HomeMy WebLinkAbout07-17-15 REV-1500Ex(02-11) t
1505610143
PA Department of Revenue � OFFICIAL USE ONLY
p pennsylvania County code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 80x.280601 INHERITANCE TAX RETURN 2 1 15 0508
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
04 20 2015 06 05 1922
Decedent's Last Name Suffix Decedent's First Name MI
HOOVER MARIE E
(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
® 1. Original Return ❑ 2. Supplemental Return ❑ 3.Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate ❑ 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required
(dale of death after 12-12-82)
g Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
❑ 9. Litigation Proceeds Received ❑ 1 o.beousal Poverty
ove Cred
ditti DatteS)f Death ❑ 11•Attach ScElection tohedule undertax Sec.9113(A)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
VICKY ANN TRIMMER ESQ 717 724 9821
REGISTER OF WILLS L[�g ONLY
rA
First Line of Address C_
635 N 12TH STREET SUITE
Second Line of Address Z' .
�C C]
CDA,. E FItl.ED Z3 ..-
City or Post Office State ZIP Code W rsl
LEMOYNE PA 17043 —f n
_..3 fU CC!1 O
O _
Correspondent's e-mail address: vtrimmer@dzmmlaw.com
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 tru rrect and plete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN E OF PER N SPONSIBLE FOR FILING RETURN DATE
Ann Pierce 7 AI/11-
ADDRESS
271 Carol Street, New Cumberland, PA 17070
SIGNATU E OF PR PARER R THAN REPRESENTATIVE DATE
Vicky Ann Trimmer Esq
ADDRES
Daley Zucker Meilton 8r Miner, LLC
635 N. 12th Street, Suite 101, Lemoyne, PA 17043
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: HOOVER, MARIE E
RECAPITULATION
1. Real Estate(Schedule A).,,,,... ..............__............. ...... ......__...... 1. 289 , 900 . 00
2. Stocks and Bonds(Schedule B)..........__........................................................__... Z 595 , 451 . 49
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. 387 , 743 . 72
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested.,........ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7. 81 , 138 . 81
8. Total Gross Assets(total Lines 1 through 7)........-............... ................................ 8. 1 , 354 , 234 . 02
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 51 , 409 81
10, Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 2 , 462 81
11. Total Deductions(total Lines 9 and 10)..................................._..................__. 11. 53 872 62
12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 , 300 361 40
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. 1 , 300 , 361 . 40
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 15.
16. Amount of Line 14 taxable
at lineal rate X .045 1 , 098 , 588 . 05 16. 49 , 436 . 46
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 201 , 773 . 35 18. 30 , 266 . 00
19. TAX DUE.................................................................._............................................. 19. 79 , 702 . 46
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 - 15 - 0508
Decedent's Complete Address:
DECEDENT'S NAME
Hoover, Marie E
STREET ADDRESS
45 Gale Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 79,702.46
2. Credits/Payments
A. Prior Payments
B. Discount 3,985.12
Total Credits(A +B) (2) 3,985.12
3. Interest
(3) 0.00
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) 75,717.34
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;.................................................................................. ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income;.................................... ❑ ❑x
c. retain a reversionary interest;or.................................................................................................................. ❑ n
d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receivingadequate consideration?....................................................................................................................... ❑ El
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?...................................................................................................................... n ❑
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 retfurn 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,w ether y bloo or adoption.
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE A
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Hoover, Marie E 21 - 15-0508
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 wilfing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which 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 OF
NUMBER DESCRIPTION DEATH
1 45 Gale Road, Hampden Township, Cumberland County, Camp Hill, Pennsylvania 17011 289,900.00
- Proceeds to be split between Decedent's children
TOTAL(Also enter on Line 1, Recapitulation) 289,900.00
REV-1503 EX+(6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Hoover, Marie E 21 - 15-0508
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
1 Clermont Wealth Strategies Investment Management Account 540,382.98
2 Scottrade Investment Account No. 398171180 55,068.51
TOTAL(Also enter on line 2, Recapitulation) 595,451.49
1 ' pennsylvania SCHEDULE E
DEPARTMENT OFCASH BANK DEPOSITS AND MISC.
INHERITANCE TAXAXRETURN
s
RESIDENT DECEDENT PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Hoover, Marie E 21 - 15 -0508
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 OF
NUMBER DESCRIPTION DEATH
1 Fulton Bank Checking Account No. XXXX5122 23,153.36
2 Fulton Bank Checking Account No. XXXX0464 177,961.76
3 Refund from Myers-Buhrig Funeral Home and Crematory, Ltd. 145.00
4 M&T Bank Account No. 43979327 125,369.59
5 M&T Bank Account No. 13334735 49,048.01
6 2003 Mercury Grand Marquis 4,000.00
7 2003 Lincoln Continental 5,000.00
8 Household Goods and Furnishings 2,289.00
9 Refund from Internal Revenue Service 777.00
TOTAL(Also enter on Line 5, Recapitulation) 387,743.72
REV-1510 EX+(08-09)
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Hoover, Marie E FILE NUMBER
21 - 15-0508
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION
NUMBER Include the name of the transferee,their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE) TAXABLE VALUE
and the date of transfer. Attach a copy of the deed for real estate. INTEREST
1 Scottrade IRA, Account No. 39817181 59,251.15 100% 59,251.15
- Estate is beneficiary
2 M&T Bank IRA, Account No. 35-004201935036 21,887.66 100% 21,887.66
-Ann Pierce (daughter) is beneficiary
TOTAL(Also enter on line 7, Recapitulation) 81,138.81
REV-1511 EX+(10-09)
pennsyllvaniaSCHEDULE H
REVENUEDEPARTMENT OF
FUNERALEXPENSESAND
INHERITANCE TAX RETURN AMINIS IW�00M
J
RESIDENT DECEDENT
ESTATE OF Hoover, Marie E FILE NUMBER21 - 15-0508
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER FUNERAL EXPENSES:
A. 1 Myers-Buhrig Funeral Home and Crematory, Ltd. 22,591.96
2 Stamps for thank you cards 68.60
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees Daley Zucker Meilton & Miner, LLC 6,000.00
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 Register of Wills of Cumberland County, Pennsylvania 385.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
Brian Withington (yard maintenace of real property) 215.00
See attached 22,148.75
TOTAL(Also enter on line 9, Recapitulation) 51,409.81
C Schedule H 9
COMMONWEALTH OF PENNSYLVANIA Funeral &
INHERITANCE TAX RETURN Administrative C isls corlfinued
RESIDENT DECEDENT
ESTATE OF Hoover, Marie E FILE NUMBER
21 - 15-0508
2 Commonwealth of Pennsylvania (registration for 2003 Lincoln Continental) 41.00
3 C.F. Acri and Son, Inc. 88.00
4 Sunrise Landscape Service, Inc. 290.00
5 Fee for estate checks 25.75
6 Hardy's Auction Service 75.00
7 Dutty's Lock, Safe, & Security, Inc. 190.74
8 Lowe's Home Centers(items for real property cleanup) 15.88
9 L.B. Smith (work on Lincoln Continental, including care inspection) 265.38
10 Ben Grimmie (trash) 30.00
11 State Farm (homeowner's insurance) 834.00
12 Estimated closing costs for sale of house (6% commission and 1% realty transfer tax) 20,293.00
Page 2 of Schedule H
pennsylvania SCHEDULE
DEPARTTANCEMENT OF REVENRETURN UE DEBTS OF DECEDENT, MORTGAGE
NHERITAX
RESIDENT DECEDENT LIABILITIES & LIENS
FILE NUMBER
ESTATE OF Hoover, Marie E 21 - 15-0508
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
I Fulton Bank VISA Account No. 4147-7685-6899-95 8.42
2 Return of Medical Alert 2.12
3 Holy Spirit EMS 200.00
4 Persun & Heim, P.C. (preparation of income tax return) 690-00
5 UGI 133.14
6 Comcast 441.30
7 Pennsylvania American Water 75.12
8 PP&L 237.83
9 Michael Langan, Tax Collector 674.88
TOTAL(Also enter on Line 10, Recapitulation) 2,462.81
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF Hoover, Marie E FILE NUMBER
21 - 15-0508
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not ListTrustee(s)
ITAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Robert C. Baker, Jr. Son 1/6 house proceeds
4815 E. Trindle Road, Unit 15 10% estate residue
Mechanicsburg, PA 17050
2 Patricia M. Bankert Daughter 1/6 house proceeds
1651 Dogwood Drive 10% estate residue
Garnet Valley, PA 19060
3 John C. Baker Son 1/6 house proceeds
1075 Orrs Bridge Road 10%estate residue
Mechanicsburg, PA 17055
Enter dollar amounts for distributions shown above on(fines 15 through 18 on Rev 1500 cover sheet,as appropriate.
H. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
REV-1513 EX+(01-10)
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Hoover, Marie E
21 - 15 -0508
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
ITAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
4 Elizabeth A. Leach Daughter 1/6 house proceeds
120 E. Hartsdale Ave., Apt. 7F 10%estate residue
Hartsdale, NY 10530
5 Robert A. Casey Son-in-Law 1/6 house proceeds
26 Nottingham Road 10% estate residue
Camp Hill, PA 17011
6 Ann M. Pierce Daughter 1/6 house proceeds
271 Carol Street 10% estate residue
New Cumberland, PA 17070 100% M&T Bank
IRA
7 Melinda Greene Granddaughter 1.1% estate residue
20276 Gilliam Drive
Park Hall, MD 20667
8 Michael Baker Grandson 1.1% estate residue
3808 Fox Chase Drive
Dover, PA 17315
9 Marianne Platt Granddaughter 1.1% estate residue
346 N. 2nd Street
Wormleysburg, PA 17043
10 Laurie Pezick Granddaughter 1.1% estate residue
2145 Delaview Avenue
Wilmington, DE 19810
11 Margaret Szymanski Granddaughter 1.1% estate residue
1023 Dettling Road
Wilmington, DE 19805
12 Christine Bankert(King) Granddaughter 1.1% estate residue
2306 Taggart Court
Wilmington, DE 19810
13 Robert Bankert Grandson 1.1%estate residue
103 E. Beaver Court
Bear, DE 19701
Page 2 of Schedule J
REV-1513 EX+(01-10)
enns Ivania
•
DEPARTMENT OF REVENUE SCHEDULE J
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Hoover, Marie E 21 - 15 -0508
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
][ TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
14 Michael Bankert Grandson 1.1% estate residue
410 St. Charles Circle
Myrtle Beach, SC 29588
15 Angela Britcher Granddaughter 1.1% estate residue
505 7th Street
New Cumberland, PA 17070
16 Amanda Bennage Granddaughter 1.1% estate residue
c/o John C. Baker
1075 Orrs Bridge Road
Mechanicsburg, PA 17055
17 Mary Elizabeth Mohnach Granddaughter 1.1% estate residue
372 Central Park Ave., Apt. 4M
Scarsdale, NY 10583
18 John Mohnach Grandson 1.1% estate residue
5074 Pajabon Drive, Apt. 308
Harrisburg, PA 17111
19 James R. Casey Grandson 1.1% estate residue
272 Marcy Street
Southbridge, MA 01550
20 Kathlene Linton Granddaughter 1.1% estate residue
2508 Honeysuckle Lane
Lancaster, PA 17603
21 Benjamin Henson Grandson 1.1% estate residue
30985 Cedar Road
Mayfield Heights, OH 44124
22 Michael Henson Grandson 1.1% estate residue
109 E. Main St., Apt. #7
Shiremanstown, PA 17011
23 James A. Baker Grandson 1.1% estate residue
145 E. 74th St., Apt. 6B
New York, NY 10021
Page 3 of Schedule J
REV-1513 EX+(01-10)
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE J
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF Hoover, Marie E I FILE NUMBER
21 - 15 -0508
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
ITAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
24 Kelly Griffin Granddaughter 1.1%estate residue
24791 Nighthawk Road
Hudson, IL 61748
25 David Hoover Nephew 3.3% estate residue
9 Cindy Circle
Enola, PA 17025
26 Joanne Reinhert Niece 3.3% estate residue
243 Virginia Avenue
Haddon Township, NJ 08108
27 Susan McGreevy Niece 3.3% estate residue
15 Citadel Drive
Camp Hill, PA 17011
28 Jennifer Humin (Hoover) Niece 3.3% estate residue
2505 Hunters Run Drive
Plano, TX 75025
29 Andrew Hoover Nephew 3.3%estate residue
301 N. 21 st Street
Camp Hill, PA 17011
30 Christopher Hoover Nephew 3.3% estate residue
P.O. Box 9538
Avon, CO 81620
Page 4 of Schedule J