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Home My WebLink About12-16-05 REV-15OQ EX +,(6-00) . I- Z W C W U w C W I- ~ :$Ul Ull::~ w15U J: 11::9 U ~lD oC( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) HOSLER DATE OF DEATH (MM-DD-Year) JOHN ~ DATE OF BIRTH (MM-DD-Year) IX] 1. Original Return D 4. Limited Estate IX] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (dalll of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit (dalllofdeath between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 5 o 392 03/30/2005 06/11/1918 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ""'Ccj'ij'NTY'CoiiE ---vEAr;-- - - NuMsER- - SOCIAL SECURITY NUMBER 2 04- 0 1 - 2 605 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required .!.. 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ;n!DlIISJseC1OORiMUSt!seb'8MjtelmFittlt00RRESPONDENCE'Mt);C-eNsbBitlAL1:,TlXiiNFIJRMA'riONstiOOli:b Be~tHREGTED:TO:c' i .' NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III, ESQUIRE FIRM NAME (If Applicable) I- Z W C Z o II. Ul W II:: II:: o U TELEPHONE NUMBER 717-697-4650 54 EAST MAIN STREET MECHANICSBURG (1) (2) (3) (4) (5) z o i= <( ..J ::I I- D: <( u w a:: 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 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) 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 Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) X _(15) X _(16) X .12 (17) X .15 (18) (19) z o i= <( I- ::I D.. :::E o U ~ I- 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (8) (11) (12) (13) (14) PA 17055 120,792.22 OFFICIAL USE ONLY (6) (7) (9) (10) 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) 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 46,856.56) : :--:) '~,] u r---, ... .,,~, f ""':1 I... f1 -~ . , , I ) ) , '-:J 1 C-,J 45,848.52 CT". r' --') ,'..) l' , ~, , 213,497.30 27,472.95 1,242.35 28,715.30 184,782.00 185,021.17 0.00 0.00 Decedent's Com lete Address: STREET ADDRESS . 1686 W. LlSBURN ROAD MECHANICSBURG STATE PA ZIP 17055 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Pen alty Total Interest/Penalty ( 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 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 income of the property transferred; ........................................................................... D IZl b. retain the right to designate who shall use the property transferred or its income; ........................................ D IZl c. retain a reversionary interest; or ...................................................................................................... D IZl d. receive the promise for lite of either payments, benefits or care? ............................................................. D IZl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. D IZl 3. Did decedent own an 'in trustfor" or payable upon death bank account or security at his or her death? ................. D IZl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... D IZl 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 best of my knowledge and belief, it is true, correct and complete. Decla-ation of prepar8f ther than the rsonal representative is based on all information of which preparer has any knowledge. SIGNATURE OF;PE . O~ RE P ; .SIL~$;~ING:ETURN DATE ADDRESS DEEN D. WATSON 830 FO G RO PA SIGNATURE OF PREPA/~HE H ADDRESS MUR EL R. ALTERS III, ESQUIRE 54 EAST MAIN STREET, MECHANICSBURG PA 17055 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)l. 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)l. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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. REV -1502.EX + (6-98) oW COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER HOSLER JOHN B. 21 05 0392 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real DroDertv which is iointJv-owned with riaht of survivors hiD must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 120,792.22 1686 W. LlSBURN ROAD MECHANICSBURG, PA 17055 NET SALE PRICE TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 120,792.22 REV-150:) EX + (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOSLER JOHN SCHEDULE B STOCKS & BONDS All property jointly-owned with right of survivorship must be disclosed on Schedule F. B. FILE NUMBER 21 05 0392 ITEM NUMBER 1. PNC STOCK 912 SHARES COMMON @ $51.38 DESCRIPTION VALUE AT DATE OF DEATH 46,856.56 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheels of the same size) 46,856.56 REV-15G8 EX + (6-98) ,W SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOSLER FILE NUMBER JOHN B. 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. 0392 ITEM NUMBER DESCRIPTION 1. CITIZENS BANK CHECKING ACCOUNT 2. CITIZENS BANK CHECKING ACCOUNT 3. SOVEREIGN BANK CERTIFICATE OF DEPOSIT 4. SOVEREIGN BANK CERTIFICATE OF DEPOSIT 5. PATRIOT NEWS REFUND 6. AARP REFUND 7. 1979 CHEVY TRUCK NET SALE PRICE 8. AT&T LEASE PHONE REFUND 9. FARM JOURNAL MEDIA REFUND 10. 1994 CHEVY CAVALIER NET SALE PRICE 11. CASH ON HAND 12. NATIONWIDE MUTUAL FIRE INSURANCE REFUND 13. HOUSEHOLD CONTENTS PUBLIC AUCTION NET VALUE AT DATE OF DEATH 1,770.45 21,621.23 1,487.27 10,010.95 44.44 171.50 50.00 17.00 48.43 1,400.00 1,026.00 89.00 8,112.25 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 45,848.52 REV-1511 EX + (12-99) .W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF HOSLER ITEM NUMBER A. 1. 2. B. 1. 2. 3. 4. 5. 6. 7. FILE NUMBER JOHN B. 21 05 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: MYERS FUNERAL HOME GINGRICH MEMORIALS - TOMBSTONE ENGRAVING ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) DEEN D. WATSON Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 830 FORGE ROAD City CARLISLE State PA Zip 17013 Year(s) Commission Paid: 2006 Attomey Fees MURREL R. WALTERS III, ESQUIRE Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS Accountanfs Fees Tax Retum Preparer's Fees ESTATE CHECK PRINTING TOTAL (Also enter on line 9, Recapitulation) $ (If more spaoe is needed. insert additional sheels of the same size) 0392 AMOUNT 8,150.00 140.00 9,404.00 9,404.00 365.00 9.95 27,472.95 REV-151~ EX + (6-98) ''* SCHEDULE' DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOSLER FILE NUMBER JOHN B. 21 05 Include unreimbursed medical expenses. 0392 ITEM NUMBER 1. MET-ED ELECTRIC 2. AT& T CONSUMER PHONE LEASE 3. MARY A. MURRAY COUNTYITOWNSHIP TAXES 4. DAVIS COUNTRY LIVING LAWN MOWER REPAIR 5. WONDERS, LTD. AUCTION TENT RENTAL 6. ALICE GIBNEY AUCTION ASSISTANCE 7. RANDALL K. WATSON AUCTION HELPER 8. MICHAEL WATSON AUCTION HELPER 9. LUCAS WATSON AUCTION HELPER 10. MARY WATSON AUCTION HELPER 11 HOLY SPIRIT HOSPITAL MEDICAL DESCRIPTION VALUE AT DATE OF DEATH 69.30 18.45 246.10 115.53 137.80 20.00 99.00 99.00 99.00 99.00 239.17 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,242.35 .'~":'>X'I* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF H()~LFR SCHEDULE J BENEFICIARIES JOHN B. NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS Vnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. FILE NUMBER 21 05 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 0392 AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET n. 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 THE GOOD NEWS BROADCASTING ASSOCIATION, INC. BACK TO BIBLE BROADCAST P.O.BOX 82808, LINCOLN, NE 68501 EMMANUEL BAPTIST CHURCH OF WEST SHORE, INC. 4681 E. TRINDLE ROAD MECHANICSBURG, PA 17050 2 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) 1,000.00 183,782.00 $ 184,782.00