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HomeMy WebLinkAbout12-15-05 REV-1S00EX(6-00) .'! ",m. 0.'" . 0.0 ..r::2..Q U~lD " Rev-1500 OFf'ICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 FILE NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT 05 0907 21 County Code Year Number I- Z UJ Cl UJ c..l UU Cl DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) LUNDGREN Frances M. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) SOCIAL SECURITY NUMBER 149-05-0549 THIS RETURN MUST BE FILED IN DUPLICATE WITH August 23, 2005 September 20,1913 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A "E ." -c = <> = ~ ." t= <> <..> x 1. Original Retum - 4. Limited Estate - x 6. Decedent Died Testate (Attach copy of Will) - 9. Litigation Proceeds Received - THIS SECTION MUST BE COMPLETED, NAME Francis A. Zulli, Esquire FIRM NAME (If Applicable) Wion. Zulli & Seibert TELEPHONE NUMBER 717-232-1488 2. Supplemental Retum 3. Remainder Return (date of death prior to 12- - - 4a. Future Interest Comprise (date of death after 12-12-82) 5. Federal Estate Tax Return Required - - 7. Decedent Maintained a Living Trust (Attach a CXlpy of Trust) 8. Total Number of Safe Deposit Boxes = 10. Spousal Poverty Credit (dateofdealh between 12-31.91 and 1-1.95) 011. Election to tax under Sec. 9113(A) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS 109 Locust Street Harrisburg, PA 17101 1. Real Estate (Schedule A) (1) (2) (3) (4) (5) (6) $0.00 ~ $0.001 ,..., = c:.:::l' <.n OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (7) $O.O~O ~,- :cJ $0.001.J,:Eo ::]".-,.r- $72,211.86 L~.~:; Si : -,- (~n7~:;: $O.OO~. -' (;C) ~ j~~~~-n CS $0.00 ~.:;~~~..............~........~~::....';~.~.~........ 3. Closely Held Corporation, Partnership or Sole-Proprietorship c::> ,-" ,..., z o ~ ~ l- ll.. <( () W a::: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) u' 6. JoinUy Owned Property (Schedule F) D Separate Billing Requested 7. InterNivos Transfers & Misc. Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) $72,211.86 (8) $6,782.29 $132.65 (11) (12) (13) (14) $65,296.72 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) .iR R1!l14 12. Net Value of Estate (Line 8 minus Line 11) $65,296.72 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) !to 00 z o i= X" <(>- >-~ IL :; o () 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) x (15) $0.00 16. Amount of line 14 taxable at lineal rate x (16) $0.00 17. Amount of line 14 taxable at sibling rate $65,296.72 x .12 (17) $7,835.61 18. Amount of line 14 taxable at collateral rate x .15 (18) ~OOO 19. Tax Due (19) $7,835.61 20.0 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: , STREET ADDRESS 1700 Market Street CITY I~TATE IZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Oue (Page 1 Line 19) (1) 2. CreditslPayments A. Spousal poverty Credit B. Prior Payments C. Discount $7.835.61 Total Credits (A + B + C) (2) soon 3. InterestlPenalty if applicable D. Interest E. penalty TotallnterestlPenalty (0 + 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) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) $0.00 $7,835.61 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. $7,835.61 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: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary 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 on 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 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which Yes No 2. ~ B m EB 3. 4. contains a beneficiary designation? c=J [TI 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 pefjUry, I declare that I have exarrined this return, including accCll'll)anying schedules and statements, and to the best of ITlj knowledge and belief. it is true, correct, and complete. Declaration of preparer other than the personal representative is based on alllhe infonnalion of YAlich preparer has any knowledge. E FOR FILING RETURN /~ ADDRESS 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 sUlViving spouse i: 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or atter January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the sUlViving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. The statute does not exemot a transfer to a sUlViving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are s applicable even if the sUlViving 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 adop 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. _.~.",..~"<~-~._..", LAST WILL AND TESTAl'v1ENT OF FRANCES M. LUNDGREN I, FRANCES M. LUNDGREN, of Lemoyne, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this my Last Will and Testament, hereby revoking and making void all former Wills and Codicils by me at any time heretofore made. ITEM I. I direct my Executrix or her successor, hereinafter named, to pay all of my just debts, funeral expenses and costs of admirJ'istration of my estate as soon after my decease as conveniently may be done. ITEM II. I give, devise and bequeath all the rest and remainder of my estate, real, personal or mixed, wheresoever situate and of every kind and description, whether now owned by me or hereafter acquired, unto my sister, Louise L. Spier, of Lemoyne, Pennsylvania. ITEM III. Should my sister, Louise L. Spier, predecease me, then and in such event, I give, devise and bequeath all the rest, residue and remainder of my estate as follows: I. One-half (1/2) of my residuary estate in equal shares to my two nieces: Mary L. Davif?~, 2429 Jericho Drive, Harrisburg, Pennsylvania .~ and Janet L. Hench, 576 East Mulberry Street, Elizabethtown, Pennsylvania. ~ .,,-' t.-;;:;l <:O..~I :-::1 ;-;"1 C) o =~ ""';';'--' t::; = ., -"1 2. The remaining one-half (1/2) in equal shar~s- to my niece arid two nephews: Betty Linda McLaughlin, 204 Heather Drive, Harrisburg, -.-" Pennsylvania; James E. Tarman, 10 Dunover Court, Hummelstown, Pennsylvania and Robert N. Tarman, 605 Sandra Avenue, Harrisburg, Pennsylvania. :-.. .,~~ -:"IJ -: ~~~~ '.0 r--~) G:. '.-:-') , ~ A ;,<'j '-:r}-7 ---,-?j;'_'j/] i; ,"9 ~,;-. FRANCES M. '-......./.., ,/ ,~. ,/, -- -'\. "V....-i.-....,.J4/U..'.i_. LUNDGREN' j ITEM IV. In the event my niece, Mary L. Davis, predeceases me, then, and in such event, I give, devise and bequeath her share of my estate unto her children, Patricia Davis and Andrew Davis, equally, or unto the survivor. ITEM V. In the event my niece, Janet L. Hench, predeceases me, then, and in such event, I give, devise and bequeath her share of my estate unto her child, Elizabeth Ann Hench. ITEM VI. In the event my niece, Betty Linda McLaughlin, predeceases me, then, and in such event, I give, . devise and bequeath her share of my estate unto her children, Dennis McLaughlin, Scott McLaughlin and Christopher McLaughlin equally, or unto the survivor. ITEM VB. I n the even t my nephew, James E. Tarman, pedecease me, then, and in such event, I give, devise and bequeath his share of my estate unto his children equally. In the event that my nephew, James E. Tarman, predeceases me, leaving no chi ld or chi ldren, then, and in such event I give, devise and bequeath his share of my estate in equal shares to my niece Betty Linda McLaughl in and my nephew Robert N. Tarman. ITEM VI I I. I n the even t my nephew, Rober t N. Tarman, predeceases me, then, and in such event, I give, devise and bequeath his share of my estate unto his children equally. In the event thay my nephew, Robert N. Tarman, predeceases me, leaving no chi ld or chi ldren, then, and in such event I give, devise and bequeath his share of my estate in equal shares to my niece Betty Linda McLaughlin and my nephew James E. Tarman. ITEM IX. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever 2 / , "7, t-/." . _ _ "//}1 . l{/ /.;,; !'f./'.!~.- y.- . FRANCES M. , "-..-.,.;.., ,', J~ -'1-, IA-"v~ /-iL'.-r;..t-, LT.JNlX;REN1 " CCXvMJNWEALTH OF PENNSYLVANIA CDUN1Y OF DAUPHIN ss We, Frances M. Lundgren, Robert N. Tarman and Frank R. Magnelli the Testatrix and Witnesses respectively, whose names are signed to the attached or foregoing instrument, being duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it 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 witnesses and that to the best of their knowledge, the Testatrix was at that tim~ ~ight~~rr y~ars of age or older, of" sound mind and under no constraint or undue influence. ) ~. _'-;7"/ :/'" /- !::/;1 ",1A(' ~./ ,~, " ~>? LU,L/'. , FRANCES M. LlNDGR,BN // -\ ,"v /~~7 ./ /,/ ,'" .. 4" It '",,~ N",/M0~ v ROBERT N :-'I'ARMAN oln%l R, I\~^,~' FRANK R. WAGNELLI ; Subscribed, sworn to and acknowledged before me by Fr,ances M. Lundgren, the Testatrix, and SUbscr(rf' and sworn to before me by Frank R. Magnelli n Rob rt N Ta man, Witnesses, the lO7'-l. day of ~ef' M( ", I NOTARIAl SEAL BENJAMIN F H,\/otlOND. JR.. Notary Pub1 'iC I My Commission Exp;r~s Se~t. S. 1993 Harrisburg C1ty Dauph1n county REV-1508EX+(1-91)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Frances M. Lundgren FILE NUMBER 21-05-0907 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Checking account #56572247 at M&T Bank VALUE AT DATE OF DEATH $10,423.56 2. Certificate of Deposit #031003913919345 at M& T Bank $5,625.15 3. Checking account #3622-70678 at Fulton Bank $55,163.15 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $72,211.86 REV-1511 EX + (1_971(1) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Frances M. Lundgren FILE NUMBER 21-05-0907 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Prepaid B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Mary L. Davis $3.560.00 Social Security Number(s) I EIN Number of Personal Representative(s) 206-32-4340 Street Address 2429 Jericho Drive City Harrisburg State PA Zip 17110 - Year(s) Commission Paid: 2006 2. Attorney Fees - Francis A. Zulli, Esquire $2,800.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills $173.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Register of Wills - filing Inventory $30.00 8. Advertising - Cumberland Law Journal $75.00 The Sentinel $144.29 TOTAL (Also enter on line 9, Recapitulation) $6,782.29 (If more space is needed, insert additional sheets of the same size) REV-1512EX+(1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF Frances M. Lundgren FILE NUMBER 21-05-0907 Include unreimbursed medical expenses. ITEM NUMBER 1. Neighbor Care ~ Pharmacy service DESCRIPTION AMOUNT $132.85 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $132.85 REV.1513EX+ (9-<lO)) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT BENEFICIARIES ESTATE OF Frances M. Lundgren FILE NUMBER 21-05-0907 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nol List TlUslee(sl OF ESTATE I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec, 9116 <al (1.2)] 1 Louise L Spier Sister Entire Estate 1700 Market Street Camp Hill, PA 17011 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $0.00 .. (If more space IS needed, Insert additional sheets of the same size)