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Home My WebLink About03-11-0915056051058 REV-1500 Ex (o6-D5, PA Department of Revenue Bureau of Individual Taxes { ~. ~ Po ecx 2aoso~ f ~ INHERITANCE TAX RETURN Harrisburg. PA •712&-06~t ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW OFFICIAL USE ONLY County Code Yea File Number o~ ~ G'~ ~~~ ~~ Soc+ai Security Number Date d Death Date of Birth 186-34-4636 06/12!2008 01;26;1943 Decedents Last Name Suffix Decedent's First Name MI APGAR WALTER 1/~i (If Applicable) Enter Surviving Spouse's Information Below S~nusn'a 4 ast FJame Suffix Spouse's First Name MI Spouse's Soeial Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL tN APPROPRIATE OVALS BELOW ~ . Original Return 2 Supplemental Return 3 Rem2inder Return (date of death prior to '• 2-13-82) 4 Limited Estate 4a. Future Interest Compromise (date of 5 Federal Estate Tax Refum Required death after 12-12-82) ~ 6- Decedent D;ed Testate 7. Decedent Maintained a Living Trust 0 g. Total Number of Safe Depcs'~t E3oxes (Attach Copy of Will) (Attach Gopy of Trusij 5. Litigation Proceeds Received i0. Spousal Poverty Credit (date of death '1. Election tc tax under Sec. 9113(A) between 12-31-91 and 1-1-95j (Attach Sch_ O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number CHARLENE r`EUCHTENBERGER (717) 530-2614 Firm Name ('ItApplicable) -~.., `-"~ R"c.iiSTER ~~0'ELLS USE E;f ORRSTOWN BANK EXEC `~ -;~ , . First line of address T~ 7 -'~ C) %~ 77 EAST KING STREET - -- ~~; , Seccnd line of address "'C7 P.O. BOX 250 ~':~~ _ ~ City or Post Office State ZIP Code [3 A,i:t~.~?Lc0 ~,. N N SHIPPENSBURG PA 17257 correspondents e-mail address: cfeuchtenberger@orrstown.tom _r - - ~5 •r~; -_ f _ ~ ~-x Under ~ naltie~ ~f penury. I decla . tha have examined this return, including accompanying schedules and statements, and to the best of my knowledge and beret, it Is t e. torte a a complete ec ion of prepa~er other than [he personal representative is based on all information of which preoare~ has any ~~now;edge SI NATUR O ~P,E~jR~SON R S LE FO FILI RETURN ~rjT A RESS ~~ t'L ~ ~~ ~~~~ ~~r~r SIGNAf URE OF PRE PARER OTHER THAN ADDRESS ~:_~rrSto~rn ~3a~k Trust - TIVE P.O. Box 250 5hsppensburg, PA 17257 17-530-~6()5 DATE PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 150560.510:8 <~- 15056052059 REV-1500 EX Decedent's Social Security Number WALTER W APGAR 186-34-4636 Decedents Nae~e. RECAPITULATION 1 FZeal estate (Schedule A). ........ 1. 120.000.00 2 Stocks and F3onds (Schedule B) .. .. 2 712.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 0.00 4. fJiortgages & Notes Receivable (Schedule G) .. - . 4. 0.00 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... .. 5. 36,046.93 6 Jointly Owned Property (Schedule F) Separate Billing Requested .... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate BiAing Requested.... 7. 343,636.08 8 Total Gross Assets (total Lines 1-7). .... 8. 5~~,395.01 9 Funeral Expenses 8 Administrative Costs (Schedule H).. ...... .. 9. 37,533.28 10. Debts of Decedent, P~lortgage Liabilities, 8 Liens (Schedule I) .. 10 6.938.93 11. Total Deductions (total Lines 9 & 10) 11. 44,472.21 12. Net Value of Estate (Line 8 minus Line 11) ............... 12 455,922.80 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election tc tax has not been made {Schedule J) .... 13. 68,388.42 14 Net Vatue Subject to Tax (Line 12 minus Line 13) .... 14 387,534.38 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15- Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(t2) X 0_ 15. 16. Amount of Line 14 taxable at lineal rate X .045 68.388.42 1B 3,077.48 i7. Amount of Line i4 taxable at sibling rate X 12 17. 18. Amount of Line 14 taxable 145.96 319 47 871 89 , at collateral rate x .15 18 , . 19. TAX DUE 19 50,949.37 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I _5056052059 Side 2 15056052059 REV-?500 EX Page 3 File Number Decedent's Complete Address: -- --- DECEDENT'S NAME WALTER W APGAR STREET ADDRESS 660 COLONIAL VIEW ROAD CITY MECHANICSBURG DECEDENT'S SOCIAL SECURITY NUMBER 186-34-4636 STATE ZIP PA 17055 Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) (1) 50,949.37 - ---- 2- CreditsiPayments 46,000.00 r1. :JpVUSa 1=weliy Ciec;li B. Pnc, Payments 2,420.98 C. Discount Total Credits (A+ B + C) (2) 48,420.98 3. InteresUPenalty if applicable D Interest E Penalty Total InteresUPenalty (D + E) (3) It L ne 2 is greater than Line 1 -Line 3. enter the difference. This is the OVERPAYMENT. U Fill in oval on Page 2, Line 20 to request a refund. (4) 5 If Line 1 + Line 3 is oreater than Lme 2. enter the difference. This is the TAX DUE, i5) 2.528.39 A. Enter the interest on the tax due (5A) 0.00 B. Enter the tctal of Line 5 + 5A This is the BALANCE DUE (5B) 2,528.39 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 :............_....... _._..__. .... u ~, n u b. retain the right to designate who shall use the property transferred or its income :..............................._... ..._ ^ ^X c. retain a reversionary interest; or__ ...._............_....._ .................__.......___......................._.._.......... ..._ r_] 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? ......._ ...................___.........................._..................................... ..... ~i LU 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? ......._ ..............._..........................__..... __ lJ n l_._i 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 tc or for the use of the surviving spouse is three (3} percent [72 P.S. §9116 (a) (1.1) (i)}. Fcr 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 st11 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 er 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)]. A sibling is defined. under Section 9102. as an individual who has at least one parent in common with the decedent. whether by blood or adoption. Pennsylvania ~ SCHEDULE A c r.irir ra er ~ ~ '".~~ i I REAL ESTAT€ ,~ _~~ 7a~~E ~x F ,",v ESTATE OF FILE NUMBER 'JVALTER W APGAR 2008-00677 Alf real property owned solely or as a tenant in common must be reported at fair market value. 3-~ ^arket ,.2i~~~e ^F ~.,°~- ~'~~ cr r at wh~c7 ~ r<<, ~r~ . ~ _ _ ~haryE C ~ ::~F ..'-c ~~~yer znc' ~ ~+ ~,re _' e~, nei!ne hero compePed to Cut' or ~Gi , ectr:~ haci~c ~easo~oh e a.'.C ~e.,,t ;, !~e re'+eva o_,- Real property that is jointly owned with right of survivorship must be disclosed on Schedule F Attach a cohd f ~ e set[~e.~~e~t ~ ee i~ the G_oper y i~ beep so o. rr_M cluuc a eopq c she Gr~C _ .,.. ...a~~~,~ is i e est ' rn ~ ,,, ,F ~~t in mmmt~n, VALLE AT ^A7E DESCRIPTl~U '-~ ~ P,~~IDEFSCE-660 COLONI.A!_ V4E\N ROP.D. ~AECHPNICSBURG PA @ APPRAISED VALUE 120.000.00 Ii - - - - --- ~ 120.000.00 TOTAL Aisc enter on Line 1, Recapitutariar~.j 1 5 f mae space is needed, insert additienz'~ cheet< of the same size. REV-1503 EXi 16-98) G1 r - SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER WALTER W APGAR 2008-00677 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) ~'-~ ~ SCHEDULE E a '~~ coMnncs~~~~~~~ H cF aFrvNSVwaNln CASH, BANK DEPOSITS, & MISC. irv~li=Rr~F~hcE T~.x REiuRN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER WALTER W APGAR 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_ ---~ - - - - ---- -------- T -- - _ IiEt.1 ~ "i' JE ~" DF~iE NUMBER I DESCRIPTION ~ OF DEi+TH o. 1 CASH FOUND AMONG BELONGINGS 433.10 2 ~ I REFUND CHECKS FROM DlALAMERIGA MARKETING j 119.90 3 PSECU CLOSED ACCOUNT PROCEEDS I 631.58 4 CASHIER'S CHECK DRAWN ON ORRSTOWN BANK 83.22 5 I REFUND CHECK FROM PROFESSIONAL INSURANCE SERVICES. tNC. 69.50 6 i REFUND RECEIVED FROM QUANTUM IMAGING & THERAPEUTIC ASSN. 1,107.00 7 ~ ERIE INSURANCE GROUP, REFUND OF AUTOMOBILE PREMIUM ~ 3:~4 00 8 I LESH AUCTION COMPANY, NET PROCEEDS FROM AUCTIONS 10;801.29 9 I FULTON BANK, PROCEEDS CLOSED CHECKING ACCOUNT # 2218-72550 22,467.34 T07AL (Also enter on line 5, Recapitulation) S 36,046.93 (If more sRace is needed, insert additional sheets of the same sizel ~. a ' "4` COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER WALTER W. APGAR 2008-00677 This schedule must be rompleted and fled if the answer to any of questions 1 throuch 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY iNauos rHE h~tiv~E or raElRa.hsrEReE,Tr;EiR eevlionsn~ia rc oEC[oEti~~ FNO Tr+EOnTEOrTRnNSFER nrrncHncocvoFlr!EOEronoaaEnrESraTE DATE OF DEATH VALUE OF ASSET °,a OF DECD'S ~ INTEREST EXCLUSION nFnPP~~icaerE~ T.4XPPLE VALUE ' , PENNSYLVANIA STATE EMPLOYEES RETIREMENT FUND BENEFICIARY: ESTATE OF WALTER W. APGAR 230 323 05 100 ~ ~ , . 23u 323.G5 2 ~ MIDLAND NATIONAL LIFE INSURANCE ANNUITY & INTEREST ACCRUED i I BENEFICIARY' ESTATE OF WALTER W APGAR 61,577.55 100 i e~ 577 55 3 EQUITRUST LIFE INSURANCE ANNUITY 3 I BENEFICIARY' ESTATE OF WALTER W. APGAR I 51,735.48 ~ I 100 I ~ 51.735.48 I I - - - I i ~~ I I ---~- i -- TOTAL (Also enter on line 7 Recapitulation) $ 343,636.08 (If more space is needed, insert additional sheets of the same size) REV-iFtt EX+ (12-99) SCHEDULE H FUNERAL EXPENSES 8c COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER WALTER W. APGAR 2008-00677 ITEt~1 NUMBER A. 1. z 3 4 5 e. 1 2 3 4. 5. 6. 7. 8 9 10 Debts of decedent must be reported on Schedule I. FUNERAL EXPENSES: MYERS-HARNER FUNERAL HOME, INC.; SERVICES FOR WALTER APGAR GINGRICH MEMORIALS, BALANCE DUE FOR WALTER APGAR MICHAEL F. HAMMER, IN GRATITUDE WALTER APGAR SERVICE J. RONALD SMITH, IN GRATITUDE WALTER APGAR SERVICE CHRISTIAN LIFE ASSEMBLY, IN GRATITUDE FCR POST SERVICE LUNCHEON ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) ORRSTCVvN BANK Social Security Number(s)/EIN Number of Personal Representative(s) 23 0934350 Street Address 7 7 EAST KING STREET City SHIPPENSBURG .State PA Zip 17257 Year(s) Commission Paid 2009 Attorney Fees CHARLES E. SHIELDS , III , ESQUIRE 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 Probate Fees Accountant's Fees Tax Return Freparer s Fees CHARLES E. SHIELDS, III, ESQUIRE. LEGAL EXPENSES CHARLENE FEUCHTENBERGER, REIMBURSEMENT FOR OBITUARY AND DEATH CERTIFICATE FOR VIRGINIA APGAR. POD SAVINGS BONDS ORRSTOWN BANK. ACCRUED INTEREST CN LOAN TO COVER INHERITANCE TAX PAYMENT AMOUNT 3,518.00 910.00 75.00 75.00 250.00 21,100.00 10.850.00 202.00 487.50 19.95 45.83 TOTAL (Also enter on line 9, Recapitulation) $ 37,533.28 (It more space is needed. insert additional sheets of the same size) REV-i512 EX+ (12-08) a Pennsylvania SCHEDULE I '~' DEPARTMENT DE REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER WALTER W APGAR _ 2008-00677 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ERIE INSURANCE GROUP -PREMIUM DUE FOR THE ESTATE OF WALTER APGAR 449.00 2. RODALE -BALANCE DUE FOR WALTER APGAR #0256424722 52.90 3. BUREAU OF ACCOUNT MANAGEMENT BALANCE GUE FOR WALTER APGAR #25324977 73.00 4. BOTTOM LINE BOOKS BALANCE DUE FOR WALTER APGAR 36.92 5. BUREAU OF RECOVERY, LLC FOR SPRINT BALANCE DUE FOR WALTER APGAR #675768711 ~ 122.11 6. YORK WASTE DISPOSAL, INC BALANCE DUE FOR WALTER APGAR #3811120256413 87.00 7. UPPER ALLEN TOWNSHIP BALANCE DUE FOR WALTER APGAR #635060 341.60 8. UNITED WATER PENNSYLVANIA #00200999479828 155.93 9. PPL ELECTRIC UTILITIES BALANCE DUE FOR WALTER APGAR #06920-75004 717.86 10. QUANTUM IMAGING & THERAPEUTIC ASSOCIATES BALANCE DUE FOR WALTER APGAR 1,551.00 11. SANDRA STAIR HOMEOWNERS ASSOCIATION DUES FOR WALTER APGAR 70.00 12. PRONTO PLUMBING BALANCE DUE FOR WALTER APGAR 483.69 13. SECCO HOME SERVICES BALANCE DUE FOR WALTER APGAR 303.59 14. SPECIALTY CLEANING SERVICES, INC. BALANCE DUE FOR CARPET CLEANING 339.20 15. SPRINT NEXTEL CORP BALANCE DUE FOR WALTER APGAR 111.95 16. VERIZON BALANCE DUE FOR WALTER APGAR #717795891336702Y 605.78 17. COLONIAL VIEW CONDOMINIUM ASSOCIATION BALANCE DUE FOR #660 350.00 18. MARLIN A YOHN SR., TREASURER 2008 REAL ESTATE TAX FOR WALTER APGAR 1,087.40 TOTAL (Also enter on Line 10, Recapitulation) ($ 6,938.93 If more space is needed, insert additional sheets of the same size. n t'~.i-:513 'cX ;.. :-05? `, i~ Pennsylvania or.rnarwENr aFaEVENUF ~rur+ERiTnrvice TAx RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER WALTER W. APGAR 2008-00677 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 ~~ousal di~tr~butions and transfers under 1. 2 3 4 5 6 7 8 9 10 II 1 1 2 3 _r _ Sec. 2116 (a) (L2).] Hugh Huntzinger, 660 Colonial View Road, Mechanicsburg, PA 17055 cousin 20%-$77,506.88 Gretchen Huntzinger, 706 Linwood Street, Collingswood, NJ 08108 cousin 20%-$77,506.88 Rita Lengel, 825 Lee Lane, Enola. PA 17025 friend 5%-$19,376.72 Marilyn Hocker, 31 Round Ridge Road, Mechanicsburg, PA 17055 friend 15°%-$58,130.16 Susan Ervin, 713 Champion Avenue, Wesi Collingswood, NJ 08107 friend 5%-$19,376.72 Kelly Myers, 513 Joyce Road, Camp Hill, PA 17011 daughter 5%-$21,770.31 Courtney Apgar, 114 North 21st Street, Camp Hill, PA 17011 granddaughter 5%-21,770.31 Grandee Apgar, 513 Joyce Road, Camp Hill, PA 17011 granddaughter 5%-21,770.31 Matthew Hocker, 31 Round Ridge Road, Mechanicsburg, PA 17055 friend 2 5%-$9,688.36 Joel L. Hocker, 31 Round Ridge Road, Mechanicsburg, PA 17055 friend 2.5%-$9.688.36 ENTER DOLLAR AMOUNTS FOR DISTR]BUTIONS SNOWN ABOVE ON LINES 15 THROUGH 18 OF REV-150D COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUT]ON4: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 21]3 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Christian Life Assembly Church. 2645 Lisburn Road. Camp Hill, PA 17011 Crossfire Ministries. 430-A Colonial Road, Harrisburg, PA 17109 Celebration Community Church; 303 Golf Club Avenue. Dillsburg, PA 17019 I I TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 1$ If more space is needed, insert additional sheets of the same size. 5%-$22;796.14 5%-$22,796.14 S%-$22;796.14 68,388.42