257, Oakwood Drive, Newport, PA 17074 76 Malibu Blvd., Cazlisle, PA 17015 36 S. West Street, Cazlisle, PA 17013 1072 Gilend Street, Hebron, CT 06248 107 Wyndham Way, Harrisburg, PA 17109 P.O. Box 711, Ahaville, CA 95221-0711 1810 Suncrest Drive, Carlisle, PA 17013 5227 Cobblestone Drive, Mechanicsburg, PA 17055 215 Gail Lane, Sapulpa, OK 74066 313 Scenic Drive, Mechanicsburg, PA 17055 275 Smith Road, Shippensburg, PA 17257 142 S. East Street, Cazlisle, PA 17013 542 Shalom Drive, New Oxford, PA 17350 988 W. Redwood Drive, Chandler, AZ 85248 141 N. East Street, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(. NO EXCEPTIONS Date: FEBRUARY 26, 2009 /^4.. h '4 ' ~_ Signature of Person Filing this F Capacity: Personal Representative Robert G. Frey, Esquire 5 South Hanover Street Carlisle, PA 17013 (717) 243-5838 N -- ... ~ ~.r-, ~_~_.1 __ -. rn Form RW-08 rev. 10.13.06 ,~ ~„~,.~_ ..,...,~ r .,.. _:..._. . -. , .] .. .,... -. .... ,. LAST WILL AND TESTAMENT OF GEORGE F. STEIGLEMAN I, GEORGE F. STEIGLEMAN, widower, of 1045 Northfield Drive in the Borough of Carlisle Cumberland County, Pennsylvania, being of sound and disposing mind, memory and undF;rstanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Hoffman Roth Funeral Home 219 North Hanover Street, Carlisle, Pennsylvania in a manor substantially similar to the arrangements which I made fpr the services for my wife, Hazei B. Steigleman, and that my body be interred beside hers on my burial lot located in Cumberland Valley Memorial Gardens near the Borough of Cazlisle, Pennsylvania. I further direct that all inheritance, transfer, succession, estate and death taxes which may be payable on account of my death, including interest and penalties thereon, shall be paid from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estaG:. 2. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: a. One-third (1/3) thereof to the Board of Trustees of First Church of the Brethren, 1340 Forge Road, Carlisle, PA 17013, to be used for such purpose or purposes as said Trustees shall deem best. b. One-half (1/2) thereof shall be divided equally among such of my following named eleven (I 1) nieces and nephews who shall survive me by a period of ninety (90) days, but should any of them fail to so survive me then the share such deceased person would have received shall lapse and be divided among the remaining nieces and nephews of such eleven (11) named persons as shall so survive me, my eleven (11) nieces and nephews being the following: John W. Steigleman, Jr., Pauline McCart, Dennis Steigleman, Gerald Steigleman, Dawn Garner, Judy Point, Edward Steigleman, David Steigleman, Jane Hubble, Deborah Cambell, and Donna Kay Phelan. c. The remaining one-sixth (1/6) thereof shall divided equally among the following seven. (7) nieces and nephews of my wife provided each of them shall survive me by a period of ninety (90) days, but should any of said seven (7) nieces and nephews of my wife fail to so survive me then the amount such deceased person would have received shall lapse and be divided among the remainder of the seven (7) nieces and nephews of my wife who shall so survive me, the said seven (7) nieces and nephews of my wife being the following: June Martin, Peggy Stoner, Leon~u•d Stoner, Bernice Hebert, Sharon Holttz, Bazbaza Johnson, and Kenneth Burket. 3. I hereby nominate, constitute and appoint my nephew, John W. Steigleman, Jr. and my wife's niece June Martin, as Co-Executors of this my Last Will and Testament, and further direct that neither of them shall be req»ired to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my band and seal to this my Last. Will and Testament written on one (1) page, this ~~~day of T - , .2000, r ' cs..-•- (SEAL) George teigleman Signed, sealed, published, and declared by George F. Steigleman the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 6486 HARRISBURG, PA 17105-8486 February 19, 2009 FREY & TILEY ROBERT G FREY ESQUIRE 5 SOUTH H.ANOVER STREET CARLISLE PA 17013 Re: GEORGE STEIGLEMAN CIS #: 580205102 SSN: 189-09-4214 Date of Death: 11/28/2008 Dear Attorney Frey: Please be advised that the Department of Public Welfare maintains a claim in the amount of $64,439.60 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A porl=ion of this medical expense, namely $30,1@3.75, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pai. C.S.A. 3392(3). The balance of the claim, namely $34,255.@5, is to be entez•ed as a priority Class ~ claim against the estate. s~ Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, ~~~, ~. Barbara I. Aschenbrenner TPL Program Investigator 717-772-6617 717-772-6553 FAX Enclosure