HomeMy WebLinkAbout11-18-111505610140
REV-1500 ~` ~°'~'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 2 1 1 1 0 9 3 4
Harrisbum, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW
5 7 8 3 2 5 0 1 0 0 8 2 0 2 0 1 1 0 1 2 5 1 9 2 2
Decedent's Last Name Suffix Decedent's First Name MI
E I C H H O R N M A R Y E
{!f Appllcabte) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffuc 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
® 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior 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
(AKach Copy of Wiil) (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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
H U B E R T X G I L R O Y E S Q 7 1 7 2 4 3 3 3 4 1
First line of address
M A R T S O N L A W O F F I C E S
Second line of address
1 0 E H I G H S T
City or Post Office
C A R L I S L E
State ZIP Code
REGl37E~F WILLS t!S tINLY
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T~ FILED ~"
P A 1 7 0 1 3
Correspondent's e-mail address: H G I L R O Y a M A R T S O N L A W• C O M
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Under penalties of perjury, I deGare 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.
~STU OF P S~SP IBL FO FILING RETURN i j j~' ~/ /1
ADDRESS
408 GLENN AVENUE _ BOILING SPRINGS PA 17007
1D E HIGH STREET
L 1505610140
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140
-~~
J~
1505610240
REV-1500 EX
Decedent's Social Security Number
Deoedenrs Name: MARY E• E I C H H O R N 5 7 8 3 2 5 0 1 0
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 1. 0 . 0 0
2. Stocks and Bonds (Schedule B) ...................................... 2. 5 3 6 7 3. 2 8
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. 3 2 3 8 7 2. 2 3
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 0 • 0 0
7. Inter-Vivos Transfers & Miscellaneous NQp;Probate Property
(Schedule G) U S
t
Bill
0
0
0
epara
e
ing Requested ....... 7. .
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 3 7 7 5 4 5. 5 1
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 2 6 4 6 2. 1 8
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 2 8 0 2 . 7 1
11. Total Deductions (total Lines 9 and 10) ............................... 11. 2 9 2 6 4 . 8 9
12. Net Value of Estate (Line 8 minus Line 11) ........................... . 12. 3 4 8 2 8 0. 6 2
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has~ot been made (Schedule J) ...................... 13. 0 . 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) ............. . ........ 14. 3 4 8 2 8 0. 6 2
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 _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 3 4 8 2 8 0. 6 2 1s. 1 5 6 7 2. 6 3
17. Amount of Line 14 taxable
at sibling rate X .1 Z 0. 0 0 17. Q. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18. 0. D 0
19. TAX DUE ...................................................... 19. 1 5 6 7 2• 6 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505610240 1505610240
REV-15U0 EX Page 3
Decedent's Complete Address:
File Number
2l 11 0934
DECEDENTS NAME
M E. Eichhorn
STREET ADDRESS
1 Lon sdorf Wa
CITY
Cazlisle STATE
PA ZIP
17015
Tax Payments and Credits:
1. Tax Due {Page 2, Line 19)
2. CreditslPayments
A. Prior Payments
B. Discount 783.63
3. interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fi111n oval on Page 2, Une 20 to request a refund.
5. If Line 1 +Une 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 15,672.63
Total Credits (A + B) (2) 783.63
(3)
(4) 0.00
(5) 14,889.00
Make check payable to: REGISTER OF WILLS, AGENT
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 life of either payments, benefits or care? ............................................. .......... ^
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration7 ............................................................................. .......... ^
3. Did decedent own an "in trust for' orpayable-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 benefiaary 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)J.
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 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)j.
• 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-1503 EX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY E. EICHHORN 21 11 0934
All property Jointly-0wned with right of survivorship must be discbsed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 781.952 shares, Franklin Templeton PA Tax Free Income CL-A; Acct No. 22915267 8,202.68
See attached
2. 942.887 shares, T. Rowe Price Spectrum Growth Fd., Inc. 14,793.90
See attached
3. 1122.455 shares, PPL Corp. 30,676.70.
See attached
TOTAL (Also enter on line 2, Recapitulation) ~ S
pf more space is needed, insert additional sheets of the same size)
REV-1508 EX + (8-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
IN RES DENT DECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
MARY E. EICHHORN 21 11 0934
Include the roceeds of IitlgaNon and the date the proceeds were reoelved by the estate,
All property ~olntly-owned with right of survh-onhip must be discbaed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M&T Bank checking 2673010977 22,989.79
($22,898.34 + $.45 interest)
See attached
2. M&T Bank savings 15004217594660 9,197.67
($9,197.46 + $.21 interest)
See attached
3. M&T Bank savings 15004224231867 34,416.98
($35,416.98 + $0.00 interest)
See attached
4. Metro Bank CD 1101170 25,726.44
($25,705.70 + $20.74)
See attached
5. Orrstown Bank CD 4000018093 96,961.80
($96,957.57 + $.03 interest)
See attached
6. Member's 1st savings 192461-00 193.69
$193.66 + $.03
See attached
7. Member's 1st CD 192461-50 23,010.02
$22,995.78 + $14.24 interest)
See attached
8. Member's 1st CD 192461-40 42,395.02
($42378.47 + $16.55)
See attached
9. Member's 1st Investment savings 192461-OS 126.82
($126.81 +$,O1)
See attached
10. 5 Series EE US Savings Bonds 67,344.00
See attached
11. Cumberland Crossings, refund 1,510.00
TOTAL (Also enter on line 5, Recapitulation) ~ Z
(If more space B needed, insert additional sheets of the same size)
REV-1511 EX+ (10-09)
pennsyivania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF ram nvmo~n
MARY E. EICHHORN 21 11 0934
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home, Carlisle, PA 10,051.58
2 Carlisle Memorial Services, Inc., gravemazker 878.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commbsion Paid:
2. Attorney Fees: Martson Law Offices 15,075.00
3, Family Exemption: (If decedents address is not the same as daimanCs, attach explanation.)
Claimant
Street Address
Cfty State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Cumberland County Register of Wills 389.50
5 Accountant Fees:
6. Tax Re1um Preparer Fees:
7. Filing Fee, Inheritance Tax Return 15.00
8. EVP stock valuation 3.10
9. Additional probate fee 50.00
TOTAL (Also enter on Line 9, Recapitulation) I S
18
If more space is needed, use additional sheets of paper of the same size.
REV-1512 FJ(+ (12-08)
pennsy{vania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, ~ LIENS
ESTATE t3F FILE NUMBER
MARY E. EICHHORN 21 11 0934
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Cumberland Crossings, account payable 755.00
2. Continuing Caze RX, account payable
3. ~ Betra In Home Care, account payable
TOTAL (Also enter on Line 10, Recapitulation) I S
If more space is needed, insert additional sheets of the same size.
3.96
2,043.75
REV-1513 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF: FILE NUMBER:
MARY F._ F.iCHH(~RN ~~ i ~ nnee
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 pndude outrgh`spousj I distributions and transfers under
Sec. 91116 a)) 1.2 .]
1. Patrick Eichhorn Lineal 49,754.38
408 Glenn Drive
Boiling Springs, PA 17007
2. Kathy Wilson Lineal 49,754.38
501 Garland Drive
Carlisle, PA 17013
3. Dorothy Basehore Lineal 49,754.38
5498 Bearcreek Drive
Mechanicsburg, PA 17050
4. William Eichhorn Lineal 49,754.37
216 Lake Street, #304
Burlington, VT 05401
5. Mary Watson Lineal 49,754.37
830 Forge Road
Carlisle, PA 17015
6. John Eichhorn Lineal 49,754.37
5 Ashley Court
Boiling Springs, PA 17007
7. Theodore Eichhorn Lineal 49,754.37
Current address unknown
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS 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:
L
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S
. 0 OU
u more space 1s neeaea, use aaamonal sneers of paper of the same size.
LAST WILL AND TESTAMENT
I, Mary E. Eichhorn, of South Middleton Township, Cumberland
County, Pennsylvania, being of sound and disposing memory and
understanding, declare the following to be my last will and
testament, hereby revoking any and all wills heretofore made by me.
Item I. I direct my executor hereinafter named to pay all my
debts and funeral expenses.
item II. I hereby give, devise and bequeath ali my property, real
and personal, to my children; Theodore, Patrick, Kathleen, William,
Dorothy, Mary and John in equal shares. If any of my children should
predecease me, then, their share shall go to the issue of their body,
per stirpes.
Item III. I hereby nominate and appoint Patrick R. Eichhorn, to
serve as executor, and direct that said individual be permitted to
serve without bond. In the event he is unable or unwilling to serve in
said capacity, I hereby nominate and appoint Dorothy Basehore to
serve in said capacity without bond.
In Witness Whereof, I hereunto set my hand and seal this ~/z day
of 1993.
J '
Mary E. ichhorn
Signed, sealed, published and declared by the above named testator,
as and for their last will and testament, who at their request, in
their presence, in our presence, and in the presence of each other
have hereunto subscribed our names as attesting witnesses:
Q
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We ~ ,and ~- ~ , the
witnesses whose na s are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as their last will, and that it was signed willingly and
executed as their last will and that it was done freely and
voluntarily for the purposes therein contained, that each of us in the
hearing and sight of the testator signed the will as witnesses; and
that to the best of our knowledge, the testator was, at that time, 18
or more years of age, of sound mind and under no constraint or undue
influence.
Sworn to and subsc ibed before
me this -1 day of 1993.
- ..` ~ 1
votary
~wra-sw. sue.
AnM M. Cac, Noagr PubN~
+drr~. sow,, brie
r
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, Mary E. Eichhorn, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do
hereby acknowledge that I signed and executed the instrument as my
last will, that I signed it willingly, and that, I signed it as my free
and voluntary act for the purposes therein expressed.
~~
Ma E. ichhorn
Sworn to and subscribed before
me this 3 day of `, ~--~-- 1993
~.
Notary
Nor~wut. sit.
/Iran Iw. CaoR, troprl- Publb
t~rliNe Sera Qaaberlend Coumy
laNon J 14,1893
- WIENKEN PAGE 02102
09/15/2011 12:35 7177611473
- ~'i~ax~cxa~.~
~Ielpi>r~g u for torxiorrow-
COREY L. BAS~HORE, CFP", CnFC•, Cw"
Partner
clbasehore~finsvca. com
September 15, 2011
Fermi/t_,717 2.43-1857 •
Mary Eichhorn
Cumberland Crossings Retirement Community
1 Longsdorf Way, Roam 37
Carlisle, PA 17013
Re: Beath of Beath Value for Franklin Templeton
To whom this may concern:
Mary Eichharn's account 22915267 at Franklin Templeton has a date of death value
of $8,202.68. This is as of August 20, 2011 where the client owned 781.982
shares of Franklin Templeton PA Tax-Free Income Class A. Shares traded on
08/19/2011 at $10.49 a share.
If you have any additional questions please contact our office at 717-763-73b5,
f
Sincerely,
~~
Corey L Basehore, CFi'~, ChFC~, CLV~
2009
(;Wort nrtltr-fuldr
MrmHrr
Dray L- Hosahore is a registered representatM~elO~nvostorts SegY ces111nc~nmember SlPpaoty. antl fin®trpiai planning services through M~RT
Estate Valuation
Date of Death: 08/20/2011
Valuation Date: 08/20/2011
Processing Date: 10/20/2011
Shares Security
or Par Description High/Ask Low/Bid
1) 992.887 ROWE T PRICE SPECTRUM FD INC (779906205; PRSGX)
GROWTH FD
NASDAQ
Estate of: Mary E. Eichhorn
Account: 14469.1
Report Type: Date of Death
Number of Securities: 2
File ID: 19969.1
Wean and/or Div and Int Security
.Adjustments Accruals Value
08/19/2011 15.69000 Bid
15.690000
2) 1122.455 PPL CORP (693517106)
NYSE
08/19/2011 27.52000 27.11000 H/L
08/22/2011 27.72000 26.97000 H/L
27.330000
Total Value:
Total Accrual:
Total: $95,470.60
14,793.90
30,676.70
$45,470.60
$0.00
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300. (Revision. 6.9.1)
r
1VI8TBanli
499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Manson Law Offices
10 East High Street
Carlisle, PA 17013
Re: Estate of Mary E Eichhorn
Social Security: 578-32-5010
Date of Death: August 20, 2011
Phone 888-502-4349
F ax (302)934-2955
September 20, 2011
Dear Sir or Madam:
Per your inquiry on September 8, 2011, please be advised that at the time of death, the above-named decedent
had on deposit with this bank the following:
1. Type of Account
Account Number
Ownership (Names ofl
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
2673010977
Mary E Eichhorn
Patrick R Eichhorn (POA)
09/01/67
$22,989.34
$ .45
$22, 989.79
2. Type of Account Savings Account
Account Number 15004217594660
Ownership (Names o~ Mary E Eichhorn
Opening Date 05/07/08
Balance on Date of Death $9,197.46
Accrued Interest $ ,21
Total _....... ___ ...._. _ .._.._..
$9,19767 _____.......__
d ~ `~~ /-3
From: Walter, Carol
Sent: Monday, September 12, 2011 11:48 AM
To: Polak-Colon, Lenay
Subject: RE: Mary E. Eichhorn, deceased
Lenay, I think the only thing you can pull is the history.
Carol Walter
Sr. Customer Service Representative
4
C ~
September 14, 2011
Martson Law Offices
Victoria L. Otto, Estates Paralegal
10 East High Street
Carlisle, PA 17013
Fax: 243-1850
Re: Estate of Mary E. Eichhorn
Social Security Number 578-32-5010
Date of Death 8/20/11
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE
FOLLOWING ACCOUNT WITH ORRSTOWN BANK:
CERTIFICATE OF DEPOSIT
Account No.- 4000018093
Account Type- 24-29 Month Growth CD
Date Issued- 7/20/07
Date Redeemed- 9/7/11
Joint Account (name/date)- No
POA on File- Patrick Eichhorn, POA
Balance- $96,957.57
Accrued Interest- $4.23
Best Regards,
R U~
J R. Worthington
Deposit Processing Clerk
2695 Philadelphia Avenue
Chambersburg, PA 17201
1.888.ORRSTOWN
www orrstawn.cam
C~~ ~, ~ s
Vti.tGJ 1 VVYlV
BANK
A Tradiiion of Excellence
MEMBERS 1st
PSDfiRAL CREDTT ANION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 192481-00
Date Account Established 03/28/2000
Principal Balance at Date of Death $193.66
Accrued Interest to Date of Death $.03
Totaf Principal and Accrued Interest $193.69
Name of Joint Owner None
INVESTMENT SAVINGS A000UNT:
Account Number/Suffix 192461-05
Date Account Established 10/10/2000
Principal Balance at Date of Death $126.81
Accrued Interest to Oate of Death $.01
Total Principal and Accrued Interest $126.82
Name of Joint Owner None
CERTIFICATES OF DEPOSIT:
Account Number/Suffix 192461-40
Date Account Established 04/10/2009*
Principal Balance at Date of Death $42,378.47
Accrued Interest to Date of Death $16.55
Total Principal and Accrued Interest $42,395.02
Name of Joint Owner None
*Rollover from certificate 192461-49, originally established 09/10/2007.
**Rollover from certificate 192461-48, originally established 03/31/2007.
192461-50
10/29/2007**
$22,995.78
$14.24
$23,010.02
None
BERS 1sT FE`.lLr~,_ REDI'~ I~di~VIQN~
Y` ~x~;
anielle A. Kline
Lending Insurance Support Specialist
September 12, 2011
Estate of: MARY E. EICHHORN
Date of Death: 08/20/2011
Social Security Number: 578-32-5010
(O -'
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org
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