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Home My WebLink About08-07-08~ 1 15056051058 05) REV-1500 EX (06 - OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes ~ INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT 21 05 0028 ENTER DECEDENT INFORMATION BEL OW Social Security Number Date of Death Date of Birth 12/28/2004 '.. 03/15/1909 Decedent's Last Name Suffix Decedent's First Name MI _ ._ _.._ _ Weaver ' Edith M _ __ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW 1. Original Return <fi~? 2. Supplemental Return tw_J 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ _ _ 4a. Future Interest Compromise (date of ~-R~i 5. Federal Estate Tax Return Required death after 12-12-82) • 6. Decedent Died Testate ': ", ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) • 9. Litigation Proceeds Received ~ `. 10. Spousal Poverty Credit (date of death r~ ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number rya Terence J. Barna, Esq. --~ ' (717) 852-70~~~ ~ _ Firm Name (If Applicable) ' -~y,' - REGISTER Of ~Yt4tS USE ~.Y ' ; Benn Law Firm I - -~.~ First line of address - ,' ~ _ , 103 E. Market Street "'Q ' '' ._> %~ -, _ Second line of address ___ -rU --I .. ' ,,_. P.O. Box 5185 - ~,p City or Post Office State ZIP Code DATE FILED York PA 17405-5185 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, ~t 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 ~DDR SE 5 ~ --- Doris Anne Young, Executrix, 9445 Carlisle Road, Dillsburg, PA 17019 SIC' REF~OTHER THAN REPRESENTATIVE D~~,//~- ADDRES E3enn Law Firm, 103 E. Market Street, P.O. Box 5185, York, PA 17405-5185 15056051058 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Edith M Weaver ' Decedent s Name: RECAPITULATION 1 . Real estate (Schedule A) ......................................... .... L - 0.00 2 . Stocks and Bonds (Schedule B) .................................... ... 2. 0.00 3 . Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00 4. Mort a es & Notes Receivable Schedule D 9 9 ( ) .......................... 4. ... 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 5,000.00 6. Jointly Owned Property (Schedule F) ~ _ ~ Separate Billing Requested .... ... 6. 0.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ___ _ (Schedule G) C~:~ Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 5,000.00 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 2,2$0.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. _. 0.00 11 Total Deductions (total Lines 9 & 10) ................................ ... 11. ! 2,280.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. ! 2,720.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .... . _ .. an election to tax has not been made (Schedule J) ...................... , .. 13. ! 0.00 14 Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 2,720.00 - ~ --- _-.__.-.. .____.. _._._ ______.__.._~. ,._.. __ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~. _....-.--.~. ._.. ~.._.._~ ...n..~... _~ ___~,.._ n_ ~a~._...~..~_ 15. Amounl of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line l4 taxable at lineal rate X .0 45 2,720.00 ' 16. i 122.40 17 _ Amount of Line 14 taxable _., _. __ at sibling rate X .12 17. 18 Amount of Line 14 taxable _ .. _ _ at collateral rate X .15 18. 19 TAX DUE ....................................................... 19. .. 122.40 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number w 21 05 0028 __ __ DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Edith M Weaver STREET ADDRESS Messiah Village, 100 Mt. Allen Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line t9) (1) 122.40 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 122.40 A Enter the interest on the tax due. (5A) 0.00 B Enter the Total of Line 5 + 5A. This is the BALANCE DUE. (56) 122.40 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 :...................................................................................... .... ^ 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? .......... .... ^ ^x 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 fax 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 fling 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 (ax 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 ;~ Ps §9116(1.2>[~2P.s §9116(x)(1)). ..: r ~ .~ :, ,nosed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(x)(1.3)]. Asibling is defined, under ~:~ J °~?'? 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 SCI~IEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 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. (Ii more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 Debts of decedent must be reported on Schedule I. ITEM !UMBER A. FUNERAL EXPENSES: t. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Slreel Address City State 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 Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~. Benn Law Firm-contingency fee on litigation proceeds e. Cumberland County Register of Wills filing fees Z.ip Zip 250.00 2,000.00 30.00 TOTAL (Also enter on line 9, Recapitulation) f $ 2,280.00 ---- (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-0O) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE t TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~ Doris Anne Young, 9445 Carlisle Road, Dillsburg, PA 17019 daughter 50% residue 2 Donald E. Weaver, 199 River isles, Bradenton, FL 34208 son 50% residue 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ 0 (If more space is needed, insert additional sheets of the same size) INVEN'~(~~~' REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA l SS COUNTY OF J COUNTY, PENNSYLVANIA File Number 21-OS-0028 Personal Representative(s) of the Estate of Edith M. Weaver deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- ij ~ tory are true and correct. I understand that false state- '~" ments herein are made subject to the penalties of Doris Anne oung, Executrix 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) Terence J. Barna, Esquire (Supreme Court LD. No.) 74410 (Address) Benn Law Firm, 103 E. Market Street, P.O. Box 5185, York, PA 1 7405-5 1 85 (Telephone) 717-852-7020 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 1228/2004 Messiah Village, 100 Mt. Allen Drive, Mechanicsburg, PA 17055 FIGURES MUST BE TOTALED 1. Prior Inventory filed on 9/22/05 listed anticipated litigation proceeds in the amount of $7,500.00. 12,500.00 The Estate in fact received $20,000.00, leaving an additional balance of $12,500.00. 2. The Estate received further litigation proceeds in July of 2008. 5,000.00 r-_, ~~ - c~ ~~ ,-, `~„ ,~-- - -- % :_ ' c` ~t _ -- ETI - ,,,, -,.1 __ i _ ... i . ,, -7 .ta ; _ ~ .1J ._ --1 J .. Q (:9rtach cnirlitlonat sheets as needed) TOTAL: ~ 17,500.00 VUl'E I'hc Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each ncm. but such figures should not be extended into [he total of [he Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-09 rev. /0.!3.06