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Home My WebLink About12-30-10EX (01-10) 1 X05610143 -~ REV-1500 PA De artment of Revenue OFFICIAL USE ONLY p pennsy vania County Code Year. File Number Bureau of Individual Taxes DEPARTMENTd~kEVENUE Po Box.2sosol INHERITANCE TAX RETURN 21 10 0 0 2 9 0 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 185 12 8422 10 02 2009 07 29 1922 Decedent's Last Name Suffix Decedent's First Name MI JULIANA PEARL E (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 ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 2 ® g Decedent Died Testate (Attach Copy of Will) ^ ~. Decedent Maintained a Living Trust (Attach Copy of Trust) ___ _ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 10 Spousal Poverty Credit date of death between 12-31-91 and -1-95) ^ 1 ~ .Election to tax under Sec. 9113(A) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number STEVEN P MINER ESQ 717 724 9821 f,,,,y _-.. REGISTER LS USE~ILY r ~r-; t~'y ~ First line of address ;J W ~~ ~ ~ ~. ~ ~' ~ ~ _ 4r P"" 'y 10 3 5 MUMMA RD S T E 101 C~1C~ ~ ,,,~ ' r 7 ~~ -rt - f ;~ -.. Second line of address Y '~-= `~ • -- -~-. ~j ~ ,c; T w neTC cu cn `.......I City or Post Office WORMLEYSBURG State ZIP Code PA 17043 Correspondent's a-mail address: s m i n e r@ d z m m g l a w. c o m der penalties of rjury, I declare that I have examined this return, including accompanying schedules and statements: and to the best of my knowledge and belief, true. correct ajl~cgmplete. Declaration of preparer other than the personal repre~erttattve Is based on all information of which greoarer has anv knowledge. Patricia J. Smith 81,1 Somerset Street, Hummelstown, PA 17036 SIGNATURE OF P EP RER.QTHER THAN REERBSENTATIVE Steven P Miner Esq ~ U ADDRESS / v C.-.J 1035 M/umma Rd., Ste. 101, Wormleysburg, PA 17043 Side 1 1505610143 1505610143 J J REV-1500 EX Decedents Name:. J U L I A N A, PEARL E Decedent's Social Security Number 185 12 8422 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 8~ 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, 8 Liens (Schedule I) ............................... 10. 11. Total Deductions (total Lines 9 8 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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 16 , 8 3 6. 8 6 1 ~• 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. 1b06610243 0.00 48,557.46 35,489.42 4,722.77 1,863.80 90,633.45 13,808.75 59,987.84 73,796.59 16,836.86 16,836.86 2,020.42 2,020.42 Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 10 - 00290 ' M Juliana, Pearl E - ------- -- --------- - - STREET ADDRESS -- - -- -- - 77 Second Street CITY ~ STATE West Fairview PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2 , 0 2 0.4 2 2. Credits/Payments A• Prior Payments B. Discount Total Credits (A + B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) 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 theTAX DUE (5) 2, 0 Z 0.42 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 :................................................ ............... ~ _J ~x ~ b. retain the right to designate who shall use the property transferred or its income :...........................__.. ~ x_ c. retain a reversionary interest; oc .............................__...... ~ j x_I d. receive the promise for life of either payments, benefits or care? .............................._...........,................ ~ ' xJ ~_ 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.?....... ~~ [x 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 FILE IT AS PART OF THE RETUR 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 retturn 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 1,2 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 bloo~ or adoption. SCHEDlJL.E A REAL ESTATE COMMONTH OF PENNSYLVANIA INHERI ANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF J liana, Pearl E 21 - 10 - 00290 All real prope owned sole)y or as a tenant in common must be re orted at fair market valu~air market value is defined as the price ld b illi i ll i h i ll ll i d b b d b d at which prope reasonable kno e exchange etween a w ng uyer an a w lling se er, ne er n compe to buy or se , both hav ng wou t e e ledge of the relevant facts.Real property which is jointly-owned with right o~ survivorship must be disclosed on schedule F. ', Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. - -- - ITEM ~ - DESCRIPTION VALUE AT DATE Of NUMBER DEATH (PI ase suspend the valuation of the real estate at this time as there are repairs being made to the real estate for purposes of sale. Executrix will file a Supplemental Return when the real est to has sold.) 1 Re I estate located at 77 Second Street, West Fairview, East Pennsboro Township, Cu berland County, PA 17025 i I ~~ ~,II ~~ ~I '~ TOTAL (Also enter on Line 1, Recapitulation) SCH~~~lLE B i STOCKS & BONDS COMMON INHERI LTH OF PENNSYLVANIA ANCE TAX RETURN RES DENT DECEDENT ESTATE OF Juliana Pearl E FILE NUMBER , 21 - 10 - 00290 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM ~ NUMBER DESCRIPTION UNIT VALUE i VALUE AT DATE OF DEATH 1 Series HH Bond -Issued Jan/1997 1000.00 6,000.00 2 Serties EE Bonds - (1) Issued 2/1984 ~ ',~ I 97.30 3 I Serries EE Bonds - (1) Issued 2/1985 ~' ~ 1 ' 92.74 4 AT$~T I nc. Stock, NYSE: T , ', 26.52 ~ 25, 591.80 5 i Vertizon Communications Inc., NYSE: VZ ~ 27.94 5,755.64 6 Frojntier Communications Corporation, NYSE: FTR ! 7.69 ! 376.81 7 LSII Corporation 5.22 167.04 8 ~ Teradata Corp, NYSE: TDC 26.35 'i ' 1,475.60 9 Ca~ncast , 15.24 ', 5, 364.48 10 NCR Corporation I 13.08 ~' 366.24 11 Fai~'Point Communications, Inc. ~ 0.39 ~' 1.17 12 Qv~est Communications, NYSE: Q ! 3.57 ' 374.85 13 Voi~afone Group PLC '~ 22.09 2,893.79 TOTAL (Also enter on line 2, Recapitulation) ', 48,557.46 i SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONILTHOFPENNSYLVANIA PERSONAL PROPERTY INHERI ANCE TAX RETURN RES DENT DECEDENT FILE NUMBER ESTATE OF Jl~liana, Pearl E 21 - 10 - 00290 Include the proc~eds of litigation and the date the proceeds were received by the estate411 property jointly-owned with the right of survivorship m st be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 PNIC Certificate of Deposit Account #21001021440 2,348.52 Accrued interest 16.10 2 PNIC Certificate of Deposit Account #21001021743 8,698.01 Accrued interest 46.44 3 Wajchovia Bank Checking Account 3,632.30 Accrued interest 0.03 4 Wachovia Bank Savings Account 3,757.21 Accrued interest 0.03 5 Amieriprise Financial Certificate Account Number 00809612617 5 001 9,033.77 6 Ameriprise Financial Interest Income, October 2010 500.00 7 Dividend income, March 2010 1,108.09 8 Dividend income, June 2010 669.81 9 Dividend income, July 2010 258.40 10 Dividend income, September 2010 901.02 11 Dividend income, October 2010 142.59 12 Dividend income, Ameriprise Financial and Stock, December 2010 788.99 TOTAL (Also enter on Line 5, Recapitulation) 35,489.42 SCHEDULE E CASH, BANK DEPbSITS, & iIAISC. COMMONVW~ALTH OF PENNSYLVANIA ' PERSONAL PROPERTY INHERI ANCE TAX RETURN RESIDENT DECEDENT continued FILE NUMBER ESTATE OF Jluliana, Pearl E 21 - 10 - 00290 Include the proceeds of litigation and the date the proceeds were received by the estate411 property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM I ~ VALUE AT DATE OF NUMBER DESCRIPTION ! DEATH ~ I 13 AT&T Pension payments (This payment made in December 2010 was for pension due and owing Ms. Juliana prior to her death. AT&T had rewritten checks that became "stale" because they had not been cashed.) 14 j Wachovia Bank IRA. There was no beneficiary designation on this IRA. 2,653.80 934.31 Page 2 of Schedule E SCHEDULE F COMMONWE LTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERI ANCE TAX RETURN REST ENT DECEDENT ESTATE OF ~ FILE NUMBER .~uliana, Pearl E I 21 - 10 - 00290 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVIN JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT 200 Atmore Street Sister q Anna R se Wilson Harrisburg, PA 17112 Kathleei Juliana 3360 Brookview Trace Cousin g Birmingham, AL 35216 JOINTLY O ED PROPERTY: ITEM LETT R DATE I~F.SCRIPTJO~V C~F PRO~ERkTY Include name o Inanclal Ins Itu Ion an ban account numb % OF ~ DATE OF DEATH rDATE OF DEATH '' NUMBER FOR J TEN 1NT NT MADE JOINT or similar identifying number. Attach deed for jointly-held real DECD'S ~ VALUE OF VALUE OF ASSETINTEREST DECEDENT'S INTEREST estate. _ 1 A - 12/31/2004 - - ------ BELCO Community Credit Union, Savings (S1), _______ __ ______ 647.16-t---- ---- - 50% ~ ----- ___ __..---------- _ ~ 323.58 plus accrued interest of $0.81 2 A 12/31/2004 BELCO Community Credit Union, 8,298.37 ! 50% 4,149.19 Checking (S4), plus accrued interest of $2.06 i 3 B i Series HH Bond -Issued Jan/1997 i soo.oo ' 50% '' ~ '~ ~' i i ~I '', i '~~ i i 250.00 TOTAL (Also enter on line 6, Recapitulation) ~ 4,722.77 a ~ a SCHEDULE G COMMONWEAL INHERITAN H OF PENNSYLVANIA E TAX RETURN INTER-VIVOS TRANSFERS & I RESIDE T DECEDENT MISC NON-PROBATE PROPERTY ~ . ESTATE OF J uliana, Pearl E FILE N MBE 2 0 - 00290 This schedule must be completed and filed if the answer to any of questions 1 throug h 4 on page 2 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY InGude the name of the transferee, their relationship to decedent DATE OF DEATH VALUE OF ASSET ~~ OF DECD'S EXCLUSION (IF APPLICABLE) TAXABLE VALUE - and the date of transfer. Attach a copy of the deed for real estate. INTEREST 1 BE CO Community Credit Union IRA, beneficiary of ~,ss3.so 100% + I -- ~ 1,863.80 IR I I ~~ ~~ i is Anna Rose Wilson l I I i I I I i _ I ~ j ' I j _ I , _~ _ TOTAL ( Also enter on line 7, Recapit ulation) 1,863.80 SCI-®ULE H COMMON LTH OF PENNSYLVANIA ~~ ~ ~ I INHE ITANCE TAX RETURN 1'~ ~~ R SIDENT DECEDENT i FILE NUMBER ESTATE OF J~liana, Pearl E 21 - 10 - 00290 Debts of decedent must be reported on Schedule I. ITEM NUMBER FU ERAL EXPENSES: DESCRIPTION AMOUNT A. I B. I AD INISTRATIVE COSTS: ~ . ~ P~ sonal Representative's Commissions i ~ NCI a of Personal Representative(s) i ~ atricia J. Smith ~ 7,000.00 Str et Address 8131 Somerset Street ~ ci Hummelstown state PA zip 17036 Y ar(s) Commission paid 2011 ~ 2. Att~rney's Fees Daley Zucker Meilton Miner & Gingrich, LLC ~ 4,294.00 3, i Fa ily Exemption: (If decedent's address is not the same as claimant's, attach explanation) I'~, ~~ Claimant ~ Street Address ~I I i City State Zip ', '~ Relationship of Claimant to Decedent ~' 4. Pr~bate Fees Register of Wills of Cumberland County ~ 277.50 5. I Accountant's Fees I 6. ~ ~ Ta~C Return Preparer's Fees j I 7, ~ Otf}er Administrative Costs 1 I j Th~ Paxton-Herald, advertise Estate Notice i I 48.00 TOTAL (Also enter on line 9, Recapitulation) 13,808.75 COMMONVW INHER RE ~A~TH OF PENNSYLVANIA ITANCE TAX RETURN SIDENT DECEDENT Sched~~le H j Funeral E~q~enses & ~ri~ ~ ww.~,Gw wl j ~JI IY~ R.~CW I ESTATE O F J _ liana, Pearl E ILE NUM _ _ BER 21 - 10 - - ~ 00290 2 Cu~ ---- -- berland Law Journal, advertise Estate Notice ~ - 75.00 3 Pe- ~nsylvania American Water ~ 213.36 4 PP Electric Utilities Corporation 249.37 5 j UG I Utilities, Inc. ~ 927.02 6 Nat ionwide Insurance (Homeowner's ~ 114.00 7 Ea t Pennsboro Townshi Trash R I p emova 610.50 Page 2 of Schedule H COMMONVYEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF Jluliana, Pearl E 21 - 10 - 00290 Report debts inclurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Jevlvish Home of Greater Harrisburg 49,392.89 2 ~ Bureau of Account Management for Pinnacle Health Services ~ 1,068.00 3 ~ Harrisburg Senior Care (Assisted Care prior to Jewish Home of Greater Harrisburg) ~ 9,526.95 I TOTAL (Also enter on Line 10, Recapitulation) I 59,987.84 REV-1513 EX+ (11-08) COMMONVWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Juliana, Pearl E 21 - 10 - 00290 RELATIONSHIP TO SHARE OF ESTATE I AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not ust Trustee(s) __ I~ TAXABLE DISTRIBUTIONS[include outright spousal f di ib i d t ons an rans ers str ut under Sec. X116 (a) (1.2)] 1 Michael Juliana Brother Thirty-three and 710 North 67th Street one-third percent Harrisburg, PA 17111 2 Peter Victor Juliana Brother Thirty-three and 20 Kingswood Drive one-third percent Mechanicsburg, PA 17055 ~ ! 3 Anna Rose Wilson ~ Sister ; ~ Thirty-three and 200 Atmore Street i one-third percent Harrisburg, PA 17112 ~ ~ j Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cove r sheet, as appropriate. II NON-TAXABLE DISTRIBUTIONS: ~ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN ~ , i B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i I i i i i l i ~~ TOT~4L OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 0.00