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Home My WebLink About08-29-11 1505610105 REV-1500 EX (o2- ii) (FI) PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 UEPI1NlMENI OFNEYENIIF County Code Year File Number INHERITANCE TAX RETURN -- - - Harrisbur , PA 1'7128-0601 RESIDENT DECEDENT ~~ C~ ~~~ ENTER DECEDENT INFORMATION BELOW - - Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 171-62-1166 10/03/2009 ' 07/17/1981 Decedent's Last Name Suffix Decedent's First Name MI oswer _. Mrs Kristin _ _ _ M _ __ _ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Bowser _ _ _ _ Mr. Christopher Spouse's Social Security Number __ 197-58-8401 THIS RETURN MUST BE FILED 1N DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return ~'j 2. Supplemental Return O 3. Remainder Return (Date of Death O 4. Limited Estate O Prior to 12-13-$2) 4a. Future Interest Compromise (date of O :i. Federal Estate Tax Retum Required death after 12-12-82) O 6. Decedent Died Testate O (Attach Copy of Will) 7. Decedent Maintained a Living Trust F3. Total Number of Safe Deposit Boxes (Attach Copy of Trust.) ~ 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0 Name : __ Daytime Telephone Number Robert F. Claraval '1 a~3 0 . ~ ~~.~ REGISTER ~ S USE ON4Y "~~~~ ~ ~ ~._ T) = ~~ _ - e. First Line of Address _ ~ _: .. 500 North 3rd Street ~,~? ~ t ~' ~-~ ;~~ `~- - -: ' Second Line of Address . ~ r} =r~ _ -, ,- ~ r City or Post Office ... State ZIP Code e.. ~ { - DATE FILED ~ . J .. Harrisburg _ __ ~ pa -17101 Correspondent's a-mail address: rfclaw@comcast.net 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 ue correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. URE O RS RESPO E F FI IN TURN DATE 08/23/2011 ADDRESS 129 uth 17th Street Camp Hill, P 17011 SI ATU E PR TH THAN R ESENTATIVE DATE A ss 08/23/2001 500 North 3rd Street, Harrisbu , Pa 17101 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 150561 0105 J 1505610205 REV-1500 EX (FI) Decedent's Social Security yumber .........._........ __ Decedent's Name: :171-62-1166 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 and Notes Receivable (Schedule D) .................. . ........ 4, ' 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5, 20 000.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property - - - - - (Schedule G) O Separate Billing Requested........ 7, 8. Total Gross Assets (total Lines 1 through 7) ........................... . . g, 20,000.00 9. Funeral Expenses and Administrative Costs (Schedule H) .................. . 9. 15,015.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .............. . 10. 11. Total Deductions (total Lines 9 and 10) .. .............................. . 11. 15,015.00 12. Net Value of Estate (Line 8 minus Line 11) . 13. ..... . ....................... Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. __ 4,985.00 an election to tax has not been made (Schedule J) ................. . ...... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 4,985.00 TAX CALCULATION -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 .o_. 4,985.00 ' 15 ... 16. Amount of Line 14 taxable -- - - . 0.00 at lineal rate X .0._ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 _ __ _ 18. 19. TAX DUE...... 19 _ 000 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610205 1,505610205 O J REV 1500 EX (FI) Page 3 File Number Decedent's Complete Address: Kristin M. Bowser STREET ADDRESS 129 South 17th Street CITY -- _._-------------._._.._...._..--------_._._.__._._._..._..._....----___------ ................._.___ --- __ __ Harrisburg _...._.__ _......_.._..___..---____-- ~ STATE ~ ZIP pa I 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + ~) (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) 0.00 Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIAT E 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 ................. ........................................................................ .............................. ....... . d. receive the promise for life of either payments, benefits or cares 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ......................................................................................... .... ^ ^ 3. Did decedent own an "in trust for" or payable-upon-death 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 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for tf•le 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(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)j. Asibling 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-i5o8 EX+ (li-io) ~ ` ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY Kristin M. Bowser PILE NUMBER: 21-09-0967 Include the proceeds of litigation and the date the proceeds were received by the estate. All property iointly owned with r~aht ~f ~.~....;...,..~ti:., .......a ~.,. ~:__~___~ _ __ . . _ -• •••-•~ .,r~~~ ~~ ,.~~~~.,, ~~~ auui~wria~ sneers or paper or the same size. REV-1511 EX+ (10-09) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kristin M. Bowser ITEM SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS -----~ FILE NUMBER 2109-0967 Decedent's debts must be reported on Schedule I. A• FUNERAL EXPENSES: "~~'''uri1uN 1. AMOUNT - ... . =Goble - Garrick Funeral Home Dubois, Pa B. 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year{s) Commission Pald: State __~ ZIP -. ~ ~., ~~. =~v..,.,, 2• Attorney Fees: . - . 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation. ) ~~ s~~~~ Claimant ~x,~ Street Address - - City --- ---- State ZIp _ Relationship of Claimant to Decedent _ 4• Probate Fees: ,~ S. Accountant Fees: 90.00 , _ ~~ •r ~:. ~~.,..:~~ __~, 6• Tax Return Preparer Fees: ~ ` " _ {~• .. .., _:., . ,~,L 7. .. ._. .. Claraval and Claraval 20°~ allocated to Survival Claim .. - s, $ _,. ..,._,. _ _. iDauphin County Registe of ~Ils Filing Fee 4,440.00 ~' ,. _. , :_k _ ~ ..: ~.__ .. _ ... .... .. .. ,Litigation Costs 20% allocated to Survival Claim .. ~. 30.00 . ~ ~, x . r _ _ ... __.. .~ 35 1.00 ~. . , .....~. _i ~_.... - _. . ._ _ _ __ _ .. . , . _.._ ...... ...._ .. _ ._. _~~- .~.. r.~r,.... . ...~......... r _,.~.... ... ............ ..-v... ... s t........... ..:.r....,... .. ~.........., ...........~...+~+..i. .. ......:...:... ............ .....,..Y... +... . .::.,..... ....... . .. .y ..~ 8:.:. . TOTAL (Also enter on Line 9. Recanir~~~~t~.-.,~ If more space is needed, use additlonal sheets of paper of the same size. ' 15,015.00 REV-1513 EX+ (01-10} ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: II __~ SCHEDULE ,7 BENEFICIARIES Kristin M. Bowser NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).j 1 __ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: REi,ATIONSHIP TO DECEDENT Oo Not Llst Trustee(s) ---__- FILE NUMBER: 2109-0967 AMOUNT OR SHARE OF ESTATE ,~ ._ -- -~ -~~; __,___.._...~._ ___._._....w..._.,wx..: " OTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 aF RFV-~ Snn rnvc~ ~~~.-~ If more space is needed, use additional sheets of paper of the same size. --•--.1- ~`~"""~" ""~'~~"~~ ROBERT F. CLARAVAL MARY ANN KENNEDY CLARAVAL Cla~aval & Claraval Attorneys at Law 500 NORTH THIRD STREET, 2"d FLOOR HARRISBURG, PA 17101 www. claravallaw. com TELEPHONE (717) 233-4780 FAX (717) 233-5830 August 25, 2011 Register of W;11~ Office Cumberland County Courthouse 1 Courthouse Square, Room 102 Carlisle, PA 17013 Re: Estate of Kristin Michele Federici Bowser No. 21-09-0967 LOUIS ). ADLER (1959-1999) ADLER &CLARAVAL (1974-2000) C"7 - /.'.~ .... - _,'~ ~ 4 {{'~). ~ 'V y ~ .' ~.;. i • t fy. 4 __ ~ + - r ~,. Dear Register of Wills: The Inheritance Tax Return was mailed to you for filing on July 19, 2011 and depicted an accurate account of the Estate. Later, we learned that inadvertently Schedule E had not been included. Upon calling your office I learned that we were to re-file the return and pay a $15 filing fee. Thus, I enclose a new Revenue 1500 form along with Schedules E, H and J. I also enclosed m check for $15 for the filing fee. Kindly advise if there is anything else I need to do. y Thank you for your attention to this matter. Sincerely, ROBERT F. CLARAVAL RFC:diw Enclosure (tax return, check, envelope) to 0 o = Z ~- J ~O W~~ A ~=~A ~~m ~ D~N~ V rn rn `J oZ~ ~o ~ ~ T C 7C7 {~(' ~•.( (~/ ~~.t. t f~ fAttf ~{ ~. + ~~ ^ lV ~ ( j ~ r ~.~ J ~ ~Q ti, ~ ~ ~: sf r0 ~+ n ch- ~ ti. ti ~ ~ :., ~. '~ o a . r A „'~ `'+J 1~ r ~ ~, ~ r~ ~~ v ~ 01 ~~ ,~~ ~ o ~~ ti o O ~ N ~ :.. ~Yr~ ~{~yfj~J~ f _IAf} ~ 11.J! I ~!F w f ~, ~ i+ V - .y~~~d~0 ,. s,~.t ~ i ~ _.' +.. ,r"~_ '~,''J~~V :;L~ :<< :... :i~ ~, U' ~ x~ i a ((S=S4tt ,^ 7N;7 ~ ,li.~ i .._ ,, . ~~.,..~.-.q... _ ,._, ___ _~_ .n,..,,,,,~;, •:~r~~' ~ ~ yy r .r' T ~y-` 1 i~r ~~ . ~`Y.~ ~' t a o i° UN/Tcb r=- O ~ ornv ~ ; , ` ~~ ~v ~~ ~ 3N ~y ~~ N -p D I oNOz m cr D .e ;oO~o o .-° 'p n~i -' -~ o w