HomeMy WebLinkAbout04-23-08
-.J
15056051047
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes. INHERITANCE TAX RETURN
PO BOX 280601
Harrisbu ,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
soot s~~ NlJm'i~r' '..;' D::e...o7f~.;., ~.'I..} ~.'."}
1..;{.,.7.~~.\~X"~'.~~?,~: v <.oJ. VI.
OFFICIAL USE ONLY
County Code Year
File Number
14
Date of Birth
Decedent's Last Name Decedent's First Name
MI
(If Applicable) Enter Surviving Spouse's Information Below
Last Name Suffix
MI
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::::)
c::::)
c::::) 4a. Future Interest Compromise (date of
death after 12-12-82)
c::::) 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c::::) 10. Spousal Poverty Credit (date of death c::::) 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 Dayt~~~ ,.elt:lp~()I1E!~~rnber
~/""~;-"'~ ~Y" -':-'o:;~r'>>'-:;" H\~%*'" '~'~;Th'-' - ---~,x, ;~,
:;},,~,Lll)~I:~;1i,t,
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
-
Firm Name (If Applicable)
..'. , , tTl
REGISTER:q llS USI!t:8NLY rei 1 C)
r ':' "lJ -0 G C-:;
. : 1,- 0 :;::Q .-' 7)
::q :~2~ N '-' ; S.:.:
C.;);~ W CJ
~3~ ~
55
~.'J -.; ~
...-i..>
First line of address
N
N
L' (--:)
---t J
c,,/f fllli if
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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS ~ 9o~
firk ti rei<?-
CaI72fJ Hd J
f2/1
/70/1
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051047
15056051047
---1~
--I
REV-1500 EX
Decedent's Name:
RECAPITULATION
15056052048
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) c::) Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . 0 . . . .. 9.
Decedent's Social Security Number
[to . r~'~'~ ..,....L'i.!~;.j............s ..;5,;0, ~"'~''h:''(:ir'1;
',f J... . it . .;t; r 'j/';}.J'V ); 0{ .1.
", . .... ~,.cf . .;0;5".. " ! ~~':u""'~"'L,4 ".,......~..>.F:
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 Subjectto 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~
16. Amount of line 14 taxable
at lineal rate X.O!1:5
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
15056052048
Side 2
c:::>
15056052048
---I
REV-1503 EX+ (6-98,*-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
etlv/V/Y1 5.
- () 7 S-<t
All roperty jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
H1-t
VALUE AT DATE
OF DEATH
DESCRIPTION
tJ/tJck S-locJ:~
980 7~ 71
TOTAL (Also enter on line 2, Recapitulation) $ q 8' 0 7.. 7 I
(If more space is needed, insert additional sheets of the same size)
REV.l508 EX + (1-97) ~
~ SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INH~~i~~i 6:;E~~~~RN PERSONAL PROPERTY
ESTATE OF..-. .,. S FILE NUMBER
trlerl CLcIVIf1.. . c?/-07-07Sr:
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
1.
(:;2 .
0.
1:
.c-
(J.
10.
1,
~L
qt
DESCRIPTION
cOl)UnerCtL 8a-JLIe. Cll.PCl!tiy /tee #J)l3'fff"To'r
/ tV G - Sa U ;1:5:5 .Ae e,# J t, 7 'f <,\' rr ..5-,
C~ j) '-#. 6G1:-~ ~ 0 'f 0 ~.~
(/'/:) .# ,50 a;; (3 f~3 9
o LJ -#- <!Jt; ~ c1 :.3 <-f tf 8
(J,/:J #- h7'Y7.:~7b8
~''j '=# 7Dlg/51,39
,SG1uertjY/ 73tlltk - ejlLek~':JAcc#O}3?:1oJ.1I71
I q 7 ~~ J-frrnd<< /J1 (
I r 85 F6yd F ISd
CIdb/ (YJe1r-cVrj
Pre. jJ uLfh Sa-far:) ftUd Po,s f /J~~~rA
I ns{) rafJ CL C /ell fit. foy m e /l t
Qovtn. -Iii
j-t5A
VALUE AT DATE
OF DEATH
/ 'I i-, b .,~'-
7iP&7./'i
:9,01-9,77
I ()j-~ ~ ~ {)
/L)!5,3~oo
,~ 6~38,(jf
3 0 l> Z),o-i)
'--/
13.j~~7f
() z..t)o, iFlJ
/(7) Oi 0-0
'I- gh CJ ~ d-J
J J.,o;.tr1,
/ ()7J D. d(j
~ b fJ d, ,S'}
.
TOTAL (Also enter on line 5, Recapitulation) $ <A -3 -/ 7 ~. 4 q'
(If more space is needed, insert additional sheets of the same size)
REV-15ll EX+ (10-06)*
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. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
33//.60
D~+h ~~
a~vro
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
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
4.
Probate Fees
310r(JD
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ a fo 4~ . 6()
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
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 OF DEATH
1.
titS u rtLYJ (Jl..;
Co fa.,ys
ahtf{),O()
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-151' EX+ (9-00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
tal 1/ /J1
FILE NUMBER
'-j V Ic,.r,
r
,j
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. .J.. r~r)e- TV I e.l-. . }V; (~)
,9'1 0 If- to-i-ie e, ,cieJ
Camp f-I.~ / J I I A I 76 II
AMOUNT OR SHARE
OF ESTATE
I aD 70
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)
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07 -0 7 58
DECEDENT'S NAME
CALVIN S TYLER
STREET ADDRESS
3904 Park Circle
CITY I STATE IZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
Total Credits (A + B + C)
(2)
0.00
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 the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(5B) 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
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;....................................D
c. retain a reversionary interest; or........ ....... ................ ........ ........ ........ ...... ...... .... ........ ......................... .......0
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
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?....................... ............... ................ .................................................. ..........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.
No
[Y]
~
~
~
~
CK]
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 exemOB 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. ~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.
-';'
i,'" '. ,,' -:,.--;..
, ......... i. ',0:':
'0 ,i~
i/~
i',:,1~
~'
..
t1
~~
.'-....
i
i
I
I
I
II
Ii
'I
II
I,
11
II
11
;,
II
!I
I,
I!
II
II
:1
'-'''',.
~~
~~
;t~
,t'
:.1
h
Ij
iJ
~ i
jl
I!
114\!
I J I
II.r.':'
I "-/1.- . :1
Ij [I
i1 ;
11
II
I
I
I:
I
~
II
Ii
II
~
THIS IS THE LAST WILL AND TESTAMENT of me, CALVIN S.
TYLER, of the Town of Sussex, in the County of Kings and Province
of New Brunswick.
1.
I HEREBY REVOKE all wills and testamentary dispositions
of every nature or kind whatsoever by me heretofore made.
2.
I NOMINATE, CONSTITUTE AND APPOINT my wife, IRENE TYLER,
sole Executrix and Trustee of this my Will, but if my said wife
should predecease me, or die within a period of thirty days
following my decease, or without having proved this my Will, then,
on the death of the survivor of me and my said wife, I NOMINATE,
CONSTITUTE AND APPOINT my brother-in-law, DOUGLAS HENRY, of
Jacksonville, Florida to be the Executor and Trustee of this my
Will in the place and stead of my said wife.
I hereinafter refer
to my Executor and Trustee for the time being as my "Trustee".
3.
I GIVE, DEVISE AND BEQUEATH all my property of every
nature and kind and wheresoever situate, including any property
over which I may have a general power of appointment,
to my said
( a)
I
I
!
I
I
!
i
I
I
I
uncontrolled discretion decide upon, or to postpone !
such conversion of my estate or any part or parts thereofl
for such length of time as she may think best, and I I
hereby declare that my Trustee may retain any portion of
my estate in the form in which it may be at my death, I
(notwithstanding that it may not be in the form of an I
investment in which trustees are authorized to invest
trust funds, and whether or not there is a liability
attached to any such portion of my estate) for such
length of time as my said Trustee may in her discretion
deem advisable and my Trustee shall not be held re-
sponsible for any loss that may happen to my estate by
reason of so doing.
Trustee upon the following trusts, namely:
To use her discretion in the realization of my estate,
with power to my Trustee to sell, call in and convert
into money any part of my estate not consisting of
money at such time or times; in such manner and upon
such terms, and either for cash or credit or for part
cash and part credit as my said Trustee may in her
,;
II
,I
,I
11
Ii
II
II
I
\\..:
lb! 'I._I,
-'("; \
.' ''"'''f)
.ij:r~6'v
. ;....J
~ Z : i \ "'f :)' ~""i',' i ole!
J
,
~
j
~
j
1
po
1
;~
>
i
~
.~
J
~
I
I'
II
!I
l!
I!
\:
iI
i!
!:
Ii
1\
ii
"
it,
. 7l:.,
II
I,
ii
II
\1
I
II
Ii
!\
- 2..
(b) To pay my just debts, funeral and testamentary expenses
and to payor transfer the residue of my estate to my
wife, if she survives me for a period cf thirty days,
for her own use absolutely.
(c) If my wife should predecease me or should survive me
but die within a period of thirty days after my death,
I direct my Trustee
( i )
To payout of and charge to the capital of my general :i
estate my just debts, funeral and testamentary expense~1
I
and all estate inheritance and succession duties or .:1
taxes whether imposed by or pursuant to the law of th1~!
or any other jurisdicition whatsoever that may be 1'1
payable in connection with any property passing (or ,I
deemed so to pass by any governing law) on my death !i
;I
or in connection with any insurance on my life or any 'I
gift or benefit given or conferred by me either during Ii
my lifetime or by survivorship or by this my Will or II
any Codicil thereto. '
:1
\1
il
(ii) To hold the residue of my estate in trust for my issue
alive at the death of the survivor of me and my said
wife in equal shares per stirpes, provided that the
share of each child of mine who shall be living at the
death of the survivor of me and my wife shall be held
and kept invested by my Trustee and the income and
capital or so much thereof as my Trustee in his uncon-
trolled discretion considers advisable shall be paid
to or applied for the benefit of such child until he
or she attains the age of nineteen years when the
capital of such share or the amount thereof remaining
shall be paid ro transferred to him or her, any income
not 50 paid or applied in any year to be added to the
capital and dealt with as part thereof, and provided
further that if any child should die before attaining
the age of nineteen years such share, or the amount
thereof remaining, shall be held by my Trustee in
trust for the children of such child who survive him
or her in equal shares or if such child should leave
no child him or her surviving, in trust for my issue
alive at the death of such child in equal shares per
stirpes. And in case no child or other issue of mine
shall acquire an absolutelY vested interest by virtue
of the trusts herein declared, I direct my Trustee to
divide the residue of my estate or the amount thereof ,
remaining in equal shares per capita among the II
follow ing pe rsons: Dougl as Henry and Jacque line Henry II
and Floyd Tyler and Helen Tyler of Malone, in the Stat~.1
of New York. , I
,
4. IF ANY PERSON should become entitled to any share in my I
I
estate before attaining the age of nineteen years, the share of
such person shall be held and kept invested by my Trustee and the
income and capital or 50 much thereof as my Trustee in his absolutel
I
~..'
::':'1
i
;
. .~
;1
'I
~_: ...good faith.
, ,,'
/ "
. / :,~t; - / IN
j.j' .. v..
"10 Y J I 'I,.
I :1 f "" day of
II
iI
il
II
'I
II
I,
;,
I
I
1\
"
q
- 3-
discretion considers necessary or advisable shall be used for
the benefit of such person until he or she attains the age of
nineteen years.
5. I AUTHORIZE my Trustee to make any payments for any person
under the age of nineteen years to a parent or guardian of such
person whose receipt shall be a sufficient discharge to my said
Trustee.
6. IN THE CASE of the death of my wife, I HEREBY CONSTITUTE
AND APPOINT Floyd Tyler and Helen Tyler to be the guardians of
the persons and estates of my children during their respective
minorities.
7. I HEREBY DECLARE that my Trustee when making investments
for my estate shall not be limited to investments authorized by
law for trustees but may make any investments which in his
uncontrolled discretion he considers advisable and my said
Trustee shall not be liable for any loss that may happen to my
estate in connection with any such investment made by him in
TESTIMONY WHEREOF I have hereunto set my hand this
Iv( I. '/
A.D. 197f.
SIGNED, PUBLISHED AND DECLARED )
by the above named Testator,
CALVIN S. TYLER, as and for his
last Will and Testament, in the
presence of us, both present
at the same time, who at his
request, in his presence and
in the presence of each other,
have~eu~to subscribed our
nattier T w~ tnesses) ,~
. / ~ I
~/:../ ~ oJ..' " ;1 il...- I L";'i (, J
( I
~~
I .
, ij. I
~~ ~
.,.' '" ,
. i...\.v'-)' ,
~-
/l~ j{~.
I.? ..