HomeMy WebLinkAbout03-08-13 REV-1500 E` 1505610140
(°' '°'
PA Department of Revenue
OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 2 1 1 2 0 1 2 9 8
Harrisburg,PA 17128-0801 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Suffix Decedent's First Name MI
M 0 R R 0 W E R M A A
(N 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 OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1.Original Return 2.Supplemental Return 3.Remainder Return(date of death
prior to 12-13-82)
4.Limited Estate 4a. Future Interest Compromise(date of 0 5. Federal Estate Tax Return Required
death after 12-12-82)
® 6.Decedent Died Testate 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 D 11.Election to tax under Sec.9113(A)
between 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 TO:
Name Daytime Telephone Number
S E T H T M 0 S E 8 E Y 7 1 7 2 4 3 3 3 4 1
REGISTERWILLS USE ONLY
CDP First line of address Qj O
1 0 E A S T H I G H S T R E E T
Second line of address Z m
C/) = C►
- �
C) C>
c�
City or Post Office State ZIP Code G9 r DATE FIC$
:U rV l-- r.y1
C A R L I S L E P A 1 7 0 1 `f Co n
w
Correspondent's e-mail address: SMOSEBEY(,MARTSONLAW.COM
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.
S RE OF PERSON ESPONSIBLE FOR fl ING RETURN DATE
AD SS
2200 CANYON DRI E, E-1 COSTA MESA CA 92627
SI TURE OF-MEPA11ER OTHER THAN REPRESENTATIVE DATE
J-
ADDRESS
10 EAST HIGH S BEET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140
J 1505610240
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A) .... ........................... ............ 1.
2. Stocks and Bonds(Schedule B) .......................... ............ 2. 2 9 2 5 3 . 7 6
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. 4 3 5 6 8 . 4 9
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers&Miscellaneous Probate Property
(Schedule G) hb Separate Billing Requested ....... 7. 4 2 3 1 6 . 8 2
8. Total Gross Assets(total Lines 1 through 7) ............... ............ 8. 1 1 5 1 3 9 . 0 7
9. Funeral Expenses and Administrative Costs(Schedule H) ...... ............ 9• 7 7 9 5. 0 8
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .... ......... 10.
11. Total Deductions(total Lines 9 and 10) ......... .......... ............ 11. 7 7 9 5 . 0 8
12. Not Value of Estate(Line 8 minus Line 11) ................... ...... ... 12. 1 0 7 3 4 3 . 9 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ............. ......... 13.
14. Not Value Subject to Tax(Line 12 minus Line 13) ................ ...... 14. 1 0 7 3 4 3 . 9 9
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(aX1.2)X-0_ 0 . 0 0 15. 0 . 0 0
16. Amount of tine 14 taxable
at lineal rate X•045 1 0 7 3 4 3 . 9 9 16. 4 8 3 0 . 4 8
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 . 0 0 18. 0 . 0 0
19. TAX DUE .................. ..... ............................... 19. 4 8 3 0 . 4 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
L 1505610240 1505610240
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 12 01298
DECEDENTS NAME
ERMA A.MORROW
STREET ADDRESS
35 EASTGATE DRIVE APT.202
CITY STATE ZIP
CARLISLE PA ]7015
Tax Payments and Credits:
1• Tax Due(Page 2,Une 19) (1) 4,830.48
2. Credits/Payments
A.Prior Payments
B.Discount 241.52
Total Credits(A+B) (2) 241.52
3. Interest
4. If Une 2 is greater than Une 1+Une 3,enter the difference.This is the OVERPAYMENT. (3)
Fill In oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Une 1+Une 3 is greater than Une 2,enter the difference.This is the TAX DUE (5) 4.588.96
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; ...................................................................... ❑
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 December 12,198Z did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑
3. Did decedent own an"in tout 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 beneficiary designation?.................................................................................................. ® ❑
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 0 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)[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.
REV-1503 EX,(8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE STOCKS & BONDS
INHERITANCE TAl(RETURN
RESIDENTDECEDENr
ESTATE OF FILE NUMBER
ERMA A.MORROW 21 12 01298
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Ameriprise Financial Company,Basic Brokerage with One,account no.000256697293113 29,253.76
See attached valuation.
TOTAL(Also enter on Line 2,Recapitulation) $ 29 253.76
If more space is needed,insert additional sheets of the same size
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS &MISC.
RRESIDDDIT�DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
ERMA A.MORROW 21 12 01298
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. M&T Bank checking account no.33370036 15,319.12
See attached valuation.
2. Ameriprise Financial,Annuity-Post 1985,account no.930074175314004 11,459.50
See attached valuation.
3. Ameriprise Financial,Annuity-Post 1985,account no.930074918101004 10,039.94
See attached valuation.
4. 1991 Dodge Spirit 1,850.00
5. Pension check received after date of death. 265.86
6. Cash in home 2,795.00
7. Personal property 1,250.00
8. Comcast-refund 45.07
9. Erie Insurance-car insurance refund 182.00
10. Apartment rental-refund 362.00
TOTAL(Also enter on line 5,Recapitulation) $ 43 568.49
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DEaMffr
ESTATE OF FILE NUMBER
ERMA A.MORROW 21 12 01298
This schedule must be completed and filed 9 the answer to any of questions/through 4 on page three of the REV•1500Is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRrnsREREE THEIR RELATIONSHIPTO DECEDENT AND DATE OF DEATH %OFDECUS EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE OEM FOR RFAL ESTATE VALUE OF ASSET INTEREST VALUE
1. *Ameriprise Financial,IRA,account no.005047185722001 3,709.79 100.00 3,709.79
Beneficiary:Gwendolyn Strom,daughter
2. *Ameriprise Financial,Certificate account no.008047185692001 1,593.22 100.00 1,593.22
Transfer on death beneficiary:Gwendolyn Strom,daughter
3. *Ameriprise Financial,Certificate account no.008097260213001 2,103.03 100.00 2,103.03
Transfer on death beneficiary:Gwendolyn Strom,daughter
4. *Ameriprise Financial,Certificate account no.063042084432001 7,095.93 100.00 7,095.93
Transfer on death beneficiary: Gwendolyn Strom,daughter
5. *Ameriprise Financial,Certificate account no.063048037376001 1,835.09 100.00 1,835.09
Transfer on death beneficiary: Gwendolyn Strom,daughter
6. *Ameriprise Financial,IRA Annuity-Post 1985 25,979.76 100.00 25,979.76
Account no.931074432523004
Beneficiary: Gwendolyn Strom,daughter
*See attached valuation.
TOTAL Also enter on Line 7,Recapitulation) S 42 316.82
N more space is needed,use additional sheets of paper Of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTAENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
ERMA A.MORROW 21 12 01298
Docedeffs dabs must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Travel expenses to plan and attend funeral(including airfare,lodging,airport parking, 1,705.38
meals and local transportation)
B. ADMINISTRATIVE COSTS:
t. Personal Representative Commissions:
Name(s)of Personal Represemad"(s)
Street Address
City Stall ZIP
Year(s)Commission Paid:
2. Attorney Fees: Manson Law Offices 5,872.20
3. Family Exemptbn:(N decedents address Is not the same as clairrots,attach explanation.)
Claimant
Street Address
City state ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Register of Wills,Cumberland County 127.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Register of Wills,filing fee of Inheritance Tax Return 15.00
8. Additional probate 75.00
TOTAL(Also enter on Line 9,Recapitulation) $ 7,795.08
It more space is needed,use additional sheets of paper of the same size.
REV-1513 EX-(01-10)
pennsyivania SCHEDULE J
OEPARTWNT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESVENT DECEDENT
ESTATE OF: FILE NUMBER:
ERMA A.MORROW 21 12 01298
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Truslee(s) OF ESTATE
1 TAXABLJ=DISTRIBUTIONS [Indudt diSWINAons and hnstam Under
Sec.91 8{a {12}j
1. Gwendolyn Strom Lineal 107,343.99
2200 Canyon Drive,E-1
Costa Mesa,CA 92627
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:
1.
8.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
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 site.
FAFU,MATAFILETimt PIUWn$\10610 vAII
LAST WILL AND TESTAAMNT
I,ERMA MORROW,of West Pennsboro Township,Cumberland County,Pennsylvania,
being of sound and disposing mind and memory,do hereby make,publish and declare this to be my
Last Will and Testament,hereby revoking any and all former Wills or Codicils by me made.
1.
I direct that all my legally enforceable debts,funeral expenses,testamentary expenses and all
inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property)shall be paid from my residuary estate as soon as practicable after my decease and as part
of the administration of my estate. My personal representative shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other
property not passing under this Will.
z.
I give, devise and bequeath all of my estate, both real and personal property, unto my
daughter,GWENDOLYN STRUM,absolutely.
3.
1 nominate,constitute and appoint my daughter,GWENDOLYN STRUM, as Executrix of
my estate.
4.
1 direct that my Executrix shall not be required to file a bond to secure the faithful
performance of her duties in any jurisdiction.
5
I authorize and empower my personal representative,in her sole and absolute discretion,to
purchase or otherwise acquire and retain any investments of which I die seized or any real or personal
property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant
options in regard to any or all property of any kind forming a part of my estate for such terms and
such prices as she may deem advisable; to borrow money for any purposes connected with the
protection and preservation of my estate;to mortgage or pledge any real or personal property forming
a part of my estate or to join in or secure the partition of same;to compromise any claims or demands
tials
Page 1 of 3 Pages
of my estate against others or of others against my estate,to make distribution in kind and to cause
any share to be composed of cash,property or undivided fractional shares in property different in kind
from any other share;to employ agents,attorneys and proxies and to delegate to them such power
as my personal representative considers desirable and to pay reasonable compensation for such
services as may be rendered by such agents,attorneys and proxies;and to execute and deliver such
instruments as may be necessary to carry out any of these powers. In addition, I direct that my
personal representative shall have the power to conduct an inventory of any safe deposit box
necessary to the administration of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this A011(day of
f (SEAL)
ma Morrow
SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testatrix,as and
for her Last Will and Testament,in the presence of us,who at her request,have hereunto subscribed
our names as witnesses therqto, in the presence of the said Testatrix and of each other.
i
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, Erma Morrow,
, and
3 r M ra 5 (1 )I.-Id tl t I ,.the Testatrix and the witnesses,4spectively,whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix
has signed willingly,and that the Testatrix executed it as her free and voluntary act for the purposes
therein expressed,and that each of the witnesses,in the presence and hearing of the Testatrix,signed
the Will as a witness and that to the best of his/her knowledge the Testatrix was at that time eighteen
years of age or older,of sound mind and under no constraint or undue influence.
' t
ttness
itness
Subscribed, sworn to and acknowledged before me by Erma Morrow, the Testatrix, and
subscribed and sworn to before me by Da V IGL A0 and
6 S. to� a,&A ,the witnesses,this �� day of 6—, 2002.
NN notary Public
NOTARIAL SEAL
CORRINE L.WEBS,Notuy Public
Carlisle Boro.Cumberlanacowty
My Commission Expires May 27,2003
Page 3 of 3 Pages
Leuschen, Ronald P
From: Shetkar, Ganesh V on behalf of SD Life EventsCommunicationCenter
Sent: Friday, December 14, 2012 8:44 AM
To: Leuschen, Ronald P
Subject: 16495722 7 001 ERMA A MORROW DEATH SETTLEMENT REQUIREMENTS PLS DO NOT
DELETE.
River8ource Life Insurance
Company
Ameriprise Financial Company
70100 Ameriprise Financial Center
Minneapolis,MN 66474
December 14,2012
RONALD PATRICK LEUSCHEN
25 S 35TH ST
CAMP HILL, PA 17011-4409
16495722 7 001
Dear RONALD PATRICK LEUSCHEN: ;
We have received notification of ERMA A MORROW's death. The deceased's name appears on the following accounts. Account
values as of 12/06/2012 are listed below. At the end of this letter,you will find a list of beneficiaries shown in our initial review of
the accounts
Account Information
Certificates
Account Number Ownership
00504718572 2 001 IRA-beneficiary designated
00804718569 2 001 Individual-TOD
00809726021 3 001 Individual-TOD
06304208443 2 001 Individual-TOD
06304803737 6 001 Individual-TOD
Annuities-Post 1985
Account Number Ownership
930074175314 004 Individual
93007491810 1 004 Individual
93 107443252 3 004 IRA -beneficiary designated
Basic Brokerage with ONE
Account Number Owners hi
00025669729 3 133 Individual
Certificates 2 -T-LOm
Account Number Total Value
5ch • C3, Z�mS 1 -b Cn �l '3�
00504718572 2 001 $3,709.79
00804718569 2 001 $1,593.22
008097260213 001 $2,103.03
06304208443 2 001 $7,095.93
06304803737 6 001 $1,835.09
Annuities -Post 1985
Account Number Total Value
93007417531 4 004 $11,459.50
930074918101004 $10,039.94
93 107443252 3 004 $25,979.76
Basic Brokerage with ONE
Account Number Total Value
00025669729 3 133 $29,253.76
ACC[Mrrns:AMWWC ErkwK IAEO W%, l71AA4AMORROW
ACCT MO:OM035OW20133 ACCITAWft -QWM W
NFL2 W- 0 �z a PAWS 0q +
,
CASH CLAM EMJWLENM 90.031.70 I in 90A01.70
RMOO NVl0TNEW BNAMO.OMP FWQX LCNMNT1 MMM FAO6 11.4* 10M.70
80MCLiC L-lew �TMIM3
Y/OLL3nVMPCWVfWM av= OMCRT-Tewr"M own am O.Tf0.31
OCU MS0OMnAl VOW R*W INr 9400YE F{Nf
MC AccwtTdd $3D=70
The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be subject to market
fluctuation as governed by each product. Please note that the values indicated for any Life Insurance products with the insured
deceased reflect the gross death benefit at date of death and not the cash value. Values indicated for Life Insurance products with only
the owner deceased reflect the cash value as of the date of death. Values for any proprietary mutual funds include accrued dividends
as.applicable.Values provided for brokerage products are manually calculated,and should be used as estimates only. The prices used
to provide values are estimates obtained from outside sources believed to be reliable. Ameriprise Financial provides these values as a
service to its clients. Actual values used in preparation of tax returns or for planning purposes should be verified by your legal and
accounting advisors.
Account Disposition
Account disposition is based on how an account is owned(the ownership type). The following information will help you understand
the process that will be used to settle the accounts. Accounts may be subject to market fluctuation as governed by each product.
Disposition for IRA-beneficiary designated ownership
Upon the death of the owner,all IRA accounts pass to the named beneficiaries. If you are inheriting multiple IRA plans of the same
plan type,they will be settled into one Inherited IRA plan.To determine the distribution options available,please consult a tax
advisor. If all IRA accounts will not be fully distributed to the beneficiaries within the year of the owner's death,we recommend the
accounts be transferred into inherited ownership by year end.This ensures we are able to meet IRS Form 5498 reporting requirements.
Transferring to inherited ownership is not a taxable distribution to the beneficiary. If an account in an IRA was subject to a Special
Beneficiary Restriction,the distribution options for that particular account will be restricted.
Disposition for Individual-TOD ownership
Upon the death of the owner,all accounts registered as individual-transfer on death pass to the named beneficiaries. Although the
assets do not become part of the estate for distribution,we understand they should be included for inheritance and/or estate tax
purposes.
MM&TBank
499 Mitchell Road,Millsboro,DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
December 24,2012
Martson Deardorff Williams Otto Gilroy& Faller
10 East High Street
Carlisle,PA 17013
Re: Estate of Erma A.Morrow
Social Security: 202-20-0605
Date of Death: December 6.2012
Dear Sir or Madam:
Per your inquiry on December 19,2012,please be advised that at the time of death,the above-named decedent
had on deposit with this bank the following:
1. Type of Account Checking Account
Account Number 33370036
Ownership(Names on Erma A.Morrow
Opening Date 0412811987
Balance on Date of Death $15,319.12
Accrued Interest $ .00
Total
For any additional information on the above secou %including ownership and any changes,closures sod/or reimbursement of funds,
please rag the High street Cu1hk at 717-M 4536.
We were unable to locate any ask deposit box for the above-mentioned decedent.
This letter does not Include any accounts In which the deceased may have been listed as Power of Attorney,Custodian of Uniform Traoskra,
Representative Payee,or Trustee under a Written Agreement.
Sincerely,
Valarie Mercer
Adjustment Services