HomeMy WebLinkAbout10-09-14 (3) 1505610105
REV-1500 EX(oa-u)(FI) }i�1
L� OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes County Code Year File Number
PO BOX f nds i o pINHERITANCE TAX RETURN
Harrisburg PA 17128-o6o1 RESIDENT DECEDENT 21 14 0048
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09/30/2005 10/28/1922
Decedent's Last Name Suffix Decedent's First Name MI
Bressler Betty M
(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
C@D 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
M 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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
Keith O. Brenneman (717)697-8528 ,
REGISTER OF WILL9u-VSE ONLY
C7 -7:� �;o rn i
First Line of Address c-7)
_.. .. .. ... .. .. .. _ .. ... ..... .. ._._ .. i/7 y7,
44 West Main Street --1 "" r."
;:O y i— r i�
t, r71 CD c
Second Line of Address
"7 t A"I"EIFILEP :•E:
City or Post Office State ZIP Code L I J
cro r-- rn
Mechanicsburg PA 17055 'A,1 -{ ,1 Ca _
CD
Correspondent's e-mail address:
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 true,correct complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATU PERSON 5ESPONSIBLE FOR FkING RETURN DTE
L
ADDRESS
Susan K. Massie, Executrix 1 Fieldstone Drive, Mechanicsburg, PA 17050
SIJATIy URE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
Keith O. Brenneman, Esquire 44 West Main Street, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: Bressler, Betty M.
RECAPITULATION
1. Real Estate(Schedule A). . ....... .. ............................... .. . 1.
2. Stocks and Bonds(Schedule B) •..•... 2'
i
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. _... . _ ._.__.._.
4. Mortgages and Notes Receivable(Schedule D). ................... ....... 4.
2,526.76 `:
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5.
6. Jointly Owned Property(Schedule F) G7 Separate Billing Requested
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) C=D Separate Billing Requested........ 7.
8. 4 2,526.76
8. Total Gross Assets(total Lines 1 through 7)................ ,
9. Funeral Expenses and Administrative Casts(Schedule H)............. ... .......... ... ... 9. , 1,181.52 .
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)........ ....... 10. ' 0'00
11. Total Deductions(total Lines 9 and 10)................................. 11. 1,181.52
12. Net Value of Estate(Line 8 minus Line 11) ....,.................. ....... 12. 1,345.24
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. _ 1,345'24
TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or _..................... ............_......_..._... .._._._.._.....__
_..._. ........._......... ._.
transfers under Sec.9116
i
(a)(1.2)X.0. 15.: �
16. Amount of Line 14 taxable
at lineal rate X.0_ 16. M
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable 1,345.24 ° 201.79;
at collateral rate X.15
201.79
19. TAX DUE ........ ....I...... ...... ....... ... 19.`-
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT COD
Side 2
1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number 21-14-0048
Decedent's Complete Address:
DECEDENT'S NAME
Bressler, Betty M.
STREET ADDRESS
6 Links Trailer Court, Hampden Township
Cumberland County
CITY STATE - ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 201.79
2. Credits/Payments
A.Prior Payments __ _ _ _____.__ —0.00-
B.Discount 0_.00
Total Credits(A+g) (2) 0.0
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 oval 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) 201.79
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.......................................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ N
c. retain a reversionary interest.............................................................................................................................. ❑ N
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ N
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ 0
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 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[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.
REV-1508 EX+(08-12)
r ?pennsylvarria
SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Bressler, Betty M. 21-14-0048
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Uncashed dividend checks from Prudential Financial Insurance received from the Commonwealth of 2,526.76
Pennsylvania,Bureau of Unclamed property(see attached documentation)
TOTAL(Also enter on Line 5, Recapitulation) $ 2,526.76
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EXE (08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bressler, Betty M. 21-14-0048
Decedent's debts must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUN.ERAL,EXPENSES;.-
L
i
S I'
" . .. ..........-..._.... .-...... ....._.._......... ..... ..... _. ..... - .. _ .. ......-. .. ........,.. ,. .. ... ... ,.. .._. .n..._'a#.,:t..,..... .-. .nom. ...n e..
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: <:
Name(s)of Personal Representative(s) _
Street Address
City State ZIP
Year(s)Commission Paid:
"
2. Attorney Fees: Snelbaker "& Brenneman, P.C. 760.00
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: 113.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Cumberland Law Journal,advertising Executrix Notice 75.00
The Sentinel,advertising Executrix Notice 233.02
TOTAL(Also enter on Line 4, Recapitulation) $; 1,181.52
If more space is needed,use additional sheets of paper of the same size:
REV-1513 EX+(01-10)
pennsylvania SCHEDULE ]
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Bressler, Betty M. 21-14-0048
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
I. Susan K.Massie Niece 1345.24 -
1 Fieldstone Drive
Mechanicsburg,PA 17050
100%of residue per Item 3 of Will
1 47
.......
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
Con)[1:1001weald) of Pennsylvania I
Remittance Advice OoO067 57 3
Pennsylvania Treasury Bureau of Unclainted Property Payment
CLAIM # 77671418
---------------------------------- ----------------------------------------------
Property 11) Holder Name Description Amount
12078915 PRUDENTIAL FINANCIAL IN UNDERLYING 2,293 .54
12078916 PRUDENTIAL FINANCIAL IN DIVIDENDS 37.05
3.2078917 PRUDENTIAL FINANCIAL, IN DIVIDENDS 44 .85
12078918 PRUDENTIAL .FINANCIAL IN DIVIDENDS 22.62
12078919 PRUDENTIAL FINANCIAL IN DIVIDENDS 27.30
12078920 PRUDENTIAL FINANCIAL IN DIVIDENDS 44 .85
1,2078921 PRUDENTIAL FINANCIAL IN DIVIDENDS 56.55
Total: 2,526.76
C)
C)
CD
PAYEE INFORMATION: NOTE: Direct payment inquiries
BRESSLER BETTY M ESTATE OF PA Unclaimed Property 1.800.222
1 FIELD STONE DR P.O. Box 1837
MECHANICSBURG PA 17050.-PAUS Harrisburg, Pik 17105-1837
FOLD ON PERFORATION,THEN DETACH CAREFULLY
Compultershare
Comput5ershare Knrestor Services
March 21,2013 250 Royall street
Canton Massachusetts 02021
www.cornputewshare.corn
SUSAN MASSIE
FIELD STONE DR
MECHANICSBURG; PA 17050
company Name: PRUDENTIAL FINANCIAL INC/PRU
Holder. Account Number: 0002933434.0
Registration: Betty M Bressler
Dear Sir I Madam:
Thank;you for your inquiry concerning the above referenced account. We appreciate the opportunity to be of
service to you.
Address at time of escheatment.
LOT 29
6 LINKS TRAILOR CT
MECHANICSBURG PA 17055
Our records indicate-that shares and/or unclaimed checks were transferred to the State of Pennsylvania as
unclaimed property.The fife for escheatment was prepared by Computershare on March 27,2012. Generally,
files prepared for escheatment are transmitted to the state within approximately 60 to 90 days from date of
preparation.You may file a claim for the property by contacting the following:
State Treasurer Robert P. Casey,Jr.
Unclaimed Property Bureau
P.O. Box 1837
Harrisburg, PA 17105-1837
(800)379-3999
Listed below is the property which was escheated and the date(s)of the escheatment.
Please.accept this letter as proof of ownership.
ESUS Book Bal 03/27/12 E:SDBS 1476111089290 39.000000-
12/16/11 Che 13828230 56.55 Esch PA 03/27/12 Dividend
12/17/10 Che 11948037 44.85 Esch PA 03/27/12 Dividend
12/18109 Che 09861434 27.30 Esch PA 03/27/12 Dividend
12/19/08 Che 07505296 22.62 Esch PA 03727/12 Dividend
12/21107 Che 05087888 44.85 Esch PA 03727/12 Dividend
12/21/06 Che 02591682 37.05 Esch PA 03/27/12 Dividend
In a process known as escheatment, state law requires that all unclaimed properly shall be remitted to the state of
last known residence for the above referenced account it any of the following occurs:
•The mailing address on.the account has been classified as "undeliverable" (the result of two or more
mailings being returned to us by the United Stales Postal Service)for a period of time exceeding the
state dormancy period.
•Shares subject to a mandatory'exchange due to corporate reorganization that remain outstanding
for a period of time exceeding the state dormancy period.
The account maintains unclaimed checks that were issued prior to the beginning of the state
dormancy period.
If you have any further questions,please visit our wet)site at www.comptitershare.com. Or you may contact us by
phone,at 781-575-2879. We offer an automated telephone service to.assist you at any ti�Rq,,_qr.you.may.reach a
_.._
reprepQntative Monday through Friday,8:30 AM to 5 PM Eastern Time.
Sincerely,
Computershare Shareholder Services
REF: Or-NIB0001341277
w 4 ::ILL .414D TESTABENT OF BETTY Tei., BRESSLER
I; BETI TY PI. BRESSLER, of the TotiTnship of Hampden,
of Cumberland and State of Pennsylvania, being ,of sound
dis po s_n tz'nd t-emorand. understanding c'!o make, publish
"[T t .
}z-l? and xesta:--nt, hereby revoking and
an— am all prior Wills by me at any time heretofore
le
T direct the payment of all my just debts and funeral
exp-anses as soon after my decease as the same can be conveniently
dna.
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and, mixed, whatsoever and
i& resoeYer the same may be situate, to my sister, DOROTHY M.
SSC BELHJT, absolutely and unconditionally, if she survives me.
r
3-
In the event that my sister, DOROTHY M. SGHEIBULHUT, should
predecease me, then in. such event, 'I give, devise and bequeath
my entire estate, real, personal and mixed, whatsoever and wheres6-
ever the same may be situate, to my niece, SUSAN K. MASSIE,
absolutely and unconditionally.
; nominate, constitute and appoint my sister,
D0 .07 SCIEIBUIJUT, Executrix of this my Last Will and
Testament, and in the event that my- said sister should predecease
.Ma3' or zhoul d she be unable or unwilling- to .serve in such capacity 3
-
s — : � t�vn Ue event, ? nrr nate, constitute and
?L,°_S3 , zxecutri.c of this my Last Will
and �vstanpnt, in her place and stead, - and in either instance, I
dl.ect G�_at -my said personal representatives be excused from postin
bNand or other security for the faithful performance of their duties
i_r, any. jurisdiction*
IN wi—I NESS WHEREOF, I have hereunto set my hand and seal
zs rQ day of October, A. D« , 199 -.
(SEA
Betty M. Bressler
-2-
Ui * ed, sealed, published and declared by the above
. M! M., BRLSSa .,: as. and for her Last Will and Testament,
�S-f '�.ti}•�.S'`jy��sl 7�i�F�6r' •` t s �i.li �'
va, s sc
. r be.d. our names hereto as
.. .. ... .. ..
�1 .v r "i'�ja� 1 1�1�rtetY't.•t � a. ,.
S=—,— test .i - n her presence 8rid
n
the %'r esence of each other.
r 1`
• l
XTA
LEU1w'uS.T'—D )
i, EET: _` TZ. BRESSLITIM , the testat rix
T.- s= u i signed to the attached or foregoing instrument, having
3ualified according to law, do hereby acknowledge that I
dx:fr Wry Y`,`,rtis,
and ,executed the instrument as:my Last 'Will and Testament;
I signed it as my free and volun-
$w i r "ri* L AA�4:Art ah r .t 5 a t „� 'crc' q y! tz,As. to -
� r`r� ` 5 �theace# cc�nta3ned
i r r 5 '+ It rf r,S! tti.-;��,,, 1'I {'$9 t •.J r
E'• ',' �` r- 1. r-�:s s.,_ •a' c a:c'k�sa.ledged before me b
�' ":77 the testate,-- , this
dZ 07- F,t.�-�->tn, , A. D 1994,
_ s
• Rotar�I Sri
COMMONWEALTH OF PENNSYLVANIA ) � Nov.6,1997
SS.
COU-NTY OF CUMBERLAND } mar►ofAic cries
We, the undersigned, J. ROBERT STAUFFER
and =2RIYU T LEVnNHAOEN the witnesses whose names are
signed to the attached or foregoing instrument, being duly .qualified
according to law, depose and say that we were present and saw the
+ BrTTY. if BRESSLER sign and exe-
icgt}d -
testatr.ix , -�
tAe tie IZls.trument As iQ7Glher :Last Will. and Testament; that'. the
..., >,,.,,;:�� > �� � r-t ��� ���' x� • B�SSL�R _ , executed it as
Chex free and voluntary act for the purposes therain expressed;
-hat each of us, in the hearing and sight of the testatrix , signed
the Will as witnesses; and that to the best of our knowledge, the
t.estat-L ix was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence,
Sworn and subscribed to before ,,--
me this /6 r� day of '
October 1994-
r
8mo,(k a C0tMty
Nov 6.t997
P�� aAsmof Pfpir s