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Home My WebLink About08-06-13 (2)� i i ; � i # i � � REV-1500 1505610143 � EX(01-10) � ' OFFICIAL USE ONLY � PA Department of Revenue pennsylvania counry code Year File Number � Bureau of Individual Taxes DEPARTMENTOFREVENUE Po Box.2soso� INHERITANCE TAX RETURN 21 13 0 0 2 0 0 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 08 2012 DecedenYs Last Name Suffix DecedenYs First Name MI HESS NINA G (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI HESS MERL C Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Retum ❑ 2. Supplemental Retum � 3.Remainder Retum(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) � 6 Decedent Died Testate � � Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) � ❑ 9. Litigation Proceeds Received � 1 p.Spousal Poverty Credit(date of death � ��.Election to tax under Sec.9113(A) , beNveen 12-31-91 and 1-1-95) (AttBCh SCh.O) i i : CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: � Name ; Daytime Telephone Number � DEBRA K WALLET 717 7 3 7 1��:i0 0 �__..� � � � p_....A � RE�T�OF WIL�3 US��1�( m .� �� ,�a :� �'+ _:a C;'ww First line of address � � �� °��; �`�G r � �--- ;"y �`�t c?;� �.�;.� '.�� 24 NORTH 32ND STREET � �' "�`��-' `� ,�°v � �~� crw:' �.� '-�;� �� _�,� Second line of address �:'°:r �-- w��E � _� _ ,•w� t,:�:: �...., ±'...:; �,-;� _ � ;�!�:� �.,v �,r.. �,�,� � �ATE FI �� Cs y s�' _ City or Post Office State ZIP Code � � CAMP HILL PA 17011 � ; ; a � Correspondent's e-mail address: w a I I e t d e b@ a o I.C o m , � 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. � SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE � Merl C. Hess � � ADDRESS � � 43 Round Ridge Road, Mechanicsburg, PA 17055 � � SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE � , �, {� ��,�. Debra K Wallet �r S, 10 i3 � ADDRESS • 3 � 24 North 32nd Street,Camp Hill, PA 17011 � 1 ; Side 1 � � � 1505610143 1505610143 � � U� � � 9j 2 � , � 1505610243 REV-1500 EX DecedenYs Social Security Number DecedenYs ivame: H E S S� N I N A G. 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 8 Notes Receivable(Schedule D).......................................................... 4. 5• Cash,Bank Deposits 8�Miscellaneous Personal Property(Schedule E)................ 5. 91 , 9 6 7 . 2 7 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested............. 7. 12 5 , 7 4 2 . 5 9 8. Total Gross Assets(total Lines 1-7)....................................................................... g. 2 1 7 , 7 0 9 . 8 6 9. Funeral Expenses 8�Administrative Costs(Schedule H)......................................... 9. 6 , 913 . 3 9 10. Debts of Decedent,Mortgage Liabilities,8 Liens(Schedule I)................................ 10. 11. Total Deductions(total Lines 9 8 10)...................................................................... 11. 6 , 913 . 3 9 12• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 2 1 O , 7 9 6 . 4 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)................................................. 13. 2 , 0 0 0 . 0 0 14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 2 0 8 , 7 9 6 . 4 7 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.00 208 , 796 . 47 15. 0 . 00 : 16. Amount of Line 14 taxable at lineal rate X •045 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 �8• 19. Tax Due..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 � � . REV-1500 EX Page 3 File Number Z 1 - 13 - 0 0 2 0 0 : Decedent's Complete Address: Hess, Nina G. STREET ADDRESS 43 Round Ridge Road CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.0 0 2. Credits/Payments A• Prior Payments B. Discount 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. (4) Check box on Page 2 Line 20 to request a refund 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 No a. retain the use or income of the property transferred:.................................................................................. � [x] 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?.............................................................. [� �x 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without ; receiving adequate consideration?....................................................................................................................... ❑ U 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... �� x� 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 Jul 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.§91�6(a)(1.1)(i)]. For dates of death on or after January 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 stafute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax refurn 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 ears 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)(�.2)]. •The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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 decedenYs 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,wfiether y blood or adoption. � , SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTHOFPENNSYLVANIA PERSONAL PROPERTY INNERITANCE TAX RETURN RESIDENT DECEDENT -__-------------- --- -----------__-----_._..----- FILE NUMBER ESTATE OF Hess, Nina G. 21 - 13-00200 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 OF NUMBER DEATH 1 Fulton Financial Advisors 89,567.27 Account#56847783 2 Personal jewelry(engagement ring and costume jewelry) 2,400.00 _ TOTAL(Also enter on Line 5,Recapitulation) 91,967.27 � � � COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCETAXRETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Hess, Nina G. FILE NUMBER 21 - 13-00200 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. . --_- -T _ � - __ --_- _-_-- ---_... ITEM � DESCRIPTION OF PROPERTY ' DATE OF DEATH %OF EXCLUSION '. TAXABLE VALUE Include the name of the transferee,their relationship to decedent � DECD'S NUMBER I � VALUE OF ASSET i(IF APPLICABLE) '�,� � and the date oi transfer. Attach a copy of the deed for real estate. � INTEREST _ _-- �- � 1 ; Fulton Financial Advisors Annuity � �os,423.23 100% � 106,423.23 '; Account#22867649 � '; I i ' � 2 ; Fulton Financial Advisors Roth IRA 19,319.36 100% � 19,319.36 ; Account#76677954 _ � � I , � j � I � ; ; , i, i , � � i ''�� j II I i � i � i � I ' i I � % � I I, j , I � i � I i ! I � � � �I i I , I � � i I i �'' � i �' ' I i I i , i , I � � i i � , � ; ; � ; � i ' , ; � , � � � i � ,I ! ! � i ,� � � �� , I i I i — — TOTAL(Also enter on line 7,Recapitulation) 125,742.59 . . H FI��ERAL D�ENSES& COMMONWEALTH OF PENN3YLVANIA �A �/�/'►� INHERITANCE TAX RETURN A�S�,v1T1YG�h7� RESIOENT DECEDENT --- --._.._..__--- --------- ------- --- FILE NUMBER ESTATE OF Hess, Nina G. 21 - 13-00200 Debts of decedent must be reported on Schedule I. ITEM i DESCRIPTION AMOUNT NUMBER I FUNERAL EXPENSES: A. 1 j Malpezzi Funeral Home 5,329.89 � � I , i i �, � ! � � � B, i ADMINISTRATIVE COSTS: �. ; Personal Representative's Commissions I iName of Personal Representative(s) ; ; ; Street Address � City State Zip � Year(s)Commission paid i 2. i Attorney's Fees Debra K. Wallet, Esq. � 1,250.00 � 3. I Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) � � Claimant j; I Street Address � City State Zip ' Relationship of Claimant to Decedent 'I i 4. '�� Probate Fees i 303.50 , '� I 5. AccountanYs Fees � I � 6. i Tax Return Preparer's Fees I i 7. ! Other Administrative Costs i 1 � Postage, photocopies, etc. 30.00 � i i l i � I ; TOTAL(Also enter on line 9,Recapitulation) 6,913.39 , REV-1513 EX+(11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Hess, Nina G. 21 - 13-00200 -_._-_____"_______T'_-"-" -__ T RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER � NAME AND ADDRESS OF PERSON(S) ; DECEDENT (Words) ($$$) RECEIVING PROPERTY � Do Not List Trustee(s) — ------�--- -- - --------- I jTAXABLE DISTRIBUTIONS[include outright spousal � ' distributions and transfers ; j under Sec.�116(a)(1.2)] � ; 1 ';, Merl C. Hess ; Husband 100%of residuary � 43 Round Ridge Road ! Estate � Mechanicsburg, PA 17055 � � I i 2 ; Janna Leigh Rice �I Daughter personal jewelry 2,400.00 ; 1237 Knightswood Road 'i � Baltimore, MD 21239 ; � , , � I i i i ; � �� II , i I I I �Enter dollar amounts for distributions shown above on lines 15 through 18 on 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 B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 St. Peter Lutheran Church 1,500.00 130 Nittany Drive, Mechanicsburg, PA 17055 2 Humane Society of Harrisburg Area, Inc. 500.00 7790 Grayson Road, Harrisburg, PA 17111 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 2,000.00 I � � � �� ffi�l � � � � � � � �� . � � Ir..�j �� i �� .� n � � i � � , � �� ~ � � .. .� ;�7 Yy i'"" �,, ;.�; T'��I .. . �" "'7i � �.� ,�.:,! � �� I, NINA G. HESS, of Mechanicsburg, Cumberland County, Penns�:��'� bein� of.� � �.i --. � �"� 'i °;� �'=� � -� ..:� _,.T ., sound and disposing mind, rnemory, and understanding, do hereby make, put��sh, an,c�,.dec�ar�� ;..-. -�� U� � this to be my Last Will and Testament and hereby revoke all other Wills a�id Codicil�;-�if any,�' that I have made. FIRST: It is my wish, and I direct, that after my death, any part of my body may be used to replace diseased or worn out parts of other humans or to rehabilitate human parts or organs. Any part of my body which can be preserved for subsequent restorative purposes in living humans may be stored for this purpose. I further direct that the remainder of my body be cremated and that a suitable disposition of my ashes be made. SECOND: I give and bequeath the sum of Five Hundred ($S00) Dollars to the HUMANE SOCIETY OF THE WEST SHORE, Mechanicsburg, Pennsylvania. THIRD: I give and beaueath the sum of One '�housand Five Hundred ($1,S�Ol Dollars to ST. PETER LUTHERAN CHURCH, Mechanicsburg, Pennsylvania. FOUkTH: I give and bequeath all of my jewelry to my daughter, JANNA LEIGH RICE, of Baltimore, Maryland, so long as she shall survive me by thirty (30) days. FIFTH: I give, devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, to my beloved husband, MERL C. HESS, so ' long as he shall survive me by thirty (30) days. SIXTH: In the event my husband fails to survive me by thirty (30) days, or should he for any reason fail to take under this, my Last Will and Testament, I give, devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, to my daughter, JANNA LEIGH RICE, so long as she shall survive me by thirty (30) days. If my daughter fails to survive me by thirty (30) days, but is represented by children then living, these children shall take, �er stirpes, the share to which my daughter would have been entitled if then living. SEVENTH: In the event that neither my daughter nor any of my grandchildren survive me by thirty (30) days, then I give, devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, in equal shares to: my sister, JANA FURST, of Camp Hill, Pennsylvania; and my husband's sister, VIRGINIA FLESHMAN of Mechanicsburg, Pennsylvania. EIGHTH: All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executor/Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. NINTH: All inheritance, estate, and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. TENTH: I nominate, constitute, and appoint my husband, MERL C. HESS, as Executor of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability of my husband to act for whatever reason in this capacity, then I nominate, constitute, and appoint my daughter, JANNA LEIGH �ICE, as Executrix of this, my Last Will and Testament. I direct that no representative named above shall be required to post security for the faithful performance of hislher duties in any jurisdiction insofar as I am able by law to relieve him/her of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth here. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ��"`` day of OC�-o b� , 1998, on this, the third of three typewritten pages. I have also signed the left-hand margin of the �rst two of these pages for purposes of identification only. NINA .� ESS SIGNED, PUBLISHED, and DECLARED by the T�statrix, NINA G. HESS, as her Last Will and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. �-l'tan�.�IC-��-- �'l 4 A�tr��.!J��.,J 1�2• IM�c.�.Ha c s�i.,r- s�us3_ � , .! �t 1 ..i;-. s%% . t!j }( � �� ,f "� r / ,� i"7 �)�} �� ` '`( f'r'�.{ , �' �f•��)r �, i l /'. r•---f. � �i.�, , � , � _a% t�� ' :i_r 1 > .��.�,� .� .-1, �r�', ., _ � , ^I�._.`�.�' :�J?•l1" � ~ '`�`, i j %;..i , . �� ACKI� OWLEDGMENT Commonwealth of Pennsylvania County of Cumberland . I, NINA G. HESS, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signe� 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. . NINA . HESS Sworn or affirmed to and subscribed before me by NINA G. HESS, the Testatrix, this j� , day of �� , 1998. . � � , ,, ,�(.�� tary Pu ic Notarial Seal �Jennifer L.Gamer,Notary Pubfic Camp Hiil Boro,Cumberland County My Commission ExpirES Au�,27 2001 AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Debra K. Wallet and � 1�>. ��j . - � , the witnesses whose names � are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Wi11 as witnesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. : 1�..�,un�'(C.t,.)a�.— ,�- --''r.�''��i -;��i,'j ./� .� �,-:�Y'� � � j /y l. ;i"��`�..1 f��=�t�"1 'J• • � (f V Sworn or affirmed to and subscribed to before me by,��,��. ��,. �,,�>(�.�I�:°� and �;�� ` �' � �- 7 ;� , witnesses, this �,�� da of � ' 7� " . � 1998. �Y�1,�rc � �1-� c�n Y � , � ; �, • � .) � � � � �` : .� �'�� tary Public J � � _.,_ ,.__._._.,._.--,� �lii�ri�t!Seal Jenni7er L Q�rr�2r: Notary Public ` i,�mp Hili Bar�i..C-u��berland County i tvly C�rnrnissior�Ex;:;i��s Aug.27 2001 = aLaw��ice�o` � DEBRA K.WALLET � 24 N.32nd STREET � CAMP HILL,PA 17011-2917 � PHONE:(717)737•1300 E mail:Walletdeb@aol.com FAX:(717)761-5319 � � August 5, 2013 � � � � i � , � Glenda F. Strasbaugh, Register of Wills � = Cumberland County Courthouse = 1 Courthouse Square � � Carlisle, PA 17013 � a � . � ' RE: Estate of Nina G. Hess � Will No. 2013-00200 � 9 � � Dear Ms. Strasbaugh: � Enclosed are an original and one copy of the Pennsylvania lnheritance Tax Return, one copy of an Inventory of the Estate, and one copy of a Status Report Under Rule 6.12 for filing in the above-caption� esta.te. I have enclosed a copy of the first page of each to be stamped in and returned to me in the pre-addressed envelope provided. Thank you. � r-._., � Sincerely yours, ca `M�' � � � � � � a � � � � � �� .��-- C_:- -,.,. � c� en � � � � , �' � r- ��: �-� 4 Debra K. Wallet � c�i-� �� c' � � :� �-, �„ `� -�r� �r: ; DKW/mm �, � ;�, � .� � � Enc. � � � ;�- � _ cc: Merl C. Hess, Executor �. � �' -n � ; � � _ � ...:_ .... ;..� .�.. :„ � »r.._ :.. 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