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Home My WebLink About01-16-07 REV.1500 EX + (6.00) *' w ... ~~1Il UlIC~ w~Si :Z:1IC~ UCLGI CL C OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER II 06 OUNTY CODE YEAR SOCIAL SECURITY NUMBER 0431 N MBER t- Z W C W o w c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Weibley, Kathryn H. DATE OF DEATH (MM-DD-YEAR) 192-14-5944 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER 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 between . 12-31-91 and 1-1-(5) D 3. Remainder Return (date of death prior to 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) [!J 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received o D D D 2. Supplemental Return 4 James Circle Shippensburg, PA 17257-216,6, = o ::3 ::0 ,~'lnl ; J !:JCIAE;.tJSE 'Cm~. .:;\ ~ ~ : ~;.,~\, 8 U);;:s;.;: c) C) (jO -0 -'Ft -TI ~j~-Tl :. ~~ ~ 'J::::'; .. rj"') C) ).:, N "T1 o (8) 168,432.91 (11 ) 42,118.84 126,314.07 0.00 DATE OF BIRTH (MM-DD-YEAR) 04-16-2006 04-16-1923 COMPLETE MAiliNG ADDRESS (1 ) 109,900.00 (2) None (3) None (4) None (5) 58,532.91 (6) None (7) None (9) 23,519.28 (10) 18,599.56 13. Charitable and Governmental Bequests/See 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) (12) (13) (14) 126,314.07 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ... z w c z o D- III W 1IC 1IC o U NAME David Patrick Perkins, Esq. FIRM NAME (If applicable) TELEPHONE NUMBER 717 532-6629 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 5,684.13 0.00 0.00 5,684.13 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 0 (16) t= 16. Amount of Line 14 taxable at lineal rate 126,314.07 x .045 ~ ::>> Q. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ~ 0 0 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) >< ~ 19. Tax Due (19) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o t= :s ::>> t- o: 4( o w << 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 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) 20.00 CHECf<. HUH W ,'QU tlRL REOUE'3TING A REF UNO ur.: AN OVEf-\PAYMENT Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; Decedent's Complete Address: STREET ADDRESS 29 Wyrick Avenue CITY Shippensburg ISTATE PA !ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 5,684.13 6,750.00 284.21 Total Credits (A + B + C) (2) 7,034.21 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1,350.08 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;.................................................................................. ~ ~ :: ::::~ ~h;e:::i~~:~s:~::s~~~..~~~.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?...................................................................................................................... 0 ~ 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?...................................................................................................................... 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. Oedaretlon of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ~ Burkett 311 Duncan Road Shippensburg, PA 17257 SIGNA URE OF PER~SPONSIBLE FOR FILING RET RN ADDRESS Robert J. Weibley Sl~ H R THAN REPRESENTA VI ~rk6?~ DATE /-/3-07 DATE 448 Whitmer Road Shippensburg, PA 17257 4 James Circle Shippensburg, PA 17257 / J :J;,IJ 61 DATE 1-1"3-01 ADDRESS 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.1502 EX+ (6-98) '* SCHEDULE A REAL ESTAtE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF All real property owned solely or a. a tenant In common must be reported at fair martlet value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wilAng seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jolntly-owned with right of survlvorehlp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Residence 29 Wyrick Avenue, Shippensburg Township, Cumberland County , Pennsylvania VALUE AT DATE OF DEATH 109,900.00 TOTAL (Also enter on Line 1, Recapitulation) 109.900.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev-15GB EX+ (e-9B) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Welbley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF Include the proceeds of litigation and the dale the proceeds were received by the estate. All property Jolntly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Citizens Bank 525 WIlliam Penn Place Pittsburgh, PA 15219 - Checking Account # 3.784.79 6100794938 2 Citizens Bank 525 William Penn Place Pittsburgh, PA 15219 - Richard Weibley IRA 18.856.03 CD Account # 6140-898463 3 F&M Trust P.O. Box 6010 Chambersburg, PA 17201-6010 - Richard Weibley IRA 10.301.40 Account # 68928200 proceeds distribution 4 MetLife 485-E US Highway 1 FL 4 PO Box 4121 Iselin, NJ 08830-4121 - MetLife Total 20.698.82 Control Acount # 4051237415 5 Proceeds of sale of vehicle -1996 Ford Ranger pickup truck 2.750.00 6 Proceeds of sale of household goods and furnishings 714.00 7 refund of Capital Blue Cross medical insurance premium 282.25 8 F&M Trust P.O. Box 6010 Chambersburg, PA 17201-6010 - Richard Weibley IRA CD 196.18 Account # 68928200 required quarterly distribution 9 refund of prepaid county and township real estate taxes - HUD-1 Settlement 90.30 Statement line 407 10 refund of prepaid school real estate taxes - HUD-1 Settlement Statement line 408 859.14 TOTAL (Also enter on Line 5, Recapitulation) 58.532.91 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1161 EX+ (12-18) '*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-G431 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,816.00 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 8,421.64 See continuation schedule(s) attached 2. Attorney's Fees 8,421.64 See continuation schedule(s) attached 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 560.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 300.00 See continuation schedule(s) attached TOTAL (Also enter on line 9. Recapitulation) 23,519.28 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule H (Rev. 6-98) Rey.1502 EX+ (1-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 funeral expenses for Kathryn H. Welbley - Fogelsanger-Brlcker Funeral Home 112 West King Street Shippensburg, PA 17257 4.631.00 2 casket and interment expenses - Cumberland Valley Memorial Gardens 1921 Ritner Highway Carlisle, PA 17013 1.185.00 Subtotal 5.816.00 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-88) * SCHEDULE H-B1 PERSONAL REPRESENTATIVE'S COMMISSIONS continued COMMONWEAlTH OF peNNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Welbley, Kathryn H. FILE NUMBER 21-08-0431 ITEM NUMBER DESCRIPTION AMOUNT 1 Personal Representative Commission - Sharon K. Burkett - 311 Duncan Road Shippensburg, PA 17257 SSN: 189-44-3901 paid 2007 4,210.82 2 Personal Representative Commission - Robert J. Weibley - 448 Whitmer Road Shippensburg, PA 17257 SSN: 178-44-2325 paid 2007 4,210.82 Subtotal 8,421.64 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B1 (Rev. 6-98) RBv-1502 EX+ (6-98) * SCHEDULE H-B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF ITEM NUMBER DESCRIPTION 1 Attorneys fees David P. Perkins, Esquire AMOUNT 8.421.64 Subtotal 8.421.64 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) Rev-1502 EX+ (6-98) '* SCHEDULE H.84 PROBATE FEES continued COMMONWEAl. TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Weibley, Kathryn H. FILE NUMBER 21-06-0431 ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills-probate fees, grant of letters, short certificates 329.00 2 Register of Wills-filing fees- inventory, inheritance tax, release 55.00 3 Cumberland County Law Journal - advertisement of grant of letters of administration 75.00 4 The News-Chronicle - advertisement of grant of letters of administration 101.00 Subtotal 560.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev-1502 EX+ (1-91) '* SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEAL 11i OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF ITEM NUMBER 1 DESCRIPTION S W Barrett Real Estate Appraisal-appraisal 29 Wyrick Avenue Shlppensburg, Pennsylvania AMOUNT 300.00 Subtotal 300.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) ReY-1512 EX+ (6-98) * SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. FILE NUMBER 21-06-0431 ESTATE OF Include unrelmbul'1Ied medlcll expenses. ITEM NUMBER DESCRIPTION 1 Fogelsanger-Bricker Funeral Home- funeral expenses for Richard J. Weibley- decedent's husband VALUE AT DATE OF DEATH 4,616.00 2 Ohio Casualty Group-homeowners insurance 121.76 3 AON Home Warranty Services, Inc - home warranty 75.00 4 Barry L. Negley, Tax Collector-2006-2007 school real estate taxes 1,034.74 5 David P. Perkins, Esquire - attorneys fees 180.00 6 Moffitt Heart & Vascular Group - medical bill 14.73 7 Belvedere Medical Corp. - medical bill 25.17 8 Dr. Schwaub - medical bill 13.00 9 Penelec - electricity 46.63 10 Cumberland Franklin Joint Municipal Authority - sewer 78.00 11 Borough of Shippensburg - water 74.12 12 Robert J. Weibley -landfill expense- trash disposal 273.24 13 Sollenberger's Messenger Service - truck title transfer 39.50 14 Annette Lane - home repair costs allowance 1,000.00 15 Expenses of real estate sale - HUD 1 Settlement Statement 11,007.67 TOTAL (Also enter on Line 10, Recapitulation) 18,599.56 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV.1513 EX+ (9-00) ESTATE OF NUMBER I. 1 2 3 4 *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weibley, Kathryn H. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal ctistributions..l and transfers under Sec. ~116(a)(1.2)] FILE NUMBER 21-06-0431 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) RELATIONSHIP TO DECEDENT Do Not Ust Trusteefsl Sharon K. Burkett 311 Duncan Road Shippensburg, PA 17257 Daughter one fourth Karen W. Joseph 8 Kingston Drive Palmyra, PA 17078-9701 Robert J. Weibley 448 Whitmer Road Shippensburg, PA 17257 Richard E. Weibley 2514 CR 332 Me Kinney, TX 75071 Daughter one fourth Son one fourth Son one fourth Total Enter dollar amounts for distributions shown above on lines 5 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 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)