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Home My WebLink About04-28-09 (2)1505607120 -' REV-1500 ~( (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2soso~ 21 0 9 0 213 Harrisburg, PA 77128-o61J1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 20 0841 O1 22 2009 10 10 1926 Decedent's Last Name Suffix Decedent's First Name MI SMITH BETTY C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum 4. Limited Estate O 8 Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-122) ~ Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 10 Spousal Poverty Credit (date of death ~ 11. Election to tax untler Sec. 9113(A) between 12-31-91 antl 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Numbera "`'~ JAMES D . BOGAR 717 737 8761s~ =''~=~`~,-', Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES First line of address ONE WEST MAIN STREET Second line of address City or Post Office SHIREMANSTOWN State ZIP Code PA 17011 Correspondent'se-mail address: jbOgar@bogarlaw.com _~ REGISTER OF Ib~JSE r J.Y ~ ~ ~ ~ _ ,_, %~ ~} '-I / ~ ~ ) J 'S ~ ~ - -o - / ~~ _ ~ ~ - ~ ~ `~ 7 DATE FILED ::; -- ~•~~ _ ~,ri ,; - ~ ~, ~,} 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. SIGMRSU OF PERSON R PONS L FOR FILING RETURN D TE ~` 11 ~ Sharon S. Hillegas /Q ADDRESS 540 Brentwater Road, Ca Hill, PA 17011 SIG'NATU O PREPA O HER THAN REPRESENTATIVE DATE James D. Bogar •,j 2 b ADDRESS One West Main Str ,Shiremanstown, PA 17011 Side 1 1505607120 1505607120 1505607220 REV-1500 EX Decedent's Social Security Number Decedents Name: Betty Ci . Smith 17 4 2 0 0 8 41 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 1 0, 9 9 4. 8 5 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. 2 9 . 1 3 E;. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. %. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets {total Lines 1-7) ....................................................................... 8. 1 1, 0 2 3. 9 8 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 0 , 4 6 0 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... . 10. 7 9 6 . 5 9 11. Total Deductions (total Lines 9 & 10) ..................................................................... . 11. 1 1 , 2 5 6 . 5 9 12. Net Value of Estate (Line 8 minus Line 11) ............................................................ . 12. ~ 2 3 2.61 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. - 2 3 2 6 1 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 .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16• 0. 0 0 117. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 1 ~• 0. 0 0 '18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due .................................................................................................................... . 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-0213 DECEDENT'S NAME Betty C. Smith STREET ADDRESS 540 Brentwater Road CITY Camp Hill STATE ZIP PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.0 0 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable p. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 p,. Enter the interest on the tax due. (5A) g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Q . 0 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 :.................................................................................. ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ 0 c. retain a reversionary interest; or .................................................................................................................. ^ x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ O 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... [~ ^x 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 p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemat 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 finrenty-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 Pineal beneficiaries is four and one-half (4.5) percent, except a;> 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. Rev-1503 FJt+ (g-98) SCHEDULE B STOCKS 8~ BONDS COMMONWEALTH OF PENNSYLVANIA ~ I INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Betty C. 21-09-0213 All propeAy jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESGRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 461 shares of Prudential Stock -170 book entry shares 23.85 10,994.85 and 291 certificate shares - Computershare Account No. 00021211443 TOTAL (Also enter on Line 2, Recapitulation) 10,994.85 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98} Investor Relations -Prudential Financial Historical Price Lookup ' Stock Quote ~ Stock Chart ~ Historical Price Lookup ~ Investment Calculator Symbol PRIJ (Common Stock) Lookup Date January 222009 Look Up Results Date Requested 01/22/09 Closing Price $23.850 Volume 9,853,744 Split Adjustment Factor 1.0000:1 Open $23.930 Day's High $24.910 Day's Low $21.490 Page 1 of 1 Print Page Close Window NOTE: The Closing Price, Day's High, Day's Low, and Day's Volume have been adjusted to account for any stock splits and/or dividends which may have occurred for this security since the date shown above. The Actual Price is not adjusted for splits or dividends. The Split Adjustment Factor is a cumulative factor which encapsulates all splits since the date shown above. The closing price above is not necessarily indicative of future price performance. 17a t~k Shares axll Cer~~~'ea~e ~res ~/(~ ~ http://www.investor.prudential.com/phoenix.zhtml?c=129695&p=irol-stockLookup_pf&t=... ?/5/2009 Rev-15013 E7(+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYL4ANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Smith, Betty C. 21-09-0213 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntlyowned with the right of survivorship must be disclosed on schedule F. Copyright (c) 2002 form software only The Lackner Group, inc. Form PA-1500 Schedule E (Rev. 6-98) (If more space is needed, additional pages of the same size) March 12, 2009 James D. Bogar 1 W Main St Shiremanstown PA 17011 RE: Estate of: Betty C. Smith Tax Identification Number: 174-20-0841 Date of Death: January 22, 2009 To Whom It May Concern:. Commerce Bank This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 32069486 Date Opened: 04/22/1997 Date Closed: 03/06/2009 Primary Owner: Betty C. Smith Date of Death Balance: $29.13 Accrued Interest: $0.08 Principal Balance: $29.05 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Diana Reynolds Commerce Bank Research Associate/Deposit Services Commerce Bank /Harrisburg PO Box 4999 3801 Paxton Street Harrisburg, PA 1 71 1 1-0999 commercepc.com REV-1157 E%+ (12-99) , SCHEDULE H FUNERAL EXPENSES & <;OMMONWEALTHOFPENNSYLVANIA IN R TE N 3 ADMINISTRATIVE COSTS DEN DE EDENT E ESTATE OF FILE NUMBER Smith, Betty C. 21-09-0213 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached ~ 7,969.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Bogar 8c Hipp Law Offices 1,827.00 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 a. Probate Fees 108.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 556.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 10,460.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Smith, Betty C. 21-09-0213 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Kris Kegris -Lay Pastor - officiant for funeral service 40.00 2 Nick's of New Cumberland -Funeral luncheon 100.00 3 Otd Towne Florist -flowers for funeral 200.00 4 Parthemore Funeral Home -funeral bill 7,629.00 H-A Subtotal 7,969.00 Other Administrative Costs 5 Freedom Blue PPO -Final premium payment 106.00 6 RESERVES: -Costs to conclude administration of Estate, including filing of PA 450.00 Inheritance Tax Return and Inventory and preparation of 2008 personal income tax returns H-67 Subtotal 556.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EK+(6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Betty C. 21-09-0213 Include unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Smith, Betty C. 21-09-02 13 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not Ltst Trustee{s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal and transfers distributions , under Sec. 9116(a)(1.2)] Michael S. Hillegas Jr. Grandson Forty-five 5901 Walton Street percent of rest, Lemoyne, PA 17043 residue and remainder Sharon S. Hillegas Daughter Fifty-five 540 Brentwater Road percent of rest, Camp Hill, PA 17011 residue and remainder Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ~~ TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS UN uNt ~ s uI- Itty-~ ouu wvtrc ants I I v.vv Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST V~IILL AND TESTAMENT OF BETTY C. SMITH I, BETTY C. SMITH, of Hampden Township, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, JOHN C. SMITH, provided he survives me by sixty (60) days. SECOND: Should my husband, JOHN C. SMITH, predecease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) Fifty-five (55%) percent thereof to my daughter, SHARON S. HILLEGAS, provided that should she predecease me, then to her son, MICHAEL S. HILLEGAS, JR. (B) Forty-five (45%) percent thereof to my grandson, MICHAEL S. HILLEGAS, JR., provided that should he predecease me, then to my daughter, SHARON S. HILLEGAS. THIRD: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give ,~, legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, Zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FOIIRTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with 2 :respect to property passing under this Will, shall be paid out of the principal of my residuary estate. FIFTH: All interests hereunder, whether principal or :income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. SMITH: I nominate and appoint my husband, JOHN C. SMITH, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said JOHN C. SMITH, I nominate and appoint SHARON S. HILLEGAS, Executrix of this, my Last Will and Testament. In the further event of the death, resignation or inability to serve for any reason whatsoever of the said JOHN C. SMITH and SHARON S. HILLEGAS, I nominate and appoint MICHAEL S. HILLEGAS, JR., Executor of this, my Last Will and Testament. I direct that my Executrix or Executor, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this '3iS•{ day of M~.~ ~~" ' 2 0 0 0 . i1 ~.L. ~ -~.~~, ( SEAL ) BETTY C. MITH 3 t" Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address 4