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HomeMy WebLinkAbout02-22-12J 1505610143 REV-1500 ~`~'-'°' OFFICIAL U8E ONLY PA Dspartmsnt d Revenue psnns~Avania ~ ~ ~ ~~ Bureau d Individual Taxes o.,~*r«-e.w,. PO Box2tl0601 fNHERITANCE TAX RETURN 21. 12 010 6 Harrisburg, PA X7128-oeol RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodeil Security Number Date d Death Data d Birth 424 26 1248 10 26 2011 07 26 1928 Decedent's Last Name Suffix Decedent's First Name MI CORTNER SANDERS A (If Apppcabls) Eller 8urvlvinp Spouse's IrNormatlon Below Spouse's Last Name Suffix Spouse's First Name MI CORTNER NANCY D Spouse's Soci~ Security Number THIS RETURN MU8T BE FILED !N DUPLICATE WITH THE REGISTER OF WILLS ~FILL IN APPROPRIATE OVALS BELOW l ^ 1 1. Oripkid Rstum ~ ~ 2. Supplanwntai Retum ~ 3. Rert~slndM Rahim (date of death prior to 12.19.82) 1~ 4. Limited Estate fn 4a. ~~ d ~ ~~ ~_~ 5. Federal Eatete Tax Retum Re~uirod ~rXJ 8' (ACOpydT,MW~) 1_.-~ ~• i ,o'y°w~>s t.tvhp True ..--~----- 8. 'Toml Number d Seta Deposk 8aooss l _] 9. Proceeds Received [~ 10. e~ r," P, -'~'~6 e~n r~f."~s4`°«a' [~ ,,.iinaE,s ,. owwer seo. s„s(~-~ CORRESPONDENT - TH18 SECTION MUST eE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX'. INFORMATION SHOULD BE DIRECTED TO: Name Daytime T~lephons Number JAMES D HUGSE3 ESQ 717 249 6333 Fkst Nns of address 354 ALEXANDER SPRING RO Second IIM of address City or Post OMcs CARLISLE Stab ZIP Cods PA 17015 RE131STER OF ~~ ~~ ~ ~ ~• m r*.~ ;r-Ci>~ fU ~~ J v,~ ~ "'7 .., ~ _... _~ ~ .~ - c~:> ~~ 7 S ~' C i .:. ~? _~~a r-,; ~__. ~;~ ., _.. G~ Corresporrd.rrt's.-mall address: an Conner James D. Hughes Esq. `~ ~ ~-b ~/ 'L ~oonESs 354 nde S rin Road Suite 1 CaHlsle PA Side 1 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: COrtner, Sanders A. 424 26 1248 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 & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers $ Miscellaneous coq Probate Property Se arate Billin Re uested S h d l G p g ) LJ q ............ ( c e u e 7. 40 221.22 , 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 40,221.22 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 6 , 3 94.35 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 114.48 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 6 , 5 0 8 . $ 3 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 33 , 712.3 9 13. Charitable and Governmental BequestslSec 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. 3 3 , 712.3 9 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 33 712 .3 9 1s at lineal rate X .045 ~ . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ................................................... .............................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1!505610243 0.00 1,517.06 0.00 0.00 1,517.06 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-12-0106 DECEDENT'S NAME Conner, Sanders A. STREET ADDRESS 1 Longsdorf Way CITY -STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 1,495.00 75.85 (1) 1,517.06 1, 570.85 53.79 Total Credit:> (A + B) (2) 3. Interest 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. Make Check Payable t©: REGISTER OF WILLS, AGENT. (3) (4) (5) 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 ............................................................................................................... ^ L i 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? .................................................................................................................... ^ 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. Rav-1510 EXF (6-98) } COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY ESTATE OF (FILE NUMBER Cortner, Sanders A. 21-12-0106 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of [he REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF^TRANSFERSATTACFI ACOPY OF TIHE DEED FOR REAL ES ~ E. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Merrill Lynch IRA Account No. -Beneficiaries are 40,221.22 100.000% 40,221.22 decedents daughters: Catherine A. Anderson, Jennifer Conner and Laura Conner TOTAL (Also enter on Line 7, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 40,221.22 Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+(10.06) EE ~HH ~`F , . COM INCHEgTANCE TAX RETUR~VANIA RE,,IDENT DECEDEENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER _ Cortner, Sanders A. 21.12-0106 VGMI-l VI MGY~iM ~i~1~ ~IIYJ~ YG IGFIVI lGY VII Vb11GY 41C 1• ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) 3,629.35 Street Address City State Zip Yearfsl Commission paid 2. Attomev's Fees Salzmann Hughes, P.C. 2,750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 6,394.35 Copyright (c) 2009 form software 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 Cortner, Sanders A. 21-12-0106 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Ewing Brothers Funeral Home, Inc. -funeral services 2,919.11 2 Nancy Cortner -funeral services paid to the Chaplain 200.00 3 Nancy Cortner -funeral services paid to the Honor Guard 100.00 4 Nancy Cortner -funeral services paid to the Organist 150.00 5 Nancy Cortner -funeral services paid for the use of the Post Chapel 150.00 6 Nancy Cortner -funeral flowers 110.24 HI-A 3,629.35 Other Administrative Costs 7 Register of Wills -filing fee 15.00 H-B7 15.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rav-1512 EX+ 02.08) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF (FILE NUMBER Conner, Sanders A. 21-12-0106 Report debts incurted by the decadent prior to death that remained unpaid at the date of death, including unrein'Ibureed medical ezpensas. (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 EX+(11-08) y~ ~: SCHEDULE J COMMON~W~~EALTH OF P~ENENSYLVANIA BENEFICIARIES iN RESID NE T DECEDENTRN ESTATE OF FILE NUMBER Cortner, 5antlers A. ~ 21-12-0 106 NAME AND ADDRESS OF RELATIONSHIP TO , SHAF,E OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) o N t ist Trustee s I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 1 Catherine A. Anderson Daughter 1/3rd value Sch. 11,654.13 1101 Rebecca St. G Carlisle, PA 17013 2 Jennifer Cortner Daughter 1/3rd value Sch. 11,654.13 202 W. Mt. IDA Avenue G Alexandria, VA 22305 3 Laura Cortner Daughter 1/3rd value Sch. 11,654.13 12428 Park Heights Ave. G Owings Mills, MD 21117 4 Nancy D. Cortner Spouse No probate 1 Longsdorf Way assets Carlisle, PA 17015 Total 34,962.39 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet, as a r o riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAx 15 NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-OS) +rtt~t ~til ~cna ~ e~tttmerct I, SANDERS A. CORTNER, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be doneconveniently after my decease. 2. I authorize and empower my executrix to sell any realty owned by me at my death and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate to my wife, Nancy D. Cortner, providing she shall survive me by sixty days. 4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my three daughters, Catherine A. Anderson, Jennifer C. Cortner and Laura E. Cortner, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 5. I nominate and appoint Nancy D. Cortner to be the executrix of this my last will and testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Jennifer C. Cortner, as substitute executrix, also to serve as such without bond, with the same powers as are given herein to my executrix. 6. I hereby suggest that my personal representative retain the services of Irwin, Irwin & Irwin, as attorneys n the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this Z7r day of February, 1984. i i ,~ ~ _ t ~` r i ;_ - .. ~C ~ -~_. '. l ~ < ~.~ ~~~ < ~. ( SEAL ) '- SANDERS A. CORTNER Signed, sealed, published and declared by Sanders A. Cortner, the above named testator, as and for his last will and testament, 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. ~° ~~I~.~ ACKNOWLEDGEMENT AND Ar'rIDAVIT We, SA?JDERS A. CORTNEP, , BETZI A . P~10RRISO~i and SH~.ROid L. SCHWALM the testat or and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testa b r signed and executed the instrument as his 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 testat or , signed the Will as a witness and that to the best of their knowledge the testator was at that time eighteen years of age or older, of sound mind anti under no constraint or undue influence. ._ .--___ SANDERS A. CORTNER BE I A. MOR SON r SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by SANDERS A. CORTNER , the testator , and subscribed and sworn to before me by BETZI A. MORRISON , and SHARON L. SCHWALM , witnesses, this L7`? day of February , 19 84 ~ - ~~ C ---~~y` /~ 'U `! uJ ~ N ~ ~^_ ~ CD W ~ o ~ c O (,a r C O ~ ~ ~ v ~~ ~ o ~ ~ ° ¢ ~> az C7 C ~ N 3 L~ U 4+ 4 Q) ~~ ~~ V r r r r Q CC7 !n N G7 a.. G N .~.. ~ w •- V S ~ fi .. .. r~ ~ ~ ~ ~ _ ~ • ' p L ~ ~ Q Cn ~~ ~ ~ w ~ } a C y fC ~ u co > q 0 N ~'i ~w (n U OQ ~~ Z .l b 1` ~ ,~ i~ ~~ O r I(m ~i~ t~ O S~~` C` ~ l o h. ~"[q o '; ,.~~~ m ~ C~ c cn ~ rn G ` rr N- ,n cn: tf~ ax ,i 1i 1;,,'.,~ ~ ~~ :4, i, i)r C. i31 ~ 1J etw~, ~ r . l' ~` ~ t Vii' ~ ~ .V' 1~ L J .x - ~. ~ 4 ~~ ~ ,; -a~ ` ' II}r ~ 1 >51 `' 1~;„~~. I,, ~ ,,; i ~ '' ~ ~I ~ ~ d u ~ F,G,V fi'r' ri [ ~ I I 9i'n w k ' I k ~ ~ ~ . t ~ ~ ~ ~,x t '~i~~ . ~~[q '+' ~F~R~ ~ /Y( . 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I T •c U ~_ a ', o ~ c m U ~ ~ ~ ~ 4 O ~~ L C ~~ xr M N ga/~ N f~ ~~ ~ " ..', ~~Gr ~~ L ~ s ~. N~ ~ } . m ~i c rn~ t! ~ ~~ s ai n ~~ .~ ~yQQ~ Q ~~ ~s mo E p~ , 4 ~~ O ~~ ~v ~ ,~ ~~ Q}( y ^.l- L ~ a' a ~y~ C N N J ~~~ o ~~~ ~ I{- m `o !] a .~ ~: ~; .u m 1m fl H (7 7_ y~ U r- --- -•---- ..-...~.. ,., ~.-~~~ r_rr~rL71T1 ~- ~i1A7F7.99FIT bb:9b:ZT TTBZ 5B ~aQ Merrill Lynch Pert 1 Account Information Beneficiary DesignationlChange Fee Preference Form ,.C~ i NCR i N,~ ~~ ~6 ~ °' i 0-a'd ~t~ grog- 8'3'~b~: ^ z~rir ~ ~a't'~ner _ D3~03~3 Zto-~--to585 ~ 4. % ^ CONTINGENT BENEFICIARY(IES)~ If there is no primary beneficiary living at the time of my death. I hereby specify That the balance is to be distributed to the contingent benefciary(ies) listed below:' ~~ Date of Birth Check if cti.,.~ rr,ea.unnniv~ Cnrial Ranvhv Nn .~i00use t 2. °~ ^ 3. 4. % ^ Indicate Your Custodial Fee Payment Preference (Does not apply to MSA or HSA} Part 3 Fea Payment ~ Sweep (Charge this account} Preference ~ Check (Bill by invoice} (Except RSA, ESA) 0 Charge All Retirement Account Custodial Fees to my Merrill Lynch Non-Retirement Account (Except RSA, ESA) Account # - I understand that i no designated beneficiary survives me, or if no benefci~ary designatton Is In effect at my death, the Part 4 aceottnt balance will be paid to my spouse, or If I am not survived by a spouse, to my estate in a single payment. I am Your Signature aware that this form replaces ail prior beneficiary designations for this aocount, becomes effective when received by Merrill Lynch, and will remain in effect until I deliver to Merrill Lynch another form with a later date.' Date Daytime Telephone a ~3-0~ Spouse's Consent to Alternate Beneflclary Part 5 To Be Completed By Basic Designation: "i am the Spouse of the participant who made the and Retirement Selector Account Holders Only beneficiary designation on Ihis form and I consent to It. I understand that It someone other than me has been designated beneficiary, my consent means that I give up my rights I may have under the Plan and applicable law (other than rights I may later have as the survivor in a joint annuity with the participant) to receive Ihoso amounts payable under the Plan by reason of the paricipants death to which I would otherwise be entitled if I were the participant's sole '~.//~~ al}~ ' bane rctary./ 2 ~i Date ~ ~ °~J ~y 5 ~ ~ ~ s Signature ! T Spouse - - Signature of Plan Administrator or Notary Public Dato Notary Title/Commission Expiration Date Unavailabllily of Spouse's Consent Spouse's consent unavailable because: 0 Participant Is not married D Participant's spouse cannot be located o Other: "It has been established to my satisfaction that the consent of the parliclpant':> spouse to the participant beneficiary designatton of this form cannot be obtained for the reason Indicated" Signature of Plan Admin. II no Pian Administrator: Notary Public Signature Date Date 'For Education Savings ACcounts$° ESA, the words "my" and "me' shall rater l0 the 'Student's' or the 'Student". Notary Titre/Commission Expiration Date coo. rzn losos> CUSTODIAL COPY rnnnnn~ uu.~i .v,.,,. ~,,~..~. ~ .~.....,.~ .._... y.._._ ..._ r_-_-_,_, _..___ __._.- __ . Part 2 payment of the balance of the account upcn my death.' ~ ~~ DeslgnatioNChange Dale o! Birtfr ~ ~ ~ Check if Of BeneflClar'y(1e8) ,,,,,~,,, ~,,,, ~,aa.~~~ Rhwm (AAtvt/1~~7rYY) Bonier Security No:~=~' SQCU$9