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Home My WebLink About06-25-06 ~ 15056041114 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisbur , PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 46~1 Date of Birth 201-16-3196 01252006 03141925 Decedent's Last Name Suffix Decedent's First Name MI BENDER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix NANCY L Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW DO 1. Original Return CJ 2. Supplemental Return CJ 4. Limited Estate c:J 4a. Future Interest Compromise (date of death after 12-12-82) 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 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) CJ CJ o CJ 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required CJ CJ CJ CJ 8. Total Number of Safe Deposit Boxes 11. Election 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 Daytime Telephone Number STEPHEN D. TILEY Firm Name (If Applicable) 717-243-5838 REGISTER-Q,F WILLS USE~~L Y --') . ~:, :....;..\ FREY & TILEY First line of address 5 SOUTH HANOVER STREET Second line of address r.,) Cl -0 " ('~',-:) - j I II -) I'l DATE FILED (.) City or Post Office State ZIP Code CARLISLE PA 17013 (~ CO --, _.J " ,", Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this retum. 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 O~F PERSON RESP NSIBLE FOR FIL.ING RETURN DATE I X IP~~ /i'lCh,..,.-!J,.,r .5"-~.J -("6 ADDRESS RAYMOND T. BENDER, TRANSFEREE, 458 STONE CHURCH ROAD, CARLISLE, PA 17013 SIG~PARE~HE~ 5A111 ~RESENTAT1VE AD ESS " STEPHEN D. TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PLEASE USE ORIGINAL FORM ONLY DATE /J4J-t/ -2J ~et!J6 ~ ./ PA 17013 Side 1 L 15056041114 15056041114 --I .-J 15056042115 REV-1500 EX Decedent's Name: NAN C Y L BEN DE R RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) C]Separate Billing Requested. . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C]Separate Billing Requested . . . . . . . . 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201-16-3196 Decedent's Social Security Number 1. NONE 2. NONE 3. NONE 4. NONE 5. 6. 7. NONE 8. 9. 1365.00 50640.00 52005.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . , 5379.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . 10. NONE 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.O ~ 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 4 6 62 6 . 0 0 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042115 15. 16. 17. 15056042115 5379.00 46626.00 0.00 46626.00 0.00 0.00 0.00 6994.00 6994.00 C] ---I REV-1500 EX Page 3 201-16-3196 Decedent's Complete Address: DECEDENT'S NAME NANCY L BENDER STREET ADDRESS 458 STONE CHURCH ROAD File Number CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 6994.00 Total Credits ( A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 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. (4) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 6994.00 A. Enter the interest on the tax due. (SA) 6994.00 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No [K] o [K] o o [K] 1. Did decedent make a transfer and: Yes a. retain the use or income of the property 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 D D D 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [K] 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. ~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 zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)). 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. ~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 four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. 99116(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. 217 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Nancy L. Bender Include the proceeds of litigation and the date the proceeds were received by the estate. All orooertv iointly-owned with right of survivorshio must be disclosed on Schedule F. FILE NUMBER ITEM NUMBER DESCRIPTION Unclaimed Property Receipt from PA Treasury - Prudential Financial Demutualization VALUE AT DATE OF DEATH 1,365 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,365 217 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Nancy L. Bender If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Raymond T. Bender 458 Stone Church Road Carlisle, PA 17013 Brother-in-law B. C. JOINTLY-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 DECO'S VALUE OF JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST NUMBER TENANT 1. A. 4/15/85 M& T Bank Checking Account #2679079976 15,111 50.00% 7,556 2. B. 9/20/85 M&T Bank Savings Account #015004200021927 86,167 50.00% 43,084 TOTAL (Also enter on line 6. Recapitulation), $ 50 640 (If more space is needed, insert additional sheets of the same size) rm M&I'Bank Manufacturers and Traders Trust Company, One West High Street, Carlisle, PA 17013, PH717 2404536 FX717 2404518 May 1, 2006 Re: Nancy L Bender Acct # 15004200021927 To Whom It May Concern: Mr. and Mrs. Bender opened this account in September of 1985. When they did so they opened it as a joint account. Furthermore, the account titling was structured so that it read Raymond Bender as Power of Attorney. The account was in fact a joint account the entire time. If further information or documentation is needed do not hesitate to contact me. Thank you for your time. Sincerely, -1~ S~ Brent S. Smith Select Banker Carlisle, High Street 717-240-4512 03/23/2006 12:05 302-934-2136 M AND T BANK RECORDS PAGE 02/e2 . ........ !I M8tI'Bank 499 Milchct1ltold. MillsbOJO. DE 19966 Man c. DE.MB~ 12 Phone (8BI) 502-4349 fax (302) 934-29$5 March 23, 2006 Frey & Tiley Attorneys At La"W S South HaDOl'er Street Carlisle, Pennsylvania 17013 Re: Estate of: Nancv L Bender Social SectOit;y: 201..16-3196 pate of Death: January 25. 2006 Dear Sir or Madant: Per )'OlB" inq1IiIy ~ March 23, 2ClO6. p"" be lIIMscd thai at tile time of dealh, 1he above-tlamCd dcccdent blIcl on deposit with this bank the following: 1. Type of Account C~cking Account Balance on Dale of Death 2679079976 N(lnty L Bender. Raymond T BerJer · rU1l5/S5 SlS.1Jl.00 Account Number ()wneTship (Names of) Open;ng Date AcCIWd intereSt $ 0.00 TotrM --jiS,l ]]~OO-..._---...._------------_.---_..--- __P'-~--"'--~---_."''''----''._--~''---''---'''--'' ;2. Type of Account Account M4nber Savi17~ Account Total 0/5004200021927 NQIfCY L Bender, Raymond T BewJe P -Atty. 09/20185 $86,139.25 J 27.38 - $86, i66. 6j.....--------..,------~--------.--. ()wnf!I"ship (NQIIIU of) Opening Dale Balance on Date of Death ACC1Wd Interest Pkase be 1IIl"ised, there _ 1IO ,. depG6it box fODiidfiw ~a1iOoii: ~-.FOi ..rtiier _.- iDformatiolo, ...,.nSin& OWllenllip, _dres and/or reiIIIb1InelllCDt orfllnds, etc., pIeaH .. tbc 11Igb SInet Carlisle 0fIice It 717- 241)..4536. Sincerely, ~ Nancy Clagett Records Management . '217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF Nancy L. Bender Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home 4,345 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 1,013 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Filing Fee - Inheritance Tax Return 15 8. Lancaster HMA Physicians Managment Central Penn. 6 TOTAL (Also enter on line 9. Recapitulation) $ 5.379 (If more space is needed, insert additional sheets of the same size)