HomeMy WebLinkAbout06-22-05
RICHARD H WIX
THOMAS L WEN~ER
DEAN A. WEIDNE
STEVEN C WILDS
THERESA L SHA E WIX .
DAVID R. GETZ
STEPHEN J DZU$NIN
STEVEN M. WILLI MS
JEFFREY C. CLAR
PETER G. HOWLA D
STEPHEN P SMIT
KATHRYN L. WIX
. Also Member Massachu etts Bar
WIX, WENGER & WEIDNER
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
508 NORTH SECOND STREET
POST OFFICE BOX 845
HARRISBURG, PENNSYLVANIA 17108-0845
4705 DUKE STREET
HARRISBURG, PA 17109-3099
(717) 652-8455
FAX (717) 652-6290
(717) 234-4182
FAX (717) 234-4224
www.wwwpalaw.com
June 20, 2005
Ms. Glenda.Farner Strasbaugh
Register of I ills
Cumberlan County Courthouse
One Courth use Square
Carlisle, PA 17013-3387
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Re: Estate of Gladys B. Sider
Dear Ms. St asbaugh: 0 l - 0 5~ o5l.o 9
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We enclose the original and two copies of the Inheritance Tax Return for filing on
behalf of th non-probated, insolvent estate. Also enclosed is our check in the amount
of $15.00, ade payable to the "Cumberland County Register of Wills," representing
your filing fee.
Plea e process these documents at your earliest convenience and return a time-
stamped co y to our office. A self-addressed, stamped envelope is enclosed for your
convenienc .
you for your assistance in this matter. If you have any questions
above, please call me.
Sincerely,
WIX, W~NGER & WEIDNER
~J 4:Y1/7 /1/
By: U/~
De ise B. Williamson
Paralegal
Idbw
Enclosures
cc: Mr. J hn A. Sider
David R. Getz, Esquire
,
'R.E\r'-1500EX + (6-J)O)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST FI ST, AND MIDDLE INITIAL)
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DATE OF BIRTH (MM-DD-Year)
02/20/2005 10/16/1911
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
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[X] 1. Original Return
o 4.lirnited Estate
[X] 6. Decedent Died Test*e (AttachcopyoIWiII)
o 9. litigation Proceeds ~eceived
o 2. Supplemental Return
o 4a. Future Interest Compromise (date 01 death after 12-12-82)
o 7. Decedent Maintained a living Trust (AttachcopyofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICIAL USE ONL Y
FILE NUMBER
d-L-iL~{1 S k.9._
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
1 68- 3 6 - 7 0 1 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (date of death pnor to 12-13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
E COMPLETED. ALLCORRESPONoeNCEiAHD CONFlOENTtALTAXrIHFORMATIONcSHOOtD BE DIRECTED TO:
COMPLETE MAILING ADDRESS
508 North Second Street
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THlsseClll0l\liMlilSll
NAME
David R. Getz, Es uire
FIRM NAME (If Applicable)
WIX, WENGER & EIDNER
TELEPHONE NUMBER
717 234-4182
Harrisbur
PA 17108-0845
OFFICIAL U~E ONLY
0.00 X _(15) 0.00
0.00 X .045 (16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
P.O. Box 845
(1)
(2)
(3)
(4)
(5)
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1 Real Estate (Schedule A
2. Stocks and Bonds (Sche ule B)
3. Closely Held Corporation!, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8 Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortglage Liabilities, & Liens (Schedule I)
11 Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Lin~ 8 minus line 11)
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13. Charitable and Governmertal Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J) I
14. Net Value Subject to Ta (Line 12 minus Line 13)
(6)
(7)
(9)
(10)
SEE INSTRUCTIO S ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxabl at the spousal tax
rate, or transfers under S c. 9116 (a)(1.2)
16. Amount of Line 14 taxabl at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19 Tax Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
C)
0.00
0.00
0.00
0.00
6,865.62
r' .'}
['..)
--.....,
c.)
(8)
6,865.62
3,015.00
92,663.61
(11)
(12)
(13)
95,678.61
-88,812.99
0.00
(14)
-88,812.99
Decedent's Complete Address:
STREET ADDRESS Messiah Village
CITY I STATE I ZIP
Mechanicsburg I PA 17055
I
Tax Payments and C~edits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + B + C)
(2)
0.00
3.
Interest/Penalty if applicable
O. Interest
E. Penalty l
TotallnterestlPenalty ( D + E) (3)
If Line 2 is greater than Line + Line 3, enter the difference. This is the OVERPAYMENT.
Check box n Page 1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
4
0.00
0.00
5.
0.00
PLEASE ANSW R THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent m ke a transfer and: Yes No
a. retain the us or income of the property transferred; ........................................................................... 0 [R]
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [R]
c. retain a reve~sionary interest; or ...................................................................................................... 0 [R]
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [R]
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 0 [R]
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ................. 0 [R]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a bene~iciary designation? ....................................................................................................... 0 [R]
IF THE ANSWER TO ANY OF l1HE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I hav~ 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 personall representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER N RESPONSIi!lLE FOR FlLlNG RETURN
DATE
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ADDRESS
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 99116 (a) (1.1) (i)].
For dates of death on or after Januar 1, 1995, the tax rate imposed on the net value of transfers to or for the I
The statute does not exempt a trans r to a surviving spouse from tax, and the statutory requirements for disc
the surviving spouse is the only ben ficiary.
For dates of death on or after July 1, 000:
The tax rate imposed on the net valu of transfers from a deceased child twenty-one years of age or younge
or a stepparent of the child is 0% [72 P.S. s9116{a){1.2)].
The tax rate imposed on the net valu of transfers to or for the use of the decedent's lineal beneficiaries is 4
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.~
Individual who has at least one parenl in common with the decedent, whether by blood or adoption.
NApD
.. ._~^"Coi~O%r72P.S.s9116{a){1.1){ii)].
I applicable even if
, an adoptive parent.
:r.~
72 P.S. s9116(a){1)].
3ection 9102, as an
\,EV-1508 ~X" (6-9B)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RIETURN
RESIDENT DECED NT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Sider. Gladys B.
FILE NUMBER
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 "Resident Refund" received from Messiah Village 6,865.62
,
I TOTAL (Also enter on line 5, Recapitulation) $ 6.865.62
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.
(If more space is needed, insert additional sheets of the same size)
f;<EV-1511 ~X + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX R~TURN
RESIDENT DECED NT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Sider. Gladys B.
FILE NUMBER
,
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EKPENSES:
PREPAID
0.00
2.
3.
ADMINISTRfl TIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) John A. Sider
So ial Security Number(s)/EIN Number of Personal Representative(s)
Str~et Address 77 Broadwell Lane
Cilt Mechanisburg State PA
Yefr(s) Commission Paid: 2005
AttorneyFees Wix, Wenger & Weidner (estimated)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Str~et Address
1,500.00
B.
Zip 17055
1,500.00
Cit~
Re/$tionship of Claimant to Decedent
State
Zip
4.
Probate Fees
5
Accountant's Fees
6
Tax Return P~eparer's Fees
7.
cumberltnd County Register of Wills - Tax Return Filing Fee
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15.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3 015.00
>,." "...._~__""""........._'.....""___..._,;,;.<;~.....,.., ;':w..-__..,.......,
~EV-1512 ~X'" (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX R$TURN
RESIDENT DECED NT
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
ESTATE OF
Sider. Gladvs B.
Include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Departmer t of Public Welfare CLASS 3 Claim 22,615.77
2. Departme~t of Public Welfare CLASS 6 Claim 70,047.84
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TOTAL (Also enter on line 10, Recapitulation) $ 92 663.61
..
(If more space IS needed, Insert addlllonal sheets of the same size)
'''.''''''.''*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REllURN
RESIDENT DECEDE T
ESTATE OF
Sidm GI ldvs B. I
SCHEDULE J
BENEFICIARIES
NUMBER
I.
I
i
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRI RUTIONS [include outright spousal distributions, and transfers under
T Sec. 9116 (a)(1.2)]
John A. Sider i
77 Broadwell Lane
Mechanicsbuq, PA 17055
Harriet Sider E icksler
127 Holly Stre ~t
Mechanicsbur~, PA 17055
Richard A. Sid~r
819 South Sw~dley Street
Lakewood, CO 80208
2.
3.
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
Lineal
Lineal
AMOUNT OR SHARE
OF ESTATE
0.00
0.00
0.00
II.
ENTER DOLLAR M~OUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIA TE, ON REV-1500 COVER SHEET
NON-TAXABLE DI$RIBUTIONS:
A SPOUSAL DIST~IBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
1.
B. CHARITABLE AN~ GOVERNMENTAL DISTRIBUTIONS
Bretheren in Ch ist Board for World Missions
Mt. Joy, PA
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TOTAL OF PART I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
0.00
$
0.00
,.
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BRI'NSER 8: WAGNER
ATTORNEYS-AT-LAW
22 NORTH RAILROAD STREET
p.~ ~~f~23
PALMYRA,;:' ~ LVANIA 17078
(717) 838-6348
..
WILL
OF
GLADYS B. SIDER
I, GLADYS B. SIDER, currently of Upper Allen Township,
Cumberland County, Pennsylvania, realizing the uncertainty of
this life, but with confidence in God and trust in His Son, my
Lord and Savior, Jesus Christ, who died for my sins upon the
cross and rose again to redeem me and give me eternal life, do
hereby make, publish and declare this to by my Last Will and
Testament, hereby revoking any and all prior Wills and Codicils
made by me.
I. I direct that all my just debts and funeral expenses be
paid from the assets of my estate as soon as practicable after my
demise.
II. I direct that all estate and inheritance taxes that may
be assessed in consequence of my death, shall be paid out of the
principal of my general estate to the same effect as if said
taxes were expenses of administration and all property
includable in my taxable estate whether or not passing under
this Will shall be free and clear thereof.
III. I bequeath unto my husband, Lewis B.
tangible personal property which I own at my death.
Sider, all
IV. All the rest, residue and remainder of my estate, of
whatever nature and wherever situate, including property over
which I hold a power of appointment, I devise and bequeath unto
my husband, Lewis B. Sider.
V. In the event that my husband, Lewis B. Sider, does not
survive me, I devise and bequeath my entire estate that would
have otherwise passed under Paragraphs III and IV above as
follows:
A. Ten (10%) percent
Board for World Missions,
be used as it sees best;
unto Brethren in Christ
Mount Joy, Pennsylvania, to
B. Ninety (90%) percent to be divided equally
among my children or their issue per stirpes.
VI.
my ~'ill.
I appoint my husband, Lewis B. Sider, Executor of this
In the event the he fails to qualify or ceases to act
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as Execu or, I appoint my son, John A. Sider, Executor of this
my Will.
VII.
the fait
direct that no bond be required by my fiduciary for
performance of his duties in any jurisdiction.
IN
to this
includin
this
ITNESS WHEREOF, I, GLADYS B. SIDER, herewith set my hand
my Last Will, typewritten on two (2) sheets of paper
the attestation clause and signatures of witnesses,
day of'~ ' 1989.
fL' . . ] ,/\ _<',,,tL \..,
GLAD~~A~( ~:Uti:DE~ '
(SEAL)
d by GLADYS B. SIDER, by her declared to be her Will in
ce, who have hereunto subscribed our names as witnesses
sence and at her request, this ~-~ day of
residing at
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COMMONWE LTH OF PENNSYLVANIA
COUNTY 0
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WE, B. SIDER, A""/I2"...J$ \J. S0'~O:>'~'" and {?...r.1.N..... .l,
the testatrix and the witnesses, respectively,
whose na es are signed to the attached or foregoing instrument,
being f'rst duly sworn, do hereby declare to the undersigned
authorit that the testatrix signed and executed the instrument
as her Last Will and that she signed willingly (or willingly
directed another to sign for her), and that she executed it as
her free i and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of
the test trix, signed the Will as witnesses and that to the best
of our k owledge the testatrix was at that time eighteen years of
age or older, of sound mind and under no constraint or undue
influenc
GLADYS
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Subscribed, sworn or affirmed and acknowledged before me by
GLADYS B. SIDER, the testatrix, f\ "''1~..Je i:1 Y"._.Q<"iI... and (L:., .:1(""....1' .,\
,- ''''"'. <ie, , i tnesses, this ,r1"~ day of Yv'-c~ ,1989.
i~" f-..OJ
~ L~~~;ARY ~UBL~J
.~ N';~;-;.sOOl-
Robert L. Fry, Notary Public
Upper Allen Twp., Cumberland County
My Commission Expires Aug. 19, 1991
Member, Panl'ls)~vlJnia i,;;~datlc:l 01 No!~;i:Jtl
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
TPL SECTION - CASUALTY UNIT
PO BOX 8486
HARRISBURG PA 17105-8486
May 24, 2005
STATEMENT OF CLAIM SUMMARY
Estate of SIDER, GLADYS
770161 090
INPATIENT
OUTPATIENT
LONG TERM CARE
DRUG
.00
.00
19,533.49
3,082.28
.00
.00
64,173.56
5,874.28
.00
.00
83,707.05
8,956.56
22,615.77
70,047.84
92,663.61
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLlCWELFARE
EIN - 23-6003113