HomeMy WebLinkAbout09-21-07 (2)
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue *
~~~~:~=~ual Taxes INHERITANCE TAX RETURN
Hanisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
201180783
02262 0 0 7
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
o 4 6 8
Decedent's last Name
Decedent's First Name
112 4 1 9 2 3
Suffix
H A I R
RUT H
(If Applicable) Enter Surviving Spouse's Infonnation Below
Spouse's last Name Suffix
Spouse's First Name
Spouse's Social Security Number
MI
E
MI
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 ofTrust)
10. Spousal Poverty Credit (date of death D 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
[&I 1. Original Retum
o 4. limited Estate
[&I
o
6. Decedent Died Testate
(Attach Copy of Will)
9. litigation Proceeds Received
D
D
D
o
2. Supplemental Return
W I L L I AM A . D U N CAN 7
Firm Name (If Applicable)
DUN C A N & HARTMAN , P C
First line of address
1 I R V I N E ROW
Second line of address
City or Post Office State ZIP Code
CAR L I S L E P A 1 7 0 1 3
D
D
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
1 7 249 7 7 8 0
1"')
C) "C'~
REGIStEt.Ot: WILLS use ONLY
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DATE FILE
Correspondent's e-mail address:billduncan@planetcable.net
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statemenls, 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.
SIGNATU~~:R~~1fES~O~B~E FOR F"dJ ~N '1 !J.i / 0 7
ADDRESS~ ~ , ,
1 Emerald Circle, Carlisle, PA 17013
E OF ~RSON RE ONSI FOR FILING RETURN
.
17241
IS80_Pine Road. Carlisle. PA 17013
l... 15056041125
15056041125
.....J
--.J
15056042126
REV-1500 EX
Decedent's Name: RUTH E. HAIR
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) 0 Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous N,Q!!;Probate Property
(Schedule G) U 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 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.
2595.19
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
16. Amount of Line 14 taxable
at lineal rate X .00L
17. Amount of Line 14 taxable
at sibling rate X. 12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
2595.19
16.
o . 0 0
17.
o . 0 0
18.
19. Tax Due
...... . . . . . . . .. .. . . . . ...... . . . . . ..... . . . . . ..... . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042126
Decedent's Social Security Number
201180783
3655.56
3 6 5 5. 5 6
9 4 6. 0 0
1 1 4. 3 7
1 0 6 O. 3 7
2 5 9 5. 1 9
O. 0 0
1 1 6.7 8
O. 0 0
O. 0 0
1 1 6.7 8
o
15056042126
-l
REV-1500 EX Page 3
Decedenfs Complete Address:
File Number
21 07 0468
DECEDENrS NAME
RUTH E. HAIR
STREET ADDRESS
1 EMERALD CIRCLE
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
116.78
Total Credits (A + 8 +C) (2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
0.00
T otallnterestlPenalty ( 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
0.00
0.00
116.78
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
A. Enter the interest on the tax due.
116.78
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 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
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.
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 (O) 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 retum 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 cornmon with the decedent, whether by blood or adoption.
REV-15G8 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RUTH E. HAIR
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 07 0468
Include the proceeds of litigation and the date the proceeds were received by the estate.
AU property jolntly-owned with right of sUl'llvorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
PNC BANK ACCOUNT # 50-7009-0921
VALUE AT DATE
OF DEATH
3,621.38
2.
UNITED AMERICAN GENERAL COMPANY REFUND
34.18
TOTAL (Also enter on line 5, Recapitulation) $
IIf more soace is needed. insert additional sheets of the same size)
3655.56
REV-1511 EX + (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RUTH E. HAIR
FILE NUMBER
21 07 0468
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MYERS FUNERAL HOME 370.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Numbel{s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees DUNCAN & HARTMAN, PC 500.00
3. Family Exemption: (If deoedenfs address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS 76.00
5. Accountant's Fees
6. Tax Return Preparel's Fees
7.
TOTAL (Also enter on Hne 9, Recapitulation) $ 946.00
(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 E. HAIR
FILE NUMBER
21 07 0468
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. UNITED CHURCH OF CHRIST HOME
VALUE AT DATE
OF DEATH
15.00
2. CUMBERLAND-GODWILL FIRE RESCUE
93.61
3. CARLISLE REGIONAL MEDICAL CENTER
5.76
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheels of UIe same size)
114.37
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 rmclude ~ht ~I distributions. and transfer.; under
Sec. 9116 (a)(1. )J
1. MARTHA I. MELLOTT Lineal
1 EMERALD CIRCLE 1/3 SHARE
CARLISLE, PA 17013
2. MARJORIE SHANNON Lineal
244 LEEDS ROAD 1/3 SHARE
NEWVILLE, PA 17241
3. STEPHEN A. HAIR Lineal
1580 PINE ROAD 1/3 SHARE
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-15QO COVER SHEET
ll. 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 $
RW."""".
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RUTH E HAIR
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 07 0468
(If more space is needed, insert additional sheets of the same size)
LAST WILL
&
TESTAMENT OF
RUTH E. HAIR, of 1 Emerald Circle, Carlisle, South Middleton Township,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and for my Last Will and
Testament, hereby revoking any and all other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred in the Mt. Zion Cemetery, side by side
my beloved husband, Lester E. Hair.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto Martha Hair, Marjorie Shannon and Stephen A. Hair, in equal
shares, per stirpes.
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of
my death, unto Martha Hair, Marjorie Shannon and Stephen A. Hair, in equal shares, per
stirpes.
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate
unto Martha Hair, Marjorie Shannon and Stephen A. Hair, in equal shares, per stirpes.
SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed
upon my estate passing under my will or otherwise, shall be paid out of the principal of my
residuary estate.
EIGHTH. I hereby nominate, constitute and appoint Martha Mellot, Marjorie Shannon
and Stephen A. Hair, as CO-E;xecutQrs of this my Last Will and Testament. I.hereby relieve my
Executors from the necessity of posting security in connection with his duties, as such, in any
jurisdiction in which they may be called upon to act insofar as I am able by law to do so. In
addition to the powers conferred by law, I authorize my Executors, in their absolute discretion,
to retain in the form received, and to sell either at public or private sale any real or personal
property owned by me at the time of my death.
NINTH. I have made, or may from time to time make, a written memorandum
expressing my desire to give certain items of personal property to specific persons. I urge my
Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be
stored in conjunction with this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, consisting of two typewritten pages this '1 (' day of October, 2000.
L?JX E: ;Vv,~
RUTHE. HAIR
Signed, sealed, published and declared by the above named Testatrix Ruth E. Hair as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
~j'~4
~~o~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, Ruth E. Hair, Testatrix whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
COMMONWEALTH OF PENNSYLVANIA
~ tt, 7~
RUTH E. HAIR
NOTARIAL SEAL
Cynthia L Darr, Notary Public
South Middleton Twp., County of Cumberland
My Commission Expires Aug. 14,2004
SS.
COUNTY OF CUMBERLAND
We, M(lIL+R.Q~)QQlWf and WIll lUM .A l'vjl1la~he
witnesses whose names are signed to the attached or foregoing instru~~eing duly qualified
according to law, do depose and say that we were present and saw Ruth E. Hair sign and
execute the instrument as her Last Will; that she signed willingly and that she executed as her
free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the
Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
Sworn or affirmed to and
sub~cJlbed before.; ~~ ~a1L
tUO:ttM ,~~an~
!DIII/o/t{ /' . I j 11 Ct? ~t, esses,
this;i y ~~r: 2000 .. ..
7XL &. -4
Notary ublic
/~ i ~4
W~~~
NOT AAIAL SEAL
Cyntl'lla L.. Oarr, Notary Public
South MiddlClton Twp., County of Cumberland
My Ogmml."Oti expires Aug, 14, 2004