HomeMy WebLinkAbout11-04-05
~EV-1500 EX + ;6.QO)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
THIS SECTION MUST BE COMPLETED. ALL CORRESPONbENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE D
NAME COMPLETE MAILING ADDRESS
ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
MOUNTZ
DATE OF DEATH (MM-DD-Year)
MARGUERITE E.
DATE OF BIRTH (MM-DD-Year)
09/06/2005 08/25/1914
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[X] 1. Original Return
D 4. Limited Estate
[X] 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 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)
0.00 X _(15)
57,568.49 X .045 (16)
0.00 X .12 (17)
0.00 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. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALl-QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
OFFICIAL USE ONLY
FILE NUMBER
-1- .L -..Q.... L ..Q... ~ ..L ..L _
COUNTY CODE YEAR NUM6ER
SOCIAL SECURITY NUMBER
2 04- 0 1 - 9 6 7
THIS RETURN MUST BE FILED IN 0 PLICATE WITH THE
REGISTER OF I ILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of death prior to 12-13-62)
D 5. Federal Estate Tax Ret rn Required
_ 8. Total Number of Safe D posit Boxes
D 11. Election to tax under S c. 9113(A) (Attach Sch 0)
40,368.21
17013
1 ,848.02
c.
21 ,000.00
(8)
63 216.23
5,539.49
108.25
(11)
(12)
(13)
5647.74
57 568.49
(14)
57 568.49
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'REV-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOUNTZ
FILE NUMBER
MARGUERITE E. 21 05
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.
0829
ITEM Vi'\LUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Citizens Bank - Certificate of Deposit - #6240410255 30,006.71
3. Personal Property 10,361.50
UAP-D
cyLwf
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TOTAL (Also enter on line 5, Recapitulation) $ 40.368.21
(If more space is needed, insert additional sheets of the same size)
'REV-1509 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOUNTZ
MARGUERITE
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
21
05
SCHEDULE F
JOINTLY-OWNED PROPERTY
E.
FILE NUMBER
0829 i
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIOI\ SHIP TO DECEDENT
A. Allen L. Mountz 248 Mt. Zion Road Son
Carlisle, PA 17013
B
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JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. Citizens Bank - Checking Account - #6100727513 3,696.04 50. 1,848.02
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TOTAL (Also enter on line 6, Recapitulation) $ 1.848.02
(If more space is needed, insert additional sheets of the same size)
'REV-1510 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOUNTZ
MARGUERITE
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ye!j.
,
E.
FILE NUMBER
21 05
0829
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE
(IF APPLICABLE)
1. Gift to Allen L. Mountz 09/23/2005 10,000.00 100. 3,000.00 7,000.00
2. Gift to Kurtis R. Mountz 09/23/2005 10,000.00 100. 3,000.00 7,000.00
3. Gift to Randall C. Mountz 09/23/2005 10,000.00 100. 3,000.00 7,000.00
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TOTAL (Also enter on line 7 Recapitulation) $ 21 000.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
MOUNTZ
FILE NUMBER
MARGUERITE
E.
21
05
0829
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home 325.80
2. Eby Granite Works - Inscription 95.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions I
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Irwin & McKnight 2,750.00
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 124.00
5. Accountant's Fees
6. Tax Return Prepare~s Fees 325.00
7. Cumberland Law Journal - Estate Notice 75.00
8. The Sentinel - Estate Notice 129.77
9. Kevin Wickard, Auctioneer 1,605.42
10. Register of Wills - Filing Fee 30.00
11. D & D Septic - Portable Restroom for Public Sale 79.50
TOTAL (Also enter on line 9, Recapitulation) $ 5539.49
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOUNTZ
MARGUERITE
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
E.
Include unreimbursed medical expenses.
FILE NUMBER
21
05
0829
ITEM VA UE AT DATE
NUMBER DESCRIPTION ~F DEATH
1. Sprint, Telephone 25.37
2. Adams Electric Cooperative, Electric 67.09
3. Masland Associates, Medical 15.79
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TOTAL (Also enter on line 10, Recapitulation) $ 108.25
(If more space is needed, insert additional sheets of the same size)
R".""""'_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
~A()IIr-.ITZ M TE F. 21 Of) OA2~
RELATIONSHIP TO DECEDENT AN OUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)] I
1. Allen L. Mountz Lineal I
248 Mt. Zion Road 1/3 Remlainder
Carlisle, PA 17013
2. Kurtis R. Mountz Lineal
407 Mt. Zion Road 1/3 Rem ainder
Carlisle, PA 17013
I
3. Randall C. Mountz Lineal 1/3 Remrinder
262 Mt. Zion Road
Carlisle, PA 17013
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ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 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.
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)
LAST JVILL AND TESTAj}fENT
I, ~lARGUERITE E. lVIOUNTZ, of Lower Frankford Township, Cumberland ounty,
Pennsylvania, declare this to be my Last Will and Testament, hereby expressly revoking
and Codicils heretofore made by me.
1. I direct my executor to pay all of my debts, funeral and administrative expenses
as may be done conveniently after my decease.
2. I authorize and empower my executor to sell any realty owned by me at my d+th and
not specifically devised herein, at either public or private sale, and to give good and s fficient
deeds therefor, in fee simple, as I could do ifliving.
3. I give, devise and bequeath all of my estate of every nature and wherever situ at to my
three sons, Allen, Kurtis and Randall, share and share alike, the child or children of any d ceased
son taking the share their parent would have taken if living.
4. I nominate and appoint Allen L. Mountz to be the executor of this my Last v ill and
Testament; he is to serve as such without bond. Should he die before my death, reno nce or
refuse to serve for any reason, or die leaving any of my estate unadministered, I nomin te and
appoint Kurtis R. Mountz and Randall C. Mountz, as substitute executors, also to serve
without bond, with the same powers as are give herein to my executor.
5. I hereby suggest that my personal representatives retain the servIces of Irwin,
McKnight & Hughes, as attorneys in the settlement of my estate.
IN 'VITNESS 'VHEREOF, I have hereunto set my hand and seal this 2.'t day pf July,
1996.
-/1/c;1J1.C'r..ttJ,';;"t.. e. )nc--'i.A....yz/ <fEAL)
l\'IARGUERITE E. l\'IOUNZ
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Signed, sealed, published and declared by l\'IARGUERITE E. l\'IOUNTZ, the tlestatrix
above named, as and for her Last Will and Testament, in the presence of us, who at her re~uest, in
her presence and in the presence of each other have subscribed our names as witnesses her~to.
2
ACKNOWLEDGJ\.tfENT AlvD AFFIDA VIT
WE, :MARGUERITE E. :MOUNTZ, :MARTHA. L. NOEL and
CLELAJ.'l"D, the testatrix and witnesses respectively, whose names are signed to the f( [egoing
instrument, being first duly sworn, do hereby declare to the undersigned authority hat the
testatrix signed and executed the instrument as her Last Will and that she had signed willin ly, and
that she executed it as her free and voluntary act for the purpose herem expressed, and t at each
of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness
to the best of their knowledge the testatrix was, at that time, eighteen years of age or
sound mind and under no constraint or undue influence.
(rlct1-( .,0::,,21. (:;, !rLCt~:..0-1
v lVIARGUERITE E. MOUN Z
CO~llVIONWEAL TH OF PENNSYL V ANL-\
SS:
COUNTY OF CU1\'lBERLAND
Subscribed, sworn to and acknowledged before me by lVLillGUERlTE E. MUNTZ,
the testatrix herein and subscribed and sworn to before me by ~L<\RTHA L. NO Land
CHERYL L. CLELAND, witnesses, this z..{ day of July, 1996.
/-------\
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I N tary Public
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Estate Account-All Accounts
Date
9/22/05
9/22/05
9/22/05
9/22/05
9/22/05
9/28/05
10/10/05
10/10/05
1 0/20/05
10/20/05
10/31/05
10/31/05
10/31/05
Acct
Num
ESTATE... DEP
ESTATE... 22252
ESTATE... 22253
ESTATE ". 22258
ESTATE... 22259
ESTATE... 22279
ESTATE... 22292
ESTATE ... 22293
ESTATE... DEP
ESTATE... 22336
ESTATE... DEP
ESTATE... 22344
ESTATE... 22345
TOTAL 12/1/94 - 11/2/05
TOTAL INFLOWS
TOT AL OUTFLOWS
Class Report
12/1/94 Through 11/2/05
Description
Memo
Category
CITIZENS BANK MOUNTZ, MARGUERI... CLOSED BK ACCT/M... R
IRWIN & McKNIGHT****... MOUNTZ, MARGUERI... REIMBURSE/MOUNT... R
CUMBERLAND LAW J... MOUNTZ, MARGUERI... ADV LET/MOUNTZ, M... R
SPRINT******************... MOUNTZ, MARGUERI... TELEPHONE/MOUNT... R
ADAMS ELECTRIC CO... MOUNTZ, MARGUERI... UTILITIES/MOUNTZ,... R
HOFFMAN - ROTH FU... MOUNTZ, MARGUERI... FUN/MOUNTZ, MARG... R
ADAMS ELECTRIC CO... MOUNTZ, MARGUERI... ELEC/MOUNTZ, MAR...
MASLAND ASSOCIATE... MOUNTZ, MARGUERI... MEDICAUMOUNTZ, M...
SPRINT******************... MOUNTZ, MARGUERI... REF OVER/MOUNTZ, '"
THE SENTINEL - LEGA... MOUNT, MARGUERIT... ADV LET/MOUNTZ, M...
KEVIN WICKARD, AUC... MOUNTZ, MARGUERI... PUBLIC SALE/MOUNT...
ALLEN MOUNTZ MOUNTZ, MARGUERI... REIMBURSE/MOUNT...
EBY GRANITE WORKS... MOUNTZ, MARGUERI... INSCRIPTION/MOUNT...
NET TOTAL
11/2/05
Page 1
Clr Amount
33,718.37
-124.00
-75.00
-25.37
-37.19
-325.80
-29.90
-15.79
12.55
-129.77
8,697.25
-79.50
-95.00
41,490.85
42,428.17
-937.32
41,490.85
II
~~ Citizens Bank
Account Number 6100727513
Account Title MARGUERITE H MOUNTZ OR ALLEN L
MOUNTZ
Date Opened 6/6/1966
Account Type Checking
Princi pal Balance as of DOD $3696.04
Interest from Last Posting to DOD $ .00
Account Balance as of DOD $3696.04
YTD Interest to DOD $52.76
II
~~ Citizens Bank
Account Number 6240410255
Account Title MARGUERITE H MOUNTZ
Date Opened 9/4/2003
Account Type Time Deposits
Principal Balance as of DOD $30000.00
Interest from Last Posting to DOD $6.71
Account Balance as of DOD $30006.71
YTD Interest to DOD $612.56
.~'
t1~AL 'I
SETTLEMEN1
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SELLER NAME E S+(J t e 0 f
8 5d- IV' t,
C(l r \ : 5 \ e
LoeA TION OF SALE S 0
k e J'j (\ I\{ .
~AQr3ueri+e
z; Dr'1 Rd-
PA
N\ 0 u (rt z
DATE OF SALE
()dt ~ IJ~ O~
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ADDRESS
PHONE
ZIP
PROFESSIONAL FEES $~
AUCTIONEER CASH $
I ~ tl6 $ CHECKS $
$ OTHER RECEIPTS
OTHER EXPENSES $
$ $
AJ VI'( t i ::;"J $ ~3113~ $
$ $
I(nt $ /3 7. go $
$ $
$ $
$ $
$
$ TOTAL RECEIPTS
$ LESS TOTAL EXPENSES
I (or we), the seller, accept this settlement and acknowledge receipt of the above specified net pr ceeds
from the auction of my goods and property sold on the above date. I accept all responsibility for pr viding
merchantable title to all goods, and property sold, and for delivery of title to the purchaser.
~~
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I el.si9oo",re-
pcl ....t7J f" t l -1-4..,.., 1< yc. '-'
(Seller's Signature)
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Dater -::0 -O~
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Auctioneer or Cashier's Signature
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SELLER'S COpy
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COMMONWEALTH OF PENNSYL VANIA
: SS
COUNTY OF CUMBERLAND
Allen L. Mountz , being duly sworn according to law, deposes and says that he is the Executol of
the Estate of Mar~uerite E. Mountz , late of Lower Frankford Township ,Cumberland County.
Pennsylvania, deceased and that the within is an inventory made by Allen L. Mountz . the said Executor of e
entire estate of said decedent. consisting of all the personal property and real estate, except real estate outside the Commonwealth
of Pennsylvania. and that the figures opposite each item of the Inventory repr sent it's fair value as of the date of decede t's death.
Sworn and subscribed before me,
thiJrd
day of November
248 Mt. Zion Road
Carlisle, PA 17013
Address
2005
Year
Date of Death
06
Day
INSTRUCTIONS
1. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty.
4. See Article IV, Fiduciaries Act of ] 949.
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Inventory of the real an personal estate of
MARGUERITE E. MOUNTZ
, deceased
1. Citizens Bank - Certificate of Deposit - #6240410255
2. Citizens Bank - Checking Account - #6100727513
3. Personal Property
TOTAL
$30,006.71
$1,848.02
$10,361.50
$42,216.23
II
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
NO. CD 005976
IRWIN ROGER B ESQ
60 W POMFRET ST
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
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AMOU~T
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ESTATE INFORMATION: SSN: 204-0 '-9567
FILE NUMBER: 2105-0829
DECEDENT NAME: MOUNTZ MARGUERITE E
DA TE OF PAYMENT: 11/04/2005
POSTMARK DATE: 11/04/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/06/2005
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101 I $2,461. :>5
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INITIALS:
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$2,4611.05
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GLENDA FARNER STRASBAI~H
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REGISTER OF WILLS :
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 022377
SEAL
RECEIVED BY:
REGISTER OF WILLS