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Home My WebLink About09-26-11J 1505610140 REV-1500 ~` (°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO Box 280801 INHERITANCE TAX RETURN County Code Year File Number Harrisburg, PA 171280601 RESIDENT DECEDENT 2 1 1 1 03~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth tuMADDYYYY 0 6 2 6 8 2 2 0 9 0 2 0 6 2 0 1 1 0 9 2 1 1 9 8 3 Decedent's Last Name Suffer Decedent's First Name MI Z I E R E R J E N N I F E R M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS Q 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of pnorto 12-13-82) ^ 5. Federal Estate Tax Retum Required ^ 8. Decedent Died Testate ^ death after t2-12-82) 7. Decedent Maintained a Living Trust 8. Total Number of Safe DepoaR Boxes (Attach Copy of Will) (Attach Copy of Trust) ^ 9. Litigation 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 CONFIDENTUL TAX INFORMATION SHOULD BE DNtECTED T0: Name Daytime Telephone Number W I L L I A M A D U N C A N 7 1 7 ~~ 9 '~= 7 8 01~ First line of address 1 I R V I N E Second line of address City or POSt Office C A R L I S L E State ZIP Code P A 1 7 0 1 3 i-n - ~. ; ~ N ~ -~,: ~~~~ ~ r , ~~~ ^'a „~;_ ~ , $~ =~ ~%~; i...'. DATE FILED Correspondents a-matt address: b i 11 d u n c a n a~ D a• n e t Under penalties of perjury. I dedare tt~at I have examined this resrm, induding accornpanyhrp schedules and atatarnents, and to the beat of my knowledge and belief, his tore, awred and complem. Daclaredon of preparer other than the personal r~pree~rd$tlve it t~ on all Infonnaaon of whk;h preparer has arty knowledoe. ,,,,,,1 ~_ ' ° f ADDRESS L 214 BOEHMLER ROAD SPARROW BUSH NY 12780 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE ADDRES PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 R 0 W ~~ ~~ ~~ 1505610240 REV-1500 EX oecedenrsName: JENNIFER M• ZIERER Decedents Social Security Number 0 8 2 6 8 2 2 0 9 RECAPITULATION 1. Real Estate (Schedub A) ....................................... .... 1. 2. Stocks and Bonds (Schedub B) .................................. .... 2. 3. Closely Hekf Corporation, Partnership or Sob-Proprbtorship (Schedub C) . .... 3. 4. Mortgages and Notes Receivabb (Schedule D) ...................... .... 4. , 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedub E)... .... 5. 2 0 3 0 1 . 7 5 6. Jointly Owned Property (Schedub F) ^ Separate Billing Requested ... .... 8. , 7. Inter-Vivos Transfers 8 Miscellaneous N Probate Property ~ (Schedub G) Separate Billing Requested ... .... 7. , 8. Total Gross Assets (total Lines 1 through 7) ....................... .... 8. 2 0 3 0 1, 7 5 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .... 9. 1 5 4 8. 6 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) .......... .. . 10. , 11. Total Deductlons (total Lines 9 and 10) ............................ ... 11. 1 5 4 8 . 6 0 12. Net Value of Estate (Line 8 minus Line 11) ......................... ... 12. 1 8 7 5 3. 1 5 13. Charitabb and Governmental Bequeats/Sec 9113 Trusts for which an ebction to tax has not been made (Schedule J) ................... ... 13. , 14. Net Value Subject to Tax (Line 12 minus Line 13) . ........... ... ..... .. 14. 1 b 7 5 3. 1 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATE8 15. Amount of Line 14 taxabb at the spousal tax rate, or transfers under Sec. 9118 (a)(1.z) x.o _ 0. 0 0 15. D. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 8 7 5 3. 1 5 ig, 8 4 3. 8 9 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 D 17. 0. 0 0 18. Amount of Line 14 taxabb at collateral rate X .15 D. 0 0 18. D. 0 0 19. TAX DUE ......................................................19. 8 4 3. 8 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505610240 1505610240 REV-1500 EX Pape 3 Decedent's Complete Address: Flla Numbe- 21 11 0 DECEDENTS NAME JENNIFER M• ZIERER STREET ADDRESS 702 HANOVER MANOR, APT- 8107 CITY CARLISLE STATE PA Ztp 17013 Tax Payments and Credits: 1 • Tax Due (Page 2, Line 19) 2. CreditslPaymerlts A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater Thar) Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIN in oval on Page 2, Line 20 fA request a mfund. 5. If Line 1 +Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 843.89 Total Credits (A + B) (2) 0.0 0 (3) (4) 0.0 0 (5) 843.89 y~j Make check payable to REGISTER OF WILLS AGENT xa ~.. r. ,~ ~ 5;5 "}E i, rt %tis t ~Y 1"55 ~.i ~t ,~y. r g {~~ ~y t' a .>~ v, ~-',. r :'ir ... ~ :~~' ~ i .Y' .1. ,.. ,. ,ler, ~~e ?''~r. ,f:~'wc~'"', .rri~ ;EI~~'-.,~;~a.. ~,i ~ ~~~"~Sy~~~553 ~. ~,QG~ ,.~L'S n ~'~' , ~ _, 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 I'rfe of either payments, benefits or care? .............................................. ......... ^ 2. If death occurred after December 12,1982, did decadent transfer property within one year of death without receiving adequate consideration? ............................................................................... ........ ^ 3. Did decedent own an "intrust far or pay~le-upon~eath 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 osntains a beneficiary designation? .......................................................................................... ........ ^ ^ EWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. HE AN n1 ~7 1 ,¢ :: i ~, ..3 T..1". ~ii~ ~ a {t t tfM to ~;f } xva, ti"?+i ~~ ~:. : .I.. "!~' " 'SP31 « ~~~r; urn' ~ r t era "~.; , j M x A ~' 3~~ x~• S ~cF3~~ ~ -Sped,. 31~,f'e~I.l7$.3~. ...:n Y4~ :~„F.~ik'... .. 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 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 discbsure of assets and filing a fax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The fax 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 decedenCs 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 decedenCs siblings is 12 percent p2 P.S. §9116(a)(1.3)]. 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-1508 EX + (8-98) COMAAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN scaEOV~E E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER JENNIFER M• ZIERER 21 11 0 Include Cle pp of Ntipation and the date the proceeds were received by the estate. ~ PrePMY k~~ wkh M of turrMonhip moat be diaelosed on tichaduM F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. MEMBERS FIRST FEDERAL CREDIT UNION 1,234.24 CHECKING ACCT• x 2183297825 [DATE OF DEATH LETTER ATTACHED] 2• MEMBERS FIRST FEDERAL CREDIT UNION 13,176.59 SAVINGS ACCT• x 329782-00 [DATE OF DEATH LETTER ATTACHED] 3• 2004 TOYOTA COROLLA 5,855.OD CSEE KELLEY'S BLUE BOOK VALUATION ATTACHED] 4. SPRINT REFUND 35.92 TOTAL (Also enter on line 5, Recapitulation) I t (If more space is needed. insert additlonal wheels of Ure same size) REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS rat RUMBtR JENNIFER M- ZIERER 21 11 0 DecedsM's debts must bs reported on Schedub I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commbsbn Paid: State ZIP 2. AtbmeyFees: DUNCAN 8 HARTMAN, PC 3. Famiy Exemption: (If deoedenCs address is not the same as cblmanCs, adach explanation.) Claimant 4. Street Address C5y State ZIP Relationship of Claimant to gecedent PnlbataFees: REGISTER OF WILLS 5 Aooountant Fees: 6. Tax Retum Preparer Fees: ~. 8• 9- 10• CUMBERLAND LAW JOURNAL- LEGAL NOTICE THE SENTINEL - LEGAL AD FILING FEE HELD IN RESERVE TOTAL (Also enter on Line 9, Recapitulation) ~ ; If mae space is needed, use additional streets of paper of the same size. 1,000.00 132.50 75.00 176.10 15.00 150-00 ,~•ro• REV-1513 EX+ (07-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JENNIFER M• ZIERER 21 11 0 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 pncp,de rn,trioM spalsal dbtribuuona and transfers user Sec. 91 6 a) 1.2).] ~. LAUREN L- LAUFENBERG Lineal 214 BOEHMLER ROAD 1001 SPARROW BUSH, NY 12780 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. 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. SCHEDULE) BENEFICIARIES TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I f ff more space Is needed, use additional sheets of paper of the same size. SAM1/INGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner MEMBERS 1# FHDHRAL CRI~1T UNION 329782-00 05/13/2008 $13,176.14 $.45 $13,176.59 NONE 329782-11 05/13/2008 $1,234.24 $0.00 $1,234.24 NONE MEMBERS 1s/T~FEDERALyC~RE~DIT~ UNION Lam'` ~~""'v Leigh- nne Stallings Lending Insurance Support Specialist June 10, 2011 Eatsts of Jenniihr M. Zierer Date of Death: 02/06/2011 Social Security Number: 082-68-2209 5000 Louise Drive P.O. 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