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Home My WebLink About02-0230REd-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I- IINHERITANCE TAX RETURN IF,LE,. M ER RESIDENT DECEDENT I ! / COUNTY CODE OFFICIAL USE ONLY YEAR NUMBER DECE- DENT CHECK APPRO- PRIATE BLOCKS DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Bow~rs~ James G. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 07/26/01 I 3/3/1927 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Bowers, Je~n~ L. SOCIAL SECURITY NUMBER 202-20-0312 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER COR- RE- SPON DENT 1. Original Return 4, Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise date of death after 12-12-82) 7. Decedent Ma ntained a Living Trust (Attach a 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 12-13-82) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes 11. Election to tax un der Sec. 9113(A) (Attach Sch O) NAME Vicky Ann Trinmer, Esquire FIRM NAME (If Applicable) Mette, Evans & Woodside TELEPHONE NUMBER 717-232-5000 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Clesely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal COMPLETE MAILING ADDRESS 3401 N. Front Street PO Bc0c 5950 Harrisburg, PA 17110-0950 Property (Schedule E) 6. Jointly Owned Property (Schedule F) I-]Separate Billing Requested 68 ,Y6 N~ne Nf~ne 1,000.00 Nc~e 43,140.81 cjOFFICIAJ~L., I~,E ONLY I RECA- PITULA- 7. TION 8. 9. 10. 11. 12. 13. 14. 15. 16. TAX COMPU- 17. TATION 18. 19. 20. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) Total Gross Assets (total Lines 1-7) (5) (6) (7) (8) 44,830.45 Funeral Expenses & Administrative Costs (Schedule H)(9) 12,835.55 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,830.40 Total Deductions (total Lines 9 & 10) (11) Net Value of Estate (Line 6 minus Line 11) (12) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) 14,665.95 30,164.50 None 30,164.50 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES Amount of Line 14 taxable at th e spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 30,164.50 X ,o 0 (15) O. O0 AmountofLine14taxableatlinealrate 0.00 x.O 45 (16) 0.00 Amount of Line 14 taxable at sibling rate O. O0 X .12 (17) O. O0 Amount of Line 14 taxable at collateral rate O. O0 X .15 (18) O. O0 Tax Due (19) 0.00 0 PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LF- Forms Software Only PA' REV-1500 EX (6-00) Decedent's Complete Address: Page 2 STREET ADDRESS 558 West Per~ Street CITY ~rl ~ ~le ISTATE PA IZlP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (4) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 0.00 0.00 0.00 0.00 0.00 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; ....................................... I 1 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, 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? .,. 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. Under penalties of perjury, I declare that I h. ave ex. am ne..d th s return; including a.ccompanying schedu.les and statement? and. to the. best of my knowledge and behef, it is true, correct ano complete, ueclaration o] preparer other than the persona~ representative is oase(~ on inTormation of which preparer has any knowledge. A~. NA!URE OF PERSONRESPONSIBLE FOR FILING RETURN DATE 6~Ess See Sche~_ lie attached SIG~IA~URE OF P~EPAR..EI;~'HER THAN REPRESENTATIVE .~DDRES~ ' 3401 N. Front Street, PO Bc~ 5950, Harrisburg, PA 17110-0950 DATE [72 P.S. § 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116(a)(1.1)(ii)]. Th e statute does not exempt 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 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 0% [72 P.S. §9115(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 4,5%, 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 si blings is 12% [72 P,S. § 9116(aXl.3)]. A si bling is defined, under Section 9102, as an indivi dual who has at least one parent in common with the decedent, whether by blood or adoption. 0 PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of: James G. ~ The followir~ persc~(s) are si~in~ the return as representative(s) Jeanne L. ~ 558 West Penn Street Carlisle, PA 17013 of the estate: REV'-'1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER James G. Bowers All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NO. DESCRIPTION OF DEATH 1 share of Franklin Oo%~ty Teachers' Credit Unic~ TOTAL (Also enter on line 2, Recapitulation) 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) 689.64 689.64 REVT1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Jame.q C-. Bowers Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with rl~lht of survivorship must be disclosed on Sch. F. ITEM NO. 1988 Cb~vroletNova DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH 1,000.00 1,000.00 7 CPA81 N~F 10908 Copyright Forms Software Only, 1997 Nelco, Inc, (If more space is needed, insert additional sheets of the same size) RE~'~1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER James G. Bowers This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF EXCLUSION INCLUDE NAME OF THE TRANSFEREE, THEIR ITEM RELATIONSHIP TO DECD & DATE OF TRANSFER. DATE OF DEATH DECD'S (IF TAXABLE VALUE NO. AI-I'ACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 Aetna Life Insurance and Annuity 43,140.81 C~, ft~ntract T511, 105629 TOTAL (Aisc enter on line 7, Recapitulation) $ 43,140.81 7 CPA01 NTF ~09~0 (If more space is needed, insert additional sheets of the same size Copyright Forms Software Only, 1997 Nelco, Inc. RE~/r-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER James G. ]~:~grs Debts of decedent must be reported on Schedule I. iTEM NO. DESCRIPTION AMOUNT 1 2 3 FUNERAL EXPENSES: Dickinson Gollege (Reception) George' s Flowers ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Name: Mette, Evans & Woodside Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Jeaz-'L,~e 'r,. Bo~grs Street Address 558 ~gst ~ St:~gt City Carlisle State PA Zip 17013 Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees su v -v-i s x use TOTAL (Also enter on line 9, Recapitulation) $ 6,469.00 787.05 79.50 0.00 2,000.00 3,500.00 0.00 0.00 0.00 12,835.55 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) RE~/~-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF James G. Bowers FILE NUMBER Include unreimbursed medical expenses. ITEM NO. DESCRIPTION First Unic~ ~ Loan #08200310767 TOTAL (Also enter on line 10, Recapitulation) $ 7 CPA12 NTF 10912 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Netco, Inc. AMOUNT 1,830.40 1,830.40 REV,-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER James G. Bowers RELATIONSHIP TO DECEDENT AMOUNT OR NO. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Mst Trustee(s) SHARE OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) II. Jeanne L. Bowers 558 West Penn Street Carlisle, PA 17013 30,164.50 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 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 ~ -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc. Notice: See reverse side for important information regarding your right to dispute errors on your sta=ement. Franklin County Teachers' Credit Union 1156 Kennebec Drive · P.O. Box 505 Chambersburg, PA 17201-0505 Phone: 717-264-6506 Toll Free: 888-968-7828 ACCOUNT NI]I~ER: 5930 YTD DIV RECEIVED: 17.44 '~ PAGE I~ER: 1 768 DIRECT INQUIRIES TO: P 0 BOX 505 CHAMBERSBURG PA 17201 717-264-6506 OR 888-968-7828 JA/W. ES G BOWERS 558 W PENN ST CARLISLE, PA 17013-2236 THE 2001 FAMILY MEMBERSHIP DRIVE RUNS THRU AUGUST 31ST. DON'T MISS THE OPPORTUNITY TO HAVE YOUR FAMILY JOIN OUR FAMILY! NEW MEMBERS WILL RECEIVE THEIR FIRST $5 SHARE FREE OF CHARGE & MEMBERSHIP FEES WILL BE WAIVED. CALL FOR DETAILS! S~RY OF YOUR ACCOUNTS SUFFIX 01 BASE SHARE ACCT STATEME/T~ PERIOD 04/01/01 - 06/30/01 BEGI1TNING BALANCE 681.15 DEPOSITS 1 8.49 WITHDRAWALS 0 .00 E/~DING BALANCE 689.64 17.44 8.49 681.15 091 DIVIDEND YEAR-TO-DATE DIVIDEND THIS PERIOD AVERAGE DAILY BALANCE DAYS DIVIDEND EARNED ANNUAL PERCENTAGE YIELD EAR/FED 5.09% SUFFIX 01 BASE SHARE ACCT HISTORY DATE DESCRIPTION 6/30/01 DIVIDEND TRANSACTION AMOb-NT 8.49 ACCOUNT BALANCE 689.64 AETNA LIFE INSURANCE AND ANNUITY COMPANY Hartford, Connecticut 06156 This statement is submitted in lieu of Treasury Department Form 712. The benefits payable under this contract following the death of the decedent do not represent life insurance on the life of the decedent. 1. NAME OF DECEDENT: James G. Bowers 2. DATE OF DEATH: July 26, 2001 3. CONTRACT(S): T511, 105629 4. ANNUITY COMMENCEMENT DATE: February 18, 1998 5. PRovISIONS OF CONTRACT: Proceeds from a tax deferred annuity payable to James G. Bowers in monthly installments, commencing February 18, 1998, f6r a specified period of 15 years. Upon his death, the remaining guaranteed installments continue to Jeanne L Bowers, beginning August 18, 2001, with a final payment due January 18, 2013. 6. AMOUNT OF PROCEEDS (if payable in one sum): N/A 7. VALUE OF PROCEEDS AS OF DATE OF DEATH: $43,140.81 8. VALUATION BASIS (if not payable in one sum at death of decedent): N/A 9. NAME AND DATE OF BIRTH OF ANY PERSON THE DURATION OF WHOSE LIFE MAY MEASURE THE NUMBER OF pAYMENTS PAYABLE AFTER THE DEATH OF TI-~ DECEDENT: 10. NAME: N/A DATE OF BIRTH: N/A WAS DECEDENT THE ANNUITANT OR PAYEE OF ANY OTHER CONTRACT ISSUED BY THE COMPANY: No Record. 11. NAMES OF OTHER COMPANIES WITH WHICH DECEDENT CARRIED OTHER POLICIES AND AMOUNT OF SUCH POLICIES IF THIS INFORMATION IS DISCLOSED BY THE COMPANY$ HOME OFFICE RECORDS: No Record. THE UNDERSIGNED OFFICER OF THE ABOVE NAMED INSURANCE COMPANY HEREBY CERTIFIES THAT THIS STATEMENT SETS FORTH CORRECT AND TRUE INFORMATION. DATE: February 1 I, 2002 AETNA LIFE INSURANCE AND ANNUITY COMPANY Manager First Union National Bank Attn: Account Verifications P O Box 40028 Roanoke VA 24022-7313 Reference ID: 226530 January'16, 2002 METTE EVANS & WOODSIDE P O BOX 5950 HARRISBURG, PA 17110-0950 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: JAMES G BOWERS Date of Death: July 26, 2001 Account Type Deposit Account Information Account Date of Death Average Date Maturity Interest Accrued Number Balance Balance* Opened Date Rate Interest YTD Interest Paid Date Closed SAVINGS 3082645331052 LEGAL TITLE: JAMES G. BOWERS JEANNE L. BOWERS $9,922.03 10/1/I 991 $0.61 $62.15 9/28/2001 Account Type * Due to system limitations, we can only provide a twelve month average balance on depository accounts. Loan Account Information Account Date of Death Balance Original Date Monthly Interest Times Number Amount Opened Payments Rate Late TelTTIS Due Date CONSUMER LOAN 08200310767 LEGAL TITLE: JAMES G. BOWERS $1,830.40 11/12/1997 Account Account Type Number Other Account Information Date of Death Date Date Balance Opened Closed Title(s) BROKERAGE 16912837 CONTACT WILLIAM A SMITH, III AT 610-376~1700 FOR INFORMATION. 12/10/1987 JAMES .G. BOWERS AND JEANNE L. BOWERS JTTEN Reference ID: 226530 * Date of death balance does not include accrued interest. * If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were made during that time period. f Depository R~p:e~entative Julia Sorrells Depository Representative January 16, 2002 Date Servicenter Associate (540)563-7323 Title Phone Number abs; at METTE, EVANS & WOODSIDE A PI~OFESSIONAL COI~POI~A~ION ATTORNEYS AT LAW HOWELL C. METTE ROBERT MOORE CHARLES B. ZWALLY PETER J. gESSLER LLOYD R. PERSUN CRAIG A. STONE JAMES A. ULSH DANIEL L. SULLIVAN STEVEN D. SNYDER CHRISTOPHER C. CONNER JEFFREY A. ERNICO KATHRYN L. SIMPSON P. DANIEL ALTLAND ANDREW H. DOWLING MICHAEL D. gEED PAULA J. LEICHT GARY J. HElM DAVID A. FITZSIMONS GUY P. BENEVENTANO THOMAS 1~. SM1DA 3401 NOI~TH I~I~ON? S?I~EET P.O. BOX 5950 ~A~I~L~BUI~G, I~A 17~0-0950 ~1985005 ~HO~ ~7) ~3~5000 ~717) 236-1816 JOHN F. YANINEK* VICKY ANN TRIMMER T1MOTHY A. HOY KATHLEEN DOYLE YANINEK JAMES M. STRONG JENNIFER A. YANKANICH RANDALL G. HURST* SUSAN D. ANDERSON OF COUNSEL JAMES W. EVANS *MARYLAND BAR February 28, 2002 Cumberland County Register of Wills Office Attn: Cheryl Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: ESTATE OF JAMES G. BOWERS Dear Cheryl: Enclosed for filing with your office, please find the inheritance tax return for the above estate. Also enclosed is our firm's check (No. 72410) in the amount of $10.00 to cover the filing fee. Also enclosed is the Estate Information Sheet. If you have any questions regarding the filing, please do not hesitate to contact me. Thank you for your assistance in this matter. Sincerely, Vicky Ann Trimmer VAT/dlh Enclosure :288160 I