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HomeMy WebLinkAbout08-28-091 1505607121 06 05 ~1 REV-1500 EX ( - ) P D f OFFICIAL USE ONLY A epartment o Revenue Bureau of IndivMual Taxes County Code Year File Number Poeox2eo6o1 INHERITANCE TAX RETURN Hanisbum. PA 17728-0601 RESIDENT DECEDENT 2 1 0 9 0 5 7 7 ENTER DECEDENT INFORMATION BELOW Social Secur'dy Number Date of Death Date of Birth 1 0 5 1 4 6 5 5 7 0 6 0 2 2 0 0 9 0 3 2 1 9 1 3 Decedent's Last Name Suffix Decedent's First Nama MI S P E N C E R D O R I S A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Nama MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW © 1. Original Return 4. Limited Estate ^X 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Meinleined a Living Trust a (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-73-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Tele hone N be G E R A L D Firm Name (If Applicable) S T O N E First line of address p um r J S H E K L E T S K I E S Q 7 1 7 7 7 4 7.4 3 5 L A F A V E R S H E K L E T S K I 4 1 4 B R I D G E S T Second line of address P 0 B O X E City or Post Office N E W C U M B E R L A N D Correspondent's e-mail address: G S H N is M this return, other Uan the State ZIP Code L P A 1 7 ~ 7 0 a end smtements, and to t on all intonBaYpn of which e.~~ ~:-. CIJ ~ N -_ ~ r `•. [ ~~ ~ ~~ C.. a o - ~O --t n DATE FILED IV of -_ - __ ~~~ ^~ ~~~~~ L~Te Zoo -7~ Side 1 1505607121 1525607121 1505607221 REV-1500 EX Decedents Social Security Number DecademsName. DORI$ A. SPENCER 1 0 5 1 4 6 5 5 7 RECAPITULATION t. Real estate (Schedule A) ........................................ 1 ~ ' 2. Stacks 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. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 7. Vnter-Vivos Transfers 8 Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 4 6 7 6. 9 6 6 4 3 5 2. 0 6 1 0 9 5 9. 5 1 7 9 9 8 8. 5 3 9. Funeral Expenses 8 Administrative Costs (Schedule H) 9. 1 D 4 7 3• b 7 70. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............ t0. 11. Total Deductions (total Lines 9 & 10) ........................... 11. 1 0 4 7 3 . 6 7 12. Net Value of Estate (Line 8 minus Line 1 i) ......................... 12. 6 9 5 1 4 • 8 6 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tex has net been made (Schedule J) .................. 13. 6 9 5 1 4 8 6 14. Net Value Subject to lax (Line 12 minus Line 13) ........ ... ..... .. 14. , TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 ts 0 0 0 (a)(t2)x.o ~ . . . 16. Amount of Line 14 taxable 6 9 5 1 4 8 6 3 1 2 8. 1 7 at lineal rate X .045 . 16. 17. Amount of Line 74 taxable D D D D D D at sibling rate X .12 17. • 18. Amount of Line 14 taxable 0 0 D D D D at collateral rate x .15 . t g. . ts. Taxbue ................................................ ts. 3 1 2 8. 1 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505607221 1505607221 REV-1500 EX Page 3 File Number ~l A4 r'1C7'] Decedent's Complete Address: `~' " ' "~' ' DECEDENT'S NAME DORIS A• SPENCER ___~.. __ _. _ _ STREET ADDRESS 170D MARKET ST• _ __ -_. _ _ - - -- - - CITY STATE ZIP CAMP HILL PA 17D11 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPaymenis A. Spousal Poverty Credit _ B. Prior Payments _ (1) 3,128.17 C. Discount 156 • 41 TolalCred%s(A+g+p) (2) 156.41 3. InteresVPenalty if applicable D. Interest E. Penalty Total 1nleresUPenalty (D +E) (3) D • D D 4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT. FIII In oval on Page 2, Llne 20 to request a refund. (4) D . D D 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. (5y 2,971.76 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 2 , 971 • 7 6 Make Check Payable to: REGISTER OF W-LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS i. Did decedent make a transfer and: Yes No a. retain the use or income of the property transfened : ................................................................. it i h f d ..... ^ ^X X ncome : .......................... erre or s e property trans b. retain the right to designate who shall use t ..... ^ 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? .................................................................................. ..... ^ ^X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .... ..... ^ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which containsabeneficiarydesignation? ............................................................................................. ..... X^ ^ 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 an the net value of transfers to or for the use of the surviving spouse is three (3) percent [/2 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 fling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dales of death on or after July i , 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)J. 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)]. 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. REV•1508 EX + (8-9e) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY DORIS A• SPENCER 21 D9 0577 IncWda the proceeds of litigation and the date the proceeds were received by the estate. All property lointry•owned wgh right of aurvWorehip moat be disclosed on &hedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MORGANSTANLEY SMITHBARNEY ACCOUNT NUMBER 574424572302 2,944.27 2- 1991 FORD TAURUS AUTOMOBILE VIN 1FACP52UOMG248774 ~•~0 THE VEHICLE WAS TRANSFERRED TO A SALVAGE YARD FOR SO CONSIDERATION• 3. SPRING RIDGE ASSOCIATES, LP DBA ASHBRIDGE MANOR SENIOR LIVING 1,732.69 REFUND CHECK TOTAL (Also enter on line 5, Recapitulation) I $ more space is needed, insert additional sheets of the same size) REV-1509 EX + (e-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN scHevu« F JOINTLY•OWNED PROPERTY DORIS A• SPENCER 21 09 0577 If an easel was made jolts within one year of the decedeM'a date of death, k must be reported on ticheduN fi. SURVIVING JOINT TENANT(S) NAME A. e c JOINTLYAWNEO PROPERTY: ADDRESS DECEDENT ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION ANO BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST i. A. 11-03 WACHOVIA BANK, N•A• XXXXXXXXX5391 45,045.45 50• 22,522.73 CHECKING ACCOUNT 2• A• D9-75 WACHOVIA BANK, N•A• XXXXXXXXX8802 60,329.20 50• 30,164.60 NOTE:FUNDS FROM ACCOUNT USED TO PAY ESTATE ADMINISTRATION EXPENSES 3• A• 07-01 HARLEYSVILLE NATIONAL BANK 23,329.46 5D• 11,664.73 CERTIFICATE OF DEPOSIT ACCOUNT X1400214287 4• A• 11/05 HARLEYSVILLE NATIONAL BANK MONEY 0.00 50• 0.00 MARKET ACCOUNT M1DD471 NOTE: THE PROCEEDS FROM THIS ACCOUNT WERE TRANSFERRED TO WACHOVIA BANK, N•A• XXXXXXXXX8802 ON 5/26/09• TOTAL (Also enter on line 6, Recapitulation) I S 6 4, 3 5 2. 0 6 Qf more space is needed, insert additional sheets of the same size) ENOLA, PA 17025 REV-1510 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON•PROBATE PROPERTY DORIS A• SPENCER 21 09 0577 This schedule must f>e completed and filed if the answer to any of quesflons 1 through 4 on the reveres side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NMAE OFTHETWl1EFEflEE, iNEIe REIAiIONSNIPT00ECE0EMIN0 THE MrE CFmrmsFEZ SnacaACOPr oFrNE OEEO FOasEx ESUrE DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION uFPPRICABLE) TAXABLE VALUE t. METLIFE INVESTORS ANNUITY CONTRACT 10,959.51 100• 10,959.51 NO. 19flB751, TRANSFEREE -JUANTA E• HENDRICKS, DAUGHTER TOTAL (Also enter on line 7 Recapitulation) I S 10 , 9 59 • 51 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(10-OB) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8 INHERITANCE TAX RETURN ADMINISTRATIVE COSTS ocmncu, ncrcncur DORIS A• SPENCER 21 D9 D577 Debts of decedent moat be reported on Schedule I. ITEM NUMBER_ _ _ DESCRIPTION_ _ AMOUNT A. FUNERAL EXPENSES: 1. SULLIVAN FUNERAL HOME 51 N• ENOLA DR•, ENOLA, PA 17025 6,867•DO B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address Ciry Year(s) Commission Paid: 2, AttomeyFees GERALD J • SHEKLETSKI, ESQ 3. Fatuity Exemptbn: (If decedents address is not the same as claimant's, attach explanadon) Claimant 4. Street Address City State _ Relatwnship of Claimant to Decedent Probate Fees LETTERS TESTAMENTARY 5. ~ AccountanCs Fees 6. 7. 8• 9• 1D 11 12 Taz Retum Preparefs Fees THE PATRIOT-NEWS - LEGAL ADVERTISING CUMBERLAND LAW JOURNAL SHORT CERTIFICATES PENNDOT - DUPLICATE AUTOMOBILE CERTIFICATE OF TITLE TRANSCARE AMBULANCE INHERITANCE TAX RETURN (b15•DD) AND INVENTORY (915•DD) REGISTER OF WILLS FILING FEES 3,10D•00 11D•DD 148.17 75•DO 16•DD 22.5D 1D5•DD 3D•DD TOTAL (Also enter on line 9, Recapitulation) I S y 0 , 4 7 3.6 7 (If more space is needed, insert additional sheets of the same size) State Zip Zip REV~1513 EX + (9-0e) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN ESTATE OF FILE NUMBER ifARTS 0. CPFNCfR 21 f19 0577 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 [nclude outAghtspousal distributions, and transfers under Sec. 9716 1(7.2 1. JUANITA E• HENDRICKS Lineal 1/2 of ttesidue 4041 CAISSONS COURT ENOLA, PA 17025 1/6 of Residue 2• RACHEL S. (HENDRICKS) WARRICK Lineal 63 COVER ROAD DUNCANNON, PA 17020 1/6 of Residue 3• JAMES W• CRELIN, III Lineal 4640 EAGLE RIDGE ROAD LINCOLN, NE 68516 1/6 of Residue 4• ABBY R• MILLER Lineal 263 BIG BEND ROAD EMLENTON, PA 16373 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX (SNOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS t. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET E pr more space Is needeo, Insert adanonal sneers a the same size) LAST WILL AND TESTAMENT DORIS A. SPENCER BE IT REMEMBERED, that F, DOR[S A. SPENCER, ofthe Township of Valley, County of Chester, and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my last Will and Testament, revoking any and all Wills and Codicils by me at any time heretofore made. FIRST: I direct the payment of all my just debts and funeral expenses as soon as possible after my decease. SECOND: All the rest, residue and remainder of my estate, both real and personal, [ give, devise and bequeath as follows: {a) If she survives me, one-half (1/2) to my daughter, JUAN[TA E. HENDRICKS; (b) One-half (!/2) to be evenly divided among my three grandchildren, RACHEL S. FFENDRICKS, JAMES W. CRELIN, FII and ABBY R. MFLLER, ahsolutely and in fee simple. THIRD: I give to my Personal Representative the fuN power to sell and convey any personal or real property that I may own at my death in order [o pay debts and legacies and administer upon my estate. "this power is at the discretion of my Personal Representative and upon such terms and conditions as my Personal Representa[ive may impose. FOURTH: I nominate, constitute and appoint my daughter, JUANITA E. HENDRICKS, Personal Representative of this my Will. If she is not living or is unable to so act, I nominate, constitute and appoint my grandson, JAMES W. CRELIN, III, Personal Representative hereunder. Finally, I direct that my Personal Representative be permitted to qualify and act in any jurisdiction without being required to post a bond or other security. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 28th day of September, A.D., 2001. ~ ~i,~ i-c [_.. CC• , ~~,~_.: ~e c: F:- ~. ' (SEAL) Doris A. pencer Signed, sealed, published and declared by the Testatrix as and for her last Will and Testament, in the presence of us, who, at her request, and in her presence, and in the presence ofeach other, all being present at the same time, have subscribed our names as witnesses. .,,. Witnesses n,inunn .aannW'a vn`s . v.' V VMYJ ~ ~ g 8~ gg T+4~ o ~ ~~ pp~ ~ M W ~V Q'- a w O OIY O4. N may, ~~~ ~~~ ~ ~ ~~~ ~ a 9 `~, s T 0 ~ ~~ m ~ ~~ m Y~ x~ ~_ ~~$ ~ ii~ ~ V O ~y'vg~ °o a g 5 $ ~ p M y w } M A ~f Z ~ t n ~ ~ ~~ -. pO 6 O O • ~ N 0 a g N H r n A Ny N~ ~ CaQ~ p ~ 9 ~ */~ ~~~ ~ ~~~ ~ o Y~ s ^.~' r 6 d! `._ ~~' 1800008 i8~~' ~: 2 360 7 380 i~: 700 30 1880~~' ~;;-. ~'13~CHdVIA w.cbovi. a.dc N.A. B~Laoe Conftcautioa sarviae. P O Banc 40028 Rounke, VA 24022-7313 June 30, 2009 STONE I.AFAVER & SHEKLETSIQ ATTN; GBRALD J cr~r?rcr.lrrcgl 414 BRIDGE STREET' POBOXE NEW CUMBERLAND, PA 17070 Ee&tearo ID: S7! I141 SUBJECT: VeciHceOon / CmStmatton of Aooount a~ Balance lEformati~ pravlded fa: Caetomer. DORIS A SPENCER (SSNB XXX-XX-63.S7) Date of Death; Jane 2, 2009 Wi AxmN Amaed I)de ofl)aelh Avaeae Dde A1dulity releetl Aeaued YTD I)de Type Nuabc EaLme Balenad Opaocd Dde Ede ItimaM Ide~e! Paid Cloeed CHECKEV(1 XXX7000OIX5391 $43,039.40 Il/SO/Jp03 Y4A3 931.4] I.BI}AI.TII'IE: DOEIB A 9PSNCHR ]UANiTA E FffiQDRICKS Cr~C[CINC' 1R%7000t'JDQ03>30't 960,3Y7.66 9/4/1973 51.34 97.76 I.BQAL7TILE: DORIB A 8PE14CSR NAN[CA H r~lDRICY.6 •.l'l~~~A ReB~eoro m: 271141 No 8s4 Depoao Hm[ Pauod firou.tomer. ` Date d' death balance daea mt include aemled intere/t. ` I[date of death ooaun on a weekend or a holiday, date ofdath balaaoe dae/not include any tran/adiona that were made during that time period. ~. ~s+~ Jemufer Straub 3ervioenter Aa/ociate Pbone:(340}SG3-7371 ot;ja ~ I~arle svilie . Y~no~n~K 483 Main Street Harleysville, PA 19438 June 25, 2009 Stone 1.aFaver &Shekletski Attorneys at Law Attn: Gerald J Shekletski 414 Bridge Street PO Box E New Cumberland PA 17070 RE: The Estate of Doris A Spencer, Deceased Dear Gerald J Shekletski Esq.: We are in receipt of your letter dated June 22, 2009 requesting information regarding the above decedent. Our records indicate the following as of June 2, 2009. Certificate of Deposit Date Date of Death Accrued Account# I/N/0 Opened Rate Balance* Interest 1 4002 1 42 87 Doris A Spencer or 7/07/01 4.65% $22,357.66 $471.80 Juanita Hendricks (Made joint 7!20!04) Interest Earned from 111!09 to 6/2109: $437.13 Money Market Date Date of Death Account# I/N/O Opened Rate Balance* 100471 Doris A Spencer or I 1/10/OS NJA N/A Juanita Hendricks (Made joint 4!4106) Account Closed: 5/26/09 Closing Balance: $20,131.24 •Balance does not include accrued interest Accrued Interest N/A www.harleysvillebank.com LEN R eawarmm.num a~wc If the decision is made to close the above account you may contact any Harleysville National BanWEast Penn $ank branch. If you have any further questions, please contact me at 2I5 256-885 ], extension 61316. Sincerely gr n . Anna ay ak CIF Department ~. MetLite Investors Insurance Company P.O. Box 295 Des Moines, IA 50.301.0295 MetLifelnvestors~ ;< JUANITA E HENDRICKS 4041 CAZSSONS COURT ENOLA, PA 17025 Date: 07-16-2009 Check No: 020317463 Contract No: 1988751 Partial Claim Proceeds Gross Payment 10,959.51 MetLifeinvestorsy Metl.ife Imesbrs Insurance Comparry P.O. 80z 295 Dee Manes, IA 50301-0295 Ten thousand nine hundred Rtty nine and 51!100 Dotlan Pay to the Order ol: JPMor JUANITA E HENDRICKS gan Chase Bank, N.A. 4041 CAISSONS COURT 6040 Tarbell Roatl Syracuse, Nv t320s ENOLA, PA 17025 5G9a1213 heck Number 020.317463 wf vase feo oar. Fmm Dau d baw 07-18.2009 Amount ,..~..a1 o,esas~ L AUTHORIZEp SIGNATURE