HomeMy WebLinkAbout11-15-05
Rt,-V-1500 EX + (&-00)
'* COMMONWEALTH OF
PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENTS NAME (LAST, RRST, AND MIDDLE INITIAL)
FLURIE JESSE L.
DATE OF DEATH (M~Ye<l")
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DATE OF BIRTH (MM-DD-Year)
06/07/2005 03/15/1928
(IF APPLICABlE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
IX} 1. Original Retum
D 4. Limited Estate
IX} 6. Decedent Died Testate (Allach copy 01 Wdl)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum
D 4a. Future Interest Compromise (daleofdealh alIer 12-12-32)
D 7. Decedent Maintained a Living Trust (Allach copy of Trust)
D 10. Spousal Poverty Credit (dare oIdeaIh between 12-31.91 and 1-1-95)
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 0 5 2 3
""COuNTYCOOE -~ - - 'iiUMiiER- -
SOOAL SECURITY NUMBER
1 74- 2 0 - 7 4 9 5
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOOAL SECURITY NUMBER
D 3. Remainder Retum (date 01 death prior 10 12-13-32)
D 5. Federal Estate Tax Retum Required
Q.. 8. Total Number 01 Sale Deposit Boxes
D 11. Election to tax under See. 9113(A) (AtIad1ScM)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
CHARLES F. CHENOT. III ESQ. P.O. BOX 250
FIRM NAME (II Applicable)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule 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)
D Separate BilHng Requested
7. Inter-Vivos T ranslers & 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 01 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 BequestslSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
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TELEPHONE NUMBER
717-582-7313
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NEW BLOOMFIELD
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount 01 Line 14 taxable atlineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount 01 Line 14 taxable at collateral rate
19. Tall Due
X _(15)
149,885.70 X .045 (16)
98,053.80 X .12 (17)
112,414.27 X .15 (18)
PA 17068
m__ __ ..__.. ',_,__ n__. "on _ ____
OFFICIAL USE ONLY
311 ,929.42j..
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17,941.37
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107,900.52
(8)
437,771.31
31,177.37
8,768.75
(11)
(12)
(13)
39,946.12
397,825.19
37,471.42
(14)
360,353.77
119\
6,744.86
11 ,766.46
16,862.14
. u35,3Z3.46
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ece ents om pi ete ress:
STREET ADDRESS
20 NORTH 12STH STREET, APT. 113
CITY I STATE I ZIP
LEMOYNE PA 17043
Tax Payments and Credits:
1. Tax Due (Page 1 Une19)
2. CreditslPayments
A.. SpoosaI Poverty Credit
8. Prior Payments
C. Discount
(1)
35,373.46
33.000.00
1.650.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total CrEdts (A +8 +C) (2)
34,650.00
TotallnteresUPenalty ( D + E) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 1 + Uoe 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
A.. Enter the interest on the tax due. (5A.)
8. Enter the toIaI of Une 5 + 5A.. This is the BALANCE DUE. (58)
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 No
a. retain the use or inoome of the property transferred; ...................................w... .................................. 0 00
b. retain the rightto designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........... .w...... ...... .......... ..... ... ......... ..... ........... ........ ........... ..... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement A.ccount, annuity, or other non-probate property which
oontains a beneficiary designation? .....................---............................................................................... 00 D
0.00
723.46
723.46
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
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PA 17948
NY 12580
DATE
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V
ADDRESS Ann M. Ka ich, 133 Roosevelt Drive, Mahanoy City
Linda Dowhower~~.JLoad. Staatsbulll ,
SIGNA(!gX07 ~ s 3~~ ~~,
ADDRESS P.O. Box 250 ~ .~ ~ . ~
New Bloomfield ___
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PA 17068
For dales of death on or after July 1, 1994 and before January 1, 1995, the tax rate in
(72 P.S. ~116 (a) (1.1) (i)].
lrs to or for the use of the surviving spouse is 3%
For dales of death on or after January 1, 1995, the tax rate imposed on the net value o. surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutOf} >sets and filing a tax return are stil 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 yeal~ OT age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(a){1.2)J.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
IDENT DE DENT
"0-
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FLURIE. JESSE L-
AI property jointly-owned willi right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2"
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
FILE NUMBER
21 05
0523
VALUE AT DATE
OF DEATH
30,060.00
12,585.00
20,334.25
5,178.00
20,676.55
7,77T78
9,459.46
5,010.00
29,592.00
12,685.00
30,120.00
26,720.00
31,116"00
25,020.00
6,412.50
24,438.88
DESCRIPTION
ABN Amra Capt. 6.08% Preferred-1200 shares @$25.05/share
AMBAC Financial Group 5.875%-500 shares @$25.17/share
Bellsouth Strats 6% Preferred-815 shares @$24.95/share
Citigraup Capital 7.125% Preferred-200 shares @$25.89/share
Citigraup Capital x 6.1% Preferred-815 shares @$25.37/share
Franklin Age High Income Fund C-3703"704 shares @$2.10/share
Franklin Income Fund A-3861.004 shares @$2.45/share
Gabelli Equity Trust 5.875%-200 shares @$25.05/share
JP Morgan Chase 5.875% Preferred-1200 shares @$24.66/share
JP Morgan Chase 6.25% Preferred-500 shares @$25.37/share
JP Morgan Chase 6.20% Preferred-1200 shares @$25.10/share
Safeco Capital Trust 18%-1000 shares @$26.72/share
Royal Bank of Scotland 6.40% Preferred-1200 shares @$25.93/share
Wells Fargo CP VII 5.85% Preferred-1000 shares @$25"02/share
Wells Fargo CP IV 7% Preferred-250 shares @$25.65/share
Bear Stearns 5.58% 03/15/2030-230 $100 bonds @$106.256/per bond
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
311 929.42
FLURIE, JESSE L.
21
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PaQe 1
Schedule B - Stocks & Bonds
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
17. FirstEnergy Corp.-200 shares @$4S.00/share 9,000.00
18. PPL Corporation-100 shares @$S7.44/share S,744.00
All above accounts held with Wachovia Securities, 3 Lemoyne Drive, Lemoyne, PA
17043
SUBTOTAL SCHEDULE B 14,744.00
GRAND TOTAL SCHEDULE B $ 311,929.42
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FLURIE. JESSE L.
FILE NUMBER
21 05
0523
Indude the proceeds of litigation 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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M&T Bank-Checking Acct. #9836185746 6,331.20
2. M& T Bank-Money Market Acct. #15004211136484 4,975.17
3. 1991 Chrysler New Yorker Salon Sedan 40 1,025.00
4. 2001 Chevrolet Venture Minivan 40 5,610.00
TOTAL (Also enter on line 5, Recapitulation) $
17941.37
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COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FlURIE. JESSE l.
FI.E NUMBER
21 05
0523
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 yes.
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE. lllEIR RElATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (If APPUCABlE)
1. IRA-84000 US Treasury Bonds 7.250%-128.453 107,900.52 100. 107,900.52
Beneficiary-Carol Gray, Grayson View, 150 Kempton Avenue
Harrisburg, PA 17111-Sister
TOTAL (Also enter on line 7, Recapitulation) $ 107900.52
(If more space is needed, insert additional sheets of the same size)
REV-1511EX+(1-97)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FLURIE JESSE L.
FILE NUMBER
21
05
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
2.
B.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
DESCRIPTION
FUNERAL EXPENSES:
Myers Funeral Home
Funeral Luncheon
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Ann M. Karpovich
Social Security Numbe~s) I EIN Number of Personal Representative(s)
Street Address 133 Roosevelt Drive
City Mahanoy City State PA Zip 17948
Yea~s) Commission Paid: 2005
AttomeyFees Charles F. Chenot, III, Esq.
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
Probate Fees
Accountanfs Fees
Tax Retum Prepare~s Fees
The Sentinel-Estate Notice
Cumberland Law Journal-Estate Notice
Unitrin Ins.-Renter's Ins.lCar Insurance
Dept. of Transportation-Duplicate Title
Neumyer Funeral Home-Wife's Funeral-D.O.D. 6/2/05
Evans Cemetery-Wife's headstone
Linda Dowhower, Exec.-Reimb. for Postage
TOTAL (Also enter on line 9, Recapitulation) $
0523
AMOUNT
9,021.97
185.00
7,000.00
2,700.00
436.00
129.77
75.00
366.50
22.50
9,691.20
1,495.00
54.43
31 177.37
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FLURIE JESSE L.
FilE NUMBER
21 05
0523
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
5,610.00
1.
Car Loan-2001 Chevrolet Venture Minivan 4D*
*Minivan was returned to dealership for balance outstanding on loan
2.
GM Card Services-Credit Card Bill
2,848.62
3.
Dept. of VA-Medical Bill
27.00
4.
Weis Pharmacy-Drug Bill
72.47
5.
Comcast-Cable
2.92
6.
Dept. of VA-Medical Bill
1.58
7.
Verizon-Phone
206.16
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert adOltional sheets of the same size)
8 768.75
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
J:I II~n:: J1::ccc I
SCHEDULE J
BENEFICIARIES
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pncIude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Michael J. Mackavage
603 Riverstix Lane, Mechanicsburg, PA 17055
1.
2. Ann M. Karpovich
133 Roosevelt Drive, Mahanoy City, PA 17948
3. Linda Dowhower
143 Rymph Road, Staatsburg, NY 12580
4. Bobby Dolack
6163 Tyler Drive, Harrisburg, PA 17112
5. Georgia C. Kenney
P.O. Box 30495 5MB, Grand Cayman, Cayman Islands
FILE NUMBER
?1 Ofi
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Ofin
AMOUNT OR SHARE
OF ESTATE
Stepson 25% Residue
Stepdaughter 25% Residue
Niece 12.5% Residue
Nephew 12.5% Residue
Niece 12.5% Residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
11. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Highland United Presbyterian Church, Newport, Pennsylvania-12.5% Residue
37,471.42
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$
37471.42
(If mnrp <:n:lN! i<; ~ inAArt MrfrtitvlJ'll ~b: rI fhp ~::vTlP ~7p.l
KATHY A. MORROW
AlIorney It Law
217 S. Carlisle S'ree'
P.O. Box 250
New Bloomfield, PA 17068
LAST WILL AND TESTAMENT OF
JESSE L. FLURIE
I, Jesse L, Flurie, of Howe Township, Perry County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as my Last Will and Testament as follows:
1. I direct my hereinafter named Executrix to pay my just
debts, funeral expenses and costs of administration of my estate as soon as
possible and convenient after my death.
2. I direct my hereafter named Executrix to payout of the
corpus of my estate, all state inheritance taxes and federal estate taxes, if
any be due, which may be assessed by reason of my death on property
passing under this my Last Will and Testament, or on property passing to
any person or persons by reason of joint ownership thereof, such as
certificates of deposit, savings bonds, etc. to the intent and effect that no
person shall be required to personally pay any Pennsylvania inheritance tax
or federal tax thereon.
3. I give and bequeath her great-grandmother's comer
cupboard, to my niece, Linda Dowhower.
4. I give and bequeath my drop-leaf table and firewood box to
Ann M. Karpovich.
5, I give, devise and bequeath all the rest, residue and
remainder of my property, both personal and real, of whatever nature and
.J2. x. 5-:
KATHY A. MORROW
Allorney It law
217 S. Carlisle Strut
P.O. Box 250
New Bloomfield, PA 17068
wheresoever situate to my wife, Betty J. Flurie, provided she survives me by
thirty (30) days.
6. In the event my wife, Betty J. Flurie, should predecease me
or die on or before the thirtieth (30th) day following my death, I give, devise
and bequeath all the rest, residue and remainder of my estate as follows:
a. Twenty-Five (25~) percent to Michael J. Mackavage;
b. Twenty-Five (25%) percent to Ann M. Karpovich;
c. Twelve and one-half (12.5%) percent to my niece,
Linda Dowhower;
d. Twelve and one-half (12.5%) percent to my nephew,
Bobby Dolack;
e. Twelve and one-half (12.5%) percent to my niece,
Georgia C. Kenny; and
e. Twelve and one-half (12.5%) percent to Highland
United Presbyterian Church, Newport, Pennsylvania.
7. I hereby nominate and appoint my wife, Betty J. Flurie, as
Executrix of this my Last Will and Testament. Should my wife, Betty J.
Flurie, fail to qualify or renounces her right to act as Executrix, I then
nominate and appoint Ann M. Karpovich and Linda Dowhower, or the
survivor thereof, as successor Executrices of this my Last Will and
Testament.
8. I direct that my Executrix or her successors shall not be
required to give bond or other security in any jurisdiction wherein
proceedings may be held in connection with my estate. Nor shall any
guardian of property or persons be required to give bond for the faithful
. performance of their duties in any jurisdiction.
p. ;t.5;
KATHY A. MORROW
Attorney at law
217 S. Carlisi. Stroet
P.O. Box 250
New Bloomfield, PA 17068
IN WITNESS WHEREOF, I hereunto set my hand and seal this
/,;)4-A day of @~002.
9~ ~ .5-~N'L ,,-
(SEAL)
ed~
ltnes
l:!1eftdA F f)t~
Witness
.*
KATHY A. MORROW
Attorney at law
217 S. Carlisle Street
P.O. Box 250
New BloomfIeld, PA 17068
COMMONWEALTH OF PENNSYLVANIA *
* ss:
COUNTY OF PERRY
*
We, Jesse L. Flurie, the testator in, and 1(1-J77ltt A. I7h),ftfoJ
and GLEdtA F. .fjiu..IV/A~ the witnesses to the Last Will and
Testament, the attached or foregoing instrument, who have signed the
instrument, having been duly qualified according to law do depose and say:
(a) that I, the testator, do hereby acknowledge that I signed and
executed the instrument as my last Will, that I signed it willingly and as my
free and voluntary act for the purposes therein expressed; and
(b) that we, the witnesses, were present and saw the testator sign and
execute the instrument as his last will, that he willingly signed and executed
it as his free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the testator signed the will as a witness and
that to the best of our knowledge the testator was at that time 18 or more
years of age, of sound mind and under no constraint or undue influence.
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J;j{PNb Ff2~
.Witness
6ic t((~~
My Commission expires:
NOT AAIAL SEAL
SANOAA KAY CAMPBELL. Notary Public
~ Bora. Perry County
My Commission Expires October 26. 2002
Charles F. Chenot, III
Attorney-at-Law
P.O. Box 250
217 S. Carlisle Street
New Bloomfield, PA 17068
November 9,2005
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: JESSE L. FLURIE, DECEASED
DATE OF DEATH: 6/7/05
SOCIAL SECURITY NO. 174-20-7495
NO. 2005-00523
PA NO. 21-05-0523
Dear Register:
(717) 582-7313
Fax (717) 582-7724
Enclosed for filing please find the Inheritance Tax Return and payment for
the above referenced decedent.
Please return a date-stamped copy in the enclosed envelope.
Thank you.
Sincerely,
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Charles F. Chenot, III
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