Loading...
HomeMy WebLinkAbout11-20-0915056D7120 REV-150a EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code rear File Number Bureau of Individual Taxes' INHERITANCE TAX RETURN 2 1 0 9 0 0 5 6 2 PO 60X.280601 ~ Harrisburg, PA 17128-06 1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BEL W Social Security Number Date of Death 186305798 b6062009 Decedent's Last Name HENCH (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 4. Limited Estate ® g. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received Date of Birth 10291908 Suffix Decedent's First Name MI STANLEY G Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-•32) ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 1 ^ ~ Decedent Maintained a living Trust (Attach Copy of Trust) e. Total Number' of Safe Deposit Boxes ^ 1 D Spousal Poverty Credit ((data of death between 12-31-91 and i-1-95) 11, Election to tat( under Sec. 9113(A) ^ (Attach SCh. O) ,CiORRESPONDENT -THIS SECTION MUST BECOMPLETED. ALL CORRESPONDENCE AND CON rvame CHRYSTAL L. PROSSER, ESQ. I Firm Name (If Applicable) LAW OFFICE OF WILiLIAM R. BUNT First line of address 109 S. CARLISLE SITREET, P.O. BOX 336 Second line of address City or Post Office State ZIP Code NEW BLOOMFIELD PA 17068 Correspondent's a-mail address: Daytime Telephone Number 7175828195 ___ REGISTER WILLS US~ ILY © ~ "' " f ~ r q ~ - ,... , ~ ` . ` ~ y. 1~ -4 ~. ` -- I "7 C~1 'r'1 ~ <.~ DA?~~ED - r ~~ G.) ~, Y ~.. J r.-" s-7 `•-;? `i 7 ~ ..I ~7 ~..t -~-~ Under penalties of perjury, I deGare that i have e it is true, corcect and complete. Declaration of pn SIGNATURE OF PERSON RESPONSIBLE FOR FILINf this return, including accompanying schedules and statements, and to the befit of my knowledge and belief, ter than the personal representative Is based on all information of which preparer has any knowledge. Mark E. Hench ADDRESS 23 Birch Street, Mechanicsbur6;, PA 17050 Chrystal L. Prosser, Esq. 109 S. Carlisle Street, P.O. Box ~~,336, New Bloomfield, PA 17068 Side 1 1505607120 DATe DATE 1505607120 ADDITIONAL Personal Representatives Hench, Stanley G. SS# 18'6-30-5798 6/6/2009 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and Complete. 2 Signature Name J n .Hench Address Jacks Lane city, state, zip Centre Hall PA 16828 Date 3 Signature Name Address City, State, Zip Date 4 Signature Name ' Address: City, State, Zip Date 5 Signature Name Address: City, State, Zip Date 6 Signature Name Address: City, State, Zip Date -J 1505607220 REV-1500 EX oacedenrs Name: H E N C Hi, STANLEY G. Decedent's Social Security Number 18 6 3 0 5 7 9 8 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 & Notes Receivable (Schedule D) ............................._........................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 9,062.69 6. Jointly Owned Property (Schedul~ F) ^ Separate Billing Requested ............. 6. 3 , 16 5 . 2 9 7. Inter-Vivos Transfers & Miscellan sous Non-Probate Property ^ Separate Billing Requested ............. (Schedule G) 7, 8. Total Gross Assets total Lines 1 12 2 2 7 . 9 8 9. ~ Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 8,672.90 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... . 10. 148,751.25 11. Total Deductions total Lines 9~ ( 10) .............................---................................. 11. 1 5 7, 4 2 4. 1 5 12• Net Value of Estate Line 8 minu ( s Line 11) ..............................__........................... 12. - 1 4 5 , 19 6.17 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 1j2 minus Line 13) .............................. ................ 14. - 1 4 5 , 19 6.17 TAX COMPUTATION -SEE INSTRU i TIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 I 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................. .................. 19. 0 0 0 20. FILL IN THE OVAL IF YOU AR~ REQUESTING A REFUND OF AN OVERPAY MENT. ^ Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 00562 DECEDENT' NAME Hench, Stanley G. STREET ADDRESS 1000 W. South Street' CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ~I Total Credits (A + B + C) (2) 0.0 0 3. InteresVPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5Aj This is theBALANCE DUE (5B) Q , Q Q Make Check Payable to: REGISTER OF W1LLS, AGENT ~~. r iid+.^, .t i ,...:L<= r~Yk ~.b~`~s:'~ w~a .,. { .. y ~. ~~ ='~ . . PLEASE ANSWER THE FALLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or i'rcome of the property transferred :............................................................................. ^ ^x b. retain the right to'designate who shall use the property transferred or its income :................................ ^ ^x c. retain a reversionary interest; or .............................__.........................................................._................ ^ d. receive the promi, a for life of either payments, benefits or care? ........................................................... ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of deatPo without receiving adequate consideration? ................................................................................................................. ^ ^x 3. Did decedent own an "irt trust for' or payable upon death bank account or security at his or her depth?......... ^ ^x 4. Did decedent own an Irdividual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .............................................................................................................. ^ ^x IF THE ANSWER TO ANY OF THE ABbVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FIILE IT AS PART OF THE RETUR 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, '995, the tax rate imposed on the net value of transfers to or for the use of tf)e surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statutedces not exemat a transfer to a surviving spouse from tax, and th@ statutory requirements for disclosure of assets and filing a tax re~urn 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 ~ransfers 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 [7~ 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. SCHEDULE E ''CASH, BANK DEPOSITS, & MISC. COMMONWEALTH DF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Hench, Stanley G. 21 - 09 - 00562 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Bank of Landisburg -Irrevocable Burial Fund -Nickel Funeral Home (Account Number 7,684.54 700017235) (please see atta~hed letter) 2 Bank of Landisburg -NOW account (Account Number 0685186) (please see attached letter) 1,145.30 3 Refund from Nickel Funeral Home 59.89 4 Refund from PA Farm Bureau for health insurance 172.96 TOTAL (Also enter on Line 5, Recapitulatlorn~ ~ 9,062.69 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Hench, Stanley G. 21 - 09 - 00562 If an asset was made joint within one year, of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ', ADDRESS RELFITIONSHIP TO DECEDENT Elwood S. Hench I 5 Oak Drive Son A Loysville, PA 17047 ~i JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT Include name o Inanclal Ins Itu Ion an ban account number or similar ibentifying number. Attach deed for jointly-held real estate. ' DATE OF DEATH VALUE OF ASSET % OF ', DECD'S ~INTERES DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 ~ A 08/10/2000 Bank of Landisburg Certificate of Deposit 6,330.57 50% 3 165 29 (Accou~t # 700009878) please see attached , . i letter i TOTAL (Also enter on line 6, Recapitulatio n) 3,165.29 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDI~E H /F ryU ~ NEE 7 ~ Z ~ A~ I _p D~ ~(PO~ VV ~S JE ~S ' ~ &~ ~ /w.AYY1~11~71 fW I IYG LrW 1 ~7 i ESTATE OF Hench, Stanley G. II FILE NUMIBER 21 - 09 - 00562 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Nickel Funeral Home 7,795.50 2 Funeral Luncheon - ' 100.00 B 1 I '~ I ADMINISTRATIVE COSTS: i Personal Representative's Commissions 2. 3. 4. 5. 6. 7. 1 Social Security Number(s) / EIN N~mber of Personal Representative(s): Street Address City I State Zip Years Commi i () ss on paid Attorney's Fees Law Office~of William R. Bunt 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 Probate Fees Cumberland county Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal 400.00 83.00 75.00 '~ TOTAL (Also enter on line 9, Recapitulation) 8,67$.90 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Scheckde~ H w~,~,,.MF,un,~er~alME~er~ses ~ W uJ /"I~~Y 1 u111~Y pY~ ~ ~1 ~.IF7~.~ FILE NUMBER ESTATE OF Hench, Stanley G. 21 - 09 - 00562 2 ~ The Sentinel 219.40 Page 2 of Schedule H L SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMDNWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TA% RETURN RESIDENT DECEDENT FILE NUIIABER ESTATE OF Hench, Stanley G. 21 - 09 - 00562 Include unreimbursed medical expenses., ITEM DESCRIPTION AMOUNT NUMBER ~, 1 Department of Public Welfare Claim (please see attached) 148,240.97 2 Spring Road Family Practice) 56.07 3 United Church of Christ Hordes -Sarah A. Todd Memorial Home 454.21 ' TOTAL (Also enter on Line 10, Recapitulatlon~ I 148,751.25 REV•1513 EX+ (9-00) ,~ ~, ~' SC HED U LE J COM w AN E ~IA .~ ~+ / BENEFICIARIES NHER I CETAX RETURN RESIDENT DECEDENT ESTATE OF ' Hench, Stanley G. FILE NUMIBER 21 - 09 - 00562 ~ RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT Do Not Llst Trustee(s) (Words) ($$$) I~ TAXABLE DISTRIBUTIONS[includ outright spousal distribu ions and transfers under ec. X116 (a) (1.2)] 1 Elwood S. Hench Son 5 Oak Drive Loysville, PA 17047 ~ 2 C. Dean Hench I Son 3003 Fort Robinson Road Loysville, PA 17047 i 3 John S. Hench ~ Son 107 Jacks Lane Centre Hall, PA 16828 I Enter dollar amounts for distribution shown above on lines 1 5 through 18, as appropriate, on Rev 1500 cover sheet II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I I~ i I II B. CHARITABLE AND GOVERNME TAL DISTRIBUTIONS ~I I ~i __ TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER GHEE 0.00 REV-1513 E)(+ (9-00) ~ ~ SCHEDULE J COM NHENRWTANCETAXERETURNANIA ~ BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF ~ Hench, Stanley G. ~ FILE NUMBER 21 - 09 - 00562 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) __ RECEIVING PROP ERTY Do Not List Trustaela) I~ TAXABLE DISTRIBUTIONS[includ outright spousal distribu ions and transfers under ec. X116 (a) (1.2)] 4 Mark E. Hench Son 23 Birch Street Mechanicsburg, PA 17050 ~ ~ 5 I Jeffrey Frank 'i Grandson 3925 Locust Lane Harrisburg, PA 17109 6 Barbara Creamer Granddaughter ~ 108 Ashwood Way ~ ~ i ~i I I Harrisburg, PA 17109 i ~~ '', ' i ' I i I I i Page 2 of Schedule J LAST WILL AND TESTAMENT OF STANLEY G. HENCH ~o i f~l~ n ~~~~ ~~~ '70Ci r~ C I, STANLEY G. HENCH, of Northeast Madison Township, N o _ °r7 ~.o •~ ~ C.. ~" t`i ~_~ C G~ ._. a x ~~ - ~1 .._., ~ -~ C-7 a. fir=, : ~ =~ -- , - i-r~ Gft '" ~ ~,"-~ Perry County, Pennsylvania, being of sound mind, memory and understanding, do hereby declare this to be my Last Will and Testament, revoking all former wills or writings in the nature thereof and any codicils th~reto made. FIRST: III I direct my hereinafter named Co-Executors to pay all of my just debts, funeral expenses, ~osts of administration and inheritance taxes out of the corpus of my estate as soon after my decease as is practicable to do so. SECOND: ', I give, bequeath and devise all of my estate, real, personal and mixed a 1 '~ti LAW OFFICE OF WILLIAM R. BUNT WILLIAM R. BUNT CHRYSTAL L. PROSSER ATTORNEYS AT LAW 109 S. Carlisle Street New Bloomfield, Pa. 17068 and wheresoever situate, unto my five (5) children, Elwood S. Hench, Lucille S. Frank, John S. Hench, Mirk E. Hench, and C. Dean Hench, in equal sharees, share and share alike. ', In the event that any of my children predecease my decease, leaving a child or children tq suriive the same, then and in that event, I give, bequeath and devise the share of said deceased child's share of my estate unto the child or children of said deceased child, in 'equal shares, share and share alike. Tel. (717) 582-8195 FAX (717) 582-7521 In the event that any of my children predecease my decease, failing to leave a child to survive the same, then and in that event, I give, bequeath and devise the share of said dece~sed child's share of my estate unto my remaining Children surviving my decease, in equal hares, share and share alike. THIRD: ~' Any person who shall have died within thirty (30) days of my death, or under such circumstances that the order of our deaths cannot be established by proof, shall be deemed to have predeceased me. FOURTH: III I name, constitute and appoint my children, Mark E. Hench and John S. Hench, as the Co-Executors of this my Last Will and Testament. My Co-Executors are hereby excused from the posting of any bond or security notwithstanding and provisions of the law to the contrary. IN WITNES~ WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament this 27'h day of July, 2001. !,I r _~ ~,~ . ~"~- `L ' ~ ..,n.~.' (SEAL) r'^ Y Signed, seal;?d; pl.ablished and declared by the above named Testator, as and for LAW OFFICE OF WILLIAM R. BUNT WILLIAM R. BUNT CHRYSTAL L. PROSSER ATTORNEYS AT LAW 109 S. Carlisle Street New Bloomfield, Pa. 17068 Tel. (717) 582-8195 FAX (717) 582-7521 his Last Will and T~stament, in our presence, who, in his presence, at his request and in the presence of each other, have hereunto set our names as attesting witnesses. Page 2 of 2 Pages ~h R~ of Landisbur ESTABLISHED 1903 e~ ~ P.O. BOX 179 LANDISBURG, PA 17040 unt rds indicate the fiollowing a o ank reco alances on 6/6/2009 for i Hench, Stanley G. SS # I c/o C Dean Hench Elwood S. Hench (son) Unknown SS~~ 5 Oak Drive Loysville PA 17047 186-30-5798 3003 Fort Robinson Rd ~ Safety Deposit Box Rented 411365 Loysville PA 17047 ~! C Dean Hench was power of attorney Acct Sole Jt Acct ~oened Ownership With )8/10/2000 Elwood S Henchl (son) )8/01/2006 Irrevocable Burial Find Nirke L Fnnaral Anmc _ )1/17/1992 Yes Balance Account Prior to Interest Accrued Number Tyge Interest Be rin Interest 700009878 CD 6,317.37 Yes 13.20 700017235 CD 7,650.21 Yes 34.33 0685186 I3ow Ac t. 1,145.22 Yes .08 BY ~~~~ LANDISBURG - 717-789-3213 SLAIN - 536-3118 SHERMANS DALE - 582-8511 -~ R COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 August 10, 2009 WILLIAM R BUNT ESQUIRE CHRYSTAL L PROSSER ESQi 109 S CARLISLE ST PO BOX 336 NEW BLOOMFIELD PA 1701 RE 8 Re: STANLEY HENCH CIS #: 410363623 SSN: 186-30-5798 Date of Death: 06j06/2009 Dear Attorney Prosser: Please be advised that the Department of Public Welfare maintains a claim in the amount of $148,240.97 against the above-mentioned estate. This claim is for restitutio4z of medical assistance granted on behalf of the decedent for which the probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, a fective June 30, 1995. Enclosed is the Department's itemized statement of c aim. A portion of this ~edical expense, namely $33,048.77, was incurred during the last six mon hs of the decedent's life; therefore, it is a Class 3 claim pursuant to Secti n 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 339 (3). The balance of the claim, namely $115,192.20, is to be entered as a p~iority Class 5.1 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is co plete, please provide a copy. If the eataite contains real estate, please pro ide copies of the deed, the latest tax ass~ssmeat, and a curreat appraisalJ, if available. Sincerely, C~~ Carl G. Rinkevich TPL Program Investigator 717-772-6258 717-772-6553 FAX Enclosure WILLIAM R. BUNT ATTORNEY AT LAW P. O. Box 336 109 SOUTH CARLISLE STREET NEW BLOOMFIELD, PA 17068 TEL (717) 582-8195 FAx (717) 582-7521 November 18, 2009 Ms. Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Stanley G. Hench No. 21-2009-00562 Dear Ms. Strasbaugh: N _~:~ ;~ as ac ~,-, , }~ o c, -~ ~, ~.- ifa O _~ ~; f ~ - ,r~-~, ~ ~ ~ r. : ; ., - a ~, , -. _, _. w Enclosed herein please find the original and two copies of the Inheritance Tax Return for the above referenced estate as well as a check in the amount of $15.00 to cover the cost of filing the same. As you will note, the estate is insolvent and no inheritance tax is due. Please time stamp one copy and return it in the enclosed self addressed stamped envelope. If you have any questions with regard to the enclosed, please do not hesitate to contact me. Very truly yours, Chrystal L. Prosser Enclosures WILLIAM R. BUNT, ESQ. CHRYSTAL L. PROSSER, ESQ. cc: _ John Hench Mark Hench