HomeMy WebLinkAbout02-02-12rJ 1505610140
REV-1500 ~` ~°'~'°'
PA DepaRment of Revenue Cour-ty Code Year FNe Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO Box 28D6D1 2 1 1 1 1 1 0 2
Harrisburo. PA 17128.0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDOYYYY
1 9 8 2 2 8 0 9 5 0 9 2 1 2 D 1 1 0 4 0 4 1 9 3 0
Decedent's Last Name Suffac Decedenra First Name MI
F R O W N F E L T E R C L A I R E
(It Applicable) Enbr Surviving Spouse's Iniormatfon Below
Spouss'a last Name Suft~c Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGfSTER OF WILLS.
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 1213-82)
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 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds RaceNed ~ 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 ANO CONF~ENTIAL TAX INFORMATION 8HOULD BE DIRECTED T0:
Name Daytime Tebphone Number
G ER A L D J S H E KL ETS KI ESQ 71? ??4 735
,,.,,
,
.
REGIS UaE dN.Y
t~ :c
First line of address ~ t ~ ~ ~~
~, f V C
4 1 4 B R I D G E S T S z~ ~'_
Second fire of address Z
~
~ c
P 0 B 0 X E .~ Qp
~-".
City or Post Oiflce State ZIP Code
DATE FILED "
N E-W C U M B E R L A N D P A 1? 0 ? 0
correspond•nrs small address:. a s h e k l e t s k i bl s t o n e l a w. n e t
Under pMattlas of perjury,) declare that 1 have examined this rehrm, indudinp acoompanyk~g schedules and statsmenb, and to the bast of my lau7wbt~ and Hegel
ft is trw, correct and oomgsM. OsclaraUon or preparor other than the tonal rs based on ae iniccmatleon of wtdch prepares fuss any krawiedpe.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
1505610140
Side 1
1505610140
PLEASE USE ORIGINAL FORM ONLY
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
GLAIR E. FROWNFELTER 21 11 1102
Decedent's Name Page 1 Fib Number
Corespondents
Name Daytime Telephone Number
First line of address
Second line of address
City or Post Ofiice
Correspondent's e-mail addrosa:
State ZIP Code
Under penatlbs of perjury, l dectNe that I have exananed this rotum, tndudhg ayfrg schedules and atatemenb, and b ths hest of my knowledge ~d treNef,
it is lore, conecd and c:ompbte. Dederation of prepelsr oUler n Use representative b based on al inforrrlation of which preperer has amr knowks'dge.
SI TUR SON RES NSIB R FILING p jE
Cc.~ ~v-- w ~ 7 /
DRESS
CONSTANCE M• FROWNFEL R BROOKS 438 GANTT ST•, NEWPORT PA 17074
1505610240
REV-1500 EX Decedent's Social Security Number
t)ecedenYsName: CLAIR E• FROWNFELTER 1 9 8 2 2 8 0 9 5
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 1
2. Stocks and Bonds (Schedule B) ...................................... 2•
3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D) .......................... 4.
5 9 0 6 3 8 • 4 7
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 9 4 3 6 . 6 5
7. Inter-Vivos Transfers 8~ Miscellaneous N -Probate Property
arate Billin
Re
uested
~ Se
l
G
S
d
7
.......
g
p
q
)
(
che
u
e .
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 6 0 0 0 7 5 . 1 2
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 1 7 2 5 6 . 8 4
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ....... 10.
11: Total Deductions (total Lines 9 and 10) ........................ ....... 11. 1 7 2 5 6 . 8 4
12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12. 5 8 2 8 1 8. 2 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............... ....... 13•
14. Nat Value Subject to Tax (Line 12 minus Line 13) ............... ....... 14. 5 8 2 8 1 8 • 2 8
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
5 8 2 8 1 8
2
8
2
6
2
2
6.
8
2
.
at lineal rate x .045 1s.
17. Amount of Line 14 taxable
0
0
0
17
0.
0
0
.
at sibling rate X .12 .
18. Amount of Line 14 taxable
0 0
0
18
0•
0
0
at collateral rate X .15 .
19. TAX DUE .......' ........................................ ....... 19. 2 6 2 2 6. 8 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610240 1505610240 J
REV-1500 EX Page 3
Decedent's Comclete Address:
FUe Number
21 11 1102
DECEDENTS NAME
GLAIR E• FROWNFELTER
STREET ADDRESS
10D MT• ALLEN DRIVE
CITY
MECHANICSBURG STATE
PA ZIP
17055
Tax Payments and Credits:.
~. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 2 5, 0 0 0.0 0
B, Discrount 1, 311.3 4
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Ftll In oval on Page 2, Line 20 to request a refund.
(1) 26, 226.82
Total Credits (A + B) (2) 2 6 , 311.3 4
(3)
(4) 8 4.52
5. If Line 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5) D • 0 0
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 consideration? ....................................................................................... ^ 0
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
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)J. 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)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficlaries 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)J. Asibling is defined, uncle
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128.0801
RECEIVED FROM:
REV-1782 EX111-981
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 015351
HANYOK TERRI
3611 WEYMOUTH DRIVE
MECHANICSBURG, PA 17050
fob
ESTATE INFORMATION: ssN: 198-22-8096
FILE NUMBER: 2111-1102
DECEDENT NAME: FROWNFELTER CLAIR E
DATE OF PAYMENT: 12/16/2011
POSTMARK. DATE: 12/16/2011
COUNTY: CUMBERLAND
DATE OF DEATH: 09/21 /2011
REMARKS: RECEIPT TO ATTY
CHECK#1001
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 525,000.00
TOTAL AMOUNT PAID:
INITIALS: HMW
RECEIVED BY:
$25,000..00
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
WILL
OF
CLAIRE. FROWNFELTER
W
I, CLAIR E. FROWNFELTER, of Bloomfield Borough, Perry County,
Pennsylvania, declare this to be my last Will and revoke any Will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my
gravemarker and alt expenses of my last illness shall be paid from my residuary estate as
soon as practical after my decease as a part of the expense of the administration of my
estate.
ITEM II. I devise and bequeath all of my estate of every nature and wherever situate
as follows:
A. Thirty percent (30%) thereof to my daughter, CONSTANCE M.
FROWNFELTER BROOKS. Should CONSTANCE M.
FROWNFELTER BROOKS predecease me, I devise and bequeath her
share of my estate to her issue per stirpes.
B. Thirty percent (30%) thereof to my daughter, TERRI I-IANYOK.
Should my daughter, TERRI I~ANYOK, predecease me, I devise and
bequeath her share of my estate to my other daughter, CONSTANCE M.
FROWNFELTER BROOKS, or to her issue per stirpes.
C. Twenty perecent (20%) thereof to my grandson, JEREMlAH J. TROUT..
Page l of 4
D. Twenty percent (20%) thereof to my granddaughter, KRISTEN
REBECCA JOHNS.
ITEM III. All federal, state and other death taxes payable because. of my death, with
respect to the property forming my gross estate for tax purposes, whether or not passing.
under this Will, including any interest or penalty imposed in connection with such tax, shall
be considered a part of the expense of the administration. of my estate and shall be paid out
of the principal of my estate without apportionment or right of reimbursement.
ITEM IV. I appoint my daughters, TERRI HANYOK and CONSTANCE M.
FROWNFELTER BROOKS, executors of this my last Will.
ITEM V. I direct that my personal representatives shall not be required to give bond
for the faithful performance for their duties in any jurisdiction.
1N WITNESS WHEREOF, I have hereunto set my hand and seal this 21~` day of
May, 2008. _ _
~~
Clair E. Frownfelter
Page 2 of 4
The preceding•insttument, consisting of this and three other typewritten pages, each
identified by the signature of the testator was on the date thereof signed, published and
~,
declared by Clair E. Frawnfelter, the testator therein named, as and for his last Will, in the
presence of us, who, at his request, in his presence, and in the presence of each other, have
subscribed our names as witnesses hereto.
--
~,
Page 3 of 4
COMMONWEALTH OF PENNSYLVANIA )
SS:
COUNTY OF PERRY )
We, Clair E. Frownfelter, Sobrenia Andrews and Keith B. Quigley, the testator and
witnesses, respectively, whose names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned authority that the testator signed
and~~t~cuted,tl~ instnunent a:~<hi~ last; Will and that he had signed willingly
and that he executed it as his free and voluntary act for the purposes therein expressed,
and that each of the. witnesses, in the presence and hearing of the testator signed the Will
as witness and that to the best of their knowledge the testator was at that time eighteen
years of age or older, of sound mind and under no constraint or undue influence.
C.~ G~
Clair E. Frownfelter, Testator
A/ l
Witness
Witness
Subscribed, sworn to and acknowledged before me by Clair E. Frownfelter, the
testator, and subscribed and sworn to before me by Sobrenia Andrews and Keith B. Quigley,
witnesses, this 21'` day of May, 2008.
(SEAL) SIGN
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
EBzabetlt P. Glulple~y, Notary P~Nc
Bloorttfleld 8oro. Perry County
My Camrrrt~eioit E~rpNas July ~ ~
E
t~Aamtrn, en err a A - . Af Nowise
Page 4 of 4
REV-1809 EX + (8-98)
SCHED~/LE E
COMMQNWEA~TH OF PENNSYWANIA CASH, BANK DEPOSITS, ~ MISC.
~" aestot~NrE EceoE~NTR" PERSONAL PROPERTY
CLAIR E• FROWNFELTER 21 11 1102
Include the of utgatbn and the date tha proceeds wars received by the es~te.
All pro -0wnsd with M of sunivorship must bs disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. MORGAN STANLEY SMITH BARNEY INVESTMENT ACCOUNT 590,588.47
NUMBER 777-17461-029
2• 2008 SNOWBEAR TRL TITLE NUMBER 66496526501 FR 50.00
VIN 2SWUW11A88G402511
TOTAL (Also enter on line 5, Rec~itulallon) I S 59.0 , 6 38 •
(If more space is needed, insert additional sheeb of the same sip)
REV-1509 EX+ (01-10)
peninsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAx RETURN
RESIDENT oec~oENr
SCHEDULE F
JOINTLY•OWNED PROPERTY
~s rArt ur: FILE NUMBER:
CLAIR E• FROWNFELTER 21 bb b102
Kan east rwls made Jointly owned within one year of the decedent's dab of death, n must be reported on ScheduM ti.
SURVMNa JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. CONSTANCE t1. FROWNFELTER BROOKS
s.
c.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCWNT NUMBER OR SIMILAR
IDENTIFYING NUMBER ATTACH OEEDfORJOINTLY-FIELD REAL ESTATE.
DATE OF OEATH
VALUE OF ASSET % OF
DECEDENTS
INTEREST DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
~. A. 10-84 fIRST NATIONAL BANK OF MIFFLINTOWN 18,873.30 50. 9,436.65
JOINT CHECKING ACCOUNT X1184456
TOTAL (Also enter on Line 6, Recapitulation) I S 9 , 4 3 6.6 5
If more space is needed, use additional sheets of paper of the same size.
__
438 GANTT STREET
NEWPORT, PA 17074
REV-1511 EX+ (10-09)
Pennsylvania
,.DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIOENr oECEDENr
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
CLAIR E• FROWNFELTER 21 11 1102
Decedent's debts must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~. BOYER FUNERAL HOME 4,085.00.
101 WEST MAIN ST•, NEW BLOOMFIELD, PA 17068
B.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representatlve(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2, AttomeyFees: STONE LAFAVER 8 SHEKLETSKI 8,500.00
3. Family Exemption: (If decedent's address is not the same as claimants, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: LETTERS TESTAMENTARY 369.50
5. Accountant Fees:
6. Tax Retum Preparer Fees:
7. LEGAL ADVERTISING - CUMBERLAND LAW JOURNAL ?5.00
8• LEGAL ADVERTISING - THE SENTINEL 232.02
9• ALERT PHARMACY 187.52
10• RICE MEMORIALS - GRAVEMARKER AND HEADSTONE 2,200.00
11• U-HAUL 220.00
12• MESSIAH VILLAGE 120.00
13• FUNERAL LUNCHEON - WEGMANS 242.•80
14• TRAVEL AND ROOM EXPENSE .FOR PASTOR ?95.00
15• ADDITIONAL PROBATE FEE 100.00
16• FILING FEES - INHERITANCE TAX RETURN AND INVENTORY 3D•00
17• RESERVE FOR. CLOSING EXPENSES 100.00
TOTAL (Also enter on line 9, Recapitulation) ~ i
If more space is needed, use additional sheets of paper of the same size.
~•
REV-iS13 EX+(01-10)
penr>is~~vania ~ -
DEPARTwAENT OPREVENUE
INHEWTANCE TAX RETURN
RESN7ENT DECEDENT
ESTATE OF:
SCHEDULE)
BENEFICIARIES
CLAIR E• FROWNFELTER 21 11 1102
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Tnntee(~) OF ESTATE
i TAXABLE DISTRIBUTIONS ~indurb outrlah~spouaal
distributlor>s and transfers under
'
Sec. 91 6 a)) (1.2 .
1. TERRI HANYOK Lineal
36b1 WEYMQUTH DRIVE 30~ OF RESIDUE
MECHANICSBURG, PA 17050
2. CONSTANCE M• FROWNFELTER BROOKS Lineal
438 GANTT STREET 30~ OF RESIDUE
-
NEWPORT,. PA 17074
3. JEREMIAH J • TROUT Lineal
623 WASHINGTON AVENUE 20~ OF RESIDUE
MIFFLINTOWN, PA 17059
4. KRISTEN REBECCA JOHNS Linear
438 GANTT STREET 20~ OF RESIDUE
NEWPORT, PA 17074
1.
1
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET. f
N more space is needed, use additional sheets of paper of the same size.
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OjMj~llarowe
PO BOX 96
MIFFLINTOWN PA 17059
RESPONSE TO ACCOUNT INQUIRY.
TO: GERALD J SHEKLETSKI, ATTORNEY AT LAW
DECEDE~iT: GLAIR E FROWNFELTER DATE OF DEATH: 09/21/2411
SOCIAL SECURITY#: 198-22-8095
WP hPlr~ arennnt (el in which this deeec~ent haci an interest at the time of his/her death as follows:
ACCOUNT OWNER(S): GLAIR E FROWNFELTER, CONSTANCE M FROWNFELTER
BROOKS
Type of Account: JOINT CHECKING Account #: 1184456
Principal Balance at D.O.D: $ 18,871.44 Interest Rate: 0.1000
Original Opening Date: 10/26/2004 Interest to DOD: $ 1.86
ACCOUNT OWNER(S):
Type of Account: Account #:
Principal Balance at D.O.D: $ Interest Rate:
Original Opening Date: Interest to D.O.D: $
ACCOUNT OWNER(S)
Type of Account: Account #:
Principal Balance at D.O.D: $ Interest Rate:
Original Opening Date: Interest to D.O.D: $
Penalty is waived on withdrawal of edent's fund before maturity: Yes No
Safe. Deposit Box:. Yes No
First Community Financial Corp. stock o other securities: Yes No
Trust Dept. Accounts: Yes No ~~' ;
Authorized Si ture/ Tit a Date