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Home My WebLink About03-27-06 CCHJHvl0N\'';EAL TH OF PENNSYLV ANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OEPT 280601 HARR,SBURC;, PA 171280601 REV-1162 EX(11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TROXELL HARRY R 4606 ABINGTON DRIVE HARRISBURG, PA 17109 ~ -- - i olLl ESTATE INFORMATION: SSN: 177-16-1534 FILE NUMBER: 2106-0144 DECEDENT NAME: TROXELL HERBERT E DA TE OF PAYMENT: 03/27/2006 POSTMARK DATE: 03/27/2006 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2005 NO. CD 006477 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $ 1 7,404. 1 1 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: H TROXELL CHECK#1002 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $17,404.11 GLENDA FARNER STRASBAUGH REGISTER OF WILLS --.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death OFFICIAL USE ONLY County Code Year Fiie Number INHERITANCE TAX RETURN RESIDENT DECEDENT Ii, e#. ~ I ~ 06 Ii? ; ,.,"< -;; :;4./......1 Date of Birth 177 -16-1534 12/25/2005 12/04/1915 Decedent's Last Name Suffix Decedent's First Name MI HERBERT E TROXELL (If Applicable) Enter Surviving Spouse's Information Below Last Name N/A Spouse's First Name MI Socia! Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FilL IN APPROPRIATE OVALS BELOW C.' 1, Original Return 2. Supplementai Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 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 12-31-91 and 1-1-95) o 8. Totai Number of Safe Deposit Boxes ell> 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 11. E!ection to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Number MICHAEL S. FERGUSON Firm Name REGISTER OF WILLS USE ONLY NEALON GOVER & PERRY First line of address Second line of address or Post Office State ZIP Code 17110 HARRISBURG Correspondent's e-mail address:mferguson@ngplawfirm.com Under penalties of perjury, 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowiedge. SIG, N'f.:rE OF PERS~..., RES~SIBLE..~6R it1ufld'G RETURN DATE . , ~ ~\ , L.,.,v-J<./X-/ "5 J2 < J tl ~.DDRESS ,- . . 'Iftofc A-bIN<"l-c~~1l>,'-, H';{j'Y6bl:n.? lOA i7/D9 ~fJ TU~ r,~ ~( ! ,O,T~ER THAN REPRESENTATIVE ] ~I U ~' {.C; ,,---.. ADDRESS - S ).. tll N ~f!.DI,il. r ATE 3 if4 0 {. MA41'sBL\(2(; . f1 /71 Ie PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ---I Number 177-16-1534 0.00 218,533.00 0.00 0.00 190,876.36 0.00 0.00 409,409.36 2,295.58 0.00 2,295.58 407,113.78 0.00 407,113.78 ---I 15056052059 REV-1500 EX Decedent's Name: HERBERT E TROXELL RECAPITULATION 1. Real estate (Schedule A). ........ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 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) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............ .. .......... 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 18. 15. 16. 17. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . 19. 20. FILL INTHE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 L 0.00 18,320.12 ---I Decedent's Complete Address: DECEDENT'S NAME HERBERT E TROXELL STREET ADDRESS 1700 MARKET STREET DECEDENT'S SOCIAL SECURITY NUMBER -, 177-16-1534 REV-1500 EX Page 3 CITY CAMP HILL STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 18,320.12 0.00 0.00 916.01 Total Credits (A + B + C ) (2) 916.01 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 0.00 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 - (4) 0.00 (5) 17,404.11 (5A) 0.00 (5B) 17,404.11 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: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 [K] d. receive the promis~ for life of either payments, benefits or care? .................................................................... 0 ~ 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? ........................................................................................................................ 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. 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 three (3) percent [72 P.S. S9116 (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 zero (0) percer,t [72 P.S. S9116 (a) (1.1) (iO]. 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 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 zero (0) percent [72 P.S. s9116(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 four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. s9116(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-1503 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF HERBERT E TROXELL FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 2. AMERICAN BALANCED FUND CAPITAL INVESTMENT BUILDER FUND 3. HARTFORD ADVISORS FUND 18,600.00 20,374.00 50,646.00 4. HARTFORD CAPITAL APPRECIATION 56,274.00 19,389.00 53,250.00 5. INCOME FUND OF AMERICA 6. GEORGIA PACIFIC BOND, Maturity Date 6/1/2020, rate 7.25%, quantity 60,000 TOTAL (Also enter on line 2, Recapitulation) $ 218,533.00 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) 9'"~() ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF HERBERT E TROXELL FILE NUMBER 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. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. PA. STATE BANK, P.O. Box 487, 2148 MarketSt., Camp Hill, PA 17011, Acct#26011064 (money market) 2. PA. STATE BANK, P.O. Box 487,2148 Market St., Camp Hill, PA 17011, Acct #503400 (CD) 3. PA. STATE BANK, PO. Box 487, 2148 Market St., Camp Hill, PA 17011, Acct #10009009 (checking) 4. PNC BANK, 500 First Ave., Pittsburgh, PA 15219, Acct#31600225651 (CD) 5. PNC BANK, 500 First Ave., Pittsburgh, PA 15219, Acct#5003701665 (Checking) 52,886.62 15,000.00 1,262.74 120,742.99 984.01 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 190,876.36 REV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF HERBERT E TROXELL FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: ZIMMERMAN AUER - BURIAL COSTS 2. WAKE AT CROSSROADS CAFE 1. 266.00 1 34.61 34.97 75.00 3. INCOME TAX PREPARATION SOFTWARE FOR FINAL RETURN 4. HONORARIUM TO RVEREND MICHAEL SEIFRIED B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name ot Personal Representative(s) Social Security Number(s)!EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attorney Fees 1,250.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State ,Zip Relationship of Claimant to Decedent 4. Probate Fees 460.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. ESTATE NOTICE - CUMBERLAND LAW JOURNAL 75.00 TOTAL (Also enter on line 9, Recapitulation) $ (It more space is needed, insert additional sheets of the same size) 2,295.58 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HERBERT E TROXELL FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. HARRY R. TROXEll, 4606 ABINGTON DR., HBG., PA 17109 SON 33.33 2. BRENDA VOVAKES, 617 EAST Hill RD., MIDDLESEX, VT 05602 DAUGHTER 33.33 3. CHARLIE TROXELL, PO. BOX 25123, GMF, GUAM 96921 SON 33.33 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 N/A B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS N/A --- 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)