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Home My WebLink About09-29-14 (3) r a _.__i 1505611185 REV-1508 EX(02-11)(R) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN ��^^�yy+ i t �-7 Harrisburg,PA 17128-G601 RESIDENT DECEDENT c xli 14 (J 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 04172014 10051928 Decedent's Last Name Suffix Decedent's First Name MI BOWKER JOAN A (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 1:1 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.) ❑ 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 RE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOU6"E DIRECTED TO: Name Daytime Tetephone NumbliG :0 rn CRAIG A . HATCH, ESQ • 717- 960rr RE *i R ._WILLS USE YG iS C7 First Line of Address 2109 MARKET STREET cl Second Line of Address -� "`I rV r r1T G? co Q City or Post Office State ZIP Code DATE FILED CAMP HILL PA 17011 Correspondents e-mail address: C - HATCH@HHGLLP • COM Under penalties of perfury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other then the personal reFresentative is based on ail information of which Preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE BETH A • REBER 0�ul - .Son-iQ1 —" IL4 ADDRESS 1 --'I 6 DEWBERRY COURT M CHA BURG, PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE , CRAIG A • HATCH, ESQ • 9a av/ ADDRESS 2109 MARKET STREET CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 OM46473,000 1505611185 �,,� 1505611285 J REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name BOWKER JOAN A RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 $0 - 00 2. Stacks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2. $0 . 00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , 3. $0 - 00 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , 4. $0 - 130 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , . 5. $0 - 00 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested , , , , 6, $16,504 - 39 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) FI Separate Billing Requested . . . . 7. $0 • 00 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8, *16 , 504 - 39 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. $415 - 00 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) , , , , , , , , . 10. $0 - 00 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. $415 - 00 12. Net Value of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , , , 12. $16 1089 - 39 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . 13. $0 - 00 14. Net Value Subject to Tax(Line 12 minus Line 13) . 14. $161089 - 39 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 D_ $0 . 00 15. $0 . 00 16. Amount of Line 14 taxable at lineal rate X.0_�55 $161089 . 39 16. $724 .02 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 - 0 0 19. TAX DUE . . . . 19. $724 . 02 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505611285 1505611285 CM4648 3.000 It REV-1500 EX(Fit Page 3 File Number Decedent's Com lete'Address: DECEDENT'S NAME t, t BOWKER- _J 6 STREET ADDRESS 6 DEWBERRY COURT CUMBERLAND CITY STATE ZIP ANZ U A 5 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) "' (1) 9724 .02 2. Credits/Payments A.Prior Payments $0 . 00 B.Discount *0 . 0 D 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. Fill in box on Page 2,Line 20 to request a refund. (4) $0 .00 5. If Line 1'+Line 3 Is greats;than Line 2,enter the difference.This Is the TAX DUE. (5) *724 - 02 V ' Make check payable,tD: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X"IN THE APPROPRIATE BLOCKS t. Did decedent make a transfer and: Yes No a. retain the use or Income of the property transferred a rgl It. retain the right to designate who shall use the property transferred or its Income . . . . . . . . . c. retain a reversionary Interest . . . . .. . .... . . . . . . . . . . . . . . . . . . . . . . . . . ❑ d, receive the promise for9lfe of either payments,benefits a care? . . . , ... .,. . , . . . . ❑ 2. If death occurred after Dec. 12. 1982,did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . ❑ ❑x 3. Old decedent own an"in trust for"or payable-upon-death bank account ar 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ EK 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 172 P.S.§9116(a)(11)()). 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 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 stiff applicable even If the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The lax 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 172 P.S.§9116(a)(1.2)1. • 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 172 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)1,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. OM4871 2.000 REVA511 EX�(0e-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND PM ERITANCE TAX RETURN ADMINISTRATIVE COSTS REStC£M CECEDEM _ ESTATE OF FILE NUMBER Joan A Egwker Decedent's debts must be reported on Schedule I. ITEM NUMBER I DESCRIPTION AMOUNT A-FUNERAL EXPENSES: None R ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Names)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: $400.00 3, 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 Fees: 8. Tax Return Preparer Fees: 7. 1 Register of Wills filing fees $15.00 TOTAL(Also enter on Line 9,Recapitulation) $ $415.00 3w46AO 2.000 If more space is needed, use additional sheets of paper of the same size. 1 REV-1b13 EX-(01-10} SCHEDULE J Pennsylvania OEFARTVEW OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Joan A. Bowater RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS jtnclude outright spousal distributions and transfers under Sec.9116(a)(I 2).] 1Beth A. Reber 6 Dewberry Court Mechanicsburg, PA 17055 All of Residue: $16,089.39 Daughter $16,089.39 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV�1500 COVER SHEET,AS APPROPRIATE. (( NON-TAXABLE DISTRIBUTIONS A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: t. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 5 $0.00 9W46AI 2 000 If more space is needed, use additional sheets of paper of the same size. st MEMBERS 1St FEDERAL CREDIT UNION May 5, 2014 Joan L Bowker(Deceased) Beth A Reber 6 Dewberry Court Mechanicsburg, PA 17055 To Whom it May Concern: Please be advised that on Septebmer 2"d, 2009, Beth A Reber became a joint owner with Joan L Bowker on Members 1st Federal Credit Union account number 366395. Please see the attached, signed membership application for proof of ownership. Should you have any further questions or concerns,please feel free to contact me at the information below. Thank you. Sincerely, 44W Meghan Noss Branch Manager 4 Market Plaza Way Mechanicsburg, PA 17055 717-637-1884 x70801 5000 Louise Drive • P.O.Box Q Mechanicsburg,Pennsylvania 17055 (800)283-2328 w .memberslst.org �15t PA Jsno raaa;, n,;.� N.iM1arvobuT„ I)Oii N.)2"-1321 MEMBERSP Membership Application Account Number 366395 Account Name Last First Middle Initial Suffix SSNON Bowker Joan L Date of Birth Home Phone Number Address 1459 Hillcrest Court Apt 502 1 10105128 717-525-7172 city State Zip code Email Atldress Camp Hill PA 17011 Employer Work Phone Number Extension Cell Phone Number RETIRED Joint Owner Last First Middle Initial Suffx SSN/EIN REBER BETH A 1 Address Date of Birth Home Phone Number 6 DEWBERRY COURT 1 03111154 717-766-3797 City State Zip Code Email Address MECHANICSBURG pa 17055 Employer Work Phone Number Extension Cell Phone Number retired Eligibility Naval Support Activity - Mechanicsburg Type Immediate Family `Name of Family Member James reber 'On the line above,please indicate the name of the Family Member,if applicable. W-9 Certification of Taxpayer Identification Number (Social Security Number) By signing below,under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number,and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding, or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. 1 am a U.S.citizen or other U.S.person. Q I am a U.S.Citizen or Resident ❑ I am not a U.S.Citizen or Resident(Complete W-8 Form) ❑ I have been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding. X •- �• -� 09/02/09 Primary Signature Date 0 I am a U.S.Citizen or Resident ❑ I am not a U.S.Citizen or Resident(Complete W-8 Form) ❑ 1 have been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding. �>� 0 ✓LQrc»/ 09102109 X Joint Owner Signature Date INVe hereby make application for membership to Members 1st FCU. INVe agree to conform to its bylaws and amendments thereof,and maintain at least a$5 minimum balance. Members list FCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account and all sub-accounts. INVe acknowledge receipt of the Membership Booklet which contains all relevant contractual obligations for this account and all sub-accounts. IMe have read and agree to the terms and conditions of the Membership Booklet,the Members tat FCU Debit Card,EZ Call and/or Members 1st Online terms and conditions,and hereby accept and Confirm that all shares and accounts held by me/us are subject to Members 1 st's Federal Statutory Lien/Pledge. INVe agree that the information above is true and complete and authorize Members 1st FCU to obtain any information necessary to this application. X 6z_ 473---s-. State Drivers License 12638710 06120108 10/06111 Signature ID Type ID Number Issue Date Exp Date JOAN L BOWKER X State Drivers License 16626817 01/23/07 03/12111 Signatu ID Type ID Number Issue Date Exp Date BETH A REBER PDA St MEMBERS P FEDERAL CREDU UMON REGULAR SAVINGS ACCOUNT: Account Number/Suffix 366395-00 Date Account Established 09/02/2009 Principal Balance at Date of Death $23,080.98 Accrued Interest to Date of Death $1.01 Total Principal and Accrued Interest $23,081.99 Name of Joint Owner Beth A Reber Date Joint Added 09/02/2009 CHECKING ACCOUNT: Account Number/Suffix 366395-11 Date Account Established 09/02/2009 Principal Balance at Date of Death $9,926.56 Accrued Interest to Date of Death $0.22 Total Principal and Accrued Interest $9,926.78 Name of Joint Owner Beth A Reber Date Joint Added 09/02/2009 MEEMMJBERS 1ST FEDERAL C EDIT UNION Tessa L Klugh Lending Insurance Support Specialist May 9, 2014 Estate of: JOAN L BOWKER Date of Death: 04/17/2014 Social Security Number: 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org