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Home My WebLink About05-01-06 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ENGLE GERALD WAYNE 145 AIRPORT ROAD MARIETTA, PA 17547 _nnn_ fold ESTATE INFORMATION: SSN: 182-16-1284 FILE NUMBER: 2106-0166 DECEDENT NAME: ENGLE JACOB MARTIN DATE OF PAYMENT: 05/01/2006 POSTMARK DATE: 05/01/2006 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2006 NO. CD 006638 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $62,250.93 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: GERALD W ENGLE CHECK#1004 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS $62,250.93 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV . 1100 EX + ('~I *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 06 __Q9UNTY CODE YEAR SOCIAL SECURITY NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 -- - -TDECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Engle, Jacob Martin ffi DATE OFO-EATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) c w u w c OFFICiAL USE ONLY 0166 ______ NUMBER_ 182-16-1284 02/01/2006 12/15/1912 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) ~ 1. Original Return 0 w 10 I- 4. Limited Estate 0 ~~m UO::~ wQ.u ~ ~ ::1:00 6. Decedent Died Testate (Attach copy uO::...I Q.ID of Will) Q. cC 0 9. Litigation Proceeds Received 0 REGISTER OF WILLS SOCIAL SECURITY NUMBER 2. Supplemental Return ~__n____------o. 3. Remainder Return (date of death prior to 12-13-82) 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- 1 n 1-1- 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) .1- mz Ww O::c O::z 00 uQ. ~_...- IRM NAME (If applicable) Ahrens Law Office, P.C. ELEPHONE NUMBER 717/697-1800 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ~ :5 :;) I- ~ cC U W 0:: 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) 5521 Carlisle Pike - - - ----.-- Mechanicsburg, P A 17050 (1 ) (2) (3) (4) (5) (6) (7) None OFFICIAL USE ONLY None ,.~ C;;;") c.:> t,.-;., None -~D iT, (-J ,=--=; -=6 ....--.,..., : r i-; c..) --;" ,-"~ None ---J .- --(~ 1,321,288.77 None -r-:1 ~E:i 262,244.47 - i "T'r (85 l-fi 8 3 ,5':f1~ ----t.;:tJ-~-"-+- (9) (10) 35,137.88 - - -- ----_._--~ 3,783.24 (11 ) 38,921.12 1,544,612.12 88,450.00 (12) 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) 1,456,162.12 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) --.-------------.---.-------- z 1,456,162.12 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x ~ ------- -~-- :J Q. 17. Amount of Line 14 taxable at sibling rate x .12 (17) ~ 0 ---~-_._- u ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) --. ----_.~.__._---_._---- 19. Tax Due (19) 65,527.30 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 65,527.30 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) C-~ Decedent's Complete Address: STREET ADDRESS 304 Messiah Circle rSTATE-;~ n-----~IZIP~~~~----~ CITY Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 65,527.30 3,276.37 Total Credits (A + 8 + C) (2) 3,276.37 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (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. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (58) 0.00 62,250.93 62,250.93 Make Check Payable to: REGISTER OF WILLS, AGENT 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?...................................................................................................................... PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS y~ I 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?...... ................................ ........ ....................................... ................................ ~ o o 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 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. 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 IdWaYDe~'_ __ &tirii~T.orlY~~47 ::-/,! rGNATURE~OF PERSON ~E FOR ADDRESS ---- --- -- ~----~o-f-!2fc" -- 2_ --- - - ~ __ -__ _ _ __ ~_ _~ ___ _ _~__ ___ _ _ _,_____ _~~_ ____ ___n_~ __ ~__n ~~~ _ _ ~__ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Thom J. :;;,s ~ DATE ADDRESS DATE 5521 Carlisle Pike Mechanicsburg, P A 17050 b? 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)]. 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. 99116 (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. ~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. . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . Engle, Jacob Martm FILE NUMBER 21 - 06 - 0166 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 -----~--- ---~-- 1 Legg Mason account # 363-00437 DESCRIPTION VALUE AT DATE OF DEATH ~__~_~ _______ _____n_____ ~-n-~f____-------- 278,929.94 2 Legg Mason account # 363-07400 1,037,040.22 3 Messiah College Annuity income 1,137.50 4 Goodville Insurance auto refund 130.42 5 Goodville Insurance homeowners refund 43.00 6 Supplemental Health Insurance refund 259.92 7 Goodville Insurance umbrella insurance policy refund 78.00 8 AAA Membership refund 36.75 9 Household contents at Messiah Village 3,500.00 10 Alert Pharmacy Service, Inc. refund 133.02 TOTAL (Also enter on Line 5, Recapitulation) 1,321,288.77 *' i i I ____------1_ SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Engle, Jacob Martin 21 - 06 - 0166 ITEM NUMBER Thi~~~he~ule must be completed an_d filed if the ~i!~~er to~ of_g~estJ~ns 1Jtlroug~ ~ on page ~}fes. ____ InCludethenameofthe~;;~r~~~~~i~~a~~:~~~c~~:':ndthedateoftransfer. VDATE OF DEATH DO~CO~S I EXCLUSION. TAXABLE VALUE Attach a copy of the deed for real estate. ALUE OF ASSET INTEREST I (IF APPLlC=~ __~ Gift to Brethem in Christ World Missions within 1 year of 10,000.00 100% 3,000.001 7,000.00 000 (Charity) I I 5,000.001 1000/0 I I 2 Gift to Gospel Tide Hour Radio Ministry within 1 year of 000 (Charity) 3 Gift to the Ethel G. Engle and J. Martin Engle Scholarship at Messiah College within 1 year of 000 (Charity) 4 I Gift to Messiah Village within 1 year of 000 (Charity) I I Gift to the Ethel G. Engle and 1. Martin Engle Scholarship at Central Pennsylvania College within 1 year of 000 (Charity) 5 6 Gift to Elizabethtown Brethem in Christ Church within 1 year ofDOD (Charity) 7 Gift ot Messiah Village Brethem in Christ Church within 1 year of DOD (Charity) 8 Gift to John C. Engle within 1 year ofDOD (Grandson) 9 Gift to Merline Engle within 1 year of DOD ( Granddaughter- in-law) 10 Equity in Messiah Village Unit payable to the Jacob Martin Engle Trust 11 PNC checking account # 50-0202-6346 in Living Trust 12 Lincoln National Life Ins. annuity - Policy # 929811646 beneficiaries are decedents 3 children TOTAL (Also enter on line 7, Recapitulation) I 262,244.47 40,000.00 I I 10,100.001 100% 100% 3,000.00 2,000.00 14,000.00 100% 3,000.001 i 37,000.00 i 20,1500001 10,200.00 100% 100% 3,000.00 7,100.00 5,000.00 100% 5,000.00 100% 22,282.87: 100% 10,356.42 100% I I 137,155.181 100% I 3,000.00 11,000.00 I i 3,000.001 17,150.00 3,000.00 7,200.00 3,000.001 I 3,000.001 ! 2,000.00 2,000.00 22,282.87 10,356.42 137,155.18 SCHEDULE H FlJN3W.. EXPENSES & COM~~~~~~~EO:~e:~~L~ANIA ADMNS1RAllVE COSTS ____ RESIDEN~OECEDENT _____~_~_ *' I FILE NUMBER ____~_ .____2~ - O~- 0166 ESTATE OF . Engle, Jacob Martm Debts of decedent must be reported on Schedule I. 2 I P A Inheritance Tax filing fee I 1 Total of Continuation Schedule(s) -----.- - . .. -- - -- ..- . --------- --- ---- .- - --- --.-- ITEM NUMBER ------- A. B. DESCRIPTION AMOUNT --- -----_.~-~-----~.~----~ --~--------------- FUNERAL EXPENSES: Miller/Sekely Funeral Home 9,122.60 2 Grave marker engraving 78.00 3 Funeral luncheon at The Gathering Place 5,081.70 4 Flowers 220.69 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative{s): 2. Street Address City State _ Zip Year(s) Commission paid Attorney's Fees Ahrens Law Firm, PC. 15,850.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills Zip State 965.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 2005 tax prep fee Estimated 2006 tax prep fee - Roy Armold 1,525.00 800.00 7. 1 Other Administrative Costs Estate notices in the Legal Journal and The Sentinel 175.73 15.00 1,304.16 TOTAL (Also enter on line 9, Recapitulation) 35,137.88 . SchecUe H A.I1eraI Expenses & AdnilistraIive Costs cooIinued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF E I J b M . ! FILE NUMBER ng e, aco artm I 21 _ 06 - 0166 -- -3--1- Movemen~ & stor~ge ofh~usehold items out of MessiahVill;g~ wti~- ~ntiidisburs;d- ---T --- .. --. 994.45-- 4 I Miscellaneous administrative costs for travel, phone and postage 309.71 I I I I ________---L_______~ Page 2 of Schedule H I I I .._ .. .1. __ ___ . __~_ _ . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE liABiliTIES, & liENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 06 - 0166 --~---~---_.._-~--~--.,~--_.-.._--~-----~ -----..-,-------- .._---_.-._---------~------ ESTATE OF . Engle, Jacob Martin Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT Messiah Village nursing home bill paid in February 673.06 2 Check written but not cleared 35.00 3 2005 Federal Income tax due 559.00 4 2005 State Income tax due 1,655.00 5 Estimated 2006 State income tax 212.00 6 Final Verizon bill 86.91 7 Final PPL electric bill 77.93 8 Final A T & T bill 1.09 9 Final medical bills 483.25 TOTAL (Also enter on Line 10, Recapitulation) 3,783.24 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT : FILE NUMBER 21 - 06 - 0166 ---------_._-----,--~-----~-~-~-- ~---~~-----, - : RELATIONSHIP TO I NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY -t' DECEDENT AMO~~~~:A~~ARE ~~_____ _~_~_____ ~~__~_________ ______ ___~LLisLIlus~---- _______ I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 l J~COb Martin Engle Living Trust dated October 9,2002 - to be distributed Trust btire residue I equally to his 3 children I II : ! ! I i I ESTATE OF Engle, Jacob Martin 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 Brethern in Christ W orId Missions 7,000.00 2 Gospel Tide Hour Radio Ministry 2,000.00 3 Ethel G. Engle and J. Martin Engle Scholarship at Messiah College 37,000.00 4 I Messiah Village 7,100.00 5 Continuation 35,350.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 88,450.00 Schedule J Estate of Engle, Jacob Martin Continuation of Charitable Distributions Ethel G. Engle and J. Martin Engle Scholarship @ Central Pennsylvania College Elizabethtown Brethern in Christ Church Messiah Village Brethern in Christ Church File Number 21-06-0166 $11,000 $17, 150 $7,200 $35,350