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Home My WebLink About07-02-09 (2)1 /C 1505607120 ~J REVS I YOO EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code veer File Number Bureau at Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 2 8 3 PO 80X.280801 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 226 32 5497 03 10 2009 08 16 1928 Decedent's Last Name Suffix Decedent's First Name MI LEPLEY NORMA J (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 WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future mtereat compromise ~ 5. Federal Estate Tax Retum Required (dale of death after 12-12A2) ~, X 1 a. DeceJant DieE Testate 1 (Attach Copy of Wll) '._~ 9. Litigation Proceeds Received ~ Decedent Maintaiired a LivinO Trust (Aaech Copy of Teust) 1 p Spousal Poveny Cretlit (sate or death between 12-31-81 entl 1-1-95) e. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 8113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA% INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L. BANGS 717 730 7310 Finn Name (If Applicable) First line of address 429 SOUTH 18TH STREET Second line of address City or Post OKce CAMP HILL REGISTER OF WILLS USE ONLY r~s 0 c ~o _. ~)~' 1i- ~1 { t ~ ~ r ., r -+ t. s ~D ~ ~„ -" -_ State ZIP Code -' "'" '-". ~- -T, PA 17 0 11 ~ cn - 0 Correspondent's a-mail address: Under penakies of perjury, I dectare that I have examined this return, including accampanying schedules antl statements, and to the bast of my knowledge and belief, it is true, coned and complete. Decleretlon of preparer other than the pereonel represenWtrve Is based an all Iniormadan of which preparer has any knowledge. Vivian B. Donlevy /, .3 p sea Michael L. Bangs 429 South 18th Street, Camp Hill, PA 17011 Side 1 1505607120 1505607120 V V PA 1 J 1505607220 REV-1500 EX oeceaem~s eame~. Norma Jane Lepley Decedent's Social Security Number 226 32 5497 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... ... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ .. 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ .. 4. 5 88,011.32 . Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .............. .. 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ........... .. 6. 7. Inter•Vivos Transfers 8 Miscellaneous Non-Probate Properly (Schedule G) ~ Separate Billing Requested ........... .. 7, 8. Total Gross Assets (total Lines 1-7) ..................................................................... .. g, 8 8, 0 1 1. 3 2 12,454.27 9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... .. 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................. ... 10. 82.79 11. Total Deductions (total Lines 9 8 10) ................................................................... ... 11. 1 2, 5 3 7. 0 6 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. 75,474.26 13. Charitable and Governmental Bequesls/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. 75,474.26 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 .00 0 . 0 0 15. 16. Amount of Line 14 taxable 3 7 6 0 5.13 16 at lineal rate X .045 , . 17. Amount ai Line 14 taxable at sibling rate X 12 1 8, 8 0 2. 5 6 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 8 , 8 0 2 . 5 7 18. 19. Tax Due .................................................... ................................................................ . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 1,692.23 2,256.31 2,820.39 6,768.93 Side 2 L 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: FIIeNumber 21-09-283 DECEDENT'S NAME Norma Jane Lepley STREET ADDRESS 325 Wesley Drive, Apt. 312 CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount 3. InteresVPenahy'rf applicable p, Interest E. Penalty 6,000.00 315.79 Total Credits (A + B + C) (1> 6,768.93 (2) 6,315.79 Total lnteresVPenahy (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Cheek box on Page 2 Line 20 to request a rofund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 453.14 (SA) (6B> 453.14 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 properly transterred;..__ ............................................................................ [] ^ 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, 1962, did decedent transfer property within one year of death without receiving adequate wnsideration? ....................................................................................................................... ^ ^ 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 [/2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 Juy 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 p2 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. ftsv-1688 E%~ (8-981 LOMAIONW£FLTN CF PENNSYLVIWI/ INHENTANLE TA%RETURN RE610EM OELEDENi SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Lepley, Norma Jane 21-09-283 Indude the praceetle o<liliaetion end Ina dale lne proceed. were received by lne eelele. All propsrrY IDIMlycwned wIM the dpM a/ auMVOrehlp moat M1 dlaeloasd on adhMUla F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Refund from Bethany Towers 225.95 2 Refund from Bethany Towers 91.00 3 Refund from Capital Blue Cross 156.40 4 Refund from Erie Insurance 25.00 5 Refund from Herd Chiropractic 264.00 6 PNC Bank -Account #5005301147 10,148.02 7 PNC Bank -Account #5140076237 1,539.79 8 Transamerica Life Insurance -Annuity #02CBT106174 75,561.16 TOTAL (Also enter on Llne 5, Recapltulatlon) I ~ 88,011.32 (If more space Is neede4 atltlitional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1161 EX~ (1]A9) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ESTATE OF FILE NUMBER Lepley, Norma Jane 21-09-283 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. ~ FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Vivian B. Donlevy Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 844 Copper Circle City Lewlsberry State PA Zip 17339 Year(s) Commission paid 2. Attorney's Fees Michael L. Bangs 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address CiH State Zip _ Relationship of Claimant to Decedent 4. I Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 3,832.21 4,000.00 4,000.00 252.00 350.00 7. Other Administrative Costs 220.06 See continuation schedule(s) attached TOTAL (Also enter on Ilne 9, Recapltulatian) 12,454.27 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedu e H (Rev. 6-98) SCHEDULE N FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Lepley, Norma Jane 21-09-283 ITEM NUMBER DESCRIPTION MOUNT Funeral Expenses 1 Harold Lepley -reimbursement for funeral expenses 271.42 2 Parthemore Funeral Home 2,470.00 3 Vivian Donlevy -reimbursement for funeral flowers 58.29 4 Woodlawn Memorial Gardens 832.50 H-A Subtotal 3,632.21 Other Administrative Costs 5 Cumberland Law Journal -estate advertising 75.00 6 The Sentinel -estate advertising 145.06 H-B7 Subtotal 220.06 Copyright (e) 2002 form software ony The Lackner Group, Inc. Form PA-1600 Schedu e H (Rev. 6-98) Ravd613 EXa (8.66( SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Cp.T%lN WEALTH OF pENN6TLVNN P INHERITANCE Tq%RETURN RE6IDENT DECEDEM ESTATE OF FILE NUMBER Lepley, Norma Jane 21-08-283 InUUtla unnlmbuna0 matllpl ~zpsmas. ITEM NUMBER DESCRIPTION VA UE AT DATE F DEATH 1 Bonnie K. Miller, Tax Collector - 2008 personal taxes 9.80 2 JC Penney 51.75 3 Verizon 5.84 4 Weis Market Pharmacy 15.80 TOTAL (Also enter on Line 10, Recapitulation) 82.79 (If more space is neede4 edtlitional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schad le I (Rev. 6-98) III May. 22. 2609 ~2:22PM PNC BANK 412-705-2747 'Vo. ;634 F., ?/i ~~~ t.eaolttcrltEwar May 22, 2009 Michael L Bangs Attorney At Law 429 South 18's St Camp Hill PA 170] 1 1tE: Norma J Lepley SSN: 226-32-5497 DOD: 03-10-2009 Dear Mr. Bangs: In response to your request for Date of Death {DOD) balances for the customer noted above, out recozds show the following: Checking Account Account # 5140076237 Established: 03-O1-1'980 NORMA J LEPLEY DOD balance: $1,539.79 non interest bearing account. Savings Account Account# 5005301147 Established: 08-29-2008 NORMA J LEPLEY VIVIAN B DONLEVY DOD balance: $ 10,148.02 + 1b.05 accrued interest Please note that this offico pn~vides dam of d~th balances fie deposit accounts (IRAs, CDs, Clxeking aad Savings). We do not pt»ceas aoy 8naadal tranactioas or provide atatemeats. Jf you seed assistance with aay of these itoms, please call 1-888-PNC-BANK (1-888-762-2265) or stop by Your local PNC Bank branch office. ~JlnCerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 2 Tx~vsA~uca • LIPH INSUB.ANCB COY PA NY April 10, 2009 Estate of Norma J Epley c/o Vivian B Donlevy 644 Copper Circle Lewisberry PA 17339 R8s Annuity Number(s) 02CST106174 Dear Personal Representative: Tranaametiu Life TnPUranee Company 4333 Edgewood Road NE PO Bo:3183 Cede Rapidy Iowa SZ406-3183 We have received notification, Norma J Lepley, annuitant of the above listed non-qualified tax deferred annuity is deceased. Our office wishes to extend sincere condolences for your loss. The following is the current information on this annuity: AnnL.i tant Owner: Primary Beneficiary: Annuity Policy Date: Full. Value as of 04/10/2009: Taxable Portion: Full. Value as of 03/10/2009: Norma J Lepley Norma J Lepley Estate of Norma J August 26, 2008 $75,389.02 $ 1,189.02 $75,122.99 Lepley 100 The attached document outlines the option available to the estate. The full value as of the date of death is for tax purposes only and is not a guaranteed death benefit amount. Opex-ations performed on an automatic basis when applicable have been ternlinated, such as; Systematic Payouts or Automatic Billing. The attached document contains general tax information based on Trallsamerica Life Insurance Company's interpretation and should not be relied upon for your personal tax planning. If you have questions concerning the direct tax consequences when selecting an option, you may wish to consult a tax advisor. Member of the `~, Group ~• Any additional questions regarding this annuity can be directed to the Annuity Service Center at 1-800-553-5957. A Transamerica Life Insurance Company representative will gladly assist you with any question you may have regarding this annuity and help you meet your financial goals. Sincerely, ~~~~ Lisa Kirk Transamerica Life Insurance Company Claims Enclosure(s): Annuity Claimants Statement Death Option Packet Postage Paid Return Envelope ,; .w: x'. y ~. //.I.v I, NORMA JANE LEPLEY, of Lower Allen Township, Cumberland County, ~ Pennsylvania, declare this to be my last will and revoke any will previously made by me. \ ITEM I. I direct that all my just debts and funeral expenses, including my gravemazker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my death as a part of the expense of the administration of my estate. \ ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all ~~~ other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, in equal shazes to the following individuals or to the survivor of them as survive my death by thirty (30) days: A. RAYMOND CLEMMONS B. MARY CLEMMONS C. JEAN JONES D. VIVIAN DONLEVY ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate in equal shares to the following individuals or to the survivor of them as survive my death by thirty (30) days: A. RAYMOND CLEMMONS B. MARY CLEMMONS C. JEAN JONES D. VIVIAN DONLEVY ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to t~ anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or ~~ attachment. ITEM V. I appoint VIVIAN DONLEVY executrix of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regazd to any principle of risk or diversification; to sell at public or private sale, to exchange, 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 or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. 2 ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this oG I day of 2008. ~GAi Q/JU~ N RMA J LEPLEY 3 The preceding instrument, consisting of this and THREE other typewritten pages, each identified by the signature of the testatrix was on the date thereof si€:ned, published, and declared by NORMA JANE LEPLEY, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 4 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. 9!/e2 ~i N MA JANE PLEY Sworn or affirmed to and acknowledged before m by the t s named above ~h~~` ~Iday of ~~~^ , 2008. Notarial Seal Wendy K Shams, Notary PWNc LowerAAen Twµ, Ctmrbedand Couriy My Commission E>ylres May 10, 2091 Pennsylvania Association oT Notaries COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) ~, ~ i~w/1 L,~l+~ ~.~h ( and ~her~ ~It ry//'~l ,the witnesses whose names are signed to th attached or foregoing instrument, being duly qualifie according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as wifiesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue ;nfl„en..a Sworn or affirmed to an acknowledged befo his _~(~ day of 2008. Wendy K Shaw, Notary PubNc LowerPmtxi Txp., Curta>an~M Cody MY Commtsslort E~kas May 90, 2011 mnsyivania Association of Notar