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Home My WebLink About12-14-05 REV -1101 to( .1.-101 *' OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENrs NAME (LAST. FIRST, AND MIDDLE INITIAL) Costello, Joanne C I I FILE NUMBER 21 05 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 172-24-9605 Q30 COMMON\NEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-ll801 NUMBER .. Z III o III o III o DATE OF BIRTH (MM-DD-YEAR) DATE OF DEATH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 11/22/1930 03/13/2005 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) III .. :.:el:l/) oii!:': IIIA-g :J:li!... oA-lIl A- el: 1. Original Return 2. Supplemental Return o 3. Remeinder Return (dete of deeth prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31 6. Decedent Died Testate (Attech copy of Will) 9. Litigation Proceeds Received ... f3z ~~ OZ o~ IRM NAME (If epplicable) Law Office of Donald L Reihart 3015 Eastern Boulevard York, PA 17402 (1) None (2) None (3) None (4) None (5) 25,000.00 (6) 2,252.95 (7) None i j ELEPHONE NUMBER 717/755-2799 OFFICIAL USE ONLY z o ~ f! ~ III 0: 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) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 4,749.08 r-",) , C.;I ~. -- - i - - (-) ;,.--) '--~-i (8) 27,252.95 (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 4,749.08 22,503.87 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 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) (13) (14) 22,503.87 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 22,503.87 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x l= ~ ::> A- 17.Amount of Line 14 taxable at sibling rate x .12 (17) ::E 0 0 S 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 1,012.67 1,012.67 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) , , , be<:edent's Complete Address: STREET ADDRESS 2352 State Street CITY Harrisburg STATE PA ZIP 17103 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 1,012.67 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theT AX DUE A. Enter the interest on the tax due. 8. Enter the total of Line 5 + SA. This is theBALANCE DUE ,." G.OO \"J (4) (5) 1,012.67 (SA) (58) 1,012.67 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income ofthe property transferred;............................................................................. ~ ~ :: ~::::~ ~h;e~:~:i~~:~s:~~e~=s~~~. ~~~~~ .~.~.~. ~.~~.:.~~:.~.~..~~~~.~~~.~~~~. .~.~ .i~~. ~~~.~~:"""".'.'.'.'.'.'.'.'.'.'.'~~:: :::::::: :~~..... d. receive the promise for life of either payments, benefits or care?........................................................... 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?..............................n................................................................................ 0 ~ 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 penafties of perjury, I daclare that I have examined this return ",i.:'Jr.lioy accompanying schedules and statements, and to tha best of my knowledge and beliaf, it is true, correct and complete. Daclaralion praparer other than the personal representativa is based on all infonn~'I'"I'_')i which preparer has any knowledge. SIGNATURE PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Kathleen Fouse DATE 2352 State Street Harrisburg, Pa 1 i 103 - - --ADDRESS William Costello 4950 Janelle Drive Harrisburg, Pa 17112 ADDRESS Donald L Reihart 3015 Eastern Boulevard York, PA 17402 I' ..t/ //,,"'~ DATE I ~~ /oF DATE /..}. /, 2. /'" S- 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 statutedoes not exemDta 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 the child is 0% [72 P.S. ~9116 (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 P.S. ~9116 1.2) [72 P.S. ~9116 (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. ~9116 (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. , , *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 - 05 - Include 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 NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 20,000.00 Proceeds from Settlement Facility- DCT Received August 2005 Class 5 Rupture 2 Proceeds from Settlement Facility - DCT Received August 2005 Class 5 Explant 5,000.00 TOTAL (Also enter on Line 5, Recapitulation) 25,000.00 . . *' SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAI.TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 - 05 - If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A Kathleen R. Fouse ADDRESS RELATIONSHIP TO DECEDENT 2353 State Street Harrisburg, Pa 17103 Daughter JOINTLY OWNED PROPERTY: DATE DESCRIPTION OF PROPERTY %OF ITEM LETTER Include name of financial institution and bank account number DATE OF DEATH DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECO'S VALUE OF TENANT JOINT estate. INTERESl DECEDENTS INTEREST 1 A M & T Checking Account #17878535 4,505.91 2,252.95 TOTAL (Also enter on line 6, Recapitulation) 2,252.95 . , . SCHEDU.EH RJNERAL EXPENSES & ADNINISTRA11VECOSlS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 - 05 - Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: 1 Hetrick Funeral Home, Balance 798.40 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year{s) Commission paid 2. Attorney's Fees Law Office of Donald L Reihart -- Donald L Reihart 3,250.00 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 Register of Wills, additional probate fee 55.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Charles Petrie, subscribing witness 20.00 2 Register of Wills, file return 10.00 3 Reimbursement, postage, photocopies 49.80 Total of Continuation Schedule(s) 565.88 TOTAL (Also enter on line 9, Recapitulation) 4,749.08 *' Schedule H Funeral Expenses & Mninisfrative Cos1s continued COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 - 05 - 4 Reception 507.88 5 Donald L Reihart, reimbursement for probate costs 58.00 Page 2 of Schedule H *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 - 05 - RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE nn Nnt I I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Kathleen Fouse Daughter 14.28% 2352 State Street Harrisburg, Pa 17103 2 William Costello Step-son 14.28% 4950 Janelle Drive Harrisburg, Pa 17112 3 Randy Fisher Son 14.28% 2995 Rosstown Road Wellsville, Pa 17365 4 Scott Fisher Son 14.28% 2295 Rosstown Road Wellsville, Pa 17365 See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover shel t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEr *' SCHEDULE J BENEFICIARIES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Costello, Joanne C I FILE NUMBER 21 . 05 . RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY DECEDENT Do Not List Trustee(sl OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 5 Josephine Salinger Step-daughter 14.28% 3803 Crooked Hill Road Harrsiburg, P A 17112 6 Joseph Costello, Jr. Step-son 14.28% 7608 Patterson Drive Harrisburg, Pa 17112 7 Floyd Costello Step-son 14.28% 1023 Walnut Street Lemoyne, Pa 17043 Page 2 of Schedule J Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Costello, Joanne C also known as , Deceased No. 21 - 05 - Date of Death 3/13/2005 Social Security No. 172-24-9605 Kathleen Fouse William Costello The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. IflNe verify that the statements made in this Inventory are true and correct. IflNe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Donald L Reihart Personal Represen~ Signature: ';/LY~~ , Ka leen Fouse Co~ Signature: lJjJj:...... - William Costello I.D. No.: 07421 Signature: Address: 3015 Eastern Boulevard York, PA 17402 Address: Kathleen Fouse 2352 State Street Harrisburg, Pa 17103 Telephone: 711-d?3~ -11/#,) Dated: J.;<-i.,/lJS- Telephone: (717) 755-2799 Personal Property Proceeds from Settlement Facility- DCT Received August 2005 Class 5 Rupture 20,000.00 Proceeds from Settlement Facility - DCT Received August 2005 Class 5 Explant 5,000.00 Total Personal Property $25,000.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate $25,000.00 AFFIDAVIT OF PERSONAL REPRESENTATIVE COMMONWEALTH OF ~r\I'oSIj\\J~\O, COUNTY OF ~\A_P~ w) Personally appeared before me, a Notary Public, in and for said County, Kathleen Fouse who being duly sworn according to law, says that the within Inventory of the personal property and real estate which were of Joanne C Costello, late of Camp Hill Borough, Cumberland County, is true and correct to the best of her knowledge, information and belief. ~(&'d~'/L Kat. een Fouse, Co-Executor AFFIDAVIT OF PERSONAL REPRESENTATIVE COMMONWEALTH OF 7f-l COUNTY OF DA LJ PH)(0 Personally appeared before me, a Notary Public, in and for said County, William Costello who being duly sworn according to law, says that the within Inventory of the personal property and real estate which were of Joanne C Costello, late of Camp Hill Borough, Cumberland County, is true and correct to the best of his knowledge, information and belief. Sworn an_~ subscribed to before me this Q~ayof~ , 2005. ~~g.~ \n~~-Wo- William Costello, Co-Executor N otcu-( ~u 10 ( I ~ COMYOMWEALTH OF PENNSYlVANIA NOTARI~ SEAl PAULA K. SMITH. Not91y NiJIo Susquehanna Twp., DauphIl 00lJIly My Comm~~ ~~..:.. aooe . . .r-' .. LAST WILL AND TESTAMENT I, JOANNE C.COSTELLO, of 1911 Rudy Road, Harrisburg, County . of Dauphin, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I give, devise, and bequeath all of my property, real, personal, and mixed, to my husband, JOSEPH J. COSTELLO. THIRD, that if my husbarrid has predeceased me, or has fa i led to , . survive me for a period of at least ninety (90) days, or if our deaths should occur in such a manner that it cannot be determined which of us has predeceased the other, then I give, devise, and bequeath all of my property, real, personal, and mixed, to be divided in the following manner: a. I give and bequeath my birthstone ring to LISA SALINGER. b. I give and bequeath my cat's eye ring to DARLENE FISHER. c. I give and bequeath my two diamond rings, one of which has a square setting and was a gift from my mother, Ruth Heiges, and one teardrop opal necklace with a diamond setting and matching earrings, to KATHLEEN RUTH FOUSE. '. " . .. d. I give and bequeath my collector's pieces of currency and coins to WILLIAM COSTELLO, to dispose of as he sees fit. e. I give, devise, and bequeath all of the rest, residue, and remainder of my property, real, personal, and mixed, to be divided equally among the following individuals: WILLIAM COSTELLO, JOSEPHINE SALINGER, JOSEPH COSTELLO, JR., FLOYD COSTELLO, KATHLEEN FOUSE, RANDY FISHER, and SCOTT J. F~SHER. FOURTH, that I hereby appoint my husband, JOSEPH J. COSTELLO, as the Executor of my estate. If he is unable or unwilling to perform in this capacity, then I appoint KATHLEEN FOUSE and WILLIAM COSTELLO as the Co-Executors.. I direct that my Personal Representatives shall not b~~required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 18th day of July, 1990. WE, the witnesses whose r~J'. r~~1P J:AN~E C. CaSTELO . names are hereto subscribed, DO CERTIFY that on the 18th day of July, 1990, the Testatrix above named did subscribe her name to the foregoing instrument, and, in to the execution thereof, which vie hereby do in the presence of the Testatrix and of each other on the date of the said will. ~E~ WITNESS ./~:i C.n:tit WITN~S . V .... ., .' f." 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 REIHART DONALD L 3015 EASTERN BOULVARD YORK, PA 17402 ____nn ford EST A TE INFORMATION: SSN: 172-24-9605 FILE NUMBER: 2105-0930 DECEDENT NAME: COSTEllO JOANNE C DATE OF PAYMENT: 12/14/2005 POSTMARK DATE: 12/12/2005 COUNTY: CUMBERLAND DATE OF DEATH: 03/13/2005 NO. CD 006103 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,012.67 I I I I I I I I TOTAL AMOUNT PAID: $1,012.67 REMARKS: CHECK# 001388 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS ~ LAW OFFICES DONALD L. REIHAR~ ESQUIRE DONALD L. REIHART KAREN L. SAXTON ELYANA TARLOW 3015 EASTERN BOULEVARD YORK, PENNSYLVANIA 17402 E-Mail reihartlaw@blazenet.net www.teihartlaw.com TELEPHONE (717) 755-2799 (800) 333- 7974 FAX (717) 755-2530 December 12, 2005 Register of Wills 1 Court House Square Carlisle, Pa 17013 Re: Estate of Joanne Costello Dear Register: Enclosed please find two copies of the Inheritance tax return, along with three checks to be filed for the above captioned estate. Please file the original and return a time-stamped copy to us in the enclosed self-addressed, stamped envelope. \--) . ':()~ Donald L Reihart :~~ .~~---, t.,",) ....:..r; 4....~ "".:1 '..co) . 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