HomeMy WebLinkAbout03-06-13 (2)J
1505610143
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes ae"""•-"*°""a°4NYE
PO 80X.280601 INHERITA
Harrisburg, PA 17{28-0601 RESIDI
OFFICIAL USE ONLY
County Catla Year File Number
TAX RETURN 21 12 0836
)ECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Binh
Decedent's Last Name Suffix Decedent's First Name MI
gAp~ER MONTE E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER O F WILLS
FILL IN APPROPRIATE OVALS BELOW
X i 1. Original Return ~ 2. Supplemental Return ~ 3. Remaintler Return (Gate of Oeath
P
12
13
82
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or to
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^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Requiretl
Itlala of Oeelh after 12-12-e2)
g Decedent Died Tealale
'
^ 7 acer~ent Nain1@jner~ a Eivine 7ruat
~Attec Copy o1 I rus ) _~ g. TotaV Number of Safe Deposit Boxes
(Attach Copy o5 Wnp
8. Liti anon Proceetls Received
9 ^ 19 5 ousel P0ved redatfoatse of Death
~ b~rwaen 12-3t ~~en 1- 5) 11,E{eCtion to tax under Sec. 9113(A)
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(Attach Sche
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CORRESPONDENT • TH19 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDEN71ALQ711r~11FORMATtON SHWL[~E DIRECTED 70:
Name C~tlmp Telephoe)e Nt~1Oq'o
EDMUND G MYERS ~t7~z-~ "ff~l r~TiiJ"AIO
r ...
Firs[ Line of Address
301 MARKET STREET
Second Line of Address
PO SOX 109
City or Post Office
LEMOYNE
Correspondent's a-mail adtlress:
State ZIP Code
PA 17043
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3t~C'r~iIS,7}R OF WILL~~U~~ ONLY
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Under penalties of perjury, l declare tnat.l have examined this return, including accompanying schedules antl 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 o! which preparer has any knowledge.
OF PREPARER OTHER THAN
EDMUND G. MYERS
GATE
301 MARKET STREET Lemoyne PA
Side 1
REV-1500 Extd2-"'
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
oa=adam'sNama: Baker, Monte E
RECAPITULATION
1. Real Estate (Schedule A) ...................................................................................... . 1.
2. Stocks and Bonds (Schedule B)..........._ ...................._._._.................................. _ 2. 1 , 068.39
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. 22 , 194.11
6. Jointly Owned Property (Schedule F) ~] Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous Nnn,-Probate Property
(Schedule G) ~ J Separate Billing Requested............ 7, 71 , $88.00
8. Total Gross Assets (total Lines 1 through 7)........._ ............................................ . 8. 94 , 650.50
- - --
9. Funeral Expenses and Administrative Costs (Schedule H) ................................... . 9. 14 , 167.88
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule q ...................._.._. . 10. 15 , ~ 02.68
11. Total Deductions (total Lines 9 and 10)...._ ....................__................................. . 11. 2 9 , 170.56
12. Net Value of Estafs (Line 8 minus Line 11) ................._....._................................ 12. 65 , 47 9.94
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. 65 , 47 9.94
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.z) x .o0 65 , 47 9.94
15.
0.OO
16. Amount of Line 14 taxable 0
00 i6 0
00
.
at lineal rate X .045 . .
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X 15 0.00 18. 0.00
19. TAX DUE....._ ............._..........................._...................... _....................... 14 0 . ~~
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243
1505610243 J
REV-1500 EX Page 3 File Number 21-12-0838
Decedent's Complete Address:
DECEDENT'S NAME
Baker, Monte E
STREETADDRESS
CITY ~ _ ~ ~- STATE ~~~ ZIP _-- -~ --
PA
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (i) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits (A + 8) (2) 0.00
3. Interest
(3)
q. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2, Line 20 to request a refund
5, If Line 1 + Line 3 is greater than Llne 2, enter the difference. This is the TAX DUE. (5) 0,00
Make Check Pa able to REGISTER OF WILLS AGENT.
i„.c.kfi,31`~s,l'~a;dot(~~si~n~l~t;i;In~F"+~tf;~`s~{~i~~l+"+1~ ,.~ aa.11~i'~~!t~1~;P',l~ik~~1~4~~1~1~~1~!'.!;4~`~l,~TMi~'il'~H~!~;1!~Il`!~~1~~,1i';~~1~,',~~!~: .:,~ ~~~~~'~4~~'.Ei~r~~;'~i:,1~lx3h~ik`I411~~ii{~
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
t. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred ...... ....... .... .... r~
l J
~~
b. retain the right to designate who shall use the property transferred or its income;.. ........ ^
c. retain a reversionary interest, or .......... .. ........ ............ ... .... ... ...... ......_ ^
d. receive the promise for life of either payments, benefits or care?..........._......._ ...................................._ ^
2. If death occurred after Dec. 12, 1982, dW decadent transfer property within one year of death without __
receiving adequate consideration?..._ ................._..........._......,._......._..............................................,,..._....,..
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......, i_ J ~ xJ
4. Did decedent own an individual retirement account, annuity, or other non-probate property which ~~' .,
~
containsabeneficiary designation? ........................._........_..,...._......................................_............................ a J
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. §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 D 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 imposetl on the net value of transfers to or for the use of the decedent's Ilneal 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)]. 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.
Rav-160] E%~ (8-88)
SCHEDULE B
STOCKS & BONDS
COMMONW£AITH OF PENNSYLVANIA
INHERITgNGE iq%ftETURN
RESIDENT DECEDENT
ESTATE OF f FILE NUMBER
Baker, Monte E I 21-12-0836
All plopartyjointly-ownatl with right o! survivorship must batllaclosatl on Schatlule F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 57 shares of UBS Financial Services Stock Plan Account No. 18.7436842 1,068.39
AB 33347 LL
TOTAL (Also enter on Line 2, Recapitulation) 1,068.39
(If more space is needed, additional pages o(the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-7500 Schedule B (Rev. 6-98)
Rev-1508 EX+ (11-101
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, 8~ MISC.
DEPARTMENT OF REVENUE
tN11ERITANDETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Baker, Monte E 21-12-0836
Inclutle fhe proceetls o! litigation end the tlate tha proceetls ware received by the estate.
All propertyjolntlyownetl with the dghl otaurvivprahip meat ba tlifclosetl on fchetlele F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 State Employees Retirement Account -Payable to the Estate 1,781.04
2 BELCO Federal Credit Union Regular Checking Account No. 856172 -A copy ofthe Date of 20,350.74
Death Letter from Belcois attached.
3 BELCO Federal Credit Union Regular Savings S1 Account No. 856172 - A copy of the Date of 62.33
Death Letter from Belco is attached.
TOTAL (Also enter on Line 5, Recapitulation) I 22,194.11
(It more apace is needed, additional pages of the same size)
Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10)
Rev4510 EX« (08-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAx RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
FILE NUMBER
This schatlule must ba completed antl liletl if the answer to eny of questions 1 through q on page three of tna REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
THE DATE OF TRANSFERSATRACIIACOPYEOF THE DEE~FDR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET ~ of DscD~s
INTEREST ExcwsioN
(IF APPLICABLE) TAXABLE
VALUE
1 AT&T Pension/Annuity Payments -Spousal Single- 0.00
Life Annuity. Beneficairy -Michele Z. Baker receives
monthly payments in the amount of $292.61. Annuity
terminates at her death.
2 Merrill Edge IRA Account No. 5WR-10F50 -Beneficiary 19,023.69 19,023.69
- Michele Z. Baker, Spouse
3 Merrill Lynch 401 K Pension Plan -Beneficiary - 5,895.54 5,895.54
Michele Z. Baker, Spouse
4 Wells Fargo Level 3 Communications 401 K Plan 45.396.44 45,396.44
Account No. WF134320 -Beneficiary -Michele Z.
Baker, Spouse
TOTAL (Also enter on Line 7, Recapitulation) ~ 70,375.67
(If more space is needed, atlditional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule G (Rev. OB-09)
REV-1511 ESQ p0-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
i""eRiTnNCErAxREruRN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Baker, Monte E 21-12-0838
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 9,825.00
B. I ADMINISTRATIVE COSTS:
L Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s) Commission Paid
2. Attorney's Fees JOHNSON DUFFIE 4,000.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6, Tax Return Preparer's Fees
7. Other Administrative Costs 342.88
See continuation scheduie(sj attached
TOTAL (Also enter on line 9, Recapitulation) 14,167.88
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Baker, Monte E 21-12-0836
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
t Funeral Expenses 9,077.00
2 Stephanie Baker -Payment of Funeral Expenses/Funeral Luncheon 748.00
H-A 9,825.00
3 Other Administrative Costs
BELCO Federal Credit Union -Account Withdrawal Fee
2.00
4 Cumberland County Register of Wills Office -Probate Fees 112.50
5 Cumberland County Register of Wills Office -Filing Fees for Inheritance Tax Return and 30.00
Inventory
6 The Cumberland Law Journal -Notice of Estate Administration 75.00
7 The Patriot News -Notice of Estate Administration 123.38
H-B7 342.88
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule H (Rev. 6-98)
Rev-1512 E%« 112-0s)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE MORTGAGE LIABILITIES AND LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Baker Monte E 21-12-0836
Raport tlebla Incumtl by Ma tlecetlant prior to death that remainetl unpaitl at the tlato of tleath, inclutling unrolmbuned medical eapensaa.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
t BELCO Federal Credit Union -Visa Account 2,946.48
2 Check Clearing After Date of Death 550.00
3 Verizon Wireless 38.98
4 Verizon Wireless 8.17
5 Wachovia BanklWells Fargo Line of Credit -1l2 of debt against jointly owned Real Estate 11,500.00
6 YMCA' Membership Dues 85.35
TOTAL (Also enter on Line 10, Recapitulation) I 15,128.96
(It more space is needed, atlditwnal pages of the same size)
Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA•1500 Schedule I(Rev. 12-08)
Rev-taro ex. mvim
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Baker, Monte E 21-72-0836
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT
(Words)
($$$)
j TAXABLE DISTRIBUTIONS [include outright spousal
distributlons, and transfers
under Sec. 9116 a 1.2
Barbara J Baker Mother Intestate Estate.
414 Reading Street 1/2 of Residue
Harrisburg, PA 17113
Michele Z Baker Spouse Intestate Estate.
83 Hanover Street First $30,000.00
Middletown, PA 17057 of Estate; 112 of
Residue
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet, as a r o riate.
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 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REY-150Q COVER SHEETI _
Copyright (c) 2010 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule J (Rev. 01-10)
ESTATE OF MONTE E. BAKER
SCHEDULE OF EXHIBITS
EXHIBITA BELCO Federal Credit Union Date of Death Letter for Checking
and Savings Accounts
544105
1. Name(s) in which the account was held:
DECEDENT ESTATE INFORMATION(On Date of Death)
MONTE E BAKER
2. Account number: 856172
3. Balance as of date of death: $2D,408.26
Balance Accrued Dividentls
Regular Saving: S1 $62.31 $0.02
Christmas Club: S2
Money Market: S6
Checking: S4 $20,345.95 $4.79
IRA S5
Certificates: Balance Accrued Dividends
NONE -
$ $
4. Date the account was initiated:
5. Name(s) in which Safe Deposit Box was held: NONE
6. Date the box was initialry rented: NIA
7. Branch address at which the box is located: NfA
8. Loan Information: Balance Accrued Interest Per Diem Int
A. Unsecured Loans:
L14 Classic Visa Card $2,820.18 $0.74
B. Secured Loans:
C. Mortgage Loans:
9. Miscellaneous:
YTD Dividends Opened
$1.01 6/13/2006
$53.02 7/8/2008
Certficate Number YTD Dividends
$ $
$ $ $
$ $ $
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L A W O F I~ I C F: S
JOHNSON
DUFFIE
March 5, 2013
Register of Wills Office
Cumtrerland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Monte E. Baker
File No. 21-12-0836
Our File No. 16738-2
Dear Register:
Enclosed for filing, please find the following:
L:IJLAISP,TH D. SSOVEH
L~AHOIS~A B. McCLniN
JuuX A. i.u~~v
IJ LYSSI S S WILSUA'
(LI I 1 1. PI III,I,IPS
MAIIHIW RIULf:Y
13.ARRII. B. GEHRLEIS
OF COUNSEL
Ito KAC6 A. IOHNSON
C. Rov WEIDNEK.IH.
QrN51 A,VClI P. BRUST
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1. 2 Original Pennsylvania Inheritance Tax Returns. Then; is no tax due. This is a spousal estate.
2. Inventory
3. Two copies of Page 1 of the Inheritance Tax Return that we ask that you time-stamp and return to us.
4. One copy of the Inventory that we ask that you time stamp and return to us.
5. Estate Check No. 1004 in the amount of $30.00 representing the filing fees for the Inheritance Tax and
Inventory
Thank you for your assistance in this matter. Should you have any question or require any additional information,
please contact the undersigned
Very truly yours,
HNSON, DUFFIE, STEnWA~RT~&'WEI,DNER
~«~~7 ~
Dana Wie man
Estate Administration Paralegal
Enc.
c: Michele Z. Baker, Administratrix
saa»>
301 MARKET STRF.BT P.O. BOX 109 LEMOI'NE. PENNSYLVANIA 17043-0109
WWW)DSW.COM 717.761.4540 FAX: 717.761.3015 MAIL@IDSW,COM
JOHNSON, DUFFIE, STEWART &WEIDNER, P.C.
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