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Home My WebLink About02-03-06 THIS SECtiON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO; NAME COMPLETE MAILING ADDRESS Steohen J. Hoea. Esauire 19 S. Hanover Street FIRM NAME (If Applicable) 19. Tax Due (19) 20. 0 ~"r4Ilb!~~liJArll"h<< . REV-1500 EX + (6-00) *' 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) I- Z W C W U W C Stillwaaon Marv W_ DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 11/16/2004 09/05/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- ::.:: :$U) uO:::::.:: w~u J: 0:::3 u a.1Il a. c( [X] 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (AltachcopyofWill) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) I- Z W C Z o a. U) w 0::: 0::: o U TELEPHONE NUMBER 7172452698 Ste.101 Carlisle z o j:: ~ ...J :::J I- a: ~ u w c::: 1. Real Estate (Scheduie 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) 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) (11) (12) (13) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) z o j:: ~ :::J a. :E o u >< ;5 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) X _(16) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 37,532.44 X .12 (17) (18) 18. Amount of Line 14 taxable at collateral rate X .15 - OFFICIAL USE ONLY FILE NUMBER 2 1 -05 0 0 3 94 COUNTY CODE -VEAR- - - NUMsER- - SOCIAL SECURITY NUMBER 2 0 1 - 0 1 - 8 1 8 6 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURIT'Y NUMBER o 3. Remainder Return (date of death 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) PA 17013 1,:-) I OFFICiAL USE ONLY 13,706.92 I I I I I I I I ~ I I I L___~__________J , .~ 32,054.74 45,761.66 6,127.29 2,101.93 8,229.22 37,532.44 37,532.44 4,503.89 4,503.89 ., REV-15Q8 EX + (6-98) * - w. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 1 FILE NUMBER 21 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ITEM NUMBER 1. DESCRIPTION Prudential Financial Life Insurance - Policy# M07186420 VALUE AT DATE OF DEATH 2,260.16 2. Prudential Financial Life Insurance - Policy# M07186419 2,260.16 3. Refund: Patriot News 41.25 4. Refund: Comcast 42.24 5. Refund: Erie Car Insurance 23.00 6. Personal Property - Household Furniture 3,360.00 7. Car - Grand Marquise VIN: 2MELM74W3RX635090 3,000.00 8. PA Treasury Department Annuitant 2,027.23 9. Interest earned from May 2005 - January 2006 692.88 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 13.706.92 REV-15.0P';'X +0(6-98) 'W - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER 21 394 w. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. John T. Work 4603 Chestnut Avenue Camp Hill, PA 17011 Brother B c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DE CD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1, A. 3/8/02 M&T Bank 7,394.01 50. 3,697.01 Personal Statement Savings Acct#15004208556140 2. A. 3/8/02 M& T Bank 56,672.01 50. 28,336.01 Relationship Checking with Interest Acct#82021856 3. A 3/8/02 M&T Bank 10.24 50. 5.12 Personal Statement Savings - #15004208556140 Earned Interest from 11/2004-5/2005 4. A 3/8/02 M& T Bank 33.19 50. 16.60 Relationsip Checking with Interest - #82021856 Earned Interest from 11/2004-5/2005 TOTAL (Also enter on line 6, Recapitulation) $ 32054.74 (If more space is needed, insert additional sheets of the same size) "REV-15.11 EX + (12-99) . - C'OMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS I FilE NUMBER ESTATE OF Stillwagon Mary W. 21 05 00394 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Neill's Funeral Home 1,030.12 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Honora M. Work 2,278.83 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 4603 Chestnut Avenue City Camp Hill State PA Zip 17011 Year(s) Commission Paid: 2. Attorney Fees Stephen J. Hogg, Esquire 2,278.83 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 187.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Advertising Cumberland Law Journal 75.00 The Sentinel 122.51 8. Inheritance Tax Return Filing Fee (est.) 25.00 9. Final Accounting Filing Fee (est.) 130.00 TOTAL (Also enter on line 9, Recapitulation) $ 6 127.29 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) - R~V-1~12 EX + (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS 1 FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stillwaaon. Mary W. 21 05 00394 Include unreimbursed medical expenses. 1. Vehicle Reistration VALUE AT DATE OF DEATH 36.00 2. PPL - final bill 119.26 3. PAWC (water) - final bill 16.23 4. Comcast Cable - final bill 42.23 5. Verizon - final bill 10.89 6. PA State Retirement System - partial repayment 946.04 7. Bank Fee for Returned Check 4.00 8. New Checks 16.75 9. L.B. Smith - car inspection 700.53 10. Appraisal Fee for personal property 190.00 11 . American Lung Association 20.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2 101.93 Stil/wanon Marv W. ?1 ()~ ()()3A4 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. John T. Work brother 50% 2. Faye Sponhauer sister 50% 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 $ .,~,.''''':L{* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - SCHEDULE J BENEFICIARIES I FILE NUMBER (If more space is needed. insert additional sheets of the same size)