HomeMy WebLinkAbout08-12-13 (2) 1 150561�143
� REV-1500 Ex�mao�'q;;! OFFICIALUSEONLY
S?:
. PA Department of Revenue pennsylvania co�nry Coae Vear File Number
BureauoflndividualTaxes °E""^M°"OFP�"""E
ao soxzsosot INHERITANCE TAX RETURN 21 13 00 680
Harrisburg,PA 1 71 28-060t REStDENT DECEDENT
ENTER pECE�JENT INFORMATION BELOW
Social Securiry Number Date of Death Date of Birth
OS 14 2013 09 15 1918
DecedenYs Last Name Suffa DecedenPs First Name MI
BAER MABEL C
Qf Applrvcable)Enter Surviving Spouse's Information Below
Spouse`s Last Name Sunx Spouse's First Name MI
Spouses Social Secunty Number
THIS RETURN MUST BE fiLED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Oriqinal Return � 2. SupplemenWl Retum � 3. Remainder Retum(date of death
priorta 12-13-82)
� 4. Limit2d Estate � qa.F�°re IMerestComprorrirse � 5. Federal EsWte Tax Retum Requiretl
(date o(tleaN aRer 1242�2)
� s DecetlentOiedTestate � �, OA�,aGer�oMaiofTNStaLivingTrusf � 8. TolalNUmberofS3feDepositBOXes
(AltachCapyo(Wilq ( PY I
� 9. LifgationPfoCeedSReceived � ���beMieen123191end��dataesoftlealh � ��,EleclionlotaxunderSeC.91i3(A)
(Attach Sch.O)
CORRESPOkDENT-THIS SECTION d1UST BE COMPLE7ED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED 70:
Name Daytime Telephone Number
HAROLD E BAER JR
,�>
EGISTER OE�IIIILLS�1�@ ONLY
p � � �
i7 !�} p
First line of address p� � r=
'T� c� va %v
12926 LURGAN ROAD � � � � ;: ni
r � r�, N � �
Second line of address n U? � � rJ
p � � '"C! -ri '�i
�� ('.� ..± � 'v��t
Ci or Post Office c> <_. 'DATE FILED= C>
�Y State ZIP Code _ �_ ���
LURGAN PA 17232 "? � { c,� � _°,.�
.�'' —� .
Correspondent's e-mail address:
a Isdiue�coirect andeco�plele�DeclahaUon of preparer oth rthen the pe�rsonal repesenlaYGve Is haseC an sldl nfortnatbn�of whlchhpreparer has sny knowledge beliet,
�ATUiEE OF PERSON RESPONS�FOR FI�ING RETURN OATE
,{� �L�� � HAROLD E BAER JR. cA-�„Z�-f 3
�ADDRESS
1292 URGAN AD Lur an PA 77232
SfGNp7 FPREPA THERiHANREPRESENTATIVE ORRSTOWN BANK 0 -E
SS
77 EAST KING STREET, HIPPENSBURG, PA 17257
Side 1
� 15U5610143 150561U143
c
_ _ . _
�
� 1505610Z43
REV-1500 EX
DecedenYs Social Security Number
oecetlern'sName: BqER� MABEL C
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2. 7 8� 5 03 . 0 8
3. Closely Held Corporetion,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 13 , 519 . 0 9
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7, Inter-Vivos Transfers&Miscellaneous I�nq Probate Property
(Schedule G) U Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines t-7)..................................................................... 8. 92 � 022 . 17
9. Funeral Ezpenses&Administrative Costs(Schetlule H)....................................... 9. 11 , 937 . 4 0
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule I).............................. 10. 514 . 00
11. ToWI Deductions(total Lines 9&10)................................................................... 11. 12 , 451 . 40
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 7 9,57 0 . 7 7
i 3. Charitable and Governmenial Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subjectto Tax(Line 12 minus Line 13)............................................... 7q. 79 F 570 . 77
TAX COMPUTATION-SEE INSTRl1CTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
iransfers under Sec.9116
(a)(12)X.00 15. 0 . 0 Q
16. nmountof�inei4tazab�e '7g 570 . 77 ts. 3 , 580 . 68
at lineal rale X .045 �
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
' 18. Amount of Line 14 tazable 0 . 00 18. 0 . 0 0
at collateral rate X.15
�s. 7ax oue.................................................................................................................. �s. 3� 580 . 68
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 Pile Number 21-13-00680
DecedenYs Complete Address:
DECEDENT'S NAME
BAER, MABEL C
STREETADDRESS
206 EAST BURD STREET
CITY STATE ZIP
Shippensburg PA 17257
Tax Payments and Credits:
t. Tax Due(Page 2,Line 19) (1) 3,580.68
2. CreditslPayments
A. Prior Payments 3,401.65
B. Discount 179.03
Total Credits(A +g) (2) 3,580.68
3. Interest �3�
q. If Line 2 is greater than Line 7+Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5, If Line t +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:............................................................................... ❑ �
b. retain the right to designate who shall use the properly transferred or its income:.................................. � �
c. retain a reversionary interest�or............................................................................................................... x
� d. receive the promise for life of either payments,benefits or care?............................................................ �
2. If death occurred after December 12, 1962,did decedent transfer property within one year of death without
receiving adeQuate considerationl.................................................................................................................... ❑ 0
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?.................................................................................................................. ❑ ❑X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
i.�.. " ��-� �—-. .. .:.�.. . � .._�. �. ".: � ��. _ � _.. .:.� ._, .�.. _ . ._.. ..�.. � �� . . . �� � � � � : .... .•. .-. ._. �-.� ..�
For dates of death on or after July t, 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 January 1,1995,the tax rate imposed on the net value of iransfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(7.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statulory requirements for disclosure of
assets and filing a tax return are still applica6le even if the surviving spouse is the only beneficiary.
For dales of death on or after July 1,2000: -
• The tax rate imposed on the net value of transfers from a deceased chiid 21 years of age or younger at death to or for the�se 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 decedenCs lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116 1.2)[72 P.S.§9116(a)(1)1•
. The taz 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,whether by blood or adoption.
Rev-1503 EX+�6-98�
a SCHEDULE B
STOCKS & BONDS
COMMON W E4Lr11 OF PENNSriVAN IA
INMERITANCE TAX RETUFN
ftE51OEMDECEDENT
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
All property jolntlyawned wilh right o(survivorship must be disclosetl on Schedula F.
ITEM CUSIP VALUEATDATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 3952.82 SHARES INCOME FUND OF AMERICA(AMECX) 78.503.08
TOTAL(Also enter on Line 2, Recapitulation) 78.503.08
(It more space is neetle4 additional pages of ihe same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.6-98)
Holdings by investor
Mabel C Baer Joseph Bowden Combined Account Portfolio
206 E Burd Street . Dale: O5l14/2013
Shippensburg,PA 17257 77 East King Street Created:08/07/2013
Shippensburg,PA
717-530-2618
Mabel C Baer
Acct Name:MABEL C BAER/DEC'D 206 E BURD ST SHIPPENSBURG PA 17257-1402
Acct No:00062117649 Acct Type:lndividual
Rep.No:77856
.ASSet Naine � � - �Ticker - �:AssetType �� ��Mgt.Name " - . . Quantity�. . �Price($) .. �Value(E)
THE INCOME FUND OF AMERICA-A AMECX � BLEND � AMERICAN 3,952.82 � 19.86 78,503.08
FUNDS
AccountTolal: $78,503.06
InvestorToWl: $78,503.06
Incomplete if presenletl withoul accompanyin9 disclosure pages Pa9e 1 of 2
Rev-7508 EXa(6-98)
� SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMON W E4lTH OF PENNSYLVAN IN
INHERITANCE TAX RETU0.N �
RESIOEMOECEOEM
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
Include lhe pracee0s of litigation and ihe da�e�he proceetls were receivetl by��e eslafe.
All property joinllyowned with ihe right of survivorship must be disclosetl on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
7 FIRST ENERGY-REFUND OF OVERPAYMENT 2.41
2 PENNSYLVANIA PROPERTY TAX REBATE 300.00
3 ORRSTOWN BANK BURIAL FUND CD#4000024978 9.650.29
4 ORRSTOWN BANK CHECKING ACCOUNT#300381 3.566.39
TOTAL(Also enter on Line 5, Recapitulation) 13,519.09
(If more space is neetletl,additional pages of lhe same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Fortn PA-1500 Schedule E(Rev.6-98)
O�sTOw[v�aN� =-i ��i���i� Q �I��
tio-i5o3 DATE
r.u. u��x ,y�i �uirrnri�i�nn�;. r... iny. 313 OH�V H� I
I
PAYTOTHE �1717��J1'1���R� I�l�14(1�I13 �UI"i�IltiL IIUI'1� � �xtrj,;'{}.Z� � I
ORDER OF
�������� t�ir� Ttausa� Six Ru�r� Fi'fty and 29(I�Q
� DOLLARS I
C���I��°S �H��K VOIDAFTER6MONTHS i
m
Remitter ��� �• �
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L - - . . �
� — -"- -u•086887n' �:03i3i5036�: iO3 004602�i' --- —
�RIGINNL-Payee e Q
�UPLICATE-FFD.MN. Y�IO �✓' :°"fl. �
RiPUCqiE�Funeral Ho�ne bU ACCT.NQ LAST BALANCE $ j
PEOERAT U _ ���3�
� �-
❑�NTEREST
[�jp �� �/J�� I.AIEPAYMEN.T_
�eoaGa���ivonr:�._LS/�.�.�1�1�.1.�� �V�—�q.� ��(�1 �� PJ1�Gf
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��.h� dU3G 1� S► �(�hcQrro4. i ��-c� �� _ �
�—�._r.J�. ,�,��„� SUB TOTAL
�, � �J t stu,h t— 6
�uneral Services M ` �
�,�., �,-� _1!. `_--� Q� t caeoirs �
i d �r. G �e � � -------- a h S��v!l�f—��� --- —
�-4 -
f�('�J r'i' Name ol�eceased
�HECK d_�,/_Y�O�d F� FOGELSAN�GER-BRICKER. �ess PnvMeN-r �S(�a�j
� _�,— —--�- - -
�REO�T _ FIJNERAL HOME, INC.
"CARD _
❑OTHER ____ q��—�� — NEW BALANCE g = �"�
l / Il =___
"/�.!L'—�_ .�O�_`.� — :"�/.f�.� __— I � —
— ��.,,,���ro,, �8 6 0 9
' �YL 1
t � V'��'r�p"M
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8/08/13 Deposit Inquiry 12 : 03 : 59
Mabel C Baer Account number: 300381
Closed Messages Internet Banking PassPort ATM/Dr Card 1 of 1
Last stmt balance: 5, 707 . 19 Last stmt date : 7/10/13 —
Current balance: . 00 Statement cycle: 10
1=View 6=Print T=Tset Control: From To
Posted Check No S T/C Debit Credit Balance
_ 5/13/13 3272 P 091 / 68 . 45 3,566.39
_ 5/15/13 3279 P 091 214 . 00 3,352 .39
5/17/13 C 163 2, 000 . 00 5,352 .39
5/31/13 C 163 610 . 66 5, 963. 05
_ 6/06/13 P 020 44 . 00 6,007 . 05
6/10/13 160 . 04 6,007 .09
6/10/13 151 . O10000000 6,007.09
6/14/13 3276 P 090 ��� 00 . 00 5,807.09
_ 6/17/13 3275 P 091 [100. 00 5,707 .09
7/10/13 160 . OS 5,707 . 14
7/10/13 151 . 01000000% 5, 707 . 14
7/17/13 N 135 610. 66 5, 096. 48
7/30/13 P 160 . 03 5, 096. 51
_ 7/30/13 P 050 5, 096. 51 . 00
F4=Redsply F6=Ba1 Inq F7=Scan Fwd F8=Scan Bkwd F11=Prior bal F15=EFT F16BSortm
F17=Top F18=Bottom F19=EDI F20=�nfold F22=T/C F23=Checks
REV-7757 EX+�70-06) �.
' SCHEDULE H
COMMONWpE��ALTC�{OTF,qP�ENNgUYLVANIA FUNERAL EXPENSES &
�NRESIDENTEOECEDENTRN ADMINISTRATNE COSTS
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
p, FUNERAL EXPENSES:
See continuation schedule(s)attached 10,473.90
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
HAROLD E BAER,JR. RITA KAY FAUVER
StreetAddress 12926 LURGAN ROAD
ciry Lurgan state PA zio 17232
Year(sl Commission oaid 1,000.00
2, Attornev's Fees
3, Family Exemption: (If decedenfs address is not the same as claimant's,attach explanation)
Claimant
Street Address
Ciry State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 233.50
5. AccountanYs Fees
� 6. Tax Retum Preparels Fees
7. Other Administrative Costs 230.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 11,937.40
Copyright(c)2009 form software only The Lackner Group, Inc. Fortn PA-1500 Schedule H(Rev. 10-06)
___.. . . _. _
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exoenses
1 FOGELSANGER-BRICKER FUNERAL HOME-BOOKMARKS 36.00
2 FOGELSANGER-BRICKER FUNERAL HOME, FUNERAL EXPENSES 10,237.90
3 UPPER STRASBURG CHURCH OF GOD-FUNERAL MEAL 200.00
H-A 10,473.90
Other Administrative Costs
4 NEWS CHRONICLE-ADVERTISING ESTATE 80.00
5 ORRSTOWN BANK-INHERITANCE TAX RETURN PREPARATION FEE 150.00
H-B7 230.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev4572 EXa(t2-0e�
- 4 SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
LOMMONWEALTHOF PENNSriVANIR
INHERRNNCETRXREIURN
- RESIDENTOEGEOEM
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
Report tlebts incurted by the tlecetlenl prior to tleath that remainetl unpaitl at the date of dealh,includin9 unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 CHECKS WRITTEN PRIOR TO DOD; NOT CLEARED 514.00
TOTAL(Also enter on Line 10, Recapitulation) 514.00
(If more space is neetled,atltli6onal pages of the same size)
Copyright(c)2009 form soflware only The Lackner Group,Inc. Fortn PA-1500 Schedule I(Rev. 12-OS)
REVd573EX*�N-0e) p�
SCHEDULE J
COMt�ANHRRETE�k7EDFeE EN�RLNANIA BENEFICIARIES
ES �f �� EN
ESTATE OF FILE NUMBER
BAER, MABEL C 21-13-00680
RELATIONSHIP TO
NAME AND ADDRESS OF SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER pERSON(Sl RECEIVING PROPERTY DECEDENT � � �$$$�
Uo Not L(st Tmstee s ords
I TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 12
HAROLD E BAER,JR. Son 19,892.69
12926 LURGAN ROAD
Lurgan, PA 17232
MARY BECRAFT Daughter 19,892.69
48 LANTERN LANE
Shippensburg, PA 17257
RITA KAY FAUVER Daughter 19,892.69
15411 W. CREEK ROAD
Newburg, PA 17240
DIANA L FERRELL Daughter 19,892.69
540 S.COLDBROOK AVENUE
Chambersburg, PA 17201
TOtel -. 79,570.76
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2009 form soilware only The lackner Group,Inc. Form PA-1500 Schedule J(Rev. 11-08)
._ __ _... ___..
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LAST WILL AN9 TSSTAMsNT �
I, Ma5e1 C. Haer, of ;.etterkenny '^oomship� Franklin Cou^ty, 2ennsylvania, �
being of sound mind, meroory, and understanding, do make, publish znd declare � �
tuic to be ny Last 11i11 cnd Testament, hereby revo{cing eu�d mnking void all �'.�
former uiills by me at e.qy time ?�eretofore made. �
ITL•Ti 1. I direct my S;ecutor hereinefter nnmed te �.xiy ¢11 my just debta
and funeral expenses AE soon aftex• my decease as may conveniently be done.
IY'nK 2. dll the rest, residue, and remainder of rqy property, ��hether �
real or�personal and Hherecoever found, I give absolutely to my husbnn3, k;arold
E. Haer, Sr., nrovided, however, theL should she not survive me for at least �
7
thirty (3p) days then I give said residue in equal shares to my cni:<lren, the �
share of any deceused child to go to his or her issue per stirpe�. §
:}
IT�?f j, I nominate� constitute� end ¢�point ny hus'n..v�d� iiurold l. Hner, �
- ::r., 5„°ac;:tor of this,r�y Last '.1i11 and Testament; cmd in the event sai3 Executor ��
. shall not uali ' ''�
q fy or shall ;or any reason be unable or uruoilling to so serve, �y'
then I nominate, constitute, and ¢ppoint karold E. Szer, Jr., �:cecutor. s
ITe^M 4. In tne event that any child be under the age of twenty-one (21) "fa
years of age at the tirae any giit hereunder vests i� hi^� or her, then I give
said Qift to the persoa serving ac executor in trust for said child LL�tiZ he . �t
or she attains the age of twenty-one (21) yearc, suid trustee to have trte �
power in his diccretion out af seid dift to provide for the support, m�intenance, `�
education, and other needs ot sairi child, to �erve es guerdian o: tF.e estate �
. oi sai3 child during said child's minority, nnd ta turn the balunce over to -
said child rihen he or she attains tlie age of ti:�enty-one (21) year�. �
IH 'rlITRESS�tiHEBFAr i have hereunto aet my hanQ and seul this ,�'�� day �'
of in the year one thousand nine hundred and si:cty-eight �,�'%�
C1968�` /� — i�:�
MMONWEAL7}V6F E 1'LLANIA /� E�%
Note�See � i.(.' C. l �N h�A
RoDlnLynneumMeel.NOtn7PUMk ���C u. i Li,L' ($E(1L�
SMCCansOURBao.CUmUanaMCOwb "—"._,_ �'
MY Commpebn Ex ms Mav e.mu 'J7� �P �;. � �� ,'- /7- C �'
MemOCr.Pe�unylvaria WsuCellon ol Nolvks ' , ��
��
Signed� Bealed� publiehed� anri declared by tne above ��
t_.
nAmed Testntrix as and for her Last :9111 �tnd Testanent, ���
in our presence, �ino in her �resence, ¢t her recuest, �
-'�and in the presence of each other, have hereunto set s
our hands as attestin6 witnesses. �
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