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Home My WebLink About12-05-06 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX! 11-96) RECEIVED FROM: PENNSYLV ANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RINGlABEN DAVID W 6114 CHARING CROSS ECHANICSBURG, PA 17050 ____un fold ESTATE INFORMATION: SSN: 171-01-2726 FILE NUMBER: 2106-0332 DECEDENT NAME: JOHNSON JAMES B DA TE OF PAYMENT: 12/05/2006 POSTMARK DATE: 12/05/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 04/01/2006 NO. CD 007513 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,110.93 I I I I I I I I TOTAL AMOUNT PAID: $2,110.93 REMARI(S: RINGlABEN DAVID W CHECI(# 9453 INITIALS: AJW RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS --.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 Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 06 00332 Date of Birth 171-01-2726 04/01/2006 08/01/1909 Decedent's Last Name Suffix Decedent's First Name MI Johnson Mr. James B (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ., 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 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 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 . 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes David W. Ringlaben Firm Name (If Applicable) (717) 697-0849 REGISTER OF WILLS USE ONLY First line of address 6114 Charing Cross Second line of address () ~O :-rJ ~ c:.:::.:J 0" o r'l"l DATE,cF~ n '''''.~S'~;; I : ci;") ~r~ Ul C_~) ~~?:5 \~~~.~~ ~ - ~ ~-~'1 Correspondent's e-mail address: ,:.; ~i-:i _-,',- f;~ I ' (_) Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the beSt-pf my knowled~d belief, "fl it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any kn~dge. SiG,N!\.T,URE OF P~RS?f'J RESPONSIB FOR FILING RETURN OAT . / .' ~,- .x.. Lu. . -L.-~~V'-' (" C A 0 ESS City or Post Office State ZIP Code Mechanicsburg PA 17050 .L-~(,,-,- ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 --.J ...J 15056052059 REV-1500 EX Decedent's Name: James B Johnson RECAPITULATION 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. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 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. 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_ 17. Amount of Line 14 taxable at sibling rate X.12 17,591.06 18. Amount of Line 14 taxable at collateral rate X .15 Decedent's Social Security Number 171-01-2726 0.00 0.00 0.00 0.00 7,191.54 21,866.02 0.00 29,057.56 10,056.13 1,410.37 11,466.50 17,591.06 17,591.06 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L 2,110.93 2,110.93 15056052059 -.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME James B Johnson STREET ADDRESS File Number 00332 DECEDENT'S SOCIAL SECURITY NUMBER 171-01-2726 CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,110.93 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + 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 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 2,110.93 0.00 2,110.93 5. If Line 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. 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;.......................................................................................... D ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D ~ 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 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 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 ESTATE OF James B. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 210600332 ITEM NUMBER 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 VALUE AT DATE OF DEATH 1. PNC Burial Reserve Account 2. 1990 Chevrolet Cavalier Sedan, Fair Condition D 3. Miscellaneous Household Goods 4. Final SERS Annuitant Payment 5,757.09 525.00 325.00 584.45 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,191.54 REV-1509 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF James B. Johnson FILE NUMBER 21060332 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 A Winifred Ringlaben 6114 Charing Cross Mechanicsburg, PA 17050 Sister B. David W. Ringlaben 6114 Charing Cross Mechanisburg, PA 17050 Nephew C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 1 A/B 06/30/90 PNC Account 51-4019-9595 2,104.49 33 701.42 D 2 A/B 06/30/95 Citigroup Account 54J-03424-14 4JX 24,025.31 33 8,007.64 3 B 03/01/06 Citigroup Account 54J-03425-13 4JX 26,313.92 50 13,156.96 TOTAL (Also enter on line 6, Recapitulation) $ 21,866.02 (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 James B. Johnson FILE NUMBER 21060332 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 ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. None TOTAL (Also enter on line 7 Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF James B. Johnson FILE NUMBER 210600332 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 10. 11. 12. 13. 14. 15. 16. 17. 20. 21. 22. 2. Comcast - Monthly Cable Bill 47.82 AT&T - Monthly Long Distance Bill 14.55 Central Medical Equipment 45.00 Long Meadows Apartment - Rent 580.00 UGI - Monthly Gas Bill 57.00 Hecht's - Burial Clothing 40.29 CVS - Prescription 68.63 PPL - Monthly Electric Bill 22.00 AT&T - Monthly Long Distance Bill 27.27 Long Meadows Apartment - Fee 30.00 R. L. Margargle, MD - Medical Bill 49.89 Urology of Central PA - Medical Bill 38.18 Penn Credit - Unpaid Personal Taxes 57.00 R. L. Margargle, MD - Medical Bill 49.89 Verizion - Telephone Bill 9.29 PPL - Electric Bill 21.99 CVS - Prescription 10.91 AT&T - Long Distance Bill 9.13 PPL - Electric Bill 11.04 UGI - Close out Gas Bill 167.15 AT&T - Telephone Equipment Lease Closeout 18.78 Foot & Ankle Center 34.56 3. 4. 5. 6. 7. 8. 9. 18. 19. TOTAL (Also enter on line 10, Recapitulation) $ 1,410.37 (If more space is needed, insert additional sheets of the same size) REV-1S13 EX+ (9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF James B. Johnson FILE NUMBER 210600332 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Winifred M. Ringlaben, 6114 Charing Cross, Mechanicsburg, PA Sister 100% 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) LAST \IIJILLAND TESTN.fENT OF JAMES B. JOHNSON I, JAMES B. JOHNSON of East pennsboro Township, Cumberland County, pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I _ I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II _ I devise and bequeath all of my estate of what- ever nature and wherever situate unto my sister, Winifred M. Ringlaben, if living, and if not, to her son, my nephew, David w. Ringlaben, if living, and if not, to his issue. III _ I appoint my sister, Winifred M. Ringlaben, Exe- cutrix of this, my Last Will and Testament. Should my said sister fail to qualify or cease to act as such, then I appoint my nephew, David W. Ringlaben, to act in this capacity. Neither of my personal representative.s shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the 3M/I>. day of Ab*,"N4!JE'e , 1978. (SEAL) ARNOLD, SLIKE & BAYLEY A'lTOIlNEYS AT LAW 8100 "",..ST !IT..r;T Signed, sealed, published and declared by JAMES B. JOHNSON, Tes- tator therein named, on this sheet of paper as and for his Last Will and Testament in our presence, who, in his presence, at his request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. -31:!-~ ~. · ~~.. PC{- _~e~ - ~tbd;1res;4 . Name ~ / Addr,ess CAMP HtLL,PHlfI4SYLVAlfU. "011 COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) I, JAMES B. JOHNSON , the testat or whose name is signed to the attached or foregoing instrument, having been duly quali- fied according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it will- ingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by ~L JAMES B. JOHNSON, the testat or this _~e2 ...... day November , 19~. of ~jJ~ N0tary Public lbelma S. MtCauslin. t~otarv ~ublic My Commission E,lpires My \, \980 Camp Hill, PA Cumberland Counly COMMONWEALTH OF PENNSYLVANIA) SSe COUNTY OF CUMBERLAND) WE, the undersigned, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that JAMES B. JOHNSON signed willingly and that JAMES B. JOHNSON executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge the testa1Pr was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~ ~ -to ~p~ JlNOI,.D, SUJCE a BAYlEY AlTCIRNf.VS AT LAW 2'" _ ...-- _tllLL..-....,,_l70l1 Sworn to and subscribed before me '7l~ this ,dJ day of November , 192.!!. (I '\ >-j~ j ~ e~~ Ndtary public Thelma S. MtCaus6n. Notary P.obtit My Commission Expires July I. 1980 (amp Hill, PA Cumberland County " '..." j '-...I