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Home My WebLink About01-23-08 (2) ( --.J 15056051047 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix Spouse's First Name MI J THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return c::> 2. Supplemental Return c::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c::> 4. Limited Estate c::> - 6. Decedent Died Testate c::> (Attach Copy of Will) c::> 9. Litigation Proceeds Received c::> 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) c::> 8. Total Number of Safe Deposit Boxes c::> 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ALL E-tv L wlEiKEL ;; I '7 73 7 :L;;1.. ;J...s- Firm Name (If Applicable) REGISTER OF WILLS USE ONLY First line of address ('") .~ ;--..) r:-:~) i ~r L If} ES TD tV E j)I<.IVE CJ i'-. ~'"1 '-I r,) w c-...:> Second line of address i ) .~.~--:~ 17CJ// :c; --1 City or Post Office State ZIP Code 6M:E::FilED CAmP H 1 L L (?fJ \.-0 (...) N Correspondent's e-mail address: Under penalties of perjury, J declare that I have examined this return, 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. DATE ~/-,3Z()- 0 g I '/CJI/ H,-/I . f/-9; I DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ....J .-J 15056052048 REV-1500 EX Decedent's Name: fJ f (;, ~y .:r. Lv ~ I K e '- RECAPITULATION 1. Real estate (Schedule A). 2. Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Receivable (Schedule D) . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::> Separate Billing Requested.. . . 8. Total Gross Assets (total Lines 1-7). . . 9. Funeral Expenses & Administrative Costs (Schedule H). . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . 11. Total Deductions (total Lines 9 & 10). . . . . . 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 1. 2. 3. 4. . 10. 11. 12. 13. . . . . 14. Decedent's Social Security Number Jt... IJ 0 ;;1... t.{?i '110 . S-17.t)O . . 5. . 6. . 7. . 8. / !J?1.DO 3.So0.bO 9. . D 0.0 D - D - . D- c') .-. 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_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 . . . . 19. TAX DUE. . . . . . . . . 15. 16. 17. 18. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 . . . . . C) 15056052048 .-J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME pf G G'/ T. tu~(K'iL STREET ADDRESS File Number / .2 '7 L... I ,t.1 ff.s -r. ff E. ?:> R. . CITY CA~-f> !-IILL i STATE ;4- . ZIP I? 011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) -0'- 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + 8 + C ) (2) 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 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) A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) -0'- 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 ~ b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 [RJ c. retain a reversionary interest; or......................................................................................................................... 0 Ga d. receive the promise for life of either payments, benefits or care? .................................................................. 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 G2I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................... ............. ...... ....... ............ .......................... ....... ....... ............. ......... 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 PS. ~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. 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 PS. ~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 PS. ~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-~ 503 EX+ (6-98) fj * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER /Jfi /' /' J "J I r 0 Z5 _ boo~S ~L~~L .T. U€-tK.,=- L- p?/ All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. ;2 0 ShiH,!''> DESCRIPTION frtA. J.Q >1'/-, c; (@ q 3 85 VALUE AT DATE OF DEATH (, J' '1?~ () ,) TOTAL (Also enter on line 2, Recapitulation) $ I ~?? L> iJ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06)W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF jJ [. &6/ T, WZI K €:..L. FilE NUMBER v< / - CJ tS-- OOD~~- Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name 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 A- LL e ",v L - ~ r , Ie ~ '- Street Address 1.;2 q L'.ME57.. Nf City C-A 11 ,t> III '-L bR., State ~ZiP /701/ Relationship of Claimant to Decedent 5 foo..s'z 4. Probate Fees 5. Accountant's Fees 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) REV-1513 EX+ (9-00) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF !fGe:,y :J, W~i~<C-L. FILE NUMBER 21- oct- - 6oo&...s- RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee{s) OF ESTATE NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1,2)J 1, ,4L-Lc,N L. Wz(,KE '- /;) '7 J.. (/H'i'S'T,,?,N€ 'b R > t:....,AHi> ,L!ILL, p~ _ I/D/( S PDr.J5 E 1?7S/0Vt;: 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 $ (If more space is needed, insert additional sheets of the same size) " WILL OF PEGGY J. WEIKEL I, PEGGY J. WEIKEL, currently of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. 1. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. I bequeath unto my husqand, Allen L. Weikel, all tangible personal property which lawn at my death. IV. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath unto my husband, Allen. / V. In the event that my husband, Allen, does not survive me, I devise and bequeath my entire estate that would have otherwise passed under Paragraphs III and IV above as follows: A. I bequeath all my tangible personal property unto my daughter, Peggy A. Floyd. B. The residue of my estate shall be divided as follows: (1) One-half (Yz) unto my daughter, Peggy, or her issue per stirpes. J~/ (.(,(. I~ -1- /,,'-~ j~j/t:-,!"'V1 ',' ~~J /' I /;' / ,/ ." ,? ,. t ,..J _ , '1'/ ;",tk ' ./' / . (2) One-half (1;2) to be divided equally between my two (2) grandchildren, Justin and Jennifer, or the survivor of them. VI. I appoint my husband, Allen L. Weikel, Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my daughter, Peggy A. Floyd, Executrix in his place. VII. I direct that no bond be required of my fiduciary for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, PEGGY J. WEIKEL, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including the attestation clause and signatures of witnesses, this 1/".-( day of February, 2004. t:~~.,Y~EI~,,;~f (SEAL) Signed by PEGGY J. WEIKEL, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this J r;J day of February, 2004. /f}~z..fJ'f~ _ _ residingat :' ..~ ~.(:;.:,,/ ,:;;7,"'-:;' c;~'/~' e.L;;/ residing at d ;/ ~-?L~/~ . /~-; ,.~ ...' .-) L.---c.. 7/_r . ,i-' -~.7 // /,...r/ ..~k--[ . ;;.? / <';; ./ -2- COMMONWEAL TH OF PENNSYL VANIA COUNTY OF WE, PEGGY J. WEIKEL, GERALD 1. BRINSER and ,4UG-A/ L. tvSA/c~,- the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. f~ )).. ~ti-d' PEGG "1. -'WEIKEL ;~L- gd~ WITNESS / "'. -/c: ~ r::j;;~, "OJ_ _.____L_ ;' t' WITNESS "------/" --..' //:, C-~. .e-<~>::".<i,7;';'__ /2~"./' Subscribed, sworn or affirmed and acknowledged before me by PEGGY 1. WEIKEL, the testatrix, CiERALD J. BRINSER and .4-t..L~ _ '-. W~II.c~ '- , witnesses, this :)f-~l day of February, 2004. NOTARIAL SEAl MARilYN K. PEiffER. NOTARY' puQue PAlMYRA BORO., LEBANON CQUNlY MY COMMISSION EXPIRES OCT. 6. 2007 (SEAL) -3-