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Home My WebLink About09-22-06 (3) ReV . 1111 ex . "--1 . I!! ~~~ 1lIQ.~ .i UQ. ~ *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 06 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00507 NUMBER COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBVRG, PA 17128-0601 I- Z III Q ~ Q DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Weisz, Rose B OFFICIAL USE ONLY 198-01-9601 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Re1um (dale of death prior to 12-13-82) 6. Decedent Died Testate (Attach copy of Will) 9. Utigation Proceeds Received o 4a. Fulure Interest Compromise (dale of dealh after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trusl) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 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) 1260 Bustleton Pike Feasterville, PA 19053 (1 ) None (2) 60,158.40 (3) None (4) None (5) None (6) None (7) None (9) 60.00 (10) 13. Charitable and Govemmental Bequests/Sec 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) 20.0 Copyright 2000 fonn software only The Lackner Group, Inc. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 04/15/2006 10/09/1914 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES OFFICIAL USE ONLY ,...., C;:) <:::::lI c::7"\ (/) f'Tl -0 N N o ~o . 'J~:g 'IO .!5~ ~/j^ ::a -r) n"1 (1"10 c.:;-)(:J ~~~ r-'-trT1 .LI CJ C,,:) ., --n C5 ~rn (../) C) -. (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( lAST, FIRST AND MIDDLE INITIAL) 1. Original Return 2. Supplemental Return =~ ~3 ~ -0 -- o 4. Umited Estate o o AME , I- E. Garrett Gummer, III mffi ::! ~ IRM NAME (If applicable) 8f ELEPHONE NUMBER 215/396-1001 z o S ::l l- ii: ~ ~ 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o 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) ~~ N (8) 60,158.40 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) (11 ) 60.00 60,098.40 (12) (13) (14) 60,098.40 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 60,098.40 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ~ ::l Q. 17.Amount of Line 14 taxable at sibling rate x .12 (17) ::I 8 ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPA YMENT 2,704.43 2,704.43 Fonn REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 1000 West South STreet CITY STATE PA ZIP 17013 " Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 2,704.43 Total Credits (A + B + C) (2) 0.00 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty (0 + E) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is thEOVERPA YMENT. 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 theTAX DUE A. Enter the interest on the tax due. B. Enter the total of line 5 + 5A. This is theBALANCE DUE. (3) 0.00 (4) (5) 2,704.43 (5A) (5B) 2,704.43 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;............................................................................. ~ I ~: ~:::~ ~~e:~~i~~:~s:~:=s~~~.~~~.I.I.~~~.~~~.~~~~~:.~.~~.~.~~~~~~.~..~~.i~:.~~.~~:~~....:..::....:::..:....:: ::::: :::: ::::.':. 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?............................................................ n........................... .n..................... 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 contains a beneficiary designation?........................................................... n........................... ....................... 0 ~ 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 perjury, 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 preparer other than the personal representative is based on all information of which preparar has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Bar ara L. Bookwalt 103 Channel Drive Carlisle, PA 17013 DATE 9 J/sft6 , DATE ADDRESS SIGNATURE OF PREPARER OT E. Garrett Gummer, III ADDRESS DATE 1260 Bustleton Pike Feasterville, PA 19053 'f ~~ ole 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. ~9116 (a) (1.1) (Ii)]. The statutedoes not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stili 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 B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Weisz, Rose B FILE NUMBER 21 - 06 - 00507 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH 1 Allstate Corporation, 1,208 shares @ $49.80/share 1208 60,158.40 TOTAL (Also enter on line 2, Recapitulation) 60,158.40 . SCI-EDll.E H ~EXPENSES& AIlVNSlRAllVECOSTS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Weisz, Rose B Debts of decedent must be reported on Schedule I. FILE NUMBER 21 - 06 - 00507 ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's 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 7. Other Administrative Costs 1 Register of Wills of Cumberland County, fees to file inheritance tax returns and 60.00 inventories TOTAL (Also enter on line 9, Recapitulation) 60.00 REV-1513 EX+ 19~1 . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF W. R B elSZ, ose I FILE NUMBER-- 21 - 06 - 00507 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I 1 Barbara L. Bookwalter daughter entire estate 103 Channel Drive Carlisle, PA 17013 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropri ~te, on Rev 1500 cover sheE t 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 I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE ~AIIstate. Direct Registration Account Statement ~1af> ~"te in good h8nds. ROSE B WEISZ 9833 MONTOUR ST PHILADELPHIA PA 19115-2208 Questions: U.S. telephone number: 800-355-5191. Outside U.S.: 651-450-4064. Fax number: 651-4&l-408! For online account information, please visit www.sharecMnerOnlll1e.com August 19, 2006 The Allstate Corporation Account # 3407265824 = Direct Registration Information CUSIP Number: Broker I Deafer Firm Name: Broker I Dealer Account Number: Broker f Dealer Patticipant Number: Transfer Agent Account Number. Account Value Market Value Date Market Value Price Total Market Value 020002101 C Account Summary 3407265824 08I18J06 $57.92 $0.00 Share Balances Direct Registration Certifiw.~s} 0iIect Purchase Plan T etal Shares (Year-to-Date Activity Tr.naction or T......ctioft Price per ~.... Type .... ORWARO Transfer Current 0.000 0.000 0.000 0.000 Year-to-Date Amounts T otaJ Dividend Paid Service Charges Paid by You Commissions Paid by You Federal Tax Wdhhefd Nonresident Alien Tax Withheld $1.618.72 $0.00 $0.00 $0.00 $0.00 $0.00 Broker.ge (", ';. n Net Amount j NUllllberof DiNd Registnltion -- ~ Please Il!!fe."",~ your Direct Pun::hase Plan statement for any activity or transaction requests aft'ecting your Plan shares. For atl sale requesls. thent is a service eharge of $15.00 and a $.12 per shaft! brokerage commission fee. The~;es reprae!'lted by tms statement a:eft:l!ypaid <md oon-as&e&5able~ This sta~ is a rsco.'d of <:dd~ rights at the time of issuar-.ce. De!ive!'y of this stalo::merrt of itself conveys no rights to the recipient This statement is neither a negotiable instrument nor a security. A full copy of any rights, privileges, restrictians. and conditions which may be attached to the securities covered by this statement can be obtained by writing to the Secretary of the Company. Detach heIe. Fotwatr1 boftDm podion *' flftpaci1reu ma- befow. ~ AIMunt 1,208.000 - (s) has been ( Transaction Request Mail to: Shareowner SeI'vices The AIIsta1e Corporation All1 Book PO Box 64874 St Pauf MN 55164-0874 The Allstate Corporation See ReYef$e for Instructions Account # 3407285824 ) o 1. Deposit the enciosed certilicate(s} for I shares to my DRS account o Please change my address as indicated. ROSE B WEISZ 9833 MONTOUR ST PHILADELPHIA PA 19115-2208 o 2. Transfer shares per the attached instructions. (Signature must bear medallion guarantee) All registered owners must sign on the fI!VeI'Se side of this 1'I!quest. 1~IJlI~",....JlJI_JIII Requests submitted on this form Will only affect DRS shares, not shares held in the Direct Purchase Plan. '___1'_'1 ALL: Historical Prices for ALLSTATE CP - Yahoo! Finance Page 1 of2 Yi'J.hoo! My Yahoo! Mail Make V! your home Rafl.~ Search: I -- h.HOOl FINANCE Welcome,lmpen finance Home -Help [Sl9D-QY..t, !'1Y.A(;~9unt] Thursday, September 7,2006, 9:44AM ET - U.S. Markets close in 5 hours and 16 minutes. Dow" 0.51% Nasdaq" 0.65% Home Investing News. Commentary Retirement. Planning Banking. Credit Loans Insurance MV Portfolio Market Overview Market Stats Stocks Mutual Funds ETFs Bonds Options Industries Currency Education Get Quotes _ Symbol Lookup I Finance Search Allstate Corp. (ALL) S.5O'APY ONA 1-YEARQ) t-II-T,"",i: t.... Active Traders .s. FidelilJt '-'it ~~r=>~~y ~5ti' Scottrade $7 .....'3df:., F2t;: E:~~~( _'^ J~ S. : U !O\ !,t Uk . At 10:23AM ET: 57.83 .. 0.18 (0.: II AMERn'IlADE : $9.99 TRADES ; NO SURPRISES ~A~~"'_~'__""'~""_ Historical Prices Get Historical Prices for: I . SET DATE RANGE ADVERTISEMENT Start Dcite: ~ @:] 12006 End Date: ~ ff[] 12006 lEg. Jan 1, 2003 @Daily o Weekly o Monthly o Dividends Only First I Prev I Next I Last PRICES Date Open High Low Close Volume Adj Close* 17 -Apr -06 SO.SS SO.88 SO.30 S0.42 1,991,800 49.80 13-Apr-06 SO.S6 SO.70 SO.38 SO.60 2,739,SOO 49.98 * Close price adjusted for dividends and splits. First I Prev I Next I Last ~,~ Download To $Q[eadsheeJ http://finance.yahoo.comlq/hp?s= ALL&a=03 &b= 13&c=2006&d=03&e= 17 &f=2006&g=d 9/7/2006 . , RECEIPT FOR PAYMENT \f { ^ i 1 ; #~ ~ \I ;../ . ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17G13 Rece~pt Date: Rece~pt Time: Receipt No, : 7/12/2006 08:23:25 1044975 WEISZ ROSE B Estate Fiie No. : Paid By Remarks: 2006-00507 BARBARA BOOKWALTER JA ------------------------ Receipt Distribution -----------_____________ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN INVENTORY Check# 4626 Total Received... ."... 15.00 15.00 ---------------- $30.00 $30.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN I (.:I 2S;;?' II ~ ~ ~ ~ .. .OUJ ~I~"'" N 8 I s:ofii.o 'IO(f';~ ~ ~ ro~ # (j .(~~. 3 l~ "'IL G. ~ (lg@ ~('t) .J: ~ :-":0:" <.&. ('" <;;) "5. -o('.s'lIl13~(\ 00; =' .. .. ~ .. LL~ C)(/' ....! 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