HomeMy WebLinkAbout01-06-10 (2)REV-'~ rJ~~ 1505607120
EX (06-05) OFFICUIL USE ONLY
PA Department of Revenue coia,ty coos veer Foe Numbx
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOx.z8o6o1 21 0 9 0.0•#1 O ~
Harrisburg, PA 17128.0601 RESIDENT DECEDENT ~'~
ENTER DECEDENT INFORAAATION BELOW
Socal Security Number Date of Death Date of Birth
Decedent's Last Name Suffix Decedent's First Name MI
PETERS REBA g
(H 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 INAPPROPRIATE OVALS BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death
prior la 12-13.82)
^ 4. Limited Estate ^ qa. Future Interest Compromlae
(date of tl6eN after 12-72-92) ^ 5. Federal Estate Tax Return Required
® g, Daoetlerd pled Tsetare
(Atlech Copy of Wrq ^ 7. Decedent Melydelned a LlvinO Trust
(Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
^ 9. Litlgation Proceeds Received ^ t0~ SpepOtweeni2al-ei r' aftf~'-e5~ de~h ^ 11. Electlon to tax under Sea 9113(A)
(Attach Sch. 0)
_C,OItRESPONDENT -THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX INFORMATION SHOULD BE DIRECTED TO:
rename
Daytime Telephone Number
DEBRA R. WALLET 7177371300
Firm Name (If Applicable)
LAW OFFICES OF DEBRA R. WALLET
First Ilns of address
24 NORTH 32ND STREET
Second line of addroas
City or Post Office
CAMP HILL
State 21P Code
PA 17011
REGISTERILLS USE,9NLYr
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CorresponderlYse-malladdreas: walletdeb~aol.com
Under penalties of perjury, I dedare that I have examined this return, induding acx;ompanying schedules and affitemenffi, and to the best of my knowledge and belief,
d u true, correct and complete. Detlaratlon of preparer other than the personal representative Ia based on all Information of which preperer has any knowledge.
SI TURE OF PERSON RESPONSIe FI NG RETURN DATE
~~r _~.__5. ~~~~ Benjamin 3 Peters, Jr. i ~ / z o ~iq
3814 Lamp Post Lane, Camp Hill, PA 17011
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
K . t+rlA/{,R^ Debra K. Wallet (~,~~ ~
ADDRESS
24 North 32nd Street, Camp Hill, PA 17011
Side 1
1505607120 1505607120 J
V- v
J
1505607220
REV-1500 EX
Decedents Social Security Number
oaaasnraNSme: PETERS, REBA B
RECAPITULATION
1. Real Eatate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
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. 12 5 , 6 8 2.61
6. Jointly Owned Properly (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vrvos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7. 10 , 9 5 7 . 6 4
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 3 6, 6 4 0. 2 5
9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 8, 1 6 2. 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 3 , 3 0 7 . 9 2
11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 11 , 4 6 9 . 9 2
12. Net Value of Estate (Line S minus Line 11) ............................................................. 12. 12 5 , 1 7 0 . 3 3
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................. 13.
14. Net Value Subjeet to Tax (Line 12 minus Line 13) ................................................. 14. 12 5 , 1 7 0 . 3 3
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(i.z> x .o0 10 , 9 5 7. 6 4 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate x .oa5 114 , 212.6 9 is. 5 , 13 9 . 5 7
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. Tax Due ..................................................................................................................... 19. 5 , 13 9 . 5 7
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
L Side 2
1505607220 1505607220 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 09 - 00441
Peters, Reba B
STREET ADDRESS
3814 Lamp Post Lane
cITY
Camp Hill STATE ZIP
PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments (1) 5,139.57
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interost/Penafty H applicable Total Credits (A + B + C) (2) 0.00
D. Interest
E. Penalty
Total InteresUPenaKy (D + E) (3) 0.0 0
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT
.
Check box on Page 2 Lina 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE
. (5) 5,139.57
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A, ThIs is the BALANCE DUE (~)
. (5B) $ ,13 9.5 7
Make Check Payable to: REGISTER OF W/LLS, 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 :..................................................................................
b. retain the right to designate who shall use the ro x
p party transferred or its income :.................................... x
c. retain a reversionary interest; or ............................... .
.................................................................................. x
d. receive the promise for fife of either payments, benefits or care? .............
2. If death occurred after December 12, 1982, did decedent transfer ro ~~~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~ x
receiving adequate consideration? ................ P Party within one year of death without
...........................................
3. Did decedent own an 'intrust 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 beneficary 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.
For dates of death on or attar 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 tha use of the surviving spouse is zero
(0) percent p2 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 filing a tax return are still applicable even if the surviving spouse is the ony 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 es 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 p2 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.
MIHERRANCETAX RETURN
°°"'"'°"'"~"`TM°~~''1N8'""""" PERSONAL PROPERTY
RESDENT DECEDENT
ESTATE OF Peters, Reba B FILE NUMBER
21 - 09 - 00441
Include the proceeds of litigation and the date the proceeds were received b
survivorship must Ise disclosed on schedule F. y the estate. All property Jointly-owned with the right of
ITEM
NUMBER
DESCRIPTION VALUE AT DATE OF
DEATH
1 PSECU Savings Acct. - 01
13,559.25
2 PSECU Checking Acct. - 04
1,062.29
3 PSECU 60 month CD - 51
49,414.90
4 PSECU 36 month CD - 52
15,397.70
5 PSECU 60 month CD - 53
32,739.01
6 PSECU 60 month CD - 54
13,509.46
TOTAL (Also enter on Line 5, Recapitulation) 125,682.61
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
ESTATE OF Peters, Reba B
FILE NUMBER
21 - 09 - 00441
...s ascneau~e must oe completed and filed tf the answer to any of questions 1 through 4 on page 2 fs yes.
ITEM DESCRIPTION OF PROPERTY
NUMBER 1ndide °1e "~A° °~ ~B ~^*~~. dxir relaumatup ro daeedern DATE OF DEATH DECO s EXCwsION TAXABLE VALUE
and tlta tlate dhana(ar. gtlxn ° mpy °(Irya d°°d ~ ~ B8~a18 VALUE OF ASSET INTEREST pF APPLICABLE)
1 Ameriprise Financial Services RVS Balanced Fund CL 10,957.64 100%
A Acct #0020702605948002 (IRA payable to surviving 10,957.64
spouse -see attached)
TOTAL (Also enter on line 7, Recapitulation) I 10,957.64
SCFEDL~E H
001.MAONWEILTH of RQNanvwu ~~
NMERfMNOE TAX RETURN /~~y`~TD w~
REMDEM DECEDENT /9~IfA1~7 ~ 1W
ESTATE OF Peters, Reba B
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION
A. 1 Myers-Hamer Funeral Home (cremation)
1903 Market St., Camp Hill, PA 17011
2 Rolling Green Cemetery -1/2 cost of joint marker (1/2 of $2,662)
3 I Rolling Green Cemetery (interment)
B. I ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
FILE NUMBER
21 - 09 - 00441
AMOUNT
3,560.00
1,331.00
895.00
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
C~' State Zip
Year(s) Commission paid
2. Attorney's Fees Debra K. Wallet, Esq. 2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Cdy State Zip
Relationship of Claimant to Decedent
4. Probate Fees 346.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Photocopies, postage, etc. 30.00
TOTAL (Also enter on line 9, Recapitulation) 8,162.00
SCIiEDULE I
DEBTS OF DECEDENT, MORTGAGE
a~HeRrtu~ r~tc RETURN
~"'"°~`°1NNeYLVA"'" LIABILITIES, & LIENS
RE'EIDENTOE~
ESTATE OF peters, Reba B
Include unrelmbursed medical expenses.
ITEM
NUMBER
1 PSECU Visa loan - 09
DESCRIPTION
FILE NUMBER
21 - 09 - 00441
AMOUNT
3,307.92
TOTAL (Also enter on Ltne 10, Recapitulation)
3,307.92
REV-167J EXs (&00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE)
BENEFICIARIES
ESTATE OF
Peters, Reba B
NUMBER NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY
I~ TAXABLE DISTRIBUTIONS[nclude outright spousal
distributions and transfers
under Sec. $116 (a) (1.2)]
FILE NUMBER
~ 21 - 09 - 00441
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
DECEDENT (Words) (ggg)
Do Not lbt TruNesls)
Benjamin S. Peters, Jr. I Husband I none
3814 Lamp.. Post Lane
Camp Hill, PA 17011
2 Jennifer B. (Bordner) Goodyear I Daughter 11/3 of residuary
930 Denis Circle Estate
Harrisburg, PA 17111
3 Georgianne M. Bordner I Daughter 11/3 of residuary
254 Coventry Close #102 Estate
Chesapeake, VA
dollar amounts for distributions shown above on lines 1 b through 18, as appropriate, on IRev 1500 cover sheet
III NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
REV.161~ EXr (9-0O) ~ ~ ~
SCHEDULE)
_
COM NHER AN EOTAXRETURNANw BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF peters, Reba B I FILE NUMBER
21 - 09 - 00441
NUMBER
NAME AND ADDRESS OF PERSON(S)
REC RELATIONSHIP TO
DECEDENT SHARE OF ESTATE
(words) AMOUNT OF ESTATE
(~)
EIVING PROPERTY Do Not List Trustss(s)
I~ TAXABLE DISTRIBUTIONS [nGude outright spousal
distributions and transfers
under Sec. X116 (a) (1.2)]
4 Steven E. Bordner Son 1/3 of residuary
251 Spangler's Mill Road Estate
New Cumberland, PA 17070
Page 2 of Schedule J
-• a
Y M ~ 4
LAST WILL
AND TESTAMENT C~ • Y
REBA B . PETERS ' ~~i''- n ~ '~'~` '-
I, REBA B. PETERS of Hampden
Township, _ ti
Cumberland ~~~~` ~' ~,,•"
ty, ~enn~yl_=
vania, declare this to be my Last Will and Testament, hereby revoking;
any will previously made by me.
I - I direct the payment of all my just debts and funeral
expenses out of my estate as soon as may be practical after my death.
II - I_devise and bequeath in equal shares to my children,
Georgianne M.• Bordner, Steven E. Bordner and Jennifer R. Brodner, those
items of my tangible personal .property which constitute family heirlooms
or are of significant sentimental or historical value, and the selection
of those items for distribution shall be determined by my Executors,
Benjamin S. Peters, Jr, and Jennifer R. Bordner.
III - In the event my said husband, Benjamin S. Peters, Jr.,
shall survive me, I devise and bequeath my residence at 3814 Lamp Post
Lane, Hampden Township, Camp Hill, Pennsylvania, together with all the
remaining household goods and furnishings (after the fulfillment of my
bequest in Paragraph II above) and all policies of. insurance on said
real and personal property to my husband, for his life, so long as he
desires to use the subject premises as a home and pays all the costs
of maintenance thereof, including taxes, assessments, insurance and
(-' ~~ ~
~
~
~ ~
Page 1
ordinary repairs, said property to be insured in a reasonable amount
insuring the interest of the remaindermen as well as himself. Further,
during the continuation of the said life estate, my husband shall have
the option to purchase the said real estate at a price to be unanimously
agreed upon by my said husband and those of my children who are living
at the-time the option is exercised. Should the parties involved fail
to unanimously agree on such price, then my Executors shall establish
such price based upon the fair market value of the property and may
acquire the services of one or more competent real estate appraisers
for those purposes. At settlement, each party shall bear the expenses
of settlement then customary in the locale. Should my husband no
longer desire to use the subject premises as a home and should he elect
not to purchase the real estate, then my Executors shall sell. or rent
the home. If rented, the net rentals shall be distributed in the
following proportions: 40~ to my husband and 60~ to the bust herein-
after created for my children. Should the house be sold, the net
proceeds from the sale shall be distributed in the same proportionate
manner.
IV - 2 devise and bequeath all the rest, residue and. remainder
of my estate of whatever nature and wheresoever situate unto my trustees
hereinafter named for the following uses and purposes and under the
following terms and conditions. The trust shall be held for the benefit
of my children, Georgianne PR. Bordner, Steven E. Bordner and Jennifer
Page 2
R. Bordner, share and share alike.
The trustees shall distribute the
income of the trust, after payment of expenses, to the children and the
trustees, at their sole and absolute discretion, shall have the tight
to distribute principal from time to time and, in fact, to terminate
the trust for any child, except that such termination or principal
distribution rights or powers shall not be exercisable by my daughter,
the Co-trustee, alone. Should any child die before the principal has
been distributed to him or her, it shall be distributed to his or her
then living issue, and if there are none, continue to be held for the
other children according to the terms of this trust.
V - No interest in income or principal shall be assignable
by, or available to anyone having a claim against, a beneficiary before
actual payment to the beneficiary.
VI - In addition to those powers and duties vested in them
by law and other portions of this will, my trustees shall have the
following powers:
A. To retain any or all. of the assets of this trust,
real or personal, including its own stock, without regard to any prin-
ciple of diversification or risk. -
B. To invest in all forms of property, including stock,
common trust funds and mortgage investment funds whether operated by it
or others, without restriction to investments authorized for Pennsyl-
vania fiduciaries, as it deems proper, without regard to any principle
of diversification or risk.
Page 3
> {,
C. To sell at public or private sale, to exchange, or
to lease for any period of time, any real or personal property and to
give options .f or sales, exchanges or leases, for such prices and upon
such terms or conditions as it deems proper.
D. To allocate receipts and expenses to principal or
income or partly to each as it from time to time thinks proper in its
sole discretion.
E. To lend to, or purchase from, my executor even
though trustee may also be such executor.'
F. To hold property in my name or in its name, or in
the name of a nominee or unregistered. .
VII - I appoint. my husband, Benjamin S. Peters, Jr., and my
daughter, Jennifer R. Bordner, Coexecutors of this, my Last Will and
Testament, to serve as such without the necessity of posting bond in
this or any jurisdiction. Should either fail to qualify or cease to
act, the survivor shall serve alone. I also appoint my said husband
and daughter Co-Trustees of the trusts hereinabove created. Should my
said husband fail to qualify or cease to act as trustee, I appoint my
attorney, James K. Arnold, successor trustee. Should my said daughter
fail to qualify or cease to act as trustee, I direct that the remaining
trustee, to wit: either my husband or my attorney, serve as trustee
alone.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this,
'~
thed= day of 1984.
~~ ~ ~
~" ~ ~ ~ ~ (SEAL)
` Reba B. Peters
Page 4
'i f
Signed, sealed, published and declared by P.EBA B. PETERS, Testatrix
therein named, on this and four (4) other sheets of paper as and for
her Last Will and Testament .in our presence, who, in her presence, at
her request and in the presence of each other, have hereunto subscribed
our ames as/~~)at[t/e~~s~ting witnesses.
-- ""~ ~ C'ainp Hill,' Pa.
Name Address
r^-
Name
Camp Hil'1~, Pa
Address
Page 5
COP~Il~IONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
WE, the undersigned, the testatrix and the witnesses, respectively,
whose names are signed to the foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the testatrix
signed and executed the instrument as her Last Will and Testament and
that she signed willingly (or willingly directed another to sign for
her), and that she executed it as her free will and voluntary act for
the purposes therein expressed,' and that each of .the witnesses, in the
presence and hearing of the testatrix signed the will as witnesses and
that to the best of their knowledge the testatrix was at that time
eighteen years of age or older, of sound mind, and under no constraint
or undue influence.
l
Testatrix
Cjwrd /L~ ~-~/,+~s/~~
Witness
~ Witness
Subscribed, sworn to and acknowledged before me by the testatr~r~,x,
and subscri ed and sworn to be ore me by both witnesses, this oz,~
day of ~ lgg~
~~ ' . ~ ~~
~r7otary Public
Thelma S. McCausGn, Notary Pu6fic
My Commission Expires July 1, 1986
Camp Hill, PA Cum6er(snd County
Ameri rise
p
Financial
Beneficiary Information
We have the following beneficiaries on record for the deceased's accounts.
Account Number: 02070260594 8 002
Designation:
PRIMARY BENEFICIARY
BENJAMIN S PETERS SPOUSE 100.00%
SECONDARY BENEFICIARY
LIVING, LAWFUL CHILDREN IN EQUAL SHARES 100.00%
IF A CHILD IS DECEASED, HIS OR HER SHARE TO BE PAID TO HIS OR HER
LIVING, LAWFUL CHILDREN IN EQUAL SHARES
Insurance and annuities
are Issued by RiverSource
Life Insurance Company,
an Ameriprise Rnancial
company. Ameriprise
Brokerage is provided
by Ameriprise Rnancial
Services, Inc. Ameriprise
Fnancial Services, Inc.
Member FlNRA and SIPC.
PHONE: (717) 737-1300
law c0~f;~E~ of
DEBRA K. WALLET
24 N. 32nd STREET
CAMP HILL„ PA 17011-2917
E mail: Walletdeb~aol.com
January 5,2010
Glenda F. Strasbaugh, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
Re:
Deaz Ms. Strasbaugh:
Estate of Reba B. Peters
Will No. 2009-00411
FAX: (717)761-5319
Enclosed aze an original and one copy of the Pennsylvania Inheritance Tax Return, a
check in the amount of $5,139.57 representing the inheritance tax due, one copy of an
Inventory of the Estate, and one copy of a Status Report Under Rule 6.12 for filing in the
above-captioned estate. I have also enclosed a check in the amount of $30.00 representing the
filing fees for the tax return and the inventory.
I have enclosed a copy of the first page of each to be stamped in and returned to me in
the pre-addressed envelope provided. Thank you.
Sincerely yours,
DKW/mml
Enc.
~ths, IC• I~R,t,~,r
Debra K. Wallet
cc: Benjamin S. Peters, Co-Executor
Jennifer B. Goodyear, Co-Executrix
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