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HomeMy WebLinkAbout03-09-10 (2)J REV-1500 1505607120 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 RESIDENT DECEDENT 21 0 9 010 8 4 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Date of Birth Social Security Number Date of Death 186284820 11082009 02061935 Decedent's Last Name Suffix Decedent's First Name MI FEISTER DALE R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix FEISTER Spouse's First Name MI PATRICIA J 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 Retum ^ 4. Limited Estate ® g Decedent Died Testate (Attach Copy of Will) ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 3, Remainder Retum (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ^ 9. Liti ation Proceeds Received 1 p, Spousal Poverty Credit (date of death ^ 11, Election to tax under Sec. 9113(A) 9 ^ between 12-31-91 and 1-1-95) (Attach SCh. O) ,CrORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: rename Daytime Telephone Number ROBERT P. KLINE 7177702540 Firm Name (If Applicable) KLINE LAW OFFICE First line of address 714 BRIDGE STREET Second line of address P.O. BOX 461 City or Post Office NEW CUMBERLAND State ZIP Code PA 17070 0 REGISTE ~F~IILLS U~DNLY ::, ; I r~ i J `/ ~..7 C-+ ~~ ~ -- ~ . J ~ ,, TE FILED p ::.~ -, w Correspondent's a-mail address: Under penalties of perjury, I deGare that I have examined this return, inGuding atx:ompanying 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 preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~~ ..~-,~ ~ ~,~ ~ ~ ~,,,;~r~ Patricia J. Feister Ir~o.~.,=-~ ''f , ~n ~ ~ cklin Street, Mechanicsburg, PA 17055 SIGNATURE PRE E THE HAN REPRESENTATIVE DATE ~ ~©- Robert P. Kline ~. VIa tb.L~l~-! 7_c'~ ~ ~ 714 Bridge Street, New Cumberland, PA 17070 Side 1 L 1505607120 1505607120 J 1505607220 REV-1500 EX Decedent's name: F E I S T E R, DALE R Decedent's Social Security Number 186284820 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. 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. 8. Total Gross Assets (total Lines 1-7) ..................................................................... 132,944.61 80,110.80 110,954.05 324,009.46 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ......................................................................11. 12. Net Value of Estate (Line 8 minus Line 11) .............................................................12. 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 314 2 3 9 . 5 0 15. , (a)(1.2) X .00 16. Amount of Line 14 taxable 16. at lineal rate X .045 17. Amount of Line 14 taxable 17 at sibling rate X .12 18. Amount of Line 14 taxable 18 at collateral rate X .15 19. 19. Tax Due ..................................................................................................................... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 7,256.80 2,513.16 9,769.96 314,239.50 314,239.50 0.00 0.00 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: Feister, Dale R 1131 Cocklin Street Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable p, Interest E. Penalty File Number 21 - 09 - 01084 TE Total Credits (A + B + C) 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 Line 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. g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. PA Make Check Payable to: REGISTER OF WILLS, AGENT 17055 (1) 0.00 (2> 0.00 (3) 0.00 (4) (5) 0, 0 0 (5A) (56) ~ , 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 :.................................................................................0 0 b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or ..............................................................................................................~ ^x 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? .....................................................................................................................^ 0 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? ................. .......................................................................................~ ~I .......... . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE 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, 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)]. 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 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Feister, Dale R FILE NUMBER 21 -09-01084 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 NUMBER 1 PNC Bank #5070072168 2 ~ PNC Bank #5000959687 3 ~ TransAmerica Annuity #02CBT143996 DESCRIPTION 4 ~ 2007 Saturn Ion VIN#1 G8AJ55F07Z145390 TOTAL (Also enter on Line 5, Recapitulation) ~., DEATH 21,255.82 74,963.96 26,144.83 10,580.00 132,944.61 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Feister, Dale R SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 -09-01084 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. -- 1131 Cocklin Street Mechanicsburg, PA 17055 Wife ADDRESS RELATIONSHIP TO DECEDENT SURVIVING JOINT TENANT(S) NAME Patricia J. Feister A JUIN I LY uvvrvty P ROPER ~ ~ . DATE ~- C~Ff.SCRIPTJO~I ~F PRO~ERTY lal Ins Itu Ion an bank account number - DATE OF DEATH % OF DECD'S DATE OF DEATH VALUE OF ITEM NUMBER LETTER FOR JOINT I MADE ~o nclude name o Inanc r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET I NTERES DECEDENT'S INTEREST 1 TENANT JOINT je 05/07/1984 state 1131 Cocklin Street, Mechanicsburg, 160,221.60 50% 80,110.80 Cumberland Co. Parcel #17-24-0791 -051; ,I ~ Assmt $127160.00 I I ~ II ~ ~I~ I i ^----:...~,..:, - ...- _ _ stn ~~n stn TOTAL (AISO enter vn une o, RCGA~JRU~nuvu~ I ...., • •..•~... SCHEDULE G COM NHE,/R~ITANCETAXRETURNANIA INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Feister, Dale R FILE NUMBER 21 -09-01084 -~ __L~J..1~ ~c.L Le ..,,..,.,lo*o~ any f~iPd if the answer to anv of questions 1 through 4 on page 2 is yes. 111, SGIIGUUI~i n~u.~. vv ....... r.. _._ ---- __-- - ITEM ~- DESCRIPTION OF PROPERTY i Include the name of the transferee, their relationshi to decedent NUMBER I P and the date of transfer. Attach a copy of the deed for real estate. _ DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST O EXCLUSION F APPLICABLE) _.. TAXABLE VALUE Genworth Financial Annuity #0100340521 51,748.18 51,748.18 2 ~ Western National Annuity #BX202727 ~ ~~ ~ I~ I I I ~I I I I II ~, III 59,205.87 I ~ 59,205.87 TOTAL (Also enter on line 7, Recapitulation) 110,954.05 SCI~DULE H FUNQ2AL Dff~E]VSES & COMMONWEALTH OF PENNSYLVANIA ~~ INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Feister, Dale R FILE NUMBER 21 -09-01084 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER ~ ri ~uGwei FxPFNSES~ i -- A. 1 Malpezzi Funeral Home B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address i City State Zip Year(s) Commission paid 2. Attorney's Fees Kline Law Office 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 a. ~ Probate Fees Register of Wills 5. ~ Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 X/S Waste Transport 4,480.00 2,000.00 360.00 416.80 'TOTAL (Also enter on line 9, Recapitulation) 7,256.80 ~ SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Feister, Dale R FILE NUMBER 21 -09-01084 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Pinnacle Health 608.28 2 West Shore EMS 1,670.66 3 Moffitt Heart & Vascular 10.51 4 Riverside Anesthesia 43.44 5 Quantum Imaging & Therapeutic Associates 20.62 6 Pulmonary & Critical Care Associates 159.65 TOTAL (Also enter on Line 10, Recapitulation) I 2,513.1.6 REV-1513 EX+ (9-00) ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT -- __.--_ ESTATE OF FILE NUMBER Feister, Dale R 21 - 09 - 01084 _ __-r- - "- RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER ~ NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS[include outright spousal • ~ distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Patricia J. Feister Wife ALL 1131 Cocklin Street ~ ~ Mechanicsburg, PA 17055 I Enter dollar amounts for distributions shown above on lines 15 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 j III B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHED 0.00 LAST WILL AMID TESTAMENT OF T14T F R. FEISTER I , ]~T F R. FEISTER, of the Borough of l~.echaru:csburg , County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, clo make, publish and declare this my Last Will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I. give, devise and bequeath. all the. rest, .residue and remainder of my estate, real, personal and. mixed, whatsoever and wheresoever the same may be situate, to my wife, PATRICIA J. FEISTER, absolutely and uncondi- tionally. 3. In the event that my wife., PATRICIA J. FEISTER, should prede- cease. me, or should she die. at about the. same dine as I clo, such.. as in an accident corom~on to both of us, then in such. event I give, devise and be- queatli my entire estate, real, personal and mixed, whatsoever and whereso- ever the same may be situated, to my three (3) children, to wit, na?~ R. FEISTER, JR,, OONNIE LYNDT CRI A IBAR and KAREN L. HOLt~REN, share and share alike., .per stixpes. -1- LASTLY', I rx~cnna.te, cons;ti:tute and appoint Tny wife., PATRICIA J. FEISTER, Executrix of this., my Last i~Ti:.ll and .Testament, and in the. event that my said wife should predecease.~e, or should she be unable to serve in such capacity for any reason, then I nominate, constitute and appoint my-son, DALE R. FEISTER, JR., Executor of this, my Last Will and Testament, in.her place and stead. IN WITNESS W~lEREO~, I have hereunto set my hand and seal this ;~~~ day of August, A. D. 1987. ~ / ~ :~-~-~-+~--~-~-~~ (SEAL) e .. ester Signed, sealed, published and declared by the: above-named DATE. R. FEISTER, as, and for hiss. Last Will and Testament, in the presence of us., who, at his .request and in his.. presence, and in the presence of each. other, have heretmto subscribed our names. as witnesses. -~- ~~ of ~s~tvANZA) )ss: 00UI~TI'Y OF Ct]NlBERLAI~ID ) I, DALE R. FEISTER the testator ,whose r~~e is signed to the attached or foregoing instrument, havinD been duly qualified according to law, do hereby acknowledge that T signed and executed the instn~ent as my Last Will and Test~naZt; that I signed it wr..].lingly; and that I signed it as my free and voltmtary act and deed for the ptsposes therein e~ressed, Sworn and affirmed to and acknowledged before me, the 14th day of August A. ~. , 19 87 ss CCt~2~'DNWEALTH OF PE~tsYLVANTA) )SS: OOt]I~?I'Y OF Ct]MBERLAND ) ~~.> Nfy Ca~miss%on Expires: September 21, 1987 We, the tmdersigned, J. R~13ER'L,4TAtTF~'ER and MARTT.YN KAY EAKIN the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the tes tat or ~4T F R. FEISTER , sign and execute the instr~ent as his/ Last Will and Testament; that the said testator HATE R. FEISTER ,, signed the same willingly and that the said DALE R. FEISTER ,executed it as his/ free and wlrntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testator signed the Will as witnesses; .and that to the best of our lmowledge the testator ,was, at the time, 18 or more years of age; of sound mind; and under no constraint, dares; Sworn and subscribed to befare ___ _ _ 14th day of August 1987 . Nfy Caamission E~-pires: September 21, 1987 =at-CT W~rraMy Dyad-•ShoR Form-Act 1909--Double SheN Henry Hall, Inc., India Pa. t ". ._. p r ~ F4 L. d+.n .-- ~ , ... 'E4 i~RY ~ ~ G3f1 i a i o ~~hi~ , ~ ~_ . .* ~__ n- v :~...._......_ i~Y~~t ~1 i. : ~t~L ~' lA);h,JFEk I,r;„'14'84 \'~~~rf~ ~ EP . ,,. ~,' 4~ ~~ 7~ MADE THE day of in the year of our Lord one thousand Trine hundred eighty-four (1984) . BETWEEN DOUGLAS B. DANKO and JOAN M. DANKO, his wife, Grantors , and DALE F. FEISTER and PATRICIA R. FEISTER, his wife, parties of the second part, hereinafter Grnntee s WITNESSETH, that in oonaider¢tion of Sixty Nine Thousand Five Hundred and no/100 ----------------------------- ($69,500.00) Dollars, in hand paid, the receipt whereof tie hereby acknowledged, the said grantors do hereby gramt and convey to the said grantees , ALL THAT CERTAIN lot or tract of land situate in the Borough of Mechanicsburg, Cumberland County, Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point at the intersection of the Northern line of Cocklin Street and the line of adjoiner between Lots Nos. 70 and 71 on the hereinafter mentioned Plan of Lots; thence North 21 degrees 13 minutes West, by said line of adjoiner 140 feet to a point; thence North 66 degrees 43 minutes East by Section 102, Orchard Crest, Inc., 75 feet to a point; thence South 21 degrees 13 minutes East by the Western line of Lot No. 72, 140 feet to the Northern line of Cocklin Street; thence South 66 degrees 43 minutes West, by the Northern line of Cocklin Street 75 feet to the point and place of BEGINNING. BEING Lot No. 71, Section 104 Orchard Crest, Inc., as recorded in the Cumberland County Recorder's Office in Plan Book 18, Page 24. HAVING THEREON ERECTED a brick and aluminum dwelling known as 1131 Cocklin Street. UNDER AND SUBJECT, NEVERTHELESS, to restrictions, reservations, easements and rights of way of record. BEING THE SAME PREMISES WHICH G. Thomas Eigenbrode and Judy Elaine Eigenbrode, his wife by their Deed dated September 15, 1976 and recorded in the Cumberland County Recorder's Office in Deed Book U, Volume 26, Page 420, granted and conveyed unto Douglas B, Danko and Joan M. Danko, his wife, the Grantors herein. -.SC11:•0'. l:';i C•u; i3 ~.:7.. r'3. Y9s-'rM ~ ~" ~ .~-~j'o Ri:a+ rsYd.e f~ra;~s3rr TeX ~~T~ Date.~__'~"Y~ I~~ITit_.-_-~.~ LMeS - ~.~-r ~ Amt, `. •••- ~(~.LLRib. Go. Li5Z :.~~i. r-~, ;~ .1r~1':'at rJ. r..t5i. vt71. ~/1Z.. And the said grantors hereby covenamt and agree that they will warrant - generally the property hereby conveyed. IN WITNESS WHEREOF, said grantors have hereunto set their hands and seal s the day and year first above 'tten. /~~ ., 4..`. :; ~~ . ~ _.i_ ' I _ ~igntD, ~cateD anD ~dibcrea C - DOUGLAS B. ANKO in the ~regence of ~" ______, s z - ------------ --------------- --------------~----------. 8~~ State of PENNSYLVAiTiA ss. County of C.u~n~'L'~""~- , On this, the 7 day of May , 1984 ,before me, a Notary Public the undersigned o,~icer, personally appeared DOUGLAS B. DANKO and JOAN M. DANKO, his wife known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acklwwledged that they executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and off~ew.l seal. . -S$ ir~7a My Commission Expires: _Pnh]-it-_ `''~..~~.~~'=~~1'~'`r1°4~ ---No-tar3cHER~RY L.BRUBAI~Rtle O~"i~,~ez -- ~~'V _ NOTARY PIIHLIC ~ ,~,, ` _ ~ , ~ - State of 11 LEBANON COUNTY PA ,, '. }3S. MY COMMISSION EXPIRES AUG.3,87 ;>; ~': i;~~.~~isn~' Count this, the day of , 19 beforb` yne, the undersigned officer, personally appeared known to me (or Satisfactorily proven) to be the person whose name subscribed to the within instrument, and acknowledged that executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and o~cutl seal. Title of O,~cer. do hereby certify that the precise residence and complete post office address o f the within named grantee is 1 ~'~ 1 C o c1~ ~ t ti `.~'~X , ~x c.~ar.~ c-5 bc.~ . ~ Pr I ~ U SS 5 Icy 19 ~y - ~~ _-0.d_'-~.--il~-------------------------------------- Attorney for' --~~~----------------------------------- BCGi; ~ ~~ ASE ~~~~ ~- A z a COMMONWEALTH OF PENNSYLVANIA 3 } ss. County of ~_ /LciX.l~ k~ ~ .._ ) 1~ RECORDED on this _.._____._~ ~~ ~~ day of .___~~Ja __~__..___.~____. A. D. 19 ~ , in the Recorder's o ice of the said County, in Deed Book j~ Vol. ____ 3v __v, Pape _~r~_ 73~_. Given under my hand a .seal. of the $gid oj~c~the date above written. ~__.__.~_, __..\.,____-`~•\]_-__, Recorder.