HomeMy WebLinkAbout04-29-14 -�
REV-1500 'k 1505610143
OFFICIAL USE ONLY
PA eau of Individual of Revenue pennsytvania County coca veer File Number
Bureau of individual Taxes eE^Aa,aa^*ornevaauE
PO 60x.260601 INHERITANCE TAX RETURN 21 13 00523
Harrisburg,PA 17126-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
04 20 2013 12 23 1925
Decedent's Last Name Suffix Decedent's First Name MI
HEISE LOIS M
(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 0 3,Remainder Return(Date of Death
Prior to 12-13.82)
(] 4. Limited Estate 4a.Future Interest Compromise (� 5. Federal Estate Tax Return Required
(data or death after 12-12-92) n
® g Decedent Died Testate Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of W Ih I�J (Attach Copy of Trust) p
❑ 9. Litigation Proceeds Received 1D,Spousal Poverty Credit{Date of Death ❑ 11,0ection to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
GERALD J BRINSER 717 838 6348
REGISTER OF WILLS USE ONLY
First Line of Address C S f
s o rn
6 E MAIN STREET b n�
Second Line of Address ?� r• f V - I O
PO sax 323 m
City or Post Office DMT F1L
State ZIP Code ,.,1 ;'" r;
PALMYRA PA 17 0 7 8 0 .tea
rn
C.-T Cts CS ;
Correspondent's e-mail address: gjbtin@aoLCOm
cv +T
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 tr e,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG URE OF PE SON RESPONSIBLE FOR FILING RETURN DATE
34 tS�_ Glen E.Heise
+� ADDRESS 5•�
2 South ;?st Street, Harrisburg, PA 17104
SIGNATURE Ot.OnPARER OTHER THAN REPRESENTATIVE DAT
Gerald J Brinser �f y
ADDRESS
Brinser Wagner&Zimmerman
6 E. Main Street, Palmyra, PA 17078
Side 1
1505610143 1505610143
i
1505610243
REV-1500 EX
Decedent's Social Security Number
oeoeaenrs taame: HEISE, LOIS MAXINE
RECAPITULATION
1. Real Estate(Schedule A)......-.................. .........-.... ....... .-...... 1.
2. Stocks and Bonds(Schedule B).................................................-..........___......... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 1
4. Mortgages&Notes Receivable(Schedule 0)........................................................ 4.
6, Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)......._.... 5. 30 , 000 . 0 0
6. Jointly Owned Property(Schedule F) ❑ 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. 30 , 000 . 00
9. Funeral Expenses and Administrative Costs(Schedule H)......__....---.._................ 9. 1 , 015 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11- Total Deductions(total Lines 9 and 10)._...................._-...................-...................- 11. 1 , 015 . 00
12. Net Value of Estate(Line 8 minus Line 11)................................__........................ 12. 28 , 985 . 00
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. 28 , 985 . 00
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 28 , 985 . 00 i6. 1 , 304 . 33
17. Amount of Line 14 taxable
at sibling rate X -12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE................__......................................._._._..........................-.--.........._...... 19. 1 , 304 . 33
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 21 - 13 - 00523
Decedent's Complete Address:
DECEDENT'S NAME
Heise, Lois Maxine
STREET ADDRESS
218 Messiah Circle
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,304.33
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) 1,304.33
Make Check Payable to: REGISTER OF WILLS, AGENT.
w,
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 property transferred or its income;.................................... ❑ ❑
c. retain a reversionary interest;or.................................................................................................................. ❑ El
d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑
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 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?...................................................................................................................... ❑ ❑
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 Julyy 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 16(a)(1.1)(1)].
For dates of death on or after Janus ry 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
172 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 fling a tax re%m 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)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.&9116(a)(1.3)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood'or adoption.
„♦,°'�j't pennsylvania SCHEDULE E
s a j DEPARTMENT OF REVENUE CASH
INNERiTANCCTAXRETURN , BANK DEPOSITS AND MISG.
RESIDENT DECEDENT PERSONAL PROPERTY
i
FILE NUMBER
ESTATE OF Heise, Lois Maxine 21 - 13-00523
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 VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 Edward Jones-Mutual Fund Account#452-02898 (Transfer to checking prior to death not 30,000.00
included in Date-of-Death Value, nor had it cleared to the bank yet.)
I
TOTAL(Also enter on Line 5, Recapitulation) 30,000.00
REV-1311 Ex111"s)
A, pennsylvania SCHEDULEH
DEPARTMENT OF REVENUE E GYOQIG`CQ A/�II1
RESIDENT RETURN CINNUMA���-�V�iJ7CW�7J'YY1J
RESIDENT DECEDENT +YJ11111r�h7'rW
ESTATE OF Heise, Lois Maxine FILE NUMBER_ _ 21 13 00523
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. —
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2, Attorney's Fees Brinser, Wagner&Zimmerman --Gerald J. Brinser 1,000.00
1 Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's fees
8. Tax Return Preparers Fees
7. Other Administrative Costs
i Register of Wills-Supplemental Filing Fee 15,00
TOTAL(Also enter on line 9,Recapitulation) 1,015.00
REV-1513 EX-(01-1 o)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Heise, Lois Maxine
21 - 13-00523
NAME AND ADDRESS OF PERSON RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER RECEIVING PROPERTY (S) DECEDENT (Words) ($$$)
Do Not List Trustees) '
I, TAXABLE DISTRIBUTIONSIinclude outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Glen E. Heise Son 1/5 Residue 5,797.00
2 South 21st Street
Harrisburg, PA 17104
2 Lois S. Climenhaga Daughter 1/5 Residue 5,797.00
117 Greenwood Street
Steinbach, Manitobe
Canada R5G 2C3
3 Carol Heise Daughter 1/5 Residue 5,797.00
2120 Paseo Del Prado
Albuquerque, NM 87104
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
REV-1513 EX-I01-10)
pennsylvania
DEPARTMENT Of REVENUE SCHEDULE J
RESIDENT DECEDENT BENEFICIARIES BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Heise, Lois Maxine
21 - 13-00523
NAME ADDRESS OF PERSONS RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
AND
NUMBER RED ADDRESS PROPERTY ( ) DECEDENT (Words) ($$$)
Do Not List Trustee(s)
I� TAXABLE DISTR I BUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)j
4 Mark Heise Son 1/5 Residue 5,797.00
1113 Temple Road
Pottstown, PA 19465
5 Janet H. Green Daughter 1/5 Residue 5,797.00
6679 Corte Maria
Carlsbad, CA 92009-5916
Page 2 of Schedule J
OF
LOIS MAXINE HEISE •;G� p
aka L MAXINE HESS
aka MAXINE HE/SE v
I,LOTS MARINE HEISE,alca L.MARINE HEISE,aka MARINE HEISE,being of
sound and disposing mind and memory,but ever mindful of the uncertainty of life,and desiring
to make such disposition of my estate as seems best to me,do make,publish and declare this to
be my LAST WILL AND TESTAMENT,hereby revoking all former Wills and Codicils by me
made.
ITEM I: I direct that all my legal debts and funeral expenses be
paid out of my estate as soon as practicable after the time of my
decease.
ITEM TI: I give,devise add bequeath all of my estate,real,
personal and mixed,wheresoever the same may be situated,which
I may own or have the right to dispose of at the time of my
decease,equally among my Children,GLEN EDWARD HEISE,
LOIS ANNE CLIMENHAGA,CAROL JEAN HEISE,MARK
ALAN HEISE and JANET ELAINE HEISE,share and share
alike or to their lineal descendants,per stirpes.
If,pursuant to the above-referenced paragraph of this Item
]I,any portion of my said estate shall become distributable to a
Grandchild who is then less than twenty-five(25)years of age,that
portion shall be distributed to the surviving parent of such child,in
Trust, for the benefit of such Grandchild,it being my intention that
a separate Trust shall be established and maintained for each
Grandchild who is less than twenty-five(25)years of age. In
administering each such Trust,the Trustees shall be guided by the
following terms,conditions and limitation's as hereinafter set forth:
A. I hereby invest my Trustees hereunder with all powers
deemed by them necessary,without the necessity of prior
Court approval,to receive,hold and manage the property
constituting the Trust estates herein established;to retain
any investments which I may have made during my lifetime
as suitable and proper investments for the Trust estates,
and of the funds thereof,for so long as they deem best;to
provide and receive the rents,issues and profits of the Trust
PAGE 2 OF LAST WILL
AND TESTAMENT OF
LOIS MAXINE HEISE
with any accumulated income,irrespective of any law
limiting the investment of trust funds,including the use of
common trust funds,to determine whether money or
property coming into their possession shall be considered as
income or as principal or as partly income and partly
principal to charge or apportion expenses and losses to the
principal or income as they may deem just and equitable;to
compromise,settle and adjust any and all claims which may
be owing to,or owing by the Trust estates;to control,
maintain,improve,lease for any term irrespective of the
duration of the Trust,rent,exchange,sell,convey and
transfer at public or private sale,and without procuring an
order of Court,all or any part of the real or personal
property comprising the Trust estates,for such prices and
upon such terms as they shall deem advisable and to
execute and deliver proper instruments of conveyance and
transfer;to execute and deliver proxies,powers of attorney
and such other instruments as are incident to the holding,
control and voting of corporate securities or the sale or
exchange thereof;to make distributions wholly or partly in
kind;to create such reserves out of income,as in their sole
discretion may deem advisable,for depreciation,
obsolescence,amortization,or to insure the prompt
payment of taxes and other obligations,and to restore to
income such reserves as may be unused;and in general to
deal with the property comprising the Trust estates as fully
and freely as if they were the absolute owners of the same.
B. To pay to,or apply for the benefit of the person for
whom each individual Trust is created,so much or all of
the net income and principal of such Trust as my Trustees,
in their sole discretion,deem necessary or desirable for the
support,maintenance,health,education,comfort or general
welfare of said Trust bern ficiary. Any balance of net
income not so paid or applied should be added to principal
annually.
C. In making payments or applications of income and
principal to or for the benefit of the beneficiaries under the
foregoing:
1. My Trustees are authorized to make such
payments or applications to and among the
beneficiaries,to the exclusion of any one or more of
them,in such amounts and in such shares and
proportions and at such time or times as my
PAGE 3 OF LAST WILL
AND TESTAMENT OF
LOIS MARINE HEISE
2. No previous distribution of income or principal
should be taken into account by my Trustees
making any such distribution of income or principal,
immediate or final.
D. When each person for whom a Trust fund has been
created attains the age of Twenty-five(25)years,said
Trustees shall pay to him or remaining balance of his or her
share in such Trust. If during the administration of this
Trust,the person for whom a Trust has been created shall
be deceased,I hereby give,devise and bequeath the
remaining balance of the Trust to his or her lineal
descendants,per stapes,the same to be theirs,absolutely
and in fee simple,provided,however,that said Trustees
shall pay to said lineal descendants their proportionate
share of their Trust when each of them attains the age of
Twenty-five(25)years. If there should be no living issue
of such person,then the Trustees shall thereupon distribute
the principal and any accrued income remaining after the
payment of taxes,debts and expenses to the person or
persons then living who would be entitled to receive
distribution of my estate had I died intestate at that time,
such persons and the proportions each receives to be
determined in accordance with the laws of descent and
distribution then in force and effect in the State of Ohio.
Making distribution under the foregoing provisions,the
Trustees may act on the information as evidence available
to them and any distribution made by them in good faith
and on evidence they may obtain from members of my
family or collateral relatives shall be a full discharge and
acquittance to the Trustee in performance of this Trust,and
any person feeling aggrieved by such distribution shall
pursue his or her remedy,if any,against the distributes and
not against the Trustees.
E. The Trustees named herein shall not be liable for the
exercise of any discretion or power hereunder or mistake
or error of judgment,nor shall any Trustee be answerable
for the acts or default of any other Trustee or Trustees,or
otherwise in connection with said Trust except for any of
Trustees' own dishonesty or willful breach of the Trust.
F. I request that no bond be required of my said
Trustees.
ITEM III:_ I make,nominate and appoint DALE McNELLY,to
PAGE 4 OF LAST WILL
AND TESTAMENT OF
LOIS MAXINE HEISE
hereby authorizing and empowering my said Executor or his
successor,to compound,compromise,settle and adjust all claims
and demands in favor of or against my estate; and to sell,at private
or public sale,at such prices and upon such terms of credit or
otherwise,as he may deem best,the whole or any part of my real or
personal property,and to execute,aclamowledge and deliver deeds
and other proper instruments of conveyance thereof to the
purchaser or purchasers.
In the event of his death,incapacity or refusal to act,I nominate
and appoint JOY MCNELLY as such Executrix. In the event of
JOY MCNELLY's death,incapacity or refusal to act,I nominate
and appoint GLEN EDWARD HEISE as such Executor. I
request that no bond be required of my said Executor or his
alternates.
IN WITNESS WHEREOF,I have hereunto set my hand at Greenville,Ohio,this
22nd day of March 2005.
LOIS MAXINE HEISE
Signed by the said LOIS MAXINE HEISE and by her acknowledged to be her LAST
WILL AND TESTAMENT,before us and in our presence,and by us subscribed as attesting
witnesses in her presence and at her request and in the presence of each other this 22nd day of
( March ,2005. T ^
residing at t�
r
(r�hvt,�rirt, ,e ,e4[ 8 cr residing at Wet,,
'erformance Checking Account Statement
For the period 03/28/2013 to 04/25/2013
51 For 24-hour information,sign on to PNC Bank Online Banking L MAXINE HEISE
on pnc.com. Primary account number:51-1374-6194
Account number:51-1374-6194-continued Page 2 of 3
Ictivity Detail
leposits and Other Additions There were 6 Deposits and Other Additions
ate Amount Description totaling$50,61695.
4/03 1,620.10 Diect Deposit-l' soc Sec
SSA Treas 310 XX\, XX833SD
1/12 15,000.01 Direct Deposit-Investment
Edward Jones 62424A= 0641
1/15 3,400.00 Direct Deposit-9044 Ccd
Edward Jones 62424 XX'XXX8981
1/17 96.6.,,-7a Deposit Reference No. 520812366
1/25 X30,000.00 —Direct-Depzrnt 113�'S'tIH°etir '
°i- Edwad Jones G2424A.�:.t_uS 981
1;'25 .0 merest ayment -
necks and Substitute Checks
ieck Dale Reference Check Date Reference
ember Amount paid number number Amount paid number
)1 50.00 04/01 084083181 316 824 04/08 08539](331)
)31' 50.00 04/18 084467891 317 170.89 04/12 o8467321i
)4 50.00 03/29 0336632» 318 123.61 04/19 084881360
)6 205.00 04/01 084805140 319 7520.52 04/19 084889493
)7 10.00 041/05 521814677 320 1,100.00 :01/24 044104315
)8 48.00 04102 0.15397507 321 1,982.00 04%24 044103477
)9 32.70 04/15 085789169 322 431.00 04/19 085333771
l0 986.76 041/02 085696959 323 300.00 04/22 035526947
11 549.44 04/04 033066090 324 10,000.00 04/19 085359689
l2 1,140.40 04/04 083162696 325 42.41 04/17 083713206
13 164.33 04;'17 083713x05 326 15.97 04/23 083070075
15 * 35.47 04;'10 086741x55 327 64.20 04/24 084112954
Gap in check sequence There were 24 checks listed totaling
$24,880.84.
Wine and Sectronie Banking Deductions There was 1 Online or Electronic Banking
rte Amount Description _ Deduction totaling$37.83.
V03 37.83 Payrnent,E-Check Pa)mients Verizou Fhlancia 0305
wily Balance Detail
de Balance Date Balance Date Balance Date Balance
:/28 4,817.30 04/04 3,369.97 04/15 21 512.68 04/23 3,661.51
1/29 4,767.30 04/051 3,359.97 04/17 21,902.61 04/24 515.31
1'/01 4,512.30 04/08 3,351-73 04/18 21,852.61 04/25 30,515.38
1/02 3,477.54 04/10 3,316 26 04/19 —3,977 Q -
I/03 5,05281 04/12 18,14538 04/22 3,6 48
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FORM166R-0111