HomeMy WebLinkAbout11-08-06 (2)
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes" .
PO BOX 280601
Harrisburg, P A 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFliCIAL USE ONLY
County Code Year
;). C ~
File Number
c q 67
Date of Birth
197076509
o 2 0 3 1 996
10021913
Decedent's Last Name
Suffix
Decedent's First Name
MI
GROSS
NORMAN
W
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
GROSS
B E 0 L A H
A
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 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 Daytime Telephone Number
FILL IN APPROPRIATE OVALS BELOW
[Xl 1. Original Return
o 4. Limited Estate
[Xl
o
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
AND R E W L WIN 0 E R
7174368799
City or Post Office
State
ZIP Code
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REGIS~ WILLS
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DATE FILED r "
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Firm Name (If Applicable)
First line of address
POBOX149
Second line of address
2 5 NOR T H M A INS T R E E T
M IFF L I N TOW N
P A
17059
Correspondent's e-mail address: WINDERLA W(ii)NMAXNET
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 of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN URE OF PERSON RE ONSIBLE FOR FILING RETURN DATE
1/- o<f " "
D7Ne/o,
MAIN STREET, PO BOX 149 MIFFLINTOWN
PLEASE USE ORIGINAL FORM ONLY
PA 17059
Side 1
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15056041125
1Ei056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: NORMAN W. G RO S S
RECAPITULA nON
197076509
1. Real estate (Schedule A)
1.
579600
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.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested. . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7)
. . . . .. . . . . . . . . . . . .. . .. . . . .. 8.
5 7 9 6 0 0
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)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 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.
5 7 9 6 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . 14. 5 7 9 6 0 0
.......... .
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 5 9
(a)(1.2)X.00_ 7 6 0 0 15. 0 0 0
16. Amount of Line 14 taxable 0 0 0
at lineal rate XO 16. 0 0 0
17. Amount of Line 14 taxable 0 0 0 0 0 0
at sibling rate X .12 17.
18. Amount of Line 14 taxable 0 0 0 0 0 0
at collateral rate X .15 18.
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
D
Side 2
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15056042126
15056042126
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"EV-1500 EX Page 3
Decedent's Complete Address:
File Number
DECEDENT'S NAME
NORMAN W. GROSS
STREET ADDRESS - -" ~_._-----
III ROSEMONT A VENUE
---_.~---
CITY I STATE I ZIP
NEW CUMBERLAND PA 17070
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
000
Total Interest/Penalty ( 0 + E ) (3)
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. (4)
0.00
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
000
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
A. Enter the interest on the tax due.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"'N TIHE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ............................................... ....................... 0 [Z]
b, retain the right to designate who shall use the property transferred or its income; ............................... 0 [Z]
c. retain a reversionary interest; or ................................................................................................ 0 [Z]
d, receive the promise for life of either payments, benefits or care? ....................................................... 0 [Z]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.................. ................................................................... 0 [Z]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 [Z]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.. ............................................................................ .................... 0 [Z]
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 dealh on or afler 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, S9116 (a) (1.1) (i)].
For dates of death on or afler 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. 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 afler 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. 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 four and one-half (4.5) percent, except as noted in
72 PS 89116(1.2) [72 P,S s9116(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. 89116(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
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
NORMAN W. GROSS
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 property which is jointlvoowned with richt of survivorshio must be disclosed on SChEidule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
One-third tenancy in common interest in five acres in Delaware Township, Juniata County, PA, acquired by deed
dated 7/5/57, recorded in Juniata County Deed Book 90, page 324. Tax parcel #2-3-43, total assessed value
in 2006 of $2,800.00. Calculated fair market value is 6.21 x $2,800 = $17,388 (1/3 =$5,796.00)
5,7%.00
TOTAL (Also enter on line 1, Recapitulation) S
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324
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Scats of Pennsylvania
55.
County of Juniata
On this, the 16th. day of July, 1957, before me, the undersigned officer,
personally appeared Ira D. Brandt and 1-lartha O. Brandt, husband and wife,' known to me
(or satisfactorily proven) to be the persons whose names are subscribed to the within
instrument, and acknowledged that they executed the same for the purposes therein con-
&
IiI i'iID: SSS ~1HEil:OF, I hereunto set my hand and official seal.
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tained.
DOLPH B. ROUSH. (SE
Notary Public.
My Conun. Expires I'lar. 7, 1959.
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I co hereby certify that the precise residence of the within named Grantees is
122 Verbeke Street, Jlarrisburg, Pennsylvania.
.
July 16, 1957.
HAROLD F. KERCHNE~
Attorney tor Grantor.
See DrAft of Lnnd in Mnu Dook No.1, Page 36 .
Esther Hower, Recorder.
,State Tax.
;)2.00
I. D. B.
7/16/57.
Documentary.
. ~. 55
I. D; B.
7/16/57.
Entered July 16, 1957.
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DEED.
THIS DEED, fude The 5th. day of July in the
year of our Lord one thousand nine hundred
Fifty-seven.
A::Lsr:E S. L:-:::T2 and 1::::I,:<;TH
A. 1::;;:T2. l!i=r Jlusband.
TO.
BE1"IIZEn
Arlene S. Lentz and Kenneth A.
~om:M: GnOSS, MERRILL GROSS,
in COT::lf.lon.
Lentz, her husband, both of Delaware Town-
ship, Juniata County, Pennsylvania, of the
e
ar.d GSOHC8 GROSS, as Tenants
First Part, .
GRANTORS,
AIID Norman Gross of New Cumberland,
Per.r.sylvania: rerrill Gross of ned Lion, Pennsylvania; and George Gross of Delaware Town-
. all
ship, Juniata County, Pennsylvania;/of the Second Part, GRANTEES:
I
\.\'IT::ESJc;TH, That in consideration of Five Hundred D500.00) Dollars, in hand paid,
the receipt whereof is hereby acknowledged, the said grantors do hereby grant and convey to
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the said ~rantees, their heirs and assigns, as Tenants in Com~on,
~
ALL THAT CERTAIN Tract of land situate in Delaware Township, Juniata .County, Pennsyl
vania. bou~ded and described as follows, to wit:
B2GH:NING at a post at the south side of the Evans Hollow Road leading to Goodville,
ther.ce along other lands of the Grantors of .~ich this was ~ormerly a part South 18-3/4
oer-rees East 5.76 rods to a chestnut oak; thence by the same South 17 degrees East 46.24
rods to a point on the line of lands of the Gross Heirs; thence by said lands of the Gross
t
Heirs South 47 dev.rees ~est 39 rods to stones on the east bank of Delaware Croek; thence
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along the east bank of the said Delaware Creek in a northeasterly direction the fo110win~
four coursesand distances: North 24t degrees East 16 rods; North I deE;ree West 12 rods;
North 23! degrees East 16.25 rods; North 5 degrees West 24.5 rods to a iron post at the
bridge wall carrying the Evans Hollow Road over the said j)ela~.Iare Creek; and thence in a
northeasterly directio.n along the south side of the said Evans Hollow Road to a post, the
Place of BEGINNING.
CONTAINING Five (5) Acres Twenty eight (28) Perches, as surveyed June 15, 1957 by
Floyd C. Graybill, a Registered Surveyor..
AND BEING a par.t of the same lands that I:enneth R. 5ausrr.an et al., by their ::leed
dated October 21, 1954 and recorded in Juniata County Deed 300k Volu~e 87, at Pa~c 240,
sold and conveyed to Arlene S. Lentz and Y.enneth A. Lentz, her husband.
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AND, the said grantors, do hereby covenant and agree to and with the said grantees. that
they, the grantors, their heirs, executors and ad~lnlstrators, shall and will warrant
G~nera1ly and forever defend the herein above described premises. with the hereditaments
and appurtenances, unto the said grantees, their heirs and assiens, D[alnst the said gran-
tors, and against every other person lawfully claiming or who shall he~eafter claim the
same Or any part thereof.
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HI WITI:E:JS WHEREOF, said Grantors have hereunto set their hands and seal:.; the
day and year first above written.
Signed, Sealed and Delivered
in the Presence of
:--A[U;::c S. LrJ:TZ.
KEJ:riSTlI A. L2!:TZ.
(SSAL)
(SSAL)
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State of Pennsylvania
County of Juniata
On this, the 5th. day ot July, 1957, before me, the undorsi~ned Officer, personally
3S.
'a;
appeared Arlene'S. Lentz and Kenneth A. ~entz, her husbar.d, both known to ~:t' (01' satL3~act-
,. '~
,
,
orily proven) to be the persons whose na~es are subscribed to the withir. i~lstru~ellt.
acknowledged that they executed the same for the purposcs therl;in contained.
IN WITt:ESS WHEREOF, I hereunto set my had and official soal.
a"'~
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CLI\1L8:CE U:ACH. (SEAL)
~~s~ice of t!le Peace.
T}:o:::pzon tOH:l, Pa.
~:y COIC.::;, Expires Jan. 1. 1962.
I do hereby certify that the precise residence or the within named Grantees is
c/o George Croes, Thompsontown, Pennsylvania.
July 5th, 1957.
11... D:lo\\'N ffiY.
Attorney fOl' GI'antees.
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Entered July Ie, 1957.
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Esther Hower, Recorder.
State ';'a)(.
$5.00
A. S. L.
7/18/57.
Do::ur:ientarv.
0\ ... _ .
.;- .))
A. S. L.
7/1S/57.
See Drart of lAnd in MAp Book No. 1,Page 28.
~'rr.-
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
NORMAN W GROSS
RELA TIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
r. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)J
1. Beulah A. Gross Spousal 10000
III Roselllollt Avenue
New Cumberland, PA 17070
EmER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APfJROPRIA TE, 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 $
(If more space is needed, insert additional sheets of the same size)
EGM/August 27, 1991/9316
Iflct51 ]NiH alto QI~sbtm~nt
OF
!WRMAN W. GROSS
I, NORM.l'~N w. GROSS I of the Borough of New Cumber land (
Cumberland County, Pennsylvania, being of sound and disposing mind,
me~Gry 3nd understa~ding. do hereby make, publish and declare this
6S and for my Last Wi~l a~4 ~~s~~ment, hereby revoking Hod ma~inq
me.
void any a~d all Wills or Codicils at any time heretofore made by
l\RTICLE I
I dir2ct the paymf'.nt of all Ply l0.g(-\l debb;, and the expenses
of my last illness and fune:r.al froill my Estate as soon after my
death as conveniently may be done. I direct that all taxes that
may be assessed in conseque?1C'2 of my death, of I,vhatever natllre and
I,\'lJ(.:;t,~vGr jurisdiction irr.posed, shall be paid from my r<esicluary
Estate 2S part of the e~pense of the administration of my Estate.
A::~:I.'ICI,E II
~;.::' ;:' ej ,:; t;; a:~:_:; ':' ::.:, cr. .c. c. r':~:,.:) ~ 2 f'''!:,- SCT:,-4.l t y 0 f 1 i.?<:e P.cl~::: 1.n- 2 (I' at in c 1u c1 i 11 c.r
I give and bequeath nlY automobiles, hm.ls(2.hold and personal
ca::::h c't" ~jccurities), tcqether ~.li.th any ~xistil1g in~,urance tllC?i::-eon,
unto my wi.fe, BEULAH A. Gl:'WGB, if she sc.:rvivl2s me by thirty (JCJ)
clay:::;. Should my wife, 13EllLp.H .A. GR.OSS nr.)t be :Living on the t:llirty--
tlrst (31sq day after ir.,! d8,"'lth, I give and beque'::1th the same t:nto
JA.NE 1\. lW1-;rn,y, provided she su:r'li ves p.le.
AR'I'ICLg III
I (jiVE;,
remaindc,r of
d(~~viS8 anct
be.qlh.?atl1 all
of wha tsof:ver
the r(:;st, n:;siduf::, and
nature Zlnd Hherc::;oever
11:i,/ Estate,
cUM/August 27, 1991/9316
situate unto my wife, BEULAH A. GROSS, provided she surV1ves me by
thirty (30) days.
ARTICLE IV
Should my wife, BEULAH A. GROSS not be living on the thirty-
first (31st) day following my death, I give, devise and bequeath
all the rest, residue and remainder of my E~;tate, of whatsoever
nature and wheresoever situate, unto, JANE K. BYERLY, or her issue
per stirpes by representation should she predecease me.
ARTICLE V
I name, constitute and appoint JANE K. BYERLY, Executrix of
this my Last Will and Testament. In the event J"l\NE R. BYERLY f
fails to qualify or ceases to so act, Inane, constitute and
appoint RICHARD P. BYERLY, alternate Executor to complete the
administration of my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal, this
\, ; day 0 f 19 9 1 .
" .'\
NAME
(SEAL)
Signed, sealed, published and declared by the above-named
Testator, as and for his Last Will and Testament, in the presence
of us, who at his request, in his presence and 1n the presence of
each other, have hereunto subscribed our names as witnesses.
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EGM/Augllst 27, 1991/9316
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
:ss
He, NORMAN W. GROSS,
L":: t'"
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'l:, '. " ",'. ~ '.
&DMun 0 (1.. )Aqt~S: the Testator and the ,,,i tnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the
instrument as his Last Will and that he had signed willingly and
that he executed it as his free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the Testator, signed the Will as witness and that to
the best of his/her knowledge the Testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
and
Norman W. Gross
.,s',
Hitness
/(, "'~!
witnesses, this
SUbscribed, sworn to and acknowledged before me by NORMAN W.
GROSS, Testator, and subscribed and sworn to before me by'
CAKL R. W'AkLPI La.-O , and E'b lAnD ~. ;0h(e-i2S
11, t da y Of~-hJ 1u (1: I, '7 II"c' " ~/~ ') 1 .
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