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HomeMy WebLinkAbout07-27-121505610140 RE~~-1500 EX ~°'.'°' PA Depar Went of Revenue OFFICIAL USE ONLY Bureau bf Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 1 1 9 2 ENTER DECEDENT INFOP111ATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 0 2 7 2 0 1 1 0 3 2 8 1 9 2 0 Decedent's Last Name Suffix Decedent's First Name MI L O W E R E R M A M (If Applicable) Enter Surviving Spouse's Information Below 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 O 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ prior to 12-13-82) 5. Federal Estate Tax Return Required Q 6 De d t Di d T death after 12-12-82) . ce en e estate (Attach Copy of W il) ~ 7. Decedent Maintained a Living Trust ~ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 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 ~'ECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D A V I D h S T O N E E S Q U I R E 7 1 7 7 7 4 7 4 3 5 -- _ - --- REGISTER OF ~S USE ONL~' ~ C1 e.,~ First line of address ~ , - ~- 4 1 4 B R I D G ~ . F 1 _. ~:: E S T R E E T <`. t~ ~ C } ~-`'` Second line of address .~ ; .. ., ~ City or Post Office DA~E FI State ZIP Code LED "~-" n't N E W C U M B E R L A N D P A 1 7 0 7 0 v Correspondent's a-mail address: D S T O N E a~ S T O N E L A W• N E T Under penalties of perjury, I decl:.re 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 OF PERSO E:I~ NSIBLE FOR FILING RETURN DATE ADDRE~/S ~ ~~ 946 INDIANA AVENUE LEMOYNE PA 17043 SIGNAT R RER OTHER THAN REPRESENTATIVE DATE ADD - i 414 BRIDGE TREET NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 15056:,0140 1505610140 J h JJ J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: E R M A M• L O W E R 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 8~ Notes Receivable (Schedule D) ..................... ... 4. 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) .... ... 5. 1 2 4 0 9 . 0 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines 1-7) ..... . . . . . . .......... . g 1 2 4 0 9 • 0 8 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9. 6 7 3 0 , 6 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 1 7 5 2 . 7 6 11. Total Deductions (total Lines 9 & 10) ......................... .. 11. 8 4 8 3 . 3 8 12. Net Value of Estate (Line 8 minus Line 11) ....................... .. 12. 3 9 2 5. 7 0 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. 3 9 2 5 , 7 0 TAX COMPUTATION -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• 0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate x• 0 4 5 3 9 2 5. 7 0 1 s. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 1 ~. 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 L 1505607221 Side 2 1505607221 0. 0 0 1 7 6. 6 6 0. 0 0 0. 0 0 1 7 6. 6 6 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 1192 DECEDENT'S NAME ERMA _M • L_OWE_R _ ___ _ STREET ADDRESS 824 LISBURN ROAD CITY CAMP HILL STATE Zlp PA 17011- Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty (1) 176.66 Total Credits (A + B + C) (2) 0.00 Total InterestlPenalty (D + E) (3) 0 • 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0 • 0 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) 176.66 (5A) (5B) 17 6.6 6 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; ......................... ...... ^ Q c. retain a reversionary interest; or .......................................................................................... ...... ^ 0 d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ Q 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 "intrust 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? ............................................................................................. ..... ^ a 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (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 zero (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 twenty-one 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 zero (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 beneficiaries is four and one-half (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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at (east one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (11-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: ERMA M• LOWER 21 11 1192 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• Newspaper refund 11.82 2 (Sovereign Bank-Checking Acct #0771024177 I 12,397.26 Princ- $12,397.25, Int• $•01 TOTAL (Also enter on Line 5 Recapitulation) I$ 12 4 0 9 0 8 If more space is needed, insert additional sheets of paper of the same size REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVAiyIA FUNERAL EXPENSES ~ IN R SI DENT DECEDENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ERMA M• LOWER 21 11 1192 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A• FUNERAL EXPENSES: Stone Murray Funeral-funeral expenses 2,520.00 Gingerich Memorials-stone engraving 1,430.00 TUM-funeral luncheon 302.92 Old Town Florist Greenery-flowers for funeral 392.20 Stone Murray Funeral-additional funeral expenses 372.00 B, ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commission Paid: State Zip 2. AttomeyFees David H • Stone, Esquire 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant 4• Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Cumberland Co, Register of Wills 5 , Accountant's Fees 6 • Tax Retum Preparers Fees 7• 2 3 4 5 PA Dept of Revenue-tax on 2011 tax return Checks written by decedent before death Register of Wills-filing Inh Tax Ret and Inv Sovereign Bank-fee for date of death values Reserve for closing expenses TOTAL (Also enter on line 9, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) 1,D00.00 119.50 174.00 270.00 30.00 20.00 100.00 6,730.62 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE( DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ERMA M• LOWER 21 11 1192 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VAOF DEATHTE 1 WITF-debt of decedent 30.00 2 IOIP-debt of decedent I 25.OD 3 (Genesis Rehab Services-debt of decedent I 450.00 4 Spartan Pharmacy-perscriptions 194.94 5 West Shore EMS-fee 1,002.82 6 (Lower Allen EMS-services rendered I 50.00 TOTAL (Also enter on Line 10 Recapitulation) I $ If more space is needed, insert addiLonal sheets of the same size. 1 , 7 5 2 7 6 REV-1513 EX + (g_00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES tSIAIE OF ERMA M• LOWER NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)j 1 JO ANN BLACKSMITH 946 INDIANA AVENUE LEMOYNE PA 17043- 2 MARY ELLEN EYER 208 MOUNTAIN ROAD LEWISBERRY PA 17339- FILE NUMBER 21 11 RELATIONSHIP TO DECEDENT Do Not List Trusteelsl Lineal Lineal 1,962.85 1,962.85 I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1• 1• B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space Is needed, Insert addltlonal sheets of the same size) 192 AMOUNT OR SHARE OF ESTATE STONE, L:-F<-VER ~ SIIEKLI;1'SKI ATTORNEYS AT LAW j 414 BRIDGE STREET NEW CU?f23ER7.:-ND K~ 17070 ~i LAST WILL AND TESTAMENT OF ERMA M. LOWER !~ I, ERMA M. LOWER, of the Borough or New Cumberland, ;,~.~mberland l County, Pennsylvania, declare this to be my last wi_Ll and r~vo're any ~ - will previously made by me. I T .. _~r.i-1 ~. 1 ct~re~t that m, _. -.. .. ,._ ,. ,. .. _ !~ X11 my just debts and funeral expenses as soon as cc~nv~ni~.ntly may be ~~ - done after my decease from the residue of my estate. II ITEM II: I devise and bequeath all the rest, resi<.?_:e and remain- i f der of my estate of every nature and wherever sir_uat=~ to :n~, spouse, i~ II HAR.R`I L . LOWER, i f he survives me . II ITEM I , II: Should my spouse, HARRY L. LOWER, fai i r~_, ,~,~,-.;;,,e m~ I' _, ~~ I devise and bequeath all the rest, residue and remai nd~~r ~f rnl. ,.state, of every nature and wherever situate ~~-i ,~~ ~, in e_ aG_ sha_._s to m~ I;' ~_laughters, JO ANN BLACKSMTTH and MARY ELLEr~I EYER, as vurT,~~;;e mie ~I .~hc,~~ld either of my daughters predecease me, I devise and ~~equ~ath the I - ,~t~iid of mine leave no such issue living rolloul_~„g ~-1 ~_,_;-~~ ~~_vi~ j and bequeath the share of such child tc my issue, per ~~-r.-~ ~, ~~rS . ITEM IV: I appoint my ~ Executor and his successors ,,,;~ r,.z ~ a,, cf ~i i; ~ =ir~'r' property which passes, either under this will or other;, se, to a ii Page 1 o f 4 minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment o:~ a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian 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 for such support and education, or to make payment. for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM V: I appoint my spouse, HARRY L. LOWER, Executor of this my last will. Should my spouse, HARRY L. LOWER, fail to qualify or cease to act as Executor, I appoint my daughter, JO ANN BLACKSMITH, Executrix of this my last will. IT-- ELI: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, HARRY L. LOWER, have hereunto set my hand and seal this _~_ day of ~1~,, ~~'-" 2 0 0 6 . ~~ ~ ~,~- -~_ ERMA M. LOWER Page 2 of 4 x ' SIGNED, SEALED, pUgyISHED and DECLARED by ERMA M, LOWER, the Testatrix above named, as and for hers Last Will and Testament, and in the presence of us, who at her request, in her presence and in the pres Wi-- // ; U e\of eac o her, have subscribed our names as witnesses. -'`~ 414 Bridae St New Cumberland PA Address Witness `~ 414 Brid e St New Cumberland pA Address COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ~ SS: as my free and voluntary act for the purposes therein contained. I, ERMA M. LOWER, the Testatrix whose name is signed to the at- tached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed ;t- ERMA M. LOWER Sworn to or affirmed to and acknowledged before me by ERMA M. LOWER, the Testatrix, this -~- SRrn, 2 0 0 6 . --.----~ COMMONWEALTH OF PENNSYLVANIA NOTAFIAL S L Notary Public DANIEL M. HARTMAN, Notary public New Cumberland Boro., Cumberland Co. My Commission Expires Jan. 21, 2009 Page 3 o f 4 COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND (''~ . f We, \~ Yk~r~ ~, .('mac and ~ V1 ~ l- , 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 Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. YY1 l.l1CJJ Sworn to or affirmed to and acknowledged before me by .~hJv, ~~~ .I't~t ~,~_ and ~,r2~Y1 ~~~ ~ ~'` ~~~l~K- , witnesses, this `day of Page 4 of 4 COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL DANIEL M. HARTMAN, Notary Public New Cumberland Boro., Cumberland Co. My Commission Expires Jan. 21, 2009 2006. Notary Public Sovereign Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 November 17, 2011 David H. Stone Stone LaFaver & Shekletski 414 Bridge St P.O. Box E New Cumberland, PA 17070 RE: Estate of Erma M. Lower Date of Death: 10/27/2011 Dear David H. Stone: 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 assistance. Ve truly yours, i ~~ icole Jo Specialist 617-514-5189 ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Sovereign Bank Erma M. Lower 131-OS-1840 October 27, 2011 Account #: 0771024177 Type: _ Checkin In the name of: Erma M Lower g Open date: 4/6/1982 Date of Death Balance: $12,397.25 Int.(YTD) from 1/1/2011 to 10/21/2011 Accrued interest to date of death: $0.01 Other Info: Accrued interest to date of death: Other Info: Account closed on 10/13/2011. $2.99 Account #: 0774101016 Type: Money Market Open date: 11/10/2008 In the name of: Erma M Lower Date of Death Balance: Account closed prior to death Int.(YTD) from to Account #: 0775544067 Type: CD In the name of: Erma M Lower Open date: 11/10/2008 Date of Death Balance: Account closed rior to death Int.(YTD) from to Accrued interest to date of death: Other Info: Account closed on 11/17/2010. Page 1 of 1