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Home My WebLink About08-04-06 REV-1500 EX + (6-00) *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -0 5 o 7 2 2 CQ'ijNTY"'Cci5E ---vEA~ - - NuM'iiER- - I- Z W C W U W C DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) ANOKA, RUTH A. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 1 77- 2 4 - 5 745 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- :.:: ~Ul l> 1Ii::.:: w:5l> J: lli:g l> 0.. III 0.. < 07/18/2005 03/07/1932 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [Xl 1. Original Return o 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Aftach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Return (date of death priorto 12-13-82) 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) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III FIRM NAME (If Applicable) 54 EAST MAIN STREET MECHANICSBURG 114,550.00 54,075.27 0.00 \ 359,625.28 14,920.87 196,383.84 (8) 18,666.20 42,244.18 I- Z W Cl Z o 0.. Ul W iii: iii: o l> TELEPHONE NUMBER 717'697-4650 z o i= <( ..J :) l- n: <( u W 0::: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) PA 17055 OFFICIAL USE ONLY c' ~ ".../ 739,555.26 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <( I- :) Q. :IE o U X <( I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1 .2) 19. Tax Due X _(15) 678,664.88 X .045 (16) X .12 (17) X .15 (18) (19) (11) (12) (13) 60,910.38 678,644.88 16. Amount of Line 14 taxable at lineal rate (14) 678,644.88 17. Amount of Line 14 taxable at sibling rate 30,539.92 30,539.92 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 < < 18. Amount of Line 14 taxable at collateral rate Decedent's Complete Address: STREET ADDRESS 17 COURTLAND ROAD CITY I STATE I ZIP CAMP HILL PA 17011 Tax Payments and Credits: 1. T ax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B, Prior Payments C, Discount (1 ) 30,539.92 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable 0, Interest E. Penalty 0.00 Total Interest/Penalty ( 0 + 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) B. Enter the total of Line 5 + 5A, This is the BALANCE DUE. (5B) Make Check to: REGISTER OF WILLS, AGENT 30,539.92 30,539.92 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes 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 d, receive the promise 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 t. b f" d' t'? I)(l con ams a ene IClary eSlgna lon, ....................................................................................................... ~ No !Xl !Xl !Xl !Xl !Xl !Xl o TIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS 54 EAST MAIN ST., MECHANICSBURG, PA 17055 1561 BRAEWOOD DRIVE, HARRISBURG PA ADDRESS M . WALTERS III., ESQ. 54 EAST MAIN STREET, MECHANICSBURG PA 17055 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. S9116 (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, S9116 (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 0% [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 4.5%, except as noted in 72 P,S, S9116(1.2) [72 PS, s9116(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. 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-1502 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ANOKA. RUTH A. 21 05 0722 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooerty which is iointlv-owned with riaht of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 114,550.00 17 COURTLAND ROAD LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY CAMP HILL, PA COUNTY ASSESSED VALUE TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 114,550.00 REV-1503 EX + (6-98) *' SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ANOKA. RUTH A. FILE NUMBER 21 05 0722 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 231 UNITED STATES SAVINGS BONDS PAYABLE UPON DEATH TO CARL T. ANOKA, JR. 2. 257 UNITED STATES SAVINGS BONDS PAYABLE UPON DEATH TO DENISE L. ANOKA VALUE AT DATE OF DEATH 24,569.46 29,505.81 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 54,075.27 REV-1508 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ANOKA. RUTH A. FILE NUMBER 21 05 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. 0722 ITEM NUMBER DESCRIPTION 1 MEMBERS 1 ST F.C.U. CERTIFICATE OF DEPOSIT 2 MEMBERS 1 ST F.C.U. CERTIFICATE OF DEPOSIT 3 MEMBERS 1 ST F.C.U CERTIFICATE OF DEPOSIT 4 MEMBERS 1 ST CERTIFICATE OF DEPOSIT 5 MEMBERS 1ST F.C.U. CERTIFICATE OF DEPOSIT 6 MEMBERS 1 ST CERTIFICATE OF DEPOSIT 7 MEMBERS 1 ST F.C.U. CERTIFICATE OF DEPOSIT 8 MEMBERS 1ST F.C.U. CERTIFICATE OF DEPOSIT 9. PNCINVESTMENTS VARIOUS INVESTMENTS 10. GMAC PENSION INVESTMENT 11. MERRILL LYNCH VARIOUS INVESTMENTS 12. JOHN HANCOCK 101.469 SHARES X 15.33 PER SHARE 13. LEGG MASON 94.904 SHARES X 23.29 PER SHARE 14. RAYTHEON 138.500 SHARES X 39.3739 PER SHARE 15. GE STOCK 3.7822 SHARES X 34.95 PER SHARE VALUE AT DATE OF DEATH 1,927.48 1,927.48 1,122.43 1,122.43 1,130.25 1,130.25 1,130.25 1,130.96 307,484.55 5,816.69 26,351.22 1,555.52 2,210.31 5,453.28 132.18 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 359,625.28 REV-1509 EX + (6-98) '* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ANOKA. RUTH A. FILE NUMBER 21 05 0722 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. DENISE L. ANOKA P.O. BOX 13174 MARINA DEL RAY, CA 90295 DAUGHTER B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 4-25-73 MEMBERS 1 ST F.C.U. 25,741.38 50. 12,870.69 SAVINGS 2 A 2-1-01 MEMBERS 1 ST F.C.U. 4,001.86 50. 2,000.93 SAVINGS 3 A 1-2-80 MEMBERS 1 ST F.C.U. 98.49 50. 49.25 CHECKING TOTAL (Also enter on line 6, Recapitulation) $ 14,920.87 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF ANOKA. RUTH A. FILE NUMBER 21 05 0722 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1. JOHN HANCOCK 98,191.92 100. 98,191.92 IRA PAYABLE TO CARL T. ANOKA, JR. 2. JOHN HANCOCK 98,191.92 100. 98,191.92 IRA PAYABLE TO DENISE L. ANOKA TOTAL (Also enter on line 7 Recapitulation) $ 196,383.84 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ANOKA. RUTH A. FILE NUMBER 21 05 0722 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. 2. 3. 4. 5. FUNERAL EXPENSES: WIEDEMAN FUNERAL HOME GINGRICH MEMORIALS - HEADSTONE ST. LAWRENCE CLUB - FUNERAL LUNCHEON MR. R'S SUBS & DELI - FUNERAL LUNCHEON MARY GOLES PASTRY - FUNERAL LUNCHEON 5,383.45 3,075.00 275.50 755.25 140.00 1. 2. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) ROBERT BENKOVICIJi - RENOUNCED i Social Security Number(s)/EIN Number of Personal Representative(s) 208-24-4607 Street Address 1561 BRAEWOOD DRIVE B. City HARRISBURG State PA Zip 17111 Year(s) Commission Paid: 2. 3. Attorney Fees MURREL R. WALTERS III, ESQUIRE Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 7,500.00 Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 537.00 5. Accountant's Fees 6. Tax Return Preparer's Fees FLOYD FAHNESTOCK 1,000.00 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 18,666.20 Continuation of REV-1500 Inheritance Tax Return Resident Decedent ANOKA, RUTH A. Decedent's Name Page 2 21 05 0722 File Number Schedule H - Funeral Expenses & Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 2 Name of Personal Representative (s) MURREL R. WALTERS III, ESQUIRE - RENOUNCED Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 54 EAST MAIN STREET City MECHANICSBURG State P A Zip 17055 Year(s) Commission Paid: Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: SUBTOT AL SCHEDULE H.B1 REV-1512 EX + (6-98) SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF ANOKA. RUTH A. 21 05 0722 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. MILTON S. HERSHEY MEDICAL CENTER MEDICAL CARE 35.89 OMNIUM WORLDWIDE, INC. CHASE MANHATTAN BANK, USA - CREDIT CARD 3,486.22 MERRILL LYNCH CREDIT CARD SERVICES CREDIT CARD 939.19 AARP VISA CREDIT CARD 3,486.22 WSO IMAGINING CENTER, L.P. MEDICAL 30.17 LORETTA A. BENSIC PERSONAL CARE 250.00 MEMBERS 1ST FEDERAL CREDIT UNION HOME EQUITY LOAN 24,746.60 MBNA 872.04 CUMBERLAND COUNTY OFFICE OF AGING CLEANING ASSISTANCE 111.00 BALOGH BECKER L TD HSBC BANK -CREDIT CARD 8,286.85 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 42,244.18 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. DENISE L. ANOKA DAUGHTER 1/2 P.O. BOX 13174 MARINA DEL RAY, CA 90295 2. CARL T. ANOKA, .JR. SON 1/2 17 COURTLAND ROAD CAMP HILL, PA 17011 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ,~~""", .'* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ANOKA RUTH A SCHEDULE J BENEFICIARIES (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 05 0722