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15056051058
REV-1500 EX (06-05)
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
OFFICIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT
21 07
Date of Birth
579-26-2733
10/18/2007
12/08/1917
Decedent's Last Name
Suffix
Decedent's First Name
Rush
Margaraet
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
. 1. Original Retum
2. Supplemental Retum
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Uving Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 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
4. Limited Estate
.
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
8. Total Number of Safe Deposit Boxes
Judith R. Wood
(717) 732-5034
Firm Name (If Applicable)
File Number
" ?J7
MI
T
MI
REGISTER OF WILLS USE o~
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Correspondent's e-mail address:
Under penalties of perjury, 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.
SIGNATU E OF PER O~ R 0 I LE FORB G RETURN / ;( "
ADDR ss
713 Alberta Avenue, Mechanicsburg, PA 17050
SIGNATURE.2f ~PARER~ER THAN REPRESENTATIVE
\~.~.......~-:~
ADDRESS
Padden, Guerrini & Associates, P.C., 3425 Simpson Ferry Road, Camp Hill, PA 17011
PLEASE USE ORIGINAL FORM ONLY
First line of address
713 Alberta Avenue
Second line of address
City or Post Office
.2
DATE. F1f.ED
: ..0
.._j
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-;>
State
ZIP Code
Mechanicsburg
PA
17050
DATE
/2-- /1-01
L
15056051058
Side 1
15056051058
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15056052059
REV-1500 EX
Decedent's Name:
Margaret
T Rush
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) Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 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 .0_
16. Amount of Line 14 taxable
at lineal rate X.O 45 364,915.39
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X. 15
15.
16.
17.
18.
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052059
Side 2
579-26-2733
Decedent's Social Security Number
15056052059
11,427.99
25,691.94
330,744.67
367,864.60
2,927.80
21.41
2,949.21
364,915.39
364,915.39
16,421.19
16,421.19
--1
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21
07
DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER
Margaret T Rush 579-26-2733
STREET ADDRESS
713 Alberta Avenue
CITY I STATE I ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
16,421.19
821.06
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
821.06
Total Interest/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 211'to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(5A)
(5B)
15,600.13
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
15,600.13
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 [i]
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i]
c. retain a reversionary interest; or.......................................................................................................................... 0 Ii]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [i]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [i] 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.
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)].
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)]. 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}].
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-1508 EX+ (6-98) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Margaret T. Rush
FILE NUMBER
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Refund of Nursing Home Expense 3,235.59
2. Blue Cross Insurance Refund 271.31
3. IRS Tax Refund - 2007 Personal Taxes 3,450.00
4. DOD Retirement - October 2007 649.00
5. Social Security - October 2007 1,104.00
6. Maryland State Employees Retirement - October 2007 2,718.09
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11,427.99
REV-150S EX+ (6-SB*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Judith R. Wood
B. James R. Rush
C.
ADDRESS
RELATIONSHIP TO DECEDENT
713 Alberta Avenue
Mechanicsburg, PA 17050
Daughter
1802 East Manhattan Drive
Tempe, Arizona 85282
Son
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 DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 02101/02 First Financial
Federal Credit Union of Maryland
Checking Account
#27330-10 8,018,38 50% 4,009.19
2. A. 01/01/01 First Financial
& Federal Credit Union of Maryland
B. Money Market Account
#27330-11 33,496.98 33% 11,164.54
3. A. 01/01/01 First Financial
& Federal Credit Union of Maryland
B. Savings Account
#27330-01 1,554.79 33% 518.21
TOTAL (Also enter on line 6, Recapitulation) $ 15,691.94
(If more space is needed, insert addttional sheets of the same size)
REV-1509 EX+ (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Margaret 1. Rush
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
B.
C.
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTlTLmON AND BANK ACCOUNT NUMBER OR SIMI LAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A.
4. A 08/01/99 US Treasury Bill - Treasury Direct
Ale #4800-394-0499
Par Value - $20,000 20,000.00 50% 10,000.00
Issue Date - 7/26/07
Maturity Date - 1/24/08
TOTAL (Also enter on line 6, Recapitulation) $ 10,000.00
(If more space is needed, insert additional sheets of the same size)
REV-is10 EX+ (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Margaret T. Rush
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.
FILE NUMBER
DESCRIPTION OF PROPERTY
ITEM INCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEOENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE OATE OF TRANSFER. ATTACH A COPY OF THE OEEO FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1, Union Central Ufe
Nonqualified Annuity
Policy #A64005447S 178,017.94 100 178,017.94
Transferees - Judith R. Wood and James R. Rush
Relationship - Daughter and Son
Date of Transfer - October 18,2007
2. Union Central Life
Nonqualified Annuity
Policy #AOOOO0603W 152,726.73 100 152,726.73
Transferees - Judith R. Wood and James R. Rush
Relationship - Daughter and Son
Date of Transfer - October 18, 2007
TOTAL (Also enter on line 7 Recapitulation) $ 330,744.67
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12099.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Auer Memorial Home - Death Certificates
Auer Memorial Home - Funeral Expense
Dulaney Valley Memorial - Internment Fee
Rev. Harry Cahill - Organist Funeral Services
Scott Frutchey - Organist Funeral Services
Mary's Kitchen - Funeral Luncheon
60.00
437.80
680.00
200.00
150.00
200.00
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
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
5.
Accountant's Fees
1,200.00
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,927.80
REV-1512 EX+ (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Margaret T. Rush
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
FILE NUMBER
1.
Continuing Care RX - Pharmacy
7.77
2.
Continuing Care RX - Pharmacy
13.64
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
21.41
. REV-1513 EX+ (9-00)
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Margaret T. Rush
FILE NUMBER
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 Dnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Judith R. Wood Daughter 50%
713 Alberta Avenue
Mechanicsburg, PA 17050
James R. Rush Son 50%
1802 East Manhattan Drive
Tempe, Arizona 85282
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 $
(If more space is needed, insert additional sheets of the same size)
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j.sicn of the es~at:a: '
Executor'O.f:
no-tsul'f!{t:tttr:-9
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w.~G'~.G::L':~ ,L\:t:;.,w ~'~'V'-e"'.~f ~v';tuJV~-..r~,~~~,_" 'f _ ,. .'
e'sztatef. If be does nots,,~vive me ~ -then
WOOD. 3700 Cheraz Rd., .&.1 buquerque t l'1ew M~x..;eo,
Execu.trix or my estate. I direct that no Exeeuto!"'"
serving hereunder shall be required to post bond..
IN 'WITNESS Tf.:EREOF,_ I have hereunto set my ha.nd and seal
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t hi s I f/J2 d.ay of ' , ~/;} 4{../f..aA,,~V . .1981.
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(~1gn here) II -~-"-:J'ty:..,-~.--
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Signed t sealed? and published and declared to be h~r
LJ;S!~LL AND~E5TAMEiVT.......eo~is"ting .of' i;1-i:rei.9 .t~~!'~~n,
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W!fO .in':~,;,pr~~,e~,e,;.~~~,~n-e:~ ..r'-eqU'~s~",~~::'i~;..'t;h~'~p1'
o:f each other, have.he~$unto' su~oocri"Pe~"'O~~ .~aafs.''ii
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