HomeMy WebLinkAbout06-23-11f
- 1 1505610140
~~1 REV-1500 ~` (°'-'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po sox 28oso1 INHERITANCE TAX RETURN
Harrisburg, PA 17128-O8D1
RESIDENT DECEDENT 2 1 1 1 0 4 6 8
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth r~IDDYYYY
2 0 0 2 2 5 4 8 1 0 4 0 3 2 0 1 1 0 1 0 3 1 9 2 9
Decedent's Last Name Suffer Decedent's First Name MI
E M L E T B E R N I C E A
(If Applicable) Enter Surviving Spouse's InfonmaUon 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 Retum ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
poor to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Lkigation Proceeds Received ~ -10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
R O G E R B- I R W I N 7 1 7 2 4 9 2 3 5 3
REGISTER OF WILLS USE ONLY
First line of address
6 0 W E S T P O M F R E T S T R E E T ,
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Second line of address r
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C A R L I S L E P A 1 7 0 1 3 ~`
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Correspondent's e-mail address:
Under penaMies oT perJury, I dedare that 1 have examined this return, inGuding acx;omparrying schedules and statements, and to fhe best of my knowledge and belief,
it is true, correct and complete. Dedaretion Of preparer other than the personal representative Is based on all information Of which
preparerhas any knowledge.
TORE Q~'P~E~R~SON~REy~ONSIBLE FOR FILING
n~~"7!~/ _ Y~l,//J /iJ~ri RETURN BATE
G//~S~ii
698 BALTIMORE PIKE GARDNERS PA 17324
SIGNATU¢ Oq ~ PREPARE~OTH~AN REPRESENTATIVE y p ~~//
60 WEST ~-0MFRET STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140 J
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REV-ty500 EX Page 3
Decedents Complete Address:
File Number
21 11 0468
DECEDENTS NAME
BERNICE A. EMLET
STREET ADDRESS
801 N. HANOVER STREET
cITY
CARLISLE srarE
PA zIP
17013
Tax Payments and Credits:
t • Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
e. Discount 1,083.80
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
FIII In oval on Page 2, Llne 20 to request a refund.
(1) 21,675.90
Total Credits (A + s) (2) 1,083.80
(3)
(4) 0.00
5. It Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 20, 592.10
Make check payable to: REGISTER OF WILLS, AGENT
~:`.a,~~,a,.ik'[ ir~t6rarL»j'rr,~~&~~I.I~I~~~~l~3~i~~~~a~~~i~I~r~~.IkN~,`~~~~'~~~~?~a~i~1~~~~~~~~~~~l~~i~~~i~Ilia~r~~u~itE~,k~E'. -~~ I~Is~~~~~~'ra~a~~+91zi,~~~
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 ................................................................................................ ^
d. receive the promise for Iffe of either payments, benefits or care? ....................................................... ^
2. If death occurced after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^
3. Did decedent own an "intrust for" or payable-upon~eath bank account or security at his or her death? ......... ^
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.
. ,. .. r~r. ` . " , . ..
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
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 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 benefiaary.
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 benefiaaries 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)]. Asibling is defined, unde
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-B8)
COA~NAONWEALTH OF PENNSYLVANIA
INHERRANCE TAX RETURN
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NU9IBER
BERNICE A. EMLET 21 11 0468
Include ihe~ of 19fgatlon end th dale th'e proceeds vrem receMad by the e~le.
119 propeAy -owned w9h d8ht of survivo ahb moat be ditdoeed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC BANK -CERTIFICATE OF DEPOSIT #31300352569 70,567.76
2. PNC BANK -CHECKING ACCOUNT #5140192043 6,559.30
3. PNC BANK -SAVINGS ACCOUNT #5112936658 27,035.74
TOTAL (Also enter on line 5, RecapiWlatlon) ~ _
(H more space is needed, Insert additional sheMS of 9re same s(ae)
REV-1510 EX+ (06.09)
Pennsylvania
DEPARTMENT OF REVENUE
INNEWTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
I:if r wi t ut FILE NUMBER
BERNICE A. EMLET 21 11 0468
This scAedule must be completed and lged g the a1ua~ to any of ques0ons 1 Ouough 4 on page Ihree of the REV-1500 b yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
a10.U0ETF~NIAEOFTHEiRM,iMeRFIB~1710N5FiPT00EC~ENfMID
TfE0ATE0FiRA!@FBi.ATUCNACOPYOFTHED~FORttEAL~TAiE
DATE OF DEATH
VALUE OF ASSET
%OFDECD'S
INTEREST
EXCLUSION
p~~wuc~aq
TAXABLE
VALUE
1. OHIO NATIONAL FINANCIAL SERVICES 72,982.18 100.00 72,982.18
ANNUITY CONTRACT S1809398
2. PNC INVESTMENT SERVICES 5,052.10 100.00 5,052.10
ALLSTATE ADVANTAGE PLUS ANNUITY
CONTRACT #GA0584861
3. PNC INVESTMENT SERVICES 10,123.40 100.00 10,123.40
NEW YORK LIFE INSURANCE ANNUITY
CONTRACT #53053672
BENEFICIARY ON ALL ANNUITIES:
DORIS M. BREAM
TOTAL (Also enter on Line 7, Recapitulation) ~ f 88 157.68
If more space is needed, use additional sheets of paper of the same s¢e.
REV-1511 EX+(~0-09)
• Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESII>ENT oEC~oENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
BERNICE A. EMLET 21 11 0468
Derxderd'a debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B.
1
2.
3.
4.
ADMINISTRATIVE COSTS:
Personal Represent~ve Commissions:
Name(s) of Personal Representasve(s)
Street Address
CIY
Year(s) Commission Paid:
State ZIP
AtBomeyFees: IRWIN & McKNIGHT, P.C.
Famiy Exemplbn: (If decedents address fs not the same as Gaimanl's, atl~h explanatbn.)
Clabrlant
Street Address
City State ZIP
Reletlarehip of Claimant to Decedent
ProbeteFees: REGISTER OF WILLS
5. Accountant Fees:
6. TaxRehrmPreparerFees: PATRICIAA. ROSENDALE, CPA
FIDUCIARY TAX PREPARATION
7. REGISTER OF WILLS -FILING FEE
8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE
9. THE SENTINEL -ESTATE NOTICE
10,750.00
182.50
375.00
30.00
75.00
187.54
TOTAL (Also enter On Une 9, RecapilulaUon) I ~ . , inn ,,.
If more space is needed, use additional sheets of paper of the same size.
REV-1512 Ex+ (12-08)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESI~NT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, ~ LIENS
ESTATE OF FILE NUNI~R
BERNICE A. EMLET 21 11 0468
Report debts incurred by the deosdent prbr m death that remained unpaid at the date of death, intdudbg unreimbursed medkal azpensKa.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
CONTINUING CARE RX -MEDICAL
2. (THREE SPRINGS FAMILY PRACTICE -MEDICAL
25.95
62.00
TOTAL (Also enter on Line 10, Recapitulation) I >;
If more space is rreeded, insert additbnal sheets of the same size.
REV-1513 EXi (01-70)
pennsylvania ~ SCHEDULE J
DEPARTMENT OF REVENUE I BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
BERNICE A. EMLET
21 11 0468
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Indude outs' ht spousal distributions and transfers under
Sec. 91 i6 (a) (1.2).]
1. DORIS M. BREAM Sibling 180,632.49
698 BALTIMORE PIKE REMAINDER
GARDNERS, PA 17324
KENNETH O. EMLET DIED IN 2007
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, A5 APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S
If more space is needed, use additional sheets of paper of the same size.
~i~st dill anD ~rstxau~~t
I, BERNICE A. SOWERS, of South Middleton Township,
Cumberland County, Pennsylvania, declare this instrument to be my
last will and testament, hereby expressly revoking all wills and
codicils heretofore made by me.
1. I direct my executrix to pay all of my debts, funeral
and administrative expenses as soon as may be done conveniently
after my decease.
2. I authorize and empower my executrix to sell any realty
owned by me at my death and not specifically devised or
bequeathed herein, at either public or private sale, and to give
good and sufficient deeds therefor, in fee simple, as I could do
if living.
3. I give, devise and bequeath all of my estate of every
nature and wherever situate as follows:
(a) As long as Kenneth 0. Emlet remains unmarried
and living alone and desires to live in my home, and actually
does so, he shall have the right to live there and use contents
therein. As long as he does live in my home, he shall pay all
the expenses incident thereto for upkeep, utilities, insurance
and taxes, and
(b) All the rest, residue and remainder of my estate,
I give to Doris M. Bream, and if she is not living at the time of
my death, to her children, share and share alike, the child or
. F.
children of any deceased child taking the share their parent
would have taken if living.
4. I nominate and appoint Doris M. Bream to be the
executrix of this my last will and testament; she is to serve as
such without bond. Should she die before my death, renounce or
refuse to serve for any reason, or die leaving any of my estate
unadministered, I nominate and appoint Tammy S. Eads, as
substitute executrix, also to serve as such without bond, with
the same powers as are given herein to my executrix.
5. I hereby suggest that my personal representative retain
the services of Irwin, Irwin & McKnight, as attorneys in the
settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this Sep day of Narch, 1990.
,,,~„~~w~-f SEAL)
Signed, sealed, published and declared by Bernice A. Sowers,
the testatrix above named, as and for her last will and
testament, in the presence of us, who at her request, in her
presence and in the presence of each other have subscribed our
names as witnesses hereto.
~~ Il~~
~~~~~
AGKNOWLED6EMENT AND AFF-IDAV~IT
WE, BERNICE A. SOWERS, BETZI A. MORRI50N and SHARON L.
SCHWALM, the testatrix and witnesses respectively, whose names
are signed to the foregoing instrument, being first duly sworn,
do hereby declare to the undersigned authority that the testatrix
signed and executed the instrument as her Last Will and that she
had signed willingly, and that she executed it as her free and
voluntary act for the purpose herein expressed, and that each of
the witnesses, in their presence and hearing of the testatrix,
signed the Will as a witness and that to the best of their
knowledge the testatrix was, at that time, eighteen years of age
or older, of sound mind and under no constraint or undue
influence.
COMMONWEALTH OF PENNSYLVANIA:
. ss:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by
BERNICE A. SOWERS, the testatrix, and subscribed and sworn to
before me by BETZI A. MORRISON and SHARON L. SCHWALM,
witnesses, this '~~ day of March, 1990.
~~~ ~. ~ . .
ROGER B. IRININ, NOTARY PUBLIC
AF~ISLB BOROUGH, CU1~IiLAND COUNT
MY COMMI8510N ExPIRES OCT. 9,1982
M9n1bC. Pa'pr'td~~ ~:... s;; , ~3' . ~ a! Ma~~es
I. v. J I / I I . II
U~
~~
LfAOW6 THE WAY
May 2, 2011
Irwin & McKnight PC
Roger B Irwin Esquire
'West Pomfret Professional Bldg
60 West Pomfret $traet
Carlisle, PA 17013-3222
RE: Bernice A Emlct
SSN: 200-ZZ-5481
DOD: D4/03/2011
Dear Mr. Irwin:
In response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Cert~cate of Deposit
Account # 31300352569 ~ Established: 08/05/2010
BERNICE ~A EMLET
DOD balance: $ 70,497.41 + 70.35 accrued interest
Iatex~est paid 01/01/2011 thru 04/02/2011- 5210.60
Checluag Account
.Accowat # 5140192043 ~ Bstablished: 04/01/1963
BERNICE EMLBT
DOD balance: S 6,55928 + 0.02 accrued interest
Interestpaid Ol/Ol/ZOl 1 thru 04/03/20411- S1.19
Ssviags Aeconat
Account # 5112936658 Established: 12!21/2007
BERI`1ICE A EMLET
DOD balance: $ 27,024.46 + 11.28 accrued interest
Interest paid 01/01/2011 tbru 04/03/2011- $34.46
Im+estsaeat Account
The decedent maintained Invostment Accotmt #30089302. For ftuther informatloq you may call the
Brokerage Departonent at 1-800-762-6111.
Pace l of 2
- - -- ._ _,,,.,. ..c ~v~ ci~i pu. 7171 f. L/c
' Please aotr that this o$ice provides date of death balances for deposit accounts (IRAs, CDs, Checlattg and
Savings). VYe do-not proceaa any Snxnclal transactbne or pravWe spit~seob. 1f you need assistance with
am- of those hems, please Dell I-888-PNC-BA,NIC (1-888-762-2263) or strop by your local PNC Bank branch
oboe.
Sincerely; •~
National Financial Services Ceder
PNC Bank, N.A.
Member•FDIC ~ •
This message is intended for the use of the iruliviatatal or amity to• which tl is addressed and may
contain i~ormation that.is privileged; tor~itkntial and exempt from disclosure .under applicable law.
If the reader of this message is not the intended recipient or the employee or agsnt responsible for
aelitiering this message to the intended recipient, you are hereby natsf'ed that arty dissemination
distribution or copying of this communications i9 strictly prohibited If y~au have received this
communicatio» in error, please notify m@ immediately by reply or by telephone m 800-762-1775 and
immediately destroy this faxed document.
Pave ~ of
-a- -
• ~
~'~ItF'Yirdam.
Annuitant: EMI.ET, BERNICE
fixed Annuity Conhaet S1s09398
Status: ACTIVE
All data if as of 04/01/11 Or ttN date shown,
r-.....rye. rnfe.
~~W4~Y~'Y~ (i'
Foundation Plua
Plan Type Non-Qualified
Contrail Issue Data 04/02/2007
Issue ~ -- - -- - --
~ Total Purdtaae Payment -78._ -
:62,195.01 ~S"ppQ _ _ ` _ -- - _ _. - -- --
Surrender Value X69,006.38 (Rider, contract d>'arges and taxes not deducted, ff aPPlicatde.)
Nurainq Home Beneffi: Yes
Blinn Ifero
Billing does not apply. No Premiums due.
Values
' Values as of 04/D4/2011
General Account Accumulated Value Value Allocation Percentage
Fixed Account #72,982.18 100.0096
Total Value s72,982':18~
Notes
TOTAL PREMIUMS PAID ON CONTRACT $62195.01
rransactlon Date ~ Dollar Amount's ~ Transaction Type
There are no trensactbrel for the transaction type and/or date range selected.
• The Dollar Amount does not reflect the taxes, charge, and Pees, IP any. Please dkk "show Details' to obtain the
Net Amourx.
Anmdla~ / flue / 0~....~ •~~~~u~~
Annuitant - --_- --- Owner Payor
Name EMLET,BERNICE EMLET,BERNICE EMLET,BERNICE
Address 698 BALTIMORE PIKE
GARDNERS, PA 17324
i • 698 BALTIMORE PIKE
GARDNERS, PA 17324
4. .898 BALTIMORE PIKE
GARDNERS, PA 17324
Tax ID ;**_~'*-5481 ***_*'_5481
Date of
Birth 01/03/1929
Gender FEMALE
I
Beneficiary DORIS BREAM ~~ ~~ O
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Info
Agency Name Reproserrtative Name
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