HomeMy WebLinkAbout03-17-14 1505610105
REV-1500"(may'("61 OFFICIAL USE ONLY
PA Department of Revenue P�.a ,Cade Yam FLAN Nader
Bureau of TndMduatTaxes INHERITANCE TAX RETURN 1
POBLDGrg O6ot I I i --
Hamsbum,PAtnzB-a6ot RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death WDOYYYY Date of Birth MMDDYYYY
LOW30/2012 i 08114H991
,Decedent's Last Name suffix Decedent's First Name MI
Bolen _..______ 1----J I Taylor
(IT Applicable)Eder 3ur4vtng Spouse's IMmmation Below
Spouse's Last Name Suffix Spouse's First Name MI
nfa ,
---�
Spouse's Social Saw*Number
r— THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
QD 1.Original Return O 2.Supplemontal Return O 3.Remahhdx Return(Date of Death
Prior to 12.1382)
O 4.Limited Estate O 4a Future InWW Compromise(date of O 6.Federal Estate Tax RstU n Required
death after 12-12.82)
O 6.Decedent Died Testate O 7.Decedent Maintained a Living Twat S.Total Number of Safe Deposit Batas
(Attach copy of WID) (Adath Copy of Trust)
O B.L'dlgat on Proceeds Received O 10.Spousal Ppreny Credit(Date of Death O 11. 09ctIon to Tax under See.8113(A)
Between 12-3"1 and 1-1.85) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.A4.00RRESPONDERMAND CONFIDENTIAL TAX INFOMUTION SHOULD BE DIRECTED TO.
Name __ _ DayOma Telephone Number
M. Fields '— ------_^^� (717)781-2121
REGISIM OF WILLS USE ONLY
First Lft of Address
_ v
831 Market Street ] :10 $ m
Second Line of Address 03'D<- O
P.O.Box 222 12- r =i
----------....---------- ----------------- 41LED
City or Post ORN:e State 21P Cow r�T
—I T
Lemoyne i PA 17043 C-7)
rn
rnOT
Cor espendord's a-mall address:I(IeldSOCOStODOUIOS.COM CD
Underpw*ff,,apaUey�1 dedme tat I rave mornawd tlsa mamh,a+dedhB>rwortryarYhg adhedaae ernd efal8merds end a aw beS olmrykmebdSe end be!IeL
a la mxt awed and complete.Dedemtlon al papaar olm Own the pe aanel rep exnteme Is owed an ss Intmmedm orwhich roarer has any knmMedge.
SIGMA RESPON E FOR F RN / DA ILI
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ADDRESS lit 1s T�E
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Y PLEASE UVE OWOINAL FOM Otur
Side 1
L 1505610105 1505610105 J
J 1505610205
REVA500 EX(R) Decadence Social Securhy Number-
' _.-..-...... i
1 Oecade x'e Nana: Taylor J. Bolen --
RECAPITULATION --
1. Rea$Estate(Schedule A)............................................. 1.j
2. StOcIm and Bonds(Schedule B) .............
3. Closely Heil COrpore6on,Pennershll)Or Sale•PropdMond"P(Schedule C) ..... 3,1
1
4. Mork"m and Notes Recehabta(Schedule D)........................... 4.1
S. Cash.Bank Dapost6 and MWOe9aneouc Personal Property(Schedule E)....... S. �390�
6. Jok*Owned Property(Schedule F) O SWaMte 311timh9 Requested ....... 6.j -!
7. Inter-Was TmWere 8 Mlscenansoua Nm*mbate Property F-
(Schedule G) O Separate SMV Requested........ 7.
B Total Oroas Assets(btel three 1 dvOhrgth 7)............................. 6.
390,000.00
9. Funeral Expenses and Administrative Costs(Solm"H)........ 9-1 139.595.37
10. Debts of Decedent Mongege Llabass and Liens(6ahodne 1)...............10.t --
11. Tow Deductions(total Lines 9 and 10).................................
12. Net Value of Estate(Una 8 minus Lute 11).............................. 12 i
13. Chartable and Governmental SequestslSec 9113 Trusts for which
an elecilon to tar has not been made(Schedule J) ........................ 13-1
14. Net Value Subject to Tax pne 12 minus Line 13) ........................14. 0.00
TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Lure 14 taxable
at the spousal tax rem.or -
transf2) undo Sec.9116 F 75. 0.00
(ax1.2)X Una
18. Amount of Una 14 taxabe 16. 0.00
at lineal rate X.0- '-
17. Amount of Una 14 ramble 17 0.00
at s1611ng rate X.12
18. Amount of Una 14 taxable t t8. 0.00'
at collateral rude X.15
0.00
19. TAX DUE.........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1 1505610205
505610205
RM16ae Ex(FI) Pap 3 FRO Numbs
Decedent's Complete Address:
D-NAME
Taylor J.Bolen
STREETADDRESS
39 North Old Stonehouse Road
CITY STATE T IIp
Carlisle PA 17016
Tax Payments and Credits:
1. Tax Due(Page 2,LBre 19) (1) 0.00
2. Creditaff*rnents
A Pdor Payments
8.Discount
Total Credita(A+8) (2) 0.00
3. bdraesl
(a) U0
4. t Line 2 is greater then Una 1+Lhm 3,order the difference. This Is the OVERPAYMM..
FBI in oval on Page$Use 20 to request a refund. (4) 0,00
5. It Une i+tine 36 greaterihan Line 2,enter the diference.This Is the TAX DOE (6) 0.00
Make check payable t0: REGISTER OF WILLS,AGENT,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X"IN THE APPROPRIATE BLOCKS
1. lXd decedent mace a transfer and: Yes No
a. retain the use orbanneofMe pro"transferred,_._..,_._._»»--------—_,.„........_..__._.._._._...,.». ❑ ■
0. ratan the rw to designate who shag use the property transferred or is Income.........»____.......».......
_. ❑
C, .......» -------- . .... . ----------
❑ ■
d looeivetleptardsefor0reoleNharpaymenls,bene6baosre?...__....»....._..__.».._...._..__.._...............❑
2, tdealb occurred after Dec,12,1982,did deoederdlraanstar eAy vMln one yaarof death '
wiaroutmontongadoquate consideration?.._............................_»_.............._..............___....»..._....0 �
a 04 decedent am an%trust fa”orpayablai o daaih bank account or seaaltyatirisorherdeath?__.._.._ ❑ ■
4. Did deoed"own on InWdual retirement aocnun,amity or oft w"robate properly,wtddh
mdaNsabonefidarydeskratim?_.._....._..,,,............__..»._...___...__._.....,.._.....,»»..,..._...___...».._._.....0 ■
IF THE ANSNIER 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 alter July I,199,and before Jan,1,1995,the tax rata 6rlposed on the not value of trarsfets to or for the use of the surviving spouse
is 3 percent(72 P.S.§4116(a)(1.1)(j).
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of barders to or for the use of the surviving spouse Is 0 percent
[72 PS,§9116(a)(1.1)(fiRb The Stabile does rrot exempts transfer to a surviving spouse from tax,and the statutory requvaments for disclosure of assets and
f[W a tax return am still applicable even N the reviving spouse is the onty beneficiary.
For dates of death on orater Judy 1,2000:
a The tax rate bnposed on the rret value of transfers from a deceased child 21 years of age or yourw at death to or for the use of a natural parent,an
adopff"parent or a stepparord of the child Is 0 percent[72 P.S.§9116(a)(12)).
The tax few Imposed an am nedvahtso(trandem toortatre use of ttadeCeden4sfinea beneficiaries isb a percent,except as noted In 172 P.S.§9118(a)I1))
• The tax rate Imposed on the net value of transfers to or for the use of the decedent's smihp is 12 percent[72 P.S.§9116(8x1.3)).A abrMg is defined,
under section 9102,as an Individual who has at least are parent in coarnon with the decedent whether by Wood or adoption.
REV-15c$IXr(o&ss)
pennsytvania SCHEDULE E
DEPARTMEW OF REVENM CASHr BANK DEPOSITS&MISC.
ee1RUrNVb TAM REnM PERSONAL PROPERTY -
AESIDWTDECEC r
ESTATE OF: FILE NUMBER:
Taylor J. Bolen 21-12-0774
Include the proceeds of lidgation and lbe date the proceeds were received by the estate.
All property 1oln fy owned with right of survfvO ship must be disclosed on Schedule F. ..... .
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEA1H
1. 4390,000.00 proceeds of 00p# n. Received on October 24,2014. 390,000.00
See Schedule H for odunsel tees x$130,000.00 Ll4dw expenses were 41898.19.
.......a.:........_ .._.. :..-: ,..... ...:.......... ..._
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�::.:�..:....: :. . .. ... ...r:r -............... . ._._.,..:.:__._,.,.,rv::.,._..r......_.....-..._.v:r.r[.-:.,-.__.u..�,:v::r.....:. .,:v.Y:Y;i-•.':.`i(:p_'„
�, ,::v-vl :.... . . ... .... :..:.:.�...... .:... ......w.;+:cyv�c:e:--..__r............r..♦.,.n.-men-....r=.._...._n-�_,_ .: ...'t.l....._ i
i
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• ' r
1 iz
•x,5 ,err...-.-e. . .2
(..._.........r.�........:.w.._�,�:.r:,..,_.....,-...:.U.x..-�-.,:.,.,[.-.,.._.n..,._.:y,..�...,_�[,♦.:[..-:_,...,x,.�-,x., .[,.,..-�-,.,:�,.:�.: rs.'�--+�[.. n.:.;c�..ir:e::'-6
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::.r..i,-.::'> :..._r.._�..,�t�e_...p::..r...........,.a.vxvax[.fr.,v'rt �:._.....vvt_:vcvem-mr„♦-.u_r..v�.r_,-n::♦v-n..•:era,<a:-r.-ruJ :K:•�!i�.:fSi�Y-w..;♦,._a::1.._.�Cr._
i,..n:,-vv._: :+.•v..,.a�....:'..:::r•.,-r.nr:..:n r:r-.an.-::.r+...-r.,,r-.:.a.._..v,.ran-.rca-:�,-n:._,:v:rt,rr,..-.-�.v.--v<=na._nvr,.arf.�u�,-n�-re.� o'�v\t1-0✓Y4ai--".:i..:.J:.,i�'.�:�'S
i
1 r ♦ r r.
r � r
. ..r6..'.ff 4'i
r ;
1 cx=aer.
TOTAL(Also enter on Litre 5,Recapblaton) 4 .x..,.,390,000.00
if more space is needed,use addMimal sheets of paper of the same sine. - - --
REV-1511 EX+(08-13)
-JOEL-pennsylvania SCHEDULE H
DEPART WrOFREVEMX FUNERAL EXPENSES AND
tmIBUAM TAX REM ADMINISTRATIVE COSTS
PRMXNT DEMDW
ESTATE OF FILE NUMBER
I Taylor J. Bolen 21-12-0774
i
Decedent's debts must he reported on Schedule L
TEEN DESCRIPTION AMOUNT
NUMBER
A. FUNER&EXPENSES;
t' Parthemore Funeral Home- 4.. ....
B. ADMINISTRATIVE COSTS:
t, Personal Representative Commissions: .
Names)of Personal Representative(s)
Street Address
M, State_ZIP
Years)Commtsstai Paid:
131,898.19
2. Attorney Fees:
3,500.00
3. Family EXemptbn:(If decedent's address is not the same as daimant8,aW explanation.) .: :.::...:.::...._....•. <:
Claimant Melody Bolen
Street Address 39 North Old Stonehouse Road
qty CaAisle state PA ZIP 17015
Rdation"of Claimant to Decedent mother
- 65.50
4. Prebate Fees:
5. Ac=ntant Fees:
6. Tax Return Preparer Fees: " v`
7.
i t ___ _ __ ..._..: k:r:p?:Y a•.q•i-:^.u::f1Ka.:v.�
.. ..._.. .......... ... ............_. .. .. ...__ ..._ ..._...._.. .-..-.:...-:ac ..-..
,
,..v.: 139,595.37!,'
TOTAL(Also enter on Line 9,Reapitutaton) 5;;,,_. ,: ..._..................
If more space is needed,use additonal sheets of paper of the same size. .
REV-1513 EXa(01.30)
pennsytvania SCHEDULE ]
DEPARTMENT OF REVENUE
INNERMANCE TAX RETURN BENEFICIARIES
RESIDENT DECEOM
ESTATE OF: FILE HUMBEP-
Taylor J.Bolen 21-12-0774
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY DO Hot LIST Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spausal dWiNutlans and transfers Under
Sec 9116(a)(1.2).) .. .. ,
i I. Md*Bolen(mother) mother 100%.
Roger Bolen (father)- disclaimer filed faNrer
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE DR LINES IS THROUGH 19 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECrION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
... .. .... ..
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
i
. ..... .. ... ......___.............. .... _, n.. .. .... ... .... ....... _ _ .... .
. n
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET.
If more space Is needed,use addRlwal shy of paper of the same dM
Williams
Cuker
Berezof sk
L L C ® 1515 Market Street O Woodland Falls Mark R.Cukert0
Protecting Rights for 29 Years Suite 1300 Corporate Center Gerald J.Williams"
Philadelphia,PA 210 Lake Drive East Esther E.Berezofsky'1
www.wcblegal.com 19102 Suite 101 Beth G.Coley
215.557.0099 Cherry Hill,NJ Alan H.Sklarsky'
215.557.0673 fax 08002-1163 Andrew F.Erba"51
Samuel Abloesert
856.667.0500 Kevin Haverty"*
March 13, 2014 856.667.5133 fax Maria C.Janoski"
Joseph A.Venti"
Christopher Markos"
Michael J.Quirkt"
VIA OVERNIGHT UNITED PARCEL SERVICE tMembm Pennsylvania Bar
t Membep New Jersey Bar
4Member,Conn.Bar
Register of Wills & Clerk Member,Wash.,D.C.ear
of Orphans' Court
Cumberland County.Pennsylvania
1 Courthouse Square
Suite 102
Carlisle, PA 17013 C) q �,
m-47 x�.m
rr 0
Attention: Heidi Warner
Re: Estate of Taylor Bolen one t-*i
Probate and Filing Fee
M z
Na `-O.
Dear Ms.Warner:,
I enclose herewith a check in the amount of$355.00 representing payment of the probate
and filing fees for the above-referenced estate.
Thank you:for your kind attention to this matter.
Very truly~yours
,GE D J: .
GJW:rap
enclosure
cc: Leslie M. Fields, Esquire w/enc.
0W y •
Profed`c *Certified by the Supreme Court of New Jersey as a Civil Trial Attorney
m
COSTOPOULOS, FOSTER & FIELDS
ATTORNEYS AND COUNSELORS AT LAW
831 MARKET STREET
P.O.BOX 222
WILLIAM C.COSTOPOULOS LEMOYNE,PENNSYLVANIA 17043-0222 TELEPHONE(717)761-2121
DAVID J.FOSTER FAX(717)761-4031
LESLIE M.FIELDS W W W.COSTOPOULOS.COM
GEORGE H.MATANGOS
HEIDI F.EAKIN
March 10, 2014
Lisa M. Grayson, Esquire
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Taylor Jean Bolen
File Number: 21-2012-0774
Dear Ms. Grayson:
Enclosed for filing please find two original duplicates of the Inheritance Tax Return
Resident Decedent pertaining to the above-referenced estate.
Thank you for your attention to this filing. Should you have any questions, please do not
hesitate to contact our office.
Very truly yours,
COSTOPOULOS, FOSTER& FIELDS
Leslie . Fields
LMF:jmk
Enclosures
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