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Home My WebLink About06-09-14 ,�° 17 South Second Street,6`"Floor S arlatos :� � � � LLc Harrisburg,PA 17101-2039 Souzad_Advice.Stnarter Decisions. 717.233.1000 Voice 717.233.6740 Fax www.ska rlatoszona rich.com June 5, 2014 Office of Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Christine M. Brady No. 21 -11 - �1284 To Whom It May Concern: Enclosed for filing is an original and one copy of the Inheritance Tax Return and Inventory for the above referenced estate. Also enclosed is a check in the amount of$30.00 in payment of the filing fees. Please time-stamp the extra copies and return to me in the envelope provided. Thank you. Sincerely, Sharon K. Shaffer Estate Administrator r-.� sharon(c�,skarlatoszonarich.ccs�n � � � � _-�- q c� �.;, c,i � � � `� -� � ;�,'> �� t P7 �7.,� `�``' ....� �.3 Enclosures =� �- f`- =:, r�� — �.�M r�r�� cL� ,a c� :.� r .+ ,;.�:, .,�.Y �,."�..a i� � � T "':.",� �� 4✓ C'a C� -i-e � -.^'� � � tV t'" f't7 -�7 �{ (j O � � � A Member of LawPactT"'-An International Association of Independent Law Firms _. . . T. �,,� .-�.,� � -�.�,K,�,�.�._,� � ,.n�. _� -,, � � �,��,�,��.... � 1505611185 REV-1500 EX�°Z_,,,�F', PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box zaosot INHERITANCE TAX RETURN 21 11 ],2 8 4 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sociai Security Number DBte Of DeSth MMDDYYYY Date Of Bifth MMDDYYYY ],0132011 1�251929 DecedenYs Last Name Suffix DecedenYs First Name . M I BRADY CHRISTINE M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WiTH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW � 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) � 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 0 9. Litigation Proceeds Received ❑ 10.Spousal Poverty Credit(Date of Death ❑ 11. Election 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 N BRIDGET M- WHITLEY, ESQ • 717-23�' 1000 � _� m -�- o �� c� REGIS7ER �WILLS U�NLYS°� - F`1 T � r -'CJ �,. �'" � . First Line of Address � � �' CO � , � � � C�� . ..__ . ;i::C ,;`."a ..] SKARLATOSZONARICH LLC ' =' �� c.�� z � Second Line of Address � c� �T� � j .: :.7 � ,•—' � 17 S 2ND ST 6TH FL ' � N �, City or Post Office State ZIP Code __ DATE FILED—� HARRISBURG PA 17101 �orrespondent'se-mai�address: BMWa�SKARLATOSZONARICH • COM Under penalties of pery'ury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on ail information of which preparer has any knowledge. SIGNATURE OF ON RESPONSIBLE FO ILING RE N DATE a ` ADDRESS `�`l �, PHYLLIS A - CAROTHERS, 151 PEYTON CIRCLE, OXFORD, MISSISSIPPI 38655 SIGNATURE OF PREPARER OTHER THAN R RESENTATIVE DATE �' , 1�� ADDRESS BRIDGET M • WHITLEY, 17 S . 2ND ST . 6TH FL . , HARRISBURG, PA 171�1 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505611185 OM46473.000 1505611185 � ..0 ... , _. . , .-x,� �� ,� ..� ,��, �� 1505611285 REV-1500 EX(FI) DecedenYs Social Security Number oecedent'SNarr�e: BRADY CHRISTINE M RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. � • �� 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2 � . �� 3. Closeiy Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , 3. � • 0� 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . 4 � • �� 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5. 3��0�� • �� 6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , , , 6. � • 0 Q 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested . . . . 7. Q-Q� 8. Total Gross Assets(total Lines 1 through 7) , , , , , , , , , , , , , , , , , , 8 3 O O�� • �� 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. 3 3,5 5 4 •0 0 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , . , . . 10. 4 9�,16 3•0❑ 11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , ��. 5 2 3,717•�� 12. Net Value of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , , , �2. (2 2�,717•0�) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3. �•�� 14. Net Value Subject to Tax(Line 12 minus Line 13) , , , , , , , , , , , , , , �q. (2 2 3�717 -0�) TAX CALCULATION -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.O� � • �0 15. 0-�0 i6. Amount of Line 14 taxable at lineal rate X.0 4 5 0 -0 0 16. 0 • �0 17. Amount of Line 14 taxable at sibling rate X.12 � •�� 17. �� 18. Amount of Line 14 taxable at collateral rate X.15 � • �� 18. � • 0� 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. �•�� 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 � 15�5611285 1505611285 � . OM4646 3.000 REV-1500�EX(FI) Page3 File Number 'Decedent's Complete Address: 21 11 12 8 4 DECEDENTS NAME BRADY CHRISTINE M STREET ADDRESS CUMBERLAND CITY STATE Z�p CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0 •O O 2. Credits/Payments A. Prior Payments 0 •�� B. Discount � •0� Total Credits(A+B) (2) 0 •Q❑ 3. Interest �3� 0 • �� 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) �-�� 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) � • �� Make check payable 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 . . . . . . . . . . . . . . . . . . . . . . . . � � b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . ❑ � c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � � 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 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 Jan. 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 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)J. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 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. OM4671 2.000 REV-1508 6X+(0&12) • pennsylvania SCHEDULE E DEPPRTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDErIf DECEDENT ESTATE OF: FILE NUMBER: Christine M. Brad 21 11 1284 Include the proceeds of litigation and the date the proceeds were received by the estate. All propert jointly owned with ri ht of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH 1. Proceeds from settlement of litigation received by Estate on May 5, 2014 300,000 TOTAL(Also enter on line 5,Recapitulation) $ 300,000 2wasAD 2.00o If more space is needed,use additional sheets of paper of the same size. �.: . � w .� �� :� „ �„�. ,� -� �_ _ � .,�.�.,�,� � � n ,�. _ _ REV-1511 EX+(08-13) SCHEDULE H • pennsylvania DEPARlMENTOFREVENUE FUNERAL EXPENSES AND , INHERITANCETAXRETURN ADMINISTRATIVE COSTS . RESIDENTDECEDENT ESTATE OF FILE NUMBER Christine M. Brad 21 11 1284 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 6,343 � Ronan Funeral Home B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 13,000 Name(s)of Personal Representative(s) Phyllils A Carothers Street Address 151 Pevton Circle City Oxford State MS ZIP 38655 Year(s)Commission Paid: t�avment pendinq 2. Attomey Fees: 12,000 3. Family Exemption:(If decedent's address is not the same as claimanYs,attach e�lanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 81 5. Accountant Fees: 6. Tax Return Preparer Fees: 1,600 7. 1 Register of Wills — Fee to File Original Inheritance Tax Return and Inventory 30 Total from continuation schedules . . . . . . . . . 500 TOTAL(Also enter on Line 9,Recapitulation) $ 33 554 3W46AG 2.000 If more space is needed,use additional sheets of paper of the same size. .,,�-� ��x,��:,.��.�-� �.M �..��.�.��._._ a�.�,..�, . _ _ _. _ . Estate of: Christine M. Brady 21 11 1284 Schedule H Part 7 (Page 2) 2 SkarlatosZonarich LLC Accrued and anticipated disbursements for copies, travel, postage, filing fees, etc. 500 Total (Carry forward to main schedule) 500 : r ,v � ��-�.��,�; � �,�� r: _� � . R��_,s,��X+"�_,�, SCHEDULE I • pennsylvania DEPAF27MENTOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Christine M Bradv 21 11 1284 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �• Capital Tax Collection Bureau Per capita tax and interest for 1997, 1998, 1999, 2000, 2001 and 2003 241 2 Department of Public Welfare - Estate Claim 334,318 3 Wilkes & McHugh, P.A. - Costs Relating to Litigation 25,293 4 Wilkes & McHugh, P.A. - Counsel Fees Relating to Litigation 120,000 5 Medicare Lien 9,626 6 TPL Lien to Medicaid/DPW 685 TOTAL(Also enter on Line 10,Recapitulation) $ 490 163 2W46AH 2.000 If more space is needed,insert additional sheets of the same size. �,, �_�� _ ��.�,� ,. . :,�..w.�..,,,.�,9..�.��. P�iYLLIB CARC)THEI�S,ADI�ITNI�TRATt)R ; OF TRE ESTA�'E�F�HRiSTIN�BRADY, . C!CkURT[JF CC}lY�M�t'�t;PY..�ArS DECEASED : GC�S1�i�ERI.�i.i'rT�1 CbUNTY,PA� Plaintiff . vs. . 2'�(�. 11-�tD94 ' �-.�-' MANQR CAR�C/F C�,RL��LE��1,LLG, : : � d/hla MAlYOR�ARE H�ALTH SEFtViCES , � � � j -CAI�LISL;E;�CR 2VIAN(��t+�ARE,I1�C.; , MAN(}I�GARE;�iaG.;I�C�fiEAL'THCARE, . �n i':: � I:L,G;H+CR TI T�EALTHeARE,LLC;HCR III . ~� '�" �. ` HEALTIiCARE,�.T�C,HCR IV HEALTHCARE,: .� .::. LLC;and SAEI�RI LYNN STULTZ�'US . ' , Defendant� . .� , C1R�►ER A AND I�QW, this �� day c�f , ZtlI4, t�n c�nsicl�ratian �f the P'etitian to �ettle of tli� Pe�itionerLPl�intif��'h�llis G�ot�e�rs, Ac�m�nz�#��tri�of t�i�B�at�o€ Chxistine Br�dy, dec�ased, it is hereby ORDERED and ��C��D that the seftlerrtent in #�ie aka�ave described matter in the arni�unt of 3�10,000.�0 is Yzer�by 1�:P�R.(�"�7ED: The settiement fiznds shall be patd tc� Willces 8i Tv1cHu�h,P.A. vvitliiri tv��n�ty (2�} da.ys c�f t3�e date of t}iis 4rder for prop�r di�tributian. IT IS FURTHER C)RDEI2ED a�d DECT�ED t�iat the 'riet settlement proc�eds (after dedueti�n of costs and�ttarn�y's fee�)b�a11c�c��d 1 f�0%o�i��e�urviv�i�Ia:ims. IT TS �'URTHER 4Rl�E�D �ud UE�REED that the�ett�.�men�proceeds be distributed as f€�Ilc�w�: 1, To; Wilkes&IvlcHu�l�,P.A. � �5 2��.'�3 Reiz�bursement of Costs,per F�e�ntract 2. To;�ilkes &Iwl�Hugh;.P.A. ,� 12{l�OO;�Q Cauns�i Fces;per Fee Contra:ct 3, Survival Cl�im th�sum vf � 15�4,707.27 To: the Estate c�f Ghristine�rady,deceased less the,�'ollowing�stimaiec�tiens: To: i�v'zlkes&McHugh,P.A. 1V��xim�.un es#irnat�d Lien to Medieare (ta be held in escrow}; � �56�5."79 Ta: Wilkes&McHugh,P.A, Maximum estimated TF'L T.,ien t�Nfedi�a�d 1 i�F�N (to t�e�elcl in es�rovv}: � 1.1��.11 The Adxninistratrix is authc�rized fc� make tiisburs�ernent�, inclut3irig ��ozr��ys' �ees and costs, purs�ant tc� the F�etition and ta execute all ne�essa�y r�leas�s, enc3gr�� all �Y��ks arid to make appropriate distribuiior�. ' B�the -c� . J. Distxi uti�n: John B.Zonarich,.8sq.;Skas°3acos�onarich LLC, 17 Souih S�ccrnd Street,6'�Floor,I�Tatrisburg,Pi1 171 Ql, William P.Murray,III,Esq,,�Jiikes&IVIcHugh,P.A.,Three Parkwap, 16{11�herry Slre�t,5uite. 13�0,Philadedphia,PA 19kt12. Jahn M.3kracki,Esq.,Burns�Ee, roa raur raus,Suite SIS, 2001 Conshah�cken S[at��ad,WeSt Ct�nShi7hoCk8t1,P�1$�#28. T�t3��Gt��lt'�f��+I R�CUFt� ir�7��timor�y v�r�tes�of;!t�ere ut�to set my hant! a��t j�a�l of said-Ct rt a# riisle�Pa 'fhi��'�daY of ,2tI �C��f3.�Pmttx�� w�e h �+��1��/�/y��4��q�� ' . ..�...... ��r��+i�+�L..�G � � v v � � � � � � o � � N � O D � � � � � 3 o r � r C� C� � C� � — � o c co = cn' c � in' = rn �`< rn = � - D � O � = � � � � _ o = _ � � � �' = w � � _ w � � = o � Q = � O = � = = :?o�,a, � `T��N � Z�� N� � o;�aco �� A°vNim o �