HomeMy WebLinkAbout10-21-05
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REV-l500 EX (6-00)
REV-1500
FILE NUMBER
21 05
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00351
- NUMBER- - -
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
17'1- Z';> - 3'5,g
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dale of death pnorlO 12.13-82)
o 5. Federal Estate Tax Return Required
.1: 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) IA_SohOl
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Novi, Leah M.
DATE OF DEATH (MM-DD-YEAR)
03/28/2005
DATE OF BIRTH (MM-DD-YEAR)
03/09/1927
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
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~ 1. Original Return
o 4. limited Estate
[5J 6. Decedent Died Testate (Attach copy of WUI)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (dale of death between 12-31-91800 1.1.95)
NAME
Michael A. Scherer, Esquire
FIRM NAME (If Appl<able)
O'Brien, Baric & Scherer
TELEPHONE NUMBER
(717) 249-6873
COMPLETE MAILING ADDRESS
19 West South Street
Carlisle, PA 17013
1. Real Estate (ScI1edule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
422,399.66
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Morigages & Noles Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(ScI1edule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(ScI1edule G or L)
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent. Mortgage liabilities, & liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for whicl1 an election to tax has not been
made (Schedule J)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (line 12 minus line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. )\mount of line 14 taxable at the spousal tax
raie. or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
424,195.14 x.O~ (16)
x .12 (17)
x .15 (18)
(19)
16. Amount of Line 14 taxable 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.@
4,817.12
C:)
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(8)
2,927.25
93.99
(11)
(12)
(13)
427,216.78
3,021.64
424,195.14
0.00
(14)
424,195.14
19,088.78
19,088.78
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STREET ADDRESS
442 Walnut Bottom Road Carlisle PA
CITY C r I I STATEpA I ZIP
arise 17013
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
19,088.78
18,500.00
925.00
Total Credits (A + B + C ) (2)
19,425.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( D + E) (3)
4. 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 (4)
336.21
5. 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.
(5)
(SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
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
a. relain the use or income of the property transferred;................""...."...."........................................"'"'''''''''''' 0
b. retain the right to designate who shall use the property transferred or its income;"............................... 0
c. retain a reversionary interest; or.......................... .............."....."......"....................................."................. ....... 0
d. receive the promise for life of either payments, benefits or care? .................................."................................. 0
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 account or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity. or other non-probate property which
contains a beneficiary designation? ............. ........................ ".....".. ...........". ................ .........."................ .............. [Kl
No
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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 pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the basI of my knowledge and bellef, 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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
A?lll~'-YL-2141A~~r.._~~e..~~__
1209 White Birch Lane, Carlisle, PA 17013/133 Pennsylvania Avenue, Carlisle, PA 17013
SIGNAT---P~EPARER.....-THERTHAt.jREPRESENTATIVE---
DATE
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DATE
'10/ f10/0g
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For dates of 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. 39116 (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 survivin9 spouse is 0% [72 P.S. 39116 (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 return 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 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 lhe child is 0% [72 P.S. 39116(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%, except as noted in 72 PS. 39116(1.2) [72 P.S. 39116(a)( 1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116(a){1.3)]. A sibling is defined, under Section 9102. as an
individual who has at least one parent in common with the decedent. whether by blood or adoption.
REV-1508 EX- (8-98) ..
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
leNIDULI I
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Leah M. Novi
ITEM
NUMBER
Include the proceeds of liligalion and !he dale !he proceeds were received by !he eslale.
All property Jointly_tel with right of survivorship must b. dlscloltd on Sch.dule F.
FILE NUMBER
21-05-0351
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
Internal Revenue Service
2004 Income Tax Refund
760.00
2.
Legg Mason Wood Walker
Retail Account
341,666.68
3.
Legg Mason Wood Walker
IRA
79,972.98
TOTAL (Also enter on line 5, Re~pitulalion) $ 42 2 , 3 9 9 . 6 6
(If more space is needed, insert additional sheels of the same size)
R::-".'5:oS EX 4 (1.9~!
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SCHEDULE F
JOINTL Y.OWNED PROPERTY
COMMONWEAL TH OF PErmSYl VANIA
INHERIT ANCE TAX RETURr~
RESIDENT DECEoEriT
ESTATE OF
Leah M. Novi
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, n must be reported on Schedule G.
21-05-0351
SURVIVING JOINT TENANT (S) NAME
ADDRESS
RELATIONSHIP TO DECEoEr;T
A. Mario N. Novi, Jr.
1209 White Birch Lane
Carlisle, Pennsylvania
17013
son
B
c.
JOiNTLY-OWNED PROPERTY:
lETTER DnE D!'SCRIPTION OF PROPERTY %OF DATE OF DEATH
ITE" FOR JOINT ~A~E Include name of financial Institution a,d bank ,"""",nt number Of similar identifying number, Atta;h DATE OF DEATH DE CD'S VAlUE OF
NUMBER TENANT JOINT deed for jointly-held real estate VAlUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. M & T Bank 9,634.24 50% 4,817.12
TOTAL (Also enter on line 6, Reca;>itulatlon) $ 4,817.12
(I: mace s~c:e is needed, inse1 additional sheets of the same size)
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~lHOFP9WSYlYANA
INltERITNICE TAX RETURH
Leah M. Novi
SCHEDULE H
fUNERAL EXPENSEs &
ADMINISTRATIVE COSTS
ESTATE OF
. ....::1..1 1........:l..::1
FLE tIJ..u
21-05-0351
DebIt of dtc:tdtnt mUlt be reported on Schedule L
ITEM
NUMBER
A.
DESCRIPTION
AMOuNT
185.50
1.
FUNERAL EXPENSES:
Georges Flowers
2.
Carlisle Memorial Service
180.00
B. ADMINISTRATIVE COSTS:
1. Personal RepresenlallYe's Cocnmisslal ~
Name of Persona/ ~,lallve (s)
Socia1 SeaJlfty NumbeI(s) I EIN Number 01 P8ISOIla1 RepI8S8/1lative(s)
Street Addnlss
2.
3.
City
Year(s) COIMIission Paid:
A\Iomey Fees
Family Exemption: (If decedents acIdr9ss ~ not 1he same as claimants, attach explanation)
Claimant
Slate
Zip
1,260.00
Street Address
City
Relationship of Claimant to Oecedel1t
State
Zip
4.
Probate Fees
503.00
5.
AccountanrsFees Stott & Stott (decedent's final 1040 &
fiduciary return)
500.00
6.
Tax Return Preparel's Fees
7.
8.
Sentinel: advertising
224.15
Cumberland Law Journal: advertising
75.00
TOTAL (Also enter on line 9. Recapitulation) $ 2, 927 . 65
(If more space Is needed, Insert addmonal sheets of the same size)
REV-1512 EX + (7.88i
ESTATE OF
~~
COMMONWEA.LTH OF PENNSvtVANIA.
INHERITANCE TAX RETURN
RESIDENT OECEDEN":"
Leah M. Novi
ITEM
NUMBER
1.
2.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABLlTIES AND LIENS
DESCRIPTION
Pharmerica (nursing home pharmacy)
Pharmerica (nursing home pharmacy)
L~. Pri., .. Typ.
I FILE NUMBER
AMOUNT
93.05
0.94
-
TOTAL (Also enter on line 10, Recapitulation)
(If more space ;s needed, insert additional sheets of some size.)
$ 93.99
ctEV.1513EX -11.'11
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SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DE CENT
ESTATE OF
Leah M. Novi
FILE NUMBER
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (indude outright spousal distributions)
21-05-0351
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not Ust Trustee(s) OF ESTATE
1.
Mario N. Novi, Jr.
1209 White Birch Lane
Carlisle, Pennsylvania 17013
son
one-half
2.
Michael E. Novi
133 Pennsylvania Avenue
Carlisle, Pennsylvania 17013
son
one-half
II.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
.
-
TOTAL OF PART II. 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)
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LAST WILL AND TESTAMENT
OF
LEAH M. NOVI
I, LEAH M. NOVI, of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other Wills
and Codicils heretofore made by me.
FIRST
I direct the payment of my just debts and expenses of my
last illness and funeral from my estate as soon after my death
as conveniently may be done. I authorize my personal
representative to have my body cremated, and to purchase a
marker in my family burial plot.
Further, I authorize my personal representative to expend
funds from my estate, in such amount as my personal
representative shall consider necessary and desirable for the
purchase, erection and inscription of said marker.
SECOND
1 give, cleYi... ~ bequeatb all tbe re.t, r..W... ~.~ '.
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In'... Olio"" .'....1 ...... ~;.,.l~.fItito.:
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N. NOVI, JR. ... III'-ar.'.. lIOYI, or tbeir t..ue.
THIRD
I direct that any and all inheritance, estate, and
transfer taxes imposed upon my estate passing under this Will
~ or otherwise shall be paid out of the principal of my residuary
d
I; estate.
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FOURTH
In addition to the powers conferred by law, I authorize
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its absolute discretion:
(a)
To retain in the form received, or to sell
either at public or private sale any real or personal
property;
(b)
To exercise any options to subscribe for
stocks, bonds, or other investments.
(C) To join in any plan of lease; mortgage,
consolidation, exchange, reorganization or foreclosure
of any corporation in which my estate or any trust may
hold stocks, bonds or other securities;
(d) To sell, transfer, convey, mortgage, pledge,
lease or exchange any property, real or personal, which
at any time may form part of my estate, for the payment
of debts or taxes, or for any purpose of administration
or distribution, for such price. an~ upon .ucb ter.a
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teras as ay personal representative in its sole
discretion may deem wise without the necessity of
obtaining any court approval thereof;
.
AlDIS, GUIDO,
SHUFF &
MASLAND
26 W. High Street
Carlisle. PA-
-
(f) To make distribution hereunder either in cash
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or kind, as my personal representative in its discretion
may deem wise.
FIFTH
I do hereby nominate, constitute and appoint Financial
TRUS~ COMPANY (formerly Farmers Trust Company), to act as my
Executor, of this my Last Will and Testament.
SIXTH
I direct that no personal representative, guardian,
trustee or other fiduciary appointed under this instrument
shall be required to give bond for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I, LEAH M. NOVI, have hereunto set my
hand and seal to this my Last Will and Testament, consisting of
four (4) typewritten pages, the first two (2) of which bear my
signature in the margin for identification, this~ day of
fi16,
1997.
L Lh, ~
Leah M. Novi
Signed, sealed, published and declared by the above-named
Testatrix, as and for her Last Will and Testament in the
presence of us, who have hereunto subscribed our names at her
request as witnesses thereto, In the presence of said Testatrix
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ADDRESS
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ADDRESS
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COMMONWEALTH OF PENNSYLVANIA:
SS
COUNTY OF CUMBERLAND
WE; LEAH M. NOVI, JOHNNA J. DEILY, ESQUIRE and AnnM. Lehnan
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II names are signed to the foregoing or attached instrument, being
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, the Testatrix and witnesses, respectively whose
first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument
as her Last Will and Testament and that she signed willingly
and that she executed as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix signed the Will as
witness and that to the best of their knowledge the Testatrix
was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
b..,~
Leah M.
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CODICIL
OF
LEAH M. NOVI
I, LEAH M. NOVI, the within named Testatrix, do hereby
make and publish this Codicil of my Last Will and Testament
dated May 20, 1997.
FIRST
as follows:
I hereby amend the FIFTH provision of said Will to provide
MARIO N. NOVI, JR., and MICHAEL E. NOVI, or their survivor, to
I do hereby nominate, constitute and appoint my sons,
act as my Executor of this my Last Will and Testament.
In all other respects I hereby ratify, confirm and
sole Codicil as and for my Last Will.
republish my Last Will dated May 20, 1997 together with this
IN WITNESS WHEREOF, I, LEAH M. NOVI, have hereunto set my
hand and seal to this Codicil to my Last Will and Testament
this I 5 -th
day of :1v~
, 2000.
~~.~
L M. NOVI
SAIDIS,
;HUFF &
MASLAND
^~ANAW
26 W. HIp slieet
Carlisle. PA
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HUFF &
MASLAND
\1TllIM!YSoATofAW
26 W. Rlsh SlR'et
Carlisle, P ^
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Signed, sealed, published and declared by the above-named
LEAH M. NOVI, as and for a Codicil to her Last Will and
Testament in the presence of us, who have hereunto subscribed
Our names at her request as witnesses thereto, in the
presence of said
Testatrix and of each other.
ADDRESS
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DDRESS
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SAIDIS,
HUFF &
MAS LAND
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26 W. Hlp Slreel
CMtJsIe,PA
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COMMONWEALTH OF PENNSYLVANIA:
SS
COUNTY OF CUMBERLAND
We, Johl1oQ. 1)/1'(
and hot!'~ ~ 1?"Ci:..<(
respectively whose names
, the Testatrix and witnesses,
are signed to the foregoing or attached instrument, being
first duly Sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the
instrument as her Codicil and that she signed willingly and
that she executed as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix signed the Codicil
as witness and that to the best of their knowledge the
estatrix was at the time 18 or more years of age, of sound
ind and under no constraint or undue influence.
~~.~
LEAH M.
SUbscribed, sworn to and
'\ Witness
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( Witness
acknowledged ~fore me by LEA
OVI, the Testatrix, and subscribed to and Sworn or affirmed
o before me by 0()hnna. n,. /...., and ~ eo rfJt..LrlCJ.J...{
itnesses, this JSf" day of Feoru..a..
NOT AAIAL SEAl
SAUl! OSMAN. Nofort Public
Corliole Boro, ClJmbwtond Co. PI.
My Coml'l'liuion &pi... Mardi 20. 2(Q)
.
m M&TBank
September 7, 2005
499 Mitchell Street, Millsboro, DE 19966
Law Offices
0' Brien, Baric & Scherer
19 West South Street
Carlisle, PA 17013
RE: Estate of Leah M. Novi
Date of Death: March 28, 2005
Social Security Number: 174-20-3568
Dear Mr. Scherer:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type. .......................... Checking Account
Account Number....................... 824127
Ownership (Names oj}.............. Leah M. Novi, Mario Novi Jr.
Opening Date. .......... ............... .12/0 1/77 (account closed OS/20/05)
Balance on Date ofDeath.........$9,634.24
Accrued Interest
$
0.00
Total................................... ....$9,634.24
The above named decedent did not have a safe deposit box with this bank.
For any additional information including ownership on this account please contact
our High Street Carlisle branch at 717-240-4536.
Sincerely,
Ch~=.!~:::agement
1-888-502-4349
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