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Home My WebLink About07-15-10 1505610140 REV-1500 EX (01-10) PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 2 1 1 0 0 0 5 0 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 7 1 6 5 8 6 3 1 2 2 6 2 0 0 9 0 9 1 1 1 9 2 1 Decedent's Last Name Suffix Decedent's First Name MI H E S S L A U R A B (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 a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to ta:K under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number T H O ~1 A S E M c D O W E L L 8 1 4 6 4I 3 3 5 5 5 I REGIST R OF WILLS U NLY ~ ~ , E _~a, `1-,f r'i First line of address ~' = `~ `•Y- r~- ~ B ~1 Z L A W 1= ~ , I ~"' - Second line of address .. " 1 1 B F O U R T H S ,, ., i ~ J ~~ '-t~ r-; T R E E T ~- ~"' ~ ~" `' - ; r~ ~ .,,,,,. - _.. .._ City or Post Office State ZIP Code __ _ _ _ Duf~T~?'~ILED •• ~.~ ~ -- C.J H U N T I N G D O N P A 1 6 6 5 2 1 4 1 7 '~~ Correspondent's a-mail address: tmcdowell~bmzlaw.com Under penalties of perjury, I declare that I have examined this return, including 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 preparer has any knowledge. NATURE OF P RSON RESPON BLE R FILING R TURN DATE ~ ~ ~ ~ "1~t~1~C~IC.- ADDRESS 91,9 MOUNT VERNON AVENUE _HUNTINGDON PA 16652 SIGNATURE O /~~~ N REPRESENTATIVE DATE .--,I 113 t ac31 ADDRESS 113 FOURTH STREET HUNTINGDON PLEASE USE ORIGINAL FORM ONLY Side 1 1,505610140 PA 16652 1505610140 J J REV-1500 EX 1505610240 Decedent's Name: LAURA B• H E S S Decedent's Social Security Number 1 8 7 1 6 5 8 6 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 and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 2 7 1 4 . 7 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. B 0 1 9 8 . 4 2 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 4 6 0 9 . 6 8 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 3 7 5 2 2 . 8 8 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .... 9. 1 3 4 7 5 . 4 c 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... .... 10. 1 5 0 0 0 11. Total Deductions (total Lines 9 and 10) ........................... .... 11. 1 3 6 2 5 . 4 2 12. Net Value of Estate (Line 8 minus Line 11) ........................ .... 12. 2 3 8 9 ~ . 4 6 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. 2 3 8 9 7 . 4 6 TAX CALCULATION -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 Q ~ ~ 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 3 8 9 7. 4 6 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g. 19. TAX DUE .................... ......................... .. ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 1 0 7 5. 3 9 0 . 0 f~ 0. 0 0 1 0 7 5. 3 9 0 Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 10 0050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2, CreditslPayments A. Prior Payments 1, 300.00 B. Discount 53.77 3. Interest 4. 1f Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIN in oval 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. Make check payable to: REGISTER OF WILLS, 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 property transferred or its income; ......................... ...... ^ c. retain a reversionary interest; or .......................................................................................... ...... ^ 0 d. receive the promise for {ife 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? ................................................................................. h? " " ...... ^ 0 ... orpayable-upon-death bank account or security at his or her deat in trust for 3, Did decedent own an ...... 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 F ILE IT ASS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 far 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 21 years of age or younger at death to or for the use of a natural par~,.~t, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(x)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(x)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(x)(1.3)]. Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. (1) 1,075.39 Total Credits (A + B) (2) 1, 353.77 (3) (4) 278.38 (5) 0.00 REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RE RN PERSONAL PROPERTY I D E S ENT DECEDENT ESTATE OF FILE NUMBER LAURA B. HESS 21 10 0050 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, 1998 Buick 2,200.00 gross sales proceeds 2. Community State Bank of Orbisonia 43.32 CD interest check account#1125888 3. Comcast Cable 14.50 account refund account #09546-39148103 4. Guarantee Trust Life Insurance Company 9.91 unearned premium refund 5. Shippen House Operating ~ 439.28 refund of unused rent 6. Nationwide Insurance 7 77 cancellation refund policy #5837A 872835 TOTAL (Also enter on line 5, Recapitulation) , $ 2, 714.78 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: LAURA B. HESS _ 21 10 0050 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Donald Mark Hess 919 Mount Vernon Avenue son Huntingdon, PA 16652 B. Linda M. Stolte 46 Jamestown Road daughter Shippensburg, PA 17257 c JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY 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 % OF CECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERESI 1. A. 6/19/08 Community State Bank of Orbisonia 30,011.18 16.667 5,001.96 certificate of deposit #1125888 2. B. 6/19/08 Community State Bank of Orbisonia 30,011.18 16.667 5,001.96 certificate of deposit #1125888 3. A. 1/16/08 F&M Trust 56,288.03 16.667 9,381.53 checking account #71-39624 4. B. 1/16/08 F&M Trust 56,288.03 16.667 9,381.53 checking account #71-39624 5. A. 9/2/88 F&M Trust 4,294.21 16.667 715.72 checking account #02-83696 6. B. 9/2/88 F&M Trust 4,294.21 16.667 715.72 checking account #02-83696 TOTAL (Also enter on Line 6, Recapitulation) I $ 30,198.42 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER I AI IRA R HESS 21 10 0050 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST 'EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. F&M Trust -IRA growth account 4,609.68 100.00 4,609.68 account #025-2985922; beneficiaries: Donald Mark Hess and Linda M. Stolte, children of decedent TOTAL (Also enter on Line 7, Recapitulation) ~ $ 4, 609.68 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER LAURA B. HESS 21 10 0050 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1. Martin R. Brown Funeral Home, Inc. -funeral services 9,092.50 B ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Donald Mark Hess street Address 919 Mount Vernon Avenue 2 3 city Huntingdon State PA zIP 16652 Year(s) Commission Paid: Attorney Fees: BMZ Lbw Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address 4 5 6 7. 8. 9. 10 City State ZIP Relationship of Claimant to Decedent Probate Fees: 938.07 1,876.14 Accountant Fees: CPA Associates -preparation of income tax returns ~ 100.00 Tax Return Preparer Fees: The Sentinel -estate advertisement 240.64 Cumberland Law Journal -estate advertisement 75.00 Cumberland County Register of Wills -filing fee; inheritance tax return 15.00 reserve to file First and Final Account 200.00 TOTAL (Also enter on Line 9, Recapitulation) I $ 13,475.42 If more space is needed, use additional sheets of paper of the same size. 1 Continuation of REV-1500 Inheritance Tax Return Resident Decedent LAURA B. HESS Decedent's Name Page 1 21 10 0050 File Number Schedule H -Funeral Expenses & Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT B, ADMINISTRATIVE COSTS: Personal Representative Commissions: 2. Name(s) of Personal Representative(s) Linda M. Stolte _ 938.07 Street Address 46 Jamestown Road _ city Shippensburq state PA z-P 1725i' Year(s) Commission Paid: SUBTOTAL SCHEDULE H-61 ~ 938.07 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER LAURA B. HESS _ 21 10 0050 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION _ OF DEATH 1. Chambersburg Hospital medical bill; DOS 9/22/09 - 9/25/09 account #H00036591105 TOTAL (Also enter on Line 10, Recapitulation) ~ $ if more space is needed, insert additional sheets of the same size. ~.- 150.00 ~ 50.00 REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LAURA B. HESS 21 10 0050 RELATIONSHIP TO DECEDENT AMOUNT OF SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under I Sec. 9116 (a) (1.2).] 1. Donald Mark Hess Lineal 11,948.73 919 Mount Vernon Avenue Huntingdon, PA 16652 2. Linda M. Stolte Lineal 11,948.73 46 Jamestown Road Shippensburg, PA 17257 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: . 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTfON TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: __ ____ ___1 300.00 Discount Interest Table Year Before 1981 1982 1983 1984 1985 1986 1987 1988 through 1991 1992 1993 through 1.994 1995 through 1998 1999 2000 2001 2002 2003 53.77 Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: _ ______ _ __ _ _ _ ___ Penalty LAST 'SILL AND TESTAMENT I, LAURA B. HESS, a/lc/a LAURA BELLE HESS, a/k/a LAURABELLE HESS; o:fDublin Township, z 1 ;< :_, .~i "T. ~~ r =, ;_, I-Iuntingdan County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void all prior Wilis and Codicils thereto heretofore made and published by me, and do hereby declare this only to be my Last Will and Testament. FIRST I hereby direct my Executor, hereinafter named, to pay all my just debts and funeral expenses as soon after my death as may be convenient. However, this clause shall not be construed to require the payment of debts not otherwise binding, such as those outlawed by the statute of limitations. SECOND All the rest, residue and remainder of the estate of which I may die possessed, be it real, personal or mixed, and wherever the same maybe located, I Give, devise and bequeatli to my clvldren, DONALD IV1AP 1`: HESS and LINDA NI. STOLTE, share and share alike, the same to be theirs absolutely. THIRD LASTLY, I nominate, constitute and appoint my children, DONALD l~~IAR.K HESS and/or LIi`iDA tiI. STOLTE, to serve as Executor(s) of this, my Last WiII and Testament, hereby directing that no fiduciary shall be required to post bond should the said fiduciary be a nonresident of the Commonwealth of Pennsylvania. any laws of the Commonwealth of Pennsylvania, to the contrary, notwithstanding. I declare that I have discussed the matter of this, my Last Will and Testament. with Thomas E. McDowell, Esquire, at his law office at 113 Fourth Street, Huntingdon, Pennsylvania 1662, on Iviarch 3, ?aOS. and he has prepared the same in accordance with my wishes and that I have carefully read the provisions herein and this instrument expresses my every wish. IN TESTIMONY WHEREOF, I, LAURA B. HESS, a/kla LAURA BELLE HESS, al1Ja LAURABELLE HESS, the Testatrix above named, have hereunto set my hand and seal to this, my Last Will ~tt~ and Testament, consisting of four {4) typewritten pages on this 2 ~ day of dti"~ ~~ ~~'~ , in the year of our Lord, two thousand five (2000. v ~ ~ (SEAL} Laura B. Hess ~...~~ ~G~-~2~- ,~~~2~~. ~ (SE.~, L) all:Ja Laura Belle Hess ~. ~..S~G-~~C~~.~ 1~~~!,~-,~ {SEAT..) alk/a Laurabelle Hess Signed, sealed, published and declared by LAURA B. HESS, a/l:/a LAURA BI~LLE HESS, a11Ja 1 i LAURABELLE HESS, the Testatril above-named, in the sight and presence of us and as and for her Last Will and Testament. who, at her request and in the sight of her and ofeach other, have hereunto subscribed our names as witnesses on the day and year aforesaid. COMMONWEALTH OF PENNSYLVANIA COUNTY OF HUNTINCrDON :SS V4re. the undersigned, being 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 that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing ofthe Testatrix. signed the Will as witnesses and that to the best oftheir knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ ,~ Laura B. Hess, Testatrix Cc- a/1Ja Laura Beile Hess, Testatrix .~ ~ ~~ a/lc/a Laurabelle Hess, Testatrix ' ,, /~ fitness -' ,~ ___- w{itness Subscribed, sworn to and acknowledged before me by LAURA B. HESS, a/Ec/a LAURA BELLE HESS, a/lcla LAURABELLE HESS, the Testatri;c, and subscribed and sworn to before me by the witnesses, Thornu.s ~ Mcf.~c,:~i*u i this end day of `f~'~h , A.D., ?005. .~ ~~-r-; <<~ ~.~.s-s~~n , `ntnrv p„~]j V Notarial5eal Shari ~.. Porshey, Notary Public Huntingdon Boro. Huntingdon County My Commission Expires Jan. 28, 2oQ7 SEAL} Member, Pennsylvania Association Oi Notaries BMZ LAw 113 FOURTH STREET HUNTINGDON, PA 16652-1417 THOMAS E. McDOWELL JAMES M. McCLURE THOMAS K. HOOPER JENNIFER B. HABEL July 13, 2010 BMZ www.bmzlaw.com Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Laura B. Hess File Number 21-10-0050 Dear Ms. Strasbaugh: PHONE 814-643-3555 FAX 814-6~3-1173 1-877-4-BMZLAW KITiIBERLY M. KITCHEN CHARLES A. BIERBACH (OF COUNSEL) I have enclosed two (2) original Pennsylvania Inheritance Tax Returns relative to the above-captioned Estate. I have also enclosed a check in the amount of $15 representing the filing fee for the Return. Kindly stamp the enclosed copy of the first page of the Return and return the same to me in the enclosed self-addressed, stamped envelope, along with a receipt for the filing fee. Thank you for your cooperation regarding this matter. Sincerely yours, BMZ LAW ,~., c~ rr /(' (~ C. ~ CA~~ ~. ~. j ~7 ~~C~..~+.++. l~ r'x . . t 4~ , ..i. Thomas E. McDowell, Esquire J' t ~, ~ ~; ~? cn ~ ~`~ Enclosures `'~ c.~ ~~'' BLAIR COLJN'I'Y OFFICE:1316 `I~-1IlZD AVENUE (RTE 22) • DIJNCANSVII_,LE, PA 16635 • PHONE 814-695-2311 FAX 814-695-2399 Mff~'FI~i COUNTY OFFICE: 20 SOUTH WAYNE STREET • LEWISTOWN, PA 17044 • PHONE 717-242-3400 FAX 717-242-8599 .. ~ ~ ,. ~,:.. ~ ~- ~ u~ . ~~ .--. 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