HomeMy WebLinkAbout11-30-12 (3)J 150561N140
REV-1500 ~` `°'-'°'
PA Department of Revenue "I-~ I'
Bureau of Individual Taxes County Code Year File Number
Po Box zaosol INHERITANCE TAX RETURN
_ Harrisburg.PA17128-0601
RESIDENT DECEDENT 2 1 1 2 0 7 5 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
3 2 2 0 1 2 1 2 1 1 1 9 6 0
Decedent's Last Name Suffix Decedent's First Name MI
B A N G E R T P E N N Y L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL INAPPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
^X 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
6. Decedent Died Testate
~ death after 12.12-82)
7. Decedent Maintained a Living Trust
0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
behveen 12-31-91 and 1-1 -95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAx INFORMATION SHOULD BE DIRECTED T0:
Nam e 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
I ~ o '~ ~',
First line of address T b ~ ymj
t':b., a ~ C to
4 1 4 B R I D G E S T R E E T b z f,ti w -w
zv,x, o ~c
Second line of address ~ ~
n Q -'t7 Q i
I cj C -'7 ~ ~...~
City or Post Office State ZIP Code I_ "DATE FILER-• ~ r
~-~. _. Thi" J~
N E W C U M B E R L A N D P A 1 7 0 7 0 ~ a~' op o
Correspondent'se-mail address: DSTONEaSTONELAW•NET
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statement, and to the best of my knowledpa and be
it is true, coned and complete. Declaration of preparer other than the personal representative is basetl on all information o/which preparer has any knowletlge.
SIGNA PERSON RES OR FILI RETUR~.y? DATE
c0 . • ~~ n~.~ 7 ~ , .
rv UIY I AJ. ICVAU JADES CREEK PA 1F
OF PREPA HER' REPRESENTATIVE DATE
IDLE STREET v ` NEW CUMBERLAND PA 1.
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
15tl5b10240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: PENNY L. BANGERT 1 6 2 5 8 2 1 9 8
RECAPITULATION
1. Real Estate (Schedule A) ........................................... t.
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.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property
(Schedule G) ~ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1 through 7) ........................... 8.
5 1 7 7, 9 5
2 7 8 4 3, 3 8
1 6 9 0, 2 8
3 4 7 1 1, 6 1
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9.
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10.
11. Total Deductions (total Lines 9 and 10) ............................... 71.
12. Net Value of Estate (Line 8 minus Line i t) ............................ 12.
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.
1 4 2 8 6. 9 6
2 3 7 4. 1 7
1 6 6 6 1. 1 3
1 8 0 5 0. 4 8
1 8 0 5 0. 4 8
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
16. Amount of Line 14 taxable
at lineal rate X •a_ 0 . 0 0 1g,
17. Amount of Line t4 taxable
at sibling rate X .12 1 8 0 5 0. 4 8 17.
18. Amount of Line 14 taxable
at collateral rate X .15 ~ 0 ~ i6.
19. TAX DUE ...................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610240
o. a o
0. 0 0
2 1 6 6. 0 6
~. ~ 0
2 1 6 6. 0 6
1505610240 J
REV-1500 EX Page 3 Flle Number
Decedent's Complete Address: 21 12 U750
DECEDENTS NAME
PENNY L• BANGERT
STREETADDRESS
940 WALNUT BOTTOM ROAD
CITY - - ------~ STATE ------ ZIP
CARLISLE 'PA '17013-
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 2,166.06
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + B) (2) 0 • 0 0
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Llne 20 to request a refund. (4) 0 • 0 0
5. If Line i +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2 ,166 • D 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 properly transferred : ................................................................ ...... ^ X^
b. retain the right to designate who shall use the propeny transferred or its income; ................... ...... ^ Q
c. retain a reversionary interest; or .......................................................................................... ...... ^
d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................................................................. ...... ^ 0
3. Did decedent own an "intrust for orpayable-upon-death bank account or secudty at his or her death? ... ...... ^ Q
4. Did decedent own an individual retirement account, annuity or other nomprobate propeny, which
contains a benefciary designation? ............................................................................................. ..... ^ ^X
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
3 percent [72 P.S. §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. §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) p2 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, unde
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-7503 EX + (8-9a)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
IN HERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PENNY L• BANGERT 21 12 0750
All property jolntty•owned with dght of survWorshlp must be disclosed on Schedule F.
ITEM VALUE A7 DATE
NUMBER DESCRIPTION OF DEATH
1• 5100 US Savings Bond ><C269068818EE dtd March 1991 145.20
in the name of Penny L• Bangert or Raymond B•
Bangert, Sr. (died 11-19-D2)
2 $100 US Savings Bond ~C270945063EE dtd May 1991 142.36
in the name of Penny L• Bangert or Raymond B•
Bangert, Sr. (died 11-19-02)
3 66 shares PNC Financial Services Group Inc stock a 3;965.94
560.090 each
4 I15 shares Prudential Financial Inc stock a 561.630 I 924.45
each
TOTAL (Also enter on line 2, Recapitulation) I E
(It more space is needed, insert additional sheets o(the same size)
REV-1508 EX~ (1 i-10) _. _.__... _...
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE
CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
PENNY L• BANGERT 21 12 0750
Include the proceeds of litigation and the date the proceeds were received by the estate.
All propertyjointty owned vMh right of survivorship must ba disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• 2001 Cherokee Sport Utility-Title ~556393040018A at 5,178.00
Kelley Blue Book value
2 HCR Manor Care-refund on living expenses 911.30
3 Highmark-insurance premium refund 940.75
4 PNC Bank-Checking Acct X5004909142 1,112.71
5 PNC Bank-Savings Acct X5000986669 639.84
Princ• $639.84, Int• $•01
6 PNC Bank-Savings Acct #5000986669 - Accrued Int• 0.01
7 SecurChoice-Prepaid Funeral Trust Annuity X712209 7,043.26
8 Social security benefit for March 956.00
9 The Hershey Company-Retirement Acct due estate 11,061.51
TOTAL (Also enter on Line 5, Recapitulation) I S 2 7 8 4 3
If more space is needed, insert additional sheets of paper of the same size
REV-150e EXi (01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY•OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
PENNY L• BANGERT 21 12 0750
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. RAYMOND B BANGERT, JR 120 DILLER ROAD BROTHER
NEW CUMBERLAND, PA 17070
B.
c.
JOINTLY•OWNED PROPERTY:
ITEM
NUMBER LETTER
FORJOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DFATH
VALUE OF ASSET %OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTERES7
1 A J,Diaai99 Susquehanna Valley FCU-Regular Sh 3,380.55 50• 1,690.28
Acct tt4792 in the name of Raymond
B• Bangert, Jr•, joint w/decedent
TOTAL (Also enter on Line 6, Recapitulation) I S y , 6 90 • 2 8
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PENNY L• BANGERT 21 12 X750
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION
AMOUNT
A. FUNERAL EXPENSES:
1 Stone & Murray Fuenral Home-funeral expenses 4,067.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) Loretta C • Martin 3 , 7 5 ~ • ~ ~
Street Address 1387 Cooper Mtn• Road
c;ty James Creek state PA zIP 16657
Year(s) Commission Paid: 2 012 / 2 013
2. AtlorneyPees: David H Stone, Esquire 3,750.00
3. Family Exemption: (If decedent's address is not Ne same as claimant's, anach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4• Probate Fees: Register of Wills Cumberland County 102.50
5 • Accountant Fees:
6 • Taz Retum Preparer Fees:
7• US Treasury-income taxes pd from Hershey Co 2,212.3
2 Cumberland Law Journal-adv grant of letters 75.00
3 The Sentinel-advertising grant of letters 200.16
4 Register of Wills-filing Inh Tax Ret and Inv 30.00
5 Reserve for closing expenses 1U0.00
TOTAL (Also enter on Line 9, Recapitulation) I S
If more space rs needed, use additional sheets of paper of Me same size.
4,286•
REV-1512 EX+ (12-0a)
pennsylvania
OEPARTME NT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE(
DEBTS OP DECEDENT,
MORTGAGE LIABILITIES, & LIENS
PENNY. L• BANGERT 21 12 0750
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 (Capital Cardiovascular Assoc-services rendered 89.00
2 (Bureau of Account Managemt-PS Hershey servs
3 iHoly Spirit Hospital-services rendered
4 ~MSHMC Physicians Co•-services rendered
5 (Commercial Acceptance Co-services rendered
6 Community Life Team EMS-services rendered
TOTAL (Also enter on Line 10, Recapitulation) I E
If more space is needed, insert additional sheets of the same size.
295.51
1,693.•26
20.00
138.40
138.00
REV-1513 EX+ (01-00)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
PENNY L• BANGERT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
] TAXABLE DISTRIBUTIONS [Include outr~' ht spousal disVibudons and transfers under
Sea 91 i6 (a) (1.2).]
1• RAYMOND B• BANGERT, JR
120 DILLER ROAD71
NEW CUMBERLAND, PA 1707
2 CANDY DEIMLER
961 BOSLER AVENUE, APT B
LEMOYNE, PA 17043
1
Do Not Llst
Sibling
Sibling
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLEAND GOVERNMENTAL DISTRIBUTIONS:
1•
750
AMOUNT OR SHARE
OF ESTATE
9,025.24
9,025.24
TOTAL Of PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I S
If more space is needed, use additional sheets of paper of the same size.
Calculated Value of Your Paper Savings Bond(s)
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 03/2012
Page 1 of 1
Total Price Total Value Total Interest YTD Interest
$100.00 $287.56 $187.56 $2 84
Bonds: i-2 of 2
Issue
Serial # Series Denom Next Final Issue Interest
Interest
Value Note
Date Accrual Maturity Price ,
Rate
C270945063EE EE $100-05/1991 05/2012 05/2021: $50.00 $92.36 4.00%.,$142.36
C269068818EE EE $100.03/1991
09/2012 03/2021,
$50.00, ,
$95.20 4.00% $145.20.
Totals for 2 Bonds! 100.00'- 187.56 287.56
Notes
NI Not Issued
NE Not eligible for payment
PS Includes 3 month interest penalty
MA Matured and not earnin interest
http://www.treasurydirect.govBC/SBCPrice 11/15/2012
PNC Financial Services Group Inc., PNC Historical Quote - (NYSE) PNC, PNC Financia... Page I of 2
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Enter Symbol: pnc ', EnterDate: 3102/12
_ PNC Financial Services Group Inc.
Pri. Mar 02, 2012
Closing Price. 59.61
LUW
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`,
News Industries Markets Hlatorlcal Quotes BlgReports
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~v 0 ~'i 1 ~
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t~o.~ $1~
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Prudential Financial Inc.
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FORt~t BC-D 1 Sheet #1
IIERSHEY RETIREMENT ACCOUNT
OPTION ELECTION AND CONIIV~NCEMENT FORIVI
FOR 5URVIVORS OF DECEASED PARTICIPANTS
Participant Name: PENNY L. BANGERT
Benefit Commencement Date:
Home Address: 120 DILLER ROAD
NEW CUMBERLAND, PA 17070
Work Locatiott/Department:
Social Security Number. 162-58-2198
Gender. Female
rrrrr•rrrrr+rrrrrrrrrrrrprrrrrrrrrrr•rrrrrrrrrrrrrrrrrrrrrrarrrrrrrrrrrrrrrrrrrrrrrrrrrgrrrr
Spouse/BeneIlciary Name:
EIN#: 46-6129434
The Estate of Penny L. Bangert
Date of Death: March 2, 2012
414 Bridge Street, New Cumberland, PA 17070
Address
A. Mandatory 100% Lump Sam Option
11061.51 NONSPOUSE BENEFICIARY
I am the participant's designated brneficiary, but not the spouse, and [understand that I will receive the entire account
balance in a single lump sum paymrnt calculated as of the date of death. Form LSE must be completed.
SPOUSE BENEFICLARY AND LUMP S[1M e4V[OUNT DOES NOT EXCEED 51,000
I understand that I will receive the entire account balance in a single lump sum payment calculated as of the date of death.
Form LSE must be completed.
1 elect to receive the total lump sum amount calculated as of the date of death. Please complete Farm LSE to give
instructions on how the lump sum is to be paid.
0 LEVEL L[FE ANNUITY (NO REFUND)
A level monthly benefit payable doting my lifetime. Upon my death, no further benefits are payable.
0 PART LUMP SUM/PART ANNUITY ~
A single payment as a lump sum and monthly peymrnb as a level life annuity (no refund). Please complete Form LSE to
give Instructions on how Lump Sum porNoa Is to be paid. (NnTF• This option is only available if the benefit
B. Spouse Beneficiary and Lump Sum Amount Greater Than $1,000
L~ 100%LUNIPSUM
Jul.2~. 20'2 '~C:OSAN PNC Bank
~~~ ,
.i.~91bi tl1E.WAY
3uly 24, 2012
David II Stone Esq.
Stone Lafaver & SheJsletsici
414 Bridge St
POBoxE
New Cumberland, PA 17070
RE: Penny L Bangert
SSN: 162.58-2198
DOD: 03-02-2012
Dear Mr. Stone:
wo.3S53 P, 1/2
In response to yow request for Date of Death (DOD) balances for the customer noted above, ow
records show the following:
Checking Account
Account # 5004909142 Established: 07-26-2007
PENNY L BANGERT
DOD balance. S 1,112.71 non interest bearing
Savings Account
Account # 5000986669 Established: 04-O1-1997
PENNY L BANGERT
DOD balance: $ 639.84 + 0.01 accrued interest
Inurest paid O1-O] -2012 then 03-02-2012 $ 0.01 YTD
Please note that this office provides date of death balances for deposit accounu (IRAs, CDs, Checking and
Savings). 'We do not process any Snancial transactions or provide statements. If you need assistance with
any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Baok branch
office.
Sincerely,
National Financial Services Center
PNC Back, NA.
Member FDIC
Page 1 of 2
Ju1.24. 2012 10,05AM PNC Bank No.38~3 °. 2/2
This message is intended for the use ojthe individual or entity to which it is addressed and may
contain information that is privileged, confidenrial and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby nohffed that any dissemination,
distribution or copying of this communications is strictly prohibited Ifyou have received this
communicarion in error, please notify me immediately by reply or by telephone at 800-76?-17?S and
immediately destroy this faxed document.
Page 2 of 2
SUSQUEHANNA VALLEY F. C. U. Member#: 4792
3850 HARTZDALB DRIVH
CAMP HILL, PA 17011-7809 Statement Date: 03/31/2012
(7171-737-4152 page#: 1
Mail Coda:
web Code: Print
RAYMOND B BANGERT, JR.
120 DILLRR ROAD
NEW CUMBERLAND, PA 17070-2509
Trap Eff Transaction Tran Bea Pinaace Loan
Date Date Description Amount Amount Charge Principal Balance
--------- ----------- -------- -
O1/O1 Type: 00 - REGULAR SHARES - 00 PREVIOUS BALANCE 3380.55
Soint wit Pen~Y L. Bangert 1 26 3381.81
03/31 03/31 Dividend Posting
~• ANNUAL PERCENTAGfi YIELD EARNED: 0.15 & FOR A PERIOD OF 91 B *BALANCE 3381.81
03/31
Member Year-to-Date Totals
YTD Dividends: 1.26
YTD Interest: 0.00
YTD Charges: 0.00
I octant change regarding Non-Sufficient Fonda (N98) and Overdraft Advance fees:
Effective August 1, x012, NSF and Overdraft Advance fees on your account will change from
$25 to $30 per item, with a daily maximum of $120.
Jp: w~
~o - ~ a-49