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HomeMy WebLinkAbout06-20-08 (2)15056041114 "~ REV-1500 EX (t)6-05) CIFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 -~ .-'~ _ Harrisburo, PA 17128-0601 RESIDENT DECEDENT ~~- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 183-07-8425 03242008 12141915 Decedent's Last Name Suffix Decedent's First Name MI SHULENBERGER ETHEL D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) (~ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0 2. Supplemental Return Q 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 0 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1.95) 3. Remainder Return (date of death prior to 12-13-82) ~] 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes (~ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G FREY Firm Name (If Applicable) FREY & TILEY First line of address 5 SOUTH HANOVER STREET Second line of address City or Post Office CARLISLE State ZIP Code PA 17013 REGISTER OF WILLS USE ONLY -~ c~ .<~ ~ ~__ _j ~, ?-; ~ - ~J `Irk DIME FILED "~- _.i rv ;~. .. r N - cn Correspondent's a-mail address: RFREY@ FREYT ILEY . COM Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and ':o 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 anYknowledge. SIG URE OF PERSON E O FOR FILING ETURN ATE SIN RE OF P PAR/f'HA R PRESENTATIVE ~ ~ ~ ~ ~ ZT~ / ~ ^ 5 SOUTH HANOVER STREET 717-243-5838 ~RLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041114 1,5056041114 15056042115 REV-1500 EX Decedent's Socia{ Security Number Decedent's Name: ETHEL D SHULENBERGER 183-07-8425 REC APITULATION 1. Real estate (Schedule A) .......................................... . 1. NONE 2. .................... Stocks and Bonds (Schedule B) ................. . 2. 319 4 . 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. NOiVE 4. Mortgages & Notes Receivable (Schedule D) ...................... . .... . 4, NONE 5, Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 3 6 0 O 4 . O O 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... . 6. NOP1E 7. Inter-Vivos Transfers & Miscellaneous Non•Probate Property (Schedule G) OSeparate Billing Requested ....... . 7 NONE 8. Total Gross Assets (total Lines 1-7) ............................ . .... . 8. 3 919 8 . O O 9. Funeral Expenses & Administrative Costs (Schedule H) ................. . . 9. 19 3 4 . O 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . ............ . 10. NONE 11. Total Deductions (total Lines 9 & 10) .......................... . ..... . 11. 19 3 4 • 0 0 12. Net Value of Estate (Line 8 minus Line 11) ........... . ................ . 12. 3 7 2 6 4 . 0 0 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... . 13, 0 . O O 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... . 14. 3 7 2 6 4 • O O 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 0 15. O.O O 16. Amount of Line 14 taxable at linea- rate x .0 4 5 3 7 2 6 4. 0 0 1 g. 16 7 7. 0 0 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 • 0 0 18. Amount of Line 14 taxable at collateral rate X , 15 1 S. 0 . 0 0 19. TAX DUE .......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042115 15056042115 1677.00 0 REV-1500 EX Page 3 183-07-8425 Decedent's Complete Address: File Number 2 ~ -~ O~ -~-~ ~t ~ 7 DECEDENT'S NAME DECE_DENT'S SOCIAL SECURITY NUMBER ETHEL D SHULENBERGER 183-I)7-8425 STREET ADDRESS CITY STATE Z!P Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 1677.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ~ S~' ~' ~ ~ S"~( 3 Total Credits (A + B + C) (2) X96 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1677.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1677.00 Make Check Payable to: REGISTER OF WILLS, ~4GENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did reta ndthe usekoranoomeeof the property transferred : ............... . ....................... ^ ^ b. retain the right to designate who shall use the property transferred or its income : ................ ^ ^ c. retain a reversionary interest; or ...................................................... ^ ^ 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? ................................................. ^ ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. ^ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................... ^ ^ 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. §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. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whettler by blood or adoption. zn REV-1503 EX+ {6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE B STOCKS & BONDS (FILE NUMBER ETHEL D SHULENBERGER .?1-08-0437 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Met Life 52 shares, $61.43 ave. share price 3,194 (If more space is needed, insert additional sheets of the same size) z» REV-1548 EX+(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER ETHEL D SHULENBERGER 21-08-0437 Include the proceeds of litigation and the date the proceeds were receivecl by the estate. (1f more space is needed, insert additional sheets of the same si:~e) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ETHEL D SHULENBERGER 21-08-0437 Debts of decedent must be reported on Schedule I. A. FUNERAL EXPENSES: ~. Egger Funeral Home 2. Eby Granite Works B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commission Paid: _ 2 3 4. 5. 6. 7. 8. State Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claiman4 Street Address City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparer's Fees Final medical bill: Special Event Emergency Medical Services Final medical bill: Continuing Care Rx AMOUNT Zip Zip TOTAL (Also enter on line 9, RI (If more space is needed, insert additional sheets of the same size) 161 106 1,200 Included w/ atty fee included w/ atty fee 160 307 S 1,934 WS).com Stock Charting for MET (NYSE) U. S. Dollar Date Price High Low Volume 3/24/08 61.52 62.53 60.32 6,391,400 No Splits Get another quote any day after 1/2/1970 1/2/1970 Symbol Date: 3/24/08 Gta Copyright ©1999-2008 BiaCharts.com Inc. All rights reserved. Please see our Terms of Use. Historical and current end-of-day data provided by FT Interactive Data. 2 tuiartth (Daii'ar:s +"":~6i0~ .rarer ~::t=rs~ ~`~ ~. ~s ~~~ ~ ~.~~_ ~'s 4 .t ,~, Imo 2mo 3mo 6mo ~ ~r ~r Copyright ©2008 Dow Jones & Company, Inc. All Rights Reserved 04/18/2008 02:00 PM http:iJwww.bigcharts.com/custom/wsjie/wsjbb-historical.asp?symb=MET&sid=8630&close_date=3(24/08 Page 1 of 1 ~..i~~r.:r" li LAST WILL AND TESTAME11fT 1, ETHEL D. SHULENBERGER, of 22 Schoolhouse Road, NE;wville, Cumberland County, Pennsylvania 17241, do hereby make, publish and declare lrhis to be my last will and testament, hereby revoking all wills heretofore made by me. 1. 1 direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and pena{ties thereon with respect to all property, whether or not such property pa~:ses under this Wil{, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds andlor bills of sale therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. l give, devise and bequeath all of my estate of whatever nature and wherever situate to my children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living'. 4. In the event that my grandson, Ricky Piper, becomes a k-eneficiary of my estate under the provisions of paragraph three above, then the share of my estate given to him shall be held in trust by the hereinafter mentioned trustee according to the following terms and conditions: A. To hold the trust principal and any undistributed income thus received far the benefit of Ricky Piper, who is designated as beneficiary of this trust. B. My trustee shall hold the trust principal for the benefit of Ricky Piper in recognition that there may be a number of needs other than support and maintenance which may be unavailable to him except through the provisions of this trust. C. This trust is intended to satisfy non-support needs as deemed appropriate in the absolute discretion of the trustee. This trust is not intended to displace any source of income otherwise available to Ricky Piper for his basic support (such as food and shelter), including any governmental assistance program to which he is or may be entitled. It is not intended to be a resource of Ricky Piper and it is not available to him upon demand. This trust is intended to be a discretionary spendthrift trust created for non-support purposes for Ricky Piper. D. No part of the principal of this trust shall be used to supplant or replace any Public Assistance or Social Security benefits received by or through any country, state, federal or other governmental agency for the benefit of Ricky Piper. E. During Ricky Piper's lifetime, to the extent that benefits are not made available to him for other than basic living expenses, including food and shelter, the trustee, in his absolute discretion, may distribute from income and principal to or for the benefit of Ricky Piper for his needs other than basic support. For the purposes of this provision, non-support purposes shalt include, but are not limited to dental care, unreimbursable medical expenses, including plastic and reconstructive surgery, diagnostic work and treatment, rehabilitative training and experimental medical services. The differenti+~l in cost between shelter for a shared and private group home or rooms, supplemental nursing care, recreation, cultural experiences, vacations, outings, travel, including payment to others to accompany Ricky Piper on outings, vacation and travel, telephone and television (including cable television), reading and education materials, exercise equipment and unreimbursed therapy. The trustee's discretion in making distributions authorized hereunder is absolute without regard to distributions from the trust estate and shall be binding on all interested persons. F. This trust is specifically not intended to provide basic support and maintenance needs for Ricky Piper, if he is unable to maini:ain and support himself from his own resources and sources of income, indE:pendent of the principal and income of this trust, the trustee shall seek sucf~ support for him from public sources. The trust has specifically not been created to supplant or replace Public Assistance or Social Security benefits. The trustee should, therefore, seek entitlements which are available to members of the cornmunity who are experiencing disabilities which are substantially similar to those which Ricky Piper experiences. The trustee shall deny requests made b~~ any agency or governmental entity requesting disbursement of trust funds to satisfy Ricky Piper's support needs. G. The trustee shah take v/hatever -legal steps mays be necessary to initiate or continue any Public Assistance or Social Security program for which Ricky Piper is or may become eligible. The trustee shall brine such action in any court having jurisdiction over the matter, to secure a ruling or order that this trust is not available to him for support purposes. Any expenses o1F the trustee, including reasonable attorney fees, in connection with matters; relating to determination of eligibility of Ricky Piper for public assistance, shall be a proper charge from this trust. H. This trust shall continue during the natural life of Ricky Piper and upon his death the then remaining principal and any accumulated and undistributed income shall be paid and distributed to Michael Piper, or if he is deceased then to his children, share and share alike. 5. I nominate and appoint my children, William Shulenberger and Nancy Piper, to be the co-personal representatives of my estate, to serve without bond. 6. I appoint my grandson, Michael Piper, to be the trustee of any trust created pursuant to paragraph four above. 7. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2"d day of March, 2002. ,. ~ r :~: ~ 2a (SEAL) E`fHEL D. SHULENBERGER Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. /~ , _. ACKNOWLEDGMENT AND AFFIDAVIT WE, ETHEL D. SHULENBERGER, RHONDA S. IRW1N and HEATHER A. BARBOUR, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument a.5 her last will and that she had signed willingly, and that she executed it as her free and vo{untary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND :ss: Subscribed, sworn to and acknowledged before me by ETHEL D. SHULENBERGER, the testatrix .herein, and subscribed and sworn to before me by RHONDA S. IRWIN and HEATHER A. BARBOUR, witnesses, this. 2nd day of March, 2002. Notarial Seat fiardd S. Irwin Ili, Notary Public Carlisle Boro, Cumherland County My Commissian Expires Sept. 23, 2002 Member, Pennsylvania Assa^iation o1 Notaries HEATHER A. BARBOUR