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Home My WebLink About09-22-09 (2)15D5607120 -~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2aosol 2 1 0 9 0 7 2 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 159 24 9471 06 29 2009 10 19 1921 Decedent's Last Name Suffix Decedent's First Name MI BROWN OLIVE R (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 a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) n 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (dale of death after 12-12-82) n g Decedent Died Testate ~, Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes u (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and i-1-95) (Attach Sch. O) CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT C. SAIDIS ESQ. 717 243 6222 Firm Name (If Applicable) SAIDIS, FLOWER & LINDSAY First line of address 26 WEST HIGH STREET Second line of address City or Post Office CARLISLE State ZIP Code PA 17013 Correspondent'se-mail address: rSa1d15@Sfl-law.com REGISTER O~IVILLS USE~ILY C (~ .,v ~ '~ r-- y m tU ,'~ : ~~ ~ N C: } C ~C DATB,F~tttED (V s~ ,_~ `.-~ ~;~ :;-"7 ~_;.: •.""'i ~t '_`` a 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 sparer other than the personal representative is based on all information of which preparer has any knowledge. SI TURE OF PER ON RESPON LE F FIL G RETURN DATE d~~~ `~~',~~ Bonnie L. McKeehan e/- 02 ~ . O 10 Pine like Drives C,brlisle, PA 17015 SIGNATU OF PREPARER HAN REPRESENTATIVE DATE Robert C. Saidis Esq. ~ Q AD ESS 26 West High Street, Carlisle, PA 17013 Side 1 15D5607120 1505607120 J 150560722D REV-1500 EX Decedent's Social Security Number Decedents Name: O i I V e R. Brown 15 9 2 4 9 4 71 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... 1. 1 1 3, 9 9 2 0 0 2. Stocks and Bonds (Schedule B) ..............................__............................._............. 2. 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. 18 , 7 6 2 9 3 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ............................._............................__..... 8. 1 3 2, 7 5 4 9 3 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 3 . 7 7 8 2 3 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 5 5 2 . 5 1 11. Total Deductions (total Lines 9 & 10) .............................___................................. 11, 4 , 3 3 0 . 7 4 12. Net Value of Estate (Line 8 minus Line 11) .............................~.......................... 12. 1 2 8 , 4 2 4.19 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. 1 2 8 , 4 2 4.19 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 12 8, 4 2 4.19 16. 5, 7 7 9 0 9 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 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. 5, 7 7 9. 0 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-0723 DECEDENT'S NAME Olive R. Brown STREET ADDRESS 278 N. Locust Point Road CITY STATE I GIP New Kingstown PA 17072 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount InteresUPenalty if applicable p. Interest E. Penalty 5,000.00 288.95 Total Credits (A + B + C) (1) 5,779.09 (2) 5,288.95 (3) (4) Total Interest/Penaity (D + E) if Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. Check box on Page 2 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE Make Check Payable to: REGISTER OF W/LLS, AGENT (5) (5A) (5B) 490.14 490.14 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; ............................._.. c. retain a reversionary interesk; or .............................._.............................._............................._................ ^ d. receive the promise for life of either payments, benefits or care? ........................................................... ^ x^ 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 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 y ary 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the For dates of death on or after Jul 1, 1994 and before Janu 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 [72 P.S. §9116 (a) (1.1) (ii)J. The statutedoes not exempla 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 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)]. 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'1502 EX+ (6.98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Brown, Olive R. 21-09-0723 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is Jolntlyowned with right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 278 North Locust Point Road -Tax Parcel #38-19-1621-103 113,992.00 Approximately .34 acres with improvements thereon erected in Silver Spring Township, Cumberland County, Pennsylvania TOTAL (Also enter on Line 1, Recapitulation) ~ 113,992.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleA (Rev. 6-98) ecev-'lauu tx* to-sat COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Brown, Olive R. 21-09-0723 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 M & T Bank Ck Acct 703923 14,704.85 2 CMS Medicare -Refund 30.58 3 Commonwealth of Pennsylvania State Treasury Department -Rebate for Real Estate 300.00 Taxes 4 HCR Manor Care Refund 3,538.76 5 Highmark Medicare Services -Refund 30.59 6 Highmark Medicare Services -Refund 158.15 TOTAL (Also enter on Line 5, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 18,762.93 Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (12.99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Brown, Olive R. 21-09-0723 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: 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 Saidis, Flower & Lindsay 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 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 100.37 3,000.00 295.00 7. Other Administrative Costs 382.86 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 3,778.23 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 Brown, Olive R. 21-09-0723 ITEM NUMBER DESCRIPTION Funeral Expenses 1 Bonnie McKeehan -Reimbursement for luncheon items after funeral AMOUNT 100.37 H-A Subtotal 100.37 Other Administrative Costs 2 Cumberland County Recorder of Deeds -Record deed 49.50 3 Cumberland County Recorder of Deeds -Recorded copy of POA 30.00 4 Cumberland Law Journal -Advertise Estate Notice 75.00 5 Register of Wills-Cumberland County -Inheritance Tax Filing Fee 15.00 6 Saidis, Flower & Lindsay -Reimbursement for travel expenses 15.20 7 The Sentinel -Advertise Estate Notice 198.16 H-67 Subtotal 382.86 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1512 EX+ (6-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF (FILE NUMBER Brown, Olive R. 21-09-0723 Include unrefmbursed medlcalexpenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Check Number 1772 Outstanding Check 38.53 2 Heartland Pharmacy of Pennsylvania -Customer ID 91635 47.20 3 Silver Spring Township Authority 125.35 4 Special Event Emergency Medical Services -Invoice #09-34431 65.84 Wheelchair Van Transport and Oxygen 5 Susquehanna Oil Company -Invoice dated June 18, 2009 125.95 6 The National Industrial Group Pension Plan -Must return amount paid on July 1, 131.03 2009 7 Verizon 18.61 TOTAL (Also enter on Line 10, Recapitulation) I 552.51 (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-7573 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Brown, Olive R. 21-09-0723 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY po Not List Trustee s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers , under Sec. 9116(a)(1.2)) 1 Hazel E. Brown Daughter One-third (1/3) 118,802.71 PO Box 97 of the residue. New Kingstown, PA 17072 2 Robert L. Brown Son One-third (1/3) 4,810.74 3850 Sullivan Street of the residue. Mechanicsburg, PA 17050 3 Bonnie L. McKeehan Daughter One-third (1/3) 4,810.74 10 Pine Lake Drive of the residue. Carlisle, PA 17015 Total 128,424.19 Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet III NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET U.UV Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) 1 cLXUD I~GSUlI LGLd115 Detailed Results for Parcel 3 8-19-162 ] DistrictNo 38 Parcel ID 38-19-1621-103. MapSuffix HouseNo 278 Direction N Street LOCUST POINT ROAD Ownerl BROWN, HAZEL C/O PropType R PropDesc LivArea 1128 CurLandVal 36450 CurImpVal 54020 CurTotVal 90470 CurPrefVa! Acreage .34 CIGrnStat TaxEx 1 SaleAmt 1 SaleMo O1 SaleDa 27 SaleCe 20 SaleYr 09 DeedBkPage 200902167 YearBlt 1950 HF File Date 11/29/2004 HF Approval_Status R -103. in the 2004 Tax Assessment Database x i, ~~ ';' ~. ~t _ ~ ~/3 yY~ -~. U i Q~G 1 yl J httn://taxdb.ccpa.net/details.asp?id=3 5-19-1621-1 Q3. &dbselect=l ~/~/20~q 278 North Locust Point Road THIS DEED MADE THE 26th day of January Two Thousand Nine (2009) PARCEL # 38-19-1621-103 in the year of our Lord BETWEEN OLIVE R. BROWN, Widow, of Silver Spring Township, County of Cumberland, Commonwealth of Pennsylvania, hereinafter referred to as (Grantor) AND HAZEL BROWN, single woman, of Silver Spring Township, County of Cumberland, Commonwealth of Pennsylvania, hereinafter referred to as (Grantee) WITNESSETH, that in consideration of ONE AND 00/100 ------------ ------------------------($1.00)-------------------------Dollars, in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey to the said grantee, her heirs and assigns ALL that certain lot of ground situated in Silver Spring Township, Cumberland County, Pennsylvania, bounded and described as follows: On the west by the road leading from the Village of New Kingstown to the Railroad, known as Railroad Street; on the south and east by lands now or formerly of Charles W. Sunday and Gertrude E. Sunday, his wife; on the north by lot now or formerly of Edgar Lee Brenizer. Having a frontage on the said road leading from the Village of New Kingstown to the road known as Railroad Street, of one hundred feet (100) and the depth of one hundred fifty feet (150) . No building to be erected closer to the road leading from New Kingstown to the railroad, or known as Railroad Street, than the next adjoining property. BEING the same property which LLOYD J. MARKLE, ET UX granted and conveyed to LESTER R. BROWN and OLIVE R. BROWN, husband and wife, by deed dated October 21, 1947, which deed is recorded in the Office of the Recorder of Deeds in an~7 fir Cumberland County in Deed Book P, Volume 13, Page 542. The said LESTER R. BROWN departed this life on September 10, 1982 thereby vesting title in the Grantor as Surviving Tenant by the Entireties. This is a tax-exempt conveyance between parent and child and, therefore, is exempt from Pennsylvania Realty TransfeY Tax. AND the said grantor hereby covenants and agrees that she will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, said grantor has hereunto set her hand and seal the day and year above written. SIGNED, SEALED AND DELIVERED IN TIE"' ~ RES NCE OF ,~~"`~ Olive R. Brown ~~~~ ~1-/ By: Bonnie McKeehan, Agent COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ~' On this , the ~~g day of ~ 1~yL~~,~j 2 0 0 9 before me , the undersigned officer personally appear d Bonnie McKeehan, Agent for Olive R. Brown, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained and in the capacity stated. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOTARIAL SEAL ~ EAL ) MERLENf J, MARHEVKA, NOTARY PUBLIC i t l e o f Office r CARLISLE, CUMBERLAND COUNTY, PA MY COMMISSION EXPIRES JUNE B, 2010 I do hereby certify that the precise residence and complete post office address of the within named grantee is P. O. Box 97, New Kingstown, PA 17072 Robert C. Saidis, Esq., NTS Attorney for Grantee au~ 1 a Zoos 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302)934-2955 August 7, 2009 Law Offices Saidis, Flower & Lindsay 2109 Market Street Camp Hill, Pennsylvania 17011 Re: Estate o~ Olive R. Brown Social Security: 159-24-9471 Date of Death: June 29, 2009 Dear Sir or Madam: Per your inquiry dated August 04, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type ofAccount Checking Account Account Number 703923 Ownership (Names o, fl Olive R Brown* Opening Date 9/01/67 Balance on Date of Death ~' 14, 704.85 Accrued Interest $ 0.00 Total $ 14, 704.85 Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our High Street Carlisle Office # 717-240-4536. Since ely, `` Tracie Hare Adjustment Services