HomeMy WebLinkAbout11-26-14 J1505610143
REV-1500 EX(02-11) UP' OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX,280601 INHERITANCE TAX RETURN 21 14 0229
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 03 2014 10 10 1937
Decedent's Last Name Suffix Decedent's First Name Ml
BERTOLETTE EDNA 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
X1. Original Return Prior to 12-13-82)
1-1 2. Supplemental Return 3, Remainder Return(Date of Death
4. Limited Estate 4&Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
El 6. Decedent Died Testate 7. ecedegaiof ntainedTrust)a Living Trust
tach py 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) FAt
a,,,Pover%Credittoato of Death 11.Election to tax under Sec.9113(A)
9. Litigation Proceeds Received El 10,b9iouse 12-31- 1 and -1-95) (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L BANGS 717 730 7310
REGISTER CE W-1j,.LS usE-6-NLY rn
177
cr
First Line of Address
rr rn
429 SOUTH 18TH STREET
Second Line of Address _10
—4
DATE ILE rn
City or Post Office State ZIP Code
CAMP HILL PA 17011
Correspondent's e-mail address: imikebangsigverizon.net
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,anwhich
to the best of m
hay knowledge and belief,
it e,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer s any knowledge,
DATE
(GNAT E OF P RSO. SPON IBLE FOR FILING RETURN Jack I. Bertolette 111/a
A
1600 Hemlock Lane, Dauphin, PA 17018
G TURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
2 Michael L. Bangs
P!T
ADDRESS
429 South 18th Street,Camp Hill, PA 17011
Side I
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Bertolette, Edna M.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 0 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2. 1, 996 . 68
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. 90 ,386 . 91
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous lyon;Probate Property
(Schedule G) �J Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 92 ,383 . 59
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 14 , 375 . 85
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 93 ,292 . 95
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 107 , 668 . 80
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -15 ,285 . 21
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. -15 ,285 . 21
TAX COMPUTATION-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.00 0 . 00 15. 0 . 00
16. Amount of Line 14 taxable 16 0 . 00
at lineal rate X .045
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. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21-14-0229
Decedent's Complete Address:
DECEDENT'S NAME
Bertolette, Edna M.
STREET ADDRESS
1601 Carlisle Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT.
I
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;or............................................................................................................... ❑ ❑
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 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
[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-1502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate-1603 Carlisle Road, Lower Allen Township. Tax Parcel No. 13-23-0547-503. 0.00
Suspended
TOTAL(Also enter on Line 1, Recapitulation) 0.00
(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 A(Rev.01-10)
Rev-1503 EX+(6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 24 shares of Prudential Financial, Inc.stock-24 shares 83.195 1,996.68
TOTAL(Also enter on Line 2, Recapitulation) 1,996.68
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98)
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Bank of America-loss draft disbursement 870.61
2 Miscellaneous personal property-All personal property owned by decedent and spouse 88,710.00
destroyed in fire. The amount listed is what was paid by Nationwide Insurance for content
for contents of house.
3 PNC Bank-Checking account 21.10
4 PNC Bank-refund of overdraft fee(class action litigation) 11.76
5 Prudential Financial, Inc.-dividend 12.72
6 Susquehanna Valley FCU -Personal savings account 26.15
7 Susquehanna Valley FCU-Personal checking account 118.80
8 Susquehanna Valley FCU -Business savings account 65.00
9 Susquehanna Valley FCU-Business checking account 481.17
10 T. Glenn Horst&Sons, Inc. -payment of business invoice 69.60
TOTAL(Also enter on Line 5, Recapitulation) 90,386.91
(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-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DEC ENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Jack I. Bertolette
Street Address 1600 Hemlock Lane
City Dauphin State PA Zio 17018
Year(s)Commission Paid 6,500.00
2. Attornev's Fees Michael L. Bangs 6,500.00
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 138.50
5. Accountant's Fees 1,000.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 237.35
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 14,375.85
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
Bertolette, Edna M. 21-14-0229
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Cumberland Law Journal -estate advertisement 75.00
2 The Patriot News Co.-estate advertisement 162.35
H-B7 237.35
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
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
1 Bayview Loan Servicing, LLC-Current total balance due on house is$143,468.48. The 52,943.48
house is in extreme disrepair. House is currently under contract for settlement on January
9, 2015. Sale price of$97,500.00 with net sale proceeds of$90,525.00. Estate is required to
pay total mortgage for clear title so the amount due by estate in excess of net sale price is
$52,943.48($143,468.48-$90,525.00=$52,943.48). Estate has requested suspension of
valuation of real estate in light of projected closing date.
2 Bonnie K. Miller,Tax Collector-school real estate tax due on 1603 Carlisle Road 2,157.29
3 Capital One Bank-Account#4092 2,847.25
4 Capital One Credit Card-Account#4063 2,112.06
5 Chase Credit Card 2,393.42
6 Credit One Bank 601.80
7 Discover Card 1,932.92
8 Exxon Mobil 971.79
9 Home Depot 12.63
10 Indo-U.S.Sales, Inc.-business account 178.50
11 Internists of Central PA 301.37
12 Juniper Master Card 5,593.92
13 Nationwide Insurance-coverage for 1603 Carlisle Road 83.00
14 Pinnacle Health 104.03
15 Quest Diagnostics 89.66
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 10, Recapitulation) 93,292.95
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
16 Sears Master Card 4,569.47
17 Sheetz Business Edge 403.54
18 Shell Gas Card 883.59
19 Staples Account 1,278.48
20 Sunoco Gas Card 1,983.90
21 Susquehanna Valley FCU-credit card outstanding balance 8,050.77
22 Susquehanna Valley FCU -vehicle loan outstanding balance 3,330.83
23 Verizon-business account 137.34
24 Wright Express 331.91
1
TOTAL(Also enter on Line 10, Recapitulation) 93,292.95
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENTDo Not Lost Truste_e(sj (Words) ($$$)
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Jack I. Bertolette Son one-half of estate
1600 Hemlock Lane
Dauphin, PA 17018
Tammy C.Cobaugh Daughter one-half of estate
52 Sunset Drive
Shelton,CT 06484
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appopriate.
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-1500 Schedule J(Rev.01-10)
385Of{urtrdulcDr. Camp Hill, PA 170II-7009
SUSQUEHANNA 339Eaot Park Dr. Harrisburg, PA 17I1I-2730
~-
Local:
ALLEY
���� ' - -
--- � �� U8U� X
, � =������ � Toll Free: 000-948-1454
FEDERAL CREDIT UNION Fax: 717-737-0589
April 21, 2O14
Michoel8angs
Bangs Law Office
429South 18`"Street
Camp Hill, RA17O1l
Re: Estate ofEdna M. 8erto|ette
Dear Mr. Bangs:
This letter is in reference to the request for information regarding accounts held by Edna M. Bertolette
atSusquehanna Valley FCU. Mrs. Berto|etteheld two accounts atSyF[U: one personal account and
one business account. The specific.information oneach |slisted below. There was nointerest paid nr
accrued oneither ofthe below accounts.
Personal Account-#16459
• This isanindividual account-nojoint owners.
w Savings Account DOD balance: $26.15
• Checking Account DOD balance: $118.80
• Account opened onDecember 12, 2O0g
p Vehicle Loan DOD balance due: $3,330.83
• Visa Credit Card DOD balance due: $8,050.77
Business Account-#16*65
• Business Name: Homespun Curtains
* TIN: 23-2327716
* Date Account was Opened: December 15, ZOOB
• Savings DOD balance: $65'00
• Checking DOD balance: $481.17
• Authorized Signer: Edna K48erto|ette
Please let meknow ifyou need any additional information.
Kind regards,
Kathy Jo McCabe
Member Services Supervisor
�� � � �� �� � T
�/�r ��7 ��r , �� �� �� �_. «_/ . or g
A r. 11. ZU 14 j:UrM m banK NO, i Vic r. i/
PNC
April 22,2014
Michael L Bangs,Esq
Bangs Lava Office LLC
429 S. 18"St
Camp Hill,PA 17011
RE: Name: Edna Bertolette
SSN. 171-28-5126
DOD:03/0312014
Dear Mr.Bares:
In response to your request for Date of Death(DOD)balances for the customer noted above,our
records show the following:
Checking Account
Amunt#5140037748 Established: 11/0111967
EDNA BERTOLETrE
DOD balance: S 21.10 non-interest bearing
please note that this office Irr codes date of death balances for deposit accounts(gals,CDs, Checking and
Savings). We do not pmess any fim meal transactions or provide staatemenft If you need assistance with
any of these items,please call 1-888-PNC-BANK 0-W-762-2265)Or sWp by Your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A.
Member FDIC
This message is intended for the use of the individual or enriry to which it is addressed and may
contain information that is privileged, confidential and exempt from disclosure under applicable law,
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited If you have received this
communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this fazed document.
Page 1 of 1
Customer Correspondence
MAC P6102-o3A
P.O.Box 6995
Portland,OR 97228-6995
Date of Death Balance Request Response Form
Decedent: Edna M.Bertolette Case number: 80309727
Date of death: Monday,March 03,2014 Completed by: Rebecca McGullion
Requested by: Michael L.Bangs Contact number: 540-562-9030
Mail: Bangs Law Office,LLC Date: April 11,2014
429 South 18th Street
Camp Hill,PA 17011
AcxounttiRie Affiliation Account Priiicipalib"nee Interest aid. Accrued Datpofdeatl
type Account dumber as-of daWdf_death Fear to elate of interest br�latice
_.
p.
.lack E.Bertolette Joint Owner Checking xxxxxxxxx6152 $329.52 $0.00 $0.00 $329.52
Edna M.Bertolette Joint Owner
The account was opened on 08/28/1990 and
was converted as a joint account from
Wachovia Bank,N.A.on 04/16/2011.
Country Patchwork Business Checking XXXUxxxx2307 $782.28 $0.00 $0.00 $782.28
Jack E.Bertolette Authorized Signer
Edna M.Bertolette Authorized Signer
The account was opened on o6/15/2009.
Note:Money Market Checking and Money Market Access accounts pay dividends only.
Comments:
No Safe Deposit Box was located for the decedent.
Please find enclosed a complimentary copy of the signature card.
BANGS LALW OFFICE, LLC
429 SOUTH 18TH{S'(Rglr'T PHONE: 717-730-7310
CAMP HILL,PA 17011 FAX: 717-730-7374
E-mail: mikebangs( er onaiet
MICHAEL.L BANGS,Attorney-at-Law WILLIAM E.MILLER,JR.
WENDY K. STRAUB,Paralegal Of Counsel
November 25, 2014
N
rn
t-7
PA Department of Revenue- rn
Bureau of Individual Taxes '
Post Office Box 28601
Harrisburg, PA 17128-0601
RE: Estate of Edna M. Bertolette :> �q
=
File No. 21-14-0229 t Fesr�i
U)
To Whom it May Concern:
Along with the attached Inheritance Tax Return for the above-referenced estate, I am filing:a
companion inheritance Tax.Return for the Estate of Jack E. Bertolette, File No.'21-14-0228. Both of
these individuals died simultaneously in a fire at their residence. There was no determination as to
who died first. Consequently, we dealt with it as a simultaneous death.
After significant negotiations with the insurance carriers, we were paid some insurance proceeds
on the residence in which they resided at the time of their death which was totally destroyed. The
parties also,owned a house next door. That is subject to an Agreement of Sale and I have suspended
the reporting of that house since it is scheduled,for closing on or before January 19, 2015.
In accordance with some directions I received from the Department of Revenue, I have.allocated
some of the debt associated with the house that is to be sold on both returns. The house that is to be
sold is upside down,that is, the house is in such a poor shape that the amount owed on the mortgage is
much greater than the expected proceeds of the sale.
I think if you read both of the returns simultaneously, it will snake more sense and you will see
how we picked up all assets owned and debts owed by the decedevts'.
Should you have any questions, please contact me.
Yery truly yours,
Michael L. Bangs
wks ~
Enclosure