HomeMy WebLinkAbout08-30-11J 1505610143
REV-1500 EX (01-10)~it
PA Department of Revenue ~•~J OFFICIAL USE ONLY
Pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
Po Box.28oso~ INHERITANCE TAX RETURN 21 11 0664
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
172 O1 1405 05 28 2011 07 26 1915
Decedent's Last Name Suffix Decedent's First Name
MI
HUBER JR HENRY S
(tf 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
1. Original Return ^ 2. Supplemental Return ^
3. Remainder Return (date of death
^
4
Limited Estate
F prior to 12-13-82)
. ^ qa
uture Interest Compromise
(date of death after 12-12-82)
^ 5. Federal Estate Tax Return Re uired
q
g. Decedent Died Testate
(Attach Copy of Will)
^ ~ Decedent Mainta'ned a Living Trust
(Attach Copy of llrust) ~-
3. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received ~ 1 p. Sppousal P ventY Credit (date of death
b9tween 12-31 ~J1 and T-1-95)
^ •I 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
N
ame :
Daytime Telephone Number
MA RK C DUFFIE 717 761 4540
First line of address
301 SET STREET
Second line of address
City or Post Office
LEMOYNE
State ZIP Code
PA 17043
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REGISTER OF~NI`ILLS USE O[~fLY
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Correspondent's a-mail address: mcd~jdsw.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.
SIG TORE OF PERSON RESPONSIBLE OR FILING RETURN
.. 1/1/1_ _ ~ .- DATE
ADDRESS
/~.
523 Ninth Street New mberland PA 1
SIGNATURE OF P~EPA~ER OTHE HAN EPRESENTATIVE
AnnaMae B Springer
/ iaC !/f r
/ DAT
Mark C Duffie ~ 2~; ~~
ADDRESS
301 Market Street, Lemoyne, PA
Side 1
1505610143
1505610143
%~1
J 15U5610243
REV-1500 EX
Decedent's Social Security Number
DecedenYsName: HUBER, Henry S Jr 172 O1 1405
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 8 Notes Receivable (Schedule D) ........................................................ 4.
5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 90 , 182.92
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6,
7. Inter-Vivos Transfers & Miscellaneous -Probate Property
(Schedule G) ~ S
eparate Billing Requested............
7~
8,770.14
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 98 , 953.0 6
9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... 9. 10 , 3 4 0. 7 5
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. 10. 4 , 555.48
11. Total Deductions (total Lines 9 8~ 10) ................................................................... 11 14 , $ 9 6 . 2 3
12. Net Value of Estate (Line 8 minus Line 11) .........................
.................................
12. $ 4
0 5 6
8 3
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. 8 4 , 0 5 6. 8 3
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. 0 . 0 0
16. Amount of Line 14 taxable
at linealrateX .045 84, 056.83 16. 3, 782.56
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. 3, 782.56
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
L 1505610243 1505610243 J
Rev-1508 EX+ (8.88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
HU
FILE NUMBER
Hen S Jr 21-11-0664
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right ofsurvivorship must be disclosedon schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 M8T Bank Certificate of Deposit Account No. 31003914495659
10,000.00
2 M&T Bank Certificate of Deposit Account No. 31003914568696
3,576.54
3 MSzT Bank Personal Checking Account No. 44534558
75,556.72
4 Aetna Insurance proceeds -Return of Insurance Premium
132.84
5 Liberty Mutual Insurance -Return of Premium
87.00
6 Parthemore Funeral Home -Reimbursement of overpayment
490.71
7 The Woods at Cedar Run -Refund on Account
339.11
TOTAL (Also enter on Line 5, Recapitulation) I 90,182.92
(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 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
HUBER, Henry S Jr FILE NUMBER
21-11-0664
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 DESCRIPTION OF PROPERTY
NUMBER THE DATE OF TROANSFER SATTACIiTA COPY OF TIRE DEIED ~OREREAL ESTATE. VALUE OF A SET % OF DECD'S CIF APPLICABNE) TAXABLE
INTEREST VALUE
1 Mg<T Bank Pension Plan Account No. 35004110093842 8,770.14
- Beneficiary: James H. Huber, Son 8,770.14
TOTAL (Also enter on Line 7, Recapitulation)
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
8,770.14
Form PA-1500 Schedule G (Rev. 6-98)
REV-1151 EX+ (10-06)
COM IN~E~WIT ENT ~EC DEN~RLVANIA
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
TESTATE OF
HUBER, Henry S Jr
FILE NUMBER
21-11-e66d
Debts of decedent must be reported on Schedule I.
ITEM
N R DESCRIPTION
A. FUNERAL EXPENSES:
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
AnnaMae B Sprinsaler
AMOUNT
city New Cumberland state PA zip 17070
Year(s) Commission oaid 4,600.00
Street Address 523 Ninth Street
2. Attorney's Fees Johnson Duffie Stewart & Weidner 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State _
Zio
Relationship of Claimant to Decedent
4. ~ Probate Fees
265.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
475.25
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 10,340.75
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
HUBER, Henry S Jr FILE NUMBER
21-11-0664
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative ost~
1 Cumberland County Register of Wills Office -Filing Fees for Inheritance Tax Return and
Inventory 30.00
2 MST Bank -Benefits Package Service Charge
2.00
3 Reserves: Additional Miscellaneous Estate Costs and Expenses
200.00
4 The Cumberland Law Journal -Notice of Estate Administration
75.00
5 The Patriot News Co. -Notice of Estate Administration
151.10
6 The Patriot News Co. -Obituary
17.15
H-B7 475.25
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-08)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
HUBER, Henrv S Jr
FILE NUMBER
21-11-~6Rd
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 AnnaMae Springer - Power of Attorney Fees and Expenses
2,500.00
2 Checks Clearing After Date of Death
1,842.84
3 Internists of Central PA
22.73
4 MST Bank Certificate of Deposit Account No. 31003914495659 -Interest Adjustment
0.68
5 Pinnacle Health
13.36
6 Quantum Imaging
2.16
7 Verizon -Final Invoice
7.40
8 West Shore EMS -Ambulance Services
166.31
TOTAL (Also enter on Line 10, Recapitulation) I 4,555.48
(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 IN(~~AENT D CED~N~RNANIA
ESTATE OF
HUBER, Hen S Jr
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)1
1 James H Huber
1060 Lisa Court
Springfield, OH 45504
FILE NUMBER
21-11-0664
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
DECEDENT (Words)
($$$)
Son
Entire Estate
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 ovOeasheet, as a I riate.
II• NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T,AX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
SCHEDULE J
BENEFICIARIES
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)
ESTATE OF HENR Y S. HUBER, JR.
SCHEDULE OF EXHIBITS
EXHIBIT A
EXHIBIT B
EXHIBIT F
Last Will and Testament for Henry S. Huber., Jr. signed and dated
May 20, 2011
MST Bank Statements for value ofAccounts ~zt Date of Death
Mc~T Computer Statement for Pension Account
457061
STATEMENT PERIOD ~ PAGE
MAY.20-JUN.17,2011 3 OF 4
HENRY S HUBER JR
REGULAR TIME DEPOSIT ~~~!~!`~'~:~~: HENRY s HUBER JR
ACCOUNT NO. ~ 31003914495659 CURRENT INTEREST RATE 1.240%
MATURITY DATE 03-30-12 HIGHLAND PARK
ACCOUNT ACTIVITY
05-20-11 BEGINNING BALANCE
05-27-11 INTEREST PAYMENT
05-27-11 INTEREST TRANSFER OUT
ENDING BALANCE
510,000.00
10.20
10.20 ~ 10,000.00
510,000.00
** END OF STATEMENT **
L008A (S/07) , ~ ~ ~ ~ ~a~ ~ ;«~~
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HENRY S HUBER JR
ACCOUNT ACTIVITY
:::::;::: ~:::::::: ~ ::::::::::::: R~ R~RS~T~ a:~N
1,477.00 73,932.99
0.59 73,933.58
S73,933.58
3918 05-23-11 29.00 3920* 05-23-11 132.84 3921 05-31-11
3924* 06-01-11 1,710.00
. ANNUAL PERCENTAGE YIELD EARNED = 0.00
COULD YOU OR SOMEONE YOU KNOW USE ADDITIONAL RETIREMENT INCOME? M8T CAN HELP.
WHETHER IT'S FOR DAY-TO-DAY LIVING EXPENSES OR TO ENJOY A BETTER LIFESTYLE, HOME
OWNERS AGE 62 AND OVER CAN CONVERT A PORTION OF THEIR HOME EQUITY INTO CASH WITH
AN M8T REVERSE MORTGAGE.
TO LEARN MORE CALL 1-888-253-0712, OR VISIT WWW.MTBREVERSEMORTGAGE.COM
132.84
REGULAR TIME DEPOSIT ::::A1!i~:::::- HENRY S HUGER JR
:~~ ::7:I:T:~:~::::::::::::
ACCOUNT N0. 31003914568696 CURRENT INTEREST RATE 0.750%
MATURITY DATE 06-10-12 HIGHLAND PARK
ACCOUNT ACTIVITY
05-20-11 BEGINNING BALANCE
06-10-11 INTEREST PAYMENT GENERATED
ENDING.BALANCE
i~oa~ t~!o7)" :~ =.
...
:<::~:~:~:~<:`s:`:`.>'~i~~:;:~:::>::::D~;P~S~~'S;~;~N~~RF~~:::;~FI!.QRA~IA~ES~i'~i~ 0!THER DAILY
::::::::~::::::< :.:: ....:.~. &~::OTH~~i ~~ADDZ'1'~ONS' ....... SUBTRACTIONS .: ; :: : BALANC E
53,574.26
2.28 3,576.54
$3,5765~r
y__. .~.
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f STATEI"tEN i F ERIOI? : , . PAGE';
MAY.20-•JUN.17,2011 1 OF 4
00 0 06118M NM I17
- 12132 ~'~
HENRY S HUBER JR ~~ ~
C/0 THE WOODS AT CEDAR RUN ~f'~~ ~ •
824 LISBURN RD ,~ ,t L
APT 311 ~,,~~~°`'~ ~'~
~ ,.,,--"°"''
CAMP HILL PA 17011
. ......
:: ;:
ACCOUNT ACCOUNT INTEREST EARNED MATURITY ENDING
TYPE: NUMBER YEAR-TO-DATE DATE BALANCE
M>!iT SELECT UITH INTEREST 000000044534558 3.90
REGULAR TIME: DEPQ3IT 031003914568696 73,933.58
REGULAR TIMfi DEPO-SIT 12.25 06-10-12 3,576.54*
031003914495659 56.76 03-30-12 10,000.00*
TOTAL DEPOSITS
• 87,510.12
* IN-'EREST EARNED IS INCLUDED IN YOUR TIME DEPOSIT ENDING BALANCE
ONLY IF IT HAS BEEN PAID TO YOUR ACCOUNT.
~~~:
N1~3cT S~;LECT WITH INTEREST ArCI!lT:;;: HENRY S HUBER JR
~'::::~I:tt:~:::;:::;::::
ACCOUNT N0. 44534558 PAXTON STREET OFFICE
INTEREST EAF',NED FQ3t STATEMENT PERIOD 0.59
.
......
~sa~r
~
.
.
........:..........:....:................•....
....:
.::•::.:.::.:.:.:.:..
:.,.......:•:BALANCE ~ ~ ~ .:....•..•.•...:: ~ ::~::~:~OT •..:.:.::_:~
,_ HERS::ADDTZONS.......,.•. ...:.:.:....,.:...:.:.......... .....:....
:::::~:.:•:•:~:•:.> .:.............:.•.~ :,::::•.::.~:;..:....::.;:::
.....•....,.,...,..CHECKS.~•:~'AID ....::.
N0. AMOUNT N0. AMOUNT
75,742_51 3 1,698.11 4 2,004.68
ARY
...,....:.
:~:~::~:~T11~~R`<:~:~:~ ::.:::::::::::::::::::::~:.:
.........................~4R T~:~:::::~: ,:::::::,:;::::::
.•.~ •.•.•.SU~'E`RACTIONS~: .•.• :::Ii+IT:E:REST: Pd? ...~:::~:::::::BA[:~ANCE`~~~:::::::::::
N0. AMOUNT
3 .1,502.95 0.59 73,933.58
ACCOUNT ACTIVITY
.,.,..~AtEs .................. ;: ,. >;: ;: > <•::~:< .:... ,.,..: ,.........:..,..........,....,...:.:...~i'QS~TS a:~N~~R~S:T.
... ~TwAwSAC~~ow:::~~SCw~~'~~oN .....:: .,.....:
.:.::&:::O~H~I~:~:Aflb:~`~ONS: ::::;::::GH~~K;~<`~?a~TH~ :::;::
............. ~.....,
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` :<:>:~:::;:.::::::::::; ~ . ~.. ; : ;:«::::;:::
....,......,..,..... ~a:~~:w:.:.:.;:.:.:.:.-.~
. •
...... SU$
.k:~{1C'I`~~NS::::::~•~: ~ :.:::::::::::::::::$Ai:A1~1C:~::::::~:~:::::~
05-20-11 BEGINNING BALANCE .
05-23-11 CHECt~ NUMBER 3918 $75,742.51
05-23-11 CHECK NUMBER 3920 29.00
05-23-11 VERI?ON AR: CHECK PYMT 000000000003919 132.84
05-31-11 TRANSFER F!i0M ACCT 031003914495659 23.45 75,556.72
05-31-11 CHECIt: NUMBER 3921 10.20
06-O1-11 RETI~'EMENT PENSION 132.84 75,434.08
06-O1-11 CHECY NUMBC:R 3924 210.91
06-03-11 US TREASUR"' 303 XXSOC SEC 1,710.00 73,934.99
06-06-11 BENEI=ITS PI~.CKAG 8002512311 1,477.00
75,411.99
~- 2.00 75,409.99
L008A (6/07)
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Page: 1 Document Name: untitled
SIFT 1 THE TRANSACTION STMT FORMAT 11/05/17 14.23.17
STSMc - CO 96 OP EBRN MS 50852 ACTION COMPLETE
ACTION COID
PROD CODE REA ACCT 35004110093842 SHORT NAME HUBER JR HENRY S
CURR CODE PAGE 3 SEARCH FROM 106/10/02 TH:RU 111/04/04
ACTN POST EFFECTIVE CHECK NUMBER TRAN AMOUNT D/C BALANCE
TRACE ID DESCRIPTION
04/04 04/02/11 22.07 C 8,770.14
I-GEN111040200004109 INTEREST PAYMENT GENERATED
04/04 04/02/11 8,770.14 C 8,770.14
CDSGN111040400004731 *RENEWED AT 0.50%, MATURES ON 10/0.?/12
00009,6 i! -'
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~ I Manufacturers and Traders Trust Comparry ~
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DATE DECEMBER 15 2010
~~~
00455
HENRY S HUBER JR
-- APT 311
824 LISBURN RD
CAMP HILL PA 17011
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Dear M&T Retirement Customer:
Attached is your distribution er 000053802 in the amount of $ ~*~~***1,138,.~1 from your
i
Retirement Account numb 35004110093842. ) ,
Distribution Amount $ *~~~~**1,138.21
Withholding Amount $ *****~****~0.00 -
+'__ Net Check {Below) $ *******1,138.21 ~`~
- ~ ~~ ~
Thank you for banking with M&T Bank.
Sincerely, ~ ~
M&T Bank ~ ;' Member FDIC
REMINDER TO RETIREMENT CUSTOMERS RECEIVING PERIODIC DISTRIBUTIONS:
If federal income taxes are being withheld from the distribution payments you are receiving from your retirement plan and 'you do not wish to have taxes withheld or you
would like to change the amount of withholding going forward, please notify your Bank Office to change your withholding election.
If federal income taxes are not being withheld from the distribution payments you are receiving because you have elected not to have withholding apply, and if you wish to
change that election and have federal income taxes withheld from your distribution going forward, please notify your Bank Office to change your withholding election.
Please note that if you elect not to have withholding apply to your distribution payments, or if you do not have enough federal income tax withheld from your distribution,
you may be responsible for payment of estimated tax and you may incur penalties if your income tax withholding and estimated tax payments are not sufficient.
....
Date: 5/17/2011 Time: 2:23:48 PM