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HomeMy WebLinkAbout10-25-07 (2) --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 2 1 0 7 File Number 061 6 Date of Birth 15918 1 302 042 820 0 7 o 2 1 8 1 921 Decedent's Last Name Suffix Decedent's First Name SHUMAKER HELEN MI E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI SHUMAKER H A R 0 L D B Spouse's Social Security Number 703071297 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW !ZI 1. Original Return o 4. limited Estate !ZI o 4a. Future Interest ce,mpromise (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 6. Decedent Died Testate (Attach Copy of Will) 9. litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes 2. Supplemental Return o o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 233 1 MAR K E T S T R E E T 7 1 7 7 6 3 1 3 8 3 REGISTER OF WILLS USE ONLY f~- " ( ~-~.J ,_. ,_....t; ,'I _.. . State ZIP Code DATE FILED , I ; P A 1 7 0 1 1 \D L I NUS E FEN I C L E Firm Name (If Applicable) REA G ERA D L E R P C First line of address Second line of address City or Post Office C AMP H ILL Correspondent's e-mail address:LFENICLE@REAGERADLERPC.COM Under penalties of pe~ury, I declare that I have examined this retum, 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. SIGN URE OF P SO ESPON ISLE F R FILl RETURN DAT . 0 MARYSVILLE ADORE S 2331 MARKET STREET CAMP HILL PLEASE USE ORIGINAL FORM ONLY PA 17011 Side 1 L 15056041125 15056041125 -..J rJ ---I 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: HELEN E. SHUMAKER RECAPITULATION 159181302 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) D Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested. . . . . .. 7. 678462 11. Total Deductions (total lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 678462 750400 2 6 6 9 6 3 1017363 -338901 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. 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. -338901 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 0 0 0 at lineal rate X .0 16. 0 0 0 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. 0 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT D Side 2 L 15056042126 15056042126 ---I REV-1500 EX Page 3 Decedent's Complete Address: File Number 0616 DECEDENT'S NAME HELEN E. SHUMAKER STREET ADDRESS 812 WERTZVILLE ROAD CITY I STATE I ZIP ENOLA PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterest/Penalty ( 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 B. Enter the total of Line S + SA. This is the BALANCE DUE. (SA) (5B) A. Enter the interest on the tax due. 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 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 (0) percent [72 P.S. ~9116 (a) (1.1) (ii)l. The statute does not exempt 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)1. 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.S) 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)1. 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) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF HELEN E. SHUMAKER FILE NUMBER 0616 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. DESCRIPTION CHECKING ACCOUNT - PNC BANK - #5004803532 VALUE AT DATE OF DEATH 6,784.62 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6 784.62 REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. SHUMAKER SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 0616 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. RICHARDSON FUNERAL HOME - FUNERAL 6,200.00 2. RICE MEMORIAL WORKS - VASES 320.00 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 REAGER & ADLER, PC 700.00 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 CUMBERLAND COUNTY REGISTER OF WILLS 60.00 5. Accountanfs Fees 6. Tax Retum Prepare~s Fees 7. SHORT CERTIFICATES 8.00 8. EXECUTRIX EXPENSES 68.00 9. LEGAL ADVERTISEMENT - THE CENTRAL PENN BUSINESS JOURNAL 73.00 10. LEGAL ADVERTISEMENT - CUMBERLAND LAW JOURNAL 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 7504.00 (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 HELEN E. SHUMAKER FILE NUMBER 0616 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. KINKORA PYTHIAN HOME - NURSING HOME BILLS VALUE AT DATE OF DEATH 2,560.00 2. PHARMERICA - MEDICATION 109.63 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2669.63 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. HAROLD B. SHUMAKER Spousal 0.00 812 WERTZVILLE ROAD ENOLA, PA 17025 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 $ ",V."" EX. ",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. SHUMAKER SCHEDULE J BENEFICIARIES FILE NUMBER 0616 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF HELEN E. SHUMAKER I, Helen E. Shumaker, of Enol a, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking any and all prior wills and codicils thereto by me at any time heretofore made. FIRST I direct that all my just debts and the expenses of my last illness and funeral shall be paid from the assets of my estate as soon as practicable after my decease. 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. SECOND I give and bequeath all automobiles, household effects and other tangible personal property, not including cash or securities, owned by me at my death, together with all polic.ies of insurance thereon, to my husband, Harold B. Shumaker, providing that he is living on the sixtieth (60th) day after the date of my death. Should my husband, Harold B. Shumaker, not be living on the sixtieth (60th) day after the date of my death, I bequeath such tangible personal property and insurance thereon to my children, Connie L. Shumaker and Paulette E. Kitner, equally. THIRD , I give and bequeath the residue of my estate, to my husband, Harold B. Shumaker, providing that he is living on the sixtieth (60th) day after the date of my death. In the event my husband, Harold B. Shumaker, is not living on the sixtieth (60th) day after the date of my death, then I give, devise and bequeath , , , , 'r' ,-\:,F,:...;-'qit'HY" the residue of my estate, of every nat8~~~~~~~MooetUate equally to my children, Connie L. Shumaker and Paulette E. Kitner. If Paulette E. :IDt~lfltils to survive me her share shall be distributed to her L \ :8 ~~ 82 tine LQGZ 3':~'\J:}=~ (JJ'Jl:(=/j:c ~~r;~ Pail' I 0/ 4 children, my grandchildren, Scott Kitner, David Kitner and Michael Kitner, equally, per stirpes. If Connie L. Shumaker fails to survive me then her share shall be distributed to Paulette E. Kitner. FOURTH All principal and income, until actual distribution to the beneficiaries, shall be free of the debts, contracts, assignments, alienations and anticipations of any beneficiary, and the same shall not be subject to any levy, attachment, execution or sequestration. FIFTH I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expenses of the administration of the estate. SIXTH My personal representative shall have the following powers in addition to those vested in them by law and by other provisions of this Will: A. To retain any or all assets of my estate, real or personal, without regard to any principle of diversification, risk or productivity. B. To invest in all forms of property as my fiduciary may deem proper, without regard to any principle of diversification, risk or productivity. C. To purchase investments at a premium or discount. D. To exercise all rights of a security holder or shareholder in any corporation; to give proxies; to join in any merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders; and to delegate discretionary duties with respect thereto. E. To sell at public or private sale, to exchange or to lease, for any period oftime, any real or personal property, and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as my personal representative deems proper. F. To alloc,ate receipts and expenses to principal or income, or partly to each. G. To borrow money from my corporate fiduciary or others and to mortgage or pledge any real or personal property as security therefore, in my personal representative's sole discretion. H. To compromise any claim or controversy without order of court or consent of any beneficiary. ~b~' Pa'J" 2 0/ 4 COMMONWEALTH OF PENNSYLVANIA ) :SS: COUNTY OF CUMBERLAND ) I, HELEN E. SHUMAKER, THE TESTATRIX, WHOSE NAME IS SIGNED TO THE FOREGOING INSTRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO HEREBY ACKNO\VLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT 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. SWORN OR AFFIRMED TO AND ACKNOWLEDGED BEFORE ME BY TESTATRIX THIS _l74h DAY OF ~-^-"'-'\ ,2000. ~ ......-1 ,THE ~ NOTARlA!. se,#"L USA A MOt-.'TC~~MEl1lY, Nett'!ry f'ublie , Hal'\'UixI",;, C:cuj):-.:n Cocmy, PA My ~:<')mr:\iui"n E"pki'S Ort. 7, ~ /~,6~.tvm~ Testatrix ~5e, 4- I1rM~ '-Notary Public (..1, U- COWIlvlONwEAL TH OF PEN'NSYL V ANlA ) :SS: COUNTY OF CUMBERLAND ) WE, iiI/liS !3if/?~ AND Li"dCL 11. Hammor) THE WITN'ESSES vv'HOSE NAMES ARE SIG1'.TSD TO THE FOREGOING INSTRUMENT, BEING DUL Y QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT Wt W.toRE PRESENT Ai\ID SAW THE AFORESAID 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 KNO\VLEDGE THE TESTATRIX WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER NO CONSTRAINT OR UNDUE INFLUENCE. SWORN OR AFFIRMED TO AND SUBSCRIBED J"/';~ DAY OF rmt//## ,2000. Witness NOTARIAL se,~l US,~ A. N~O~'700A~~Y" NC':'~rv Ft!.:.bl~;: ~!~ni~bttr" O>::u~!'in c..'5~;rt:;1 PA 4'otY ~nw~!~~re eni~~:~:S!'; O~', 7, ~C'lr:J.2 ~d/L. '/){, 7Ii1lnlrUf7U Witn~s / i 1,\ ~/~ h' Netary Public 1 ~ ~. \A {~\/\ .,' ~~ rJ-....... "-.-' Pa~e 4 0/4