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Home My WebLink About10-15-07 (2) f . ---I 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 {;2t 0 6 File Number 00481 Date of Birth 182226028 0510200 6 112 1 1 9 2 8 Decedent's Last Name o e V 0 r Suffix Decedent's First Name A m 0 s MI L (If Applicable) Enter Surviving Spouse's Infonnation 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 00 1. Original Retum D 4. Limited Estate 00 6. Decedent Died Testate (Attach Copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach Copy of Trust) D 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 D D 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 Firm Name (If Applicable) Second line of address ~ -L. 7 ._~- '_._; ;-1"- ""'-. :~ 1_ )',-- ,.:~~-~, ~ ~ -n j;. H . Ant h 0 n y First line of address A dam s , E s qui r e REGISTER OF WILLS ~ ONLY () ;:-3 ,..-' -J '=';:::) ::::J =Tl CJ r:-) -I 4 9 W est Ora n g e S t r e e t U1 Sui t e 3 City or Post Office S hip pen s bur g PA 17257 ~ FILED fy '1> a o State ZIP Code Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statemen1s, 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~ OF PERSON RESPONSIBI-E FOR FILING RETURN DATE ',~I'f'^Jl ~ . W~ \C - \\ - 0 1 ADDRESS () - 611 Wa nut Bottom Road PA 17257 SIGNATU E P R THAN REPRESENTATIVE ADDRESS 49 West Orange Street, Suite3 Shippensburg PLEASE USE ORIGINAL FORM ONLY PA 17257 Side 1 L 15056041125 15056041125 ---I~ .....J 15056042126 REV-1500 EX Decedenfs Name: Amos L. Devor 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. Decedent's Social Security Number 18222 602 8 4. Mortgages & Notes Receivable (Schedule D) ........'O........ . . . . . . . . . .. .. . . . . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 7 8 6 5. 5 4 ...... . . . . 6. Jointly Owned Property (Schedule F) D Separate Billing Requested . . . . . . . 6. 1 5 4 1. 1 3 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D 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.O _ 16. Amount of Line 14 taxable at lineal rate X .O~ 17. . Amount of Line 14 taxable at sibling rate X .12 18. Amount of Une 14 taxable at collateral rate X .15 o . 0 0 15. 1685.07 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 9 4 0 6.6 7 7 7 2 1.6 0 7 7 2 1.6 0 1 6 8 5.0 7 1 6 8 5.0 7 O. 0 0 7 5.8 3 O. 0 0 O. 0 0 7 5.8 3 D 15056042126 ---I REV-1500 EX Page 3 Decedent's.Complete Address: DECEDENrs NAME Amos L. Devor STREET ADDRESS ~t~ Walnut Bottom Road File Number 06 00481 -- -- I STATE PA I ZIP 17257 CITY Shippensburg Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 75.83 Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterest/Penalty ( D + E ) 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. 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) (SA) (58) 0.00 0.00 75.83 4. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. 75.83 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? ....................................................................................... D 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. D 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 (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 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 common with the decedent, whether by blood or adoption. REV-1508 EX + (6-98) 'w SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amos L. Devor FILE NUMBER 06 00481 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. ITEM NUMBER 1. 2. 3. DESCRIPTION Tangible Personal Property sold at public auction (sheet attached) Series E Bonds 1991 Ford Taurus Station Wagon VALUE AT DATE OF DEATH 224.09 4,941.45 2,700.00 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 7 865.54 REV-1509 EX + (6-98) ow SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amos L. Devor FILE NUMBER 06 00481 If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Jane E. Wilson 611 Walnut Bottom Road Shippensburg, PA 17257 child/lineal B 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 DECEDENrSINTEREST 1. A. 2004 Checking Account M& T Bank 160.62 50. 80.31 #000009834682271 2. A. 2004 Savings Account M& T Bank 2,921.64 50. 1,460.82 #015004205391052 TOTAL (Also enter on line 6, Recapitulation) $ 1,541.13 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + {12-99} "W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amos L. Devor SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 06 00481 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsonger-Bricker 6,216.60 2. Spring Hill Cemetary Association 650.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) 105.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees H. Anthony Adams 750.00 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. Probate Fees 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 7,721.60 (If more space is needed, insert additional sheets of the same size) 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 pnclude oU~ht s~usal distributions, and transfers under Sec. 9116 (a (1. )] 1. Jane E. Wilson Lineal 611 Walnut Bottom Road Shippensburg, PA 17257 2. John J. Devor Lineal 450 Ridge Road, Finks Trailer Court, Lot No. 19 Etters, PA 17319 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 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 $ REV_l~l~EX+(* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amos L. Devor SCHEDULE J BENEFICIARIES FILE NUMBER 06 00481 (If more space is needed, insert additional sheets of the same size) - DAN HERSHEY AUcnON SERVICE, L~~ 790 West High Street Carlisle, PA 17013 (717) 532-4647 SteveEge 717-38S-~~,~8 Cell .. C~!i~ Bream,-:(1?'"-2267" 1920 Cell SEI,LERS NAME E9(qf ~ dP"'t1~~~()~AAi~,~<i .. I)An;~~~'$S'f;~ .' . '< .i "~i'> ..'. '.., . ,..,... .."'-"~~ . ..... ' ><' c ADDRESS ~."&v ,-.,' .',... ',';~;:PH()NE 'i5a;r~'5:cr',..5,'1 OTHERfutUl ~,'(dffA~ ~ @"t,llS~el~Q~;i>>,..ho~,-$t f 30 . AUCTIONEER % I ~ ,. AUCTION DATE/LOCATION CLERK % DESCRIPTION OF MERCHANDISE ~ 0" S q ( a ( .t I to, 1'1 f \ 5 5f1lLld5, h\ i{ ro~uQ, ( Q.,{J '" 1(1 OC"lC.V~1 De ~p ((PO_ -e Iv ~t-J ~~ I 6;a A.~,h(~,.~1hfq, ~5b"t((~ ({(VI 'it 9( ~"d~ lc~ fg~I~, ~ ClhGt '!'{)O (5 I' b-vd \ I Id~1ro h I G./!4 ft~ ~(tx ~ S~/~f' ~\toS'i t bttQ~s c'Vlb, ( ~ v Isf....cb I 0 &~ ~\ ((or \ \ l'~P~ S, ~o,Q ~rl ~ (Me Sfl.ql(' \ ; ., fr\"'t(L~ ~O 41.M '"' . _.. .~ h: ... . ___1tf\~f)t\\.flrlb.Y/VS:'<""i'" .... ,'. ......{ .,.,,,..;., ;., ." '. " " · ..Lf~.l.J. ('#till ~"'~ e ~ifrltS~ ffel..l.3', ~('t\s~t5~f7 ~Sl I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all respqnsibility for providing merchantable title and for delivery of title to the purchaser. I agree to hold harmless th~' Auctioneers against any claims of the natUre referred to in this agreement. Y~~I~-';\<_ '.> ~~. ~~E~lSIG~~ TotEtlSales' (Clerkin-gf. Tick~ts Attached{ $~ '/;57.: 75' t I' ! .' fl' . " r . .':;JJ:..,^ ~(\ ~l'- Less Sale Expense: ( )' % Commission Auctioneer $ (~ S. Co Co % Commission Clerks $ OTHER: [,.0 b,,( (pO, <>0 Bu; I J i<A.g g..J (05. "" AjJ 7'0.0" . TOTAL SALE EXPENSE DEDUCTED. $ tL. . .jl . SELLERS NET S ~ , ~CTION SIGNATURE 2~ 3'3, ~(. t:l.y ~.e? SELLERS SIGNATURE LAST WILL AND TESTAMENT KNOW ALL MEN BY ll;iESE PRESENTS, that I, AMOS L. DEVOR, of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking all prior wills and codicils by me at any time heretofore made. FIRST: I direct the payment of all my legal debts, funeral expenses including my grave marker and all expenses of my last illness, state, federal estate and inheritance taxes and administration costs shall be paid as soon as may be conveniently done following my decease leaving all specific bequests free of tax to the legatee. SECOND: I give, devise and bequeath all my property be it real, mixed or personal, wherever situate to my children, Jane E. Wilson and John J. Devor in equal shares to share and share alike, per stirpes. THIRD: I nominate and appoint Jane E. Wilson, as Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I, AMOS L. DEVOR, to this my Last Will and Testament set my hand and official seal, this 1 day of i!l.f"c..h 2004. ~~~ (SEAL) Amos L. Devor Sworn to and subscribed, declared and Published by Amos L. Devor, as His Last Will and Testament, and so Done in the presence of we the Witnesses, who sign at his request, And in his presence, and in the presence Of each other. 011-<~~ i1J. I~ ~~ ~UL ,,,/~ COMMONWEALTH OF PENNSYLVANIA: :SS COUNTY OF CUMBERLAND I, AMOS L. DEVOR, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. ~rJ~ Amos L. Devor Sworn to and acknowledged, before me, By Amos L. Devor, the Testator, This ....1- day of !i1 Arch 2004. ~~G1 - Notary Public , ,,,-.~. ,~... .------~ - ~ -, - Notarial Seal ---.. - j , . d. -"J1thony Adams NoWy Pu'-lk. t I Shipper,sbu~g .Boro. C~mberJand Coon ~y CommIssIon Expires May 15, 2J - (\. I r.lr pt)nnC!\lfu 'Ass ~ , ......""ama OCiationotNotar.m~ ... 1 l t . COMMONWEALTH OF PENNSYLVANIA: :SS COUNTY OF CUMBERLAND WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we saw the Testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he 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 and belief the Testator was at the time at least eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. ~ (JJ, /3ilidt A~~~ Sworn to and subscribed before me by, Darlene M. Bigler and Sharon Coleman Adams, The witnesses, this ~ day of ~2004. J~~ Notary Public . .".- ~~--;~ta~al Seal ....... - t I d. !..nthony Adams, Notary Pt'~lk t , Si.llpper.sburg Boro. Cumberland County 'fy Commission Expires May IS, 2006 . ~\. I ~r, Prmnsylvania Associatlon otNoU:mcR