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Home My WebLink About07-21-1115D561D143 REV-1504 EX (01-10) ~ LiJ 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 0865 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 191 42 8073 03 06 2005 03 17 1955 Decedent's Last Name Suffix Decedent's First Name MI MICKEY ELIZABETH A (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 INAPPROPRIATE OVALS BELOW X^ 1, Original Return ^ 2, Supplemental Return ~ g. 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) (~ 6 Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ~ g. Total Number of Safe Deposit Boxes g, Litigation Proceeds Received ^ 10• between l2 31 9~andtl(datges~f death ~ 11 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 KEVIN D DOLAN ESQ (717)367 1370 First line of address 222 S MARKET STREET SUI Second line of address PO BOX 267 City or Post Office State ZIP Code ELIZABETHTOWN PA 17022 Correspondent's a-mail address: kdolan@gskdlaw.com ,.__ _~. REGISTEt'~~"~7"ILLS USE ONLY, ; ~- :~ -~^ ~__ ~ ~ f ..~1 ~ ~J ~ r`._ ~ .7 ti J~~ µ~ ~ f`.7 ..~ -~ ~._ D DATE FILED `''~ 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 claration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATU E N RESPQNSI E FOR FILING RETURN DATE Britt M. O erman ~ a / ADDRE 36 Eas i h Street Elizabethtown PA 17022 SIGNAT RE ER THAN REPRESENTATIVE p Kevin D. Dolan Esq. ?~~~/ 222 S. Market Street, Suite 201, Elizabethtown, PA Side 1 15D561D143 15D561D143 ,J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Mickey, Elizabeth Ann :191 42 8073 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. 10 , 916.11 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous I~ao; Probate Property arate Billing Requested Se 7 ............ p (Schedule G) ^ . 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 10 , 916.11 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 13 , 2 $ 7 . 7 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 13 , 2 5 7 . ? 5 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. -2 , 341.64 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. -2 , 341.64 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0.00 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 0. 0 0 16. x. 0 0 at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 ~ . 0 ~ . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 ~• ~ ~ . at collateral rate X .15 . 19. Tax Due .................................................................................................................. 19. 0 . 0 ~ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0865 DECEDENT'S NAME Mickey, Elizabeth Ann STREET ADDRESS 1153 Brockon Circle CITY New Cumberland STATE_ PA ZIP 17070 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. (1) Total Credits (A + B) (2) (3) (4) (5) 0.00 0.00 ~.~~ Make Check Payable to: REGISTER OF WILLS, AGENT. _ a 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? .................................................................................................................... ^ 0 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. v .. 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+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Mickey, Elizabeth Ann 21-10-0865 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-1151 EX+ (10-06) COMMNHERITANCEDTAX RET~RN ANIA RESIDENT DECEDEN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mickey, Elizabeth Ann 21-10-0865 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N M R A, FUNERAL EXPENSES: Matinchek and Daughter Funeral Home & Cremation Services, Inc. 7,263.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio _ Yearlsl Commission paid 2. Attorney's Fees Kevin D. Dolan, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) ~` Claimant Britt M. Opperman & Ariel Mickey Street Address 36 East High Street, Apt. 101 city Elizabethtown state PA zio 17022 Relationship of Claimant to Decedent daughter s **Britt M. Oppettr~n, age 18 at deol~nt's death, arrl., Ariel Mikey, age 14 at 4. ro a e Fees~'~' both resl~ ~'~-~ deoed,~t at 1153 Btrockcn Circle, New (~xr~berl.and, PA. , 17070, an N1~ch 6, x005. 5. Accountant's Fees 6. Tax Return Preparer's Fees 750.00 3,500.00 86.50 7. Other Administrative Costs 1,658.25 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 13,257.75 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 Mickey, Elizabeth Ann 21-10-0865 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Register of Wills, Short Certificate and copies of filed documents. 4.50 2 Weigle 8~ Associates, P.C., estate attorney fees from 2006. 1,653.75 HI-B7 1,658.25 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+(~~-08) SCHEDULE J COM INOHERITANCE~ ~ RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Mickev. Elizabeth Ann 21-10-0865 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Ariel Mickey *~ Daughter 112 of residue 36 E. High Street Apt. 101 Elizabethtown, PA 17022 2 Britt M Opperman ~' ~ Daughter 1/2 of residue 36 East High Street Apt. 101 Elizabethtown, PA 17022 ** Please note beneficiaries were ages 14 and 18 on the date of decedent's death. 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. 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) Q Mt~TBank 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302)934-2955 May 25, 2011 Ginrich, Smith, Klingensmith & Dolan 222 South Market Street Suite 201 Elizabethtown, PA 17022 Re: Estate of Elizabeth Mickey Social Security: 191-42-8073 Date of Death: March 06, 2005 Dear Sir or Madam: Per your inquiry on February 24, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type of Account Checking Account 2 Account Number 66586240 Ownership (Names of) Eli: abeth A Mickey Opening Date 11/10/97 Balance on Date of Death $91 S.OS Accrued Interest $ .00 Total $91 S.OS Type of Account Checking Account Account Number 62622668 Ownership (Names o, fl Elizabeth A Mickey (Signatory Micke~~s Insurance Se~~~ices (Organization) Opening Date 01/16/98 Balance orz Date of Death $10, 001.06 Accrued Interest $ .00 Total $10, 001.06 For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the Paxton Street Office at#717-255-2240. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, Tammy Spencer Adjustment Services Matinchek and Daughter Funeral Home and Cremation Services, Inc. 260 East Main Street, Middletown, PA 17057 Paula J. Matinchek, Supervisor Frank E. Matinchek, F D. TO: ~,.~ ~c.r;~~i z~ F 1~i1~.i.°i~~ .i ~.~~.~ 1ld~.~C~,T~i~.~*' ~{ L~.iic`. , t`.~c.i!"~'i5~32.1~"~ , $.'~. For the Funeral Expenses of Ml~~'ch ~ , ~'~I'i~ , CASKET AS SELECTED PROFESSIONAL SERVICES INCLUDING EMBALMING AND PREPARATION, REMOVAL, USE OF EQUIPMENT, ASSISTAN'T'S AND ALL SERVICES IN THE ARRANGING, CARE AND DIRE(~ - TTON OF FUNERAL. ~:, ~ C,~t,~, ~ VAULT .. _~ r ~~ TOTAL ~ ~~-~~ ~~ ~a5~~.~1D CASH DISBURSEMENTS For your convenience we have advanced cash for the following: GRAVE OPENING } F FLOWERS NEWSPAPERS ~'AT. ~(~Ci T''~J. ~7~ $ ~4~ ~3~ CLOTHING ~ ~ ~~ ~~-, CLERGYMAN .~ ~.°~E; ~C~ HEARSE ~ I15 ~G AUTOS TENT, LOWERING DEVICE AND GREENS ,~. ., ~_, COPIES OF DEATH CERTIFICATE -s 0 ~~ ~; ~ . ~, ~ ~ ~ ~'~ MEMORIAL FOLDERS, REGISTER BOOKLET, ACK. CARDS 9v ~I3 ORGANIST ~ l~t~ ~~ HAIRDRESSER ~yrvi.~ .{'s.'~~~r~~ ~ ~ ~Ll ~~ TOTAL CASH DISBURSEL- ~ ` ~ ~ ~3 0U ~; ~ ~~~ ; ~ All Cash Disbursement items NET 30 days, ,/ f /~ ~~J ~~ An annual interest rate of 12 percent per an- / ~~"~~"~' num on any part of the account after 90 days. ~~ ~ ~' D a ~~~ ~ ~- " ~~~~/ ~ ~r ~ r ;fl~ /'~~~ /~ ~~~~ ,.~~~ . :~ ~- t..~. WEIGL~, ~ A_ SS'~GIATES', P. ~`. ~ ~~ :' ~ - f~ Attorneys-at-Law ~~ 1Z6 East King Street Shippensburg, PA 17257-1397 Phone: (717) 532-7388 Fax: (717) .532-5289 Elizabeth Ann Mickel; Estate l~ra.y 10, ?006 c1~ Dolula F. Intrieri Britt Opperman 2404 S~~uth 5th Street 2404 South 5th Street Steelton, P.A 17113 Steelton, PA 17113 File #: 10191 Inv #: 7260 Total Fees & Disbursements .a~.~~~ Previous Balance $1,653.75 Previous Payments ~=- ~ 0.00 _.._~.~, ~~ Balance Due Now .a1~VJJ. i ~ r, x: ~~ PAYMENT IS DUE UPON RECEIPT OF THIS BILL. P]~E MAKE CHECK PAYABLE TO "WEIGLE & ASSOCIATES, P.C.". A VISA OR MASTERCARD MAY BE USED TO MAKE PAYMENT. WE THANK YOU FOR YOUR CONFIDENCE PLACED IN OUR FIRM. A billing fee often dollars ($10.00) per monthly statement ~~vill be cry :urged after thirty (3 0) days. c~ 9 ~€'I ~ ' S r . WEIGLE ~ ASSOCIA TES, P. C. `~ ~~"' ~~ s~ . _ ___ ___ u._:~ - _ Attorneys-at-Law -- --- -- ~ , , - --- ~- ~ *~ 126 East King Street ~ ~, `' }~-~ Shippensburg, PA 17257-1397 .-- - Phone:(717) 532-7388 Fax:(717) 532--5289 Elizabeth Ann Mickey Estate c/o Donna F. Intrieri 2404 South 5th Street Steelton, PA 17113 DATE DESCRIPTION HOURS Dec-10-OS Call to Donna regarding life insurance issues 0.25 Dec-21-OS Review letter from MetLife -prepare letter to 0.25 MetLife -prepare letter to clients Dec-27-OS Review letter from New England Life - 0.00 prepare letter to clients Jan-06-06 Review correspondence from New England 0.50 Life -call to Donna -letter to Donna, Britt Totals 1.00 Total Fees & Disbursements Previous Payments Previous Balance January 12, 2006 File #: Inv #: 10191 6957 AMOUNT 33.75 33.75 0.00 67.50 .D1JJ.VV ~p1JJ.VV $1,518.75 $0.00 Balance Due Now $1,653.75 Invoice #: PAYMENT IS DUE UPON RECEIPT OF THIS BILL. PLEASE MAKE CHECK PAYABLE TO "WEIGLE & ASSOCIATES, P.C.". A VISA OR MASTERCARD MAYBE USED TO MAKE PAYMENT. WE THANK YOU :FOR YOUR CONFIDENCE PLACED IN OUR FIRM. A billing fee often dollars ($10.00) per monthly statement will be charged after thirty (30) days. WEIGLE ~ AS'SOCIA TES', P. C: Attorneys-at-Law 126 East King Street Shippensburg, PA 17257-1397 Phone:(717) 532-7388 Fax:(717) 532-5289 Elizabeth Ann Mickey Estate c/o Donna F. Intrieri 2404 South Sth Street Steelton, PA 17113 ~~ ~ ~ ti , i ';~°; ~' December 12, 2005 File #: 10191 Inv #: 6885 DATE DESCRIPTION ~IOURS AMOUNT Apr-04-05 Several calls -prepare petition for Letters of 1.25 168.75 Administration, Estate Information Sheet and Renunciations Apr-OS-OS Several calls -finalize documents 0.50 67.50 Apr-11-0 S Returned Donna's call (no charge) 0.25 0.00 Apr-12-OS Call from Donna Intrieri (no charge} 0.25 0.00 Apr-14-OS Calls from Donna Intriei -work on letter to 0.50 67.50 Brian Carey Apr-15-OS Several calls (no charge) 0.25 0.00 Apr-20-OS Call to Donna Intrieri 0.25 33.75 Apr-22-OS Cali to Donna Intrieri (no charge} 0.25 0.00 May-10-05 Call from Donna regarding life insurance -call 0.50 67.50 to Jerry Wahn of MetLife May-11-05 Work on life insurance application -call to 0.50 67.50 Donna -letter to Donna May-16-OS Prepare IRS form SS-4 and Authorization to 0.25 33.75 obtain taxpayer ID# May-17-OS Calls to and from Donna regarding opening 0.50 67.50 estate, TRAC claim May-18-OS Prepare letter to Gerald Waln 0.25 33.75 May-19-OS Call to Donna regarding New England life 0.25 33.75 policy Sun-21-OS Call from Donna Intrieri regarding MetLife; 0.50 67.50 review letter from MetLife; call to MetLife Invoice #: Jun-22-0~ Call from Charles O'Neill of Metlife; call to 0.50 67.50 Donna Intrieri Jun-27-OS Call to Charles O'Neill of Met Life; call to 0.25 33.75 Donna Intri eri Jul-07-05 Call from Donna regarding Metlife 0.25 33.75 Aug-04-OS Call to Donna regarding life insurance 0.25 3 3.75 Sep-07-OS Call to Donna -call to Metlife -review fax 0.75 101.25 from Donna -prepare letter to Metlife Sep-09-OS Call to New England Life -call to Donna - 0.25 33.75 prepare letter to New England Life Sep-13-OS Prepare letter to New England Life 0.25 33.75 Sep-20-OS Research life insurance issues (no charge) 0.2 ~ 0.00 Sep-22-OS Call to New England Life -call to client 0.25 33.75 Sep-26-OS Review letter from New England Life - 0.25 33.75 prepare letter to Donna Nov-30-OS Call to Metlife; Review New England Life 1.25 168.75 materials forwarded by Donna; Call to Donna Dec-02-OS Prepare letter to Metlife; Prepare letter to 1.00 135.00 New England Life; Call to Donna Dec-06-OS Two calls from Donna regarding Metlife 0.75 101.25 P011Cy Totals 12.50 $1,518.75 Total Fees & Disbursements P~ evi ous Payments Previous Balance tiDl,J10. /J $0.00 $0.00 Balance Due Now $1,518.75