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Home My WebLink About05-14-13 1 1505610105 .1 REV-1500 EX(W-u)(Fh OFFI CIAL USE ONLY PA Department of Revenue Ixm�Varda Cony Code Year File Number Bureau aftndividuat fazes INHERITANCE TAX RETURN 1 �� PO BOX 28o6o%- Harrisburg,PA 19128-0601 RESIDENT DECEDENT I !C! i i ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDDYYYY-Y�t Dole of Birth MMDDYYYY r Gf— 2- -7 Decedent's Last Name _ Suffix JJ ii...D±e,,,,ecedent's First Name _-} Mi,� i PArlLtctq^ - -J u (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name SIARx 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 O 2.Supplemental Return p 3. Remainder Return(Date of Death Prior to 12-1382) O 4.Limited Estate O 4a.Future Interest Compronsse(date of O 5. Federal Estate Tax Return Required death after 12.12.52) O B.Decedent Died Testate O 7.Decadent Maintained a Living Trust B.Total Number of Safe Deposit Bekaa (Attach Copy of will) (Attach Copy of TIusL) 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) (Afton Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: - Name _____ _ Daytime Telephone Number R�l W�GrifrErz `. _ _ __ f717 - 73Z- M90_ REGISTER OF WILLS CA''ONLY C.O First tine of Address M 2 CS -mac � Y 7 /�/Nh Atot-F Cix i if - rO z r- I- —f MY r r't ITT Second Line of Address _ �_ D U3 S � O O O 7 1 NLED City or Post Office State ZIP Code - Lr-hrfiCq �� P l_ Corrospondent s e•meli address: PL. CIO CAT f 1- A G L • C.O A'\. Under penalties of partury,i declare Met i have examined ttas return,Indudsq;accompanying srhedwas and statements,and to the bast of my knowtedge and berref. it Is tore,correct and complete.Declaration of preparer other men the personal represenlstive is based on all IMonraticn of which preparer has any knowledge. SIGDJATU E OF PERSOtt;RESPONSIBUE FOR FILING RETURN DATE J-4 Ar ADDRESS PI AfnCF EPriaA pR -70 t„r- SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ' ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 1505610205 REV-1500 EX(Fl) Decedent's Social Security Number Decedents Name: RECAPITULATION 1. Real Estate(Schedule A). ............................................ 1 2. Stocks and Bonds(Schedule B) ....................................... 2, 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .... 3. 4. Mortgages and Notes Receivable(Schedule D)........................... 4. 1 L 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 41 0 -7 j 6. Jointly Owned Property(Schedule F) o Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested........ 7. 8. Total Gross Assets(total Lines 1 through 7).................. 8. Y z-1 73-0 7 9. Funeral Expenses and Administrative Costs(Schedule H)................ ... 9. 61 10. Debts of Decadent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 11. Total Deductions(total Lines 9 and 10)................................. it. 3 0 7 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental BequesWSec 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. 1 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. 16. Amount of Line 14 taxable at lineal rate X.0 16., 17. Amount of Line 14 taxable 1 at sibling rate X.12 17. 18. Amount of Line 14 taxable I at collateral rate X.15 18 19. TAX DUE.............................. ... ........ . ...... ... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=:) Side 2 1505610205 1505610205 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME n l A it-/Z/LIB Gpa.L/Z STREETADDRESS ,F20 LiflyLIL" ALA Clry 1✓Ahx/7 14, 11 STATE n ZIP Tax Payments and Credits: I. Tax Due(Page 2,Line 19) (t) 2. Credits/Payments A.Prior Payments B.Discount 3. Interest Total Credits(A+B) (2) (3) 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) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 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 Ntcceoeii a. retain the use or income of the property transferred.......................................................................................... El N 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?...................................................................... ❑ t� 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(rust foe 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)C)J. 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 beneficiaries is 4.5 percent,except as noted in 72 P.S.§9116(a)(1)J. • The tax rate imposed on the net value of transfers to or for the use of the decedents 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. MMI$BURG PA 17126.0601 JOINTLY HELD OR TRUST ASSETS s. �r DATE 10-29-2012 ESTATE OF GOWER PATRICIA M DATE OF• DEATH 04-23-2012 FILE NUMBER 21 12-1055 COUNTY CUMBERLAND SSN/DC PAUL W GOWER ACM 12151726 33 PINE RIDGE CIR APPEAL BY DATE:12-28-2012 ENOLA PA 17025-2056 (See reverse side under Objections) Amount Remitted f— MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE '► RETAIN LOWER PORTION FOR YOUR RECORDS 4— --------------------------------------- REV-1548 EX AFP 1112-113 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-29-2012 ESTATE OF:GOWER PATRICIA M DATE OF DEATH:04-23-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1055 S.S/D.C. NO. : ACN: 12151726 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: METRO BANK ACCOUNT NO. : 512065301 TYPE OF ACCOUNT: ( )SAVINGS ( X) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 01-02-1992 Account Balance 3,493.07 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 1,746.54 UPPER PORTION OF THIS NOTICE ' Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 1,746.54 REGISTER OF WILLS AT THE Tax. Rate y .15 ABOVE ADDRESS. MAKE CHECK Tax Due 261.98 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: °—— PAYMENT '—' - RECEIPT" DISCOUNT' C-)—— AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 09-25-2012 CU0165SB .00 261.98 TOTAL TAX PAYMENT 261.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. s Malpezzi Funeral Home 8 Market Plaza Way (717)697-4696 Mechanicsburg,PA 17055 www.MalpezziFuneralHome.com Jeremy J.Shartzer,FD Michael J.Malpezzi,Owner,FD Kyle C.Knipe,FD May 21, 2012 Patrice Motter 601 Bluebill Drive Mechanicsburg,PA 17055 This is the final statement for the funeral services of Patricia May Gower We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way. PROFESSIONAL SERVICES: -Services,Facilities-and Cremation - - - - - - - -- - $4,400.00 - FUNERAL HOME SERVICE CHARGES $4,400.00 SELECTED MERCHANDISE: Shaker Pine $775.00 Cultured Marble Um $425.00 Quiet Reflections Register Package $75.00 THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE THAT YOU HAVE SELECTED - $5,675.00 CASH ADVANCES: At the time funeral arrangements were made, we advanced certain payments to others as an accomodation. The following is an accounting of those charges. Certified Death Certificates $60.00 Newspaper Notices-Patriot $242.87 Clergy/Mass Offering $200.00 Flowers $125.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES $627.87 CONTRACT PRICE $6,302.87 HISTORY: 05/20/2012 Payment Patrice Motter $6,302.87 - -- TOTAL AMOUNT DUE - -- — _ .. $0.00 If you have any questions or concerns regarding this bill,please call our office at(717)697-4696. pa'u V-V ?W-(- �� RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 5/14/2013 Cumberland County - Register Of Wills Receipt Time : 11 : 16 :40 One Courthouse Square Receipt No . : 1074187 Carlisle, PA 17013 GOWER PATRICIA M Estate File No. : 2012-01055 Paid By Remarks : PAUL W GOWER DMB ----- ------ ----- ------ -- Receipt Distribution --------- ---- ----------- Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 3709 15 .,00 Total Received. . . . . . . . . 15 . 00 A T . . » rTl , � � • � > «3