HomeMy WebLinkAbout01-12-06
REV.11OClI!!X.I...ot1 . REV-1500 r .. ---'-'-i
INHERITANCE TAX RETURN ~--_._----'
COMMONWEAlTH OF PENNSYLVANIA ! FilE NUMBER C03lp
DEPARTMENT OF REVENUE RESIDENT DECEDENT 21 05
DEPT. 280601
HARRISBURG, PA 17128.0801 COUNTY CODE YEAR NUMBER
o 2. Supplemental Return
o 4a. Future Inlerest Compromise (dete 01 death altar
12-12-82)
o 7. Decedent Maintained a Living Trust (Attach
copy 01 Trust)
o 10. Spousal Poverty Credit (data 01 death between
12-31-9.1 and 1-1-95)
iTl-IlS Sr:CTION MUSJBI: CQMPLE"TI:p. AL,L CQI'IRESPO!,!DI:",~E ~NQC~NAQENTI~_L TAX INFOR-'~.A TlONuSHQl,J'!-Q~E: _[)IRECTJ;D TO:
NAME !COMPlETE MAILING ADDRESS
Stephen L. Bloom
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DECEDENT"S NAME (LAST. FIRST. AND MIDDLE INITIAL)
Leidigh, Mary J.
SOCIAL SECURlrY NUMBER
216-32-6589
THIS RETURN MUST BE FilED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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3. Remainder Return (date 01 death prior 1012-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
. DATE OF DEATH (MM-DD-YEAR)
I DATE OF BIRTH (MM-DD-YEAR)
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11. Election to tax under Sec. 9113(A) (Attech Sch 0)
02/20/2005
09/11/1905
2100 Longs Gap Road
Carlisle, P A 17013
(1) None
(2) None
(3) None
(4) None
(5) 802.30
(6) None
(7) None
(8)
(9) 9,215.90
(10)
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802.30
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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6. Decedent Died Testate (Attach copy
01 Will)
9. Litigation Proceeds Received
(11 )
9,215.90
1. Original Return
4. Limited Estate
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FIRM NAME (11 applicable)
Stephen L. Bloom, Esquire
~ElEPHONE NUMBER
717/249-7717
(12)
insolvent
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)
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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)
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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
20. D
15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
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Q. 17.Amount of Line 14 taxable at sibling rate x .12 (17)
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~ 18. Amount of Line 14 taxable at collateral rate x .15 (18)
....
19. Tax Due (19)
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)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<<
Copyright 2000 form software only The Lackner Group, Inc.
Fo~ REV-15" EX CR,,- 6-0')
Decedent's Complete Address:
STREET ADDRESS
442 Walnut Bottom Road
CITY
Carlisle
I STATE PA
!
ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 0.00
(SA)
(5B) 0.00
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPA YMENT.
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 the TAX DUE.
A. Enter the interest on the tax due.
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 reversionary interest: or..................................................................................................................
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?......... ...................... ............... ..................................... ................ ...................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.... ................. .................... ..... ............... ............... .......................... ...............
Yes No
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D ~
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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 perjury, I declare that [ have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Dedaration of
preparer other than the personal representative is based on all information of which preparer has any knowledge
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
8ren~..c ~::e~ns'J~v ~ L __
SIGNAZJot((~pZf~~Wl~
,1980,3. Ru~!Ie~Q<29 Drive
tlUlTItJle, I,.', 11",,8
DATE
1'2/2 '1/ tJ <:;'
ADDRESS
DATE
ADDRESS
DATE
2100 LOT)gs Gap Road
Carlisle, t'A 17013
6
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. !l9116 (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. !l9116 (a) (1.1) (ii)]. The statute does not exemot a 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. !l9116 (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. !l9116
1.2) [72 PS !l9116 (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. !l9116 (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
Leidigh, Mary J.
! 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
I
DESCRIPTION
VALUE AT DATE OF
DEATH
802.30
Refund of Resident Account - United Church of Christ Homes
TOTAL (Also enter on Line 5, Recapitulation)
802.30
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINlSlRATlVE COSlS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX ReTURN
RESIDENT DECEDENT
ESTATE OF
Leidigh, Mary J.
! FILE NUMBER
21 - 05 -
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Funeral Services - Hoffman-Roth Funeral Home, Inc.
6.929.85
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State _ Zip
2.
Attorney's Fees
Stephen L. Bloom, Attorney and Counsellor at Law
2.286.05
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
I
TOTAL (Also enter on line 9, Recapitulation)
9,215.90
F IFIl.ES\DA TAFILEIWILLSI7466WIL
LAST WILL AND TESTAMENT
I, MARY J. LEIDIGH, of the Borough of Carlisle, Cumberland County, Pennsylvania, being
of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last
Will and Testament, hereby revoking any and all former Wills or Codicils by me made.
1.
I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance
taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be
paid from my residuary estate as soon as practicable after my decease and as part of the
administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement
for any such tax so paid, even though on proceeds of insurance or other property not passing under
this Will.
2.
I give the sum of FIVE DOLLARS ($5.00) unto my son, W. KENNETH LEIDIGH.
3.
1 give the sum of FIVE DOLLARS ($5.00) unto my son, W ALTER RITTENHOUSE.
4.
All the rest, residue and remainder of my estate, both real and personal property, I give,
devise and bequeath unto my daughter, BRENDA MAE CRENSHAW.
5.
I nominate, constitute and appoint FINANCIAL TRUST SERVICES COMPANY of Carlisle,
Pennsylvania, or its successor, as Executor of my estate.
6.
I direct that my Executor shall not be required to file a bond to secure the faithful
performance of its duties in any jurisdiction.
7.
I authorize and empower my Executor, in its sole and absolute discretion, to purchase or
otherwise acquire and retain any investments of which I die seized or any real or personal property
of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in
regard to any or all property of any kind forming a part of my estate for such terms and such prices
Page 1 of 3 Pages ~.
as it may deem advisable; to borrow money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any real or personal property forming a part of my
estate or to join in or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
share to be composed of cash, property or undivided fractional shares in property different in kind
from any other share; and to execute and deliver such instruments as may be necessary to carry out
any of these powers.
IN WITNESS WHEREOF I have hereunto set my hand and seal this )s t
day of
~
,1997.
~ah ~#.rl'~
Mary J. ~gh
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
(SEAL)
for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other.
~--f~~
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Page 2 of 3 Pages
COMMONWEAL TH OF PENNSYL VANIA )
: SS.
COUNTY OF CUMBERLAND )
I, Mary J. Leidigh, Testatrix, whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed the
instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary
act for the purposes therein expressed.
h/~~~r
Mary J. Igh
Sworn or affirmed to and acknowledged before me by Mary J. Leidigh, the Testatrix, this
iSI dayof ~ ,1997.
(' ~0.~~
Notary Public
COMMONWEAL TH OF PENNSYLVANIA
)
: SS.
)
We, S~~ (. /.?J ()"TWl ~ Tf'cC(.A. L. (!J~ ley 1
the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw Mary J. Leidigh, the Testatrix,
sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the
Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of
us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our
knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Notana! Seal
Corrine L. Myers. Notary Public
Carlisle Bora. Cumberland County
My Commission Expires May 27.1999
COUNTY OF CUMBERLAND
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Address 7.... E;A~ I-I,,~ ~~t
tltic!/Ct_ "0,3
Address . ~ fA /7d:J7
Sworn or affirmed to and subscribed before me this I ~, day of ~, 1997.
~~~
Notary Public
Notanal Seal I
Corrine L Myers. Notary Public
Carlisle Boro, Cumberland County
I My CommisSion Expires May 2,'. 1 C!9Cl .:
Page 3 of 3 Pages
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STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR AT LAW
w w W I'R ^ C TIC ALe 0 II N S E I. COM
2100 LONGS GAP ROAD
CARLISLE, PENNSYLVANIA 17013
SBLOOM@PRACTICAl.CO{'NSEL COM
Invoice submitted to:
Leidigh, Mary J. Estate
c/o 2100 Longs Gap Road
Carlisle, PA 17013
May 20, 2005
In Reference To: Estate Administration
Invoice # 1582
Professional Services
2/28/2005 Telephone conference with M&T Bank; Preliminary matters of Estate
Administration
3/2/2005 Telephone conferences with M& T Bank
3/3/2005 Telephone conference with M&T Bank
3/8/2005 Review correspondence from M&T Bank and documentation provided
by same (including original Will, M& T Bank Renunciation, obituary,
MetLife Policy information, funeral statement, Durable POA, Thornwald
Home information, miscellaneous information re various past personal
and financial matters)
3/15/2005 Review expense/liability information provided to M& T Bank by former
POA
3/16/2005 Telephone conference with daughter of Decedent (Ms. Crenshaw)
3/23/2005 Review correspondence from M& T Bank and documentation re funeral
bill
4/19/2005 Review correspondence from M& T Bank and Department of Public
Welfare Medical Assistance Estate Recovery information
4/29/2005 Administrative and estate accounting matters; Telephone conference
with M&T Bank; Research re Medicaid Estate Recovery and other
liabilities of insolvent estate; Prepare and file DPW information form
TELEPHONE 717-249-7717
FACSIMILE 717-249-7757
TOLL FRFE 877-548-9602
Hrs/Rate Amount
0.25 50.00
200.00/hr
0.17 33.33
200.00/hr
0.08 16.67
200.00/hr
0.39 77.94
200.00/hr
0.06 12.50
200.00/hr
0.17 33.33
200.00/hr
0.04 7.78
200.00/hr
0.12 23.67
200.00/hr
2.53 506.61
200.00/hr
PRACTICAL COUNSEL >l< CHRISTIAN PERSPECTIVE
Leidigh, Mary J. Estate
and correspondence with DPW, Estate Recovery Section;
Correspondence with creditors and institutions with whom Decedent
maintained business relationships; Correspondence with BGE re
possible life insurance; Correspondence with Decedent's former Power
of Attorney
5/3/2005 Telephone conference with Funeral Home re outstanding balance;
Determination of priority of claims and status of possible assets;
Correspondence with Funeral Home and residuary beneficiary;
Preparation of Authorization and Release
5/6/2005 Administrative and estate accounting matters; Review correspondence
from Thornwald Home and Hoffman-Roth Funeral Home, Inc.;
Correspondence with former Power of Attorney; Telephone
conferences with Hoffman-Roth Funeral Home, Inc.
5/11/2005 Review correspondence and information from former Agent under
Power of Attorney; Administrative matters
5/20/2005 Administrative and estate accounting matters
For professional services rendered
Balance due
PAYABLE UPON RECEIPT - THANK YOU
Page
2
Hrs/Rate
Amount
1.70 339.11
200.00/hr
0.46 91.72
200.00/hr
0.23 45.89
200.00/hr
0.37 73.94
200.00/hr
6.57 $1,312.49
$1,312.49
PRACTICAL COUNSEL 01< CHRISTIAN PERSPECTIVE
STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR AT LAW
WWW PRACTICALCOUNSEL COM
2100 LONGS GAP ROAD
CARLISLE, PENNSYLVANIA 17013
SBLOOM@pRACTICALCOUNSEL.COM
Invoice submitted to:
Leidigh, Mary J. Estate
clo 2100 Longs Gap Road
Carlisle, PA 17013
July 29, 2005
In Reference To: Estate Administration
Invoice #1614
Professional Services
6/2/2005 Review and file correspondence from Constellation Energy
7/6/2005 Review correspondence from Department of Public Welfare, Estate
Recovery Program
7/29/2005 Administrative and estate accounting matters; Research re distribution
in light of DPW waiver of claim; Preparation and assembly of
Pennsylvania Inheritance Tax Return, Exhibits and Schedules;
Correspondence with heir; Receipt, Release and Refunding Agreement
Reserve for final administrative and estate accounting matters,
including review of executed documents, appearance at Register of
Wills for filing of Inheritance Tax Return, correspondence with heir re
distribution, review of correspondence from Department of Revenue re
Notice of Appraisement, and miscellaneous final correspondence
For professional services rendered
Previous balance
5/20/2005 Payment - thank you
7/29/2005 Payment - thank you
Total payments and adjustments
Balance due
TELEPHONE 717-249.7717
FACSIMILE 717-249-7757
TOLLFREE 877-548-9602
Hrs/Rate Amount
0.08 16.67
200.00/hr
0.08 16.67
200.00/hr
3.20 640.22
200.00/hr
1.50 300.00
200.00/hr
4.86 $973.56
$1,312.49
($1,312.49)
($973.56)
($2,286.05)
$0.00
PRACTICAL COUNSEL II< CHRISTIAN PERSPECTIVE