HomeMy WebLinkAbout04-11-06
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OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
RLE NUMBER
~ 2005 0805
COUN1Y CODE YEAR NUMBER
SOCIAL SECURI1Y NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Bishop, Eric A.
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
07 -12-2005
10-29-1976
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
~ 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D
D
D
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)
D 3. Remainder Retum (date of death prior to 12-13-82)
D 5. Fe~eral Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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COMPLETE MAILING ADDRESS
NAME
James D. Bogar
FIRM NAME (If applicable)
Bogar & Hipp Law Offices
TELEPHONE NUMBER
717-737-8761
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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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) D Separate Billing Requested
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)
201-68-6515
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURI1Y NUMBER
One West Main Street
Shiremanstown, PA 17011
(1 ) None
(2) None
(3) None
(4) None
(5) 21,338.81
(6) None
(7) None
(8)
(9) 5,838.67
(10)
C?1;J;ICIA~tJSEONLY
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21,338.81
(11 )
.5,838.67
15,500.14
0.00
(12)
(13)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
not been made (ScheduleJ)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
15,500.14
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec, 9116(a)(1.2)
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0 .045 (16)
~ 16.Amount of Line 14 taxable at lineal rate 15,500.14 x
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a.. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
0 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18)
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I- 19. Tax Due
(19)
Copyright 2002 form software only The Lackner Group, Inc.
0.00
697.51
0.00
0.00
697.51
Form REV-1500 EX (Rev. 6-00:
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Decedent's Complete Address:
STREET ADDRESS
159 Amy Drive
CITY Carlisle
I STATE PA
I ZIP 1 701 3
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
Total Credits (A + B + C)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenally (D + E)
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
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
697.51
(2)
0.00
(3)
(4)
(5) 697.51
(5A)
(5B) 697.51
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 properly transferred;.................................................................................. D ~
b. retain the right to designate who shall use the property transferred or its income;.................................... D [!]
c. retain a reversionary interest; or.................................................................................................................. D ~
d. receive the promise for life of either payments, benefits or care?............................................................. D [!]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...... ... .... ..... .......... .......... ....... ........ ........ ........................... ...... ... ....... ... ........... D ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.... ........... ... .... ..... .... .............. ................. ...... .................... ...... .... ......... .......... D ~
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 penanies of perjury, I declare that J 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 knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
ROl!17 -/ ~
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
1005 Pheasant Drive North
Carlisle, PA 17013
ADDRESS
ADDRESS
One West Main Street
Shiremanstown, PA 17011
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. 39116 (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 1
[72 P.S. 39116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, an,
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. {. C' 0 V..A..
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 yc 2 .
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 39116 (a) (1.2)]. ..:. 0
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiarie
39116 1.2) [72 P.S. 39116 (a) (1 )].
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The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [7:
defined under Section 9102, as an individual who has at least one parent in common with the decedem, VYllelller uy UIUUU or aOOpuon.
c,..-
Rev-1508 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Bishop, Eric A.
FILE NUMBER
21-2005-0805
ESTATE OF
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 DESCRIPTION
1 Members 1st Federal Credit Union - Savings Account No. 224420-00, date of death
balance $171.25, accrued interest $0.05
VALUE AT DATE
OF DEATH
171.30
2 Members 1st Federal Credit Union - Savings Account No. 224420-11, date of death
balance $263.02, accrued interest $0.00
263.02
3 Members 1st Federal Credit Union - Supplemental Savings Account No. 224420-01,
date of death balance $57.12, accrued interest $0.02
57.14
4 Nationwide Insurance - Property Damage Claim
2.889.88
5 Nationwide Insurance - Premium Refund
52.10
6 Personal Property - Sold at Private Sale
300.00
7 Joseph Machine Company - Wages Paid
1.375.74
8 John Hancock Life Insurance Company - 401 (k) account balance $16,229.63 (see
attached letter from the Healey Group)
16.229.63
TOTAL (Also enter on Line 5, Recapitulation)
21.338.81
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
tv 1st
MEMBERS 1st
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
224420 -00
11/23/2002
$171.25
$.05
$171.30
None
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
224420 -11
11/23/2002
$263.02
$.00
$263.02
None
SUPPLEMENTAL SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
224420 -01
02/22/2005
$57.12
$.02
$57.14
None
X2:ERS 1~T FERAL CREDIT UNION
- I- //J4~
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Denise A. Wolfe
Insurance Services Supervisor
October 7, 2005
Estate of: ERIC A. BISHOP
Date of Death: 07/12/2005
Social Security Number: 201-68-6515
5000 Louise Drive . P.o. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 · www:members1st.org
H
THE HEALEY GROUP
1000 North Front Street, Suite 240, Wormleysburg, PA 17043
Tel717.730.0800 Fax 717.730.0887
E-mail dscarazzo@jhnerwork.com
March 21, 2006
Mr. James D. Bogar, Esquire
1 West Main Street
Shiremanstown, P A 17011
Dear Attorney Bogar,
Pursuant with the request from your office I have enclosed a valuation of Eric Bishop's
401(k) account balance as of the date of his death; July 12, 2005. The balance on that
date was $16,229.63.
If you require additional information about this account, please feel free to contact me.
Best regards,
tdt/Uatd~
./
Donald A. Scarazzo
Enclosure
Donald A. Scarano
Registered Representative
Registered Representative/Securities offered thtough
Signaror Invesrors, Inc., Member NASD. SlPC
138 River Road. Suite 310, Andover, MA 01810
978.689.9303
Insurance Producrs offered through John Hancock Life
Insurance Company, Bosron, MA 02117
Bisys :: ParticipantInfo
Page 1 of 2
Home >> Participant Information >> Participant Data
Select a Participant
To search, please enter either the participant's entire Social Security Number or a partial first or last
name and click Continue.
Social Security Number (xxx-xx-xxxx) t_________.___I
First Name
I__,___._.._..__~_...J
L___. ___.......______..
--
Last Name
Participant Data
You have selected ERIC BISHOP. He or she is now the active participant whose information
will display on each of the Participant Information screens until you select another participant.
Participant Demographics
Social Security Number 201-68-6515 Employee Number
First Name ERIC MI A Last Name BISHOP
Address 170 FAITH CIRCLE
City CARLISLE State PA Zip Code (Zip+4 requires a dash) 17013
Country Foreign Code
Date of Bi rth 10/29/1976 Gender Male Marital Status Single
Employment Information
: Location 0000000000 Estimated Annual Compensation $35000.00
Participation ELIGIBLE/CONTRIBUTING 1000 Hours (Initial Yes
Status Code Eligibility Requirement)
Insider No Federal Exemption 0
Date of Hire 08/24/1998 Termination Date
Prior Date of Hire N/A Prior Date of Termination N/A
Eligibility Date 01/01/2000 Union Status Non Union
Compliance Section
- Key Employee
Non-Key
Highly Compensated Code (HCE) Not Reported
....-,,-_-.-..-~._,~.<...._...'.._~~.............--.-.,........~,~..._,~._,_.--..,.-,,-;.~~~,"~,._--~"..~----,-_.>-~~..-,...._"",--.~-,.~~...<........._.....>__....."....,.,......,.".....,,,,,._."-"'_,.....,.__'r_"""_"'"',..... >_'''''''''''''{
https:/ /www.sponsorinsight.comlplaninsight/index.cfm ?privilegeid=204
7/13/2005
Bisys :: AccountInfo
Account Balance
Page 1 of 2
The following is ERIC BISHOP's retirement account balance as of 7/12/2005. For your
convenience, we have listed Balances by Fund and by Source. The total balance does not take
vesting into account. Please refer to your plan's vesting schedule for more information.
Please refer to the page help if you need details regarding the information displayed in the tablE
below.
This table lists the fund name, number of units, unit price and balance in each fund.
Franklin Flex Cap Growth A
(CL) ALLlANZ NFJ Small Value Fund A
AIM Basic Value Fund A
AIM Mid Cap Core Equity Fund A
John Hancock Financial Industries Fund A
John Hancock Technology Fund A
John Hancock Stable Value Trust A
John Hancock Bond Fund A
John Hancock Health Sciences Fund A
American Funds American Balanced A
John Hancock US Global Leaders Growth A
.fo.i1.und~ ~..~i9r.?~.qaPm~q~ity
Lord Abbett Mid Cap Value
John Hancock Strategic Income Fund A
lAmerican Funds NewPerse.~~ctive ~~~_..
Sources
0.0000
0.0000
132.2850
0.0000
0.00001
2050.1640
0.0000
0.0000
98.0090
0.0000 I
0.0000
0.0000
0.0000
0:0000 I
0.0000 I
$ 38.08 $0.00
$ 31 .42 $0.00
$ 32.94 $4,357.47
$ 29.98 $0.00
$ 19.041 $0.00
$ 3.50 $7,175.57
$ 1.00 $0.00
$ 15.23 $0.00
$ 47.92 $4,696.59
$ 18.141 $0.00
$ 27.49 $0.00
$ 42.91
$ 23.18
$7.031
$ 27.431
$0.00
$0.00
$0.00
This table lists the balance from each source, the percent the participant is vested and the
participant's total vested balance according to your plan's vesting schedule.
EMPLOYER PROFIT SHARING
EMPLOYER MATCH
EMPLOYEE 401 (K)
Total Balance (Less Outstanding Loan Balance):
Total Vested Balance (Less Outstanding Loan Balance):
Total Loan Payoff Amount:
Maximum Amount Available for Loan:
$16,229.63
$16,229.63
$0.00
$0.00
https://www.sponsorinsight.com/planinsightJindex.cfm
7/13/2005
REV-1151 EX+ (12-99)
.*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Bishop, Eric A.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-2005-0805
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule{s) attached 2,288.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Bogar & Hipp Law Offices 1,950.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 70.00
5. Accountant's Fees Greenawalt & Company, P .C. 225.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,305.67
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 5,838.67
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONVvV,L TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Bishop, Eric A.
IFILE NUMBER
21-2005-0805
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Carlisle Memorial Service, Inc. - Monument
2.000.00
2
Westminster Cemetery Inc. - Grave Stone Placement
288.00
Subtotal
2.288.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1S02 EX+ (6-98)
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMON~lTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Bishop, Eric A.
FILE NUMBER
21-2005-0805
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Comcast - Final Bill
48.25
2
Cumberland Law Journal - Administrator's Notice
75.00
3
PPL - Final Electric Bill
79.66
4
Prothonotary - Photocopies of Divorce Decree
7.00
5
Register of Wills - Short Certificates (2)
12.00
6
Register of Wills - Filing Fee-Pa. Inheritance Tax Return and Inventory
30.00
7
RESERVES: - Costs to conclude administration of Estate including filing fee for
First and Final Account preparation of fiduciary income tax returns
850.00
8
Sprint - Final Bill
81.25
9
The Sentinel - Administrator's Notice
122.51
Subtotal
1,305.67
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
REV-1513 EX+ (9-00)
*'
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Bishop, Eric A.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-2005-0805
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not list Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
1
Collin R. Bishop
7816 Wertzville Road
Carlisle, PA 17013
Son
One-half (1/2)
of rest, residue
and remainder
2
Tessa M. Bishop
7816 Wertzville Road
Carlisle, PA 17013
Daughter
One-half (1/2)
of rest, residue
and remainder
Total
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)