HomeMy WebLinkAbout08-29-12 (3)1505610149
REV-1500 EX(°'-'°'~%~,
Pennsylvania OFFICIAL USE ONLY
PA Department of Revenue """"""""""'""'
County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO e0X 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 0 10 116 4
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
195 28 8228 09 12 2010 06 10 1936
Decedent's Last Name Suffix Decedent's Frst Name MI
Ertel Shirley M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's Frst Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
O 1. Original Return
O 4. Limited Estate
~ 6. Decedent Died Testate
(Attach Copy of Will)
l~ 9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
~ 2. Supplemental Return
D 4a. Future Interest Compromise (date of
death after 12-12-82)
I~ 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death
prior to 12-13-$2)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -This section must be completed. All Correspondence and Confidential Tax Information Should be Directed to:
Name Daytime Telephone Number
Elyse E • Rogers, Esquire 717 612 5801 ,...,
First line of address
635 North 12th Street, Suite 400
Second line of address
City or Post Office State ZIP Code
Lemoyne PA 17043
REGISi~ WILLS US~,Q NLY T
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DATE FIL ED -""
Correspondent's a-mail address: efOgel'S@SSI"-attOfneyS.COm
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Under penalties of perjua~; (declare 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 ' pl e. Declaration of the preparer her than personal representative is based on all information of which preparer has any knowledge.
SIGNATUREOFP O RESPO SIB FOR IN RETURN D E
ADDRESS 2LT66 Maple Roams r
Camp Hil A 17011
SIGNATUR O REPARER HERT AN REPRESENTATIVE DATE
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ADDRESS 63 North 12th St eet, uite 400
Lemoyne, P 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610149 1505610149
`Y
J
1505610249
Rev-1500 EX
Decedent's Social Security Number
Decedent's Name: Shirley M. ErtCI 19 5 2 8 8 2 2 8
RECAPITULATION
1. Real estate (Schedule A) ......................................... 1. ~ • ~ ~
2. Stocks and Bonds (Schedule B) .................................... 2. ~ ' 0 ~
3. Closel Held Co oration, Partnershi or Sole-Proprietorshi (Schedule C
Y rp P p ) ......
3. ~ - ~ ~
4. Mortgages and Notes Receivable (Schedule D) ......................... 4. ~ • ~ ~
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ....... 5. 2 4 , 2 5 9 - 6 4
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... 6. ~ ' ~ ~
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested ...... 7. 0 • 0 0
8. Total Gross Assets (total Lines 1 through 7) ............................ 8. 2 4 ~ 2 5 9 -6 4
9.
P ( ..................
Funeral Ex enses and Administrative Costs Schedule H) g, 2 , 2 7 3 - 7 3
10.
9 9 ) .............
Debts of Decedent, Mort a e Liabilities, and Liens (Schedule I 10. ~ • ~ ~
11. Total Deductions (total Lines 9 and 10) .............................. 11. 2 , 2 ~ ~ ' 7 ~
21, 9 8 5 • 91
12. .............................
Net Value of Estate (Line 8 minus Line 11) 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
.......................
an election to tax has not been made (Schedule J) 13. ~ ' ~ ~
~ 21, 9 8 5 - 91
14. Net Value Sub
ect to Tax Line 12 minus Line 13 14.
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 .00 ~ • ~ 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 21, 9 8 5. 91
16,
9 8 9. 2 7
17. Amount of Line 14 taxable
~ • ~~
~ - ~~
at siblingrateX.12 17.
18. Amount of Line 14 taxable
~ ' ~ ~
~ ' 0 ~
at collateral rate X .15 18
9 8 9. 3 7
19. TAX DUE .................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~
Side 2
1505610249 1505610249
Rev-1500 EX Page 3
Decedent's Complete Address:
Fle Number
20 10 1164
DECEDENTS NAME
Shirley M. Ertel
STREET ADDRESS
200 North 30th Street
CITY
Camp Hill STATE
PA ZI P
17011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
(1)
0.00
0.00
Total Credits (A + B) (2)
989.37
0.00
0.00
989.37
3. Interest
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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
(4)
(5)
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;..•..•...•.•.•...••.•.••••••••••••••• Q
b. retain the right to designate who shall use the property transferred or its income; ..... • • • • . • • • • • • Q
c. retainareversionaryinterest;or .•.••.•••••••••••••••..•......•••..••••••••.••.•..• Q
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? •............••••••.•.•..•••••••••••••• Q
3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her death? .. Q
4. Did decedent own an individual retirement account, annuity, or other non-probate property,
which containsabeneficiarydesignation? .•••••••••••••......•..•..••••.•••••••••••••• Q
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. Sect. 9116(a)(1.1)(i)].
For dates 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. Sect. 9116(a)(1.1)(ii)]. The statue 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. Sect. 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. Sect. 9116(1.2) [72 P.S. Sect. 9116(a)(1)J.
• 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. Sect. 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 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAX RETURN
RESIDENTDECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Shirley M. Ertel 20 10 1164
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.
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+(10-09)
5 i ~ pennsylvania SCHEDULE H
FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Shirley M. Ertel 20 10 1164
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
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 Fees:
6. Tax Return Preparer Fees:
7 Register of Wills, filing fees
8 Saidis, Sullivan & Rogers, out of pocket expenses
9 Cumberland County Recorder of Deeds
10 Lycoming County Recorder of Deeds
TOTAL (Also enter on Line 9, Recapitulation)
If more space is needed, use additional sheets of paper of the same size.
2,000.00
30.00
55.73
64.00
124.00
2,273.73
REV -1513 EX+(01-10)
i ~ pennsylvania SCHEDULE J
1]E PAFt1p.;~N Cit. Rs V?;:Nt.rf
INHERITANCETAXRETURN BENEFICIARIES
RESIDENTDECEDENT
ESTATE OF: FILE NUMBER:
Shirley M. Ertel 20 10 1164
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBE NAME AND ADDRESS OF PERSON S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2).]
Christel L. Ertel
2966 Maple Road
Camp Hill, PA 17011
Daughter
21,985.91
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18 OF REV-1500 COVER SH E ET, AS APPROPRIATE.
zz NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET.
If more space is needed, use additional sheets of paper of the same size.
LAST WILL .AND TESTAMEn'T
I_ Shirle~~~ M. Ertel. of Cumberland Count}~. Peiu~sylvania. revolve m~~ prior
wills and declare this to be m}~ will:
GIFTS
I. Personal and I-household Effects: I gi~~e all m~~ articles of personal or
household use, including automobiles, together with all insurance relating. thereto, to n1y
only child, Cl~-istel L. Ertel (Stewart); who so survives me.
I may leave a memorandum setting forth suggestions as to the distribution
of certain items and, while the memorandum is not to be legall}% binding, I hope the
suggestions in it will be carried out.
Ih. Residuary Estate: I give the residue of my estate; real and personal:
To my daughter, Christel L. Ertel, if she survives me and if not, to
my grandchild Grace Martha Ertel Stewart
III. Powers of g~pointment: No provision of this tivill shall exercise any
power of appointment I may have.
,gDMINISTRATI~TE PROVISIONS
V. Minor Benef curies: Any property passing under this tivill to a person
under twenty-one years of age shall be paid to a custodian for the minor selected and
appointed b}t my executor under the Pennsylvania Uniform Transfers to Minors Act.
VI. Protective Provision: No interest in income or principal shall be
assignable by; or available to anyone having a claim against; a beneficiar}-' before actual
payi~nent to the beneficiar~~~.
VII. Death Taxes; All federal, state and other death taxes payable because of
nay death on the property forming, m}~~ gross estate for tax purposes; whether or not it
passes under this will_ shall be paid out of the principal of nay probate estate so that the
burden thereof falls on m}~ residuary estate, and none of those taxes shall be charged
against any benef ciarv ox~ an}' outside fund. This provision shall not aphl}~ to generation-
shipping transfer taxes.
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VIII. Mana~~enlent Provisions: 1 authorize m~~ executor:
A. To retain and to invest in all fol~nls of real and personal property.
without being confined to investments authorized by a statutory
list:.
B. To compromise claims and to abandon any property which, in my
executor's opinion, is of little or no value:,
C. "fo sell at public or private sale, to exchange or to lease for any
period of tinge, any real or personal property, and to give options
for sales or leases;
D. To join in any merger, reorganization. voting-trust plan or other
concerted action of securit}~ holders, and to delegate discretionary
duties with respect thereto;
E. To borrow and to pledge property as security for repayment of any
funds borrowed;
F. To partition. subdivide or improve real estate and to enter into
agreements concerning the partition, subdivision, improvement;
zoning or management of any real estate in which lny estate has an
lllterest a11d t0 llllpose OI' extlllgUlsh restl'1Ct1o11S OI1 any such real
estate;
G. To employ and to rely upon. advice given by investment counsel, to
delegate discretionary authority to make changes in investments to
investment counsel, and to pay investment cotulsel reasonable
compensation in addition to any fees otherwise payable to my
executor;
I~. To employ a custodian. to hold propehy unregistered o~~ in the
name of a nominee including the nominee of any institution
employed as custodian], and to pay reasonable compensation to the
custodian in addition to any fees other~~~ise payable to nay executor;
and
1. To distribute. in cash or in Jcind.
These authorities s11a11 be in addition to those granted by law and shall be exercisable
without court authorization.
Ix. Business Interests: In dealing with the stocl: of any close corporation, any
partnership or any other business interest forming a part of m}-~ estate. T authorize my
executor:
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A. To disregard any principle of investment diversification and to
retain any pa1-t or all of such interest as long as n7}~ executor
considers it advisable to do so;
B. To sell any part or all of such interest at such time or time's for
such prices. to such persons (including persons who are fiduciaries
or beneficiaries hereunder) and on such terms and conditions as my
executor may thinh advisable;
C. To do an>~thing that play seem advisable with respect to the
operation or liquidation of any such business or any change in the
purpose.. nature or structure of any such business;
D, To delegate authority to any director. stockholder, manager, agent,
partner or employee, and to approve payment from the business of
adequate compensation to any such person;
E. To cause the. business to borrow money from the banking
department of any corporate executor, regardless of any rule of lain
with respect to conflict of interest; and
F. To make additional investments in any such business, if such
action seems in the best interest of the beneficiaries hereunder.
The fact that any executor of this will may be interested in any such business as director,
stockholder, manger, agent, pal-tner; employee or creditor shall not constitute an adverse
or conflicting interest, and the acts of such executor shall be judged as if he or she had no
interest in the business. No executor shall be liable to anyone for an}thing done or not
done by any other executor or by any beneficiar}~, except for willful or gross negligence.
In short; I intend that in making decisions hereunder; my executor shall have the same
freedom of action that I would have. if living.
X. Debts and Funeral Expenses: My debts and the expenses of my last
illness, funeral and burial shall be paid out of nay estate.
XI. F,xecutor: l appoint nay daughter, Glristel L. Ertel, executor of this will,
and I direct that:
~. If my daughter, C1lristel L. Ertel, for any reason fails to qualify or
ceases to act as executor, I appoint Gary 1y. Stewal-i. executor in
her place;
B. My executor ma}-~ at any time be written instrument appoint a
corporation with fiduciar~~ powers as a co-executor and may enter
into a binding agreement with it regarding its compensation;
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C. The words "mv executor" shall refer to al] those from time to time
acting. as such and
D. No executor shall be required to give bond.
Executed~~~~ ~ Z~ , 201 U.
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In our presence the above-named testatrix signed this and declared it to be his will, and
nova-~ at his request, in his presence; and in the presence of each other; we sign as
«~ltnesses:
t l ~ ~ ~ ~~~
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Witness Address ~ ~ ~ ~
V~~itness Address
!-rte
STATE OF PENN] S~rL~~'ANIA
~ ..~ S S
LOLT~T~ OF ~ cr ~,~ ~ ~'
1
I, Shirley M. Ertel. having been duly qualified according to law,
acknov~~ledge~ that I signed the foregoing instrument as my will; and that I signed it as my
free and voluntary act for the puzposes therein expressed.
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`--~ ~ hir-l~e IUI . Ez`tel: - ~-~= ~==.
:~-----~
V~~e, having been duly qualified according to law. depose and say that we
were present and saw Shirley M. Ertel sign the foregoing instrument as his will; that he
signed it as his free and voluntar~J act for the puzposes therein expressed; that each of us
in his sight and hearing and at his request signed the will as witnesses; and that to the best
of our l~z~owledge he was at that time 18 or more years of age, of sound mind and under
no constraint or undue influence.
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V~%itness ~
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Subscribed, sworn to or
affirmed, and aclUlowledged
before me by the above-named
testatrix anal by the v~ritnesses
whose names appear opposite,
ol~ .~ ~ ~ t ~'~ , 2010 .
J
Notary Public
COMi'dlON1NEALTH OF PENNSYLVANIA
Notarial Seal
Michelle A. Sine, Notary Public
Ci#y of Harrisburg, Dauphin County
NFy Commission EXplres Nov. 18, 2012
tvlember, Pennsylvania Association of Notaries
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SHIRLEY M ERTEL
Account # 52070074
Balances
.Beginning Balance $15.348.64 Current Balance $15,264.97
Deposits/Credits '- $0.12 Average Daily Balance $15,33$.46
Withdrawals/Debits - 583.79
interest
Paid this Period # $ 0.12 Annual Percentage Yield Earned 0.01
Earned this Period $ 0.12 Paid Last Year $0.98
Paid Year-To-Date $ 1.18
*The interest earned and the interest paid may differ depending on when interest is credited to your account.
Service Fees -Itemized
r•
1, D to ~~ p~a~---_._, ~`
10:15 Beginning 8alanca \
,ra ~''; 1 fi-19 :'Sullivan payments 1011 ~-9 1841
(' ~ 1 14 Sullivan payments 119 2573
k
$30.11
Date # Transactions Fee
MONTHLY MAINTENANCE FEE 11/22!10 1 10.00 $10.00
Total $'! 0.00
Account Activity
Total
Balance
$15,348.64
$ ,,, 4.96
$15,274.85
1- - 2~T~fi~CSERVICE FEES ~-i u.uu ~ i ~,~n4.a~
11-22 INTEREST CREDIT $0.12 $15,264.97
11-22 Ending Balance $15.264.97
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS
t CALL YOUR CUSTOMER SERVICE CENTER AT THE NUMBER SHO~Vi~1 ON THE TOP OF YOUK STATEMENT OR WRITE TO 1'HE B:1NI:
r; FOR'DEBIT CARD ISSUES: FOR ALL OTHER ISSUES:
~, j (1 j Sovereign Bank Sovereign Bank
f Attn: Card Disputes Team Attn. Client Relations
t /' MA1 MB3 02 06 10-421-CR1
` ~ P.O. Box 831002 P.O BOY 12646
~~ ~ Boston MA 02283-1002 RE.°.DING, PA 1961'_-2646
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Please contact=usif you think your statement or receipt is wrong or if you need additional informauon about a transfer on the statement or receipt Vv'e must heal
from you no-later than 60 days after we sent ti~ou the FIRST statement on which the error appeared.
~ Tell us your name and account number- • Describe the error or the transfer that you are unsure about and explain as clearly as you can why
• Tell us the dollar anlount of the suspected error. you believe there is an error or why you need further information.
If you tell us orally, we may require you to send your complaint or question in writing within ] 0 business days.
We willpromptly investigate the matter and call or write to you with an answer within 10 business days (10 calendar davs in Massachusetts). If we need more time,
we may-takeup~to 4~ days to investiUate your complaint or question. If we do, we will credit your account within this l.0-da}' period for the amount you think is in
error, so you wtll`have the use of the money during the time rt takes us to complete our investigation. If the ask you to put vour complaint or yuesUon in venting
and we do not receive it within 10 business days, we may choose not to credit your account.
For errors inuolvinQ new accounts, point of sale purchases or forei~m transactions, we may take up to 90 days to investigate your complaint or question- For ne~~~ accounts,
we may takeup to ~l0 business days to credit your account for the amount you think is in error-
Wewill tell you the results of our investigation ~~'ithin 3 business days after completing our investigation If we decide there was no error, we will send you a written
explanation. You may ask for copies of the documents we used in our investigation.
Iml)ortani information ai;'out vour Sovereign Dcbit Card
The networks through which some of your Sovereign Debit Card purchases are processed have begun allowing merchants to process your purchases without
either a si,gnature..or a PIN. If you are not required to enter your PIN when you make a purchase. }'our purchase may be processed either through the Visa
network or hrou~hthe STAR or NYCE networks. If your purchase is processed through STAR or NYCE, different terms appiv and you will not he eligible
for the rights andproteetions available through Visa. Please see your Personal Deposit .Account Agreement for more information.
page 2 of 2
Additions Subtractions
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