HomeMy WebLinkAbout01-18-08
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15D5bDlf11lf7
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 2 1 0 7
RESIDENT DECEDENT
File Number
0605
Date of Birth
192146331
06102007
07091922
Decedent's Last Name Suffix
SHANK
Decedent's First Name
PAULINE
MI
L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
SHANK
Spouse's First Name
DONALD
MI
M
Spouse's Social Security Number
204013624
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
B 1. Original Return 0 2. Supplemental Return
o
4. Limited Estate
o
4a. Future Interest Compromise
(date of death after 12-12-82)
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
B
6. Decedent Died Testate
(Attach Copy of Will)
o
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
o
9. Litigation Proceeds Received
o
10 Spousal Pove~ Credit (date Of death
. between 12-31-91 and 1-1-95)
o
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
DAVID R. MORRISON 7175601500
Firm Name (If Applicable)
DAVID R. MORRISON &
REGISTER OF WILLS USE ONLY
,.......;)
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First line of address
600-A EDEN ROAD
~.......
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Second line of address
C)
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City or Post Office
LANCASTER
State
PA
ZIP Code
17601
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DATE ~Etrl
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Correspondent's e-mail address:
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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
NATU OF PER ON RESPONSIBLE FOR FILING RETURN DATE
Christal A. Burns
David R. Morrison
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600-A Eden Road, Lancaster, PA 17601
Side 1
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15D5bDlf11lf7
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15056042148
REV-1500 EX
Decedent's Name:
SHANK, PAULINE L.
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) 0 Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested............. 7.
8. Total Gross Assets (total lines 1-7)............................._.................................. 8.
Decedent's Social Security Number
192146331
51,822.22
51,822.22
5,202.73
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, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15,008.70
15.
30,017.40
16.
17.
18.
19. Tax Due............................ ............... .......... ...... .................................... ................ 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
L
Side 2
15056042148
1,593.39
6,796.12
45,026.10
45,026.10
o . 00
1,350.78
1,350.78
D
15056042148
~
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 . 07 . 0605
Shank, Pauline L.
STREET ADDRESS
1 W. Penn St.
Apt. 118
STATE
IZIP
CITY
Carlisle
PA
17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
1,350.78
1,200.00
63.16
Total Credits (A + B + C)
(2)
1,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE
(3)
(4)
(5)
(5A)
(58)
0.00
87.62
87.62
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;............................................................................. D [!J
b. retain the right to designate who shall use the property transferred or its income;................................ [] [!J
c. retain a reversionary interest; or..... .................. ......--............................... .......... ....... ........................... 0 [!J
D r-~
d. receive the promise for life of either payments, benefits or care?........................................................... l ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?..... '" ................................ ......... ................. ....................... ............. .......... [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ Ii]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?. ..................................... ....................................... ....... .......... ........... ...... [!J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR
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'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 ~se of th~ 'M" .d'
surviving spouse is three (3) percent [72 P.S. ~9116 (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. ~9116 (a) (1.1) (ii)l. The statutedoes not exemota 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. S9116 (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. S9116 (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.
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
_L
i FILE NUMBER
121 - 07 - 0605
ESTATE OF Shank, Pauline L.
Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of
survivorship must be disclosed on schedule F.
-, ---.---- -.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE OF
DEATH
1,350.55
1 M& T Bank, Christmas Club, Acct. No. 025004910493226
2 M& T Bank, Checking Acct. No. 000009830434842
2,324.80
3 M&T Bank, Money Market Acct. No. 015004198141548
47,100.00
4 M& T Bank, Interest on above accounts
52.03
5 Commonwealth of P A - revenue rebate
500.00
6 Embarq - refund
22.35
7 Comcast - refund
2.80
8 Carlisle Regional Medical Center - refund
469.69
TOTAL (Also enter on line 5. Recapitulation)
51,822.22
Page: 1 Document Name: untitled
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CULO
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CUP1 1 CIS
96 OP EBRN
CUST NO.
SSN/TID: NO 192146331
INDIVIDUAL CUSTOMER PROFILE 07/06/22 14.06.00
MS 64282 INDIVIDUAL CUSTOMER DISPLAYED
CUST SEG STATUS - -
CD 0 COST CENTR 4319 BRN-- 4319
TIE 1 OPENED 750501 OFF01
CLOSED OFF02
LST MAIN 1060203 MAR STATS
BRTHDATE 220709 SEX------ F
DECEASED ADVERTIS?
BANKRUPT EMPLOYEE? N
OCCUP CD HH# 0
HOME PHONE (717)258-0298 CUST TYPE T2 SENS CODE 0
BUS. PHONE LANGUAGE REFER? N
REM ARK S NATIONALITY NEXT: 1
COlD 96
N PAULINE L SHANK
A 1 W PENN ST APT 118
C CARLISLE PA 17013-2353
EMPLOYER
BK REL
BK SVC P3
RETIRED
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c/7;'1- I/2t &J;d,
PLACED EXP. DATE
PLACED EXP. DATE
LIST HIST ACCTS? N LIST CLOSED ACCTS? Y
ACTN: ACPR ACDT A C C 0 U N T R E L A T ION S HIP S NEXT: 6
SEQ- COID- PRDSP ACCOUNT---------------- OPEN ST CURR ------BALANCE----~- REL
0001 96 CSV90 025004910493226 10210 99 ~CO ~ 1,350.55 IND
0002 96 DDAH2 000009830434842 10206 99 ~ 2,324.80 IND
0003 96 DDA9M 015004198141548 10209 99 1V~ ~ 47,100.00 JT1
0004 96 VDR 4258 3645 0020 6876 10512 INn
0005 96 VDR 4258 3845 0272 8776 10206 07 50) ?z??11 IND
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Date: 6/22/2007 Time: 2:07:01 PM
.
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCf TAX RETURN
RESIDENT DECEDENT
SCtfiXJLEH
FUNERAL EXPENSES &
ADNINSTRA11VE COSTS
I
FILE NUMBER
21 - 07 - 0605
Debts of decedent must be reported on Schedule I.
-lfEM-~----~------------
. ~MBER I FUNERAL EXPENSES:
A. ,
i
I
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Christal A. Burns
Social Security Number(s) / EIN Number of Personal Representative(s):
206-36-3384
Street Address 16 Jason Ave.
City Denver
ESTATE OF Shank, Pauline L.
B.
1.
DESCRIPTION
AMOUNT
State P A
Zip 17517
2.
Year(s) Commission paid 2007
Attorney's Fees David R. Morrison & Associates -- David R. Morrison
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4.
City
Relationship of Claimant to Decedent
Probate Fees Register of Wills
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs
1
Cumberland Law Journal
State
Zip
1,500.00
3,341.11
128.00
75.00
TOTAL (Also enter on line 9, Recapitulation)
5,202.73
.
SchecUe H
FmeraI ExpeIISeS&
M11ini:1b~Costs ccnIimed
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
! FILE NUMBER
21 - 07 - 0605
ESTATE OF Shank, Pauline L.
2 The Sentinel
158.62
Page 2 of Schedule H
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE !
liABiliTIES, & liENS I
I
I FILE NUMBER
I
~21 - 07 - 0605
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RET\JRN
RESIDENT DECEDENT
ESTATE OF Shank, Pauline L.
Include unreimbursed medical expenses.
ITEM
NUMBER
- ~ ~ ---~ -~-- --------~~ ~-~
1 Embarq - phone service
DESCRIPTION
AMOUNT
_.--~--..- ---_~._~._____._.n__._~ ~_"_~~___ ______.._._._~__
41.36
2 Lane. HMA Phys. Mgmt. Cent. Penn
32.17
3 Comcast
8.19
4 Pinker & Assoc. - foot specialist
14.93
5 Retail Services - Bon Ton credit card
184.16
6 David Sheibley - trash removal
75.00
7 PP&L
15.53
8 Belvedere Medical Corp.
122.47
9 Physicians of Rehabilitation, Industrial & Spine Medicine
25.29
10 Moffitt Heart & Vascular Group
52.86
11 PP&L
18.66
12 Carlisle Regional Medical Center
992.00
13 Physicians of Rehabilitation, Industrial & Spine Medicine
10.77
14
0.00
-- '---~ ~-~------'--~---~'-~"-
TOTAL (Also enter on Line 10, Recapitulation)
1 ,593.39
REV.1513 EX~(9-o0)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
RELATIONSHIP TO
DECEDENT
Do Not List Trustee('L___---"---
I FILE NUMBER
, 21 - 07 - 0605
SHARE OF ESTATE I AMOUNT OF ESTATE
(Words) " ($$$)
ESTATE OF
Shank, Pauline L.
NUMBER
NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY
I.
i TAXABLE DISTRIBUTION~~~~~~tig~~g:~ds~~~f~rs
under Sec. 9116 (a)(1.2)]
1 Christal A. Burns
16 Jason Ave.
Denver, PA 17517
Daughter
i
]
,
i one-third
2 Michael Shank
609 NW 170 Terrace
Pembroke Pines, FL 33028
Son
one-third
3 Donald M. Shank
Claremont Nursing Home
1000 Claremont Road
Carlisle, PA 17013
Husband
one-third
I
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 SHEE
0.00
IN THE COURT OF COMMON PLEAS
OF LANCASTER COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
PAULINE L. SHANK,
deceased
)
)
) No. 21-07-00605
)
ESTATE OF:
ELECTION AGAINST THE WILL
I, DONALD M. SHANK, the spouse of the decedent, do hereby elect against the
Will to the extent of 1/3 of the net estate.
Dated: fd - d 1- () 7
~~OALvn.~~
DONALD M. SHANK
By: ~
Chris A. Bums, Agent under a
Power of Attorney for Donald M. Shank
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1!Iast mill anb QJcstaluent
OF
PAULINE L. SHANK
I, PAULINE L. SHANK, of the County of Lancaster and
Commonwealth of Pennsylvania, being of sound mind and memory, do
hereby declare this to be my Last will and Testament, hereby
revoking all wills and codicils heretofore made by me.
ARTICLE I
I devise and bequeath all my estate of every nature and
wherever situate to my children in equal shares. If any child
dies before I do, I devise and bequeath that child's share to my
grandchildren of that deceased child in equal shares. If a child
dies without children, I give that child's share to my survivin~
child in equal shares. All of my children are living and they
are:
1) CHRISTAL A. BURNS, and
2) MICHAEL A. SHANK.
ARTICLE II
No fiduciary under this will shall be required to give
bond or other security for the faithful performance of the
fiduciary's duties.
ARTICLE III
I hereby nominate and appoint CHRISTAL A. BURNS,
personal representative of this, my Last Will and Testament. In
the event that CHRISTAL A. BURNS predeceases me, or is unable to
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serve, or renounces the right to serve, I hereby appoint DAVID
//
BURNS, alternative personal representative. It is my preference
that David R. Morrison & Associates be retained as counsel for
the estate.
IN WITNESS WHEREOF, I, PAULINE L. SHANK, have hereunto
subscribed my name and affixed my seal this 30th day of August,
2002.
~~ ;f -/~
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(SEAL)
PAULINE L. SHANK
Signed, sealed, published and declared by PAULINE L. SHANK
as and for that person's Last will and Testament in the presence
of us and each of us, who, at the request of PAULINE L. SHANK,
and in the presence of PAULINE L. SHANK, and in the presence of
each other, have hereunto subscribed our names as witnesses
day and year last above written.
residing at: 3091 Harrisburg Pike
t 6tL71 7Irp.;>;j~/-Z-
residlng at:
Landisville, PA 17538
9 Wolf Circle
Ephrata, PA 17522
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