HomeMy WebLinkAbout03-18-111505610143
REV-1500 Ex (°'-'°'
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania county code Year File Number
Bureau of Individual Taxes OEPARTMENTOFREVENUE
PO 80X.280601 INHERITANCE TAX RETURN 21 10 0 0 68 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
196 18 2600 06 26 2010 09 02 1923
Decedent's Last Name Suffix Decedent's First Name MI
SOWERBROWER ROBERT E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
1
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
(date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required
8 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 Povert Creditl(date of death 11 _ Election to tax under Sec. 9113(A)
between 12-31 ~1 and -1-95) ^
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMP LETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number`
WM D SCHRACK III ES
4 ~-
717 432n9~733 -~-,
- ...
- , ~ ,
First line of address
124 W HARRISBURG STREET
Second line of address
City or Post Office
DILLSBURG
State
PA
Correspondent's a-mail address: Schracklaw@comcast.net
ZIP Code ~'
170191268
DATE FILED
~:;
_-
~ i
G
~~
Under pe Ities 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, rrect d complete. Declaratio of reparer of r than the personal representative Is based on all information of which preparer has any knowledge.
SIGNA OF S N ESP IBLE F F G ET DATE
' ' Debra A. Shook
201 Martel Circle Dillsbur PA 17019
SIGNATURE O E THER THAN REPRESENTATIVE DATE
Wm. D. Schrack III ' ~S'- //'
ADDRESS
124 W. Harrisburg Street, Dillsburg, PA 17019-1268
Side 1
1505610143
1505610143 J
r ,'
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedents Name: SOWerbrOWer, Robert E. 19 6 18 2 60 0
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. 7 , '7 8 5 . 3 6
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous -Probate Property
~ Se
arate Billin
R
S
h
d
l
G
t
d
p
g
(
c
e
u
eques
e
)
e
............ 7, 65 , 7 4 3.15
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 73 , 528.51
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 10 , 4 7 4 . 7 4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 7 , 8 8 7.33
11. Total Deductions (total Lines 9 8 10) ....................................................
...............
.
11 18 , 3 62.07
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 55
166.44
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. 55 ,166.44
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 .o0 0. 0 0
15.
0. 0 0
16. Amount of Line 14 taxable 5 5 16 6. 4 4
at lineal rate X .045 r 1 s. 2 4 8 2. 4 9
r
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18. 0. 0 0
19. Tax Due .................................................................................................................. 19. 2, 4 8 2. 4 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Slde 2
150561D243 1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10-00686
DECEDENT'S NAME
Sowerbrower, Robert E.
STREET ADDRESS
5225 Wilson Lane
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
2,000.00
105.26
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.
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
2,482.49
2,105.26
377.23
Make Check Pa able to: REGISTER OF WILLS, AGENT.
;r .. _.
.,
.moo.. .~„ P.
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 life 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? .................................................................................................................... ^ Cx~
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-1508 EX+ (g-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sowerbrower, Robert E.
FILE NUMBER
21-10-00686
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.
~ "'-' - -r^-~- ~~ ~ ~~~~~•+~ ~-.av~uvi ~a~ fIGyCJ VI if IC same $IZe)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
A . _ _ _ . __._ __ _ _ _ _ w
FILE NUMBER
21-10-00686
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 THE DEED OR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET °~ OF DECD'S
INTEREST
( EAPPLICABNE)
IF
TAXABLE
VALUE
1 Edward Jones Annuity -account #896-06694-1-7 53,172.65 53,172.65
2 PNC Bank -IRA account #65001016733 7.576.12 7,576.12
3 PNC Bank -IRA account #75300033908 4,994.38 4,994.38
TOTAL (Also enter on Line 7, Recapitulation) I 65,743.15
(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+ (10-05)
,HH~ EN L,~
COM INHE~ITA~~~E~TgX RET~RNVANIA
RE IDEN DECEDEN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Sowerbrower, Robert E.
FILE NUMBER
21-10-00686
ITEM
NUMBE
A.
FUNERAL EXPENSES:
- -- -- ----__.........~~ .,.. „~.,...~ ~caa v~ ~ ~7W ICUUIG ~.
DESCRIPTION
See continuation schedule(s) attached
AMOUNT
3,383.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s) Commission paid
2. Attorney's Fees Wm. D. Schrack III Esq. 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zin
Relationship of Claimant to Decedent
4. Probate Fees
335.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1,756.24
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 10 474.74
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
Sowerbrower, Robert E. 21-10-00686
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex eta nses
1 Parthemore Funeral Home
2,438.00
2 Rolling Green Cemetery -grave opening 945.00
H-A 3,383.00
Other Administrative Cos S
3 Brown, Schultz, Sheridan, Fritz -final bill to account for services rendered
410.00
4 Brown, Schultz, Sheridan, Fritz -phone calls and correspondence with IRS concerning 2008 565.00
Federal Income Tax filing
5 Clerk of Orphans' Court -Fiduciary Release filing fee
5.00
6 Cumberland Law Journal -estate advertisement
75.00
7 Miscellaneous expenses incurred during period of administration (postage, faxes,
photocopies, etc.) 25.00
8 Patriot News -estate advertisement
141.24
9 Register of wills -Inheritance Tax Return filing fee
15.00
10 Reserve for future administrative expense
500.00
11 Sovereign Bank -processing fee for date of death account balances
20.00
H-B7 1,756.24
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
CO MMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sowerbrower, Robert E. 21-10-00686
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Bethany Skilled Nursing -debt of decedent (final bill for care) 5,757.90
2 Brown, Schultz, Sheridan, Fritz -CPA expenses for IRS research and correspondence 975
00
regarding 2008 tax filing error .
3 Continuing Care RX -debt of decedent
417.26
4 Continuing Care RX -debt of decedent (final prescription bill)
284.79
5 Lung, Asthma & Sleep Associates -debt of decedent
27.24
6 Patriot News -debt of decedent (final bill)
17.00
7 United States Treasury -payment of tax due to IRS from 2008 Income Tax fili
ng 408.14
TOTAL (Also enter on Line 10, Recapitulation) I 7,887.33
(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)
COM INHE~ITANT~EOF~ R~Tj~RN ANIA
RE IDEN DE ED N I
SCHEDULE J
BENEFICIARIES
ESTATE OF
Sowerbrower, Robert E.
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.211
Debra A. Shook
201 Martel Circle
Dillsburg, PA 17019
FILE NUMBER
21-10-00686
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
DECEDENT (Words)
($$$)
Daughter entire residuary
estate
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 o~easheet as a Io riate.
II• NON-TAXABLE DISTRIBUTIONS:
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)
~ttst rll ttx~ ~CCES#zatnent
OF
ROBERT E. SOWERBROWER
BE IT REMEMBERED, that I, ROBERT E. SOWERBROWER, presently of 5225 Z~V.ils~:n
Lane, Room 231, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind,
memory and understanding, do make, publish and declare this as and for my Last Will and
Testament, hereby revoking and making null and void any and all Wills and Testaments and
writings in the nature thereof by me at any time heretofore made.
ITEM 1: I direct that my hereinafter named Executrix pay all my just debts, my
funeral expenses, and the expenses of the administration of my estate. With this direction, I
authorize and empower my Executrix to expend for my funeral expenses and interment such
amounts as may be considered necessary and proper, without regard to any limit that may be
prescribed by a court of law.
ITEM 2: I direct my Executrix to pay all inheritance, estate, succession, and legacy
taxes of whatsoever nature and kind, to which my estate, or the transfer of any property passing
hereunder or otherwise passing by reason of my demise, may be subject, and to charge such
taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either
federal or state, on any property required to be included in my gross estate, under the provisions
of any state or federal law now in force or hereafter enacted, shall be prorated among the
persons interested in my estate to whom such property is or may be transferred or to whom any
benefit accrues.
ITEM 3: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which I have
a power of appointment, I give, devise and bequeath unto my daughter, DEBRA A. SHOOK,
provided she survives me for a period of thirty (30) days.
ITEM 4: I nominate, constitute and appoint my daughter, DEBRA A. SHOOK, as
Executrix of this my Last Will and Testament.
ITEM 5: I direct that my hereinbefore named Executrix shall not be required to
give bond for the faithful performance of duties in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set m hand and seal this n
Y ~ , ~ day of
,.---y .
~~ , 2008.
'~
,~lr sw~~-t:-~, ~s ~..,~:.~:~..~r;~:.::
- ~~.
ROBERT E. SOWERBROWER
The preceding instrument, consisting of this and two (2) other typewritten pages, was
on the day and date thereof signed, sealed, published, and declared by the Testator herein
Page -2-
named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his
presence and in the presence of each other, have subscribed our names as witnesses hereto.
~ A
Page -3-
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF YORK
We, R//~l OWF~$ROWER, --
and ~/ Gu/V~/~/~--~
ri
the Testator and the
witnesses, respectively, whose names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testator signed and
executed the instrument as his Last Will and Testament, and that he signed willingly, and that
he executed it as his free and voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the Testator signed the Will as witnesses, and that
to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older,
of sound mind, and under no constraint or undue influence.
SWORN TO AND SUBSCRIBED
BEFO ME THIS ~~ ~ DAY
OFw~~~i~i l'Jl/L_ 2008.
NOTARY PU$~.IC
COMMONWEALTH Off' PENNSYLVANIA
Notaria Seal
Janet S. Gore, Notary Pt~lic
Dillsburg Boro, York County
My C.nmmission Expires Od 25, 2010
F.d~m•`.~•;~r. Penns;rlvania Rssociatlon of Notsrles
ROBERT E. SOWERBROWER
,-
;~ ;
ji
r'
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•
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~ .. w..~ 4 , ! I ~~
ti 1
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J ~„~.. r+' .,
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pug. 26. 2010 2.21 PM
d/
PNC BANK 412-705-2747
1 PNC
~acnrst~t~war
August 26, 2010
William D Scgrack III, Esq,
124 W Harrisburg St
P OBox310
Dillsburg, PA 17019-0310
RE: Robert Sowerbrower
SSN: 196-18-2600
DOD: 06-26-2010
V
No. 8756 P. 1/2
Dear Mr. Scgrack:
Yn response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Checking Account .
Account # 5005808175 Established: 09-12-2008
ROBERT SOWERBROWER
DOD balance: ~ 6,735.54 non interest bearing
Account # 5140198103 Established: 06-01-1967
ROBERT SOWERBROWER
CLA.RA E SOWERBROWER
DOD balance: $14.89 non interest bearing
IRA Account
Account # 65001016733 Established: 03-10-1995
• ROBERT SOWERBROWER
DOD balance: $ 7,558.37 + 17.75 accrued interest
Interest paid O 1-01-20] 0 thru 06-26-2010 $ 198.76 YTD
Account # 75300033908 Established: 10-03-2006
ROBERT SOWERBROWER
DOD balance: $ 4,992.42 + 1.96 accrued interest
Interest paid 01-0 l -2010 thru 06-26-2010 $ 11. S4 Y1'D
For beneficiary infozxnation,,please call 1-888-762-4727.
e~~f-/~,DU~~
p~.,o 1 ..f 7
r Sovereign Bank
ESTATE OF Robert E. Sowerbrower
SOCIAL SECURITY #: 196-18-2600
DATE OF DEATH: June 26, 2010
Account #: 0571113052 Type: Checking Open date: 2/18/1998
In the name of: Robert E Sowerbrower or Clara E Sowerbrower
Date of Death Balance: $56.57
Int.(YTD) from 1 /1 /2010 to 6/26/2010 $0.00
Accrued interest to date of death:
$0.00
Other Info: Account closed on 07/09/10.
Account #: 1200235134 Type: Checking Open date: 8/26/2008
In the name of: Robert E Sowerbrower
Date of Death Balance: $978.36
Int.(YTD) from 1/1/2010 to 6/25/2010 $0.06
Accrued interest to date of death: $0.00
Other Info: Account closed on 07/23/10.
~.
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~~ug. 26. 2010 2: 21 PM PNC BANK 412-705-2747
~/
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~ ~Di~l~ ?~E V~AY
August 26, 2010
William D Scgrack IIT, Esq,
124 W Harrisburg St
POBox310
Dillsburg, PA 17019-0310
RE: Robert Sowerbrower
SSN: 196-18-2600
DOD: 06-26-2010
Dear Mr. Scgrack:
No. 8756 P. 1/2
Yn response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Checking Account
Account # 5005808175 Established: 09=12-2008
ROBERT SOWERBROWER
DOD balance: $ 6,735.54 non interest bearing
Account # 5140198103 ~ Established: 06-01-1967
ROBERT SOWERBROWER
~~ CLARA E SOWERBROWER
DOD balance: $14.89 non interest bearing
IRA A,ccoutit
Account # 65001016733 Established: 03-10-1995
ROBERT SOWERBROWER 4
DOD balance: $ 7,558.37 + 17.75 accrued interest
Interest paid O 1-01-2010 thru 06-26-2010 $ 195.76 YTD
Account # 75300033908 Established: 10-03-2006
ROBERT SOWERBROWER
DOD balance: $ 4,992.42 + 1.96 accrued interest
Interest paid 01-01-2010 thru 06-26-2010 $ 11.84 YTD
For beneficiary inforruation,,piease call 1-888-762-4727,
U~no 1 ..f 7