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HomeMy WebLinkAbout10-09-07 --.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 File Number 2 0 7 o 1 9 9 Date of Birth 201 184001 12312006 01291925 Decedent's Last Name Suffix Decedent's First Name MI S m i h M Loui se (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI S m j h Ge 0 r 9 e E Spouse's Social Security Number 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 of Trust) 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 r-:> 7 1 70 7 7 4 ~;':7 4 3 5 _ _-J . -:Q C) REGIST~~?WILL~Yl>E ONLY i; I \.0 FILL IN APPROPRIATE OVALS BELOW [ZJ 1. Original Return o 4. Limited Estate [ZJ o 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes D A V I D H STONE, E S QUI R E Firm Name (If Applicable) S TON E LAFAVER SHE K LET S KI First line of address 414 B R D G E STREET -0 Second line of address (:? OJ City or Post Office State ZIP Code DATE FILED NEW CUMBERLAND P A 17070 Correspondent's e-mail address:dstone@stonelaw.net 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, rrect and complete. Declaration of preparer other than the personal r ve is based on all information of which preparer has any knowledge. OF PERSO ESP ISLE F FILING RETURN DATE /0- -J Cam Hill PA 17011 DATE / - - New Cumberland PLEASE USE ORIGINAL FORM ONLY PA 17070 Side 1 L 15056041125 15056041125 --.J -I 15056042126 REV-1500 EX Decedent's Name: M Louise Smith 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) 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested .... . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Npn;Probate Property (Schedule G) U Separate Billing Requested .... . .. 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. Decedent's Social Security Number 201 1 8 4 0 0 5. 33321.53 3 3 3 2 .53 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 1945.00 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.00_ 3 1 3 7 6. 5 3 16. Amount of Line 14 taxable at lineal rate X .0 0 . 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 15. 16. 17. 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042126 1945.00 376.53 o . 0 0 31376.53 3 o . 0 0 o . 0 0 o . 0 0 o . 0 0 o . 0 0 o 15056042126 ---I REV-1500 EX Page 3 File Number 21 07 0199 'Decedent's Complete Address: DECEDENT'S NAME M Louise Smith STREET ADDRESS 39 Center Drive - -------~--,.._---._~--._.~_. CITY Camp Hill I STATE PA ZIP i 17011- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits ( A + B + C ) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( 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. (5) 0.00 0.00 0.00 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, A GENT 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 00 b. retain the right to designate who shall use the property transferred or its income; ............................... D 00 c. retain a reversionary interest; or ................................................................................................ D 00 d. receive the promise for life of either payments, benefits or care? ....................................................... D 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? .................................................................................................. 00 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. 99116 (a) (1.1) (i)l. 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. 99116 (a) (1.1) (ii)l. 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. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(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-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 07 0199 ESTATE OF M Louise Smith Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees David H. Stone, Esquire 1,750.00 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 Register of Wills, Cumberland Co. 95.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Reserve for closing expenses 100.00 TOTAL (Also enter on line 9, Recapitulation) $ 1,945.00 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF M Louise Smith FILE NUMBER 21 07 0199 This schedule must be completed and filed if the answer to any of questions 1lhrough 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 DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1 Enterprise Financial-Post 1985 Annuity 33,321.53 100. 33,321.53 #930034053619004 P/O the beneficiary is the estate TOTAL (Also enter on line 7 Recapitulation) $ 33,321.53 (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 l. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. George E. Smith Spousal 31,376.53 39 Center Drive Camp Hill, PA 17011 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 ,,,.,,,,,,. ",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF M Louise Smith SCHEDULE J BENEFICIARIES FILE NUMBER 21 07 0199 (If more space is needed, insert additional sheets of the same size) ~ ' . J.,i ~ . n .. LAST WILL AND TESTAMENT OF M. LOUISE SMITH I, M. LOUISE SMITH, of P. O. Box 237, Lewisberry, York County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils made by me. FIRST: I give my tangible personal property, together with any casualty insurances that I may carry with regard to said tangible personal property, to my husband, George E. Smith. Should my husband not survive me, I direct that my tangible personal property be distributed in accordance with the provisions of the residuary clause of this my Last Will and Testament. SECOND: I give the rest and remainder of my estate to my husband, George E. Smith Should my husband not survive me, I give said rest and remainder to my daughter, Kimberly Louise Whittington, or, if my daughter does not survive me, then to her issue per stirpes. In default of issue by my daughter, I give the rest and remainder of my estate to my mother, Pauline S. Hale, if she survives me. If my mother does not survive me, I give said rest and remainder as follows: (a) Thirty percent (30%) to my son-in-law, Benjamin R. Whittington, Jr. / ;-) . / , / "\ '_10. / f (' / .c --.I '('- -1- (b) Thirty percent (30%) to my husband's nephew, Larry E. McSherry. (c) Fifteen percent (15%) to my cousin, Betty Jane Shay. (d) Ten percent (10%) to my husband's nephew, Donald L. Rosenzweig. (e) Ten percent (10%) to the Lewisberry United Methodist Church, Lewisberry, Pennsylvania. (f) Five percent (5%) to the Emanuel Cemetary Association, Lewisberry, Pennsylvania. THIRD: If any beneficiary under Item SECOND is under thirty-five (35) years of age, I direct that his or her interest be held in trust by Dauphin Deposit Bank and Trust Company, 213 Market Street, Harrisburg, Dauphin County, Pennsylvania, hereinafter called Trustee, until such beneficiary reaches thirty-five (35) years of age. My Trustee shall apply such amounts of income and principal as it, in its sole discretion, deems proper for the support, education and welfare of such beneficiary, and may accumulate any unexpended balance of income to the extent permitted by law. Such amounts may be applied directly or may be paid to the beneficiary or to the person with whom such beneficiary resides or who has the care and control of such beneficiary, without the intervention of a guardian. My Trustee shall not be obliged to supervise or inquire into the application of such amounts by such person, and the receipt of -/'. ;-' ~ ) ".:. .~ ( j /1.... .,/,,/ L ._ . -2- such person shall be a complete release of my Trustee. Should the share of a beneficiary, in the sole opinion of my Trustee, be or become too small to warrant continuing such fund in trust, or should its administration be or become impractical for any other reason, my Trustee, in its sole discretion, may pay such share absolutely to the beneficiary, or may deposit such share in the beneficiary's name in a savings account in a savings institution of its choosing, payable to the beneficiary at majority, which I define as twenty-one (21) years. FOURTH: I appoint my husband, George E. Smith, as my Executor. If he is unable or unwilling to serve, I name my daughter, Kimberly Louise Whittington, as my Executrix. If my daughter is unable or unwilling to serve, I name Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania as my Executor. I direct that my Executrix or Executor shall serve without bond in any jurisdiction in which called upon to act. FIFTH: I give to any Executrix or Executor and to any Trustee or Trustees named in this will or any Codicil hereto all of the powers now applicable by law to fiduciaries in the Cornrnon- wealth of Pennsylvania and in particular, through the Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the / " / - . -l // 1/' ........... -3- completion of the distribution of my estate, and until the termination of all trusts created hereunder and until the com- pletion of the distribution of the assets of such trusts. SIXTH: I direct that this Last Will and Testament control the distribution of my property irrespective of whether there are of this Last Will and Testament. children born to me or adopted by me subsequent to the execution SEVENTH: The words "issue" and "children" whenever used in this Last Will and Testament shall include adopted children. EIGHTH: No interest of any beneficiary under this Will or tary or involuntary alienation. any Codicil hereto shall be subject to anticipation or to volun- NINTH: I direct my personal representative to pay any and all death taxes in connection with the administration of my estate from the residue of my estate. IN WITNESS WHEREOF, I have set my hand and seal on this my 1984. Last Will and Testament this ~lf~ day of , SIGNED, SEALED, PUBLISHED, and DECLARED by M. Louise Smith, as and for her Last Will and Testament, on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: {A,.c-("fl'- t. / /nl'-<~~'u . , / / ,,:X'c:. o. ._. .-<. M. LOUISE SMITH .! //1. 0 ;o.L_o (SEAL) Ja<"1 ;J /~;i_X-(' , o' / ,/ /; -, /1 1'/,/ . /" L} // /.( /1 /;ftJ..I(~) :./ A-/ C~f. P /. t.Cju f' " -4- ACKNOWLEDGMENT COMMO~mALTH OF PENNSYLVANIA COUNTY OF DAUPHIN : SSe I, M. LOUISE SMITH, the Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instru- ment as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. / /1) ~ >/~~~~ 4.-,Z/~ M. LOUISE SMITH Sworn or affirmed to and acknowledged before me by M. Louise Smith, the Testatrix, this ..;JNi--., day of LlU "fl.AT , 1984. _Ko:lh ~" ~ e tJ ~1, ~'fU Notary ublic " My Commission Expires: Kathryn C. P.or:-n,"'r, t-:ctl"ry ?u~'i: My C:JI"l1'll:...::on t^plr~$ ,.C'r~j-" :", '-1:]7 HQrri.burg. fA C"Op~'" Coul1Y ---,.~,,-,_._.--~. .""'-.... .~......_~ ---, _.,-,.".~.,. ~. AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SSe WE, Stacy L. Stefancin , Carol A. Loomis and Gary E. French , the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it 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. , " / --) .H-' , )/:1 _fit''! <7>.-7:( ~/a.u:<. L, '/). t/?~ . [/ill. (, /,.47X!:) GAl (- ti-~i/J Sworn or affirmed to and subscribed to before me by Stacy L. Stefancin Carol A. Loomis and Gary E. French this d 7;;'. day of (tU,y<4:l: 1984. , , ~/ct TJl.-~l'v C Notary, ubl1c I / ' i'-l.~-f... (l .. ~1. "1__,,' " My Commission Expires: Katf1ryn C ":01";'0 'r, ~!~'~r:, PIJ')'ic My CC:T.m;~.jn [A~;:es I.,;.',.:,...., 14, '"'';;7 HorriJ:'ur], e... :.:J_';f11.1 C",:;.),,'y 'lI'" -. .""..... L-V L-VVI nL..LI .I..I..tJ~ jjJj jUU..J\.J.jJ\J.tJLo I" n/\ I1V, V! '- V,! V'iOV : I 'f1)'1 it III .:t. .. ~ {"II.... ; c '.r:~ :;. ....' ~ J .\ t.. ~..I ,1.Il.a ~ 'n: . ., . '.1.1. .,. . Fi;umcial RiVGrSourcc Life 'l1suranco Comp11OY Rivcr$ource Funds AmeriprisQ Certificate Company Amariprise Brokerage 70100 Amuripriso Fll\ilIncial Cont~r Minne3polis, MN 55474 Sq)t<:fl,b~'r ~!(I. ZOO"! 1)/\ VID ~)'l pr-.fn HTONE LA fA VER & ~HHKr..E'fSK I -114 UftH>('jF I':T NEW C'UMIWRJ.ANf.>.....A 17070 lk.ll' D.A.Vm STONE; 1'1l.lnk YOll fm )'ot.t rc,'wlt inquiry TIolC;1rdillg M I. SMITH's account. This is lhc vallie of the II~C<ltil\1 tls of 12/J 1/2006. Alj~4Ihii!:';" l~M;f. 1985 !\C::\:~j.II!J.t Nltq)l.~.':':I: . 9.~003,1I)~ :l(i 1 900.1 Pit) lnl.11 V~.!lll;: $U.321.5J nl~ ""\(~ ,~f ~kllh 'Valll~~ Ilmvidtd un: for estale lax rlllpO~CS and are nol a value to be paid. ^~'N\lj rto.. nv.ty he t-;ul.jl.:l.'l1.1 m,lI'kd Llllclll:.ltfon IlS guwrllcd by each produ~~l. PJCl1.'iC note that tt,," v~lhl~~'l ir'\,JfC'at~'d fo1' ilLIY r ,ife Ins\ltall(;l; prudnct(s) fe-fleet lIte gross cJelllh b~ncfit at dlltc of d.:;:! 11~ J,nI1hC' c,Hh: V:l hl~'. Valu...... for llU)' propl ict:lry Ullllulll funds include accl1Iec.111ividends as :Jppll'::llhlu. Vi"I'I~S pr()\'jd<>d for hrokewge pmdLlcls OlJ'(l1l\i.lnlllllly caJcutalcu, and should bo used 0:1 C!llilll.!to:~ (wly. :rll:~ p/'ic~s u~i~'(l to }llovidc v:Jtm:s ,ll'e l'slim:Hes obt(lineJ from oUlside (;(I'Pf~'l.$ h~lil;\l~'d io be rdillble. ^m,:rjrris~ Finoncial/lwvidc:s lhese values aN a service to ils clit~l.,i;,. A~tll:I' vLllneli u.'\~d in PH:JllLtUHol1 oftax Tl:lurn.1 or for planning ptllpOJoiCS should bL' ""I'il;~," h)! YlHlr lep,.!1 ,me! tlCCOlUHillg advis(lcs. WL' appn:(l!lk fhe lli'pol'tlIIlity U') b;: of ~e-rvi('c to yon Jllcasc COnlClClus if yoU have any 'jllnH iOLl!':. Slt1~CI d)'. J)\',Hh ~kllkm:I)L~ '10 1M AIIl~'flpri"'l; Htl~H'ldnl Cell(~" M jllll,~:i l~I)1i 4. l\IN 15<174 1.f,OO.f!(,),.7f) 19, Op!irlll 5.1 r. uc: InsuriJrlCli! and annuities ol'a ;:;Sucd by RiverSovrCH Life Insur:l!1CO Compfl'ly. an Amcriprlsc Financial compol'lll. Ameriprise BfClcl~r61~(p. ;5 provided by Ameriprise Financial SerVices. Inc. Amcripri:,;u Fin(1n(;iClJ ServIces. Inc.