HomeMy WebLinkAbout03-19-13 -J REV-1500 EX(01-10) 1505610143
OFFICIAL USE ONLY
PADepartmentof Revenue pennsyvania County Code Year File Number
Bureau of lndividualTaxes DEPARTMENTOFREVENUE
PO BOx.280601 INHERITANCE TAX RETURN 21 11 01326
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12 05 2011 05 15 1944
Decedent's Last Name Suffix Decedent's First Name MI
ZENTZ LINDA L
(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 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 ❑ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® 8 Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust) p
❑ 9. Litigation Proceeds Received ❑ 10,Spousal Poverty Credit(date of death 11,Election to tax under Sec.911 3 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
SCOTT M DINNER ESQ 717 7f1 5800:"
c m
REGISTERL ".*ILLS USEJDNLY-w
First line of address
CD =`j
3117 CHESTNUT STREET
_7? -,I 1
Second line of address
DATE FILED
City or Post Office State ZIP Code
CAMP HILL PA 17011
Correspondent's e-mail address: dinner @localnet.com
Under penal'es 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,co d complete.Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATUR DN NG RETURN DATE
Gerald E.Smith,Jr. 3 -9
ADD ESS
1841singtpM Drive, C p Hill,,PA 17011
SIGN OF ER THER T N PRESENTATIVE DATE 1
Scott M Dinner Esq
ADD sS
3117 Chestnut Street,Camp Hill, PA 17011
Side 1
1505610143 1505610143 J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: ZENTZ, LINDA LOUISE
RECAPITULATION
1. Real Estate(Schedule A).......................... 155 , 000 . 00
2. Stocks and Bonds(Schedule B)................................................................................. 2. 48 , 201 . 78
3. Closely Held Corporation,Partnership orSole-Proprietorship(Schedule C).............. 3.
4. Mortgages&Notes Receivable(Schedule D)............................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E).................... 5. 49 , 464 . 62
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested.............. 6.
7. Inter-VivosTransfers&Miscellaneous Non-Probate Property 39 , 619 . 97
(Schedule G) [] Separate Billing Requested.............. 7,
8. Total Gross Assets(total Lines 1-7)........................................................................ 8. 292 , 2 8 6 . 3 7
9. Funeral Expenses&Administrative Costs(Schedule H)............................................ 9. 14 , 8 9 4 . 8 5
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1)................................... 10. 1 , 228 . 74
11. Total Deductions(total Lines 9&10)....................................................................... 11. 16 , 12 3 . 5 9
12. Net Value of Estate(Line 8 minus Line 11).............................................................. 12. 276 , 1 6 2 . 7 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts forwhich
an election to tax has not been made(Schedule J).................................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................... 14. 276 , 162 . 78
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X .00 15.
16. Amount of Line 14 taxable
at lineal rate x .045 276 , 162 . 7 8 16. 121427 . 33
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate .15 18.
19. Tax Due..................................................................................................................... 19. 1 2 , 4 2 7 . 3 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
SCHEDULE A
law
COMMONWEALTHOFPENNSYLVANIA REAL ESTATE
INHERITANCETAXRETURN
RESIOENTDECEDENT
FILE NUMBER
ESTATE OF Zentz, Linda Louise
21 - 11 -01326
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Contract sales price (line 401. of attached HUD-1 Settlement Statement)for decedent's principal 155,000.00
residence located at 20 Grinnel Drive, Lower Allen Twp., Cumberland County, Pennsylvania
[parcel ID 13-24-0807-066]; purchased 10/12/2007
TOTAL(Also enter on Line 1, Recapitulation) 155,000.00
SCHEDULE B
COMMONwEALTHOFPENNSYLVANIA STOCKS & BONDS
INHERITANCETAXRETURN
RESIDENTDECEDENT
FILE NUMBER
ESTATE OF Zentz, Linda Louise 21 - 11 -01326
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE
NUMBER OF DEATH
1 Franklin Income Fund Class C [CUSIP: 353496805] 2.09 16,395.45
2 Franklin Federal Tax Free Cl C [CUSIP: 353519200] 11.98 16,670.04
3 ! Franklin Pennsylvania Tax Free Cl C 10.53 12,887.27
[CUSIP:3547234471
4 Federated Municipal Trust money market 1.0 2,249.02
5 Note: mutual funds/money market positions were held with The O.N. Equity
Sales Company brokerage account. # 3CG-004790
TOTAL(Also enter on line 2, Recapitulation) 48,201.78
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTHOF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCETAXRETURN
RESIDENTDECEDENT
FILE NUMBER
ESTATE OF Zentz, Linda Louise 21 - 11 -01326
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
sale price of 2006 Dodge Grand Caravan [VIN#2D8GP44L96R612008 11,000.00
1 personal property 2,350.00
2 Integrity Bank savings account#403005647 24,137.12
3 Integrity Bank savings account#403007354 3,331.08
4 Integrity Bank checking account#203012122 5,209.23
5 Integrity Bank checking account#203018318 2,851.14
6 refunds from UGI Utilities, Inc. and American Water 248.96
7 refunds from Comcast and Verizon Wireless 142.09
8 Sight&Sound show refund 88.00
9 Traveler's Ins. refund 107.00
TOTAL(Also enter on Line 5, Recapitulation) 49,464.62
SCHEDULE G
COMMON PENNSYLVANIA INTER-VIVOS TRANSFERS &
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Zentz, Linda Louise FILE NUMBER
21 - 11 -01326
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION 'TAXABLE VALUE
NUMBER Include the name of the transferee,their relationship to decedent VALUE OF ASSET INTEREST (IF APPLICABLE)
and the date of transfer. Attach a copy of the deed for real estate.
IRA#3CG-002851 held with 0.N. Equity Sales 39,619.97 100% 39,619.97
Company[equal 1/3 beneficiaries are decedent's son,
daughter and step-daughter]
TOTAL(Also enter on line 7, Recapitulation) 39,619.97
, , SCHEDULE H
M 91 FUNERAL EXPENSES&
COMMONWEALTHOFPENNSYLVANIA
INHERITANCETAXRETORN eD'W e��S
RESIDENTDECEDENT �'�nf_,w�.,v-�
FILE NUMBER
ESTATE OF Zentz, Linda Louise 21 - 11 -01326
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT —
A 1 Parthemore Funeral Home Cremation Services, Inc. 3,082.75
New Cumberland, PA 17070
2 Newport Cemetary Association -perpetual care/headstone 700.00
B. ADMINISTRATIVE COSTS:
1. PersonalRepresentative'sCommissions
Name of Personal Representative(s)
Gerald E. Smith, Jr. 7,300.00
StreetAddress 18 Kensington Drive
City Camp Hill State PA Zip 17011
Year(s)Commission paid 2012
2. Attorney's Fees Scott M. Dinner, Esq. 2,850.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
StreetAddress
City State Zip
Relationship of Claimant to Decedent
4. ProbateFees Cumberland County Register of Wills 347.50
5. Accountant's Fees
6. Tax Return Preparer'sFees H&R Block-2011 Federal & PA final individual income 71.00
7. Other Administrative Costs
1 advertisement of letters-Cumberland law Journal/The Patriot-News 209.31
TOTAL(Also enter on line 9, Recapitulation) 14,894.85
Shckie H
VW- Fmmal E wim&
COMMONWEALTH OF PENNSYLVANIA �. �M
INHERITANCE TAX RETURN /"w1R�I* YY6 Qxft(`f*'xmd
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Zentz, Linda Louise
21 - 11 -01326
2 Settlement costs(net) per attached HUD-1 (406, 408, 409, and 502) 220.34
3 vehicle transfer notary fee 5.00
4 Lower alien Twp. sewer/trash bill- 1 Q 2012 108.95
i
I
Page 2 of Schedule H
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTHOFPENNSYLVANIA LIABILITIES LIENS
INHERITANCETAXRETURN 7
RESIDENTDECEDENT
72'1 LE NUMBER
ESTATE OF Zentz, Linda Louise
- 11 -01326
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 personal care services payable to Elizabeth Lopez 1,228.74
TOTAL(Also enter on Line 10, Recapitulation) 1,228.74
i
t
x�p *0 OMB Approval No.2502-0246
d c
` A. Settlement Statement(HUD-1)
B.Type of Loan
1.O FHA 2.0 RHS 3.❑Cow Unkns. 8. File Number. 7. Loan Number. 8. Mork pe insurance Case Number.
I 4.Q VA 5.[N Corn.Ins. SM1246-12 6800637634
C. Note_ TNS kum is auniabed to ghm you a shosmar t of ackwet sof larnemt ousts.Amounts paid to and kY the aelGenent ap w are shown,
ilerms malked'(p.0x.)*wale paid outside Me obrNnp:they am shown two for Nrkumsdonsi pwposes end am not kxahrdsd in OW fatels.
D. Name and Address of Borrower. E.Name and Address of Seller. F. Name and Address of tender.
CANDICE L.SMITH ESTATE OF LINDA L.ZENTZ MEMBERST 1 ST FCU
20 GRINNEL DRIVE 20 GRINNEL DRIVE 50011 LOUISE DR.
CAMP HILL,PA 17011 CAMP HILL,PA 17011 MECHANICSBURG.PA 17055
G. PropeAy Location: H. SethINnsnt Agent: 1. SaMbmsnt Dale:
20 GRINNEL DRIVE SCOTT M.DINNER,ESQ.
CAMP HILL,PA 17011 3117 CHESTNUT STREET December 18,2012
CUMBERLAND County,Pannsylvartia CAMP HILL,PA 17011 Ph. (717)781-W00
Piece of SeBkanant
48 CENTRAL BLVD.
CAMP HILL,PA 17011
J. lummary of BorroaWs transaction K summinyotsweestronsoction
100. Gross Amouu Due from Borrows 400.Gross Amount Due to Segal:
101. Contract sales price 1 155 000.00 401.Conttsct ad"price 1 155.000.00 t
102. Personal properly 402. Personal property I
103. Settlement Charges to Borrower Wne 1400 4 281.73 403.
104. 404. I
105. 405. {
for home paid by Seder In Wwarwe Adkortments for loome Paid by Seller in advance
108.Ckyfrown To" 12114112 to 011011`13 26.58 406.CIWToom Taxes 12118112 to 01101113 X68 {
107. Taxes b 407. Tom to
108.SCHOOL TAXES 12n8M2 to 07/01113 800.30 406.SCHOOL TAXES 17118112 In 07101113 800.50
109. SEWER/TRASH 12/10112 lo 01101113 14.58 409.SEWERNRASH 12MB112 to 01/01/13 18.58
110, 41D.
111. 411,
112. 412.
120.Groat Amount Drs from Bodgwor 160,105.39 420.Oro"Amount Due to Seller 155,843.84
200.Amount Pald or le BNWf of Borrower IWO.Reductions in Amount Due SNiar:
201. sh or esmsxd from 3100.00 501. Exomdepooll two Instructions)
202. Prindpoli amount of new s 147X%00 502. Ssitionent to Saber Line 1400 1,05C00
2D3. Existing bans Won pubod to 503. loon(s)taken subiad to
204.CREDIT FOR APPRAISAL FEE 425.00 504.Priall First M
205. 505.Pawff Seca nd
206. 505.
207. 507. A disb.-as
208. 506.
209. 509.
Adluatments for hams unodd by Seller Adkwbnwb for hems unpaid by Seller
210.C" own Taxes to 510.CwTown Taxes to
211.CountyTaxes to 511.Couniv Taxes to
212 SCHOOL TAXES to 512.SCHOOLTAXES to
213. 513.
214. 514.
218. 515.
216- 516.
217. 1 617.
218. 518.
219. 5%
220.Toot Paid byRor Borrower 150,775.00 820.Total Reduction Amount Drs Seller 1,084.00
300.Cash at .Cash at tonrom Seller
301. Gross amount due from Borrower Okw 120 180105.34 501.Gmss arnoutt di as to Saba 420 165.843.46
302. Less amourN Boma or"220 1W.775.001 no due Seller one 520 1,044.
303.Cash K From E] To Borrnwwr 9,330.39 40.1.Cash D To E] From Seller 154.779.66
P.M OA"orI ,son aw l..+iwM W-VU.oraidpwytrt
The undersigned hereby actnowledyelreregt of a oomploW copy of this statement 6 any attschmants Taloned to herein Xk`:SN4 I
Borrower r' Selw ESTATE
CE L.SMiTtt"� BY:
TO THE BEST OF MY KNOWLEDGE,THE HUD-i SETTLEMENT STATEMENT WHICH I HAVE PREPARED IS A Vft AND ACCURATEs COUNT OF THE FUNDS
WHICH WERE RECEIVED AND HAVE BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF TqE IETTLE N THIS
T OFFICE Apart WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES o 11#3 OR ANY SaaLAR FORM. PENALTIES UPON CONVICTION
CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE:TITLE 1e U.S.CODE SECTION 1001 b SECTION 1010.
nwft WR.pankeewer`fortocobw6nofadwaaw,r wwbdweaw►ab.Paln.Po Wwa ooana,r.raWs.andn"fttlwdal.Ttw wry nenw cow f tadoimmon,.Myour.MMWk.ab
waeMr.aW ern.wba 1 e"wo a Maw*wwome ow".06W No aaAWANV M rwn4 a"dwdaf .a nwKw"Tea b dwaarwlb P�a.ba ass 4wU.b a NESPA aorwW aanoaWonrna i�dwMawtion
dubp In...w.nw11 gpyaa.
Pape 1 of 3 HUD-1
(SM1246-12,PFD/SM124(J-12/19}
1
1
L. !Went CtuA es
Paid From Pair From
Division or ann=S&%w as AMws: swowds Severs
T01. to Funds at Funds at
702.S to Settlement Settlement
7
704.
705.
tf00eatsrris'M ay�UN itr Cehrielflc4 a ieMlr L*w wt
801.Our or n cha S 48 rom E#1
602. r F
f F #A 3.13
r " 1 fee to MEMBERSTIITFCU f FE 13 426.22
805.Credit Repod to from GFE 03
Tax sa Nice to (from GFE#
1807.Flood n
809. (from GFE$31
810. from GFE 03
811. (froth GFE#3
9D0.1bMSRMttinldby ' bs 8e PaM1''o►Advertce':."
901.Os interest diagges from 12118112 to 01/01/13 14 13.815800! from GFE 010 190-52
902.Mortgage isurenoe premium for months to (from GFE#3)
903.Homaowstet's insurance for years to TRAVELERS (lram GFE 011) POCK 620.00
904. from GFE#11)
905. (from GFE#11)
1000.Reserves l ttdir
1001.lnitimfdeposk for your escrow accowtt (from GFE#9 995.48
11002.HomeownsPs insurance 1000 monOtc $ 51.87 per month S 156.01
1003.marwaw insurance months i per month i
1004.Property taxes S
SCHOOL TAXES per month
C' flown Tartss nwn#s S per n nlh
1005.
1000.COUNTY)TOWNSMIP TAXES 11.000 months $ 5615 per month S 624.25
1007.SCHOOL TAXES 7.000 months S 122.37 per month S 858.59
1005. $ �
1009,AGGREGATE ESCROW ADJUSTME $ -640.37
1100s�R(s;Giteey�s., i
1'101.Tkle services and lender`s tMo isuranco (from GFE 04) 1,652.25
1`102.Settiemarit or closing fee $
1103.Owners OW Mwtanae to (from GFE#fi} 19.25
1104.Lender's Me insurance to $ 8'3410 END'100,300,8.1
1105,Lender'stNle poliq Ism S 147,250.00 5011342.0080990E
1108.Owners line poky Wt8 S 155,000.00 5011442.0056743E
1107.Agents potion of the total title krawence prwnkwn to TRI-COUNTY ABSTRACT SERVICE $ 653075
1106,Underwrilers PoMm of the total1Nls insurance ptemWm $
1109.RE-IMBURSEMENT TAX CERT to TRI-COUNTY ABSTRACT SERVICE S 10•d3
1110.ATTORNEY'S FEE to SCOTT M.DINNER,ESQ. $ 991!•00
1111 $
1112. i
1113. $
1206 ilf>
Nn1E i (en
1201.Government charm to RECORDER OF DEEDS from GFE# 158.00
1202.Deed $ 64.00 MorlGlop i 92.00 Releases$ Dow
1203.Transfer taxes RECORDER OF DEEDS (tram GFE#e)
1204.PjWounty todstamps 3
1205.Stets S $
1206.RECORD 1ST DEED to CUMBERLAND Recorders Office 64.00
1
1300.AddNionit Swdlh mwtt Cidegse,.
1301.Raquired servkes that you clots for (from GFE#6)
1302. $
1303. $
1304. i
1905• i
1100.Ltptal'S�IdlrtslAdF;G`tirrge{. en.itfwtriO3;$IlEtitifl•i! 8ec4ftin'1� 4261 73:;` 1.;DE:OQ'
'caw a+traa of dose M bWoMna).Mate),)tnar0.).w VedfaWn
By wpw+e Vatw t Of T"Ms"-w*aw nanvAr-mdMaiaapa tamp of s mep)Ned amew at pass 6 E at I*Immo
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SETTLE NT OFFICER, nt Agent
CERTIFIED,TRUE AND CORRECT
Page 2 of 3 HUD-1
(SM1246-/2.PFOiSM1246-12M 11)
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Integrity
B A N K
02/06/2012
To Whom It May Concern,
Linda Zentz had 4 separate accounts with Integrity at her time of death on Dec. 5`h 2011.
The following is a list of her accounts with the balances as of Dec. 5`h 2011.
Savings account: #403005647 $24,137.12
Savings account: #403007354 $3,331.08
Checking account: #203012122 $5,209.23
Checking account: #203018318 $2,851.14
If you need any further information please contact me at (717)-901-5500. Thank you.
Joe Ritter
Customer Service Rep.
Integrity Bank
3345 Market Street. Camp Hill,PA 17011 •Phone:717-920-4900.877-I-HAVEIT,.Fax.717-920-4904•www.integritybankonAne.com