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Home My WebLink About03-26-14 (2) ,S 1505610143 REV-1500 Ex(D2-,,, OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Duda Year F{Is Number Bureau eau of Individual Taxes ae"""'.*a"nevexuc PO 60X.280601 INHERITANCE TAX RETURN 21 13 1238 Harrisburg, PA 17126-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 03 2013 02 18 1914 Decedent's Last Name Suffix Decedent's First Name Ml NOVAL EVELYN M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Ml Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ox IN APPROPRIATE OVALS BELOW ox 1. Original Return 2, Supplemental Return 3, Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate Ad,Future Interest compiamtie 5. Federal Estate Tax Return Required (date of death after 12-12-e2) I..I 6 Dscedent Died Testate I—! 7 oeceden2 Maintained a Living Twat 8. Total Number of Safe Deposit Boxes Ld (Attar,Copy of Viii) I_1 (Attach Gopy of Trust) p El 3. Litigation Proceeds Received 1e,Spcasai PovegrtYCradit((D=teor Death (� 11,Election to tax under Sec.9113(A) between,2-31-9,and 7-1-95) �-J (Attach Schedule 0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LEONARD TINTNER ESQUIRE 717 236 9377 ry REGISTE@DIIJVILLS Ua�ONttlM First Line of Address 2 D M 315 NORTH FRONT STREET a 01 rn � � Second Line of Address a n O DA 12 FILED h+ City or Post Office State ZIP Code x . HARRISBURG PA 17101 co Correspondent's e-mail address: ItintneMbtttalaw.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 Derider other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ma:rul.14/t, �vtahQ.m r ` Mary Ann Ingream- ADDRESS 1386 Lowther Road Gamp Hill PA 17011 SIGNATUR f REPARER 0TH" ftESENTATIVE DATE Leonard Tintner, Esquire ADORES 315 North Front Street, Harrisburg, PA 17101 Side 1 1505610143 1505610143 l`l� 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Noval, Evelyn M. RECAPITULATION t Real Estate(Schedule A)._......................................._............. 2. Stocks and Bonds(Schedule B).............. ....... ......__.......... 2. 2 , 049 . 28 1 Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)...._... 3. 4. Mortgages&Notes Receivable(Schedule ..............__.............. 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E).......... 5. 170 ,386. 43 6, Jointly Owned Property(Schedule F) [3 Separate Billing Requested..........., 6. 7, inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) Lj Separate Billing Requested. . 7, 8. Total Gross Assets(total Lines I through 7)........................................................ 8, 172 , 435 . 71 9. Funeral Expenses and Administrative Costs(Schedule H)....._.__..__........_._.._. 9. 26, 316. 68 10, Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............_...._........ 10, It- Total Deductions(total Lines 9 and 10)......................... 11. 26, 316. 68 12. Net Value of Estate(Line 8 minus Line 11)._._............_...._ 12, 146,119 . 03 13. Charitable and Governmental Bequests/Sec;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, 146, 119 . 03 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec,9116 15- 0 . 00 (a)(1.2)X.00 16, Amount of Line 14 taxable at lineal rate X .045 15, 000 . 00 16- 675 . 00 17. Amount of Line 14 taxable at sibling rate X.12 111 , 119 . 03 IT 13 , 334 . 28 18. Amount of Line 14 taxable at collateral rate X.1 5 20, 000 . 00 1& 3, 000 . 00 19 TAX DUE....................... ....... ................................ 19. 17 , 009 . 28 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 REV-1500G{Page 3 File Number 21^13-1238 Decedent's Complete Address: DECEDENT'S NAME Nov at, Evelyn M. ST EETADDRESS 1100 Grandon Way Mechanicsburg R 17050 Tax Payments and Credits: 1. Tax Due(Page 2.Line 1o) 17,009.28 Z Credits/Payments � x. Prior Payments | ' S. Discount 0.00 Total Credits p\ +8> (z) 0.00 3 Interest (3} ______________ ^` )/Line 2io greater than Line i +Line Jex�armed&��ooa This' <*> Check box un Page 2'Lino znu,request arefund 5� //Line I +Line 3is greater than Line 2,enter the difference. This|o the TAX DUE, (s) 17,009.28� �___ Make Check Payable tO REGISTER OF WILLS AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING ANmVYy1 THE APPROPRIATE BLOCKS ,. Did decedent make n transfer and: vom No u. retain the use o/income v/the property tm^s/enno�........____..............' ...... 11 1XI b. retain the right w designate who shelf use the property transferred u/its income;........................ ......... 1:1 5XI o. retain a reversionary interest;or......._..... .......... .................. ....................— ..........--- ............. LJ hd d. receive the promise for life m either payments,benefits o,care?............................................................ [l 1J 2- If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate oormioeration?.. ........ ........ .... . ...........___.............................. .............. .........1.1 [l [] 3. Did decedent own an'in trust 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?...........—~—........................—^—^^..................... ........ .... ... .... ^^ [l [] IF THE ANSWER ro ANY 0F THE ABOVE QUESTIONS|S YES,YOU MUST COMPLETE SCHEDULE G AND FILE|r«S PART VF THE RETURN, For dates o,death on^,after July 1. i984and be/n/oJan1. 18y5,the tax rate imposed oo the net value vf transfers wvr for the use or the surviving spouse is 3 percent|77P*.§9116(a)(11)(ol. 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 ioopercent [72 P.S.§9116(a)(IA)(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 x the surviving spouse is the only beneficiary. For dates of death vnn,after July 1,zo0o: ^ The tax rate imposed ov the net value*f 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,oru stepparent of the child u0 percent[7zp.S.§9116(a)(I�2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4s percent,except as noted m [,zP.S. §9118<a>(1)l, ^ The tax rate imposed vn the net value v,transfers{oo,for the use'f the decedent's siblings is/z percent[r1P,S.§9116o4(1J)1� k 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) SCHEDULE B STOCKS & BONDS COMMONWEALTHoFPENNSYLVANIA INHERITANCE TAX RETuRN RESIDENT DECEDENT ESTATE OF Nova[, Evelyn, M. FILE NUMBER 21-13-1238 All property Jointly-pwnetl with right o(survivorshi p must be di-CI osetl on Schetlule F. ITEM CUSIP NUMBER NUMBER DESCRIPTION VALUE AT DATE 1 64 shares of Mett-ife -64 shares UNIT VALUE OF DEATH 32.02 2,049.28 TOTAL (Also enter on Line 2, Recapitulation) (If more space is needed,additional page m softwa s of the same size) 2,049.28 Copyright(c)2002 for re only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98) Rev4908 EX.(11-10) SCHEDULE E pennsylvania CASH, SANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF (FILE NUMBER Noval, Evelyn M. ! 21-13-1238 Include the proceeds of litigator and the earn the proceeds were received by the estate. All property jointly-owned with the right of sumivombip must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Metro Bank-50 Plus Checking 0537059610 4,607.79 2 PSECU-Regular Share Account No.8028419581-01 47.92 3 PSECU -Regular Checking Account No.8028419581-04 1,573.81 4 PSECU-Money Market Account No.8028419581.07 69.285.71 5 PSECU-12 Month Certificate of Deposit No.8028419581.50 30,653.22 6 PSECU-12 Month Certificate of Deposit No.8028419581-52 21,430.28 7 PSECU-6 Month Certificate of Deposit No.8028419581-53 12,425.35 8 PSECU -12 Month Certificate of Deposit No. 8028419581.54 15,607.26 9 PSECU-12 Month Certificate of Deposit No.8028419581-56 13,738.54 10 Personal Property 1,000.00 11 Omnicare,Inc.-refund 16.55 TOTAL(Also enter on Line 5, Recapitulation) 170,386.43 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10) REV-1511 EX+(10.09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE NHERMANCE TAX RETURN FUNERAL EXPENSES AND RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF Noval, Evel n M. FILE NUMBER ITEM Decedent's debts must be reported on Schedule I. 21-13-1238 NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT See continuation schedule(s) attached 11,971.42 B. ADMINISTRATIVE COSTS: 1 Personal Representative's Commissions Name of Personal Representative(s) Mary Ann In ream Street Address 1386 LOWther Road city Camp Hill State PA Zip 17011 Year(s)Commission Paid 6,500.00 2. Attorneys Fees Boswell, Tintner& PICCOIa 6,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City Relationship Of Claimant to Decedent State Zip 4. Probate Fees Cumberland County Register of Wills 350.50 5. Accountant's Fees 6. Tax Return Preparer's Fees BOSWell, Tintner& Plccola 250.00 7. Other Administrative Costs See continuation schedule(S) attached 744.76 TOTAL(Also enter on line 9, Recapitulation) Copyright(c)2009 form software only The Lackner Group, Inc. 26,316.68 Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Noval, Evelyn M. 21-13-1238 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expense s 1 Parthemore Funeral Home&Cremation Services,Inc.-funeral 11.971.42 H-A 11,971.42 Other Administrative Costs 2 Boswell,Tintner&Piccola-disbursements-copies-mailing 41.50 3 Boswell, Tintner&Piccola-Reserve-balance of probate costs and filing of Family 375.00 Settlement Agreement 4 Cumberland Law Journal-legal advertising 75.00 5 The Sentinel-legal advertising 253.26 H-67 744.76 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1513 EX-f0140) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE /� INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Noval, Evelyn M. 21-13-1238 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT no Not Li st st e s (Words) ($$$) ` �• TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9115 a 1.2 Betty Bunting Sister 50% of personal 379 Schoolhouse Road and household Honesdale, PA 18431 effects and residue Mary Ann Ingram Friend specific bequest 20,000.00 1386 Lowther Road Camp Hill, PA 17011 Marie Muncey Sister 50% of personal 344 Lake Ellis Road and household Gatehouse effects and Wingdale,NY 12594 residue John Noval Stepchild specific bequest 15,000.00 94 North Lake Drive Hartwell, GA 30643 Total 35,000.00 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate- 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 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)