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HomeMy WebLinkAbout01-06-111505610143 REV-1500 Ex `°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 10 0 4 0 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 171 28 5364 04 05 2010 09 27 1934 Decedent's Last Name Suffix Decedent's First Name MI CROOK JEAN D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI CROOK WILLIAM B 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 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 Povert Credit (date of death between 12-31 ~1 and T-1-95) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BER~3IRECTED TO: Name Daytime Teleph umber.~nF -~ WAYNE M PECHT ESQ 717 6 91 ~. 0 8 °~---- ~ ~ ~ ~~ First line of address 1205 MANOR DRIVE SUITE Second line of address City or Post Office MECHANICSBURG State ZIP Code PA 17055 ~~ .:j .....~ .;-_,I ..,,,. ~ ~., CQ ..~ DATE FILED Correspondent's a-mail address: wpeCht al peChtlaW.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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE William B Crook ADDRESS 1125 Baldwin Streets Me~chanicsburct, PA 17 SIGNATURE OF R PAtjE~R OTH TH REPRF4ENTATIVE Wayne M Pecht Esq DATE ADDRESS ~ - ' 1205 Manor Drive, Suite 200, Mechanicsburg, PA 17055 Side 1 L 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: CirOOk, Jean D 171 2 8 53 64 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 60,984.00 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. 801.67 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 74,550.00 7. Inter-Vivos Transfers & Miscellaneous Ian; Probate Property arate Billin Se R t d S h l d G 8 8 , 2 3 8 . 2 6 p g ............ eques e ) u ( c e u e 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... g. 224,573.93 18,452.84 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 19,468.25 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 37,921.09 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 186,652.84 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. 186,652.84 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or an1 f erXun tr d er Sec. 9116 1$ 6 652 84 15 2 a O O O( ) , . . 16. Amount of Line 14 taxable at lineal rate X .045 0 • 0 0 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 18. 19. Tax Due ................................................. ..................... .... _ _ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 0.00 0.00 0.00 0.00 0.00 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0404 DECEDENT'S NAME Crook, Jean D STREET ADDRESS 1125 Baldwin Street CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 0.00 3. Interest 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. Total Credits (A + B) (1) 0.00 (2) 0.00 (3) (4) (5) 0.~~ Make Check Pa able 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 ............................................................................................................... ^ ^x 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?....... ^ ^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 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) (1.3)]. 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-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crook, Jean D 21-10-0404 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 BKNY Mellon -1936 Shares 60,984.00 TOTAL (Also enter on Line 2, Recapitulation) 60,984.00 (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 B (Rev. 6-98) Rev-1508 EX+ (6-98) SCHEDULE E , ~ CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Crook, Jean D 21-10-0404 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. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) (If more space is needed, additional pages of the same size) Rev-1509 EX+ (6-98) ,. SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crook, Jean D 21-10-0404 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. 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 William B. Crook -1125 Baldwin Street 149,100.00 50.000% 74,550.00 Mechanicsburg, PA 17055 TOTAL (Also enter on Line 6, Recapitulation) I 74,550.00 (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) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PR PERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAY. RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Crook, Jean D 21-10-0404 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TROANSFERSATTACIiTA COPY OF TIRE DEIED FOOREREAL ESTATE. DATE OF DEATH VALUE OF ASSET °~ OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Linda Jean Crook Saylor -IRA 27,254.26 27,254.26 2 LindaJean Crook Saylor - BNKY Stocks 60,984.00 60,984.00 TOTAL (Also enter on Line 7, Recapitulation) I 88,238.26 (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 G (Rev. 6-98) REV-1151 EX+ (10-06) p , COM INHE~ITAN~ T~ RET~RNANIA RE IDEN DE EDEN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Crook, Jean D 21-10-0404 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) 13,125.34 Street Address City State Zia Year(sl Commission paid 2. Attorney's Fees PeCht & ASSOCiates,PC 5,000.00 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 327.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs TOTAL (Also enter on line 9, Recapitulation) I 18,452.84 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 Crook, Jean D 21-10-0404 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex ep nses 1 Gingrich Memorials -Grave Marker 540.00 2 Kathryn Wiley -Fellowship following funeral 174.12 3 Malpezzi Funeral Home -Mechanicsburg, PA 11,325.72 4 Malpezzi Funeral Home -Grave Opening -Mechanicsburg, PA 750.00 5 Reverand Norman Evans -Funeral Service 150.00 6 Royer's Flowers -Casket Spray 185.50 H-A 13,125.34 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crook, Jean D 21-10-0404 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 Alert Pharmacy 103.85 2 Cumberland Law Journal - 32 South Bedford Street, Carlisle, PA 17013 75.00 3 Gannett Fleming, Inc. -Health Insurance Coverage 1,086.24 4 Holy Spirit Hospital 50.00 5 Messiah Village -Mechanicsburg, PA 17,841.64 6 PA Neurological Associates ~ 15.00 7 Rite-Aid -Miscellaneous Health Care Supplies 46.95 8 The Patriot-News Co. -Legal Advertisement - 2020 Technology PArkway, Suite 300, 249.57 Mechanicsburg, PA 17050 TOTAL (Also enter on Line 10, Recapitulation) I 19,468.25 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) ,,. COMMNHERITAN~E TAX RET~IRN ANIA RE3,IDEN DEC:EDEN II SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Crook, Jean D ~ 21-10-04 04 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 Linda Jean Crook Saylor Child 6 Paddock Drive Lititr, PA 17543 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION 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 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) 201-.0'~`---Warraxity Deed, Short Form, Act of 1909. Henry Hell, Inc., Indiana, Pa ~~ .. .. ,. ,~L.. .' . F~GtrF;DER dF ®E£~5 ~: ~ E a t2 ~~ P~~ ,:. r _ t MADE THE i ~ ~~ day o f ~%~~ in the •year Q11M~~~RL; 1a~ :oUt17Y'~ of our Lord one thousand nine hundred s ixty-six ( 1966 ) .- ~=~itsSY.Y,iNtA, - BETWEEN MELVI N C . CHRONI STEM? and ETHEL 'L . CHRONI STAB, h i s wife , of the Borough of Shiremanstown, County o~~`"~um6e~'fi~~Rtl••~R 'a and State of Pennsylvania, - Grantors , and WILLIAM B. CROOK and JEAN D. C800K, his wife, of the City of Harrisburg, County of Dauphin and State of Pennsylvania,- - ~ . Grantee s WITIVESSETH,-that in consideration of Twenty Thousand Nine Hundred -------- 0 0 -----------------------------------------~----- (20,90 0} Dollars, in hand paid, the receipt whereof is hereby acknowledged, ~ the said grantors do hereby grant and convey to the said grantee s, ALL that certain piece or parcel of land situate in the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the north side of Baldwin Street at the - dividing line between Lots Nos. 37 and 38 on the plan of lots re- ferred to Yiereinafter and which said point`of beginning is also referenced South 66 degrees 43 minutes West, a distance of one hundred ninety-eight and seventy-five hundredths (198.75) feet measured along the north side of Baldwin Street from its inter- section with the west side of Apple Drive; thence along the north side of Baldwin Street South 66 degrees-43~m'inutes West, a distance of seventy-five (75) feet to a point; thence along the dividing line between .Lots Nos. 36 and 37 on said plan North 21 degrees 13 minutes West, a distance of one hundred forty (140) feet to a point; thence along other lands now or formerly of Orchard Crest, Inc., North 66 degrees 4.3 minutes East, a distance of seventy-f ive ( 75 ) feet to a point; and thence along the dividing line between Lots Nos. 37 and 38 on said-plan South 21 degrees 13 minutes East, a distance of one hundred forty (140) feet to a.point, the place of BEGINNING. BEING Lot No. 37 on the Plan of Section 102 of Orchard Crest, Inc., said plan being recorded in the Cumberland County Recorder's Office in Plan Book 15, Page 10. HAVING THEREON ERECTED a brick ranch type dwelling house with attached carport and being known and numbered as 1125 Baldwin Street. BEING Tract No. 2 which Orchard Crest, Inc., by deed dated August 18, 1965 and recorded in the Cumberland County Recorder's Office in Deed Book "S", Volume 21, Page 4.69, granted and conveyed unto Melvin C. Chronister, one of the grantors herein. UNDER and SUBJECT to building and use restrictions recorded in Miscellaneous Record Book 166, Page 948, Cumberland County records. E~~K~,2~.PAGE 69~ AND the said grantors hereby covenant and agree that they and each o f them will warrant GENEEALL~ the property hereby conveyed. ~~ s ~ ~ ~ ~~ ~~~'! ~ ~..a. Comb: (~o. o• $ch~oa,. Dist; Cum,b. Co. ~~: 1 Reei Estet'i Trensfar Tai 7. 19i R.eeiEstate TTensier iei •'* u to ^ Ap't.~'.'~ ~ Dlttf ~ ~ i ~ , ~ ~, ! ~ J, SD 1F•tr .. IN WITNESS WHEREOF, said grantors have hereunto set their hand and seal the day and year first above written. i{,gisrD, ~sslsDauD $el~[uerea Melvin C . -Chronister Etr for ~rrarnrs at ~~ _._------------------------------ ---•--_._..-------------------------------__ 3~AI. Ethel L. Chronister ~--~ --_--_------------------. ...___._..------------------------------------------------------------------------ sasi. ~'.~ C(3F'Mitp ~~FFdtdc~ ,. State of Pennsylvania ss. County of Cumberland S .-~ ~ ,. On this, the / ~ '=~ day of Vii`" / CL/ , 19 66 ,before me, the undersigned o~ccer, personally appeared Melvin C. Chronister and Ethel L. Chronister, his wife, known to me' (or satisfactorily proven) to be the persons whose names are within instrument, and acknowledged that they executed the same for the contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal C~ ~' ,.- --- f. `,,~ ..ate •.-~, `~. `` - ~ .~. . _ ';~ of 0}fi'eeo~,~.,,,~~~' i State of ss. County of On this, the day of , 19 ,before nxe, the undersigned o,~cer, personally appeared known to me (or satisfactorily proven) to be the person . -whose name , ; subscribed to the within instrument, and acknowledged that he executed the same f o7• the purposes therein contained. -, IN WITNESS WHEREOF, I hereunto set my hand and o~cial seal. ~--. --------------------------------------------------------------------------------------- s~e~. Tithe ~of O,~cer. do hereby certify that t precise residence and complete past office ad ress of the within named grantee xs ~`~,~ ~/ ~*'~G s'z.-~ ~ ~ „ ~ ~ ` ~~~ .. ~f~ ~j ~C, 19 ~ ..- "' ~ ,- Attorney for -------- '" ' ~~'~__,----------- i ^~^ , 4 `~ w ~, . \r N 4-, ~ 40 ~ ~ ~ c~ ~ ~ cd •rl a7 cn Pi Ri ,~ rd 4-~ N U • ~ ~ U2 ~i ~"°I ~ ~ +~ ~ E-~ O ~ Z ~ U ~ ~ ~ P4 H (~ ~ U U U O ~' ~ ~ O fr O ~ a ~ ~ w ~ ~ Q ~ W W H ~ GU U ~ x ~ ~ E-+ w w ~ r,~, COMMONWE TH OF PENNSYLVANIA, ~~' ss. County of -- - ~,~~? -- ------- ---------- - ---- .. •~•: ::.~ •. RECORDED on this -----------~C--~~ day of ---- ----- - - -------------- •.. ~: ~ , - :• ' ~ ~-A~.'~D. 19~~, in the Recorder's Of.~ice of said County, in Deed Book • - . _ •Vol. -----~-------, Page __~_~f---------• • • Given under my hand a~,zd ~ s ~•e#-th~..sa~-~. .t~ dote above wrstteat. ,.. - - ---- ------------ ---------~- -- --- - - ` --, Recorder. E~;.K ~ 2j.PAGE X99 `y .. .4: c c ~i v ~. 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