HomeMy WebLinkAbout01-05-12 (4)J 1505610143
REV-1500 Ex (01-10> ~it~" OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county coda rear File Number
Bureau of Individual Taxes °°'"'"F"'°r"~1f11°
PO 60x.280601 INHERITANCE TAX RETURN 21 11 0712
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
207 03 7830 06 19 2011 09 08 1912
Decedent's Last Name
SENSENIG
(lf Applicable) Enter Surviving Spouse's Information Below
Suffix Decedent's First Name
PAUL
MI
M
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 IN APPROPRIATE OVALS BELOW
1. Original Return ^ 2. Supplemental Return ^ 3. peor to td2r73 82)n (date of tleath
^ 4. Limited Estate ^ qa, Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-92)
g Decedent Died Testate ^ ~, ~A ~e~oPYi~~ ed)a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will)
^ 9. Litigation Proceeds Received ^ 10. ~p°t~nP~~1 ~3i a^a Tda~es~rdeatn ^ 11,Efection 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
GEORGE F DOUGLAS III ESQ 717 249 6333
First line of address
354 ALEXANDER SPRING RO
Second line of address
City or Post Office State ZIP Code
CARLISIaE PA 17015
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REGISTER OF~LS USE ONLY
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Correspondent's a-mail address: gdouglas@salzmannhughes.com
Under penalties of perjury, I declare that.l have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. D~larabon of preparer other than the personal representative is based on all information of which preparer has any knowledge.
pa ,~L„~r~D~,,,En.-ti Paul Terry Sensenig J ~ -ate" ~
ADDRESS
115 Bobcat Road Carlisle. PA 17015
SIGNATUR OF PREPARER OTHER THAN REPRESENT TIVE DATE
~ ,~ ~~ /' ~np/~p ~ ~ George F Douglas, III Esq. / "722 ~ ( 1
ADDRESS
354 Alexander Spring Road, Suite 1, Carlisle, PA
Side 1
1505610143 1505610143 J
~~
PA Inheritance Tax Return
Signature of Additional Fiduciaries
Se sen gFPaul M. I 1i 11-07 26ER
Under penakies 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.
Signature #2
Name
Addressi
Address2
City, State, Zip
Date
900 Bowling Green Trail `~
Chesapeake VA 23320
/~ .? ~- /~
J
1505610243
REV-1500 EX
Decedent's Social Security Number
oeeedern~eName: Sensenig, Paul M. 207 03 7830
RECAPITULATION
1. Real Estate (Schedule A) ..................................:.................................................. .. 1.
2. Stocks and Bonds (Schedule B) .......................................................................... ... 2. 234 , 640.83
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. 316 , 8 8 6.90
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6.
7. Inter-Vivos Transfers 8 Miscellaneous -Probate Property
(Schedule G) Separate Billing Requested........... . 7,
8. Total Gross Assets (total Lines t-7) .................................................................. ... 8. 551 , 527.73
9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................................... .. 9. 31 , 2 63.55
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................ .. 10. 1 , 473.96
11. Total Deduettons (total Lines 9 8 10) ................................................................. .. 11. 32 , 7 3 7.51
12. Net Value of Estate (Line 8 minus Line 11) ........................................................ .. 12. 518 , 7 90.22
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. 518 , 7 90.22
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 l4 taxable 518,790.22 1s. 23,345.56
at lineal rate X .045
17. Amount of Line 14 taxable
00
0
17
0.00
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0
00
18
0.00
at collateral rate X .15 . .
19. Tax Due ................................................. ................................................................ . 19. 23,345.56
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 21-11-0712
DECEDENT'S NAME
Sensenig, Paul M.
STREET ADDRESS
3 Ridge Lane
CITY
Newville STATE
PA ZIP
17241
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 23,345.56
2. Credits/Payments
A. Prior Payments 20,000.00
B. Discount 1,052.63
Total Credits (A + g) (2) 21,052.63
3. Interest (3)
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.
(4)
(5) 2,292.93
Make_Chec_k Pa rLable 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 :............................................................................... ^ ^x
b. retain the right to designate who shall use the property transferred or its inwme :.................................. ^x
c. retain a reversionary interest; or ............................................................................................................... x
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.
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.
SCHEDULE B
STOCKS 8 BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TA%RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Sensenig, Paul M. 21-11-0712
All propsny )ointlyovm°d with right of survivorship must be dl°clo°ed on SchWul° F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
pF DEATH
Wells Fargo, Account No. 7568-5064
1 200 shares of Bank of America 10.635 2,127.00
2 4,460 shares of Dreyfus Strategic Municipal Bond Fund Inc. 7.8975 35,222.85
3 450 shares of Eaton Vance Tax-Managed Global 12.0275111 5,412.38
4 1,075 shares of Pimco High Yield Income Fd 12,77 13,727.75
5 8,952.551 shares of Pimco Total Return Admin 10.9999999 98,478.06
6 2,244.482 shares of Prudential High Yield Fund Inc, Class A 5.5199997 12,389.54
7 1,200.706 shares of RS Investment Trust Floating Rate Fund, 10.2650024 12,325.25
Class C
8 1,295 shares of Wells Fargo Advantage Utilities 8 High 11.4225019 14,792.14
Income Fd
Wells Fargo, Account No. 7566-5064
9 55,000 FNMA 95 G3 EE - 7°~; due 03/25/2025 106.025 5,301.25
10 51,000 Westam Mtg Finl - 5.35%; due 06/26/2020 100 1,000.00
11 1,713.796 shares of Gas Utility Index Fund 19.76 33,864.61
TOTAL (Also enter on Line 2, Recapitulation) 234,640.83
(tf more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev7908 EX~ (8.89)
COMMONWEALTH OF 7ENNSVLVANIA
INHERITANCE TA% RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Sensenig, Paul M. 21-11-0712
Indude the proceeds d litigation and the date the Droceeds were received Dy the estate.
All property jointly-owned with the right of survivorship must Ds disclosed on echedul• F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 ACNE Bank, Classic Money Market Account No. 1595889 234,441.24
Accrued interest on Item 1 through date of death 18.31
2 ACNE Bank, Esteem Checking Account No. 2164159 18,937.52
Accrued interest on Item 2 through date of death 0.71
3 Wells Fargo, Money Market Asset Account No. 7568-5084 489.12
4 Presbyterian Homes, Inc. -refund 83,000.00
TOTAL (Also enter on Line 5, Recapitulation) I 316,886.90
(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-1161 Exa (70-08)
COM~F~T OF~$V~.,yANIA
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COST;
ESTATE OF FILE NUMBER
Sensenig, Paul M. 21-11-0712
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached ~ 9,12x.27
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(sl Commission oaid
2. Attorney's Fees Salzmann Hughes, P.C. 20,300.00
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 523.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,315.78
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 31,263.55
Copyright (c) 2009 form soHware 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
Sensenig, Paul M. 21-11-0712
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral ExRenses
1 Argana -funeral food 68.36
2 Egger Funeral Home, Inc. -funeral services 8,845.63
3 Kohl's -burial suit 210.28
H-A 9,124.27
Other Administrative Costs
4 Register of Wills -filing fees
5 Salzmann Hughes, P.C. -closing costs and final fees for income tax preparation, postage
and miscellaneous contingencies in order to administer the estate
6 Salzmann Hughes, PC -reimbursement for payment to Cumberland Law Journal for legal
advertising
7 The Sentinel -Legal advertising
H-67
30.00
1,000.00
75.00
210.78
1,315.78
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1612 EX~ (12-08)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8r LIENS
ESTATE OF FILE NUMBER
Sensenig, Paul M. 21-11-0712
Report debt incumd by the decedent prior to death that romainsd unpaid at the date of death, Including unreimburoed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Green Ridge Village -final payment on Account #207037GRVIL 74.37
2 Green Ridge Village -final payment on Account #61257GRV 293.60
3 Green Ridge Village -final phone service payment 17.39
4 Green Ridge Village -donation, Walking Trail Endowment Fund 500.00
5 Green Ridge Village Fund -donation 500.00
6 Millennium Phcy. systems Mechanicst -prescription drugs 25.63
7 Millennium Phcy. systems Mechanicst -prescription drugs 20.54
8 PPL -electric service 36.53
9 PPL Electric Utilities -final electric service 5.90
TOTAL (Also enter on Line 10, Recapitulation) I 1,473.96
(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 E%~ (11-08)
SCHEDULE J
coM~ r~~~ANw BENEFICIARIES
ESTATE OF I FILE NUMBER
5enseni ,Paul M. 21-11-0 712
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
1 Paul Terry Sensenig Son 1/2 Residue 250,682.61
115 Bobcat Road
Carlisle, PA 17015
2 Carol Ann Sensenig Daughter 1/2 Residue 250,682.61
900 Bowling Green Trail
Chesapeake, VA 23320
Total 501,365.22
Enter dollar amounts for distributions shown above on lines 15 throw 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 SHEETI
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
WILLS:SENSEN-P.WIL
LAST WILL AND TESTAMENT
OF
PAUL M. SENSENIG
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I, PAUL M. SENSENIG, of Newberry Township, York
County, Pennsylvania, declare this to be my last will and
revoke any will previously made by me.
ITEM I: I devise and bequeath all of my estate, real
and personal, of every nature and wherever situate, in equal
shares to my children, PAUL TERRY SENSENIG and CAROL SENSENIG.
Should either of my children predecease me, I devise and
bequeath the share of such deceased child to his or her issue,
per stirpes, living at the time of my death. Should either of
my children leave no such issue living at the time of my death,
I devise and bequeath the share of such deceased child to my
issue, per stirpes, living at the time of my death. Should
there be no issue of mine living at the time of my death, I
devise and bequeath all of my estate, real and personal, of
every nature and wherever situate, to the American Heart
Association.
ITEM II: I appoint my children, PAUL TERRY
SENSENIG and CAROL SENSENIG, or the survivor of them, guardians
of any property which passes, either under this will or other-
wise, to a minor and with respect to which I am authorized to
appoint a guardian and have not otherwise specifically done so,
provided that this appointment of a guardian shall not super-
-1-
sede the right of any fiduciary in their discretion to distrib-
ute a share where possible to the minor or to another for the
minor's benefit. Such guardians shall have the power to use
principal as well as income from time to time for the minor's
support and education (including college education, both
graduate and undergraduate) without regard to his or her
parent's ability to provide far such support and education, or
to make payment for these purposes, without further responsi-
bility, to the minor or to the minor's parent or to any person
taking care of the minor.
ITEM III: I appoint my children, PAUL, TERRY SENSENIG
and CAROL SENSENIG, or the survivor of them, executors of this
my last will.
ITEM IV: I direct that my executors, guardians, or
their successors shall not be required to give bond for the
faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I, PAUL M.
c
my hand and seal this ~ day of
J ;
SENSENIG, have hereunto set
~' ~ , 1991.
;'
PAUL M. SENSENIG
-2-
SIGNED, SEALED, PUBLISHED and DECLARED by PAUL M.
SENSENIG, the Testator above named, as and for his Last Will
and Testament, and in the presence of us, who at his request,
in his presence and in the presence of each other, have sub-
s b d our names•as witnesses.
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COMMONWEALTH OF PENNSYLVANIA:
:SS:
COUNTY OF CUMBERLAND
I, PAUL M. SENSENIG, the Testator 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 this instrument as my last will; that I
signed it willingly and that I signed it as my free and valun-
terry act for the purposes therein contained.
C%
PA L M. SENSENIG- ,~-
Sworn to or affirmed to and acknowledged before me by PAUL
M. SENSENIG, the Testator, this ~ ~~ day of `-' ,
1991. /"
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Notary Public
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COMMONWEALTH OF PENNSYLVANIA
:SS:
COUNTY OF CUMBERLAND
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We, ~ Cs ~~ ~ ,~V and
~ ~
~~~ -~ ,-'~~~~ , the witnesses whose names
are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present
and saw Testator sign and execute the instrument as his last
will; that Testator signed willingly and that he executed it as
his free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testator signed
the will as witnesses; that to the best of our knowledge, the
Testator was at that time eighteen or more years of age, of
sound mind and under no constraint~Y~u~ndue injf~luence.
Witness
Witness
Sworn to or affirmed to and ac
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by _ ~i~ez~~ 7 ~~~t~--tt~c? - and
witnesses, this ~ ~ day of ~~ ,,
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ledged before me
~~7 ~~~
1991.
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~~FBR
MUTUAL FUNDS
6/28/2011
SALZMANN HUGHES, P.C.
ATTN: GEORGE F. DOUGLAS
354 ALEXANDER SPRING ROAD, SUITE 1
CARLISLE, PA 17015
Reference id: L6SOOY
Re: The FBR Funds
Account No. 34-3524774
Dear Mr. Douglas:
Please accept our condolences on the passing of Paul M. Sensening. We appreciated the
opportunity to have Mr. Sensening as a shareholder.
This letter is in reference to your recent request for a Verification of Deposit. The information is
as follows:
Date Account Value Total Shares NAV
June 19 , 2011 $33,864.61 1,713.796 $19.76
In order to assist you with your request to re-register the account, please provide The FBR Funds
the following materials, referencing task id #t11062800dh:
• Medallion Signature Guaranteed Letter of Instruction signed by the Executors
• New Account Application
Please return the appropriate documents to The FBR Funds. Enclosed is a postage-paid envelope
for your convenience.
Should you have any questions, please feel free to contact The FBR Funds between the weekday
hours of 8:30 a.m. and 7:00 p.m. Eastern Standard Time at 1.888.888.0025, and a Shareholder
Services Representative will be available to assist you.
Sincerely,
The FBR Funds
CHRISTOPHER SCHWAB,
SHLDR SVCS
Encl.: Copy of Request, New Account Application
FBR Mutual Funds
eo. Box s3sa
Cincinnati, Ohio 45201-5354
vrrnv.fbrfunds.com
ACNB
BANK
June 30, 2011
Salzmann Hughes, PC
Attn: George F Douglas III, Esquire
354 Alexander Spring Rd Ste 1
Carlisle PA 17015
RE: Estate of Paul M Sensenig
Dear Mr. Douglas:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
D.O.D.
Classic 1595989 $234,441.24 $18.31 Individual 10/2/02
Money
Market
Account
Esteem 2164159 $18,937.52 $0.71 Individual 3/15/04
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company
at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5122.
Sincerely,
Barbara J Warn
ACNB Bank's
Deposit Services Representative II
. -..,-.~~ .,~_ ___ "o »w o,a, _ T..n C.cc 1 RRR 3~4.ACN8 (2262)