HomeMy WebLinkAbout03-03-14 1505610143
EX{024t) a�
REV-1500 OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County cede rear pna Nomear
Bureau of Individual Taxes AR1wrITMR Ua
PO 80X.280601 INHERITANCE TAX RETURN 21 12
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 1241
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
11 10 2012 12 07 1933
Decedent's Last Name Suffix Decedent's First Name MI
WACHOWSKI LORRAINE E
f 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
CK 1. Original Return 2. Supplemental Return 3, Remainder Return(Date of Death
Prior to 12.13-82)
4. Limded Estate 4a.Future Interest Compromise
(date of death after 12-12-82) L $, Federal Estate Tax Return Required
r.a g Decedent Died Testate T oAlg dagaiofained a Living Trust _ O a, Total Number of Safe Deposit Boxes
Ld.l (Attach Copy of Nall) ( ch G py )
91 Litigation Proceeds Received ❑ 1iJ.S sal PovertyV C1 ditI011et Death 11,Election to tax under Sec.9118A
bean t2-31 91 slid -i-95) ❑ (Attach Schedule O) ( )
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime 7ete ne Nurrlbero
GARY L JAMES ESQ 717 53�§ 80 �
x► ri T C7
REGISTER{p_f' us F NLY r i£
First Line of Address r—, '
t`j
134 SIPE AVENUE ti ry
r
Second Line of Address t `'
City or Post Office DATE FILED
Stale ZIP Code
HUNNELSTOWN PA 17036
Correspondent's e-mail address: glj(alisdc.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 t correct and complete.Declaration of prepare r other than the personal representative is based on all Information of which preparer has any knowledge.
S A OF PERSON RES ONSIBLE FOR FILING R URN DATE
Eileen M.Wachowski Z
ADDRESS
2 Sadore Lane Apt. 2P,Yonkers NY 10710
SIG TURE OF PREPAR pTH R THAN REPRESENTATNE DATE
Gary L.James Esq.
ADDRESS
DDR en e, Hu melstown, PA
Side 1
1505610143 1505610143
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's N.11. Wachowski, Lorraine 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&Miscellaneous Personal Property(Schedule E)............... 5. 8 , 972 . 00
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Inq-Probate Property
(Schedule G) a Separate Billing Requested............ 7. 405, 758 . 73
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 414 , 730 . 73
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 45 , 645 . 14
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)........................... 10. 340 . 00
11. Total Deductions(total Lines 9 and 10)................................................................ 11 45, 985 . 14
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 368 , 745 . 59
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, 368, 745 . 59
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
r 15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 368, 745 . 59 16. 16, 593 . 55
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 16, 593 . 55
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. FRI
Side 2
L 1505610243 1505610243 J
REV-1500 EX Page 3 Fife Number 2142-1241
Decedent's Complete Address:
FDECEDENTS NAME
achowski, Lorraine E.
ADDRESS - --
3 Hillside Circle
ST ZIP amp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 16,593.55
2, Credits/Payments
A. Prior Payments 16,000.00
B. Discount 829.68
Total Credits(A +B) (2) 16,829.68
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 236.13
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 t0: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
I. 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:.............._........-........ x ❑
c. retain a reversionary interest or..............................................................................................._......._..... x ❑
d. receive the promise for life of either payments,benefits or care?............................................................ x ❑
2. If death occurred after Dec. 12, 1962, 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?_.... ❑ ❑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 QUESTIONSIS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
:,.. h , ... ...
- , .i:. , .v. ,µ' _. i 4* �.xi R{i ii ,. � .3a.r.. � ,.. ,tu' ..
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 172 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
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
filing a tax return 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 172 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-1508 EX+(11-00) '
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS p
DEPARTMENT OF REVENUE r 8t MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wachowski Lorraine E 21-12-1241
Include the proceeds of litigation and the date the proceeds were received by the estate.
All Property)ointlyowned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 2006 Toyota Camry-valued per Kelley blue book value 8,972.00
TOTAL(Also enter on Line 5, Recapitulation) 8,972.00
(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-1510 EX.100-09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241 _
This schedule must be canPised and AW 9 me Grower io any Of qu Mons I ft 4an -
ouph yaps tnrea of itre REV-1500a yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECO•s EXCLUSION TAXABLE
NUMBER THE RATE OF NAME OF A THEIR ORELATIONSHIP Y F TH ED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Lincoln Financial Group Fixed Annuity#97-5623435 37,210.61 37,210.61
Pinnacle Health System Retirement Plan 403(b)tax
deferred-valued per letter dated December 31,2012;
beneficiaries are daughters
2 Met Life Annuity#2284899-valued per letter dated 112,751.84 112,751.84
February 21,2013; beneficiaries are daughters
3 Transamerica Retirement Plan Account 23,150.68 23,150.68
#02CBT0062183-valued per letter dated January 3,
2013;beneficiaries are daughters
4 BELCO Certificate of Deposit-valued per letter dated 25,730.18 25,730.18
November 26,2012;titled in the Norman P.
Wachowski(deceased August 28,1997)and Lorraine
E.Wachowski Living Trust dated December 18, 1995
5 M&T Bank Certificate of Deposit#31003919237519- 5,359.34 5,359.34
valued,per letter dated December 14,2012;titled in the
Norman P.Wachowski (deceased August 28, 1997)
and Lorraine E.Wachowski Living Trust dated
December 18,1995
6 M&T Bank Checking Account#88025047-valued 10,592.51 10,692.51
per letter dated December 14,2012;titled in the
Norman P.Wachowski(deceased August 28, 1997)
and Lorraine E.Wachowski Living Trust dated
December 18,1995
7 M&T Bank Savings Account#015004208556017- 2,003.93 2,003.93
valued per letter dated December 14,2102; titled in the
Norman P.Wachowski(deceased August 28, 1997)
and Lorraine E.Wachowski Living Trust dated
December 18, 1995
Total of Continuation Schedule Be attached page
TOTAL(Also enter on Line 7,Recapitulation) 405,758.73
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09)
ROV-1510 EX-(08,09)
SCHEDULE G
Pennsylvania
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF OECD's EXCLUSION TAXABLE
NUMBER THE DATE ONAME AANSTRANSFEREE TTCH THEIR COPY RELATIONSHIP F TH ED OR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE} VALUE
8 Members 1st Credit Union Certificate of Deposit 50,459.64 50,459.64
9486187-valued per letter dated December 24,2012;
titled in the Norman P.Wachowski(deceased August
28,1997)and Lorraine E.Wachowski Living Trust
dated December 18, 1995
9 Personal property 1,500.00 1,500.00
10 Real Estate located at 83 Hillside Circle,Camp Hill, 137,000.00 137,000.00
Cumberland County, Pennsylvania-valued per selling
price;titled in the Norman P.Wachowski (deceased
August 28, 1997)and Lorraine E.Wachowski Living
Trust dated December 18, 1995
TOTAL(Also enter on Line 7,Recapitulation) 405,758.73
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09)
REV-1511 EX.(10-091
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF
Wachowski Lorraine E FILE NUMBER 21-12-1241
Decedent's debts must be reported on Schedule I.
ITEM
NUM ER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 4,324.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State DO-
Year(s)Commission Paid
2. Attorney's Fees James, Smith, Dietterick& Connelly, LLP 7,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. Probate Fees 466.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 33,355.14
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 45,645.14
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exl2enses
1 Funeral Luncheon 250,00
2 Neill Funeral Home-funeral 4,074.00
H-A 4,324.00
Other Administrative Costs
3 ADT Security-service for residence 255.00
4 ADT Security-service for residence 435.00
5 AT&T-service for residence 49.00
6 Century 21 Realty Services -real estate commission per HUD 1 settlement sheet 4,255.00
7 Century 21 Realty Services-deed preparation per HUD 1 settlement sheet 150.00
6 Coldwell Banker Select Professionals-real estate commission per HUD 1 settlement sheet 4,260.00
9 Comcast-service for residence 71,00
10 Comcast-service for residence 71,00
11 Comcast-service for residence 71.00
12 Comcast-service for residence 71,00
13 Comcast-service for residence 71,00
14 Comcast-service for residence 71,00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6.98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Wachowski,Lorraine E. 21-12-1241
I
ITEM
NUMBER DESCRIPTION AMOUNT
15 Comcast-service for residence 91,00
16 Cumberland County Recorder of Deeds-transfer tax per HUD 1 settlement sheet 1,370.00
17 Elaine Wachowski-reimbursement for travel expenses to administer estate 5,25140
16 Guardian Transfer Corporation-tax certification fee per HUD 1 settlement sheet 10.00
19 Heating-service for residence 299.00
20 Heating-service for residence 226.00
21 Heating-service for residence 226.00
22 Heating-service for residence 226.00
23 Heating-service for residence 226.00
24 Heating-service for residence 226.00
25 Heating-service for residence 22640
26 Heating-service for residence 226,00
27 Heating-service for residence 226,00
28 Heating-service for residence 226.00
29 Heating-service for residence 226.00
30 Heating-service for residence 226,00
31 Heating-service for residence 300.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-92_1241
ITEM
NUMBER DESCRIPTION AMOUNT
32 Home Owners Insurance 947.00
33 House Repairs 900.00
34 John R.Zimmerman-messenger service to Cumberland County ROW Office 75.55
35 M&T Bank-check order 12.59
36 Moving Expense 1700.00
37 PA American Water-service for residence 3140
38 PA American Water-service for residence 59.00
39 PA American Water-service for residence 20.00
40 PA American Water-service for residence 27.00
41 PA American Water-service for residence 27.00
42 PA American Water-service for residence 27.00
43 PA American Water-service for residence 27.00
44 PA American Water-service for residence 27.00
45 PA American Water-service for residence 27.00
46 PA American Water-service for residence 27.00
47 PA American Water-service for residence 27.00
48 PA American Water-service for residence 27.00
Copyright(c)2002 form software only The Lackner Gr9up,Inc. Forth PA-1600 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
ITEM
NUMBER DESCRIPTION AMOUNT
49 PA American Water-service for residence 27.00
5o PA American Water-service for residence 27.00
51 PPL Electric-service for residence 4800
52 PPL Electric-service for residence 31.00
53 PPL Electric-service for residence 23.00
54 PPL Electric-service for residence 29.00
i
55 PPL Electric-service for residence 2900
56 PPL Electric-service for residence 30.00
57 PPL Electric-service for residence 30.00
58 PPL Electric-service for residence 3000
59 PPL Electric-service for residence 30.00
60 PPL Electric-service for residence 30.00
61 PPL Electric-service for residence 3000
62 PPL Electric-service for residence 30.00
63 PPL Electric-service for residence 30.00
64 Sewer Sanitation - service for residence 138.00
65 Snow removal/Lawn service-service for residence 967.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
! FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
ITEM
NUMBER DESCRIPTION AMOUNT
66 Trash Removal -service for residence 375.00
67 Trash Removal-service for residence 650.00
66 Tyler D.Schmidt-sellers assistance per HUD7 settlement sheet 5.000.00
69 Verizon-service for residence 25.00
70 Verizon-service for residence 25.00
71• Verizon-service for residence 26.00
I
72 Verizon-service for residence 25.00
73 Vital Records-death certificates Norman Wachowski(deceased spouse) 46.00
H-B7 33,355.14
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1 500 Schedule H(Rev.6.98)
C
Rev16i2 EX.(1248)
SCHEDULE I
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,Including unreimbumed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 M&T Visa 340.00
TOTAL(Also enter on Line 10,Recapitulation) 340.00
(if more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1800 Schedule I(Rev. 12-08)
REV-1613 EX+(0140)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAR RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wachowski, Lorraine E. 21-12-1241
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
00 Not Ust Tmstaefs)I• TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Eileen M.Wachowski Daughter 50%of residue 184,372.80
2 Sadore Lane Apt. 2P
Yonkers,NY 10710
2 Kathleen F.Wachowski Daughter 50%of residue 184,372.80
P.O. Box 273507
Concord,CA 94527-3507
Total 368,745.60
Enter dollar amounts for distributions shown above on lines 15 through 16 on Rev 1500 cover sheet,as approp 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-1600 Schedule J(Rev.01-10)
as
• Yy
February 28, 2014
Lisa M. Grayson, Esq. s THE
Register of Wills & ESTATE 1
Clerk of Orphans' Court
1 Courthouse Square SECURITY
Carlisle, PA 17013 FORMULA..
RE: ESTATE OF LORRAINE E. WACHOWSKI, DECEASED
FILE NO. 21-12-1241
Denise M.Long
dml@jsdc.com
Dear Ms. Grayson:
Enclosed are the following documents to be filed in the above-referenced Estate:
1. An original and two (2) copies of the Pennsylvania Inheritance Tax
Return.
2. A check made payable to the "Cumberland County Register of Wills" in
the amount of Fifteen Dollars ($15.00) representing the filing fee.
3. A copy of the HUD 1 settlement sheet.
Please time-stamp the additional copy of the Return and return to me in the enclosed self-
addressed, stamped envelope.
If you have any questions, please feel free to give me a call.
Sincerely,
JSDC LAW OFFICES
Denise M. Long
� m rTT
Cc: Eileen M. Wachowski �'? .S`D
a+
134 SIPE AVENUE
HUMMELSTOWN,PA 17036
MAILING ADDRESS
P.O.BOX 650
HERSHEY,PA 17033
TOLL FREE 1.600.942.3660
TEL.717.533.3280
FAX 717.5331771
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