HomeMy WebLinkAbout05-04-12 (3)1505610143
REV-1500 Ex`°''°'
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county code rear File Number
Bureau of Individual Taxes 0°""T"'"T°`a"""'~
PO 60X.280601 INHERITANCE TAX RETURN ~!], 12 0298
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
02 09 2012 08 20 1923
Decedent's Last Name Suffix Decedent's First Name MI
ADOMAITIS DOROTHY A
(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
1. Original Retum ~ 2. Supplemental Return
4, Limited Estate ~ qa, Future Interest compromise
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er 12-12A2)
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S Decedent Dietl Testate ~ ra
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T~ (Attach Copy of Tf sd)a living Trust
(Attach Copy W WII)
9, UGgaGOn Proceeds Received ~ 10. Delwa~enP2J1-91 eentllt laatae5~f death
3. Remaintler Retum (tlate of tleath
poor to l2-13-82)
5. Federal Estate Tax Return Required
~
e. Total Number of Safe Deposit 8ozes
11. Election to [ax untler Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA:%INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telep~gne Number?";,
JAMES D BOGAR (i'17) 87B~ _:,~
"•_?
RE~oISTER Ij~~J USE pNLY ~-: ; r:-
+
First line of address
-~ ~ `n '"
~ ~~
~+ •`
ONE WEST MAIN STREET +'_ : s„
Second line of address ~ r•~ ~ ~.
City or Post Otfice
SHIREMANSTOWN
State ZIP Code
PA 17011
Correspondent's a-malt address: Juv~artwuoyanaw.wrn
U ~dtrrupen~alti~en0 crimlilete Utlecleretion of pr~epamer ofhe than the persdolalrepresentative Iscbased on aldl infortnaGOn~af wti'~ocfihpreparerfhas am~knowleEge.belief,
David
ADDRESS
One West Main
Sames D. Bogar
PATE
Side 1
1505610143 1505610143 J
150561243
REV-1500 EX
Decedent's Social Security Number
oe~eae~rsr~me~. Adomaitis, Dorothy A.
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. 105 , 080.32
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Probate Property
Inter-Vivos Transfers & Miscellaneous N
~
(Schedule G) Separate Billing Requested............ 7.
g. Total Gross Assets (total lines 1-7) ................................................................... .. 8. 105 , 080.32
9. Funeral Expenses & Administrative Costs (Schedule H) ............................... ........ 9. 14 , 418.60
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 10.
11. Total Deductions (total Lines 9 & 10) .......................................................... ......... 11. 14 , 418.60
12. Net Vatue of Estate (Line 8 minus Line 11) .................................................. ........ 12. 90 , 661.72
13. Chadtable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ....................................... ........ 13.
1A. Net Value Subject to Tax (Line 12 minus Line 13) ...................................... ......... 14. 90 , 661.72
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
15.
(a)(1 2) X .00
15. Amount of Line 14 taxable QO , 661.72 16.
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 0 0 17.
at sibling rate X .12
18. Amount of Line 14 taxable 0 . 0 0 18.
at collateral rate X .15
19. Tax Due ................................................... ...................._........................................ . 19.
20. FELL iN THE OVAL 1F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 150561Q243
0.00
4,079.78
0.00
0.00
4,079.78
REV-1500 EX Page 3
DPCedent's Complete Address:
File Number 21-12-0298
DECEDENT'S NAME
Adomaitis, Dorothy A.
STREET ADDRESS
909 Williams Grove Road
CITY STATE: ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
e. Discount 203.99
Total Credits (A + B) (2)
3. Interest
q, If Line 2 is greater than Line 1 + Line 3, enter [he difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
(1) 4,079.76
203.99
(3)
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,875.79
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 :................................................._............................ x
b. retain the right to designate who shall use the property transferred or its income :..................................
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 wNhout
receiving adequate considerationl .................................................................................................................... ^
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or hen death?....... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ^
contains a beneficiary designation? .................................................................................................................. x
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 antl before Jan. 1, 1995, the tax rate imposed on the net value of transfers to orfor 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 orfor 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 hr orfor 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 orfor tfie use of the decedent's siblings is 12 percent [72 F~. 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.
Rev-1508 EXt )6-98)
SCHEDULE E
CASH, BANK DEPOSITS, 8r MISC.
PERSONAL PROPERTY
CDMMONWEALTH OFPENN6YLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Adomaitis, Dorothy A. 21-12-0298
Include the proceetls of litigation and Ne date the proceeds were receivetl by fhe estate.
All propertyjolndyowned with Me right of survlvorsMp must be disclosed on schetlule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Janney Montgomery Scott -Investment Account No. 3369-7589 20,803.12
2 Sovereign Bank -Checking Account No. 1161092854. Date of death balance $80,492.57; 80,492.66
accrued interest $0.09.
3 Keystone Elder Law -Refund 3,000.00
4 Quantum Imaging -Refund 46.92
5 U.S. Treasury - 2011 Personal Income Tax Refund 737.62
TOTAL (Also enter on Line 5, Recaoihdationl I 105,080.32
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Trotted h8vi~a» ror Geveni4m s
Apr1130, 2012
Attorney.James Bogar
1 w. Main Street
Shiremanstown, Pa'. 17011
Subject: 6orothy Adomaitis account 3369-7589
Attorney Bogar..
ZO L:YfOt'(I L~OAfJ
3+'I r1cTm~, suite :315
Lemo}+r~e, P't1 T70tJ$
9M.i3L94~0
Fflx: 913.7:; L.=i A I J
t5touffeT?<±ij an ncy.c~fn
lCN'tV . teT' C\'StOllf fe.Y.GYdiTt
Per yqur request, the above referenced account far DgrothyAdomaitishad',a value of 520,843.12 qn
February 9; 2012, her date ofdeath, This accountwas al(n cash at that ime.
Sincerely,
J ~ ~' I <.'^~.
~~`~c ~'
Terry L. t uffer, CFP®
Janney Montggmery±Scgtt, lLC
20 €tford Road, Suite 35
Lemoyne, Pa. 17043
(717-731-2105
"fhi4 iniarmFliion Is noL dto ufhr iatttrtrrd u(VS'uitmun[ar+d iisul+ject to ch inset, errata and <+miysians and .alvnrt be gucvanteeJ us In iln ateura}+c+r
complcKea>~ss, }our printed eonfiuauitii,ns ani! In.•rindtc aCaaamt slulemKlit3 Concuhrteq'ou( o(Fimal arCplntl rerorcl. This Ingenrn+ati(»i is uat .r spUsiiluk~.
Ior othct important i+dorvnation that Jammu}~ sentl~to }'au. T#~e p6er'e tnay niit be used f6k laxr¢por6n~ purposes. Janrte5' will piulv.te ufReial t,n:
dvcumentettun reganiutb rAUx,ueelunt ka pao.U}+ awii.
TerT;v L. StouffeT..C1~P'E, C1ZPC~", C1;1'C'.
Pice~ PrevirleTTf>IPirrrllb .1d1r1,nKeeaend
2%}n.7nciiil ridrisar
Jfmney M(uttgomery Scott LT.C t~lenilier: NYSE t?TR~itl1 STPC
Sovereign
Ordered Processing \ Decedents - MAl-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284
March 19, 2012
James D. Bogar
One West Main Street
Shiremanstown, PA 17011
RE: Estate of Dorothy A. Adomaitis
Date of Death: 02/09/2012
Dear Mr. Bogar:
Per your request, enclosed please find the account information as of the date of death
for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
Please feel free to contact me if I can be of any further assistsince.
Very truly yours,
-~ ~.
Ed Stevens
COP Specialist
617-514-5189
Sovereign Bank
ESTATE OF Dorothy A. Adomaitis
SOCIAL SECURITY #: 180-16-1377
DATE OF DEATH: February 9, 2012
Account #: 1161092854 Type: Checking Open date: 12/30/2009
In the name of: Dorothy A Adomaitis (David N Kurth, POA)
Date of Death Balance: $80,492.57
Int.(YTD) from 1/1/2012 to 2/7/2012 _ $0.12
Accrued interest to date of death: $0.09
Otherlnfo:
Account #: 1681706806 Type: Checking Open date: 4/24/1997
In the name of: Dorothy A Adomaitis or David N Kurth
Date of Death Balance:
Int.(YTD) from
Accrued interest to date of death;
Otherlnfo: Closed prior to death,
to
on 08/31/2010
Page 1 of 1
REV-1151 EX+116-06)
SCHEDULE H
COMMpNy./EA~TH p~PENNgy~yANIA FUNERAL EXPENSES &
~NHERITANCETAX RETURN ADMINISTRATIVE COSTS
RE IDEN DECEDENT
ESTATE OF FILE NUMBER
Adomaitis, Dorothy A. 21-12-0298
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
233,71
B.
1. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
David N. Kurth
Street Address 909 Williams Grove Road
city Mechanicsburg state PA zip 17055 _
Year(sl Commission paid 5,254.00
z. Anornev's Fees Bogar & Hipp Law Offices 3,150.00
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 265.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 5,515.39
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 14,418.60
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. t0-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Adomaitis, Dorothy A. 21-12-0298
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 Funeral Expenses
Malpeui Funeral Home -balance of funeral bill
233.71
H••A 233.71
2 Other Administrative Costs
HSBC Card Services -payoff of credit card -payment for Christmas presents bought prior to
2,372.76
date of death
3 Manor Care Carlisle -nursing home bill 1,156.00
4 Manor Care Carlisle -nursing home bill 867.00
5 PPL -electric bill 349.63
6 RESERVES: -Costs to conclude administration of Estate, including filing fee for PA 750.00
Inheritance Tax Retum and Inventory, preparation and filing of final 2012 Personal Income
Taxes and Fiduciary Income Taxes
7 Sovereign Bank -fee for date of death valuation 20.00
H-B7 5,515.39
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98)
SCHEDULE J
COM INON~W~EA~N,Ii_OFgP~ED~~$,RL VANIA
IJ
+
E
T `
f7 'i BENEFICIARIES
t
`~
4
S
ESTATE OF FILE NUMBER
Adomaitis, Doroth A. 21-12-0298
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (1Nords) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
Donna Kearney Granddaughter One-third of rest,
1175 Morefield Drive residue and
Philadelphia, PA 19115 remainder
Christopher D. Kurth Grandson One-third of rest,
1409 East Street Road residue and
Glen Mills, PA 19342 remainder
Michael D. Kurth Grandson One-third of rest,
2744 Tupelo St, S.E. residue and
Atlanta, GA 30317 remainder
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TA;K IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule J (Rev. 11-Ofi)
LAST WILL AND TESTAMENT
OF
DOROTRY A. ADOMAITIS
I, DOROTHY A. ADOMAITIS, of Mechanicsk~urg, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wi11s and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, in equal shares, to
my grandchildren, CHRISTOPHER D. KURTH, MICHAEL D. KURTH, and
DONNA L. KEARNEY, provided that should any of my grandchildren
predecease me, I give and bequeath such grandchild's share unto
his or her issue per stirpes by representation, and if there be a
failure of same, then to my surviving grandchildren.
SECOND: Should any of my great-grandchildren not have
attained the age of eighteen (18) years at the time for dis-
tribution to him or-her, I give, devise and bequeath the share of
each such great-grandchild to my hereinafter named Trustee or
~ Trus*_ees, IN SEPARATE TRUSTS; to hold, manage, invest and rein-
vest the shares so received, and to use and apply from time to
time such portion of income and principal for the said great-
grandchild's education (including college, trade school or other
'" similar training or education), support and welf<sre as my Trustee
'~ or Trustees, in their sole discretion, deem advi;aable. My
Trustee or Trustees may make the payments for th<=_ support and
maintenance of my great-grandchildren directly to said grandchil-
dren or to their Guardian or Guardians. Any payments made by my
Trustee or Trustees pursuant hereto shall be made= without further
responsibility to the said grandchildren, their Guardian or
Guardians, or to any person taking care of my grandchildren. The
Trustee or Trustees, in exercising their discretionary authority
with respect to the payment of income or principal of the within
Trust to my grandchildren, shall take into consideration any
income or other resources available to my grandchildren from
sources outside this Trust. In addition, my hereinafter named
Trustee or Trustees shall have the right, in the=ir sole discre-
tion, to purchase and pay for out of the principal, as well as
income, such insurance policies as will provide for the grand-
child's medical care.
Any income or principal not so applied shall be dis-
tributed to each great-grandchild when he or she attains the age
of eighteen (18) years. In the event any of my great-
grandchildren die prior to the termination of this Trust
established herein for their benefit, the interest of said great-
grandchild in said Trust shall cease with any ir.,come and
principal being divided evenly between or among that deceased
great-grandchild's brothers or sisters or the separate Trusts
established hereunder for their benefit and, in the absence of
any brothers or sisters, or any Trust established hereunder for
their benefit, to my other great-grandchildren, or the Trusts
established hereunder for their benefit, in equal shares.
THIRD: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
~ (A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes i:he power to give
2
legally sufficient instruments for transfer of i~he property and
to receive the proceeds of any disposition of its.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
Sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
'(D) To invest in all forms of propert;y, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to tiny principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
i
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,.
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
i
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
3
FOURTH: I nominate and appoint my son-in-law, DAVID N.
KURTH, as Trustee of the hereinabove described Trusts. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said DAVID N. KURTH, I nominate and
appoint, my granddaughter, DONNA L. KEARNEY, as Trustee of the
hereinabove described Trusts. In the event of t;he death, resig-
nation or inability to serve for any reason whatsoever of the
said DONNA L. KEARNEY, I nominate and appoint, my grandson,
CHRISTOPHER D. KURTH, as Trustee of the hereinabove described
Trusts. In the event of the death, resignation or inability to
serve for any reason whatsoever of the said CHRISTOPHER D. KURTH,
I nominate and appoint, my grandson, MICHAEL D. KURTH, as Trustee
of the hereinabove described Trusts. I direct ghat my Trustee or
Trustees shall serve without bond and shall recs~ive fair and
reasonable compensation.
FIFTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or' not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SIXTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested. or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SEVENTH: I nominate and appoint my son-in-law, DAVID
N. KURTH, Executor of this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said DAVID N. KURTH, I Nominate and
appoint my grandson, CHRISTOPHER D. KURTH, Executor of this, my
4
Last Will and Testament.. I direct that my Executor or Executors,
Trustee or Trustees, as the case may be, and their successors,
shall not be required to post security or a bond for the
performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set=p my hand and
seal to this, my Last Will and Testament, this jp day of
~~~~G~ 2 0 0 5 .
t/~ (SEAL)
DOROTHY ADOMAITIS
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
Address
5