HomeMy WebLinkAbout08-31-05
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT.280601
HARRISBURG, PA 17' 28-0601
REV-1 162 EX(1 1-96l
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND EST ATE TAX
OFFICIAL RECEIPT
FREY ROBERT G
5 S HANOVER STREET
CARLISLE, PA 17013
nnn__ fold
ESTATE INFORMATION: SSN: 198-01-3971
FILE NUMBER: 2105-0149
DECEDENT NAME: GUISE HELEN I
DATE OF PAYMENT: 08/31/2005
POSTMARK DATE: 08/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/2005
NO. CD 005745
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,078.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$2,078.00
REMARKS:
HELEN GUISE
CHECK# 2537
INITIALS: RSK
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
FREY ROBERT G
5 S HANOVER STREET
CARLISLE, PA 17013
n~n~__ fokl
ESTATE INFORMATION: SSN: 198-01-3971
FILE NUMBER: 2105-0149
DECEDENT NAME: GUISE HELEN I
DATE OF PAYMENT: 08/31/2005
POSTMARK DATE: 08/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/2005
NO. CD 005746
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $338.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$338.00
REMARKS:
FREY & TILEY
CHECK#6131
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WillS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
217
RE\~1500 EX (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-05-0149
COUNTY CODE
YOAR
NUMBER
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DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
Guise, Helen I.
DATE OF DEATH (MM-DD-YEAR)
SOCIAL SECURITY NUMBER
198-01-3971
DATE OF BIRTH (MM-DD-YEAR)
THIS RETURN MUST BE. FILED 1M O\JI"LlCA TE 'MTH ,HE
2/5/2005 3/3/1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl)
REGISTER OF WILLS
SOCIAl SECURITY NUMBER
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2
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Federal Estate Tax Return Required
03
05
Original Retum
02
04a
07
....3- e To\aI Number 01 Safe Deposit Boxes
011. Ejection 10 tax under Sec. 9113(A} (Attach Sch 0)
..~1lOlt~l!eUI>D'BED\R.ECTED TO:
COMPLETE MAILING ADDRESS
5 South Hanover Street
Carlisle, PA 17013
Supplemental Return
Rem3indllfRetlNT1 (datepfdealh priorlO 12_13_82)
UmiledEstatEl
Future Interest Compromise (dale of death after 12.12-82)
Decedent Died Testate (Attach copy of Will)
Decedent Maintained a Living Trust (Attach copy of Trust)
010. SjIOUSalPvvertyCrealt{aateofdeattlbetwCun 12-31-91 and 1-1.95)
liligation Proceeds Received
Rober! G, Fre
FIRM NAME (If Applicable)
Fre & Tile
TELEPHONE NUMBER
717-243-5838
OFFICIAL USE ONLY
1, Real Estate (Schedule A)
(1)
(2)
(3) NONE
(4) NONE
81,000
32,314
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,,'-10
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2. Stocks and Bonds (Schedule B)
c.,
3. Closely Held Corporation, Partnership or Sole-Proprietorship
-,...
73,001
'7
,--1'1
.(]
;:f)
'-')
4. Mortgages & Notes Receivable (Schedule D)
5. Cash. Bank Deposits & Miscenaneous Personal Property
(Schedule E)
(5)
(6)
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6. Jointly Owned Property (Schedule F)
OSeparate Billing Requested
_.:(
7. Inter.Vivos Transfer & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
103,867
o
8. TOTAL GROSS ASSETS (total Lines 1~7)
(8)
290,182
9. Funeral Expenses & Administrative Costs {Schedule H)
(9)
26,503
10 Debts of Decedent, Mortgage liabilities, & liens (Schedule I) ~10) NONE
11. TOTAL DEDUCTIONS (total lines 9 & 10)
(11)
(12)
26,503
263,679
12. NET VALUE OF ESTATE (line B minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J)
(13)
(14)
263,679
14. Net Value Subject to Tax (Line 12 minus Une 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate ,or transfers under Sec.9116 (a)(1.2) 263,679 X .045 (15)
z
0
;:: 16. Amount of Line 14 taxable at lineal rate X .0 (16)
~
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11.
:Jl 17. Amount of Une 14 taxable at sibling rate X ,12 (17)
0
0
X X .15 (18)
~ 18. Amount of line 14 taxable at collateral rate
19. Tax D....e (19)
200
11,866
11,866
~
217
Decedent's Com lete Address:
STREET ADDRESS
Guise, Helen I.
o
CITY
STATE
PA
ZIP
S
Tax Payments and Credits:
1. Tax Due (page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
9,000
450
Total Credits (A + B + C) (2)
'3. Il'ItereslfPeoalty if applicable
D.lnterest
E Penalty
4
TotallnterestlPenalty (0 + E 1
If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(3)
5.
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
198-01-3971
17065
11,-g::;c:1
9,450
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
9,.[.1 G
2.4111
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
2.
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right \0 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?
If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiVing adequate consideration?
Did decedent own an "in trust for" or payable upon death bank. account or security at his or her death?
Yes
o
o
o
o
o
o
3.
4.
Did decedent own an Individual Retirement Account, annuity or other oon-probate property which
contains a beneficiary designation?
No
o
o
o
o
o
o
o
o
IF THE ANSWER TO ANY OF lliE fdlOVE QUESTiONS is YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
7
For dales of death on or after July 1, 1994 ~md before January 1, 1995, the tax rate imposed on the net value of transfers 10 or for the use of the survilling spouse is 3%
[72 P.S. Section 9116 (a){1.1)(i)J.
for Oates of death on or after January 1, 1995. the lax rate imposed on the net value of transfers 10 or for the use of the surviving spouse is 0% (72 P.S. Section 9116 (a)(1.1)(ii)].
The statute does nol exempt a transfer to a surviving spouse from lax. and Ihe slalulory requirements for disclosure of assets and filing a lax relum are still applicable even If
the surviving spouse is the only beneficiary.
For dales of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or your'lger at death 10 or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0%[72 P.S. Section 9116(a)(1.2)J.
The lax rate imposed on the nel value of ltansfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 9116(a}(1)].
The lax rate imposed on the net value of transfers to or for the use of the deceder'lrs siblings is 12% [72 P.S. Section 9116(a)(1.3)) .A sibling is defined, under Section 9102, as an
individual who has alleast one parent in common with the decedent, whether by blood or adoption.
AT
REV-1502 EX+ (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
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 WHICH IS JOINTLY-OWNED WITH RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F
ITEM
NUMBER
1.
DESCRIPTION
House and lot of ground, 307 North Baltimore Avenue, Mi. Holly Springs, PA
VALUE AT DATE
OF DEATH
81,000
TOTAL (Also enter on line 1 Recaoitulation $
(If more space is needed, insert additional sheets of the same size)
81000
217
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
594 shares of PNC Financial, Average 2/4/05 = $53.82; Average 2/7/05-$54.98
Overall average for date of death = $54.40 per share
VALUE AT DATE
OF DEATH
32,314
TOTAL (Also enter on line 2 Recanitulation I~
(If more space is needed, insert additional sheets of the same size)
32314
AT
REV-1508 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Guise, Helen I.
FILE NUMBER
21-05-0149
Include lI1e proceeds of Ullgatilln 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
NUMBER
1.
2.
3.
4.
5.
6.
DESCRIPTION
VALUE AT DATE
OF DEATH
PNC Account no. 31500226742
PNC Account no. 31000231602
PNC Account no. 31300233357
PNC Account no. 5140185273
Real estate lax proration
Proceeds from auction
20,019
25,005
12,594
8,316
246
6,821
TOTAL (Also enter on line 5 Recanilulation\' $
(If more space is needed, insert additional sheets of the same size)
73 001
217
REV-1510 EX+ (6-96)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Guise. Helen I.
FILE NUMBER
21-05-0149
This schedule must be completed and filed if the answer to any of questions 1 through 4 an the reverse side of the REV~1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM lNCLUoe. THE m.lAE OF Tl-IE. TRANSFEREE. THEIR RELATIONSHIP TO DECE~NT AND THE DA.TE Of DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER TRANSfER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Allstate Annuity. Contract No. GA0751853 73,567 100.00% 73,567
Allstate Annuity 30,300 100.00% 30,300
TOTAL (Also enter on line 7 Recanitulation\ $ 103 867
(If more space is needed, insert additional sheets of the same size)
217
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYlVANb\
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Guise, Helen I.
21-05-0149
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
,. Hollinger Funeral Home and Crematorium 7,744
B. ADMINISTRATIVE COSTS:
,. Personal Represerrtative's Commissions
Name of Personal Representative (s) Dolores Hair/Kathy Alvey
Social Security Number(s) I EIN Number of Personal Representative(s) 171-28-2295/173-58-8759
Slcee! Address 2 Maurice Road/18 East Locust Street
City Mt. Holly SprinQs/MechanicsburQ State PA Zip 17065/17050
Year(s) Commission Paid: 2005 8,941
2. Attorney Fees 3,500
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 317
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Costs of Public Sale 3,428
8. Expenses of sale of real estate 1,086
9. Utilities for property sold 930
10. Real estate taxes on property sold 368
11. Repairs on property sold 51
12. Finai medical bills 138
TOTAL (Also enter on line 9 Recanitulation $ 26 503
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
217
REV.1513 EX + (9-00)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Guise Helen I
NUMBER
NAME AND ADDRESS OF PERSONISI RECEIVING PROPERTY
FILE NUMBER
21-05-0149
RELATIONSHIP TO DECEDENT
Do Not List Trustee's'
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (al (1.2)]
1.
Dolores A. Hair
2 Maurice Road
MI. Holly Springs, PA 17065 Daughter 75%
Kathy Jo Alvey
18 East Locust SI.
Mechanicsburg, PA 17055 granddaughter 8.33%
Debra Chandler
266 Chandler Drive
Ashford, AL 36312 granddaughter 8.33%
Robert Hair, Jr.
12127 Songbird Lane
Germantown, MD 20876 grandson 8.33%
2.
3.
4.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- 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)
American Red Cross (Medical Alert Machine)
Cumberland Crossings
Moffitt Heart and Vascular
Three Springs Medical Practice
Total Final Medical Bills
20.00
7.68
9.18
100.82
137.68
Sprint
Metropolitan Edison
Aero Oil
Sprint
Metropolitan Edison
Aero Oil
Borough of Ml. Holly, water & sewer bill
Metropolitan Edison
Metropolitan Edison
Metropolitan Edison
Metropolitan Edison
Total Utilities
27.26
69.77
148.12
12.35
66.47
212.5
275.82
53.17
46.01
14.59
4.05
930.11
Life and Annuity Claims
P.G. Box 94212
Palatine,IL 60094-4212
~
Allstate.
You're in good hands.
July 13, 2005
Robert G. Frey
Attorney at Law
5 South Hanover Street
Carlisle PA 17013
Re:
Administrator for:
Contract No:
Helen I Guise
Allstate Life Insurance Company
GA0751853
Dear Mr. Frey:
We have been requested to complete Internal Revenue Service (IRS) Form 712 with regard to the
referenced contract.
The purpose of Form 712 is to provide an estate or donor with the value ofa life insurance contract or
with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract).
The contract referenced was an annuity contract, which is not reportable on IRS form 712.
The following information is provided regarding the value of the annuity and other data as of the date
specified:
Date of Death: 02-05-2005
Annuity Value* as of Date of Death: $73,566.88
Cost Basis: $ 73,162.59
Named Beneficiary: Dolores A. Hair
*The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, or need further assistance, please contact the Customer Care Unit at 1-877-499-
6418.
Sincerely,
Bobbi Jo Seveska
Life and Annuity Claims
Overnight Address: 544 Lakeview Parkway, Vernon Hills, IL 60061
Toll Free Fax: 1-866-635-4523
FREY & TILEY
ATTORNEYS-AT-LAW
5 50UTH HANOVER STREET
CAAUSLE. PENNSYlVANIA 17013
ROBEAT M. FREY
OF COUNSEL
STEPHEN D. TILEY
ROBEAT G. FREY
DOLORES A. HAIR, EXECUTRIX
KATJf( JO ALVEY, EXECUTRIX
ESTATE OF HELEN I. GUISE
TO
DENIS P. DEVINE
ISETTLEMENT DATE:
Price:
Less Down:
81,000.00
-8,100.00
72,900.00
10/0 Penna. StatTrf. Tax
1/2% County Transfer Tax
1/2% School Transfer lax
Notary Public Fee
Recard Deed
Record Mortgage
Hazard Insurance
TELEPHONE (717) 243-5838
FACSIMilE (711) 243-0441
307 NORTH BALTIMORE AVENUE
MT. HOLLY SPRINGS BOROUGH
CUMBERLAND COUNTY, PENNA.
Wednesday: June 15. 2005
Guise Est.
Devine
72,900.00
Bl0.00
405.00
405.00
0.00
38.50
N/A
N/A
200S Assessment:
2004 Assessment:
$97,360.00
$81,170.00
2005 Co. & Twp. Real Estate Tax
2005 Co. & Twp. Real Estate Tax- Face
200S Co. & Twp. Real Estate Tax- Per Day
200 Days Pre-paid $205.70
2004-2005 School Real Estate Tax
2004-2005 School Real Estate Tax. Face
2004-2005 School Real Estate Tax. Per Day
16 Days Pre-paid: $45.19
Purchaser owes:
16 Days Pre-paid School
Plus 200 Days Pre-paid County & Twp.
Less 2% discount
fiNAL WATER/SEWER TO MHSMA
Satisfy First Mortgage
Attomey's Fee
Net due Seller:
Price
Less Down Pmt. Received
Plus Tax ~ro-Ration
81,000.00
-8,100.00
245.87
73,145.87
1 085.82
72 060.05
Less Above Charges
3.856 mills
$375.41
$1.02852
P.O.C.
12.7 mills
$1,030.86
$2.82427
P.O.c.
45.19
205.70
250.89
5.02
245.87
245.87
275.82
P.O.C.
1,085.82
M/A
N/A
73,994.37
========== ==~=======
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FEB-17-2005 22:31
PHClllN<
412 768 3458 P.B1
0PNCBAN<
February 18, 200S
Robert Frey
S S. Hanover Stred
Carlisle, P A 17013
RE: Estate of He1en L Guile, deceased
SSN: 198-01-3971
DOD: 2/512005
Dear Mr. Frey:
In response to your request for Date of Death balances for the customer nOled above, our
records show the foJlowiDg:
Certificalel of Deposit
Ac4:ount #31500226742
Established 05/13/2002
HELEN I GUISE
DOD ba1ancc: 520,008.78 + $9.90 accrued interest
Account #31000231602
Established 12103/2002
HELEN J GUISE
COD balance: 525,000.00 + $4.60 accrued interest
Account #31300233357
Eslablished04/01/1963
HELEN I GUISE
DOD baiaDce: $12,592.37 + $2.33 accrued interest
C1aedall AecoIIIlt
Account #5140 185273
Established 0410111963
HELEN GUISE
DOD balance: $8,315.50 + $,29 accrued interest
Safe Depollt Do
#328
HEU!N I GUlSB
Pagelof2
FEB-17-2005 22'31
PHCBl<<<
412 768 3458 P.B2
Located;
MOUNT HOLLY BRANCH
2 WEST PINE ST.
MT.HOLLYSPlUNOSPA 17065
717-486-3416
Please note that this office OlIly provides date of death balanceo for deposit accoums
(lRA&, CDs. Ooe--lM"g8lld Savings accounts). We do IIOC JII'OC"I U)' ,.......1
truaeUoDS or JII'O"ide Rat_e.... If you need uaistance with any of these itelll8,
please call 1-888.PNC-BANK (1-888-762-2265) or stop by your 10081 PNC BanIc: branch
office.
Sincerely,
~~
RacheUe Wells
1-800-762-1775
P7.PFSC-04-F
soo lint Ave.
p;-..p PA IS219
,.20f2
Member FDIC
TOTR P.B2
Da.te: 04-32-23G5
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