HomeMy WebLinkAbout11-03-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-ll OL t:XI'II-~b)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ANDREWS TAYLOR P
78 W POMFRET STREET
CARLISLE, PA 17013
n______ fold
ESTATE INFORMATION: SSN: 193-18-5030
FILE NUMBER: 2105-0277
DECEDENT NAME: RABENSTINE CHARLES E
DA TE OF PAYMENT: 11/03/2006
POSTMARK DATE: 11/03/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 03/15/2005
NO. CD 007387
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $7,754.33
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TOTAL AMOUNT PAID:
$7,754.33
REMARI<S: PNC BANK
CHECK#1035
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
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- 05-
0277
COUNTY CODE
YEAR
NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Rabenstine, Charles E.
DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY)
311 5/2005 1111 5/1923
(IF APPLICABLE) SURVIVING SPOUSE'S NAME
N/A
SOCIAL SECURITY NUMBER
193-18-5030
THIS MUST BE FILED IN DUPLICATE
WITH THE REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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1. Original Return [i] 2. Supplemental Return
4. Limited Estate 0 4a. Future interest Compromise
6. Decedent Died Testate 0 7. Decedent had Living Trust
o 3. Remainder Return
o 5. Fed. Est. Tax Return Req'd
8. Total number of SDB's
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NAME:
Taylor P. Andrews, Esquire
FIRM NAME:
Andrews & Johnson
TELEPHONE NUMBER
717243-0123
COMPLETE MAILING ADDRESS:
Taylor P. Andrews, Esq.
Andrews & Johnson
78 W. Pomfret 8t.
Carlisle, P A 17013
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3.Closely Held Corporation, Partnership or Sole-Prop.
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Propate Prop.
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administration Costs (Sch H)
10. Debts of Decedent, Mortgage liabilities, & Liens
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 (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amnt of Line 14 taxable at the spousal rate,
or transfers under Sec.9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
(1 )
(2)
(3)
(4)
(5)
(6)
OFFICIAL USE ON~Y
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$194,607.90
$0.00
(7)
(9)
(10)
(8) $194,607.90
$22,289.38
C)
(11 )
(12)
$22,289.38
$172,318.52
$172,318.52
$172,318.52
$0
$0
x.O_
x.045
x.12
x.15
(15)
(16)
(17)
(18)
(19)
$0.00
$7,754.33
$0.00
$0.00
$7,754.33
19. Tax Due
20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
~
ueceoem; ~ ,",UnlPleLe ,",uure~~;
STREET ADDRESS
12 Moore Circle
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
Total Credits (A+B+C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnterestlPentalty (D+E)
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
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.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
(2)
(3)
(4)
(5)
(SA)
(58)
$7,754.33
$0.00
$0.00
$7,754.33
$7,754.33
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:
b. retain the right to designate who shall use the property transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments 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 fo(' 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 disignation?
D
D
D
D
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D
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EJ
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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, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
ADDRESS
DATE // ~0'/-06
DATE 10 - 3t> -0 ~
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. Sec. 9116(a)(1.1 )(1)].
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. Sec. 9116(a)(1.1)(ii)).
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disciosure 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 deseased child twenty-<lne 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. Sec. 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. Sec. 9116(1.2) [72 P.S. Sec.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. Sec.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 E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
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
DESCRIPTION
21-05-0277
ITEM
NUMBER
VALUE AT DATE
OF DEATH
Refund received October 30, 2006 from Decedent's investment in
a retirement cottage at Cumberland Crossing Retirement Community.
This only became a right when the cottage that Decedent occupied at
12 Moore Circle was reoccupied by a new occupant.
$194,607.90
Copies of the Cottage residency agreement and correspondance were attached.
to the original Inheritance Tax return.
TOTAL (also on line 5, Recapitulation)
$194,607.90
. \
Entrance Fee Refund
Facility: Cumberland Crossings
Name: Charles Rabenstine, 12 Moore Circle
Entry Date: 08/23/1999
Exit Date: 06/22/2005
Plan type: 90% Refundable, 10% Non Refundable - Earned @ 1 % per month for 10 Months.
Entrance Fee Paid Per Contract $216,231.00
Amortization Per Month 1% $2,162.31
# of mths 69 149,199.39
Refund prior to cap 67,031.61
Refund should be no lower 90% of Entrance Fee 194,607.90 127,576.29
Total Refund due 194,607.90
1 8/23/1999 12/31/1999 4.00 $8,649.24
2 1/1/2000 12/31/2000 12.00 $25,947.72
3 1/1/2001 12/31/2001 12.00 $25,947.72
4 1/1/2002 12/31/2002 12.00 $25,947.72
5 1/1/2003 12/31/2003 12.00 $25,947.72
6 1/1/2004 12/31/2004 12.00 $25,947.72
7 1/1/2005 6/16/2005 5.00 $10,811.55
69.00 $149,199.39
lKI!;~~LEK LV 1 tlEKA1~ ~EK V lL~~
10/26/2006
EST ATE OF CHARLES RABENSTINE No. 156844
INVOICE DATE REF ID DESCRIPTIOt-J TOTAL AMOUNT DISCOUNT AMOUNT APPLIED
10/19/2006 101906 REFUND ENTAANCE FEE 194607.90 0.00 194607.90
CHECK AMOUNT $194,607.90 TOTALS $194,607.90 $0.00 $194,607.90
TRESSLER LUTHERAN SERVICES
10/26/2006
ESTATE OF CHARLES RABENSTINE No. 156844
INVOICE DATE REF ID
10 19 2006101906
DESCRIPTION
REFUND ENTAANCE FEE
TOTAL AMOUNT DISCOUNT AMOUNT APPLIED
194607.90 0.00 194607.90
CHECK AMOUNT . $194,607.90._ ........_...........dIOT/\LS..
~<<~* ~*,,;i* ~*~,i*(~(<<~* f.o:*~*,' THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON
$194,607.90
$0.00
$194,607.90
TRESSLER LUTHERAN SER VICES
POBox 2001
MechanicsburgP Al 7055
WACHOVIABANK
No. 156844
/;' GH5CK NO.
156844
62-22
311
AMOUNT
194 607.90
PAY One Hundred Ninety-Four Thousand Six Hundred Seven Dollars and 90/100 Cents
VOID AFTER 180 DAYS
TO THE
ORDER
OF
ESTATE OF CHARLES RABENSTINE
C/O ATTORNEY TAYLOR ANDREWS
78 WEST PAM FRET STREET
CARLISLE PA 17013
2nd Signature Required Over $20,000.00
'''''~<t~;* ~"J!<'."1~.*< ,,~;"*<.~,;*< ~,%"",<< ". THE BACK OF THIS D.OCUMENT CONTAINSAN ARTIFICI.ALWATERMARK HOLD AT AN ANGLE TO VIEW 'i< f""'i<('''''''*< '""',,*<'~;'i< ,,*<<"'~.*< ,,,~,,*<,,,,,,
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SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
B.
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral Expenses:
I Hoffman Roth Funeral Home
2 Service expenses
Administrative Costs:
I Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s) commissions paid:
2 Additional Attorney fees to Andrews & Johnson $10,000.00
3 Family Exemption
Claimant
Street:
City: State & Zip
Relationship of Claimant to Decedent:
4 Probate Fees to Register of Wills
5 Accountant Fees - income tax returns $250.00
6 Rock Commercial Real Estate - commission sale of Littlestown property $10,400.00
7 Transfer Tax - sale of Littlestown property $1,300.00
8 final water and sewer bill for Littlestown property $129.93
9 notary for sale of Littlestown property $5.00
10 net real estate taxes due on Littlestown property at settlement $204.45
11
12
13
14
15
16
17
18
TOTAL (also on line 9, Recapitulation) $22,289.38
Debts of decedent must be reported on Schedule I.
A.
--;-'-~
A. Settlement Statement
U.S. Department of Housing
and Urban Development
~
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OMS No. 2502-0265
B. Type of Loan
1.0 FHA 2.0 RHS 3.0 Conv. un,ns.16. File Number 17. Loan Number \8, Mortgage Insurance Case Number
4.0 VA 5.0 Cony. Ins. T -20990 C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shawn. Items
marked "(p.o. c.)" were paid outside the closing; they are shawn here for infonnatian purposes and are not included in the totals.
D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender
150 Monarch. LLC Estate of Charles E. Rabenstine Fulton Bank
One Penn Square
Lancaster, PA 17602
G. Property Location H. Settlement Agent
150 Monarch Street Stack and Leader
Littlestown, PA 17340
Littlestawn Barau9h Place of Settlement i. Settlement Date
Susquehanna Commerce Center 05/10/06
221 West Philadelphia Street
York, PA 17404
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales orice 130,000.00 401. Contract sales crice 130,000.00
102. Personal oraoertv 402. Personal orooertv
103. Settlement charoes to borrower mne 1400) 4,519.25 403.
104. 404.
105. 405.
Adjustments for items oaid bv seller in advance Adjustments for Items paid bv seller in advance
106. Citv/town taxes 05/10 to 12131 473.20 406. Citv/tawn taxes 05110 to 12131 473.20
107. County taxes 05/10 to 12131 648.56 407. County taxes 05/10 to 12/31 648.56
108. School taxes 05110 to 06130 408.71 408. School taxes 05/10 to 06/30 408.71
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 136,049.72 420. GROSS AMOUNT DUE TO SELLER 131,530.47
200. AMOUNTS PAlD BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT TO SELLER
201. Deposit or earnest money 10,000.00 501. Excess Deposit (see instructions)
202. Principal amount of new loan(s) 104,000.00 502. Settlement charges to seller (line 1400) 13,569.85
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff of firs! mortgage Joan
205. 505. Payoff of second mortgage loan
206. 506.
207. 507.
208. 508.
209. 509.
Adlustments for items unoaid bv seller Adlustments for items unoaid bv seller
210. City/town taxes 10 510. City/town taxes to
211. County taxes to 511. County taxes to
212. School taxes to 512. Schaal taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
216. 516.
219. 519.
220. TOTAL PAID BY / FOR BORROWER 114,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 13,569.85
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Grass amount due fram borrower lIine 120) 136,049.72 601. Gross amount due to seller (line 420\ 131,530.47
302. Less amounts naid bY/for borrower lline 220) 114,000.00 602. Less reduction amount due to seller lline 520\ 13,569.85
303. CASH FROM BORROWER 22,049.72 603. CASH TO SELLER 117,960.62
Gross Proceeds of this transaction.
SELLER INSTRUCTIONS: T.o determine if you have to report the sale or exchange of your primary residence on your tax return. see the SdleQule 0 (Form 1040) instructions. If the real estate was not your primary
reSidence, complete the applicable parts of Form 4797, Form 6252. and lor Schedule D (Form 1040).
RESPA. HB 4305.2 - REV. HUD1(3/86)
NT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
PAGE 2
.::
. rTLEMENT CHARGES: File Number: T-20990 PAID FROM PAlD FROM
BORROWER'S SELLER'S
JTAL SALES/BROKER'S COMMISSION based on price $ 130,OOO.00@ 8.00 = 10,400.00 FUNDS AT FUNDS AT
Division of commission (line 700) as follows: SETTLEMENT SETTLEMENT
01. $ to
702. $ 10,400.00 to ROCK Commercial Real Estate, LLC
703. Commission oaid at Settlement 10,400.00
704.
800. ITEMS PAYABLE IN CONNECTION WITH LOAN P.O.C.
801. Loan Oriaination Fee % Fulton Bank 750.00
802. Loan Discount %
803. Aoaraisal Fee to Fulton Bank 100.00
804. Credit Reoort to
805. Lender's Insaection Fee to
806. Mtg. Ins. Aoallcation Fee to
807. Assumalion Fee to
808. Flood Cert. Fulton Bank 10.00
809.
810.
811.
812.
813.
814.
815.
900. ITEMS REQUIRED BY LENDER TO BE PAlD IN ADVANCE
901. Interest from to @$ Idav
902. Mortaaae Insurance Premium to
903. Hazard Insurance Premium vrs. to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance mo.@$ I mo.
1002. Mortgage Insurance mO.@$ Imo.
1003. City oroperIV taxes mo.@$ Imo.
1004. County proaerty taxes mO.@$ I mo.
1005. School taxes mO.@$ Imo.
1006. mO.@$ Imo.
1007. mo.@$ fmo.
1008. Aggregate Reserve for Hazard/Flood Ins, CltylCounty Prop Taxes, School Taxes & Mortoaoe Ins
1100. TITLE CHARGES
1101. Settlement or closina fee to
1102. Abstract or title search to
1103. Title examination to
1104. Title insurance binder to
1105. Document oreoaration to
1106. Notarv fees to Stock and Leader 30.00 5.00
1107. Attomev's fees to
(includes above item No: I
1108. Title insurance to Stock and Leader, Aoent for Chicago Title 1,008.75
(includes above item No: )
1109. Lender's coveraoe 104,000.00
1110. Owner's coveraQe 130,000.00 -1,008.75
1111. PA 100, PA 300, PA 710 Stock and Leader, Aoent for Chicago Title 150.00
1112. Insured ClosinQ Letter Chicaoo Title Insurance Comaanv 35.00
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordino fees Deed $ ; Morlgage $ ; Releases $
1202. City/countvlstamps Deed $ 1,300.00 : Morloaoe $ 1,300.00
1203. State taxlstamos Deed $ 1,300.00 ; Morloaoe $ 1,300.00
1204. Adams County Recordina Fees 138.50
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest Insoeclion to
1303. 06 Co. & Twp. Taxes Marilvn J. Basehoar 1,734.92
1304. Reimb. for Tax Cerl Stock and Leader 10.00
1305. Reimb. for Fed Ex Stock and Leader 12.00
1306. LLC Formalion 217200-1 Stock and Leader 850.00
1307. LLC Formation Costs 217200-1 Stock and Leader 125.00
1308. Final Water & Sewer Borough of lIttlestown 129.93
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502 Sections J and Kl 4,519.25 13,569.85
I have carefully reviewe the HUD-1 Settlement Statement and to the,best of my knOWledge and belief, it is a true and accurate sta~nt of all r~eipts and disburse~ts made on rT'ttQ;:counl or by me in this
:ransactlO,n. I furtf1 If{ thai I have recelV~ ~ S. ~Y:/j 1e HUD.-1 SeUJ~t Slateme'lt. '-r~ i/-O~ .c...d:L j-J(' tI- .A _ -;..{~
) " . 'i"LOcUvt",-0..-.:;,..', :1'1-........ _ ., '-'"'V r~ L.t1q J. I
15 Monarch, l.: - Estate ofChar1es E.. Rabensline iE ~
0-1 We I have caused or will cause the funds 10 be disbursed in accordance with this statement.
and l der Dale
NARNING: II s a crime to knowingly make false slatemenls to tne Urofed Slates on /his 01 any other similar form. Penames upon convicllon can include a fine or imprisonment. For details see: ntle 18 U.S. Code
Section 1001 and Section 1010.
RESPA. HB 4305.2 - REV. HUD1i3/861
SCHEDULE J
BENEFICIARlES
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributious. aud trausfers uuder Sec. 9116(a)(\.2)}
I Donna J. Houser, 1314 Georgetown Circle, Carlisle, P A
17013 Daughter residue
2 Brian K. Houser, 10807 Catron Rd., Perry Hall, MD 21128-
8956 Grandson 7%
3 Michelle Renee Maim, 106 Ellsworth St., Colorado Springs,
CO 80906 Granddaughter 7%
4 James Q. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Grandson 5% in Trust
5 Charles K. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Grandson 5% in Trust
6 Megan H. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Granddaughter 5% in Trust
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
N/A
B. Charitable and Governmental Bequests
N/A
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$0