HomeMy WebLinkAbout11-15-06
'l'KtS;Se:cnDNMUSth_;COMRIii;.\~lIi'~coRResPONDiNcs!ANb;CONl'laett'lil!t.'CINft.811DN?saOUEDaeDIAECftD'''fO:,'''
NAME COMPLETE MAILING ADDRESS
ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM ~AME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
O~IAL USE <?,~ y
0"'\ : I '1
5~:3
-<: ,~:g
('h
Ul CJ
0.00 X _(15) 0.00
0.00 X _(16) 0.00
0.00 X .12 (17) 0.00
55,077.57 X .15 (18) 8,261.64
(19) 8,261.64
REV.l500 EX + (&-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
""
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
~. ......' ~~
~1r~~A.'
r. -,; - . ' ..""
... '.-,', t. ,
'~~")'Lr4'
'~.cl~ ~"!.>~.
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
I-
Z
W
C
w
o
w
C
GROFF
DATE OF DEATH (MM-DD-Year)
EMMA G.
DATE OF BIRTH (MM-DD-Year)
08/27/2006 06/19/1914
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
w
~
~-cn
U a:::llI:
w Q. (.)
:E: 00
u~~
Q.
C
[Xl 1. Original Return
D 4. Limited Estate
[Xl 6. Decedent Died Testate (AlIach copy of Will)
D 9, Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dale oldeatll after 12.12.82)
D 7. Decedent Maintained a Living Trust (Allach copy of Trust)
D 10. Spousal Poverty Credit (dale of death belween 12-31-91 and 1-1-95)
I-
Z
w
C
Z
o
Q.
(I)
W
a::
a::
o
u
z
o
~
..J
:)
I-
0:
c(
o
w
a:
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)
D 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 lax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-
:)
0..
:IE
o
o
)(
c(
I-
15. Amount of Line 14 taxable at the spousal tax
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
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
......, ;:>>,,:;;i:SE'SURE:';:rOANSWSffALtrnUestroflS(!OftR ". ERSESIDS' ANO RECHECK MATH <<iF:"
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 6 0 7 9 3
"'COuNTYCOliE --VEAR- - - NuMaER- -
SOCIAL SECURITY NUMBER
1 98- 0 3 - 2 066
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCiAl SECURITY NUMBER
D 3. Remainder Return (dale of death prior 10 12.13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
-0
:x
w
.'.
+'
(8)
69,557.12
9,476.33
1,003.22
(11 )
(12)
(13)
10,479.55
59,077.57
4,000.00
(14)
55,077.57
d
'C
Add
Dece ents amp ete ress:
STREET ADDRESS 30 SKYLINE DRIVE
CITY MECHANICSBURG I STATE I ZIP
PA 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
8,261.64
413.08
Total Credits ( A + B + C )
(2)
413.08
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/Penalty ( D + E ) (3)
4. If Une 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 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. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check to: REGISTER OF AGENT
0.00
0.00
7.848.56
7,848.56
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 IXI
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXI
c. retain a reversionary interest; or ......................................................................:............................... 0 IXI
d. receive the promise for life of either payments, benefits or care? ............................:...........'..................... 0 IXI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death'
without receiving adequate consid~ration?........... ............... ........ ....... ......... ........ ............ ......... ............... 0 IXI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......'........... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 00
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, includi~ accompanying schedules and statements, and to the best of my knowledge and beliel, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on a1llnlormation of which preparer has any knowledge.
SIGNATURE OF PERSO RESPONSIBLE FOR FILI~G RETURN DATE JIlL-
t3. ~ /-pF. t9~
ADDRESS 60 WES MFRET STREET
CARLlSL A 17013
SIGNATURE OF PREPARER OTH TH REPRESENTATIV
ADDRESS
30 SKYLINE DR IV
MECHANICSBURG PA 17050
DATE
1)--1'-1/40
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 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 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.
REV-150B EX + (6-9B)
,f '*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GROFF
FILE NUMBER
EMMA G 21 06
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.
0793
DESCRIPTION
ITEM
NUMBER
1.
Jewelry - Appraisal Attached
2.
Orrstown Bank - Checking Account #416215
3.
Orrstown Bank - Certificate of Deposit #4000008328
4.
Orrstown Bank - Certificate of Deposit #4000008329
5.
Cash on Hand
"I
VALUE AT DATE
OF DEATH
810.00
28,174.87
20,104.79
20,447.09
20.37
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert addnional sheets of the same size)
69.557.12
REV-1511 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
. COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GROFF EMMA
ITEM
NUMBER
A.
1.
B.
1.
2.
3.
4.
5.
6.
7.
8.
9.
G
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
Clyde W. Kraft Funeral Home, Inc.
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 60 West Pomfret Street
City Carlisle
State P A
Year(s) Commission Paid:
Attorney Fees Irwin & McKnight
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Probate Fees Register of Wills
Accountanfs Fees
Tax Return Preparer's Fees Patricia A. Rosendale, CPA
Register of Wills, Filing Fee
Cumberland Law Journal, Advertise Estate
The Sentinel - Legal, Advertise Estate
FILE NUMBER
21 06
Zip 17013
Zip
0793
TOTAL (Also enter on line 9. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
1,035.30
1,750.00
4,22?00
124.00
350.00
30.00
75.00
137.03
9.476.33
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
GROFF
DeCedent's Name
EMMA
G.
Page 1
21 06 0793
File Number
Schedule H - Funeral Expenses & Administrative Costs - 81
ITEM
NUMBER DESCRIPTION AMOUNT
B. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
2. Name of Personal Representative (s) Rev. William A. Groff, Jr. 1,750.00
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 30 Skyline Drive
City Mechanicsburo State P A Zip 17050
Year(s) Commission Paid:
SUBTOTAL SCHEDULE H-B1 1,750.00
REV.1512 EX + (6-98)
*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GROFF
EMMA
G
Include unreimbursed medical expenses.
FILE NUMBER
21 06
0793
ITEM
NUMBER DESCRIPTION
1. Orrstown Bank - Reimbursement of Social Security
VALUE AT DATE
OF DEATH
979.00
2. Continuing Care, RX, Medical
24.22
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 003.22
REV-""EX+.',*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
l:iHUt-t-
FMMA ~
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
William A. Groff, Jr. and Phyllis J. Groff
30 Skyline Drive
Mechanicsburg, PA 17050
1.
2.
Jerry Foltz (Ann Marie Foltz - deceased)
35 Anderson Road
Lewistown, P A 17044
Nevin Groff and Mary Groff
429 N. 45th Street
Harrisburg, PA 17111
3.
FILE NUMBER
?1 06
RELATIONSHIP TO DECEDENT
Do Not List Trustee{s)
Collateral
Collateral
Collateral
07Q3
AMOUNT OR SHARE
OF ESTATE
3/4th Remainder
()Jld- ~~
pn~
1/4th Remainder
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.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Church of God Home (Forever Caring Fund)
801 N. Hanover Street
Carlisle, PA 17013
Camp Y olijwa
1500 Doubling Gap Road
Newville, PA 17241
Creswell Cemetery Association
3044 River Road
Conestoga, PA 17516
2.
3.
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)
1,000.00
1,000.00
1,000.00
$
4 000.00
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Page 2
21 06 0793
File Number
GROFF
DeCedent's Name
EMMA
G.
Schedule J - Beneficiaries - 2B
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
4. Church of God
43 N. Seventh Street
Columbia, PA 17512
1,000.00
SUBTOTALSCHEDULEJ~B
1 ,000.00
REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death:
8.261.64
Discount:
413.08
Interest Table
! Days Delinquent Balance Due Interest
I
I Year
I this time period this year this period
!
Before 1981
.1982
1983
1984
1985
1986
1987
1988 throuQh 1991
: 1992
! 1993 throuah 1994
1995 throuah 1998
1999
2000
2001
2002
:
2003
12004
I
i
TOTALS
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17,1996:
Penalty:
~
LAST WILL AND TESTAMENT
I, EMMA G. GROFF, of North Middleton Township, Cumberland County,
Pennsylvania, deciare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore mad~ by me.
1. I direct my executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my executors to sell any realty owned by me at my death and \
not specifically devised herein, at either public or private sale, and to give good and sufficient.
deeds therefor, in fee simple, as I could do if living.
3. I give, devise and bequeath all of my estate of every nature and wherever situate as
follows:
(a)
Pennsylvania,
I gIve the sum of $1,000.00 to the Church of God, Columbia,
(b)
I give the sum ot .1J ,000.00 to Creswell Cemetery Association, Creswell,
Pennsylvania,
(c) I give the sum of $1,000.00 to the Church of God HO!TIe, Carlisle,
Pennsylvania, for the Forever Caring Fund,
(d) I give the sum of $1,000.00 to Camp Yo lijwa, Doubling Gap,
Pennsylvania, and
(e) All the rest, residu~ and remainder as follows:
(1) Everything in my apartment (personal property) and 75% to
William A. Groff and Phyllis 1. Groff, share and share alike or to the survivor, and
(2) 25% in two (2) parts as follows:
A. One-part to Ann Marie Foltz and Jerry Foltz, or the survivor,
and
B. One-part to Nevin Groff and Mary Groff, or the survivor.
4. I nominate and appoint William A. Groff and Roger B. Irwin, to be the executors
of this my Last Will and Testament; they are to serve as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin,
2
McKnight & Hughes, as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal 15TH day of
November, 2000.
~'t77A1L<,1 ,I.?, -J~SEAL)
EMMA G. GROFF
Signed, sealed, published and declared by EMMA G. GROFF, the above named
Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her
presence and in the presence of each o!her have subscribed our names as witnesses hereto.
3
ACKNOWLEDGMENT AND AFFIDAVIT
WE, EMMA G. GROFF, CHERYL L. CLELAND and MARTHA L. NOEL, the
testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being
flI'St duly sworn, do hereby declare to the undersigned authority that the testatrix signed and
executed the instrument as her Last Will, and that she had signed willingly, and that she executed
it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses,
in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of
their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and
under no constraint or undue influence.
~/f)t-;tu/~, if/'if
E8AG.G~ d.lJ
1 ~LflMJ
R A .NOEL
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTYOFCUMrnERLAND
Subscribed, sworn to and acknowledged before me by, EMMA G. GROFF, the testatrix
herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L.
NOEL, witnesses, this 15TH day of November, 2000.
//)
(;~ {"
---L2
t3 .G-UL-
No rial Seal
Roge B. I 'n, Notary Public
Carlisle m,ro, Cumberland County
My Commission Expires Oct. 3, 2004
Member, PennsylVania Association of NoIarieS
EMMA. G. GROff ES1'A.1'E
dlo/d _ A.Ugust 27 , 2006
APpraisa\ bY:
\-,\arf'/ E. Danson
CARUSLE COU-.l S\-\oP
25 Circle Orive
car\\s\e, PA '\70'\3
243-8943
I ~ 3 );;.:.,.,~ i?~
:J ~
/ ~ D I -,..,v'\ #' ~
C ..v ..... '1"'- ~ ./"'
1l''V't -Vf
~
------
ff.s--- So ~ c
( cf
tV ft((yy-'2.e.... ~
2iO/
-------
-r--
)'0 ~
~J ~.~
A ~\AY~
g.-D>O'~"~
.~ c'^"'\n- 'JJ c~- ~'
c~t :
. (
September 22, 2006
TO: Irwin & McKnight
60 W. Pomfret Street
Carlisle, PA 17013
~\&CIU'li~
SiP 262006
IR Wll'i & McKNIGHT
FROM: Carrie E. McGee
22 S. Hanover St.
Carlisle, PA 17013
RE: ESTATE OF Emma G. Groff
DATE OF DEATH: August 27,2006
IT IS HEREBY CERTIFIED~THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOllOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKING ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
416215 50+ Interest Checking 7/11/97 28137.83 $37.04
CERTIFICATES OF DEPOSIT
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
4000008328 3 month income 12/28/05 $20,000.00 $104.79
Matured on: 3/28/06
4000008329
6 month income
12/28/05
$20,000.00
$447.09
Matured on: 6/28/06
Kevin M. Kraft. Sr. - Supervisor
P.O. Box 218
247 Main Street
Landi~ille, PA 17538
717 898-2240
P.O. Box 231
519 lValnut Street
Cohnnbia, R\ 17512
717684-2'};-o
Patrick M. Bransby - Supervisor
Clyde llZ Kraft
Funeral Home, Inc.
September 13,2006
Rev. William A.Groff, Jr.
30 Skyline Drive
Mechanicsburg, P A 17050
Dear Rev. Groff:
Your late Aunt Emma .had pre-arranged, pre-financed funeral instructions with us. Therefore, the
following are the only outstanding items: '.
." Additi()nal Stafi7TransportatiOll. for CcirlisleSerVice
Carlisle Sentinel (newspaper obituaiy)
Harrisburg Patriot (obituary)
Non-Guaranteed Charges for Cash Advance Items
(not covered by contract)
$ 318.00
170.10
253.60
293.60
BALANCE
$1,035.30
A check for this amount maYbe made payable to the Clyde W. Kraft.Funera1 Home, Inc. and
mailed to POBox 231, Columbia P A 17512. ' . " ,
'1~
Should you have any questions, or if we can be of any further. service to you, please do hdf '.."
hesitate to contact us.
,:i,
7t/;{~
Patrick M. Bransby
PMB/sm
"Our Fa'mib.' Serving lour Family Since 1954:"