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HomeMy WebLinkAbout11-21-07 (2) ~ 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY County Code Year File Number PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT 21-06-01103 Date of Birth 203-10-6890 11292006 07281916 Decedent's Last Name Suffix Decedent's First Name MI MYERS MR. (If Applicable) Enter Surviving Spouse's Information Below Spouse"s Last Name Suffix MERLE S 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 DU 1. Original Return D 2. Supplemental Return D D 1 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required D 4. Limited Estate D 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 between 12-31-91 and 1-1-95) 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) DU 6. Decedent Died Testate D (Attach Copy of Will) D 9. Litigation Proceeds Received D 8. Total Number of Safe Deposit Boxes D CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name STEPHEN D. TILEY Firm Name (If Applicable) Daytime Telephone Number o 717-243-58~O ':,':0 REGISTER OF W1.L~_ ~ ON'5? ~ 1> r---. 7rTl '--":0 N O)X ''') -,60 =-; c: -n :::0 u--1 -p: 1"-3 c:::. c:::. "-oJ FREY & TILEY First line of address 5 SOUTH HANOVER STREET Second line of address :z::.. :x - - .. Ul Ul City or Post Office DATE FILED State ZIP Code CARLISLE 17013 PA STILEY@FREYTILEY.COM ADDRESS WAYNE CARLISLE, PA 17015 DATE d.&7-'" 7 D. TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 ~ 15056041114 .-.0 I I"; c-.; t~? f-~'{l '~..J C) .:.--r-, -.!..7 C') 1'1'1 :-.:) 1", 0~ --1 15056042115 REV-1500 EX Decedent's Social Security Number Decedent's Name: MERLE S MYERS MR. RECAPITULATION 203-10-6890 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. NONE 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 3. NONE 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 5. 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . . 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 7. 8. Total Gross Assets (total Lines 1-7) . . . . .......... . ........... . 8. 26350.00 0.00 26350.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . .. 9. 7724.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . 10. 8641.00 16365.00 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. 9985.00 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 L 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 0.00 9985.00 15. 0.00 18. 449.00 0.00 0.00 998 5 . 00 16. 17. 19. TAX DUE. . . . . . . . ......................................... . .....19. 449.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 L 15056042115 15056042115 --1 REV-1500 EX P.age 3 203-10-6890 Decedent's Complete Address: File Number 21-06--1103 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER MERLE SMYERS MR. 203-10-6890 STREET ADDRESS 1000 CLAREMONT ROAD 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. Priclr Payments C. Discount (1 ) 449.00 Total Credits ( A + B + C ) (2) 0.00 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) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 449.00 A. Enter the interest on the tax due. (5A) 457.36 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 8.36 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. D c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No o o o [I] o o 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 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. ~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. 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. 217 REV-150B EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myers, Merle S. FILE NUMBER 21-06--1103 Include the proceeds of litigation and the date the proceeds were received by the estate. All orooertv iointlv-owned with riaht of survivorshio must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION M&T Bank - Checking Account No. 3740101815 See Attached Statement DOD Value Accrued Interest to DOD VALUE AT DATE OF DEATH 25,430 o 2 M&T Bank - Holiday Club Account No. 02500492011313 See Attachd Statement DOD Value Accrued Interest to DOD 24 o 3 Income distribution from Irvin D. Sheaffer Irrevocable Trust, PNC Bank, Trustee 896 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 26,350 217 REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Myers, Merls S. 21-06-01103 DESCRIPTION OF PROPERTY ITEM II~CLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Net Proceeds from sale of auction of personal property 5/19/06 2,603 100.00% 2,603 0 See Kasey's Auction Service Statement Attached 0 Transfered to: 0 Wayne S. Myers, 22 Cardinal Drive, Carlisle, PA 17015 0 0 2. Personal Property Distributed prior to auction. 340 100.00% 340 0 See Attached Stateent 0 Transfered to: 0 Wayne S. Myers, 22 Cardinal Drive, Carlisle, PA 17015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 7 Recapitulation) $ 0 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. (If more space is needed, insert additional sheets of the same size) 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Myers, Merle S. 21-06-01103 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hffman Roth Funeral Home 4,878 2. Westminster Cemetary, Inc. 220 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 (FREY & TILEY) 2,500 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 98 5. Accountant's Fees (FREY & TILEY) 0 6. Tax Return Preparer's Fees (FREY & TILEY) 0 7. Delux Check Fee 13 8. Filing Fee for Inheritance Tax Return 15 TOTAL (Also enter on line 9 RecaDitulation) $ 7724 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Myers, Merle S. 21-06-01103 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Checks Cleared After Death. M&T Checking Account No. 3740101815 Check No. 1102 - Highmark - November Medical Insurance Payment 137 Check No. 1103 - Claremont Nursing & Rehabilitation Center - Final Monthly Bill 8,530 2. Refund - Highmark -5 3. Refund - Claremont Nursing & Rehabilitation Center -21 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 8,641 217 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF M MIS SCHEDULE J BENEFICIARIES FILE NUMBER nvers ere 21-06-01103 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 outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] a. Norma J. Weis, 95 Westview Drive, Shrewsbury, PA 17361 Daughter 50% b Wayne S. Myers, 22 Cardinal Drive, Carlisle, PA 17015 Son 50% 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 (If more space is needed, insert additional sheets of the same size) / m1 M&rBank 499 Mitchell Road, Millsboro, DE 1 9966 Mail Code DE-MB.l2 }rrey & Tiley Attorneys At Law 5 South Hanover Street Carlisle, Pennsylvania 17013-3385 Re: Estate QL Merle S Mvers Social Securitv: 203-10-6890 Date of Death: November 29. 2006 Phone (888) 502-4349 Fax (302) 934-2955 February 20, 2007 Dear Sir or Madam: Per your inquiry dated February 15,2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following; 1. Type of Account ChecJ..:ing Account Account Number 3740101815 Ownership (Names oj) Grace E Myers * Merle SMyers * Opening Date 02/25/98 Closed 01/02/07 Balance on Date of Death $25,430.17 Accrued Interest $ 0.34 Total $25,430.51 2. Type of Account Savings Account / Holiday Club Account Number 025004920111313 Ownership (Names oj) Grace E Myers * Merle SMyers * Opening Date 10/04/83 Balance on Date of Death $ 24. 00 Accrued Interest $ 0.01 Total $ 24.01 l' -'. Type of Account Safe Deposit Box Box Number/Location 0001615/ High Street-Carlisle Office Ownership (Names oj) Merle SMyers * Opening Date 02/07/92 * For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, please contact our High Street Carlisle Branch at One West High Street, Carlisle, P A 17013, or # 717- 240-4536. Sincerely, 'l;tJ'?0IC~y/ Nancy Clagett Records Management oveJ &el'o're /ru <:.- T,'~ ~rr. 5 ~ <l ( (} '];&11 ~/fP! . ~()O Ie S -- ~ II '6 IJ JesK --- 15"0, '7()I),.Vei/\I,6f> :1;..r 12..0 6 J I<. _ ~7 5 %xl el'l S",rJ^ t.- o l ) es . 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'C;i"l ~.:t-"it "::;, :; ".1 i.~'. 'c" 1..J tj. t:' t: D ':~ ~::' 1. :L ;~7 ;: . .. ., '''''1'.1..' ., .....'..:;'. r U,(, "./ ',,1 '..'.r r', ; I .::.: .~ :", -::~::: -;: , '_.' ..... ..: .1. : I '._ .... ~~ . ,,,..... .,.. .... ., :5" i;,:iCi :t'l (,?JC: .M., ._.....:., C... ;;~.U ; .i. .'. \> j21jZ~ " I." l ~:'! ..... ......~. .j. , II :Zf~~:! '~'~'\I ,D:O ~~.':.' I' ',... ~_.' f::.1'l i,,)i..J ::::1 G.'\(?i 1._. l' ....' "'_' :1. L :~ ': Ql ~Z~ .::;u :Dl.J ':-;'1.! i'-:"':;{/'i . n. .L ',i ~-i' i.;) .~. " ..j l ,'---. .'~ "". ."'. ""', .-. no. :...,.:,-'.... ....L.' 0.- l,i '._' '.~: i_h U ~f ...of LAST WILL AND TEST AMENT OF MERLE S. MYERS ~!~I I, MERLE S. l\1YERS, widower, of 150 North College Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memoI)', and understanding, do hereby make, publish, and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my body be interred beside that of my wife, Grace E. Myers on my burial lot located in Westminster Memorial Gardens located in North Middleton Township near the Borough of Carlisle, Pennsylvania. I direct that my services be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania in a manner substantially similar to the arrangements made by me for my wife, Grace E. Myers. I bring to the attention of my Executors that I have pre-paid to Hoffman- Roth Funeral Home the cost of a vault for my interment. 2. I give and bequeath all household goods and furnishings which I may own at the time of my death in equal shares to my two children, NORMA J. WEIS and WAYNE S. MYERS, to be divided between them as they may agree, and any items not desired by them shall be added to the residue of my estate 'j 3. All the rest, residue, and remainder of my estate, real, personal, or mixed, and wheresoever the same may be situate, I give, devise, and bequeath in equal shares to my daughter, NORMA J. WEIS and my son, WAYNE S. MYERS, their heirs and assigns, provided each of them shall survive me by a period of ninety (90) days, but should either of them fail to so survive me by the aforesaid period of ninety (90) days, then the share which my daughter, Norma J. Weis would have received shall be paid to her husband, REVEREND JAMES A. WEIS, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me then the same shall lapse and be added to the share of my other child, Wayne S. Myers, but should he fail to survive me by the aforesaid period of ninety (90) days, then the share which he would have received shall pass to such of his issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. At the present time my daughter Nanna J.Weis is not the mother of any child or children and my son, Wayne S. Myers is the father of only one child who is BREELYNNE.MYERS. . . 4. I hereby nominate, constitute, and appoint my two children NORMA J. ~IS and W~YNE S. MYERS as Ex~cutors of this my Last Will and Tes~ament, and I further ~~that neIther of them shall be reqUIred to post any bond to secure the fmthful perfonnance of nlS,:PJl her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. . ..:2. ~ ('") .....r- IN WITNESS WHEREOF, I ha)( hereunto set m..)' han,d and seal to this my L.~~f~"WfilI and Testament written on 1 page, this 10 day of 5' y le"""'- b ~ ,2003. ~:? C; ~_./11 " :::J _-=,-J . ,.;..,-~ 9nv1J1 ()?W~ MERLE S. MYERS ) (SEAL) Signed, sealed, published and de.elared, by MERLE S'. M'(ERS the Testa~or above name~, as and for his Last Will and Testament, III our presence, who, m his presence, at hIS request, and m tOt;; pre~em;e of t;;<lch other, have ht;;reUlllo stlbscribedour names as attesting witnesses. t2.iS ).,... "{b'l /~ // ;/ .~~. , . (~~~__-~! ~i",-- 0. I A Page 1 r-...) = <= 0""\ CJ r1 n --r~ .-"'-j ..~ ::~5 3:) C:;l r"T"l ,:'-:J CJ -" -n .;=) -- ,~ c-- N -::> -~. (,...,) N -.J ~....) g