HomeMy WebLinkAbout10-11-12 (2)
1505610105
J REV-1500 EX (02-u) (FI)
PA Department of Revenue pennsylvarda
Bureau of Individual Taxes «`""'~»'«"`»`""`
PO Box zl3o6o1 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY
__ ~_ .
Decedent's Last Name Suffix
~lloss __
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
_~OSS_
Spouse's Social Security Number
OFFICIAL USE ONLY
County Code Year File Number
_..
Date of Birth MMDDYYYY
09~~d~! ~3C~
Decedent's FirstName MI
Spouse's First Name
_... MI
LJ'oQ/7/'Ir~ M
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Llna'ri'~c~ C~ S/1c~lyr ~sPU<'r~ _ 7~7-C91~- zGsx:J
--
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First Line of Address ~~ .
8~
Second Line of Address
USE
3
t;J1
113
City or Post Office State ZIP Code DATE FILED
437~C61~niCshc~.rS,~ /°A- l7~SS
Correspondent's a-mail addresVVs: Q~~'~ ~ G ~ ~ hcel ~/ ~/ V~°r% ~~ - ~
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under penalties of perjury, I declare that 1 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.
SIGN URE OF PERSON RESPONSIBLE FOR FILING RETURN reTo
ifixn.~~ 7l. ~-. to ~ip ~ 0 i
~i RFCC ~~
SIG RE OF
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REPRESENTATIVE ~~j~;ATF 1
PLEASE USE ORIGINAL FORM ONLY
1505610105
Side 1
1505610105
J,\~'-~
~r ~
J
REV-1500 EX (FI)
Decedent's Name: NOSS, Larry E.
Decedent's Social Security Number
C ?~ 30 • YG'y~Z,
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 and Notes Receivable (Schedule D) ......................... .. 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 13,477.74
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. ',
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property $43
044
48
(Schedule G) O Separate Billing Requested...... .. 7. ,
.
8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. $56,522.22 `
9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. $4,250.61
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10.
11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. ! $4,250.61"
12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12 $52,271.61
13. Charitable and Governmental BequestsfSec 9113 Trusts for which
an election to tax has not been made (Schedule J) .................. ...... 13.
14. NQt;-Value Sub/4gtto Tax (Line 12 minus Line 13) .................. ...... 14. $52,271.61
TAX CALCULATION :6EE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at tTie spousal tax rate, or
transfers undP~ cec. 9116 $52,271.61
(a)j1.2) X .00
16. Amount of Line 14 ~=table
at lineal rate X .0
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
1 s. $0.00
16.
17.
18.
19. TAX DUE ........... 19 $0.00
.............................................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
O
1505610205
Side 2
1505610205 1505610205 J
REV-1500 ~X (FI) Page 3 File Number
Decedent's Complete Address: "7~~ ~l ~~~ l
DECEDENT'S NAME
Larry E. Noss
STR~~TAn~RFSS --
602 West Keller Street
rirv STATE ZIP
Mechanicsburg ~ 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) $0.00
2. Credits/Payments
A. Prior Payments
B. Discount _
Total Credits (A + B) (2)
3. Interest
4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) -
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $0.00
Make check payable to: REGISTER OF WILLS, AGENT.
t 2 r y~~ ~ggFn i ~ k i y,(~ U c ~e {i A +"~,.
n ,e. w r rh Ix I.A : .' r e'e+~ =~ ° P(~ai1~91~e~4, r . '.3~°i'1e`°P e.°~a2~°t~~ ..~ :~rcP~d~. .s~h9Pih19k;~ ~"f Y~*7 ~~ . .m `Pd~l~i~'~'~~~I£P~t a ,.41 ..i~t~ii~ "dt fi. ~r ~ ~„",~4
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 ............................................................................. ............. ^
b. retain the right to designate who shall use the property transferred or its income ............................... ............. ^
c. retain a reversionary interest ........................................................:........................................................ ............. ^ '~
d. receive the promise for life of either payments, benefits or rare? ......................................................... ............. ^
2. If death occurred after Dec. 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? . ............. ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ...................... '~( ^
IF THE ANSWERS ~,TO^ANY OF T~'(HE ABOVEQ, UESTIOtgNS IS YES, YOU MU({ST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
~'. .ed'~~,. Pa ~'~''"Na~3a-r~d%.`+&'w+'~.u '~°AI'i~~~Y?~';~A~"" pGil ~, i+Ai a~Jd lri^2's,,.v~~~~° ~~--.r II~~e°.~ .",913 Y 5~~1~ 4eiyy pfd%~" `. K tl~' U7~.T"`P S r~^ ,~ ~~t. E,,
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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. §9116 (a) (1.1) (i}j.
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. §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(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)]. Asibling 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-i5o8 EX+ (u-io)
pennsylvarria
OEOARTMENT OF REVENUE
1NHERTfANCE TAX RETURN
RESIDENT DECEDENT
SCNEpULE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
ESTATE OF:
Larry E. Noss
FILE NUMBER:
21-11-1101
Include the proceeds of litigation and the date-the proceeds were received by the estate.
All property jointly owned with right of survivorshio must be disclosed on Schedule t:
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REV-110 EX+ (08-09?
~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Larry E. Noss 21-11-1101
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCUIDE 711E NAME OF THE TRANSFEREE, THEIR RELA770NSNIP TO DECEDENT AND
THE DATE OF TRANSFER ATTACH A CDPY OF THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
°k OF DECD'S
INTEREST
EXCLUSION
IF APPLICAaIE)
TAXABLE
VALUE
1. Citizens Investment account #LSC-000280 Benefiaary: Joanna M. Noss, 543,044. 100% 543,044
Wife, 602 West Keller Street, Mechanicsburg, PA 17055
TOTAL (Also enter on Line 7, Recapitulation) $ I $43,044.48
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REV-1511 EX+ (10-09)
~ Pennsylvania
DEPARTMENT OF REVENUE
1NNERtTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Larry E. Noss
Decedent's debts must be reported on Schedule I.
ITEM _.
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Malpezzi Funeral Expenses $3,362.11
e. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: $ 0.00
Name(s) of Personal Representative(s) .IOanna M. NOSs
street address 602 West Keller Street
city _Mechanicsburg _., state PA zIP 17055
Year(s) Commission Paid:
$500.00
Z• Attorney Fees: ~ yit1reW [ , ,S htt/r ~syv; r~
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
a. Probate Fees: $123.50
5• Accountant Fees:
6. Tax Return Preparer Fees:.
~• Filing Fee $15.00
B Reserves to conclude Estate administration, taxes and final accounting $250.00
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
FILE NUMBER
21-11-1101
TOTAL (Also enter on Line 9, Recapitulation) I # 4,250.61
If more space Is needed, use additional sheets of paper of the same size.
Wednesday, October 10, 2012 10:15 AM Malpeui Funeral Home 7176972414
Malpezzi Funeral Home
8 Market Plaza Way
Mechanicsburg, PA 17055
(717)697696
p.01
Michael J. Maloezzi, Owner, FD Jeremv J. Shartzer, FD Kyle C Knioe FD
October 10, 2012
Joarma M. Noss
602 West Keller Street
Mechanicsburg, PA 17055
The Funeral Service for Lany E. Noss
We sincerel appreciate the confidence ou have placed in us and will continue to assist you in every
way we cant' Please feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES:
Direct Cremation $2,095.00
FUNERAL HOME SERVICE CHARGES 52,095.00
SELECTED MERCHANDISE:
Transporter Cremation Container $165.00
Chestnut Bronze Um $300.00
Peaceful Retreat Register Package $195.00
Walnut Flag Case $95.00
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED $2,850.00
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO
OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
CASH ADVANCES:
Certified Death Certificates $72 Op
Newspaper Notices -Patriot $292 92
Newspaper Notices - Seminel $147.19
TOTAL CASH ADVANCES AND 3PECIAL CHARGES $512.11
CONTRACT PRICE $3,362,11
HISTORY:
I 1 /29/2011 Payment Joanna M. Noss $3,362.11
TOTAL AMOUNT DUE SO,pp
RECEIPT FOR PAYMENT
GLENDA FARMER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
MOSS LARRY E
Estate File No.: 2011-01101
Paid By Remarks: JOANNA M MOSS.
HMW
-------------------
Fee/Tax Description
PETITION LTRS TEST
WILL
SHORT CERTIFICATE
JCS FEE
AUTOMATION FEE
Check# 3929
Total Received.........
Receipt Date: 10/19/2011
Receipt Time: 09:38:08
Receipt No.: 1067354
Receipt Distribution ----- -------- -------- ---
Payment Amount Payee Name
30.00 CUMBERLAND COUNTY GENERAL FUN
15.00 CUMBERLAND COUNTY GENERAL FUN
20.00 CUMBERLAND COUNTY GENERAL FUN
23.50 BUREAU OF RECEIPTS & CNTR M.D
5.00
------------ CUMBERLAND COUNTY GENERAL FUN
----
93.50
93.50
REV-713 EX+ (O1-10)
"~r Pennsylvania SCHEDULE 7
DEPARTMENT Of REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Larry E. Noss 21-11-1101
RtLAl1UNSMIV IU UtC:tUtNl HMUUNI UK ~hIHKt
NUMBER 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).}
1, Joanna M. Noss, 602 West Keller Street, Mechanicsburg, PA 17055 Wife 100% Rest, Residue &
Ramainriar
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A5 APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARCIABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
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 TESTAMENT
OF
LARRY E. NOSS
I, LARRY E. NOSS, of 602 West Keller Street,
Mechanicsburg, (Borough of Mechanicsburg), Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last Will and
Testament, hereby revoking all other Wills and Codicils heretofore made
by me.
FIRST: I diurect that all inheritance, estate, transfer, succession
and death taxes, as well as my just debts and funeral expenses, of any kind
whatsoever, which may be payable by reason of my death, shall be paid
out of the principal of my estate as the same can conveniently be done.
SECOND: I give, 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, unto my husband,
JOANNA M. NOSS provided she survives me by thirty (30) days.
Tom: Should my wife, JOANNA M. NOSS, predecease
me or die on or before the thirty-first (31st) day following my death, I
give, 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, as follows:
A. One third (1/3) thereof to my son, MICHAEL E. NOSS,
of Mechanicsburg, Pennsylvania, provided that should MICHAEL E.
NOSS predecease me, I give, devise and bequeath his share unto his issue
per stirpes, and if there be a failure of same, then I give and bequeath such
deceased child's share to my surviving children as provided for and named
herein.
B. One third (1/3) thereof to my son, JEFFREY L. NOSS, of
Carlisle, Pennsylvania, provided that should JEFFREY L. NOSS prede-
cease me, I give, devise and bequeath his share unto his issue per stirpes,
and if there be a failure of same, then I give and bequeath such deceased
child's share to my surviving children as provided for and named herein.
C. One third (1/3) thereof to my daughter, BONNIE L.
NESTER, of New Kingstown, Pennsylvania, provided that should BON-
NIE L. NESTER predecease me, I give, devise and bequeath her share
unto her issue per stirpes, and if there be a failure of same, then I give and
bequeath such deceased child's share to my surviving children as provided
for and named herein.
FOURTH: 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 property, 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
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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 the power to give legally sufficient instruments for transfer of the
property and to receive the proceeds of any disposition.
(B) To partition, subdivide, or improve real estate and to
enter into agreements concerning the partition, subdivision, improvement,
zoning or management of real estate and to impose or extinguish restric-
tions 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 property, including stocks,
common trust funds and mortgage investment funds, without restriction to
investments authorized for Pennsylvania fiduciaries, as are deemed
proper, without regard to any principle of diversification, risk or pro-
ductivity.
(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, per-
sonal income, gift and estate or inheritance tax laws.
~ (G) To make distributions to my herein named beneficiaries
in cash or in kind or partly in each.
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(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 retire-
ment 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.
FIFTH: No part of the income or principal of any Trust
created by this Will shall be subject to attachment, levy or seizure by any
creditor, spouse, assignee or trustee or received in bax-lauptcy of any
beneficiary prior to his or her actual receipt of income or principal distrib-
uted. The Trustee shall pay the net income and the principal to the
beneficiaries specified by me, as their interests may appear, without regard
to any attempted anticipation, pledging or assignment, and without regard
to any claim or attempted levy, attachment, seizure or other process
against the beneficiary.
SIXTH: I nominate and appoint my wife, JOANNA M.
NOSS, Executrix, of this, my Last Will and Testament. In the event of
the death, resignation or inability to serve for any reason whatsoever of
jOA.-NNA M. NOSS, I nominate and appoint my daughter, BONNIE L.
NESTER, Executrix, of this, my Last Will and Testament. Should both
JOANNA M. NOSS and BONNIE L. NESTER be unable or unwilling
~e as Executrix, then I nominate and appoint my son, JEFFREY L.
NOSS, Executor, of this, my Last Will and Testament. I direct that my
4
Executor or Executrix, as the case may be, shall not be required to post
security or a bond for the performance of his or her duties in any jurisdic-
tion.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this / o day of February, 2000.
(SF-~-)
Signed, sealed, published and declared by the above-named
Testator as and for his Last Will and Testament in our presence, who, at
his request, in his presence and in the presence of each other, have here-
unto subscribed our names as attesting witnesses.
Address Name
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Address Name
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