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Home My WebLink About12-16-101505610143 REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 10 1056 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 174 20 0388 09 16 2010 Decedent's Last Name PANNEBAKER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number Date of Birth 10 16 1925 Suffix Decedent's First Name MI EVELYN p, Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WI1fH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ^ 2. Supplemental Return 4. Limited Estate ^ 4a. Future Interest Compromise (date of death after 12-12-82) g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death between 12-31 ~1 and 1-1-95) 3. Remainder Return (date of death 11, Election to tax under Sec. 9113(A) (Attach Sch. O) prior to 12-13-82) 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LAUREN E BOGAR 7 7 7 7 '~ 7 R '7 ~ ~ ~'' First line of address ONE WEST MAIN STREET Second line of address City or Post Office State ZIP Code SHIREMANSTOWN FA Correspondent's a-mail address: IbOgar@bogarlaW.COm ~ ~ ~ REGISTER OF {r.,i~, LSE O~t( ' ~. 0 r r-" ~,.~ ~~~ ..._.~ .. ;v W DATE FILED ~.., _ _.r~ ., '= i ty • 3 -__= ~•~; ~•. ~ ~. r-{'t ;~ 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 ail information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE Doris J. Miller ~ ~,~J l l ~~ ADDRE 916 E. Simpson Street, Mechanicsbur , PA 17055 SIGNATU E OF PREPARER OTHER THAN REPRESENTATIVE DATE ~ ~ ~ Lauren E. Bogar ~ ~ ~~ /`~ ADDRESS r One West Main Street, Shiremanstown, PA Side 1 L 1505610143 1505610143 Eiu~ J 1505610243 REV-1500 EX Decedent's Social Security Number DecedenPs Name: pannebaker, Evelyn A. 17 4 2 0 0:3 8 8 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. 1.3,090.49 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 1.1 , 7 0 6.67 7. Inter-Vivos Transfers & Miscellaneous fin-Probate Property arate Billin u Se Re uested h l S d G p g q ............ ( c e u e ) 7, g. Total Gross Assets (total Lines 1-7) ..................................................................... g, 24 , 7 97.16 1.4 , 743.07 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. 1.4 , 743.07 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 1.0 , 054.0 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 Q 5 . 4 0 ~- an election to tax has not been made (Schedule J) ............................................... 13. , 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 9,048.69 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 0 0 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 0 Q Q 16 0 0 0 , at lineal rate X .045 . . 17. Amount of Line 14 taxable at sibling rate X .12 4 , 524.35 17. 542.92 18. Amount of Line 14 taxable at collateral rate X .15 4 , 524.34 1s. 678.65 19. Tax Due .................................................................................................................. 19. 1 , 2 21.5 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-1056 DECEDENT'S NAME Pannebaker, Evelyn A. STREET ADDRESS 500 Walnut Street Apt. C-3 CITY STATE ZIP Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + B) (1) 1,221.57 (2) 61.08 (3) (4) (5) 1,160.49 61.08 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. 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 :.................................. ^ ^x c. retain a reversionary interest; or ............................................................................................................... ^ 0 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? .................................................................................................................... ^ ^x 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 ff~~11 contains a beneficiary designation? .................................................................................................................. l-I 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 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 21 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 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 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 12 percent [72 P.S. §9116 (a) 1;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. Rev-1508 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Pannebaker, Evel n A. 21-10-1056 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 DESCRIPTION VALUE AT DATE OF DEATH 1 Cash -Sale of Craft Items 82.85 2 AARP -Hospital -Refund 465.00 3 Nationwide -pension payment 896.81 4 PNC Bank -Certificate of Deposit No. 21001028106. Date of death balance $9,157.50; 9,172.26 accrued interest $14.76 5 Hummel Figurine -sold at private sale 5.00 6 Personal Property -sold at auction 109.90 7 Personal Property -sold at auction 1,327.40 8 AARP -Refund 1.10 9 Comcast -Refund 12.61 10 Genworth Financial -Refund 86.36 11 Michael S. Murphy -Refund of security deposit for apartment 630.00 12 Nationwide -Refund of tenant's insurance premium 230.00 13 PPL -Refund 51.75 14 Verizon -Refund 19.45 TOTAL (Also enter on Line 5, Recapitulation) I 13,090.49 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) i.EltQ1~1G THE'V~A!I' November 17, 2010 James D Bogar Esq. One West Main St Shiremanstown, PA 17011 RE: Evelyn A Pannebaker SSN: 174-ZO-0388 DOD: 09-16-2010 Dear Mr. Bvgar: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Cerkificate of Deposit Account # 21001028106 Established: 02-26-1988 . EVELYN A PANNEBAI~ER DOD balance: $ 9,157.50 + 14.76 accrued interest Interest paid O 1-01-2010 thru 09-16-2010 $ 170.70 YTD Please note t~,at this off ce provides date v,f death balances for deposit accounts (JRAs, CDs, Checkuig and Savings). We do not process any financial transactions or provide statements. If you need assas~ce vrith any ol,these i.te,ms, please call 188$-P].YC~BANK (1-588-762-2265) or step by your local PNC Baal: branch oi~ice. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC This message is intended for the use of the individual or entity to which it is addressed and nzay contain information that is privileged, con~den'tial and exempt from disclosure under applic~ahle law. If the reader of Phis message is not the intended recipient or the employee or agent responsz~-le for deliy~ering this message to the intended recipient, you are hereby notified that anv dissemination, distribution or copying of this communications is strictly prohibited. ,If you have received th.rs communication in error, please notes me immediately by reply ar by telephone at X00-76~-1775 and immediately destroy this faxed document. Page 1 o.f 1 Rev-1509 EX+ (6-98) SCHEDULE F ~~ COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Pannebaker, Evel n A. 21-10-1056 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 ADDRESS RELATIONSHIP TO DECEDENT A. Doris J. Miller 916 E. Simpson Street Sister Mechanicsburg, PA 17055 B. 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 ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 04/06/1990 MST Bank -Checking Account No. 67216668. 6,404.67 50.001)% 3,202.34 Date of death balance $6,404.63; accrued interest $0.04 2 A 08/28/1964 M8~T Bank -Savings Account No. 17,008.66 50.000% 8,504.33 15004208555829. Date of death balance $17008.03; accrued interest $0.63 TOTAL (Also enter on Line 6, Recapitulation) I 11,706.67 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Q MsTSank 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 November 2, 2010 James D Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 Re: Estate of Evelyn A Pannebaker Social Security: 174-20-0388 Date of Death: September 16, 2010 Dear Sir or Madam: In response to your request, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following accounts: 1. Type of Account Checking Account Account Number 67216668 Ownership (Names of) Evelyn A Pannebaker Doris J Miller Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total 08/28/64 $6,404.63 $ .04 $6,404.67 Savings Account 15004208555829 Evelyn A Pannebaker Doris J Miller 04/06/90 $17, 008.03 $ .63 $17, 008.66 *We were unable to locate any safe deposit box for the above-mentioned decedent. **For further account information, closures and/or reimbursement of funds please call the West Shore Plaza Office at #1717-731-1730. ***This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of lUniform Transfers, Representative Payee, or Trustee under a Written Agreement S' e ly, Suz e M Kimble Adjustment Services REV-1151 EX+ (10-06) t COM IN~HERITANCE~T~ RETURN ANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Pannebaker, Evelyn A. 21-10-1056 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(sl Commission paid 9,746.73 2. Attorney's Fees Bogar & Hipp Law Offices 3,885.00 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 4. Probate Fees 119.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 991.84 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,743.07 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Pannebaker, Evelyn A. 21-10-1056 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Gingrich Memorials -engrave headstone 140.00 2 Grace United Methodist Church -funeral luncheon 233.06 3 Musselman Funeral Home -funeral 8,473.67 4 Shoops Cemetery -Internment 900.00 H-A 9,746.73 5 Other Administrative Costs Ambulance 25.00 6 Ed Miller -Reimbursement for trash removal from apartment 95.00 7 PPL -electric bill 88 08 8 RESERVES: -Costs to conclude administration of Estate, including filing fee for PA 750.00 Inheritance Tax Return and Inventory, prep and filing of final Federal and State Personal Income Tax Returns and Fiduciary Income Tax Returns, preparation of Accounting 9 Verizon -phone bill 33.76 H-B7 991.84 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-08) SCHEDULE J COMMNHERITANCEOT~ RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Pannebaker_ Evelyn A_ 71 _~ n_~ nsa NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 Jean Louise Fickel Niece Fifteen percent 207 West Courtland Avenue of rest, residue Shiremanstown, PA 17011 and remainder Larry Edwin Miller Nephew Fifteen percent 1105 Rana Villa Avenue of rest, residue Camp Hill, PA 17011 and remainder Doris J. Miller Sister Forty-five 916 E. Simpson Street percent of rest, Mechanicsburg, PA 17055 residue and remainder James Carl Miller Nephew Fifteen percent 209 N. Second Street of rest, residue West Fairview, PA 17025 and remainder Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o ~riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ~ Grace United Methodist Church 1,005.40 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1,005 40 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAMENT OF EVELYN A. PANNEBAKER I, EVELYN A. PANNEBARER, of the Borough of Lemoyne, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give and bequeath forty-five (45~) percent. of my net distributable estate to my sister, DORIS J. MILLER. 3. I give and bequeath ten (10~) percent. of my net distri- butable estate to GRACE UNITED METHODIST CHURCH, of Lemoyne, Pennsyl- vania. 4. I give and bequeath fifteen (15) percent. of my net distri- butable estate to my niece, JEAN LOUISE FICKEL. -1- 5. I give and bequeath fifteen (15~) percent. of my net dis- tributable estate to my nephew, TARRY IDWIN MILLER. 6. I give and bequeath fifteen (15~) percent. of my net dis- tributable estate to my nephew, JAMES CARL MILLER. 7. LASTLY, I nominate, constitute and appoint my sister, DORIS J. MILLER, Executrix of this, my Last Will and Testament, and in the event that she should be unwilling or unable to serve in this capacity for any reason, then I nominate, constitute and appoint my brother-in- law, EDWIN C. MILLER, JR., to be the Executor of this, my Last Will and Testament, in her place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th day of February, A. D. 1990. w .;. ~/ ~ ' ~~~~ _ (SEAL ) Evelyn A. Pannebaker L' -2- Signed, sealed, published and declared by the above-named EVELYN A. PANNEBAKER, as and for her Last Will and Testament, i:n the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as w:it- nesses. -3- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, EVELYN A. PANNEBAKF.R , the 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 and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by EVELYN A. PANNEBARER the testatr~X , this 27th day of February ~ A• D• 1990. ls1~T:~~iifi. 5Eti±. ~~RY S. ~~~IPISt?iJ;. ~U'i',~~Y ~IJBtIt COMMONWEALTH OF PENNSYLVANIA ) ~9ECHA'~lICSEiURG BUecf~. ~UMBcRLl~ND CJ. My Corrunission Expires Sept. 2il ~ i~9t COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUFFER and IDWIN C. MILLER, JR. the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat RIX ~ EVELYN A. PAATIITFRAKF.R sign and exe- cute the instrument as ~~s/her Last Will and Testament; that the said testatrix ~ EVELYN ,A,_ PANNFRARF.R executed it as bd~/her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testat rix ~ signed the Will as witnesses; and that to the best of our knowledge, the testatrix was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subscribed to befor me this 27th day of February, ~ 1990. !~'t)T.~Rl~.!_ SEAS. _ .-, t~RY .;. Ri~3lrlUt~l~ i~fl"fia~;Y PJ6f.IC ~~ rNiECNA;VIu5i3URv EO;tJ. CtiMS::Rl.A1i0 t0. ~;~ -,~'. / "' %r'''r =°t'=~ Co~nmis4i~n Expire; Sept. 2i s~~i