HomeMy WebLinkAbout03-19-14 � 1505610143
REV-1500 EX`°2_"' �.�``
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania co�r,ty coae Year File Number
Bureau of Individuai Taxes �•""*"E"*�"�""'E
Po Box.2aoso� INHERITANCE TAX RETURN �
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 13 �,
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of BiRh
04 06 2013 06 25 1927
Decedent's Last Name Suffix Decedent's First Name MI
PROPER FLORENCE E
(If Appiicable)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 Retum � 2. Supplementai Retum � 3. Remainder Retum(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a.Fu�ure Interest Compromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
a 6 Decedent Died Testate � 7. Ajtacdhec:oMa�of TNSi a Liviny Trust � 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wi�l) PY 1
� 9. LiGgation Proceeds Received � ���be°M,"ee�P�'3i�t a e�t 1Da95j f Oeath � ��.ElecBon to tax under Sec.9113(A)
� (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name � Daytime Telephone Number
GEORGE F DOUGLAS III ESQ 717 249 6333
REGISTER OF WILLS USE ONLY
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C 4
First Line of Address p �.. . .�
�� �� .
354 ALEXANDER SPRING RO ��,, � r'.;{ '
Second Line of Address ��� � �����
�C.J: � f ' i
'fE FILE � ,'', :;
City or Post Office State ZIP Code = � �-:-
CARLI SLE PA 17 015 ,n �� � `��''
Ct� �
Correspondent's e-mail address: gdouqlas(a�salzmannhuqhes.com
Under penal6es 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 We,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA7U OF PERSON SP IBLE FOR FILING RETURN �ATE
7
� � 2Cyu,� ,,�' t,i Ciarence H. Proper - Zv
ADDRESS
Mount Jewett PA 16740
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
� •
T� George F Douglas, III Esq. 3� (0 � (�-
DDRESS �
354 Alexander Spring Road, Suite 1, Carlisle, PA __
� Side 1 _ �
7,50561,07,43 15�5610143
h
� 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent'sName: PrOp@�� Florence E.
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&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Misce�laneous Personal Property(Schedule E)............... 5. 883 . 86
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 14, 498 . 17
7. Inter-Vivos Transfers&Miscellaneous f�aq Probate Property
(Schedule G) �J Separate Biliing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ g. 1$,382 . �3
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 3, 744 . 91
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 3, 7 4 4 . 91
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 11, 637 . �.2
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)............................................... �4. 11 , 637 . 12
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 . 0�
(a)(1.2)X.00
16. Amount of Line 14 taxable 11 637 . 12 16. 523 . 67
at lineal rate X .045 �
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable
at collateral rate X.15 0 . �� 18. 0 . ��
19. TAX DUE................................................................................................................ 19. 523 . 67
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
Decedent's Complete Address:
DECEDENT'S NAME
Proper, Florence E.
STREET ADDRESS
121 Conodoguinet Mobile Estates
CITY STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 523.67
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3) 0.00
4. If�ine 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) 523.67
Make Check Pa able 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:............................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑ 0
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
receivingadequate consideration?.................................................................................................................... ❑ �
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.
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)(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 statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax retum 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 decedenYs 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 decedenfs siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is deflned, .
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OFREVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Pro er, Florence E. 21-13
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship muat be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Carlisle Regional Medical Center-refund 147.00
2 Highmark-reimbursement for medical services 16.00
3 Highmark-refund of unearned premium 720.86
TOTAL(Also enter on Line 5, Recapitulation) 883.86
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-7500 Schedule E(Rev. 11-10)
Rev-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Proper, Florence E. 21-13
If an asset waa made joint within one year of the decedent's date of death,it must be reported on achedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS REIATIONSHIP TO DECEDENT
A. Christine L. Proper 121 CME Daughter-in-l.aw
Newville, PA 17241
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT DATE OF DEATH DECD�S VALUE OF
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE �NTEREST DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A 04/11/2012 Members 1st Federal Credit Union,Checking 10,761.14 100.000% 10,761.14
Account No.457401-0011
2 A 04/11/2012 Members 1st Federal Credit Union, Regular 3,737.03 100.000% 3,737.03
Savings Account No.457401-0000
TOTAL(Also enter on Line 6, Recapitulation) 14,498.17
(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 F(Rev.01-10)
_
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Proper, Florence E. 21-13
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N M
A. FUNERAL EXPENSES:
See continuation schedule(s)attached - 329.91
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees Salzmann Hughes, P.C. 3,400.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 3,744.91
Copyright(c)2009 form software oniy The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Proper, Florence E. 21-13
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exqgp,�
1 Gordon B.Garrett Funeral Home Inc. -balance due for funeral service not covered by Great 329.91
Western insurance policy
H-A 329.91
Other Administrative Costs
2 Register of Wilis-filing fee ' 15.00
H-B7 15.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Pro er, Florence E. 21-13
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT �Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions,and transfers
under Sec.9116 a 1.2
1 Clarence H. Proper Son 1/5th Residue
P.O. Box 79
Mount Jewett, PA 16740
2 Ronald E. Proper Son Item Third A.of
16109 Lynn Rd. W���
Saegertown,PA 16433 1/5th Residue
3 Richard L.Proper Son 1/5th Residue
42047 Ames 3rd Lane
Titusville, PA 16354
4 Craig A. Proper Son 1/5th Residue
121 CME
Newville, PA 17241
5 Carissa D. Hodak Daughter 1/5th Residue
P.O. Box 112
Pittsfield, PA 16340
See continuation schedule attached Continuation
Total
Enter doliar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
SCHEDULE J
BENEFICIARIES
(Part 1,Taxable Distributions)
ESTATE OF:
Florence E. Proper 04/06/2013 182-22-9638
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Christine L. Proper Daughter-in-Law Schedule F Items
121 CME
Newville,PA 17241
Total
1
�
LAST WILL AND TESTAMENT
OF
FLORENCE E.PROPER
I, FT,ORENCE E. PROPER, of Oil Creek Township, Crawford County,
Pennsylvania,do hereby make my Last Will and Testament,and revoke all Wills by me at
any time heretofore made:
FIRST: I will and direct that all of my debts and funeral expenses be paid
by my Executor hereinafter named as soon as convenient.
SECOND: I bequeath certain of my household furniture and furnishings,
personal effects and other tangible personal property of like nature to my Executor to be
distributed by him in accordance with a memorandum which I may prepare and leave with
my will.
THIRD: I give,devise and bequeath all the residue of my estate,of whatever
nature and wherever situate, as follows:
A. The sum of Three Thousand Dollars ($3,000.00) to my son, RONALD E.
PROPER, as repayment of a loan.
B. All the balance of said residue I devise and bequeath to my children,
CLARENCE H. PROPER, RONALD E. PROPER, RICHARD L. PROPER,
CRAIG A.PROPER and CARISSA D.HODAK,or to the issue by representation
of any of them who predeceases me.
FOURTH: I appoint my sons, CLARENCE H. PROPER and RONALD E.
PROPER,or the survivor of them,Co-Executors of this my Last Will,to serve without
bond.
F1FI'H: 1 appouu 'v�1TI�"��L :I7'Y BANK C�F PENNSYI.VAN?�,
TitusvIlle,Pennsylvania,or its successors, guardian of any property which passes,either
JOHN S. KOOKOGEY
KEMP C. SCALES under this Will or otherwise, to a minor and with respect to which I am authorized to
FTiOFNEYS AT LAW
TI7USVILLE,PA aPpoint a guardian and have not otherwise specifically done so, provided that this
appointment of a guardian shall not apply to property distributable under this Will to a
1
minor for whom special provision has otherwise been made herein and provided further
that this appointment of a guardian shall not supersede the right of any fiduciary in its
discretion to distribute such share to the minor or to another for the minor's benefit. Such
guardian shall have the power to use principal as well as income from time to time for the
minor's support and education (including college education, both graduate and
undergraduate) and to make payment for these purposes,without further responsibility,
to the minor or to any person taking care of the minor.
SIXTH: My personal representative and guardian appointed under this Will
shall have the power(a)to retain any investments and property being a part of my estate
at my death for such length of time as they may deem proper,without liability by reason
of such retention; (b) to lease, sell and partition any real or personal property which may
be a part of my estate at any time,for such prices and terms,and at private or public sales,
as may seem proper in their sole discretion,without any liability on the purchasers to see
to the application of the purchase moneys;(c)to invest and reinvest in any real or personal
property without restriction to legal investments;and(d)to make distributions hereunder
in cash or in kind, or partly in cash and partly in kind and in such manner as they may
determine.
In Witness Whereof, I, FLORENCE E. PROPER, the aforementioned
Testatrix have hereunto signed my name this 16 day of Mav ,in the
year of our Lord nineteen hundred and ninety-seven(1997).
�` �,` >
f,'n-L.t:.-1.,.L.` �+4j� ?.Z...,'µ1..1.
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r
Social Security No. l � %� ��� �� �`7 5 �
Signed,sealed,published and declared by the forenamed Testatrix as and for 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 thereof.
���:Y-,�, �i"�� -t��'.^ '1-5j
!�
JOHN S. KOOKOGEY
KEMP C. SCALES
ATTORNEYSATLAW ' �-.;���� i ..� l.��,. ���...
TITUSVILLE,PA � � �` �
2
COMMONWEALTH OF PENNSYLVANIA .
. SS
COUNTY OF CRAWFORD .
We,FT.ORENCE E.PROPER,the Testatrix,and Tohn s_ x��kogP�r
and LeAnn rt, xalfast , witnesses, whose names are signed to the attached or
foregoing instrument,having been duly qualified according to law,do hereby acknowledge
that the Testatrix signed and executed the instrument as her Last Will;that she signed it
willingly and as her free and voluntary act for the proposes therLin expressed, and that
each of the witnesses were present and saw the Testatrix sign and execute the instrument
as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix
signed the wIll as a�vitness;and that to the best of their knowledge,the Testatrix was at
the time eighteen years of age or older,of sound mind and under no constraint or undue
influence.
Testatrix: !� ���r�-�-Y.�� ,r � . ;, h�� _
;:
r 1 ,- <� .
Witness: •' `'�'-.,<:%'� � a..-�-��-��L-t1
- �f
� �
�- �� �F ' =-�-
Wimess: �-� ` i 11 �t ;'.r'
'�
Sworn to or affiimed and acknowledged before me by FLORENCE E.PROPER,
the Testauix, and by John S. Kookogey and LeAnn M. Halfa�t ,
witnesses, this 16 day of May , 1997.
'�G`�(�<�t�. �,__.l„_.G'-jL�zc�aC-----------------
f----------
JOHN S. KOOKOGEY Nptari;l SBaI
KEMP C. SCALES Fohin E Ccnr��,�Jc!ary PubliC
Ti,u^t;ile�,Grstv;orc�Cauntv
erronxers er��w (,Sy CClT1�ii��(q�E��I�.��n �
�ept 2S,1999
TITUSVILLE,PA Member,Pemisy;vania Assodation of Notaries �
3
St
0
MEMBERS 1S�
FEDER2�L CREDII UPIION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 457401-00
Date Account Established 04/11/2012
Principal Balance at Date of Death $3,737.03
Accrued Interest to Date of Death $0.08
Total Principai and Accrued Interest $3,737.11
Name of Joint Owner Christine L Proper
Date Joint Added 04/11/2012
CHECKING ACCOUNT:
Account Number/Suffix 457401-11
Date Account Established 04/11/2012
Principal Balance at Date of Death $10,761.14
Accrued Interest to Date of Death �0.07
Total Principal and Accrued Interest �10,761.21
Name of Joint Owner Christine L Proper
Date Joint Added 04/11/2012
MEMBERS 1ST FEDERAL CREDIT UNION
�/�_
Tessa L Kiugh
Lending Insurance Support Specialist
February 6, 2014
Estate of: FLORENCE E PROPER
Date of Death: 04/06/2013
Social Security Number: 182-22-9638
5C10()I.ouise Drive • P.().Box 40 • I�Techanicsbur�;,Pennsylvania 17055 • (S()0) 283-2328 ' ww�L.memberslst.c�r�;