HomeMy WebLinkAbout04-20-0915056041103
REV-1500 EX cD5-o5> oFFICULL USE ONLY
PA Dspemnent d Revenue
Buroeu dlntlivitluel Taxes County Cotle Yar File Number
Po eox zaoeot INHERITANCE TAX RETURN
Namsnuro,PAlT1ze-oeol REgIpENTDECEDENT Z1 08 0777
ENTER DECEDENT INFORMATION BELOW
SoGel Sac~my Number Dale of Death Date of Birth
190-58-8D71 07172008 10211974
Decedent's Last Name
HOOVER
Suffix Decedent's First Name
DENNIS
(It Applicable) Eller Surviving Spouse's IMormaUon Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Seadly Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF VVILL3
MI
E
MI
FILL IN APPROPRIATE BOXES BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death
^ ^ prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required
8. Decedent Dletl Testate
~ 7. death after 12.12.82)
Decedent Maintained a LINng Trust
0 8. Total Numt»r of Safe Depos9 Bmaes
(Atach Copy d Wig)
^ (Attach Copy of Trust)
9. Litigation Proceeds Received ^ 10. Spousal PoveAy CredS (date of death ^ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1.1-95) (Attach Sch. O)
CORRESPONDENT - TFSS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL. TAX INFORMATION BNOULD BE DIRECTED TO:
Name Daytime Telephone Number
RICHARD S HOOVER SR 570-374-9749
Firm Name (If Applicable)
First Ilne of address
218 SUNSET DRIVE
Second line of address
City or Post Office
SELINSGROVE
State ZIP Code
PA 1787D
REGISTER OF WILLS USE ONLY
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CorreapondenCS e-mdl address:
Under psneaks of pequry, I tlsUero thM I have sxeminetl mia roWm, inelutlinp eccompanylna schetluks entl sutementa, end to the bat of my knowladpe end belief,
it b true, cortecl endcompkts. Dadereaon oT proparx other than the personY reprosenutlve b besW on ell informetlan of which properor hn any knowledge.
218 SUNSET DRIVE, SELINSGROVE, PA 17870 ~
RE OF PR ARF12 OTH R T
~g ~yo D TE
1372 N SUSQUEHANNA TRAIL SUITE 21D, SELINSGROVE, PA 17870 r
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041103 ew~ee~toso 15056041103
~~
~~
15056042104
REY-1500 F~(
Decedent's Social Secudty Number
190-58-8071
~sceasnra Hama: DENNI$ E HOOVER
RECAPIruunoN
1. Real estate (Sdx3dule A) .............. 1.
2. Stocks and Bonds (Sdxsdule B) ....................... ... 2.
3. Closely Held Corporation, Partnerahlp a Sde-Proprietorship (Schedule C) ... ... 3.
4. Mortgages & Notes ReceNable (Schedub D) ................. ... a.
5. Cash, Benk Dgxrsita 8 Miscellaneous Personal Property (Schedule ~ ..... ... 5.
1486.83
8. Jointly Crvmed Property (Schedule F) ~ Separate Billing Requestetl .. ... 8.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Sehedub G) ~ Separate Billing Requested .. ... 7.
B. Total Gras Aassb (total Lines 1-7)............. 8. 14 86.83
g. Funeral ExpenaesBAdminiatrative Costs (Schedule H) ............ ... g. 2575.82
10. Debts of Decedent, Mortgage Liabllltlas, & Liens (Schedule I)......... .. 10.
11. Total Daduetlons (total Linea g & 10) ............. 11. 2575 • 82
12. Nat Value of Esfab (Line 8 minus Line 11) .... .. 12. -1088 • 99
13. Charitable antl Governmental BequeatslSec 9113 Trusts for which
an eleetlon to tax has not bean made (Schedule J) .............. .. 13.
14. Nat Value Sub)ast to lax (Line 12 minus Line 13) ............. .. 14. 0 • 0 0
TAX COMPUTATION • SEE INSTRUCTION3 FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(7.2) X .0- 15.
18. Amount of Line 14 taxable
at lineal rate X .0- 16
17. Amount of Line 14 taxable
at sibling rate X .12 17
1 B. Amount of Line 14 taxable
at collateral rate X .15 1 g,
19. TAX DUE ........ .. 18.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
31de 2
15056042104 eweees,.aco 15056042104
REV-1500 EX Paps 3
Decedent's Complete Address:
FlI•Nambar 21-08-0777
DECEDENT'S NAME
DENNIS E HOOVER
STREET ADDRESS
76 COUNTRY VIEW ESTATET
CITY
NEWVILLE STATE
PA ZIP
17241
Tax Payments and Credits:
1. Tax Due (Pape 2 Line 19)
2. Credits/Payments
A. Spousal Poverty CredN _
B. Prior Payments _
C. Dlaccunt
3. InleresUPenalty if applicable
D. Interest
E. Penally
(1) 0.00
Thal Credke (A+B+C) (2)
Total IntsroaVPendty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the dgference. Th(s Ia the OVERPAYMENT.
FIII In box on Papa 2, Lina 20 to roqusat a rotund.
5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TA% DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4) ~ . 0 ~
(5) 0.0~
(SA)
(SB) ~ • 0~
Make Check Payable to: I~GISTER CIF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: N
a. retain the use or income of the property transferred; , ~
b. retain the right to designate who Shall use the property transferred or Ks Income; .........
c. retain a reversionary interest; a ................................ . B
-
d. receive the promlae for life of either payments, bene5ts 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 en "In trust for" or payable upon death bank account or security at his or her death? .
4. Did decedent own an Intlividual Retirement Account, annuity
or other non-probate property which
,
contains a beneficiary designadon7 ................... ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMIPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after Juy 1, 1994 and before January 1, 1995, the tax rate Imposed on the net value of transfers to or far the use of the surviving spouse
is three (3) percent [72 P.S. X9118 (a) (1.1) (i)).
Far 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 suMving spouse is zero (0) percent
[72 P.S. §9118 (a) (1.1) (II)]. The statute does not exemot a transfer to a surviving spouse from taz, antl the statutory requirements for tlisclosure o1 assets and
filing a tax return are still applicable even if the suMving spouse is the only beneficary.
For Oates of death on or after July 1, 2000:
The tax rate impoaetl on the net value of transfers from a deceased chlitl twenty-one years of age or younger at death to or for use of a natural parent, an
adoptive parent, or a stepparent of the child Is zero (0) percent [72 P.S. ~118(a)(1.2)[.
The tax rate imposed on the net value of transfers to or for the use of the decetlent's lineal benefidaries is four and ono-hal/ (4.5) percent, except as noletl in
72 P.S. X116(1.2) [72 P.S. ~118(a)(1)].
The lax rate Imposed on the net value of transfers to or for the use of the decetlent's siblings is twelve (12) percent [72 P.S. ~118(a)(1.3)]. A sibling is definetl,
under Section 9102, as an indlWdual who has at least one parent In common with the decedent, whether by blood or adoption.
ewae~t t.ooo
REV-1508 EX. (&ae)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8t M~SCi.
INHERITANCE TAX RETURN
DENNI3 E HOOVER 21-08-0777
Inclutls the procesde of Iitpatbn and the dots the proceeds were rsosMO oy the stars.
~ ~ ProMrH lolrrtyowned wNh the right o1 survlvonhlP must M dlaelopd on Sehetlub F.
ITEM VALUE AT DATE
NUMBER DE~RIP110N OF DEATH
1. I CORNERSTONE FEDERAL CREDIT UNION MBpSSBER ACCOUNT NUMBER
8472
[388 ATTACHHD COPY OF STATEMENT OF ACCOUNT]
2. JFC TEMPS INC NHT PAY PAID AFTER DATE OF DHATH
3. FHDBRAL INCOME TAX WITHHSLD FROM JFC TRNPS INC PAY
(TO BB RBFUNDHD ON FORM 1040 FOR TAX YEAR 2008)
4. PENNSYLVANIA STATH INCOME TAX WITHHSLD FROM JFC TEMPS INC
PAY
(TO 88 REFUNDED ON FORM PA-40 FOR TAX YEAR 2008)
5. VALK MANUFACTIIRING COMPANY PROFIT SHARING TRUST -
DECEDENT'3 PARTICIPANT ACCOUNT VALIIB - - 4,120.90
TAXABLE VALUE FOR INHERITANCE TAX ........................
**DSCEDENT DID NOT REACH TH8 AG8 OF 59 1/2 AT THE TINS OF
HI8 DEATH AND DID NOT P033883 THE RIGHT TO ENJOY, A33IGN
OR ANTICIPATE PAYNENTS FRON HIS PARTICIPANT ACCOUNT.**
(AT THE TIME OF HIS DEATH, DECEDENT HAD NOT DESIGNATED
A BENEFICIARY, SO TH8 DEATH PAYMENT WAS RECEIVED BY
HIS E3TAT8.)
1,341.92
127.53
12.10
5.28
0.00
ew4eAD t.ooo (If more space is needed, insert additional sheets rA Me same aizs)
REV-1511 EXs (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAx RETURN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
DENNIS E HOOVER 21-08-0777
Debts o/ dseeden! must bs nportsd on SeheduN I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t. SWING SROTHHRS FUNERAL HONE INC, 630 SOUTH HANOVER ST,
CARLISLE, PA 17013 1,567.56
2. SHARON L WILSON - FOOD FOR NSNORIAL 560.00
B.
t.
ADMINISTRATIVE COSTS:
Personal Repreaentafive's Commissions
Name of Personal Representative(s)
Street Addresa
CIN
State Zip
2. AUOrney Fees
3. Femlly Exemption: (It decedent's address is not the same as dalmant's, attach explanation)
Claimant
Street Address
4.
5.
e.
7.
8.
9.
aW48AG 1.000
Year(s) Commission Peld:
city state zip _
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tex Return Preparer's Feea
TH8 DAILY ITEM - ADVERTISBNENT OF LBTTHRS
THE 88NTINEL - ADVERTI88LdENT OF LBTTHRB
CUD~ERLAND COUNTY REGISTER OF WILLS - FILING FEES
TOTQ (Also enter on line 9, Ri
(It more space is needed, Insert additional sheets of the same siu)
40.00
125.00
134.54
118.72
30.00
M01-003110
CORNERSfiONE
Federal Credit Union
Metnber,Jbwnird-SerufasGawd.
P.O. BOX 1181
CARLISLE, PA 17015
71744&1861
DENNIS E HOOVER
SCHEDULE E, ITEM NUMBER 1
001602
DENNIS E. HOOVER
76 COUNTRYVIEW ESTATES
NEWVILLE PA 17241
STATEMENT OF ACCOUNT
NOTICE
SEE ENCLOSED FORM FOR IMPORTANT
INFORMATION REGARDING YOUR RIGNTS TO
DISPUTE BI WNG ERRORS.
NoncE
SEE ENCLOSED FORM FOR MIPORTMIT
BiFORMATION IN CASE OF ERRORS OR
WESTIgJ3 ABOUT YOUR ELECTRONIC
TRMISFERS IDENTIFlED WITH LETTERS'EFT•
EM
N
BER 8472
AAENT
DATE 07 O1 2008 - 07 31 2008
OWNERSHIP OF BHARE. DEPOBR MID CERTIRCATE ACCOUNTS 9HOWI1 ON THIS STATBAENT Ni NOT TRANBR]iPBLE EXCEPT CN THE 50016 OF THE CREDIT UNION.
Trensec8an O40a Trmsecian D4eaip8an Tr~~^ an Prind~pN P~aymonts Fl~E Bp~E
d G CHARGE
SHARE O1..REGULAR SHARE ACCOUNT
07-01 Previous Balance 25.28
06-30e DIVIDEND .06 25.34
Annual Percentage Yield earned from 04/01/2008 - 06/30/2008
an an average daily balance of $ 25.28 was .964
07-24 DIVIDEND .02 25.36
DIVS PD TO CLOSE
07-24 TRANSFER IN 1341.92 1367.28
07-24 WITHDRAWAL -1367.28 .00
07-31 New Balance .00
Year-to-Date Dividends this account .20
SHARE 07..SHARE DRAFT ACCOUNT - -
07-01 Previous Balance 2107.58
06-30e DIVIDEND 2.46 2110.04
Annual Percentage Yieifl earned from 04/01/2008 - 06/30/2008
on an avet`age daily balance of $ 3943.81 was .25~k
07-01' DEBIT CARD.PURCHASE -30.01 EFT 2080.03.
01-013941-HP OIL 06142384-PLAINFIELD-PA-US
07-01- DEBIT CARD PURCHASE -18.64 EFT 2061.39
72409427-023087-DELI C-NEWVILLE-PA-US
07-02 DEBIT CARD PURCHASE -26.33 EFT 2035.06
12345678-011901-BEVERAGE EXPRESS-CARLISLE-PA-US -
07-03 DRAFT'# 482 0011061529 -40.00 1995.06
07-03 POS DEBIT/PURCHASE -30.24 EFT 194.82
-00002407-572679-BEVERAGE EXPRE-1021 RITNER HIGHWA-CARLISLE-P "
07-03- DEBIT-CARD PURCHASE -15.15 EFT 1949.67"
LK360865-027512-YOUNG'S DELI-NEWVILLE-PA-US
07-07 DEBIT'CARD PURCHASE -23.72 EFT 1925.95
003-013384-ANILE'S RESTAURANT-BOILING 3PRIN-PA-US
07-07 DEBIT-.CARD PURCHASE -20.20 EFT 1905.75
i LK360865-010284-YOUNG'S DELI-NEWVILLE-PA-US
07-OB DEBIT CARD PURCHASE -20.00 EFT. 1885.75
t 01-008822-BP OIL 06142384-PLAINFIELD-PA-US
07-08' DEBIT CARD PURCHASE -16.50 EFT 1869.25
00408547-017507-CARLISLE BEVERAGE-CARLISLE-pA-US
07-09 POS DEBIT/PURCHASE - -12.71 EFT 1856.54
08825333-052794-WINE & SPIRITS-281.3 SPRING GARDE-CARLISLE-P
07-10 DEBIT CARD. PURCHASE -29.25 EFT 3827,29
12345678-028517-BEVERAGE EXPRESS-CARLISLE-PA-US
07-10 DEBIT CARD PURCHASE -17.81 EFT 1809.48
001-024375-BHEETZ 00002634-CARLISLE-PA-US
07-10 ATM WITHDRAWAL:. -60.00 EFT 1749.48
0000000000064F9-005039-5 EASTGATE DR-CARLISLE-PA-US
07-10 ATM WITHDRAWAL -240.00 EFT 1509.48
0000000000064F9-005040-5 EASTGATE DR-CARLISL$-PA-US
07-10 DEBIT CARD PURCHASE -17.93 EFT 1491.55
65009402-026210-CARLISLE DINER-CARLISLE-PA-US".'
07-10 DEBIT CARD PURCHASE -19.49 EFT 1472.06
12345678-026211-BEVERAGE EXPRESS-CARLISLE-PA-US
07-11 DEBIT CARD PURCHASE -26.00 EFT 1446.06
01-030283-HP OIL 06142384-PLAINFIELD-PA-US
07-14 DEBIT CARD PURCHASE -20.13 EFT 1425.93-
00078211-012397-MISEN03 BISTO PUB-CARLISLE-PA-US
07-14 POS DEBIT/PURCHASE -10.41 EFT 1415.52
. 24257401-585312-WAL-MART #2574-60 NOBLE BLVD-CARLISLE-PA-US
*** CONTINUED ON NEXT PAGE ***
FILE N0.21-08-0777
M01-003111
PeKp'.. 2 OF., 2 MemberNurtiher~ • ~ 8472 • statemantPeriod Q7/O1f2008 -~07~31f200-
Transaction Date
Transaction Descriptlon Transaction
s......~r Prindpsl PsymrrnG
New na FlNANCE
,,,,. s„~
BALANCE
07-14 DEBIT CARD PURCNASE -32.58 EFT 1382.94
12345678-031275-BEVERAGE EXPRESS-CARLISLE-PA-US
07-14 DEBIT CARD PURCHASE -8.91 EFT 1374.03
001-012367-SHEETZ 00002634-CARLISLE-PA-US
07-15 DEBIT CARD PURCHASE -6.04 EFT 1367.99
LK360865-019034-YOUNG'S DELI-NEWVILLE-PA-US
07-15 DEBIT CARD PURCHASE -26.33 EFT 1341.66
12345678-019039-BEVERAGE EXPRESS-CARLISLE-PA-US
07-24 DIVIDEND .26 1341.92
DIVS PD TO CLOSE
07-24 TRANSFER OUT -1341.92 .00
07-31 New Balance .00
Year-to-Date Dividends this account 7.32
Draft# Amount Draft# Amount Draft# Amount Draft# Amount
482 40.00
Total Dividends Earned This Year $ 7.52
Total- Finance Charges Paid. This Year $ .00 -
Cornerstone FCU is now a Community Charter Credit Union!
Cornerstone Federal Credit Union is pleased to announce that more people are
now eligible to experience. the Cornerstone difference: affordable financial
service delivered by caring professionals.
Now anyone who lives, works, worships or attends school. in Cumberland County
and the entire borough of Shippensburg is eligible to become a member of
Cornerstone. Additionally, family members of these individuals are al so
eligible
to join. .
.This is great news! Go tell all of your neighbors anfl'friends. Let them enjoy
the same great rates, products and services that you enjoy.
Watch for a special edition newsletter for more details.
DENNIS E HOOVER FILE N0.21-08-0777
SCHEDULE E, ITEM NUMBER 1
DENNIS E HOOVER FILE N0.21-08-0777
SCHEDULE E, ITEM NUMBER 5
SEE ACCOMPANYING ESTATE'S CHECKING ACCOUNT
FOR DEPOSIT OF NET DISTRIBUTION AFTER TAX WAS WITHHELD
Form 1099-R n CORRECTED (H checkedl
PAYER'Sname, streatatldresa, city, stab, and ZlP eeda 1 Gross distribution OMB Na, 15ae-Otte QlStrlbUtl99ns Frorc
VALK MANUFACTURING COMPANY PROFIT PBOSIonS
AnnYiUes
SHARING TRUST
3 4120
90 ,
,
Retirement of
66 . 2008 P
fi
EAST MAIN STREET t-Sharing
ro
NEW KINGSTOWN PA 17072-0928 2a Taaabbameunt Plens, IRiAs,
Insurance
4120.90 Form 7099-R Contracts, etc.
(717) 766-0711 26 Taabbansunt Tebl
netdebrminad dbtrlbudon X Copy B
PAYER'Sfideral ldentifiutron RECIPIENPSIdsntNiutlen
number number
3 c.piw pain (incwded 4 FtNi~yN Mcom~btt
i
b
2 Report this
InCOme On YOUr
n
oa
y WHbhald federal taX
return. If this
23-6417591 190-58-6071 S 824.18 iormshows
RECIPIENT'8 federal Income
nuns, addrus, and ZlPCOde 5 Empbyea tontributlons 9 Nat unnaSZed }~ withheld in
DENNIS E HOOVER IDulOnated Roth
u
eributrons er appnefNienb
'
t10X 4
attach
218 SUNSET DRIVE n
insureneevnmbma employer
s securities ,
this copy to
SELINSGROVE PA 17870 9 your return:
3
7 Distributon IRA/ 9 OtMr
cedNy sSAEPiE This lniormatlon iS
$ ,~ being furMshed to
9a Yourpvunbeaaf tobl
9b Toblempbyee eentribs. the Internal
ReYenue SetVlCe.
distribution
tat year of dais. Reth contrib. 10 Sbb ba withheld 11 Sbb/Payer's abb no. 12 Sbb distribution
s---------- ----------- ~--------
a s
Aceountnumber(uNnsWetiony ~ 13 Loul bx withheld 14 Nsme of bulity 15 Local diskibutlen
5---------- ----------- s----
-
s --
-
3
ae-zoweo
Department of th• Treasury -- Inbrnal Revenue Sarviee
S ~ord
National Bank
I~~~III~~~II~~I~I~~~III,~.I~~~II
DENNIS S HOOVER ESTATE
218 SONSST DR
SELINSGROVE PA 17870
1079 0002
3625 Y
STATEMENT OF ACCOUNTS
0004-02174
STATEMENT PERIOD
FRON THROUGH
8-20-08 - 9-18-08
PAGfi 1 OF 1
0 ENCLOSURES
X
7
0
FRHS`CH$CKING - ACCOUNT: -0004-02174
PREVIOUS DEPOSITS/ CHECKS/ SERVICE ENDING
STATEMENT BALANCE CREDITS 1 DEBITS 2 FEES BALANCE
.00 3,296.72 1,060.00 .00 2,236.72
DEPOSITS/ CHECKS/
DATE ACTIVITY DESCRIPTION REFERENCE CREDITS DEBITS BALANCE
08-20 BEGINNING BALANCE 5
T
.00
08-21 DEPOSIT. 05575508720 3,296.72 3,296.72
OS-28 CHECK 2 '05477701130 500.00 .2,796.72
08-29 CHECK 1 01562507780 560..00 2,236.72
09-18 ENDING BALANCE 2,236.72
CHECK SUMlIARY
* INDICATES SKIP IN CHECK NUMBERS
:CHECK N0 AMOUNT CHECK NO AMOUNT
1 560.00 2 500.00
TCTAL NUMBER OF CHECKS 2 TOTAL AMOONT OF CHECKS 1,060.00
SERVICE FSS BALANCE INFORMATION FROM 8-208 THROUGH 9-18-08
AVERAGE LEDGER BALANCE 2,428.16 AVERAGE COLLECTED BALANCE 2,318.27
MINIMUM LEDGER BALANCE .00 MINIMUM COLLECTED BALANCE .00
DENNIS E HOOVER FILE N0.21-08-0777
SCHEDULE E, ITEM NUMBER 5
ESTATE'S CHECKING ACCOUNT
SHOWING 8/21/08 DEPOSIT OF NET DISTRIBUTION
AFTER TAX WAS WITHHELD
DIRECT SNINSFORD NATIONAL BANK BANK BY PHONE MemtierF.D.I.C.
INQUIRIES T0: P O HOX 241 1-800-343-6510
t~rnnrRTC WHARF PA 17831-0241 swineford.com
TELEPHONE: 1-866-SNB-1903
USA iIM151-CLP54 ~
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