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Home My WebLink About08-02-10 (2)15056041114 REV-1500 EX (06-05) OFfIC1A1 USE ONLY PA Department of Revenue Courriy Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN /J f ~ D /~ PO BOX 280801 `~,I ~, O L hlarttabcxa. PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATN~N BELOW Social Security Number Date of Death Date of Birth 166-46-4038 07252009 11031954 Decedents Last Name Suffix Decedents First Name ' MI LEBO PAUL B (If Applicable) Enfsr SurvivinS 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'VI~ITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Orlyinal Return 0 2. Suppbmental Return Q 3. Remainder (dent of death 0 4. Llmfted Estate prior to 12-13-8 ) 0 4a. Future Interest Compromise (date of ~ 5. Federal Estate ax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number oj' Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Tnist) 9. Litlyaaon Proceeds Received ~ 10. Spousal Poverty Credit (date of death 0 11. Electlon tp talc rider Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O~ CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUU. TAX INFORMATION SHO L Name Daytime Telephone r ROBERT G. FREY 717-243-58'38 Finn Name (If Applipble) REGISTE l FREY & TILEY ~' BE DNiECTED T0: First line of address -aa '~~ i- ~• ~] 5 SOUTH HANOVER STREET ~'" Second line of address ~~a ~ City or Post Office CARLISLE State ZIP Code PA 17013 Correspondents e-mail address: RFREY®FREYTLEY . COM ° ,r:~ EbONLY y '~.'_~ C ~ cY 1 =' 1-r-r N ~ <:_ ~ '~~7 3 f_ C.7 W i'r't .+ Cl3 1 unaer penaioes ar pequry, I cetsare tnet l nave examined this return, including aocompamnrg ts, fD my~ , d e true correct and . Decieradort ~ rot otlter than lire I tatlve is based on aN inforrrtatlon of which rer has e. SIGNATURE PERS PONSIBLE FOR FILING RETURN ATE 2204 RIVER BEND COURT, WHITE HALL, MD 21161 SIGNA OF P TH R REPRESENTATIVE BATE d ADDRESS 5 SOUTH HANOVER STR , CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 15056041111 ~' J~ J 1~056~1421~5 REV-1500 EX DecedenPs Soaali Security Number oecedern~swme: PAUL B LEBO 166-46-4 038 RECAPITULATION 1. Reat estate (Schedule A} ........................................... 1. 10 9 0 9 0.8 0 2. stocks and Bonds (schedule B) ...................................... 2. ' 4 0 2 7 7 . 0 0 3. Closely Hekl Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages 8 Notes Receivable (Schedule D) ............................ 4. NONE ~ 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ........ 5. 2 6 3 3 7.0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. NONE 7. Inter-Vivos Transfers ~ Miscellaneous Non•Probate Property (Schedule G) OSeparate Billing Requested ........ 7, NONE I 8. Total Gross Assets (total Lines 1-7) .................................. 8. li 17 5 7 0 4.8 0 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. NetYalue of Estate (Line 8 minus Line 11) ............................. 12. 13. Charitable and Governmental eequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 14. Net-Value Subiect to Tax (line 12 minus Line 13) ....... . ..... . ,_._ . TAX COMPUTATION -SEE lN3TRUCTION$ FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (ax1.2) X .0 0 16. Amount of Line 14 taxable 18266.00 506.00 18772.00 156932.80 0.00 156932.80 15. at lineal rate X .0 4 5 16. 17. Amount of Line 14 taxable at sibling rate X • 12 15 6 9 3 2 . 8 0 17, 18. Amount of Line 14 taxable at collateral rate X . 15 18. 19. TAX DUE ....................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L„~ 15056042115 $IC~@ Z 0.00 0.00 18832.00 0.00 18832.00 15D560421]~5 I~ ~I J REV-,eoo a gage s 1ss-as-ao3a Decedent's Complete Address: Flk Number 21-09-0731 DECEDENTS NAME PAUL B LEBO DECEDENTS SOCIAIa SECURITY NUMBER 166-46-4038 STREET ADDRESS 160 FAITH CIRCLE CITY ARLISLE STATE PA IP 1 013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 15500.00 C. Discount 3. InteresUPenaity if applicable D. Interest E. Penalty (1) 18832.00 Total Credits (A + B + C) (2) ,~ ~ 15500.00 Total Interest/Penalty (D + E) (3) ~ 0.00 4. It Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FlII In oval on Page 2, Line 20 to request a refund. (4) I 0.00 I 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE (5) I '~ 3332.00 A. Enter the'interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~ 3332.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APp OPRIATE BLOCKS 1. Did decedent make a transfer and: rt ferred f th tra i t i th Y No Q : ....................................... e prope y ns e use or ncome o a. re a n b. retain the right to designate who shall use the property transferred or its income : ................ 0 c, retain a reversionary interest; or ...................................................... 0 d. receive the promise for life of either paymerrts, benefits or care? ............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................. Q 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. ~X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which contains a beneficiary designation? ...................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R 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 tr~nsfers 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 ~f 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 tai, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the 'odrly 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)(ti.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four anc~, 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. §9 11i(a)(1.3)J. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood o adoption. REV-1502 EX+(11-08) Pennsylvania APARTMENT OF REVENUE INHERRANCE TAX RETURN ESTATE OF SCHEDULE A REAL ESTATE Ali -eal property owned solely or as a tenant in common must bs reported at fair market value. Fair market value fs defined as tlhe price at which property would be exchanged beMreen a willing buyer and a willing seller, neither being campelled to buy or sell. troth having reaaonabls wwwl~dge of the rolevant facts. 11 mUrd sWacd IS I ltleudu, II IAdI l aYY~ Wna~ anww v~ u ~o aanw aKV. i. 217 REV-1503 EX+ (8.98) COAAUONVYEALTH of PErINSYlVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER F'aUl CS L@DO c i -v~-v r v i All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 2. Brokerage account Scott Trade Brokerage Accoount, see statement ' i I ~I ~I ~~ ~I I ~~ I 8,000 32.277 TOTAL Also enter on line 2 Roca itulati 'n 40 277 (If more space is needed, insert additional sheets of the same size) ~i REV-1508 p(+ (&98) 217 SCWEDULE E CASH, BANK DEPOSITS, $ MISC. ~~°F~~w~""~" PERSONAL PROPERTY ~oErrr oecEOErrr ESTATE OF FILE NUMBER Pauf B Lebo ' 21-09-0731 _ __ Indude the proceeds of litlgatlon and the date the proceeds were received by the estate. (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H cotYe~oNweA~rw of PErtrtsvwANw FUNERAL EXPENSES 8i '"" ~ To ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Paul B Lebo 21-09-0731 Det><s of decedent must be m rtad on Schedule I. ITEM NUMBER DESCRIPTION ~ ' AMOUNT A. FUNERAL EXPENSES: 1. Expenses of memorial service, cremation and internment, itemzation attached I 902 B. ADMINISTRATIVE COSTS: 1. Personal Raprosentative's Commissions Name of Personal Reprosentatlve(s) Street Addross City State Zip Year(s) Commission Paid: 2. Attorney Fees 5,640 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanarion) Claimant Street Addross City State Zip Relatlonship of Claimant to Decedent 4. Probate Fees 572 5. Accountant's Fees included wl atty fee 6. Tax Re1um Preparor's Fees ', InClUded W/ atty fee 7. Federal Retirement Benefits overpayment 835 8. Final Medical Bills, itemization attached 338 9. Maintenance 8~ Repair Expenses 1n connection with real estate held for sale, itemization attached 7,694 10. Miscellaneous travel expenses and mileage for Executor 261 11. Maintenance, repair and insurance expenses for automobile to be sold 2,024 ~ TOTAL (Also enter on line 9, R~ (If more space is needed, insert additional sheets of the same size) REY-1512 IX* (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SGHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8 LIENS ESTATE OF 'FILE NUMBER rain o ~cw Report debts incumd by the decedent prbr to death that romained unpaid at the dab of death, IncludMg unrNmbuned expettue. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Visa credit card 506 I i it ~I III TOTAL (Also enter on Une 10, Recapitulation) 506 ff more space is needed, insert additlonal sheets of the same size. ~ REV-1513 EX+ (11-08) pennsytvania SCHEDULE J t>EPARTMENT OF REVENUE BENEFICIARIES INHERRANCE TAX RETURN ESTATE OF ~ILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERS S RECEIVING PROPERTY Do Not List Trusbs(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pt>clude outright spousal distributions and transfers under Sec. 2118 (a) (1.2).) 1. Esther Dundore, 9853 Richter Ln, St. Louis, MO 63126 sister '~/3 of residue 2. Mary Lebo, 158 Central Avenue, St. Louis, MO 6119 sister '~/3 of residue 3. John Lebo, 2204 River Bend Ct., Whitehall, MD 21161 brother ~/3/ of residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18 OF REV-1500 COVER S i H ET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARfTABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. r); Q H moro space is needed, Insert additional sheets of the earns size. TaxD6 Result Details Detailed Results for Parce129-1 DistrictNo 29 Parcel_ID 29-14-0868-067. MapSuffix HouseNo 160 Direction Street FAITH CIRCLE Ownerl LEBO, PAUL B C/O PropType R PropDesc LivArea 1288 CurI,andVal 19100 CurImpVal 67480 CarTotVal 86580 CarPretVal Acreage .23 CIGraStat TaxEx 1 SaleAmt 4000 SaleMo 07 SaleDa 12 SaleCe 19 SaleYr 76 DeedBkPage 0026R-Q0450 YearBlt 1977 HF File_Date 10/26/2004 HF_Approval Status A 4-0868-067. in the 2004 Tax Assessment Database http: / /taxdb.ccpa.net /details.asp?id=29-14-0868-067.&dbselect=1 9/29/09 3:28 PM Page 1 of 1 ORRSTO~NN saNx ATindirion ofEacellence August 22, 2009 To: Frey & Titey 5 South Hanover Street Carlisle Pa 17013 From: Traci Rohe Orrstown Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of Paul B Lebo Date of death July 25, 2009 IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON T ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWNBAII~: CHECKING ACCOUNT Account # Title of Account ?43000069 Paul B Lebo Date opened Principal Accrued Interest 09!12!02 4644.62 0.47 SAVINGS ACCOUNT Account # Title of Account CERTIFICATE OF DEPOSIT Account # Title of Account Date opened Prim Accrued Inter~t Date ppened Prince Accrued Interesit P.O. Box 250 • Shippensburg, PA 17257. 717.530.3530. 717.532.4143 fax 1~~TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Frey & Tiley Attorneys at Law 5 South Hanover Street Carlisle,. Pennsylvania 17013 Phone (888)502-4349 Fax (302)34-2955 August 24, 2 9 Re: .state of Paul B. Lebo Social Security: 166-46-4038 Date of Death: July ZS. 2009 Deaz Sir or Madam: Per your inquiry dated August 19, 2009, please be advised that at the time of death, the above-named d~Oedent had on deposit with this bank the following: ~, 1. 7j~pe ofAccoura CheckingAccount Aceoura Number 1183117 Ownership (Names o~ Paul B Lebo' Opening Date 1131/94 Closed8/18/09 Balance on Date of Death $19,691.85 Aaaued Iraerest $ 0.00 Total $19, 691.85 ____ ~~~ Please be advised, there was no safe deposit box found for the above decedent. * If apon reviewing the information above, you believe there are additional accounts not referenced, p provide ns with an aceoant number and/or name of any possible joint account holder. For any additional info tion on the above acxounts, incfnding ownership and any changes, closures and/or reimbursement of >Wunds, etc., p contact our North 1Kiddkton Office # 717-240-4521. Sincerely, ~ ie Harp Y Adjustment Services