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HomeMy WebLinkAbout03-04-131505610105 REV-1500 ~x f~-"'tFn ~' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Coun Code Year __ File Number E.,w,,,. .,E,~~~ Bureau of Individual Taxes __ _-__,_______- _ _-.__ RITANCE TAX RETURN - "---- I ~ PO BOX 280601 ; ~) Harrisburg, PA 178-0601 RESIDENT DECEDENT r I ~ p~ ~ ~ ~ ~ ~~ ENTER DECEDENT INFORMATION BELOW Social Security Number ___ _ ___ Date of Death - MMDDYYYY Date of Birth MMDDYYYY ~ ' 06/18/2012 .06/26/1926 Decedent's Last Name Suffix Decedent's First Name MI Robi -- __ - .i _ _ nson I S I i Lois ~_--- - _ ---------- -------- --~ ~ ', (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI _ _ -- - -- - ' - - --- ------ --- - , - - ~ Spouse's Social Secunty Number r ~ ! _ i - - -"-~-~--" i- -~--~-- ; 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) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wili) (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 DIRECTEQ T0: Name Daytime Teleph~e Number = ~ • .~ _ __. -- __ - ----- ---- Alan B. Robinson ~; ~ © ~ tai ra - ---- - ---- ------ -- _ --- -- - --- - _ __ -- - --- - ~ ~ --' -'~ _._-3 - ---------tS1--L7---- --~----.=JK~ REGISTE F~ L USE O LY ~ '"`7 L;-) ~ First Line ofAddress -. Cn ~R1 --.- i_ ~ C:J _ _ - - - 2406 Rolling Hills Dr ----` ~- -- ----_. - - ~~ ----- __ _--__-_ --.__ _ _._.-_-_ I ' ~ 4 ~~ i ' ~ ~~ , .,. ` Second Line of Address __ _ - - .., ,; ,~ ~--~ - _._ r"~ _ _ _ -___ ...- -____ _ __-_ ___ --- - _- -- ___ _. ----- -- --- .~ -i r.v d Yri - _ ------ - -- City or Post Office ---- - ------ - - State ZIP Code o DATE FILED -n Mechanicsburg i , ~ PA ' 17055 I i ~ Correspondent's e-mail address: alanrobinson0ll~verizon.net Under penalties of perjury, I 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 complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. i rt~ ~r r~rt rct I ut FUR FILING RETURN DATE ~~~^ t ~ ~-~-~- 02/20/2013 240~}Rolling Hills Dr., Mechanicsburg, PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE PLEASE USE ORIGINAL FORM ONLY Side 1 L, 1505610105 1505610105 J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number decedent's Name: Lois S. Robinson RECAPITULATION 1. Real Estate (Schedule A) ........................................ ..... 1. 0.00 2. Stocks and Bonds (Schedule B) .................................. ..... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ...................... ..... 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. 11,648.96 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .. ..... 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested... ..... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7} ........................ ..... 8. 11,648.96 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 0.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......... ..... 10. 101,156.87 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. .._ 101,156.$7 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. 0.00 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. 0,00 ; TAX CALCULATION -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 .0- 15. 0.00 16. Amount of Line 14 taxable _ _ _ _ .. at lineal rate X .0 _. 16. ' 0.00 17. Amount of Line 14 taxable _ _ _ at sibling rate X:.12 17.. 0.00 18. Amount of Line 14 taxable _ _ . at cotlatera! rate X .15 18. 0.00 19. TAX DUE ...................................................... ... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 O REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Lois S. Robinson STREET ADDRESS 1000 West South Street CITY Carlisle STATE ZIP PA 17013 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 + g) (2) 0.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) 0.00 Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 ake 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 ..................................................... . 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 care? .............................................. 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 "in trust 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 beneficary designation? ......................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE 1T AS PART OF THE RETURN. - ______ ~_.....~...~A For dates of death on or after July 1, 1994, and before Jan. 1,1995, the tax rats 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 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 benefiaaries 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+ (o8-iz) Pennsylvania DEPARTMENT DF REVENU7 DEPARTMENT OF REVENUE INHERTIANCE TAX RETURN RESIDENT DECEDENT SCNEDl~LE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Lois S. Robinson 2012-00691 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 dise~esed ~n c~hpd~~~p F -• • • ~~• _ ~r=== ~~ ~ ~__~~~, uac aumuona~ sneers or paper of the same size. REV-1512 EX+ (12-12) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TA:K RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Lois S. Robinson 2012-00069 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sara Todd Nursing Home 1,599.74 2 West Shore Emergency Medical Services 137.00 3 ;Pennsylvania Dept of Public Welfare 98,420.13 4' Debra Wallet, Attorney 500.00 5.' Alan B. Robinson, Executor 500.00 TOTAL (Also enter on Line 10, Recapitulation) $ 101,156.87 If more space is needed, insert additional sheets of the same size ESTATE OF LOTS S ROBINSON ALAN B ROBINSON EXEC Balances Account # 1921035897 Interest Earned this Period $0 10 Paid Last Year $0.58 * The interest earned and the interest paid may differ depending on when interest is credited to your account. Account Activity Date Description 12-01 Beginning Balance -01 Ending $11 IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS CALL YOUR CUSTOMER SERVICE CENTER AT THE NUMBER SHOWN ON THE TOP OF YOUR STATEMENT OR WRITE TO THE BANK FOR DEBIT CARD ISSUES: FOR ALL OTHER ELECTRONIC TRANSFER ISSUES: Sovereign Bank Sovereign Bank Attn: Card Disputes Team Attn: Client Relations MAI MB3 02 OS ]0-421-CRI P.O. Box 831002 P.O. Box 12646 Boston, MA 02283-1002 Reading, PA 19612-2646 Please contact us if you think information about an electronic transfer on your statement or receipt is wrong or if you need additional information about an electronic transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error appeared. • Tell us your name and account number. • Describe the electronic transfer error or the electronic transfer that you are unsure about and • Tell us the dollar amount of the suspected error. explain as clearly as you can why 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 10 business days. We will promptly investigate the matter and call or write to you with an answer within 10 business days. If we need more time, we may take up to 45 days to investr ate your complaint or question. If we do, we wrll credit your account within this 10-day period for the amountyou think is in error, so you will have the use of the money during the time it takes us to complete our invesdga[ion. If we ask you to put your complaint or question in wrrtmg and we do not receive it within 10 business days, we may choose not to credit your account. For errors involving new accounts, point of sale ppurchases or foreign transactions, we may take up to 90 days to investigate your complaint or question. For new accounts, we may take up to 2D business days to credit your account for the amount you think is in error. We will tell you the results of our investigation within 3 business days after completing our investigation. Ifwe decide there was no error, we will send you a wntten explanation. You may ask for copies of the documents we used m our investigation. IN CASE OF ERRORS OR QUESTIONS ABOUT OTHER TRANSACTIONS ON YOUR STATEMENT You must contact us within thirty (30) days after you receive your statement if you think a transaction, other than an electronic transfer, shown on your statement is wrong or if you need more information about the transaction. You ma contact yyour nearest branch or our Customer Contact Center at 877-SOV-BANK. Customers with heazing impairments may call 800-428Y9121 (TTY/TDD). We will investigate your dispute and tell you the results of that investigation. Additions Subtractions Balance $ 71.648.86 page 2 of I 1921035897 SARAH A. TODD MEMORIAL HOME 1000 West South Street, Carlisle, PA 17013 (717) 245-2187 • (717) 245-9733 FAX www.ucc-homes.org January 26, 201:3 Alan Robinson 2406 Rolling Hills Drive Mechanicsburg PA 17055 Re: Lois S. Robinson, # 102149 Dear Mr. Robinson, The account for Lois S. Robinson is now past due. We recommend your immediate attention in this matter. Please forward the total amount due of $1,599.74 by February 2, 2013. If this payment is not received by the stated date, please contact me to establish a meeting time to review your options. If payment is not received or arrangements made within the above mentioned deadline, I will be referring this account to our legal counsel. Thank you for your prompt attention in this important matter. Sincerely, I ~ 1 ~/ a ~ ~ ~~ Mary Jane Walker, NHA Executive Director A program of service for the older person sponsored by United Church of Christ Homes w~ V'VEST 5~IURE EMERGENCY MEDICAL SERVICES WSEMS - Chambersburg ALS/BLS DISCOVER 205 GRANDVIEW AVE ~ CAMP HILL, PA 17011-1708 Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 ON REVERSE SIDE PATIENT NAME: LOTS ROBINSON CALL NUMBER: 0229935 LOTS ROBINSON C/O ALAN ROBINSON 2406 ROLLING HILLS DR MECHANICSBURG, PA 17055 >~''" ~t`~k. , INSURANCE: AETNA-MEDICARE ESTATE ADVANTRA C DATE OF CALL: 05/30/2012 FROM: SARA A TODD MEMORIAL HOME TO: 1 DUNWOODY DR ACCOUNT SUMMARY TOTAL CHARGES: 137.00 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 137.00 DETACH ALONG PERFORATION AND RETURN STUB WITH PAYMENT \ . -. ~ D200-500PI PHONE: (717) 737-1300 Alan B. Robinson, Executor Estate of Lois S. Robinson 2406 Rolling Hills Drive Mechanicsburg, PA 17055 Dear Mr. Robinson: 1.RW VlftL'ES Of DEBRA K.//WALLET 24 N. 32nd STREET CAMP HILL, PA 17011-2917 Email Walletdeb@aol.com June 27, 2012 FAX: (717) 761-5319 Thank you for retaining me to serve as attorney for you in your capacity as Executor of the estate of Lois S. Robinson. At this time, I would like to confirm our agreement concerning how I will be paid. will charge a flat rate of $500 (based on the anticipated size of the Estate) for the following services: a. reviewing and analyzing the will or advising you as to the persons who will take the deceased's estate according to law and providing advice throughout the Estate administration process; b. preparing the petition for probate and related documents; c. traveling with you to the Carlisle Court House to file the petition for probate; d. advising you as to your duties and responsibilities as you perform your Executor duties; e. helping you to set up an Estate account, including the obtaining of a tax IJ num her; f. preparing the formal notices to heirs and the certification which must be filed with the Curt; g. closing the estate by informal accounting; and h. preparing receipts and releases for persons receiving benefits from the estate, a process required to close the estate by informal accounting. I am able to charge such a low fee because it is expected that you will be preparing an inheritance tax estimate to take advantage of the three-month discount period and filing the inheritance tax return(s) and any fiduciary tax returns. I will also expect that you will be doing most of the work on the accounting and that I will simply have to place it in the proper format. It is estimated that it will take 9 months to a year to complete this process. RECEIPT FOR PAYMENT GLENDA FARNER BTRASBAUGH Receipt Date: 3/04/2013 Cumberland County - Register Of Wills Receipt Time: 12:22:19 One Courthouse S uare Receipt No.: 1073280 Carlisle, PA ]_713 ROBINSON LOIS S Estate File No.: 2012-00691 Paid By Remarks: ALAN B ROBINSON DMB ------------------------ Receipt Distribution ----------------________ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15.00 CUMBERLAND COUNTY GENERAL FUN ADD PROBATE FEE 15.00 CUMBERLAND COUNTY GENERAL FUN Check# 109 $ $30.00 Total Received......... 30.00 ~, (/r r` `. \ `~ . L ¢ w ~i C.7 ^ , i ¢ ~.7 M ` \i 111 F- IL - ' ^ V7 _~~• H I.i /tf7 00[T]lf7 •Z .N d.-,~no,_~ N ¢Uf~oO ~"'~o .d~~, ~ o cn z ¢¢ ~}o = S ~ :L ~ U I11 M o r ~~ ~~ N V W ;; O w ~` O h W O W ,i J C' ~ ~1 ~~ ~~ ~ i~~ } ' : b ~ ~ r~~ h s '~• /+~~~J' y C2 ~ Y [ t 4.~ ~ ,,,/// [ - ,...t [l. ~~ ~ ~ ~s ~ P ~ 'L P ~ .. ;, ~ i ~ ~ 4 1~~I ~~[f ' ~~ 1~'` 1~ ~~ ~ ~ r ~~, .. N E 1 ~ •• w - ? 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