HomeMy WebLinkAbout03-01-10J 1505607121
REV-1500 EX
06
(
-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX 280601 County Code Year File Number
INHERITANCE TAX RETURN
Harrisbur , PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 6 7 3
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 9 5 1 6 0 6 7 3 0 6 0 2 2 0 0 9 1 1 1 6 1 9 2 4
Decedent's Last Name Suffix Decedent's First Name
E C K E R T MI
V E R A ~
(If 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 IN APPROPRIATE OVALS BELOW
0 1. Original Return ~ 2. Supplemental Return
3. Remainder Return (date of death
4. Limited Estate prior to 12-13-82)
4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
OX 6. Decedent Died Testate ~ death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Will) _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec
9113(A)
b
.
etween 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD
N
ame BE DIRECTED TO:
Daytime Telephone Number
M U R R E L R W A L T E R S I I I 7 1 7 6 9 7 4
.~, 5 0
Firm Name (If Applicable) , ,
__, ~ . ~.
..~._ --,
REGISTER OFpUILLS US~NLY
`.P
J
First line of address ,
, _t_~
_. .-~ ._~
_ _ ,,
5 4 E A S T M A I N -; I
S T R E E T -
Second line of address
7
;-..~
y .. ~ ,
City or Post Office t ,3 ~ _,'
State ZIP Code DATE FILED "'
G7-~
M E C H A N I C S B U R G P A 1 7 0 5 5
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompan ing 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 repres to is based on all information of which preparer has any knowledge.
ATURE OF PERS N E O IBLE FOR FILING RETURN
_ t TE
ADDRESS ~ ' ~~• ,a ~~ ~V
43 SUNSET DRIVE, M HBG• PA 17D50 58 ORANGE CARLISLE P 17013
SIGNATURE OF R ARE O HER T N REPRESENTATIVE
D E
ADDRESS ,~ ~ ~ 5~ ~
MURREL R• AL E ESQ 54 E• MAIN ST MECHANICSBURG PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 1505607121
f ~,
~~
REV-1500 EX
1505607221
Decedent's Social Security Number
Decedent's Name: V E R A J• E C K E R T 1 9 5 1 6 0 6 7 3
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. Total Gross Assets (total Lines 1-7)
........................... 8.
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
(a)(1.2)X.0 _ 0 0 0 15
16. Amount of Line 14 taxable
at lineal rate X .4.5 3 0 9 6 0. 1 2 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17
18. Amount of Line 14 taxable
at collateral rate X .15 0 ~ 0 0 18
19. Tax Due ...............................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505607221
3 6. 9 0
5 7 0 5 4, 8 4
5 7 0 9 1. 7 4
3 9 8 8. 0 0
2 2 1 4 3. 6 2
2 6 1 3 1. 6 2
3 0 9 6 0, 1 2
3 0 9 6 0. 1 2
0. 0 0
1 3 9 3. 2 1
0. 0 0
o. 0 0
1 3 9 3. 2 1
1505607221 J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
VERA J. ECKERT
STREET ADDRESS
203 WEST MIDDLESEX DRIVE
CITY
CARLISLE
Tax Payments and Credits:
~ Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
File Number
21 09 0673
STATE
PA
ZIP
17013
(1) 1 393.21
Total Credits (A + g + C) (2)
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Total Interest/Penalty (D + E) (3) 0.00
Fill in oval on Page 2, Line 20 to request a refund. (4)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5) 1 393.21
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56)
1 393.21
Make Check Payable fo: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;
............................................................... Yes
...... ^ No
^
X
b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^
c. retain a reversionary interest; or .......................................................................................... ...... ^ 0
d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ Q
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? ... ....
^
.... 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ..
contains a beneficiary designation? ............................................................................................. ..... ^ 0
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 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)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
VERA J. ECKERT
Decedent's Name
Page 1
21 09 0673
File Number
Schedule H -Funeral Expenses & Administrative Costs - B1
ITEM
NUMBER DESCRIPTION
B• ADMINISTRATIVE COSTS: AMOUNT
Personal Representative's Commissions
Name of Personal Representative (s) DOROTHY A. WERTZ (renounced)
Street Address 58 N. ORANGE STREET
City CARLISLE State PA Zip 17013
Year(s) Commission Paid:
SUBTOTAL SCHEDULE H-61
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VERA J. ECKERT
ITEM
NUMBER
1.
2
Include the
All orooertv
of litigation and the date the proceeds were received by the estate.
ned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
REBPULIC SERVICES -REFUSE REMOVAL REFUND
MET LIFE
VALUE AT DATE
OF DEATH
16.92
19.98
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 09 0673
TOTAL (Also enter on line 5 Recapitulation) I $
(If more space is needed, insert additional sheets of the same size) 36 90
REV-1509 EX + (6-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
VERA J. ECKERT
21 09 0673
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
A. PAUL C. ECKERT
ADDRESS
43 SUNSET DRIVE
MECHANICSBURG, PA 17050
RELATIONSHIP TO DECEDENT
SON
B DOROTHY A. WERTZ
C
JOINTLY-OWNED PROPERTY:
58 N. ORANGE STREET
CARLISLE, PA 17013
DAUGHTER
LETTER DATE DESCRIPTION OF PRO
ITEM
NUMBER
FOR JOINT
TENANT
MADE
JOINT PERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
DEt°D'S
INTEREST
DAVAL~E OF TH
DECEDENT'
S INTEREST
1. A/B. 9122/94 REAL ESTATE SITUATE AT 203 W. MIDDLESEX DRIVE
MIDDLESEX TOWNSHIP, CUMBERLAND COUNTY 166,257.00 33.33 55,413.46
CARLISLE, PA 17013
COUNTY ASSESSED 131,950.00 TIMES
CLR 1.26 =166,257.00
2. B 3/26/74 CITIZENS BANK
2,801.10 50. 1,400.55
CHECKING
3. B 2/19/99 CITIZENS BANK 481.65 50. 240.83
SAVINGS
TOTAL (Also enter on line 6, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
VERA J. ECKERT 21 09 0673
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A• FUNERAL EXPENSES:
7 MYERS FUNERAL HOME, MECHANICSBURG -PREPAID
B• ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) PAUL C. ECKERT (renounced)
Street Address 43 SUNSET DRIVE
City MECHANICSBURG State PA Zip 17050
Year(s) Commission Paid:
2.
3.
City State Zip
Relationship of Claimant to Decedent
Attorney Fees MURREL R. WALTERS, III, ESQUIRE
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4• I Probate Fees REGISTER OF WILLS -CUMBERLAND COUNTY
5 ~ Accountant's Fees
6. ~ Tax Return Preparer's Fees
7• ~ REAL ESTATE APPRAISAL
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
3,500.00
188.00
300.00
3
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8r LIENS
ESTATE OF FILE NUMBER
VERA J. ECKERT 21 09 0673
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VAOF DEATHTE
1. DEPARTMENT OF PUBLIC WELFARE 14,649.93
MEDICAID REIMBU
RSEMENT
2. SARAH TODD HOME
RESIDENTIAL CARE 6,054.22
3. CARLISLE REGIONAL MEDICAL CENTER
MEDICAL 534.00
4. WEST SHORE EMT
MEDICAL 42.46
5. ALEXANDER SPASIC, MD
MEDICAL 50.66
6. ANDREWS & PATEL
MEDICAL 5.93
7. CARLISLE DIGESTIVE DISEASE
MEDICAL 30.91
8. SCHOOL REAL ESTATE TAX
PATTY DAVIS
416.91
9. NEPHROLOGY ASSOCIATES
MEDICAL 18.60
10. MILLENIUM PHARMACY
MEDICAL 340.00
TOTAL (Also enter on line 10, Recapitulation) I $
22 1
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (g-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
tJ I A l t ~r FILE NUMBER
VERA J. ECKERT
LI VA VV/J
RELATIONSHIP TO DECEDENT
AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. PAUL C. ECKERT Lineal 15,480.06
43 SUNSET DRIVE
MECHANICSBURG, PA 17050
2. DOROTHY A. WERTZ Lineal 15,480.06
58 N. ORANGE STREET
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
1 A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART [I -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
~1r more space Is neeaetl, Insert atltlltlonal sheets of the same size)
~~~
LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, VERA J. ECKERT, a resident of Cumberland County,
Pennsylvania, being of sound and. disposing mind, memory and
understanding, do make, publish and declare this to be my LAST WILL
and TESTAMENT, hereby revoking any and all Wills and Codicils
previously made by me.
I
I declare that I am not married, my beloved husband, PAUL R.
ECKERT, having predeceased me, and that I have two (2) children,
PAUL C. ECKERT and DOROTHY A. WERTZ.
II
I direct that all my just debts and funeral expenses shall be
paid from my residuary estate as soon as practicable after m~
decease.
III
I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of
the administration of my estate.
IV
I give, devise and bequeath all my property, whether real or
personal, wherever situate, including any property over which I may
have a power of appointment to my children, PAUL and DOROTHY, in
equal shares, per stirpes.
V
I nominate, constitute and appoint my son, PAUL, and my
daughter, DOROTHY, as Co-Executors of this LAST WILL, to serve
without bond. If either is unable or unwilling to act in that
capacity, then the other may act alone as Executor of this LAST
WILL, to serve without bond.
IN WITNESS WHEREOF, I, VERA J. ECKERT, have set my hand to
this LAST WILL this ~ ~ day of ~~_ ; 1994.
VERA J. ECKER
Signed, sealed, published and declared by the above-named VERA
J. ECKERT, as and for her Last Will and Testament, in the presence
of us, who, at her request and in her presence; and in the pre ~nce
of each other, have hereunto subscribe our names as w'~tnes s.
~~~ ~ . ,c~
z
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
I, VERA J. ECKERT, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my LAST WILL; that I signed it as my free and
voluntary act for the purposes therein expressed.
l/,~ ~
VERA J. ECK
Sworn or affirmed to and acknowledged befor me by VERA J. ECKERT,
Testatrix, this ~~in~ day of 1994.
~e'u-
Not -r-y ublic
Notarial Seal
Mary Lou Ruthkosky, Notary Public
Mechanicsburg Boro, Cumberland County
My Commission Expires June 9,1997
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
We, r~7L/~2,R.EL R• lJfJI.TE~'S; .~I and dlf1N~. /I1. Sp~iT}/ ~
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 Testatrix sign and execute the
instrument as her LAST WILL; that VERA J. ECKERT signed willingly
and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing ar~d
sight of the Testatrix signed the Will as witnesses; and that/to
the best of our knowledge, the Testatrix was at the time 18 bars
of age or more, of sound mind and un er no constraint or ndue
influence.
Sworn or affirmed to and acknowledged before me
this ~a ~,~Lday of 1994 .
Not y u lic
Notarial Seal
Mary Lou Ruthkosky, Notary Public
Mechanicsburg Boro, Cumberland County
My Commission Expires June 9,1997