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HomeMy WebLinkAbout09-07-06 'w ....J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 0570 Date of Birth 06/18/2006 916 Decedent's Last Name Suffix Decedent's First Name MI HUBBARD ALDA L (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix First Name MI .~.p()~~~'~~()c.ic:ll~~C?'l~o/~~l"I1ber THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW <I[) 1. Original Return Co::) 2. Supplemental Return c=> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required ~ 4. Limited Estate Co::) c;a, c=> 4a. Future Interest Compromise (date of death after 12-12-82) Co::) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c=> 10. Spousal Poverty Credit (date of death Co::) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name~~Y.t.i~~.!~I~p~()~~~~~~~r.. 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c::::,) THOMAS E. FLOWER i (717) 737-3405 Firm Name REGISTER OF WILLS USE ONLY SAIDIS,FLOWER&L1NDSA Y First line of address i ~ i i ("") co I c:: c:::;) ::J:J I ~i CI" "::I~ rn i CD en I fl~ (J ; m ('") ~ ,GJO i ::0 r- I C0 ~ l____..____.E~~_. ;. ._~ ~fJ eg o8~ -U ~~ Q c:: :x -:s= :!J .::0 N ~ C') :0 ~ .. !-- irl Correspondent's e-mail address: )> U1 ......') (''') r- ...:;--, 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 P SON R PONS FO LING ETURN 2109 MARKET STREET Second line of address or Post Office State ZIP Code i 17011 ADDRESS MARK D. HUBBARD, 273 CAMPGROUND ROAD, DILLSBURG, PA 17019 REPRESENTATIVE ADD ESS SAlOIS, FLOWER & LINDSAY, 2109 MARKET STREET, CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 --.J '. .....I 15056052059 REV-1500 EX Decedent's Name: RECAPITULATION ALDA L HUBBARD ,[)Et~l!(jEt~t'~..~()?i~I..~.Et.?~.~ty..f'JurTlb.Etr ! 181-38-0102 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 5. 2,000.00 6. Jointly Owned Property (Schedule F) c:::J Separate Billing Requested . . . . . . . 6. 10,105.54 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::J Separate Billing Requested.. . . . . . . 7. 414,083.00 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 426,188.54 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . . . 9. 12,931.19 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 6,982.20 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 .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 406,954.89 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X. 15 19. TAX DUE. . . . . . . . .. . . . . .. .. . .. . . . . . . . . .. . . . . . . . . .. . . . .. . . .. . . . . . . . 19. L 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 19,913.39 406,954.89 0.00 406,954.89 15. 16. 18,312.97 17. 18. c:> 15056052059 --.J REV-1500 EX Page 3 '. Decedent's Complete Address: - ,_ d DECEDENrs NAME DECEDENrs SOCIAL SECURITY NUMBER ALDA L HUBBARD 181-38.0102 STREET ADDRESS 3609 KOHLER PLACE APARTMENT 4 CITY \ STATE \ ZIP CAMP HILL PA 17011 File Number 0~ [0570-'.-'-~__'-"m'l Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 18,312.97 915.62 Total Credits ( A + 8 + C ) (2) 915.62 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnterestJPenalty ( D + E ) 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. (3) (4) (5) 17,397.35 (SA) (58) 17,397.35 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 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT 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 property transferred;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or.......................................................................................................................... 0 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [i] 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [i] 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. ~9116 (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 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. ~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. '. REV-1508 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ALDA L HUBBARD FILE NUMBER 21-06-0570 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. ITEM NUMBER VALUE AT DATE OF DEATH DESCRIPTION 1 HOUSEHOLD FURNITURE, FURNISHINGS AND EFFECTS (CONTENTS OF APARTMENT) 2,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,000.00 '. REV.'SO' EX+ (6.... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF ALDA L HUBBARD FILE NUMBER 21-06-0570 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 B. 273 CAMP GROUND ROAD DILLSBURG, PA 17019 A. MARK D. HUBBARD C. JOINTLY-OWNED PROPERTY: 1. A LmER ITEM FOR JOINT NUMBER TENANT 1. A. DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTlY-HELD REAL ESTATE. TOTAL (Also enter on line 6, Recapitulation) (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-PROBATE PROPERTY ESTATE OF ALDA L. HUBBARD FILE NUMBER 21-06-0570 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. ITEM NUMBE 1. MARK D, HUBBARD, SON (11/24/04 made Wtransfer on deathW) WACHOVIA SECURITIES ACCOUNT #4385-7096 TOTAL (Also enter on line 7 Recapitulation) (If more space is needed, insert additional sheets of the same size) '. REV.1511 EX+ (12.991. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ALDA L HUBBARD FILE NUMBER 21-06-0570 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT fL!N~RAL~XPENS~S; Neill Funeral Home, professional services 2. Embalming 1. 3. 4. 5. 6. Casket 7. Funeral Reception, Flowers, Obits., Death Certs, Honorarium (Less package discount) B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Street Address 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant City Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. THE SENTINEL, PUBLISH ESTATE NOTICE 8. CUMBERLAND LAW JOURNAL, PUBLISH ESTATE NOTICE 9. Rent, August TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 12,931.19 ! ". ."'1512 EX' (12~J .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ALDA L HUBBARD FILE NUMBER 21-06-0570 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Comfort Keepers, home health aides 2. Rent, June 3. A,T & T, phone bill 4. Verizon, phone bill 5. PP&L TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) '. _1513 EX. f'<lOl .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE , BENEFICIARIES ESTATE OF ALDA L HUBBARD NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under ~f3~,911~ JCI)O,?)J 1 MARK D. HUBBARD, 273 CAMP GROUND RD., DILLSBURG, PA 17019 FILE NUMBER 21-06-0570 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 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 (If more space Is needed, insert additional sheets of the same size) m1 M8iI~ Hank . - cd, ~cf. 611'#6 ACtOUNTNO. ... .ACCOUNT -TYPE 44515502 RELATIONSHIP CHECKING WITH INTEREST JUN.03-JUL.03,2006 1 OF 2 00 17 06123H M 021 -"-- 8179 ""'--- ALDA L HUBBARD OR MARK D HUBBARD 3609 KOHLER PL APT 4 CAMP HILL PA 17011-2760 INTEREST PAID YEAR TO DATE 14.75 WEST SHORE PLAZA 15,248.47 06-03-06 BEGINNING BALANCE ~ 06-05-06 CHECK NUMBER 4243 06-05-06 MET LIFE INS. CO AARPLTCJUN /' 06-05-06 CHECK NUHBER 4242 ~ 06-05-06 CHECK NUMBER 4236 ~ 06-05-06 AARP HEALT~RE PREMIUM ~ 06-06-06 DEPOSIT 06-06-06 CHECK NUMBER 4246~ 06- 06- 06 CHECK NUMBER ~: 06-07-06 VERIZON ARC. CHECK PYHT 000000000004244 06-08-06 CHECK NUMBER 4245 ~ 06-13- 06 CHECK NUMBER 4247 ./ /' 06-13-06 CHECK NUKBER 4249 /' 06-13- 06 CHECK NUtlBER 4248 '/-. 06-16-06 CHECK NUMBER 4250 06-20-06 CHECK NUHBER 4256 06- 20- 06 CHECK NUtlBER 4251 /" 06-20-06 CHECK NUtlBER 4254/ 06-20-06 CHECK NUMBER 4255 ./ 06-21-06 CHECK NUttBER 4253./ 06-29-06 CHECK NUtlBER 4257/' 06- 29- 06 CHECK NUttBER 4259 ,/, 06-30-06 CITICARD PAYMENT CHECK PYHT 000000000004258 ~ 07-03-06 INTEREST PAYMENT $23,478.88 3,000.00 184.00 125.00 53.65 21.00 20,095.23 2,502.15 190.00 53.00 51.64 253.66 338.00 250.00 200.00 1,050.00 1,973.43 190.00 110.60 53.10 53.13 2,128.34 418.00 37.65 22,354.38 22,302.74 22,049.08 21,261.08 20,211.08 17,883.95 17,830.82 1.64 15,284.48 15,246.83 15,248.47 ENDING BALANCE $15,248.47 I · -CHECKS . PAID .SUMlilA.RV: . . . . /- I 4235 06-06-06 4243 06-05-06 53.00 3,000.00 4236 06-05-06 4245- 06-08-06 53.65 253 . 66 4242- 06-05-06 4246 06-06-06 125 . 00 190.00 LOO8A (1/03) ACCOUNT.NO. 44515502 RELATIONSHIP CHECKING WITH INTEREST f!:1 M8UBank , ., JUN. 03-JUL. 03,2006 2 OF 2 AlDA l HUBBARD OR MARK D HUBBARD 4247 4250 4254 4257 338.00 1,050.00 11 0.60 2,126.34 CHECKS .P.AID .SUI'II1ARY . . 4248 06-13-06 4251 06-20-06 4255 06-20-06 4259. 06-29-06 ., 06-13-06 06-16-06 06-20-06 06-29-06 200.00 190.00 53.10 418.00 4249 06-13-06 4253. 06-21-06 4256 06-20-06 250.00 53.13 1,973.43 ANNUAL PERCENTAGE YIELD EARNED = 0.09 % WHAT DO YOU WANT TO DO THIS ~ER VACATION? ENJOY FAHILY BARBECUES WITH A NEW WEBER (R) GAS GRILL? PLANT THE PERFECT GARDEN WITH A .100 GIFT CARD F~ THE HOHE DEPOT (R)? GET IN SHAPE LISTENING TO YOUR FAVORITE TUNES ON YOUR NEW APPLE IPOD (R) NAND? IMPROVE YOUR GAHE WITH SOHE NEW TITLEIST PRO VI (R) GOLF BALLS? YOU CAN DO IT ALL! REWARD YOURSELF! 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Hubbard Services of Funeral Director and Staff . . . . . . . . . . . . . . . . .. $ Embalming ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dressing Casketing and Cosmetology . . . . . . . . . . . . . . . . . . Visitation ........................................ Funeral Service ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . '. . . Transfer of Remains .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hearse/Coach and Driver . . . . . . . . . . . . . . . . . . . . . . . . . . . Safety/Lead Vehicle and Driver . . . . . . . . . . . . . . . . . . . . . . . Flower Van and Driver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Flowers .............. . . . . . . . . . . . . . . . . . . . . . . . . . . . Death Certificates ................ . . . . . . . . . . . . . . . . . Rev. Carola Beasley-Topliffe ......... . . . . . . . . . . . . . . . . Patriot News Obituary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OT9 625 DH PLATINUM ............................ Package Savings ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Funeral Charges Adjustments (Payments) $ $ 1,935.00 515.00 205.00 315.00 515.00 415.00 315.00 205.00 1 00.00 336.00 90.00 100.00 256.20 3,545.00 (370.00) $8,477.20 (8,477.20) Balance Due on Account $ $0.00 3401 Market Street Camp Hill, PA - 17011-4428 tel 717 737-8726 fax 717 737-1859 Rebecca J. Donahue, Supervisor 3501 Derry Street Harrisburg, PA - 17111-1817 tel 717 564-2633 fax 717 561-9918 Stephen J. Wilsbach, Supervisor Member of ALDERWOODS . GROUP 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 HUBBARD MARK D 273 CAMP GROUND ROAD DILLSBURG, PA 17019 -------- lold ESTATE INFORMATION: SSN: 181-38-0102 FILE NUMBER: 2106-0570 DECEDENT NAME: HUBBARD ALDA L DATE OF PAYMENT: 09/07/2006 '.POSTMARK DATE: 09/07/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/18/2006 NO. CD 007180 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $17,397.35 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: HUBBARD MARK CHECK# 1001 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS $17,397.35 GLENDA FARNER STRASBAUGH REGISTER OF WILLS \I.... .~~~ ~ \~:I ~:., ~~i~;:~\ ~~~~~~ X~ {. 'v" <>~ :.\ \~~/'~'~~f ~\ ' ::. I ,~ c." ) \\"<:!::. ~l:~" " ,) ", ~ ~ \ ,- \ f, ~ (/) 0 ~€ ~~Q) ~ ...~ '00'(0 ~ ~o '- 0 6- ~[~ ~~(/)~ ~ 3. ff).( fJ) Q f/) ~ ~ p.- OOl ~ Q) 0 ~~\%'1~ 8(/)!- ~ ~~ 04:. f/) ~~ ~ ~ i Q)~€Q.. ~ <"IU ..s ~ ~ ~ ~ ~~o.9! o 0 (/) jU 8-E~~ ) \ te ~ 0 000 -~ . . 0 ~\- \ ......