HomeMy WebLinkAbout03-05-15 J 1505610140
REV-1500 E` `°' '°'
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 1 1 4 2
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY y
0 5. 1 2 2 0 1 2 0 3 1 1 1 9 4 0
Decedent's Last Name Suffix Decedent's First Name MI
We b e r Do n n a L
(If Applicable)Enter Surviving Spouse's Information Below'
Spouse's Last Name Suffix Spouse's First Name MI
Weber Jos - eph C
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1.Original Return 2.Supplemental Return 3. Remainder Return(date of death
prior to 12-13-82) i
El 4.Limited Estate F-1 4a.Future Interest Compromise(date of 5.Federal Estate Tax Return Required
death after 12-12-82)
OX 6.Decedent Died Testate 7.Decedent Maintained a Living Trust B.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 Sch.0) t
{
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: i
Name Daytime Telephone Number `
S
S C o t t W . Mo r r i s o n E s q 7 1 7 5 8 2 2 3 0 0
REGISTER OF WILLS USE ONLY
C -
First line of address O n
X o
6 We s t Ma i n St r e e t 1:1 ='
Second line of address I' M Ln
—1 V
P O . Box 2 32 ! `� -
F ji �l {
City or Post Office State ZIP Code DANE_ - , _
New BI o o m f i e I d PA 17. 068 r%)
r.) U' C3 .
CD
Correspondent's e-mail address: SnlOfl'ISOnlaW Centuryllnk.net
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 and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI N TURE OF ZPITMIBLE FOR FILING RETURN DAT
O
,
DR SS
4.WVen Ayipnue Carlisle PA 17015
SIGNATU OT THAN REPRESENTATIVE A i
ADD
6 W St in Street New Bloomfield PA 17068
PLEASE"USE ORIGINAL FORM ONLY
Side 1 i
1505610140 1505610140 ��
1505610240
a
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: D011lla L. W@bt✓I"
.RECAPITULATION
1. Real Estate(Schedule A) . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Stocks and Bonds(Schedule B) . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Closely,Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .... . 3.
4. Mortgages and Notes Receivable(Schedule D) .. . .. . . . . . . . . . . . . . . .. . . . . . 4.
-- . .5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . .. . . 5, 5 8 0 d 0 . d 0
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .. .. . . 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested .... ... 7.
8. Total Gross Assets(total Lines 1 through 7) .. . . . . .. . :. . . . . . . . . . . . . ... . 8. 5 $ 0 0 .0 • 0 0
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . .. . . . . 9. 4 7 7 3 • 7 8
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) . . . . .. . . . . . . . 10.
11 Total Deductions(total Lines 9 and 10) ... . ...:. ..: 11. 4 7 7 3 ., 7 8
12. Net Value of Estate(Line 8 minus Line`11) ......... ..... ..........:.. 12. 5 3 '2 2 6 . 2 .2
13. Charitable and Governmental.Bequests[Sec 9113 Trusts for which
an election to tax.has not been made(Schedule J) . . . . . . . . . . . . . . . .. . . . . . 13. 0 . 0 0
14. Net Value Subject to Tax(Line 12 minus Line 13) 5 3 2 2 6 . 2 2
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of t_'irie 14 Taxable' -
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.000 0 . 0 0 15. 0o 0 0
16. Amount of Line 14 taxable
at lineal rate X A_ 0 . 0 0 16, 0 0 0
17. Amount of Line 14 taxable Q Q 17 Q
at sibling rate X.12 0 .
18. Amount of Line 14 taxable
at collateral rate X.15 0 • 0 0. 18. 0 • 0 .0
19. TAX DUE . . . . . : . . . . . . . .. ... . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . .. . . 19. 0 , 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ I
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Side 2
1505610240 1505610240
REV-1508 EX+(6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL
PROPERTY
ESTATE OF FILE NUMBER
Donna L. Weber 21 14 1142
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. Share of Donald Failor Trust-see attached letter 58,000.00
TOTAL(Also enter on line 5,Recapitulation) $ 58 000.00
(If more space is needed,insert additional sheets of the same size)
i
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
i
ESTATE OF FILE NUMBER
t.
Donna' L. Weber 21 14 1142
Decedent's debts must be reported on Schedule 1.
t
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: a
1:
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: Scott W. Morrison 750.00
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.) 3,500.00.
Claimant Joseph Charles Weber
street Address 408 Venice Avenue
City Carlisle state PA zip 17015
Relationship of Claimant to Decedent husband
4. Probate Fees: Lisa M. Grayson 237.00
5 Accountant Fees:
6. Tax Return Preparer Fees:
7. Cumberland Law Journal 75.00
8. The Sentinel 211.78 a
• ;t
TOTAL(Also enter on Line 9,Recapitulation) $ 4,773.78
4
If more space is needed,use additional sheets of paper of the same size.
t
)
REV-1512 EX+(12-08)
pennsylvania SCHEDULE i
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, &LIENS
RESIDENT DECEDENT i
ESTATE OF FILE NUMBER
Donna L. Weber 21 14 1142
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 t
i
1.
7
TOTAL(Also enter on Line 10,Recapitulation) $
If more.sp ace is needed,insert additional sheets of the same size.
i
., 9
4
REV-1513 EX+(01-10) 1
i
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donna L. Weber 21 14 1142
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).J
1. Joseph Charles Weber Spousal
408 Venice Avenue 100%
Carlisle, PA 17015
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 TAXIS NOT TAKEN:
• i
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
. 1
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t
I
i
I
i
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, $ 0.00
If more space is needed,use additional sheets of paper of the same size.
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LAST WILL AND TESTAMENT
OF i— Mn V_
(n
DONNA LEE WEBER
S
1, DONNA LEE WEBER, of 408 Venice Avenue, Carlisle,Cumberland County,
Pennsylvania,being of sound and disposing mind,memory and understanding do hereby F
4
make publish and declare this my Last Will and Testament,hereby expressly revoking all
other writings in nature testamentary by me at any time heretofore made.
FIRST: I direct that all my debts and funeral expenses be paid as soon after my
decease as may be practicable.
- R
SECOND: I direct that inheritance tax on property disposed of herein shall be paid
from my residuary estate.
,.--.,-.THIRD-. I give;bequeath":and devise all the rest.and residue of rny"estate and property,
real,personal and mixed, of whatsoever nature and wheresoever situated of which I may
own at the time of my death, or to which I may be entitled or of which I may have the
right to dispose at the time of my death,to my husband,Joseph Charles Weber,if he is
living at the time of my death.
a
(SEAL)
DONNA LEE WEBER
Page one of three
FOURTH: In the event that my husband is not living at the time of my death, or in
the event that he and I shall die simultaneously, then I give,-bequeath and devise all my
property to my four children, Christina K. Minich, Joseph C. Weber,Jr.,Mark A. Weber
and Angela K. Weber, each person to share equally.
FIFTH: I hereby appoint my husband, Joseph Charles Weber, as Executor of this,my
Last Will and Testament, but in the event that he is unable or unwilling to serve,I then
appoint my two daughters, Christina K. Minich and Angela K. Weber,as Co-Executrices
E
of this,my Last Will and Testament. I direct that they shall not be required to give bond
or other security in any jurisdiction wherein proceedings may be held in connection with
i
my estate.
IN WITNESS WHEREOF,I have hereunto set my hand and seal this 20th day of t
April, 2012.
WITNESS: .
(SEAL)
DONNA LEE WEBER
r:
n
I
a
i
Page two of three
ACKNOWLEDGMENT
Commonwealth of Pennsylvania
County of Perry
I, Donna Lee Weber,the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and.executed the instrument as my Last Will; and that I signed
it willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Donna Lee Weber,the
i
Testatrix, this 201h day of April, 2012.
-A-t-
DOW L E WEBER
P lic
AFFIDAVIT
NOTARIAL SEAL
SCOTT W.MORRISON,NOTARY PUBLIC
Commonwealth of Pennsylvania BLOOMFIELD BORO,PERRY COUNTY
MY COMMISSION EXPIRES MAY 3,2012
County of Perry
We, Sheila M. Brugger and Tamatha R. Kauffman,the witnesses whose names
are signed to"the attached or foregoing instrument,being duly qualified according to law,
f
do depose and say that we were present and saw the Testatrix sign and execute the
instrument as her Last Will;that the Testatrix signed willingly and executed it as her free
and voluntary act for the purposes therein expressed;that each subscribing witness in the e
hearing and sight of the Testatrix signed the Will as a witness;and that to the.best of our
knowledge the Testatrix was at that time 18 or more years of age, of sound mind and
under no constraint or undue influence.
s
Sworn to or affirmed and subscribed to before'me by Sheila M. Brugger and
Tamatha R. Kauffman, witnesses,this 20th day of April,2012,
Witness
WitnVV
C�Ojey P lic
CTARIAL SEAL
Page three of three SCOTT�N.Mc?.Rlso�,,No raRY PUBLIC
PERRY CUUi'iV
BLUU1 FIELD BORO
eav enc,ntnISSION EXPIRES„j„V 3 2012
McNees
Wallace & Nurick LLC
Timothy M.Finnerty
100 Pine Street• PO Box 1166• Harrisburg,PA 17108-1166 Direct Dial:717.237.5394
Tel: 717.232.8000 • Fax: 717.237.5300 Direct Fax:717.260.1691
tnnerty@mwn.com
Mr. Joseph Weber
408 Venice Avenue October 27, 2014
Carlisle, PA 17015
RE: Donald Failor Trust-Trust Administration
Dear Mr. Weber:
Our firm is counsel to Wendy Lou McNiff and Sharon Ann Rich, Trustees of the Donald Failor
Trust.
The Donald Failor Trust (the "Trust) was created under the Will of Donald E. Failor, who died on
October 31, 2005. The Trust was for the lifetime benefit of Ruth E. Failor, who died on
January 12, 2014. With Ruth's death, and per the terms of the Trust, the trust assets are
distributable to.Mr. Failor's six (6) children, which included your wife, Donna Weber. Since
Donna passed away before Ruth, the Estate of Donna Weber is now entitled to Donna's one-
sixth (1/6) share of the Trust.
The Trust is now in a position to distribute its assets to the trust beneficiaries; however, before
any distributions can be made to the Estate of Donna Weber (the "Estate"), we need a Short
Certificate showing the appointment of a personal representative for the Estate. According to the
-Cumberland_County_:Register:of:Yl Is,no.formal.estate proceed in g..has been opened at this time,
therefore a formal proceeding will need to be opened. Once a personal representative is
appointed, and we receive a Short Certificate, the trustees can proceed to make distributions to
the Estate.
For your information, based on our current information, the Estate's share of the Trust is
approximately $58,000.
If you have any questions, or require any assistance in obtaining a Short Certificate, please call
me at (717) 237-5394, or my paralegal, Linda M. Eshelman, at (717) 237-5210.
Sincerely,
McNEES WALLACE & NURICK LLC
By
Timothy M: Finnerty
TM F/kac
cc: Wendy Lou McNiff, Co-Trustee
Sharon Ann Rich, Co-Trustee
www.mwn.com
HARRISBURG, PA • LANCASTER, PA • SCRANTON, PA • STATE COLLEGE,PA • COLUMBUS, OH • WASHINGTON,DC
pennsylvanja
DEPARTMENT.OF:PUBLbC WELFARE
December 15, 2014
SCOTT W MORRISON ESQUIRE
6 W MAIN ST
PO BOX 232
NEW BLOOMFIELD PA 17068
Re: Donna Weber
SSN: ###-##-
Dear Attorney Morrison:
Pursuant to your letter dated December 10, 2014, the Department's, Estate Recovery
Program, has reviewed the information you provided regarding the above-referenced estate.
It has been determined that the above individual did receive medical assistance.
However, the medical assistance received is not recoverable in accordance with Act 49, 62
P.S. § 1412.
Therefore, according to the information provided, the Department's Estate Recovery
Program will not seek any recovery from this estate.
cbboeYation•in-thjs -
contact me.
Sincerely,
CL
Y
Vince A. Porter
Recovery Section Manager
(717)772-6604
Bureau of Program Integrity Division of Third Party Liability Recovery Section
PO Box 8486 1 Harrisburg,Pennsylvania 17105-8486 s
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