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HomeMy WebLinkAbout06-21-06 (2) REV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L - QlL J2 )S~_ COUNlY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) !z KURTZ ABRAM ~ DATE OF DEATH (MM-DD- YEAR) DATE OF BIRTH (MM-DD- YEAR) ~ 1/25/2006 4/25/1909 UJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C G SOCIAL SECURITY NUMBER 146-30-2530 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w .... :.:: ~lI) 00:::.:: Wll..O :1:00 OO::...J lI..al lI.. <( [XJ 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 3. Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) _ 6. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z W o Z o D- en W a: a: o (,) PATRICIA K AMELING FIRM NAME (If Applicable) 3921 ILFORD ROAD SILVER SPRING, MD 20906-4423 TELEPHONE NUMBER 301-933-7940 0 0 0 0 0 56,940 0 (6) 3,167 315 (11) (12) (13) (14) OFFICIAL USE!6Nl Y {':,;:.-, '-) ..::; .'-~ 1. Real Estate (Schedule A) (1) (2) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Reeeivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested i= ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ::) (Schedule G or l) I- 0: 6. Total Gross Assets (total Lines 1-7) c:( 0 UJ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) l:t:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) r-'~~; ceo 1 ~ 1 I ) ---'-'1 ) N N 56,940 12. Net Value of Estate (Line 6 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for Yh1ich an election to tax has not been made (Schedule J) 3,482 53,458 o 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0 z rate, or transfers under Sec. 9116 (a)(1.2) 0 i= 16. Amount of Line 14 taxable at lineal rate 53,458 <( .... ::) 0 a.. 17. Amount of Line 14 taxable at sibling rate :E 0 0 0 16. Amount of Line 14 taxable at collateral rate >< <( Tax Due .... 19. 53,458 x .0 ~(15) X.O 45 (16) x .12 (17) x.15 (18) (19) o 2,406 o o 2,406 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3 W4645 1. 000 Yes D D D D D D 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 penalties of pe~ury, I declare that I have examined this return, induding 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 P RESPONSIBLE FOR FI Decedent's Complete Address: SlREET ADDRESS 3921 ILFORD ROAD CIIY SILVER SPRING Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount STATE PA (1) o o o Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty o o TotallnterestlPenalty (D + E) (3) 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 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (58) PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 ADDRESS ZIP 17013 2,406 o o o 2,406 o 2,406 No og og og ~ []I og SILVER SPRING, MD 20906-4423 DATE r ~.rr-. c A 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% [72P.S.g9916 (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. 9 9116 (a) (1.1) (Ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disdosure 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. 9 9116(a)(l.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. S 9116(1.2) (72 P.S. S 9116(a)(l)]. 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. S 9116(a)(l.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. 3W4646 1.000 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ABRAM G KURTZ SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER 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. AMELING, PATRICIA K 3921 ILFORD ROAD, SILVER SPRING, MD 20906 Daughter B. c. JOINTLY-OWNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUOE NA.ME OF FI~IAL INSTITUTION Af'V BMI< ACCOLNT DATE OF DEATH DECD'S VALUE OF N...MBER OR SIMILAR IDENTIFYING MlMBER. ATTACH DEED FOR NUMBER TENANT JOINT JQINTLY-I-El.DREAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 1 A 12/30/1899 ACNB SAVINGS AC 936 50.0000 468 2 A 12/30/1899 2,640.949 Shares COLUMBIA TAX EX INS FUND - A 22,131 50.0000 11,066 3 A 12/30/1899 1,878.107 Shares FIRST INVESTORS INS TX EX FUND - INCLUDING ACC DIV OF 51. SO 18,762 50.0000 9,381 Dividend accrued on 1/25/2006 52 50.0000 26 4 A 12/30/1899 5,965.428 Shares MTB MANAGED ALLOC MOD GR - A 60,668 50.0000 30,334 5 A 12/30/1899 4,786.8 Shares MTB MONEY MARKET FUND 4,787 50.0000 2,393 6 A 12/30/1899 900 Shares PUTNAM INVESTMENTS 6,543 50.0000 3,272 TOTAL (Also enter on line 6, Recaoitulationl $ 56.940 3W46AE 1.000 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INt-ERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ABRAM G KURTZ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1. FUNERAL EXPENSES: CREMATION SOCIETY OF PA 170 2 EBY GRANITE WORKS - ENGRAVING 100 Total from continuation schedules 1,868 B. 1. ADMINISTRATIVE COSTS: 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 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 650 7. 1 OBITUARIES 287 2 POSTGE, ETC 92 3W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 3.167 146-30-2530 Estate of: ABRAM G KURTZ Item No. 3 4 5 Schedule H Part 1 (Page 2) Description Amount GRV GUEST MEALS 56 HANOVER GREEN CEMETERY - BASE FOR MARKER 187 HANOVER GREEN CEMETERY - INURNMENT, INTERMENT 1,000 6 M J JUDGE MONUMENT CO - MARKER 525 7 REV KATHRYN JOHNSTON 100 Total (Carry forward to main schedule) 1,868 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INl-ERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ABRAM G KURTZ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION BOYER & RITTER - 2005 TAX PREP 2 CONTINUING CARE RX 3 CREDIT CARD 4 PA DEPT OF REV - FINAL INCOME TAX VALUE AT DATE OF DEATH 250 27 ~8 20 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 315 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ABRAM G KURTZ NUMBER I J. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] PATRICIA K. AMBLING 392J. ILFORD ROAD SILVER SPRING, MD 20906 J.OO% Residue: 53,458 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter FILE NUMBER AMOUNT OR SHARE OF ESTATE 53,458 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 3W46AI 1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space IS needed, Insert additional sheets of the same size) $ o ~ ADAMS COUNlY NATIONAL BANK May 11,2006 Patricia K. AmeIing 1921 Ilford Rd Wheaton, MD 20906-4423 Re: Savings Account #9622446 Dear Ms. Ameling: The following information is being provided as per your request: Acct. Type Account Account Ownership Date Joint No. Value on D.O.D. Savings 9622446 $935.60 / Abram G. Kurtz or 10-22-01 Patricia Ameling Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5116. Sincerely, 'fI riA M L~ Lois Kime Deposit Services Columbia Management Columbia Management Services, Inc. P.O. Box SOSl Boston, MA 02266.S0S1 May 12, 2006 Patricia K Ameling 3921 Ilford Rd Silver Spring MD 20906-4423 RE: Correspondence # 00357945 Account Number: 765-7650002897 Abram G Kurtz & Patricia K Ameling JTWROS Dear Ms. Ameling: We recently received your inquiry concerning the value of the referenced account. The information requested is as follows: As of January 25, 2006: Columbia Tax Exempt Insured Fund, Class A - 7650002897 . The Share Balance was 2640.949 . The Price Per Share was $8.38 . The Account Value was $22,131.15 ./ If we may be of further assistance, please feel free to contact a Shareholder Services Representative at 1-800-345-6611 or visit us on the Internet at www.Columbiafunds.com. Sincerely, Columbia Management Services, Inc. ('olulllbia Manag'elllent is the primary asset management gTOUp, and a nonbank subsidiary of Bank of America COl1J. ;"il-;"];"}-0074\,'-\H OJ-'Wl)t.; ADMINISTRATIVE DATA MANAGEMENT CORP. 11111111 First Investor> May 18, 2006 Patricia K. Ameling 3921 Hford Road Silver Spring, MD 20906 Re: Insured Tax Exempt Fund, Account Number oEV 83118-8 Patricia K. Ameling Trust VIA DTD 5/4/99 Insured Tax Exempt Fund, Account Number oEV 21907-7 Abram G. Kurtz Patricia K. Ameling JTWROS ("Joint") Dear Ms. Ameling, We were recently notified by Blen Fisseha of Legacy Advisors, LLC that the above referenced account (oEV 83118-8) was established under an incorrect registration. When opened, the account was initially registered as "Patricia K. Ameling Rev Trust." Please allow this letter to confirm the registration was corrected to "Patricia K. Ameling Trust" on May 10, 2006. We also received your request for the market value of account number oEV 21907-7 on January 25,2006. On January 25,2006 the market value ofthe above referenced account was $18,813.79. This amount represents 1878.107 shares at a Net Asset Value ("NA V") price of $9.99 per share and includes a dividend of $51.50 accrued from January 1,2006 through January 25,2006. We apologize for any inconvenience this may have caused. You are valued First Investors customers and we look forward to serving your future investment needs. If you have any questions or require additional assistance, please contact our Shareholder Services Department at 1-800-423-4026. Olivia Camilleri ADM Correspondence Department Regular Mail Address: POBox 7837, Edison, NJ 08818-7837 . Overnight Mail Address: Raritan Plaza 1, 8th Floor, Edison, NJ 08837-3620 Shareholder Services 1 (800) 423-4026 M-F 9am - 6pm EST . www.firslinvestors.com DST\'1S10n™ H0I11e()ftlce l~n"I.'''('~iOperations > Search Results> Account Details Operations Account Value by Date MTB GROUP OF FUNDS Statements Statements Details Acct Overview Acct Value by Date Transaction History Maintenance Hi!;tory Cost Basis 2005 Tax Summary 2006 Tax Summary Rights of Accumulation friday, J / MTB GROUP. Account #: 9014765166 BIN #: 46017567 Tax ID/SSN: 146-30-2530 Registration: ABRAM G KURTZ PATRICIA K AMELlNG JTWROS 3921 ILFORD RD SILVER SPRING MD 20906-4423 Mgmt Co: MTB GROUP OF FUNDS Fund Name: MTB MANAGED ALLOCATION MODERATE GROWfH-A View Fund Details Fund Code: 129 Ticker: VMMGX Total Shares: 0.0000 CUSIP: 55376T593 Account Value: $0.00 Phone #: Not On File Enter a price date to retrieve an account value from a previous day. Price Date: 01/25/2006 _ Current Price Date: Current Net Asset Value: Current Total Shares: Current Value: 06/01/2006 $10.2700 .0000 $0.00 Price Date: Net Asset Value: Total Shares: Value: T()p of page Contact Us I Disclaimer Copyright <9 2006 DST Systems, Inc. All Rights Reserved. 01/25/2006 $10.1700 5,965.4280 $60,668.40 DST \ 'lsionT" H( )lne()ffice l.nl"l;,I,,(I~Operations > Search Result.s :;> Account Details Operatio n$ Account Value by Date MTB GROUP OF FUNDS Statements Statements Details Acct Overview Acct Value by Date TransactiQnHii5t:Qry Maintenance HistQry Bank Information 20Q5 Tax summary 2006 Tax: SUmmary Rights of Accumulation Account #: 70369 Tax ID/SSN: 146-30-2530 Registration: ABRAM G KURTZ PATRICIA K AMELlNG JT WROS 3921 ILFORD RD SILVER SPRING MD 20906-4423 Phone #: Not On File Friday, j / MTB GROUP I Mgmt Co: MTB GROUP OF FUNDS Fund Name: MTB MONEY MARKET FUND - A View Fund Details Fund Code: 83 Ticker: VSMXX Total Shares: 0.0000 CUSIP: 55376T460 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: 01/25/2006 _ Current Price Date: Current Net Asset Value: Current Total Shares: Current Value: 06/02/2006 $1.0000 .0000 $0.00 Top of page ContactlJs I Disclaimer Price Date: Net Asset Value: Total Shares: Value: Copyright @ 2006 DST Systems, Inc. All Rights Reserved. 01/25/2006 $1.0000 4,786.8000 $4,786.80 , . PUT NAM INVESTMENTS Putnam Investor Services Post Office Box 41203 Providence, Rhode Island 02940-1203 www.putnaminv.com May 11,2006 PATRICIA K AMELING 3921 ILFORD RD SILVER SPRING MD 20906-4423 Account No.: C011146302530BBBH Registration: Abram G Kurtz & Patricia K Ameling JTWROS Reference No.: 0452248258 Dear Ms. Ameling: Thank you for your letter regarding the above-referenced account. The following table provides the information requested as of January 25,2006: We hope this information is helpful to you. To assist you with future inquiries concerning this letter, please provide the reference number shown above when calling or sending written correspondence. Should you have any questions, please call us toll-free at 1-800-225-1581. One of our representatives will be pleased to assist you. Sincerely, .I ..-.)>, J )/)k/JlIfdd.(~t-'--- ~,., Sandra Madden Putnam Investor Services . \\j ~ ? D