HomeMy WebLinkAbout03-11-13
_J 1505610105
REV-1500 EX(oa-u)(FI) I!1r
~ OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
Bureau of Individual Taxes o..E~.-
PO BOX28o6o1 INHERITANCE TAX RETURN ` Z r 2
Harrisburg, PA 17128-o6oi RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
571-36-7765 03/19/2012 05/13/1928
Decedent's Last Name Suffix Decedent's First Name MI
Arnold Eugene F
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouses Social Security Number
- THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
tap 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
p 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
C@D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 B. 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 r-) 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:
c_~ 73
Name Daytimoffelephone Number ;0 M
rn c->
Ronald E. Johnson, Esq (717)Vg123 3 c-.) Gl
Ii tE F WILLS USEP4yr•,
171 I_-+ ;;',I 5-)
First Line of Address C-
78 1 -T t
West Pomfret Street
Second Line of Address - r \ t/'11 )
O (_0
(D
DATE FILED
City or Post Office State ZIP Code
Carlisle PA 17013
Correspondent's e-mail address: rejohnson@pa.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.
SIGN AT„iR`PERSON RESPONSIBLE FOR FILIN R 4~ DA
ADDRESS
c/o 78 West Pomfret Stre t, rlisle, PA 17013
SI R o REPRESENTATIVE DATE
A. 2
S c/ 78 West Pomfr Street, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX (Fl)
Decedent's Social Security Number
Decedent's Name: Eugene F. Arnold 571-36-7765
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. ! 13,267.01
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. 13,267.01
9. Funeral Expenses and Administrative Costs (Schedule H) 9. ! 4,246.94
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule 1) 10. 28,828.41
11. Total Deductions (total Lines 9 and 10) 11. 35,075.35
12. Net Value of Estate (Line 8 minus Line 11) 12. j -21,808.34
13. Charitable and Governmental Bequests/Sec 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. ! -21,808.34
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 collateral 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 O
Side 2
L 1505610205 1505610205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Eugene F. Arnold
STREETADDRESS
210 Big Spring Road
CITY STATE ZIP
Nevvville PA 17241
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments 0.00
B. Discount 0.00
Total Credits (A + B) (2) 0.00
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, 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
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 property transferred ❑ 0
b. retain the right to designate who shall use the property transferred or its income ❑ 0
c. retain a reversionary interest ❑ 0
d. receive the promise for life of either payments, benefits or care? ❑ 0
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ❑ 0
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ❑ E
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ❑ E
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 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 172 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)]. 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.
LAST WILL AND TESTAMENT
OF
EUGENE F. ARNOLD
I, EUGENE F. ARNOLD, of West Pennsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby 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: It is my desire that my body be cremated after my death and the cost
thereof paid from the assets of my estate.
SECOND: I direct that all my just debts and funeral expenses shall be paid from
the assets of my estate as soon as practicable after my decease.
THIRD: I give, devise and bequeath the residue of my estate, of every nature
and wherever situate, to my three children equally, namely, LINDA K. FREY, ROBERT E.
ARNOLD and WILLIAM ARNOLD, provided that the share of any of my named children who
predecease shall be distributed to their issues per stripes living at the time of my death, and in default
of such then living issue, such share shall be added to the share or shares for my other children.
FOURTH: I direct that all taxes that may be assessed in consequence of my death,
of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a
part of the expense of the administration of my estate.
FIFTH: I nominate, constitute and appoint my children, LINDA K. FREY and
ROBERT E. ARNOLD, or the survivor of them, Executors of this my Last Will and Testament.
SIXTH: I direct my Executors and their successors shall not be required to give
bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of two (2) typewritten pages, each identified by my signature, this
day of~~! , 2011. 1
(SEAL)
Eugene/Y. Arnold
Signed, sealed, published and declared by the above-named Testator, Eugene F. Arnold, as
and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and
presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
I, Eugene F. Arnold, Testator, whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed the
instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by Eugene F. Arnold, the Testator, this
day of 2011.
(SAL)
C6tdMONWEALTH OF PENNSYLVANIA Eugene F. Arnold, ~~gstator
NOTARIAL SEAL
RONALD E. JOHNSON. NOTARY PUBLIC.
CARLISLE BORO, CUMBERLAND CO., PA~
MY COMMISSION EXPIRES MARCH 11, 2012
Notary~Public l
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, ~E and /tvVe~lYf1 the
witnesses whose names are signed'to the attached or fo gorrrg instrument, being duly qualified
according to law, do depose and say that we were present and saw Testator sign and execute the
instrument as his Last Will and Testament; that Eugene F. Arnold, signed willingly and that he
executed it as his free and voluntary act for the purpose 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 IS or more years of age, of sound mind and under no constraint or
undue influence.
Sworn or affirmed to and subscribed to before me by 6F-, 1=5'6Lf
and witnesses, this , hl day of
)2011.
N ~r-cs
E (SEAL)
Witness
(SEAL)
Zr At Nib. b~ €KINSYL-VANIA
/ NOTARIAL SEAL
RONALD E, JOHNSON, NOTARY PUBLIC
C ARUSL E 80RO, CUMBERLAND CO., PA
ICY COMMISSION EXPIRES MARCH 11, 2012
REV-1508 EX+ (08-12)
i pennsyLvania SCHEDULE E
t& DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Eugene F. Arnold 21-12-0402
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 disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Checking account no: 1091174784--Sovereign Bank (see attached) 13,149.14
2. Presbyterian Homes - nursing home refund 17.87
3. Hoffman-Roth Funeral Home - refund 100.00
TOTAL (Also enter on Line 5, Recapitulation) $ 13,267.01
If more space is needed, use additional sheets of paper of the same size.
Sovereigff
Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box 841005 - Boston, MA 02284
b
N April 12, 2012
Ronald E Johnson
s Andrews & Johnson Attorneys at Law
78 West Pomfret Street
Carlisle, PA 17013
RE: Estate of Eugene F Arnold
Date of Death: 03/19/2012
m
z Dear Mr. Johnson:
m
Per your request, enclosed please find the account information as of the date of death
for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
b
Please feel free to contact me if I can be of any further assistance.
Very truly yours,
Ed Stevens
z COP Specialist
617-514-5189
a
m
3
_U
E
Z
o'
Sovereign Bank
ESTATE OF. Eugene F. Arnold
SOCIAL SECURITY 571-36-7765
DATE OF DEATH: March 19, 2012
Account 1091174784 Type: Checking Open date: 5/6/2011
In the name of: Eugene F Arnold (Robert E Arnold POA; Linda K Frey POA)
Date of Death Balance: $13,149.07
Int.(YTD) from 1/1/2012 to 2/24/2012 $0.15
Accrued interest to date of death: $0.07
Other Info:
Page 1 of 1
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
Eugene F. Arnold 21-12-0402
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home 17.04
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 800.00
Name(s) of Personal Representative(s) Linda K. Frey and Robert E. Arnold ($400 each)
Street Address 177 Crossroads School Road and 250 Crossroads School Road
City Newville State PA ZIP 17241
Year(s) Commission Paid: 2013
2. Attorney Fees: 2,500.00
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: 104.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Presbyterian Homes - final nursing home bill 110.40
s. Register of Wills - Inheritance Tax Return filing fee 15.00
9. Reserve for closing and accounting 700.00
TOTAL (Also enter on Line 9, Recapitulation) $ 4,246.94
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX~ (12-12)
•
~ ~ Pennsylvania SCHEDULEI
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Eugene F. Arnold 21-12-0402
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. Checking account transaction in Sovereign Bank account no: 1091174784 (Item 1, Schedule E) prior
to death and outstanding on date of death
Payee Date Cashed Amount Check No.
Presbyterian Homes 3120/12 $1,869.04 565
Elsie Arnold 3/20/12 $3,762.00 566 5,631.04
2. Commonwealth of Pennsylvania-Dept of Public Welfare (see letter attached) 23,197.37
TOTAL (Also enter on Line 10, Recapitulation) $ 28,82841
If more space is needed, insert additional sheets of the same size.
w
REV-1513 EX+ (01-10)
pennsytvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Eugene F. Arnold 21-12-0402
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
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. Linda K. Frey, 177 Crossroads School Road, Newville, PA 17241 daughter 1/3
2. Robert E. Arnold, 250 Crossroads School Road, Newville, PA 17241 son 1/3
3. William H. Arnold, 150 Georgetown Road, Gardners, PA 17321 son 1/3
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
L
B. CHARITABLE 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.