HomeMy WebLinkAbout08-26-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF AEVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005730
DUPLlCA TE
ANTHONY DELUCA ESQ
11 3 FRONT ST
POBOX 358
BOILING SPRINGS, PA 17007
__u__u fold
ESTATE INFORMATION: SSN: 175-03-4543
FILE NUMBER: 2105-0549
DECEDENT NAME: STEWART WINIFRED T
DATE OF PAYMENT: 08/26/2005
POSTMARK DATE: 08/26/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 11/12/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $246.90
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TOTAL AMOUNT PAID:
REMARKS: ANTHONY DELUCA
CHECK# 147635
SEAL
INITIALS: RSK
RECEIVED BY:
TAXPAYER
$246.90
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
RE1I;1500 EX (6-00) ,
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
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DECEDENTS NAME (lAST, FIRST, AND MIDDLE INITIAL)
stewart Winifred T.
DATE OF OEATH (MM-DO-YEAR) DATE OF 81RTH (MM-DO-YEAR)
November 12, 2003 October 11 1909
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, ANDMIDOLE INITiAl)
SOCIAL SECURITY NUM8ER
175 - 03 - 4543
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAl SECURITY NUMBER
1KI1. Original Retum
o 4, Limited Estate
~ 6, Decedent Died Testate \Allach ropy ofWiI~
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest COmpromise (date of death after 12-12-82)'
07. Decedent Maintained a LivingTrust/A1tachoopyofTRlsQ
010. Spousal Poverty Credit\,<l8t$oldealhbetMlen1~1-91 and 1-1-95)
o 3. Remainder'Return (da\eoflle6tt\pl\or\o.11A3-a2)
o 5. Federal Estate Tax Return Required
J!. 8. Jotal Number of Safe Deposit Boxes
o 11. Eleclion to tax under 50<:. 9113(A){^"", "" 0)
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NAME
Anthon L. DeLuc
FIRM NAME (If Appkabl.)
COMPLETE MAILING ADDRESS
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113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
OFFICIAL USE ONLY
TELEPHONE NUMBER
717 258-6844
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1. Real Estate (Schedule A)
2. SlDcI<s and Bonds (Schedule B)
3. Closely Held COIpOI'ation, Partnership 01' Sole-Proprietorship
4. Mortgages & Noles R<l<Oivable (Schedule OJ
5. Cash, Bank Deposits & MisceUaneous Personal Property
(Schedute E)
6. JoinUy OWned Property <Schedule F)
o Separate BilUng Requested
7. Inter.Vivos Transfers & MIscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gran Assets (Iotal Unes 1-7)
9. Funeral Expenses & Admlnistnilive Costs (Schedule H)
10. Debts 01 Decedent, Mortgage lIabiliUes, & liens (Schedule I)
11. Total Deductions (Iotalllnas 9 & 10)
12. Nel Value of Estate (line 6 minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an electJon to tax has nol been
made (Schedule J)
(11) 10,204.16
(12) 2,462.84
(13) -0-
(14) 2,462.84
(1)
(2)
(3)
(4)
(5)
-0-
-0-
-0-
-0-
12.667.00
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(6)
-0-
(7)
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(8)
12,667.00
(9)
(10)
360.00
9.844.16
14. Net Valu. Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under 50<:.9116 (a)(1.2)
x..O_ (15)
x .0 45 (16) 52.52
x .12 (17)
x .15 (18) 194.38
(19) 246.90
16. Amoontof line 14 taxable at lineal.rate
$1.167.00
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable al colleteral rate
$1.295.84
19. Tax Du.
CHECK HERE IF YOU ARE REQUESTING A REFUND DF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS 801 North Hanover Street .
CITY Carlisle, I STATE PA I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
$246.90
.-0-
-0-
-0-
fotai Credits (A+ B + C) (2)
-0-
3. interesUPenalty Wapplicable
D. Interest
E. Penalty
TotallnteresUPenaltY ( D + E ) (3)
4. If Line 2 Is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT,
Check box on Page 1 line 20 to request a refund (4)
-0-,-
-0-
-0-
5. If Line 1 + Line 3 is greater than Line.2, enter the difference. This is the TAX DUE. (5)
246.90
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
. (5.0.)
(5B)
-0-
246.90
A. Enter the interest on the tax due.
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: Ves No
a. retain the use or income of the property transferred;.......................................................................................... 0 IX]
b.retain the nght to designate who shall use the property transferred or os income; ............................................ 0 IX]
c. retain a reversionary interest; or........................................................................................................................... 0 IX]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 IKI
2. If death occurred after December 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 acoount or secunty at his or her death? .............. 0
4. Old decedent own an Individual RetirementAccount, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................,..........,..................................;......................... D
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IX]
IX]
IF THE ANSWER TO ANY OF THE 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 have examinedlhis 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 !he personal representative is based on an information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FiLING RETURN
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ADD ESS, ,
R~Sn,J~,(~$, ~J()~
SIGNATURE OF PRE PARER OTHER THAN EP SE TATlVE
Df'TE
S?' f 1/ c?.s-
ADDRESS
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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 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% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are stili appiicable 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 ~eceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of tho child is 0% [72 P.S. ~9116(a)(1.2)J.
The tax rale imposed on the net value of transfers to orforthe uso of the decedenfs lineal beneficianes is 4.5%, except as noted in n P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)J.
The tax rate imposed on the net vaiue of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)J. A sibling is denned, under Section 9102, as an
individual who has at least one parent in common with tho dece.den~ whether by blood or adoption.
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Pleose Print or T e
FilE NUMBER
COMMONWEA..LTH Of PENNSYLVANIA..
INHERlTANCI TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Winifred T. stewart
(All property jointly-owned with the Right of Survivonhip must b. disclosed on Schedule F)
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
Undivided one half interest in cabin situated
in Greene Township, Franklin County, PA
See attached appFaisal
$11,500.00
2.
Checking account, #33-10647, at F&M Trust,
Carlisle, PA.
1,167.00
TOTAL (Also enter on line 5, Recapitulation) $
12 667.0"
(Attach additional 8Y1" X 11" sheets if more space is needed.)
IE~15l1 EX. 17.'"
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~O!M\ONWe.A.l.f~ OF peNN$YWANIA
INHE~ITAN~E rAX .~URN
.E$I~!NT ~'e!~'NT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES,
AOMINISTRATlVl! COSTS AND
MISCELLANEOUS IlXPENSES
ITEM
NUMBER
P1.a.. Print or Typ.
FILE NUMBER
Winifred T. Stewart
DESCRIPTION
A. Fun.ral. Exp.n....
1.
1.
B. Admlnlstrativ. CO.t"
2.
3.
4.
C.
1.
2
"
3.
4.
5.
6.
7.
8.
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney fees Anthony L. DeLuca, Esquire
Family Exemption
Claimant
Address of Claimant at decedent's death
Street Address
City
Relationship
State
Zip Code
Probate fees
Miscellaneous Expens.s:
Filing Fee - Small Estate Petition
Filing Fee for Inheritance Tax Return and Inventory
TOTAL (Also enter on line 9, Recapitulation)
(If mar. .pac. I. n..d.d, In..rt additional .h.et. of .ame .Ize.)
AMOUNT
300.00
30.00
30.00
$ 360.00
EV.1512 EX.... (9-11)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT .l>ECEDENT
ESTATE OF
SCHEDULE "I"
DEBTS OF DECEDENT.
MORTGAGES. AND LIENS
FILE NUMBER
Winifred T. stewart
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Claim of Department of Public Welfare for restitution
of medical assistance. Copy of DPW statement
attached.
$8,305.08
2.
Repair expenses on undivided one half interest in
cabin. Work done prior to death.
1,364.08
3.
Appraisal of leasehold interest
Ausherman Bros. Real Estate Svc.
229 N. 2nd street
Chambersburg, PA 17201
175.00
.;;..
TOTAL (Also enter on line 10, Recapitulation)
$ 9,El44 1"
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1fIast 2Jill aub 'Q}~gtam~nt
I, Winifred T. Stewart, a resident of the Borough of Chambersburg,
Franklin County, Pennsylvania, being of sound mind, memory and
understanding, do make, publish and declare this to be my Last Will and
Testament, hereby revoking and making null and void all former Wills by me at
any time heretofore made.
ITEM 1: I direct that all my just debts and funeral expenses shall be paid
from the assets of my estate as soon as practicable after my decease.
ITEM 2: I give and devise my undivided on~half interest in a leasehold
interest for property lying and being situate in Greene Township, Franklin
County, Pennsylvania, being a cabin erected on Parcel C27K-11 in the
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{ Greenwood Hills Bible Conference as more fully set forth in Franklin County
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Deed Book Volume 1368, Page 0622 to my niece, Barbara K. Hocking.
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ITEM 3: I give, devise and bequeath 75% of all the rest, residue and
remainder of my estate, real and personal, whatsoever and wheresoever situate,
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to my sister, Nellie T. Hocking and 25% to my nephew, Paul R. Pettry, provided,
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however, th8tshol,!lpmy~~,.~J.~~'
devise and bequeath her 75% share to my niece, Barbara K. Hocking, and
should my nephew, Paul R. Pettry, predecease me, f give, devise and bequeath
his 25% share to his wife, Doris Pettry.
ITEM 4: I direct that all taxes that may be assessed in
consequence of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid from the principal of my residuary estate as a part of the
Page 1 of a Two Page Will
.,".
expense of the administration of my estate.
ITEM 5: And I do hereby constitute and appoint my sister, Nellie T.
Hocking, Executrix of this, my Last Will and Testament. Should my sister, Nellie
T. Hocking, predecease me or cease to act as Executrix, I constitute and
appoint my nephew, Paul R. Pettry, Executor of this, my Last Will and
Testament. I hereby authorize and empower my sister, Nellie T. Hocking,
as Executrix aforesaid, and my nephew, Paul R. Pettry, as Executor aforesaid, to
sell at eithefpUblic or pri'late~~I~._~!~~~~the
time of my death and to make, execute, acknowledge and deliver a deed or
deeds to the purchaser or purchasers thereof, the same as I could do if living.
direct that my sister, Nellie T. Hocking, as Executrix aforesaid, and my nephew,
Paul R. Pettry, as Executor aforesaid, shall not be required to post bond for the
faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
d ~\..c\ day of re..\::'n..o.ju. , 1999.
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i., L1v~G,"-..c:t_-r:,b$::-;~. t, (SEAL)
Winifred T. Stewart
Signed, seales;!, pub~. '
",. ..oc.":.,........,".
as
and for her Last Will and Testament in our presence, who, in her presence, at
::;.
her request and in the presence of each other have hereunto set our hands as
attestiD9.l1!Sitnesses.
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Address
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Ad ress
Page 2 of a Two Page Will
jnifred StewarVNellie Hockin
Addres 9 Ball ark Lane
C' Fa etteville
lender A raisal for Market Value
Ale 0
C II Franklin
State Pa
Zi Code 17222-9608
APPRAISAL AND REPORT IDENTIFICATION
this appraisal confonns to.ant of the following definitions:
o Complete Appraisal (The act or process of estimating value, or an opinion of value, performed wnhout invoking the Departure Rule.)
(8J limited Appraisal (The act or process of estimating value, or an opinion of value, performed under and resulting from invoking the
Departure Rule.)
this report Is mti of the following types:
o Se" Contained (A written report prepared under Standards Rule 2-2(a) of a Complete or Limited Appraisal performed under STANDARD 1.)
o Summary (A written report prepared under Standards Rule 2-2(b) of a Complete or Limned Appraisal performed under STANDARD 1.)
[8J Restricted (A written report prepared under Standards Rule 2-2(c) of a Complete or Limned Appraisal performed under STANDARD 1,
restricted to the stated intended use by the specified cllent or intended user.)
Comments on Standards Rule 2-3
I certily that, to the best of my knowledge and belief:
[The statements of lactcontained in this report are true andcorrecl.
OTlle reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions, and are my personal, impartial, and unbiaseQ
professional analyses, opinions and conclusions.
DI have no (or the specllied) present or prospective interest in the property that is the subject 01 this report, and no (orthespecilied) pe rsonalinterestwithrespecttothe
parties involved.
[I have no bias wilh respect to the property that is the sUbjeclofthls report or the parties involvedwilhlhisassignmenl.
[My engagement in this assignment was not contingent upon developing or reporting predetermined resutts.
DMy compensation for completing this assignment is not contingent UlKln the development or reporting of a predetermined value or direction in value thai favors the cause
01 the client, the amounl of the value opinlon, the attainment of a stlpulated result, orlheoccurrenceofa subsequent event directly related to the intend ed use of this appraisal.
[My analyses, opinions and conclusions were develofled and this report has been flrepared, in conformity wfth the Uniform Standards of Professional Appraisal Practice.
Dlhave (or have not} made a personal inspection of the property lhat is lh e subjectollhis report.
DNo one prOvided signilicant real property appraisal assistance to the per son Signing this certification. (If there are exceptions, lhe name of e achinelividualprovidingsignilicant
real property appraisal assistance must be stated.)
Comments on Appraisal and Report Identification
Note any departures from Standards Rules 1-3 and 1-4, plus any USPAP-related issues requiling disciosure:
APP~
Signaturv~
Name: :JOhn D. Ausherman SRA
Date Signed: Januarv 16 2004
Slate Certification #: GA-000148L
or State License #:
Slate: Pa
Expiration Date of Certification or License: 6130/2005
SUPERVISORY APPRAISER (only if required):
Signature:
Name:
Date Signed:
State Certification #:
orStatelicense#:
State:
Expiration Date of Certilication or license:
D Oiel 0 Did Not Inspect Property
Ausherman Bros. Real Eslate Inc.
Form IDS - "TOTAL lor Windows" appraisal software by a la mode, inc. -1-800-ALAMOOE
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SUMMARY OF SALIENT FEATURES
SubjeclAddress 9 Ballpark Lane
Legal Description Franklin County Deed Book 1368 page 622
City Fayetteville
~ County Franklin
Slale Pa
Zip Code 17222-9608
Census Tracl 0105.00
Map Reference C-27K-11
Sale Price $ N/A
Dateo/Sale N/A
Borrower/Client Winifred StewarVNellie Hocking
lender Appraisal for Markel Value
Size (Square Feet) 600
Price per Square Foot I
location ~vg
Ag. 70+-
Condition Average
Total Rooms 5
Bedrooms 2
Baths
Appraiser John D. Ausherman SRA
Date of Appraised Value January 16, 2004
Final Estimate Q/Value
I 23.000
Form SSD - "TOTAL for Willdows' appraisal software by a la mode, inc. - 1-BOO-AlAMODE
02/23/2004 11:23
71 72406118
GUMB CO AGING CM SVC
PAGE Ell
.
COMMONWEAl.tH OF ~ENNSYLVANI4.
CEPNtTMiNT OF PUBLIC WELFAJUi
BuREAU OF f!INANCIAL OPliHATIONS
1)1v\sION OF THIRD PARTY L1,a,eILITY
eSTAT;: REC:OVERY PROGAAM
PO BOX a4t1ll
HNVUSBU"G. PA 171Q5-84&S
February 9, 200~
BAABARA HOCKING
417 N HANOVER S~
CAALISL~ PA 17013
Re, WINIFRED S~EWAR'1'
CIS #: 330163879
SSN: 175-03-4543
Pat.c ':\t <;lea":!> ,- -1-<l/4-1;..Q-(I3
Dear MS hocking,
Please be advised that the Department of PUblic Welfare is attempting to
recover the monetary value of any and all eligible assets in the subject
estate. Although t.h.. aJll.OUDt in t.he ell tate may be consid.."al>ly less than that.
which is owed to the Department, our clai~ is against the est.ate, no One
else. Your responsibilities, as the primary ne~t of
kin/administrator/executor, is to advise t.he Department of any assets in the
estate and to insure that the remaining money, after all funeral and
administrative costs are deducted, is sent to the Department.
The Department of pUblic Welfare maintains a claim in the amount of
$8,305.08 against the above-mentioned estate. This claim is for restitution
of medical assistance granted on ~ehalf of the decedent for which the Probate
Estate is now responsible to reimburse the Department according to Act 4~, 62
P.S. 1412, effective August 15, 1994, as amsnded by Act 20-$5, effective June
30, 1995. Enclosed is the Depa~tment's itemized statement of claim.
A portion of this medical expense, namely $8,305.Q8, was incurred during
the last six months Qf the decedent's life; therefore, it is a Class 3 claim
pursuant to section 3392 of the Decedents, Estates, and Fiduciaries Code, 20
Pa. C.S.A. 3392(3) _ The balance of the claim, namely $.00, is to be entered
as a priority Class G cJ.aim aga.inst the estate. -
please acknowledge receipt of this letter and advise when payment may be
expected. If the estate aCCOuDtin~ ia complete, please provide a copy. Xt
the estate contains real eetate, please provide copies of the deed, the
lat.est t.ax assessment and a current appraisal, if available.
Enclosure
Sincerely,
~T\,u4
Brian M. Holler
Claims Investigation Agent
717-772-6607
717-705-6150 ~AX
0/2005 07:50
71 72405118
eUMB co AGING eM sve
PAGE 01
Frazer Construction
2053 Guilford Station Road
Chambersburg, P A 17201
Invoice
Date
Invoice #
31912004 529
BIITo
I N.~. Nctli IC- Itoc:~
: '?d.5 N. ~cN~rO$t-
CdJ-hk, PA nO 13
P.O. No. Term& Project
Item QIy Descriplion Rate Amount
I New :a.throom, -lUles, dmin lines. _ heater. 6,536.00 6,536.00T
~wiDdows 8Dd -.s, _Ooor in KiTchen
and Porch. Repair KiIdlm. Caucel, te1droDo jacks,
railios, wiIItcri7ie - opell cotlsf!e S ya., etc:.
2 RA>cdvcd2 pll)IIl1Ol1ts (1200.00 & 3,000.(0) = $4,200.00 ... 4,200.00 4,200.00
PA s.tes Tax 6.000A, 392.16
~
" Total ' ,
S2, 728.16