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Home My WebLink About05-22-12 (2)1505611185 REV-1500 EX (02-11)(FI) OFFICIAL USE ONLY PA Deportment of Revenue County Code Veer File Numher Buroau of IndlWdual Taxes INNERITANCE TAX RETURN Po cox zeosol 21 11 0 0 9 9 2 Hemiabura, PA 1712140601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social SeCUdry NUmber Data 0( Death MMDDYYYY Date ai Binh MMDDVYVY Decedent's Last Neme Suffix Decedent's First Nama MI ETSHIED JANICE W (If Applicable) Enter Surviving Spouse's Information Bebw Spouse's Last Name Suffix Spouse's First Neme M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRUITE BOXE5 BELOW ® 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 12-12.32) ® 6. Decedent Died Testate ^ 7. Decedent Maintained a L'Mng Trust ~ 8. Total Number of Safe DeposR Bolcea (Attach Copy of Will) ^ (Attach Copy of Trust.) ^ ^ 9. LiligatlDn Proceeds Received 1 U. Spousal Poverty Credit (Date of Deelh 11, Election to Tex under Sec. 9113(A) Between 12.31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST EE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD EE DIRECTED TO: Name Daytime Telephone Number BRIDGET M• WHITLEY, ESQ• 717-233-1000 First Line of Adtlress SKARLATOSZONARICH LLC Second Line of Address 17 S 2ND ST FL 6 City or Post Office HARRISBURG REGISTER OF WILLS USE ONLY (~ r~ o C ~~ na ~. -ct ' am- -C _p c `_, _Ty r , (_ _ - 'Ta state ZIP coda D '= C1.i x' PA 17101 cn "'~ a., , corraspondent'se-ma9addreas: BMWNSKARLATOSZONARICH•COM Under penalties of perjury, I tleclare that i nave exemMed This roWm. Including eccompenyln0 schedules and atelemenU, and to the heat of my knaxiedee arW belief, a is true, wrroct end complete. Declaration M preperer other loan Ne personal roproaentelWe is based on aN intormatlon of which praperor has any knowledge. SIGNATURE OF pyF~~ SON RES N FOR FILING RETURN DAT r ^, PREPPRER OTHER THAN EPRESENTATNE ~~ ty yu ~~ DATE , I ~ y ~ 17 S• SECOND ST, 6TH FL HARRISBURG, PA 17101 PLEASE USE ORIGINAL FORM ONLY Stde 1 L 1505611185 OM484]3.eW 1505611185 J J 1505611285 REV-1500 FCC (FI) Decedent's Social Security Number 194-22-7525 D cede e N e ETSHIED IAN ICE W RECAPITULATION 1. Real Estate (Schedule A) t 9 S, a Q Q. Q a 2. Stocks and Bonds (Schedule B) . 2 Q . Q Q 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3. Q . Q Q 4. Mortgages antl Notes Receivable (Schedule D) q. Q • Q Q 5. Cash, Bank Deposits antl Miscellaneous Personal Property (Schedule E) 5. 4 7 ,13 6.0 0 6. Jointly Ownetl Property (Schedule F) ~ Separate Billing Requested g, Q • 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .... 7. 2 8 , 10 0 • 0 0 8. Total Gross Assets (total Lines i through 7) . . . . . . . . . . . . . . . . . . g. 170 , 236.00 g. Funeral Expenses and Administrative Costs (Schedule H). g. 21 , Q 5 3 • Q Q 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 14 2 , 59 2.0 0 11. Total Deductions (tolat Lines 9 and 10), 11. 163 , 6 4 5.00 12. Net Value of Estate (Line 8 minus Line 11) i2 6 , 591 • 00 13. Charitable and Governmental Bequests/Sec 9113 Trusls for which an election to tax has not been made (Schedule J) , 13. Q , Q Q t 4. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 6 , 591.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 (a)(1.2) X .0 - 0.0 0 15. 0.0 0 16. Amount of Line 14 t xable 4~ at linealratex.o 28,100.00 ts. 1,265.00 17. Amount of Line 74 taxable at sibling raleX .12 0.00 17. 0 • 00 18. Amount of Line 14 taxable at collateral rate X .15 Q. Q Q 18. Q• Q Q 1s .rnxDUE ................................... ts. 1,265.00 20 . FILL IN THE BOx IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ 1505611285 Side 2 t1M4648 3Dp0 1505611285 REV-1500 EX (FI) Page 3 r,......r..+., edd..,~~. File Number at T.T. nnaaa DECEDENT'S NAME ETSH D AN W STREET ADDRESS UMB R AND CIN STATE ZIP CAMP H L PA 17 - 7 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 1,265.00 2. Credits/Payments A. Prior Payments B. Discount ~ • 0~ Total Credits (A + B) (2) 3. Interest (3) 0 • ~ ~ 4. If Line 2 is greater than Line 1 + Line 3, enter the dfference. This is fhe OVERPAYMENT. Fill in box on Page 2, Line 20 [o request a refuntl. (4) ~ • ~ p 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the 7AX DUE. (5) 1, 2 6 5 • 0 D 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 antl: Yes ^ No a. retain the use or income of the property transferred ........ i X ncome ...... b. retain the right [o designate who shall use the property transferred or its c. retain a reversionary interest .. ...................... . ^ d. receive the promise for life of either payments, benefits or care? ........... If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death 2 . 0 ^ without receiving adequate consitleration? ............ i th? " ' ^ s or her dea or payable-upon-death bank acwunt or security at h 9n trust For 3. Did decedent own an 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, antl 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)]. Far tlates 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 taz 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 deceasetl 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 chiltl is 0 percent f72 P.S. §9116(a)(1.2)]. • The tax rate imposetl 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. §911fi(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the tlecedent's siblings is 12 percent ]72 P.S. §9116(a)(1.3)). Asibling is tlefined, untler Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. a Ma6]t zaoo REV-~ 502E% ~ (Ot-10) Pennsylvania OEPMTMEMOF REVENUE INHERITMlCE TPX RETURN ESTATE SCHEDULE A REAL ESTATE FILE NUMBER: Janice W Etshied 2~ 11 00992 All real property owned solely or as a tenant In common must be reportetl at felt market value. Fair market value is defined as the pace at which progeny would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knoMedge of the relevant taCta. Real properly that is joinllyownetl with right of survivorship must be tllsclosetl on Schedule F. swasss zoos I( more space is needetl, use atlditional sheets of paper of the same size. REV-1 WB EX• (1140) pennsylvania SCHEDULE E °E'"n^"E"roFRE"E'm'E CASH, BANK DEPOSITS, & MISC. Es oErrt oECeoeNiTU~N _ PERSONAL PROPERTY ESTATE owasno 2pao It more space is nestled, use additional sheets of paper of the same s¢e. REV-1510 EX . (08-09) pennsylvania DEPARTMEM OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT W SCHEDULE G INTER-VIV05 TRANSFERS AND MISC. NON-PROBATE PROPERTY 11 00992 This schedule must be completed antl filed if the answer to any of questions 1 through 4 on page three of the REV-1500 Is yes. ITEM NUMBE DESCRIPTION OF PROPERTY INQILEIFE WJAE OC n~maHSFEaEE, rr~ia aEwnor+srea TO OSCSO~+r nNO T~oarE Or masFax. aTrwincoar or*~oeEO FOa aeu ESrnrs. DATE OF DEATH VALUE OF ASSET °IoOF DECD'S INTEREST EXCLUSION IT PPpUCAaLE TAXABLE VALUE t- Cash gift to Janice Bolton 10,000 100.0000 3,000 7,000 Gift made on July 17, 2011 to daughter 2 Cash gift to Karl Etshied 10,000 100.0000 3,000 7,000 Gift made on July 17, 2011 to son. Check cleared after date of death. 3 Cash gift to Carson Etshield 10,000 100.0000 3,000 7,000 Gift made on July 17, 2011 to grandson. Check cleared after date of death. 4 Cash gift to Carson Etshield 100 100.0000 0 100 Gift made on July 19, 2011 to grandson. Check cleared after date of death. 5 Cash Gift to Madeline Holton 10,000 100.0000 3,000 7,000 Gift made on July 17, 2011 to granddaughter. Check cleared after date of death. TOTAL (Also enter on line 7, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 9 W O6AF 2 000 REV~iei+ Ex~ [raosl pennsylvania OEPPRTMENTOF REVENUE SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF ' " """"""" Janice W Etshied 2~ ~1 00992 Decedent's tlebts must be reportetl on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Myers-Harner Funeral Home, Inc. 3,953 B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Atltlress Cilv State ZIP Year(s) Commission Paid: 2. 3. Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Karl Etshied 6 , 110 3, 500 Street Address 54 Westerly Rd City Camp Hill State PA ZIP 17011 Relationship of Claimant to Decedent SON a. Probate Fees: 263 5. Accountant Fees: 6. Tax Return Preparer Fees: 550 ~. 1 Fulton Bank Service charge 2 2 Cumberland Law Journal Estate advertisng 75 Total from continuation schedules 6,600 9WA6AG 2.000 TOTAL (Also enter on Line 9, Recapil If more space is needed, use adtlitional sheets of paper of the same size. Estate of: Janice W. Etshied Schedule H Part 7 (Page 2) 3 4 5 6 7 B 9 10 Estimated closing costs Skarlatos 6 Zonarich, LLP Attorney's accrued and anticipated disbursements The Patriot News Estate Advertising Comcast PPL Electric Utilities Borough of Camp Hill Pennsylvania American Water Company Penn Waste 2 (~ 11 00992 2,500 111 158 419 2,503 631 232 46 Total (Carry forward to main schedule) 6,600 REV.,S,~Ex^„rc~> I SCHEDULE pennsylvania cfPnalrme"r of rtEVE"ue DEBTS OF DECEDENT, i""eair^NCETA%RETUn" MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Janice W Etshied 2~ 11 00992 Report debts incurred by the decedent prior to death that remained unpaitl at the tla[e aF death, including unreimbursetl medical expenses. ewaSnH zooo If more space is needed, inseR additional sheets of the same size. REV-1513 EX+(01-10) Pennsylvania pEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: _ _ 7 A l1 ftn009 Jan1Ce W . GLSR1eU _ -~ RELATIONSHIP TO DECEDEM -^~- AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [InGUde outn9ht spousal distributions and transfers untler Sec. 91 is (a) (t_2).] 1 Madeline Holton 483 Country Club Road Camp Bill, PA 17011 Cash Gift to Madeline Bolton Inventory Value: 7,000 Granddaughter 7,000 2 Carson Etshied 54 Westerlly Rd Camp Hill, PA 1701 Cash gift to Carson Etshield Inventory Value: 100 Cash gift to Carson Etshield Inventory Value: 7,000 Grandson 7,100 EMER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APP ROPRIATE. II tJ01~4TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN'. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0 swa6Al z ooo If more space is needed, use additional sheets of paper o! the same size. Estate of: Janice W. Etshied Schedule J Part 1 (Page 2) item No. Description 3 Janice Bolton 483 Country Club Road Camp Rill, PA 17011 Cash gift to Janice Bolton Inventory Value: 7,000 4 Karl J. Etshied 54 Westerly Road Camp Hill, PA 17011 Relation Daughter ~` 11 00992 Amount 7,000 Cash gift to Karl Etshied Inventory Value: 7,000 Son 7,000 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMON WEALTH OF PENNSYLVAMA COUNTY OF CUMBERLAND SS File Number 2[-11-0992 Personal Representative(s) of the Estate of JAN[CE W. ETSHIED deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all ofthe real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item ofsaid inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- ~ y,,, ~; S~i GQ tory are true and correct. 1 understand that false state- - ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -(Name) Bndgct M. Whitley, Esq. (Supreme Courtl.D. No.) 33580 (Address) SkarlatosZonerich LLC, 17 S. 2nd St., 6th Floor, Hazrisburg, PA 17101 (Telephone) 717-233-1000;688-851-5628 DATE OF DEATH LAST RESIDENCE nECEDEMS SOC. SEC. Nn. 08/21/2011 54 Westerly Road, Camp Hill, PA 17011 194-22-7525 FIGURES MUST BE TOTALED CASH in bank checking account 45,570.38 Federal income tax refund 543.00 Household goods and personal effects 1,022,75 Real estate located et 54 Westerly Road, Camp Hill, PA 95,000.00 CJ n, c: y O ,~, ~ ~~,r n m ! -' ~ .r tV ~ r-; ~. -- .. : , " C7C . - ~ . C- ~ - _ ~; '~ tV ..~ C-'i c.ry ~~ p cx ~- , L (Attad+ additioua! Skeels as aeeded) _ TOTAL: 142,136.13 NOTE: the Memorendum of real estate outside [he Cammonweelth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. CS § 330/(b)J Form RW-09 ran, 10./3.06 t ~ € -, S ar atos~~ .~ ~~~~~~~ ~ ~ ~.~_~ LLC, Sound Advice.. Smarter Decisions. 17 South Second Street, 616 Floor Harrisburg, PA 17101-2039 717.233.1000 Voice 717.233.6740 Fax May 21, 2011 Glenda F. Strasbaugh Register of Wills for Cumberland County 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Janice W. Etshied No. 21-11-0992 Dear Mrs. Strasbaugh: www.s ka rlatoszo na rich.co m Bridget M. Whitley, Esquire b mw@s ka rlatoszona rich.com r., ~~ ~.., ~ a m ~ ` ~ ('l ,, N C J ~. t ~ ~ D -~ N ~_ m cn ~'~ O ~=, Tt Enclosed for filing please find two copies of the Pennsylvania Inheritance Tax Return and one copy of the Inventory for the above-referenced Estate. I also enclose two checks, one in the amount of $1,265 in payment of the inheritance tax and one in the amount of $30 to cover your filing fees. Please confirm the filing and receipt of payments. I have enclosed aself-addressed, stamped envelope for your use in returning the receipt and confirmation copies. Sincerely, ~~~~~ Bridget M. Whitley Enclosure A Member of LawPactT'" - An International Association of Independent Business Law Firms 5 „0655452. pU' N°o r~ ~~~~~ fig. 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