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Home My WebLink About03-22-07 . -.J 15056041125 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year 2 1 0 6 File Number 656 Date of Birth 29614 0 0 5 3 062 4 2 0 0 6 o 8 0 8 1 923 Decedent's Last Name Suffix Decedent's First Name STAKE RUT H MI A (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 o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach Copy of Trust) o 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 00 1. Original Return o 4. Limited Estate o o 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes WAY N E F S HAD E 7 1 7 2-,4 3 {~: --.0 REGISTER~r<.~IL':'S US~L Y--~' , ~~ P :::0 , - 1",1 1"',) :::rJ N ! ) -,),~ 5 3 W EST P 0 M F R E T S T R E E T F>'-, "---', (:::) ~'ci~ ::Po Firm Name (If Applicable) First line of address Second line of address ....... :.::J ..-1 C> City or Post Office .::- State ZIP Code DATE FILED CAR LIS L E P A 17013 Correspondent's e-mail address: Under penallies 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PE ON RESPONSIB E FO ILlNG RETYRN, DATE ,I) .VL- ~/.21 I}? REPRESENTA TNE Sr.ippensburg PA 17257 Pomfret Street Carlisle PLEASE USE ORIGINAL FORM ONLY PA 17013 Side 1 L 15056041125 15056041125 .....J .....J 15056042126 REV-1500 EX Decedent's Social Security Number DecedenfsName: Ruth A. Stake RECAPITULATION 296140053 1. Real estate (Schedule A) ...................................... . 1. 2. Stocks and Bonds (Schedule B) 2. 1 2 292 o 0 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. 7323063 8. Total Gross Assets (total Lines 1-7) 8. 8 5 5 2 2 6 3 . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 7 1 9 4 2 9 ............. . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . 10. 1 2 6 2 3 0 5 .......... . 11. Total Deductions (total Lines 9 & 10) . . 11. 1 9 8 1 7 3 4 . . . . . . . . . . . . . . . . . . . . . . . . . 12. Net Value of Estate (Line 8 minus Line 11) . . 12. 6 5 7 0 5 2 9 ...................... . 13. Charitable and Govemmental 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. 6 5 7 0 5 2 9 ................ . 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.O _ 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable 6 5 7 0 5 2 9 at lineal rate X .04L 16. 2 9 5 6 7 4 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. 2 9 5 6 7 4 ........................................ . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT r&l Side 2 L 15056042126 15056042126 .....J REV-1500.EX Page3 Decedent's Complete Address: DECEDENTS NAME Ruth A. Stake ~----~ -----------~-~--~----- STREET ADDRESS 100 Mt. Allen Drive ~---~----- File Number 656 CITY Mechanicsburg - -!STATE IPA jZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,956.74 3,000.00 147.84 Total Credits ( A + B + C) (2) 3,147.84 3. Interest/Penalty if applicable D. Interest E. Penalty 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 191.10 0.00 A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 0.00 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; ..................... ................................................. 0 IX! b. retain the right to designate who shall use the property transferred or its income; ............................... 0 IX! c. retain a reversionary interest; or ............................................................................................... 0 IX! d. receive the promise for life of either payments, benefits or care? ...................................................... 0 IX! 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........... .......... .................. ...... .... ...................................... 0 IX! 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 IX! 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................. ............ ......... ............. ......... ...................................... 0 IX! 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 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 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-1503 EX + (6-98) 'w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Ruth A. Stake FILE NUMBER 656 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. orporatlOn, 4 TOTAL (Also enter on line 2, Recapitulation) $ 12 292.00 {If I11OI'A ~M i!l nP.P.llM inAArt Iltftfitinnlll !lhAP.!!l nf lhA AAITlA !li7A \ REV-"",! EX. '6-. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth A. Stake ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. FILE NUMBER 656 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntJy-owned with right of survivorship must be disclosed on Schedule F. Members 1st Federal Credit Union, Account #15170-00 Members 1st Federal Credit Union, Account #15170-04 Members 1st Federal Credit Union, Account #15170-05 Members 1st Federal Credit Union, Account #15170-49 Manulife Financial Corporation, dividend U. S. Treasury, 2006 federal income tax refund TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH ,5 997.21 4,002.52 4,164.22 50,886.75 52.99 594.00 73 230.63 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Pate of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established ~1~ MEMBERS 1st FEDERAL CREDIT UNION 15170 -00 08/31/1973 $996.58 $.63 $997.21 Carol L. Hoy 06/16/1996 LIFE SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 15170 -04 02/01/2001 * $4,000.00 $2.52 $4,002.52 Carol L. Hoy 02/01/2001 MONEY MANAGEMENT ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 15170 -05 11/0211992 $4,159.66 $4.56 $4,164.22 Carol L. Hoy 06/16/1996 CERTIFICATES OF DEPOSIT: Account NumberlSuffix Date Certificate Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 15170 -49 01/11/2006- $50,776.36 $110.39 $50,886.75 Carol L. Hoy 01/11/2006 * AcC'-Ount established. by transfer of funds from 15170-00 **Rollover from certificate #15170-42 purchased 01/11/2005 listing Carol Hoy as joint. {JBERS~ST F DERAL CREDIT UNION W~ /~:t: enise A. olfe Insurance Services upervisor September 13, 2006 Estate of: RUTH A. STAKE Date of Death: 06/24/2006 Social Security Number: 296-14-0053 5000 Louise Drive · P.o. Box 40 · Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . WW\v.members1st.org o PNCBAN< August 21, 2006 Wayne F. Shade Attorney at Law 53 West Pomfret Street Carlisle, P A 17013 RE: Estate of Ruth A. Stake, deceased SSN: 296-14-0053 DOD: 6/24/2006 Dear Mr. Shade: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140061203 Established 09/01/1963 RUTH A STAKE DOD balance: $12,530.72 + $2.22 accrued interest .Our office does no fmancial transactions or closing of accounts. TO have the account closed, you may contact the branch of the account which is listed below or you may contact your local PNC Bank Branch. WINDSOR PARK BRANCH 5288 SIMPSON FERRY ROAD MECHANICS BURG, P A 17055 (717) 697-1641 Please note that this office only provides date of death balances for deposit accounts (!RAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, GiOcl1lQQt LJlij~ Rachelle Wells 1-800-762-1775 P7-PFSC-04-F 500 first Ave. Pittsburgh P A 15219 Member FDIC .'V_151\"'0". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth A. Stake SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 656 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 3,375.00 1. Myers Funeral Home, Inc., funeral services B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representalive(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees Wayne F. Shade, Esquire 3,000.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. ProbateFees Register of Wills of Cumberland County, PA 177.00 5. Accountanfs Fees 6. Tax Retum Preparer's Fees 7. Cumberland Law Journal, advertise Letters of Administration 75.00 8. Register of Wills, Short Certificate 4.00 9. The Sentinel, advertise Letters of Administration 144.29 10. Register of Wills, filing inheritance tax return 15.00 11. Register of Wills, reserve for filing Account, etc. 400.00 12. Register of Wills, Short Certificate 4.00 TOTAL (Also enter on line 9, Recapitulation) $ 7 194.29 (If more space is needed. insert additional sheets of the same size) REV-1512 EX + (12-03) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth A. Stake FILE NUMBER 656 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Alert Pharmacy Services, Inc., pharmaceuticals VALUE AT DATE OF DEATH 23.05 2. Messiah Village, nursing home services 12,600.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12,623.05 ~"-":' \". ",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth A. Stake SCHEDULE J BENEFICIARIES 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 OU~ht s~usal distributions. and transfers under Sec. 9116 (a (1. )] 1. Lynne E. Landi Lineal 32,852.65 607 Brad Street Shippensburg, P A 17257 2. Wendy J. Alspaugh Lineal 10,950.88 46 Farmington Lane Elizabethtown, PA 17032 3. Carrie A. Hoy Lineal 10,950.88 71 Dogwood Road Hamburg, P A 19526 4. Daniel B. Hoy Lineal 10,950.88 307 Brandy Lane Mechanicsburg, PA 17055 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. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ FILE NUMBER 656 (If more space is needed, insert additional sheets of the same size) Jun 26 06 lO:42a , '1 ,.J ...J. .j J :1 < j i '. 'j :,\ j I I I .,( " ,j .- p.l LAST 1nLL AND TESTAKENT OF RUTH A. StAKE ~ I, RUTH .\. STAKE, of the Borough of Mechanicsburg, County of Cumberland and Sta:e of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, her,~by revoking and making void any and all former Wills by me at any tille 'leretofore made. ;":1 '- "' . j 1. ,~~ .}1 . '. ~ " :., I direct the payment of all my just debts and funeral expenses 1 . . ;,j ...: '., I :1 ):1 ";f ~ ", .1 ,j <I I I . :j ,j .''J ",-.,j as soon after my d~cease as the same can be conveniently done. 2. All the cest, residue and remainder of my estate, real, per- sonal and mixed, of whatsoever nature and wheresoever the same may be situate, I give, davise and bequeath to .y husband, JOHN R. STAKE, absolutely and unc~nditionally. 3. In the event my said husband, JOHR R. S~, should predecease me, or should he die within thirty (30) days of my death, I give, devise and bequeath my entire estate, real, personal and mixed, whatsoever and wheresoever situate, in equal shares, to my children. 4. LASTLY, r nominate, constitute and appoint my husband, JOBll ,.. R. STAKE, ExecutoT of this, my Last Will and Testament, and in the event he should predecease me, or should he be unable or unwilling to serve in such capacity for any reason, I nominate, constitute and appoint my daughter. CAROL L. BOY, to be the Executrix of this, my Last Will and Testament, in his place and stead. IN WlTNl:SS WHEREOF, I have hereunto set my hand and seal Jun 26 06 10:42a ."ll ',., 1 i p.2 ,,'".1'.. . ~. . '. ..... this If/( day of May, A. D. 1990. C? L~#~ (SEAL) Signed, 5ealed, published and declared by the above-named RUTH A. STAKE, as lnd for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have h~reunto subscribed our names as witnesses. ....' ')u-e. 'Kl ~p 1) ,S-. db ~ . ~..sr ~ ,~y(o 2iO' OD I ?;b \ (/0