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Home My WebLink About11-30-09 1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code veer File Number Po Box.2aoso~ INHERITANCE TAX RETURN 2 1 0 7 0 7 1 1 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 187 18 2555 12 29 2006 03 05 1917 Decedent's Last Name WENRICH (If Applicable) Enter Surviving Spouse'a Information Below Spouse's Last Name Suffix Decedent's First Name MI IRENE B 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 Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) ~~ g Decedent Died Testate (Attach Copy of Will) ~ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) O g, Total Number of Safe De Sit Boxes Po 9. Litigation Proceeds Received ~ 1p, Spousal Poverty Credit (date otdeath 11,Election to tax under Sec. 9113(A) between 7237-91 end i-t-s5) ~ (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAt10N SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES C. OMDAHL ESQUIRE (610) 866 7716 Firm Name (If Applicable) First line of address 54 SOUTH COMMERCE WAY, SUITE 172 Second line of address City or Post Office BETHLEHEM State ZIP Code PA 18017 _t..f ..:rj t~_.-7? ~~ r: r7 r-~ =- t Correspondent'se-mail address: omdahl@verizon.net Under penalties of perjury, I deGare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which oreaarer has env knowledge ADDRESS Robert F. Choma REGISTER --~II~LS USE ~ILY .r"~ ~ ~ i ,.'t .r7 ~ ` { ~ t. ~' ~ = ~ - " ~ ~ ~ ~~-i.1 i N a. -i .. DA~FILED y '~ p _,.,_ 214515th Street, Bethlehem, PA 18020 SIGNA URE OF PREPARER OTHER THAN REPRE N TIVE DATE ~ C James C. Omdahl, Esquire Esquire 1 ~ ~ l '7 ~ d 54`South Commerce Way, Suite 172, Bethlehem, PA 18017 Side 1 1505607120 1505607120 ~~~ 1505607220 REV-1500 EX Decedent's Social Security Number ~eceaern~s Name: Irene Bonin W e n r i c h 18 7 18 2 5 5 5 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 4,824.14 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1,638.97 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) ....................................................................... g. 6 , 4 6 3 . 1 1 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 5,454.10 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 75,236.08 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 8 0 , 6 9 0.18 12• Net Value of Estate (Line 8 minus Line 11) .................................. ........................... 12. - 7 4 , 2 2 7 . 0 7 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, - 7 4 , 2 2 7 . 0 7 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 0 . 0 0 at lineal rate X .045 16. 0 . 0 0 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. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-0711 DECEDENT'S NAME Irene Bonin Wenrich STREET ADDRESS 100 Mt. Allen Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable p. Interest E. Penalty 0.00 Total Credits (A + B + C) (1) 0.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Ltne 20 to request a refund 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. Make Check Payable to: REGISTER OF WILLS, AGENT (2) 0.00 (3) (4) (5) 0.00 (5A) (5B) ~,Q~ .,ix. .. & .,. 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 :.................................................................................. ^ a 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? ....................................................................................................................... ^ ^x 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. ,`, , . ,,x. } ; y, i~ 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 [72 P.S. §9116 (a) (1.1) (iij]. 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 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-1603 EX+ (8-9ti) SCHEDULE B STOCKS 8r. BONDS COMMONWEALTH OF PENNSYLVANIA I I INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 All property Jolydly-owned with rlgM of:unlvoTehlp must be disclosed on Schedule F ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 037833100 20 shares of Apple Computer Inc -Com 84.38 1,687.60 2 591568108 53 shares of Metlife Inc -Com 59.18 3,136.54 TOTAL (Also enter on Line 2, Recapitulation) 4,824.14 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule B (Rev. 6-98) Rev-tli08 EJ(+ (8-98 J SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 InGude the proceeds of Iltlga0on and the date the proceeds were received by the estate. All property Jointly-owned with the right of survlvorshlp must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Escheated property - 20 shares of Coeur d' Alene Mines Corporation common stock 25.10 and a dividend of x3.00 payable 04/21/1995 were escheated to Pennsylvania on 03/16/2003 2 ~ PSERS -Final pension payment ~ 1,613.87 TOTAL (Also enter on Line 5, Recapitulation) I 1,638.97 (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 E (Rev. 6-98) REV-1151 Ex+ (12-89) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Robert F. Choma Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 214515th Street c;ty Bethlehem state PA zip 18020 Year(s) Commission paid 2, Attorney's Fees James C. Omdahl Esquire 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. I Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 750.00 4,500.00 109.00 7. Other Administrative Costs 95.10 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 5,454.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-9t3) SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 ITEM AMOUNT NUMBER DESCRIPTION Other Administrative Costs 1 James C. Omdahl, Esquire -Reimburse costs advanced: short certificates, certified 35.10 mail fees 2 Register of Wills -Filing fee -Inventory 15.00 3 Robert Choma -Reimburse for death certificates 45.00 H-B7 subtotal 95.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS CONMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 Include unrelmburead msdlcal expenses. (It more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule 1(Rev. 6-98) REV-151 S EX+ t8.00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Wenrich, Irene Bonin 21-07-0711 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not Llst Trustees (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include.outright spousal distributions, and transfers under Sec. 9116(a)(1.2)1 Hilary J. Bonin Jr. Nephew 99 West Green Street Hazleton, PA 18202 Theodore J. Bonin Nephew 821 Peace Street Hazleton, PA 18201 John M. Greenley Friend 301 Sharon Drive New Cumberland, PA 17070 Carol Lynn Choma Maurer Niece 3541 March Drive Camp Hill, PA 17011 Jay Brian Maurer Grand Nephew 70 Van Buren Street Apt. 11 Voorhees, NJ 08043 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 5 throw h 18, as appropri ate, on Rev 1500 cover sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE J The BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Irene Bonin Wenrich 12/29/2006 187-18-2555 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Daniel A. Palermo Jr. Nephew 70 West Juniper Street Apt. 305 Hazleton, PA 18201 7 Jill Bonin Palermo Niece Butler Valley Manor RD #1, Box 135 Drums, PA 18222 Total 1 COMMONWEALTH OF PENNSYLVANUI DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ONISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM Po sox sass HARRISBURG, PA 17105-8486 July 28, 2009 JAMES C OMDAHL ESQUIRE STE 172 54 SOUTH COMMERCE WAX BETHLEHEM PA 18017 Re: IRENE WENRICH CIS #: 410300790 SSN: 187-18-2555 Date of Death: 12/29/2006 Dear Attorney Omdahl: I am in receipt of your correspondence dated July 22, 2009 regarding the above-referenced estate. The Department has reviewed the information presented and agrees with the accounting of the estate. Please notify us of any change in circumstances as they may change this agreement. Thank you for your cooperation in this matter. If you have any questions, please contact me. Sincerely, Ca4 ~ Carl G. Rinkevich TPL Program Investigator 717-772-6258 717-772-6553 FAX .TAMES C. OMDAHL ATTORNEY AT LAW SUITE 172 54 SOUTH COMMERCE WAY BETHLEHEM, PENNSYLVANIA 18017 TELEPHONE (610) 866-7716 July 22, 2009 Department of Public Welfare Division of Third Party Liability Estate Recovery Program P.O. Box 8486 Harrisburg, PA 17105-8486 Attention: Mr. Carl G. Rinkevich Re: Estate of Irene Bonin Wenrich, deceased Date of Birth: 03/05/1917 Date of Death: 12/29/2007 SSN: 187-18-2555 Dear Mr. Rinkevich: FAX (610) 868-6657 Thank you for your letter of June 3, 2009. I am pleased to report that the executor has completed his administration of this estate. In that regard, enclosed for your review please find a copy of the executor's First and Final Account. Copies of the First and Final Account have been distributed to all of the decedent's named beneficiaries, along with an explanation that the estate is insolvent, having reported assets totaling $7,789.66 and claims by the Commonwealth of Pennsylvania for services provided under the medical assistance program totaling $75,236.08. The result, of course, is that after payment of the costs of administration the remaining balance of the estate is due the Commonwealth of Pennsylvania, Department of Welfare, leaving nothing for the named beneficiaries under the decedent's Iast Will. Given the limited nature of the estate, and in view of the fact that the decedent's last Will was necessarily probated in Cumberland County while the executor and I reside in Northampton County, it makes little sense to proceed further with a formal court accounting and incur the additional costs and time that would require. Therefore, I have recommended that the executor to make a risk distribution of the remaining balance of the estate directly to the Department of Public Welfare, subject to the approval of that approach by the Department. Accordingly, I hereby request that the Department acknowledge its approval or disapproval of the aforesaid proposal to close out this estate administration. If approved, I will see to the immediate release of the remaining balance of the estate to the Commonwealth as the Department may direct. In the event the Mr. Carl G. Rinkevich Department of Public Welfaze Division of Third Party Liability Estate Recovery Program July 22, 2009 Page 2 Department requires a formal court audit of the executor's account, I will proceed to prepare the appropriate petition and notices. If you have any questions regazding the First and Final Account or the proposed method of closing out the estate, please do not hesitate to contact me. Very truly yours, l VvY- ~.,/.-wL James C. Omdahl JCO:ps Enclosure cc: Mr. Robert F. Choma