HomeMy WebLinkAbout10-27-06 (2)
REV-1990EXy(e-OO)
c
weALTH of REV 1500 OFFICIAL USE ONLY
oMMDN
PENNSYLVANIA
DEPARTMENTOFREVENUE
INHERITANCE TAX RETURN -
FlLE NUMBER
DEPT. 280801
HARRISBURG, PA 17128-0601
RESIDENT DECEDENT COUNTY CODE YEA6R QNUMBE~R
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
z Kfein, Harold J. 180-22-0483
C DATE OF DEATH (MM-0D-YEAR) DATE OF BIRTH (MM-0D-YEAR) TNIS RETURN MUST BE FlLED IN DUPLICATE WITH THE
~ 07-31-2008 09-23-1926 REGISTER OF WILLS
~ (IF APPLICABLE) SURVMNG SPOUSE'S NAME (IAST, FiR3T AND MIDDLE INTIAL) SOCIAL SECURITY NUMBER
a 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (tlete or death prig to 12-73-82)
W
r ~ 0
^ 4. Limifetl Estate ^ 4a. Future Interest canpraniee (date of deem alter
12-12.92)
^ 5. Federal Estate Tax Return Required
Y~ ~
u m ~ 8. Decedent Disd Testate (Attach ^ 7. Decedent Maintained a Uving Trust (Attach 0 8. Total Number of Safe Deposit Boxes
spy awe) mpr ar rout)
^ 9. Litigation Proceeds Received ^ 1 D. Spousal Poverly~Credit (date of tleath belwaen
i ~t~ai and l
l- ^ 71. Election t0 tax under Sec. 9113(A) (ANadi Sch 0)
-
)
NAr~IE COMPLETE MAILING ADDRESS
Michael L. Bangs
$ FIRM NAME (aepplic~b) 429 South 18th Street
W
~
C
Hi
ll
PA 17011
amp ,
~-?
-
TELEPHONE NUMBER ~ }~,
~
~~ ~*'
"'"`
717/730-7310 _
;~-~'
1, Real Estate(SchaduleA) (1) None QF~FyICI 'US
2. Stocks and Bonds (Schedule B) (2) None . i -1 - ' ~ ~~
3. Closely Heil Corporation, Partnership or Sole-Proprietorship (3) N O n 8 ' ~' 1 ""' ~ _' -~i
-
- _ ;
ii _ -:- C=j
4. Mortgages & Notes Receivable (Schedule D) (4) (~ O n g = _ = ~ _ = "' I
5.Cash, Bank Deposits & Miscellaneous Personal Property (5) 108
686.87 c"1 -r1
(Schedule E) - , ~ )
z 6. Jomtly Owned Property (Schedule F) (6) Non e
0
F ^ Separate Billing Requested
S 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) Non e
~ (Schedule G or L) n Separate Billing Requested
`a
$,Total Gross Assets (total Lines 1-7) ($)
W 9.Funerai Expenses &Administrative Costs (Schedule H) (9) 12,585.85
z
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) (10) 1,823.22
11. Total Deductions (total Lines 9 8 10) (11)
12.Net Value of Esfate (Line 8 minus Line 11) (12)
13. Charitable and Governmental BequestsiSec 9113 Trusts for which an election to tax has (13)
not been made (Schedule J)
14. Net value SubJect to Tax (Line 12 minus line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax rate,
15 0.0 0 x .00 (15)
.
or transfers under Sec. 9116(a)(1.2)
z
4
Amounl of Line 14 taxable at lineal rate
16
94,277.80
x •045
(16)
.
~ 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
0
v
18. Amount of Line 14 taxable at collateral rete
0.00
x .15
(18)
19. Tax Due (19)
20.
108,688.87
14,409.07
94,277.80
None
94,277.80
0.00
4,242.50
0.00
0.00
4,242.50
Copyright 2002 form softwaro only The Lackner Group, Inc. Fonn REV-1500 EX (Rev. 6-00;
Decedent's Complete Address:
STREET ADDRESS
200 Pineview Road
CITY Camp Hill STATE PA zIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/PenakyIf applicable
p, Interest
E. Penalty
(1)
_ 4,030.38
212.13
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This Is theOYERPAYMENT. (q)
Check box on Paga 1 Line 20 to request a rotund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is thdTAX DUE (5)
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE
(SA)
(5B)
4,242.50
4,242.51
0.01
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTION8 BY PLACING AN eX" 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 :................................
c. retain a reversionary interest; or ..............................._...........................__.............................................. ^
x
d. roceive the promise for life of either payments, benefits or care? ........................................................... ^ x^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ............................................................_....................................................
3. Did decadent own an "in trust fob' 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 deaignation? ................................................................................................................ ^ ~~
IF THE ANSYYER TO ANY OF THE ABOVE QUESTION813 YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN
.
~b. DsrJrdaw~n d • I dseWS IMt I have e~camMW thu rNUm, inchdln0 accanPBnYinG eclbdules entl atatanenb, and to Mie best of mY knowbdpe mW belief, i1 is tn», cared and
PraDerer other Mien Mts personal repreaer~tatlva is beaed on aN itAOrtmetiai of which txaoarar hea env knewleeo"
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
Peter Lassi ~ A- 200 Fineview Drive
~ ` ~ ~ Camp H[II, PA 17011 f o - Z~06
b- a3' UL
_____.. ___._____..._. ____._._ ....~..~.,.. DATE
Michael L. Bangs 429 South 18th Street
Camp Hill, PA 17011
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of trensfers to or for the use of the
surviving spouse is 3°~ [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°r6
[72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disGosure
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-0ne 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% [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 traeeficiaries is 4.5%, except as noted in 72 P.S.
§9116 1.2) [72 P.S. §g116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12°~ [72 P.S. §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.
Rw•1509 Fx+ la-eat
COMMIOlIWEALTM of rEm+avLVnww
IM/ERRMICE TA%RFTURN
RE810f71T OECEDEI7T
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
ESTATE OF (FILE NUMBER
Klein, Haroid J. 21-06-0728
hdude the proceeds of Irtpalbn and the data the proceeds vivre rsceNetl by the estate.
All property jointly-ovmad wiM the rlyht or wrvivorship moat W disNosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUt A I UA I t
OF DEATH
1 PA Farm Bureau Members Service Corp. - Reimbursment of health insurance 548.75
premiums (August and September)
2 PNC Bank -Account No. 51003-4854 17.917.40
3 Prudential Financial -Whole Life Insurance Policy #73 491 273 with cash surrender 39,741.94
value.
4 PSECU -Regular Shares Account 4.534.66
5 PSECU -Checking Account 543.18
6 PSECU -Money Market Account 45,400.94
TOTAL (Also enter on Line 5, Recapitulation) I 108,686.87
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form stRtwaro only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 8-98)
SEP-24-2006 21:46 PNCBANVC 412 768 3458 P.01i01
$~ ~'NCBANC
September 25, 2006
Michael L. Bangs
429 South 18"' Street
Camp Hill, PA 170] 1
RE: Estate of Harold J. Klein, deceased
SSN: 180-22-0463
DOD: 7/31!2006
Dear Mr. Bangs:
]n response to your request for Date of beach balances for the customer noted above, ow'
records show the following:
Checking Account
Acacount #5140034854 Established 12!01/1972
HAROLD J KLEIN
DOD balance: 517,917.40 + $6.90 aecnacd interest
Interest Paid 1!1/ZOOtS - 7/31!2006 - Sl 14.11
Please note that this office only provides date of death balsnocs for deposit accounts
(IRAs, CDs, Checking and Sayings accaatts). We do !tat process aey fi;wsuacial
trsisaactlons or provide stateilgelNs. if you need assistance with any of these iterraa,
please call 1-$88-PNC-HANK (1-888-762-22b5) or stop by your local I'NC Bank branela
office.
Sincerely, ~ ~ ~ ~ ~
~it~,C:~~.~- t~.~.~
Raehelle wells
1-800-762-1775
P7-PP5C-04-F
500 first Ave.
Pittsburgh PA 15219 Member PD1C
REV-1161 EX+t12-99)
COM NHEM~AL E~AX RETl1RN ANIA
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES 8r
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Klein, Harold J. 21-08-0729
~~. VOVIi VI YO{.OY011{ IIIYaL YC 101JVI YJV VII VYIIBYYIO 1.
ITEM DESCRIPTION
NUMBER
A. FUNERAL EXPENSES:
Ses continuation schedule(s) attached
B.
1.
r ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees
See continuation schedule(s) attached
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
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
See continuation schedule(s) attached
AMOUNT
9,872.80
2,500.00
185.00
228.25
TOTAL (Also enter on line 9, Recapitulation) I 12,585.85
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule H (Rev. 6-98)
Rw-1602 p(a (6'YB)
'~'
COAMAONJiEALT)i of pENNan,vANIA
INfffRITANCE TALC RETURN
RE810ENT DEC60ENi
.~
SCHEDULE H-A
FUNERAL EXPENSES
continued
ESTATE OF FILE NUMBER
Klein, Harold J. 21-01i-0729
ITEM DESCRIPTION AMOUNT
NUMBER
1 Anna Royer -Church organist 100.00
2 Constance Morrow, Pastor -Honorarium 100.00
3 Michael Seifried, Pastor - HonoraHum 150.00
4 Myers-Hamer Funeral Home, Inc. 7,469.00
5 Rolling Green Cemetery 1.195.00
6 Royef's Flowers -Funeral arrangements 492.90
7 St. John's Lutheran Church -Funeral luncheon 165.70
Subtotal I 9,672.60
Copyright (c) 2002 form software only The l.adcner Group, Inc, Fonn PA-1500 Schedule H-A (Rev. 6-98)
e.v-1602 EX+ ls.esl
conwoRwEnun of rF,wsr~vwu
INHERRANCE TAX RETURN
RE810ENT [X?CEDENT
ESTATE OF
Klein, Harold J.
SCHEDULE H-B2
ATTORNEY'S FEES
continued
LE NUMBER
21-06-0729
Copyright (c) 2002 form software only The Lackner Group, lnc. Fonn PA-7500 Schedule H-82 (Rev. 6-98)
liw-602 EX+ fe-9a1
SCHEDULE H-B4
PROBATE FEES
continued
co,un~ of rEnws~nvnau
nr~niru~cE T,uc rsE7urtn
r+r=aroErn ueceorzrr
ESTATE OF (FILE NUMBER
Klein, Harold J. 21-08-0729
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule H-B4 (Rev.13-98)
Rw-7884 E7(• (6-88)
SCHEDULE H-67
OTHER
ADMINISTRATIVE COSTS
~° ~°;""'" continued
RFAlo~rr oECeoErrt
ESTATE OF FILE NUMBER
Klein, Harold J. 21-06-0729
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H-B7 (Rev. 8-98)
ikw-7612 EX+ le-re)
cora~oNwE~uTN of ppJwsnvum,
INIeeRRMlCE TA% rterkseN
RE8IDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Klein, Harold J. 21-06-0729
Include unnlnWUrsIM mWkal sxpsnsw.
ITEM
NUMBER DESCRIPTION VA F DEATDH~
1 Country Meadows Living Center West Shore 497.37
2 Kelly Home Care Services, Inc. -Services 7/24/06 to 7/29/06 1.057.50
3 Kelly Home Care Services, Inc. -Services 7/24/06 93.71
4 Ljubisa M. Stankovic, MD 2.00
5 Marie Huber, Tax Collector 9.80
6 West Shore EMS 55.15
7 West Shore EMS 107.68
TOTAL (Also enter on Line 10, Recapitulation) I 1,823.22
(If more space is needed, additional payee of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule 4 (Rev. 6-98)
REV•161a FX• (9-00)
SCHEDULE J
CAM NHENR NiCE~~RETURN ~~ BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Klein. Harold J. 21-06-0729
NUMBER NAME AND ADDRESS OF RELATIONSHIP TO
DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S) RECEIVING PROPERTY
Do Not u•t Tru • (Words) ($$$]
I~ TAXABLE DISTRIBUTIONS [include outright s ousel
dlstrlbutrons and transfers
under Sec. ~118(a)(1.2)]
1 Bruce H. Klein Son One-quarter
189 Delmont Avenue
Middletown, PA 17057
2 Susan K. Lassi Daughter One~uarter
200 Fineview Road
Camp Hill, PA 17011
3 Jessica L. Prentice Granddaughter One~ighth
81 Charter Circle
Apt. 5H
Ossining, NY 10562
4 Kristen R. Prentice Granddaughter One~ighth
1100 Vine Street
Apt. 503
Philadelphia, PA 19107
5 Anita K. Taylor Daughter One-quarter
d5 Old Farm Road
Camp Hill, PA 17011
Total
Enter dollar amounta for distributions shown above on lines 5 throu h 18, as appropn ate, on Rev 1500 cove r sheet
III NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
l UTAL OF PART 11- EN 1 tFi 1 V l AL PION-1 AXAt3Lt UIS t RIHUTIC7N5 UN LINE 13 OF REV-1500 DOVER SHEETI U.UU
Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-7600 Schedule) (Rev. 6-98)
,,ff~
cC.71~lCli~ c,~~,reri!G
I, HAROLD J. KLEIN, of 1907 Letchworth Drive, Lower Allen Township, Cumberland
County, Pennsylvania, declare this to be my last will and revoke any will previously made by
me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemazker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
0 governmental body as a result of my death, whether on property passing under this will or
r
~ otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
~ part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
~i other articles of household and personal use, equipment and ornament, together with all
~? insurance thereon and relating thereto, to those of my issue, per stirpes, as survive my death by
thirty (30) days.
~. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to those of my issue, per stirpes, as
survive my death by thirty (30) days.
ITEM IV. Should any of my issue entitled to a shaze of my estate not have attained the
age of twenty-five (25) yeazs at the time for distribution to him or her, I devise and bequeath the
share of such issue to my hereinafter named trustee, IN SEPARATE TRUSTS, to hold, manage,
invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use
1
and apply from time to time such portion of income and principal thereof as my trustee thinks
proper for the comfortable support, maintenance, health, welfare, and education of the issue or to
make payment for such purposes, without further responsibility, directly to such issue, or directly
to any person taking care of such issue. Any principal or income not so applied shall be
distributed to such issue when he or she attains the age of twenty-five (25) years, or if he or she
dies prior thereto, to his or her personal representative.
ITEM V. I appoint my son-in-law PETER LASSI trustee of the trust or trusts created by
this my last will. Should Peter T;assi predecease me or otherwise fail to qualify or cease to serve
as Trustee of this my last will, I appoint my son-in-law ROBERT TAYLOR trustee of the trust
or trusts created by this my last will. In addition to the other powers and authorities granted to
j my trustee by Pennsylvania Law and by the preceding paragraph of this my last will, I hereby
K give my trustee the following special powers and authorities:
'~ A. To retain any or all of the assets of my estate, real or personal
~ (including any stock or securities of any corporate fiduciazies), without any regard
^T
to any principle of diversification, risk, or productivity
a` B. To invest and re-invest in all forms of property without restriction to
investments aut~-orized for Pennsg~lvania Fiduciaries, as my trustee deems proper,
without regazd to any principle of diversification, risk or productivity;
C. To sell at public or private sale, to exchange or to lease, for any period
of time, any real or personal property and to give options for sales, exchanges, or
2
leases, for such prices and upon such terms or conditions as my trustee deems
proper and in the best interest of the beneficiary or beneficiaries of said trusts;
D. To allocate receipts and expenses to principal or income or partly to
each as my trustee from time to time deems proper in its sole discretion;
E. To compromise any claim or controversy;
F. To exercise any option, right, or privilege granted in insurance policies
or in any other investments;
G. My trustee may accumulate the income from this trust during the term
thereof but may, from time to time, distribute from current income or from
0
-~
accumulated income or from principal such amounts as my trustee, in its sole
discretion, deems advisable for the education, welfare, and comfort of the trust
beneficiary.
ITEM VI. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM VII. I appoint my son-in-law PETER LASSI executor of this my last will.
Should Peter Lassi predecease me or otherwise fail to qualify or cease to serve as executor of this
my last will, I appoint my son-in-law ROBERT TAYLOR executor of this my last will.
ITEM VIII. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
3
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM IX. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this ~ '1 dip`(' day of
2004.
HAROLD J. KLEIN
4
The preceding instrument, consisting of this and FOUR (4) other typewritten pages, each
identified by the signature of the testator was on the date thereof signed, published, and declared
by HAROLD J. KLEIN, the testator therein named, as and for his last will, in the presence of us,
who at his request, in his presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
5
.•
COMMONWEALTH OF PENNSYLVANIA )
( 5S:
COUNTY OF CUMBERLAND )
The undersigned, being the testator whose name is signed to the attached or foregoing instniment,
having been duly qualified according to law, does hereby acknowledge that I signed and executed the
foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
,tblai~k~CQ~~
HAROLD J. ICLEIN
$wr,rn er affirmed to and acknowledged
btfafe me b~~ the testator named above
this. ~~ dey,of~'_~ll,lQ!U~!200
COUNTY OF CUMBERLAN~DJ )
WE, ~~c-NarG ~ ~. ~qN 6S and ~~,~~~~~~~ the
witnesses whose names are signed to the attached or foregoing instrument, being duly qual~f~ied according
to law, do depose and say that we were present and saw the testator sign and execute the instrument as his
last will; that he signed it willingly and that he executed it as his free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and
that to the best of our knowledge, the testator was at that time 18 or more years of age, of sound mind,
and under no constraint or undue influence.
W~IVDY S. g0a~trolat3l PubMc
L,owerllMen'1Yrp., i~enndd
My Comn~fon E>~ Mey ~~.
'OMMONWEALTH OF PENNSYLVANIA )
( SS:
~ccorn or affirmed to and acknowledged
befe:P~s', t is ~ ~- day of
~_•, ~-`~~~ ~-___, 2004.
...,...~ --N-wry
~ S. Cunb~rNnd PubAc
~ con won Vie, ~ ~0~0`i
6
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