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Home My WebLink About09-26-12 15D5610143 1J REV-1500 Ex1°'-'D) thj!y PA Department of Revenue Pennsylvania Bureau of Individual Taxes p°"ar"`"1f0F R`~""` Po eox.zaosol INHE Harrisburg, PA 17128-0601 RF ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Decedent's Last Name Suffix FOSTER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix OFFICIAL USE ONLY County Code Year File Number TAX RETURN 21 'v' ~ ~~~ )ECEDENT Date of Birth it 20 1932 Decedent's First Name MI EUGENE I' Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DLIPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ s. F:emainder Return (date of death l R t 1. Original Return ^ e 2. Supplementa urn prior to 12-13.82) ^ 4. Limited Estate ^ qa. Future Interest Compromise I ^ 5. Federal Estate Tax Return Required (tlete of death ader 12-12A2 S Decetlent Died Testate ^ 7. (Atlacti GOPYiot~NSt~ Living Trust 0 a. Total Number of Safe Deposit Boxes (Attach Copy of Will) ^ 9. Litigation Proceeds Received ^ 10. baMreen12~3rt91 ntltl Tta95) deem ^ 1 tAttach Scha%O' rider Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Daytime Telephone Number r,,, Name 717 737 ~8~1 ~ ~ ~ LAUREN E BOGAR , ~ , ~ Ti cn F C~ ~ rr--~~ REGISTER OF ~rtlSE ONLR' l L' ; ~? Gj =~t Q~ ..X) Ci ~C'•` - ' ~ ?(~' First line of address - - " ~ ~ ' _. -rT ONE WEST MAIN STREET ~ m ~"_ Second line of address y GJ `~ City or Post Office State ZIP Code SgIREMANSTOWN PA 17011 Correspondent's a-mail address: ""'aa•v~~a•-•••---•--^• Under penalties of perjury, I tleclare that, I have examined this return, including accompanying schetlules and statements, antl tp the best of my knowledge and belief, it is We, correct and complete. Declaretion of preparer other than the personal representative Is based on all tnformatton of which preparer has any knowledge. SIGyyATyyRE OF PERSON RESPONSIBLE OR FILING ETURN DATE 14n A r .0 `f1~1 // ~ n ~ Karvl M. Wentz 9 - aZJ~--~~ 2202 Fenwick Avenue Mechanicsburg PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE .. r-.1 Lauren E. One West Main Street, Shiremanstown, PA 17011 Side 1 L 1505610143 1.505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number oersaanrs came. Foster, Eugene L. 391 28 6758 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. 3 697.73 ~ 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 3 ,104 .73 7. Inter-Vivos Transfers & Miscellaneous f~tq Probate Property u Separate Billing Requested........... . 7. 314 , 35 9.16 (Schedule G) 8. Total Gross Assets (total Lines 1-7) .................................................................. ... 8. 321 , 161.62 9. Funeral Expenses & Administrative Costs (Schedule H) ............................... ........ 9. 8 173.83 ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 10. 11. Total Deductions (total Lines 9 & 10) .......................................................... ......... 11, 8 ,173.83 12. Net Value of Estate (Line 8 minus Line 11) ................................................. ......... 12. 312 987.79 r 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. 312 987.79 r 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 16. Amount of Line 14 taxable 98 7 . 7 9 312 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 0.00 18. at collateral rate X .15 1 s. 19. Tax Due ................................................. ............................................................... .. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 14,084.45 0.00 0-00 14,084.45 Side 2 1505610243 1.505610243 REV-t 500 EX Page 3 Decedent's Complete Address: Foster, Eugene L. STREET ADDRESS 2202 Fenwick Avenue Tax Payments and Credits: t. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 704.22 3. Interest q. 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 (3) (q) Yes No 704.22 1. Did decedent make a transfer and: a. retain the use or income of the property transfened :............................................................................... 111^~~~1 z b. retain the right to designate who shall use the property transferred or its income :.................................. ~ x c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ z 2. If death occurred after December t2, 1982, did decedent transfer property within one year of death wdhout ^ ^ 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 Acwunt, 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 I\ND 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 tnansfers 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 wmmon with the decedent, whether by blood or adoption. File Number 21 STATE ZIP pA 17055 (t) 14,084.45 Total Credits (A. + B) (21 Rev-7 aa6 FXi (6-99) COMMONV.~EALTH OF PENNRYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Indutle the procaetls M litigation antl the date the proceetls were received by the estate. All pmpem/ }olndyowned whh the dgM of aurvivorahip must be dlsolosetl on echetlule F'. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 00 517 1 Andrews and Patel -Physician visit out-of-pocket payment refund . nkers Life and Casualty Company -Cancellation Refund B 24.36 2 a 3 Commerce Insurance -Automobile insurance premium refund 389.00 45.00 4 Empire Vision Centers -Contact lens refund 5 Everence -Health insurance premium refund 2,090.64 6 Everence -Patient out-of-pocket payment refund 310.73 7 Malpeui Funeral Home -Veteran's Refund 100.00 8 Quincy Mutual -Homeowners insurance premium refund 221.00 TOTAL (Also enter on Line 5, Recapitulation) I 3,697.73 (I( 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) Rav-0509 E%+t6-98) COMMONWEALTH OFPENNSVLVANIA INHERITANCE TA%RETURN RESIDENT DECEDEM SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Foster Eugene L. Han asset was matle )omt within one y ar f th tl tl t tl t of SURVIVING JOINT TENANT(S) NAME ADDRESS A. Karyl M. Wentz 2202 Fenwick Avenue Mechanicsburg, PA 17055 g. Kevin G. Foster 33 Old Chester Road Huntington, MA 01050 C. be , ~ w weco :nsawe ~. RELATIONSHIP TO DECEDENT Daughter Son JOINI LY ITEM NUMBER UWNeu r LETTER FOR JOIN TENANT rtvPcrtl .. DATE I MADE JOINT DESCRIPTION OF PROPERTY NCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEI~TH ALUE OF ASSE % OF DECD'S INTEREST - DATE OF DEATH yALUE OF DECEDENT'S INTEREST Berkshire Bank -Checking Account. Date of 5,209.45 50.000°/a 3,704.73 ~ g death balance $5,209.45. This account was jointly owned with Decedent's son, Kevin G. Foster. TOTAL (Also enter on Line 6, Recapitulation) I s,T U9.ra (If more space is neetle4 atlditional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule F (Rev. 6-98) BERKSHI BANK® America's Most Exciting Bank" July 25, 2012 Dear Madam: At the time of his death, Mr. Eugene Foster held 1 checking accotlnt with Berkshire Bank. On June 27`h , 2012 the balance was $6,209.45. The account was opened on 12/06/1991 and is co-owned by Kevin G. Foster. The account is non-interest bearing. Sincerely, Nicholas ~ aprio Branch Officer Westfield Court Street Office 413-564-6216 P.O. Box 1308, Pittsfield, MA 01202-1308 (413) 443-5601 • 1-8'00-773-5601 Rev-1510 EX+IB-86) gCHEDULE G I INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMON W EALTH OF PENN SYLVrW IA INHERITANCE TAX RETURN REe1DEM DELEOENT ESTATE OF NUMBER This schetlule must be completed and filed 1f the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND INTEREST NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET 1 American General Life -Annuity Contract No. 85,430.08 HEA006653F. The Decedent's three (3) children are the named beneficiaries of this account. 2 I Bankers Life and Casualty Company -Annuity Policy I 20,992.56 No. 7728280. The Decendent's three (3) children are the named beneficiaries of this account. 3 Sovereign Bank -Money Market Account No. 201,281.94 7673603985. Date of death value $201,272.29; accrued interest $9.65. This asset was made joint with Karyl M. Wentz on May 23, 2012, less than one (1) year prior to the date of Decedent's passing. 4 Sovereign Bank -Checking Account No.1921106026. 6,654.58 Date of death value $8,654.57; accrued interest $0.01. This account was made joint with Decendent's daughter, Karyl M. Wentz, on May 23, 2072, less than one (1) year prior to the date of Decedent's passing. TOTAL (Also enter on Line 7, Recapitulation) TAXABLE VALUE 85,430.08 20,992.56 201,281.94 6.654.58 314,359.76 (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 G (Rev. 6-98) Ft9-iL1-' 12 15.4[1 FF3LC]-P.IG LIFE. American General life Companies September 20, 2012 LAUREN BOGAR FAX: 717-737-2086 Contract Number: HEA006653F Insured: EUGENE L FOSTER DEAR LAUREN BOGAR: T..?qo, FQIF(z11/f~llyll F-94[~ Insurance Service Center fora American General 'Life Insurance Company Per our conversation on September 20, 2012, you requested information regarding the insured listed above. Our records have been carefully researched and we found the policy listed above to be the only accounts our company held on the life of Eugene L Foster. This policy was an Annuity IRA. The owner on this account was Eugene L Foster. The value of this account as of 8/27/2012 (date of death) was $85,430.08. If you should have any questions regarding this information or forms, please do not he+>itate to contact our office at 1.800.231.3655. Sincerely, INDIVIDUAL CLAIMS DEPARTMENT cc: 068221 FRA NEW CAREER ODD05 / GERALD W NANNEN U40CL54 American General Life Insurance Company P.O. Box 4443 . Houston, TX 77210-4443 .1.800.231,3855. Fax 713.831.3028 BANKERS LIFE AND CASUALTY COMPANY (800) 621-3724 PO Box 1937 Carmel IN 46082-1937 July 30, 2012 James D Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 Policy: 7728280 RE: Eugene Foster, deceased Dear Family of Eugene Foster: Please accept our sincere sympathy on the passing of your loved one. Eugene had 1 annuity policy, and that is the contract policy listed above. The date of death value of the annuity policy listed above basecl on a date of death of 06/27/2012 is $20,992.56. The issue date of the policy listed above was 02/19/2002. Please contact our Customer Service Department at 1-800-654-3072 by phone or 1-317-817-4431 by fax if you have questions or require additional assistance. Sincerely, Annuity Claims Department Sovereign !, ~ ' Court Ordered Processing \ Decedents - MAl-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 August 6, 2012 Lauren E. Bogar James D. Bogar, Attorney at Law One West Main St. Shiremanstown, PA 17011 RE: Estate of Eugene L Foster Date of Death: 06/27/2012 Dear Ms. 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 iinterest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, r~~ Ed Stevens COP Specialist 617-514-5189 Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: June 27, 2012 Account #: 7673603985 Type: Money Market Open date: 5/23/2012 In the name of: Eugene L Foster or Karyl M Wentz Date of Death Balance: $201,272.29 lnt.(YTD) from 5/23/2012 Accrued interest to date of death: Otherlnfo: to 6/23/2012 $47.88 Account#: 1921106026 Type: Checking Open date: 5/23/2012 In the name of: Eugene L Foster or Karyl M Wentz Date of Death Balance: $6,654.57 Int.(YTD) from 5/23/2012 to 6/23/2012 _ $0.07 Accrued interest to date of death: $0.01 Otherlnfo: ene L. Foster 391-28-6758 Page 1 of 1 REV-1151 E%+110-06) ~E q%Egfff. L COMMN~~e~AA NT DECEUN`N~RNVANIA SCHEDULE H FUNERAL EXPENSES 8r FILE NUMBER ESTATE OF 21 Foster Eugene L Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 3,628.83 See continuation schedule(s) attached g, I ADMINISTRATIVE COSTS: i. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State __ Zio Year(sl Commission paid 7,890.00 2. Attorney's Fees Bogar 8r Hipp Law Offices 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zio City -' Relationshio of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Faes 2,455.00 7. Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 8,773.83 Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF ITEM NUMBER 1 ~~~~a~al Expenses Malpeui Funeral Home -funeral bill DESCRIPTION FILE NUMBER H-A 2 3 4 5 6 7 Other Administrative Costs Mary E. King, M.D. Mercy Medical Center RESERVES: -Costs to conclude the administration of the Estate, including filiny of PA Inheritance Tax Return and Inventory and preparation and filing of final 2012 Personal Income Tax Returns Sovereign Bank -fee to obtain date of death valuation System Coordinated Services DIB/A Life Lab Theodore Krawiec, MD H-67 AMOUNT 3,828.83 3,828.83 20.00 1,600.00 750.00 20.00 zo.oo 45.00 2,455.00 Form PA-1500 Schedule H (Rev. 6-98) Copyright (c) 2002 form software only The Lackner Group, Inc. REV-1513E%+(11-06) p COMM~I~pF~A TH OECED~N~RRANIA ESTATE OF `E'~ DEfJC.E Foster, Eugene L. SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF NUMBER PERSON(Sl RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spc distdbations~ and tra Kevin G. Foster 33 Old Chester Road Huntington, MA 01050 Lisa J. Lutz 101 Alverta Court Dillsburg, PA 17019 Karyl M. Wentz 2202 Fenwick Avenue Mechanicsburg, PA 17055 FILE NUMBER 21 ATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT fWOrdsl ($$$) _ Son Daughter Daughter One-thircd of rest, residue and remainder One-third of rest, residue and remainder One-third of rest, residua and remainder Total I Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet, as a ro r NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - Gn i en r v i e+~ ~.~~~- ~ ~~^~-- -•- ~ ~ --- - - Fonn PA-1500 Schedule J (Rev. 11-08) Copyright (c) 2009 form software only The Lackner Group, Inc. K ,y C W A L L M E N B Y T H E S E P R E S E N T S ~~~ that I, EUGENE L. FOSTER, of Westfield, Rampden County, !, i ',Massachusetts, being of sound and disposing mind and memory, do ~ I I!imake, publish and declare this to be my Last Will and Testament, ~I I 'land I do hereby revoke ali other and former wills and codicils made) I' I ~, by me. ~j FIRST: i direct that all my just debts, my funeral expenses and the cast of the administration of my estate. be paid out of my residuary estate as soon as practicable after my death. ~I SECOND: I give, devise and bequeath my entire estate, real, !I property over which ' (!personal and mixed, wherever situated, and all ~, II,I may have a power of appointment, to my children, namely, KEVIN I. II GENE FOSTER of Huntington, Massachusetts, KARYL MAY FOSTER WENTZ Ili of East Longmeadow, Massachusetts and LISA JEAN FOSTER LUFT of Mechanicsburg, Pennsylvania. issue, the share of the deceased shall gass to the survivors of my equally to his or her surviving lawful issue. If"there is no In the event any of my above-named children shall predecease' me, then and in that event, the share of the deceased shall pass children, in equal shares. Gerald L. Galegn Ai TURYEV Ai lAW E `NASHfNCrTCN STREET `NESTEIE l.D, MA 0085 ,e tai 5fft 1483 THIRD: I direct that all estate, inheritance and similar taxes which may become due by reason of my death with respect to property passing under this will, joint property and insurance proceeds payable as a result of my death, shall be paid out of the residue of my estate as an expense of administration. FOURTH: I hereby nomiua~c a.... arr--•-- - • - GENE FOSTER, Executor of this, my Last Will and Testament, and request that he be not required to furnish any surety or sureties on his official bond as such Executor. In the event said KEVIN GENE FOSTER shall predecease me or~for any reason declines '.. appeintment hereunder or fails to complete 1:he administration of my estate, then and in that event, I hereby nominate and appoint my daughter KARYL MAY FOSTER WENTZ as Alternate Executrix. I ', further request that no bond or sureties shall be required of said ~trix hereunder. Ct +~ I~, ~~y~ e.°h '" :'; .~ .~ t. ~ a "&" rarer ?Execvt+€sr or TemParary A~~ristrator w,tu »he ti7i3 ancexed b>_ appointed in accordance with Section 13 of Chapter 192 of the General Laws of Massachusetts, as .;amended, upon application of the Executor crr Alternate Executrix jl named in this will. ~~i !~ IN WITNESS WHEREOF, I have hereunto set my hand to this, mY i Last Will and Testament, consisting of three pages, this page ~lincluded, this 17th day of May, 1994. ~: ~~ _L- ~1~ Eugene L. Foster ~ i ~i .,Sighed, published and declared by the Testator, EUGENE L. FOSTER, , to ksa his last mill, in the presence of us, who at his request, in , is gresence amd in the presence of each otaer, hereunto subscribe our names as witnesses: Gerald L. Galego ATOR NE" AT :Alti 9 WASHINGTON BTHEEI WESTFlE! D. MA 0106° ih161 666 ta63 COMMONWEALTH OF MASSACHUSETTS ~~ Gerald L. Galego HTTORNEY AT +AW 6 WASHik G'ON STREET JJ FgT:IC'. ';. b1A O':OfiS .;ct 31 56n .;aP,3 HAMPDEN, ss. May 1?, i99? Before me, the undersigned authority, on this day persanally appeared EUGENE L. FOSTER and GERALD L. GALEGO and LISA A. DeROIN, known to me to be the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, and all of these persons being by me duly sworn, EUGENE L. FOSTER, the 'Testator, declared to me and to the witnesses, in my presence, that the instrument is his last will and that he had willingly signed 'it and that he executed it as his free and voluntary act for the !,purposes therein expressed; and that each of th.e witnesses stated to me, in the presence of the Testator, that they signed the will as witnesses anal that to the best of their ksaawl.edge, the Testator was eaghteen years of age ar aver, of saund mind and under no .constraint or undue influence. i Subscribed and sworn to before witnesses this 17th day of May,