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Home My WebLink About10-10-0815056041147 RED/-1500 Ex (06-05) OFFICIAL USE ONLY PA Department of Revenue courtyCade rear FfleNumber Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.zaosoi 21 0 8 0 3 9 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 181 32 4446 02 06 2008 02 16 1939 Decedent's Last Name Suffix Decedent's First Name MI MYERS RUBY J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW XC~ 1. Original Return 4. Limited Estate g Decedent Died Testate (Attach Copy of Will) MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-122) 7 Decedent Maintained a Living Trust 0 8. Totat Number of Safe Deposit Boxes (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty CredR (date of death 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 TO: Name Daytime Telephone Number JENNIFER B. HIPP 717 737 8761 r_, ~- Firm Name (if Applicable) BOGAR AND HIPP LAW OFFICES First line of address 1 WEST MAIN STREET Second fine of address City or Post Office State ZIP Code SHIREMANSTOWN PA 17011 c; ,-; REGISTER OF~JLLS US~9NLY ? ,, c: ~--~ ._-+ -_- ; - _ C~ -- c~3 o --, , . DATE FILED Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, inGuding 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. ~, , ~-,~tio Angela M. Myers 1(1, 'a ~ 6 ADDRESS 724 North Front Street, Lemoyne, PA 17043 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE Jennifer B. Hipp ~ C~•''Z- O A R S 1 West Main Street, Shiremanstown, PA 17011 Side 1 15U56Q41147 15056041147 J 15056042148 REV-1500 EX Decedent's Social Security Number ~ecedenrs Name: Ruby J. Myers 181 3 2 4 4 4 6 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 0 5 3. 8 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. 5. 6. 7. 8. Mortgages & Notes Receivable (Schedule D) .......................................................... Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. Total Gross Assets (total Lines 1-7) ....................................................................... 4. 5. 6. 7. 8. 7 4 1 . 9 5 , 3 9 5 . 7 9 9. Funeral Expenses 8~ Administrative Costs (Schedule H) ......................................... 9. 5 , 3 1 7 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 5 , 317.0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. - 3 , 9 2 1 . 2 1 13. Charitable and Governmental Bequests/Sec 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. - 3 , 9 2 1 . 2 1 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 .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 0 0 0 16. 0 0 0 . at lineal rate X .045 . 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due ..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L„ 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0398 DECEDENT'S NAME Ruby J. Myers STREET ADDRESS 9 N. Second Street CITY Lemoyne STATE ZIP PA 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit g. Prior Payments C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable p. Interest E. Penalty Total Interest/Penalty (D + E) {3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 0.0 0 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Q , Q Q 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 :.................................................................................. ~ x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. x d. receive the promise for life of either payments, benefits or care? .............................................................. x 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?......... ^ 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 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 disGosure of assets and fi{ing 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. Rev-1503 FJC+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Myers, Ruby J. 21-08-0398 All property jointlycwned with right of survivorship must be diadosed on Sohedula F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 U.S. Savings Bonds - 5 Series EE Bonds (See copies 653.84 of Bonds and Savings Bond Calculations attached.) TOTAL (Also enter on Line 2, Recapitulation) 653.84 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) l..Llll.U10.LGLL V iAIUG Vl 1 VUl r0.~1G1 JiaVlll~j'J 1JV11LL`J~ Calculated Value of Your Paper SavRngs Bond(s) Calculator Results for Redemption Date 02/2008 1 LLSV 1 Vl 1 Total Rriee Total Va6ue Totafl Interest VTD Ic~terest $250 00 $653 84 $403.84 $0.00 Bonds: 1-5 of 5 Seraal # Issue Next Finaf SecBes Denom Date Accrual Mateariity Issue Interest t?rBee .Interest Rate Value [dote C333198612EE 03/1;992 ~3f2008',03/2022~_ ~100 EE ~ _.~50.OQM___„ ~66.76~ 4.00%, ~116~76. . C20270842EE _, , __ ,_, 03/1990 03/2008:' 03/2020 EE X100 $50 00~ X76 40 4 00% $126.40 . , 85832785EE~ C1 : .__.. 03/2019,_,__$50.00.;,___ 100 03%1989 0 2008 EE x $81 52,~,.~ 4 00%, T~131.52,r , , , C149840270EE ; _, _ _., ..., 03/1988103/2008! 03/2018 100 EE . __$50 OOr____ $86 80a _ 4 00% ~136.80T _ C131998962EE r : _ _ , __ ~03f 1987 03%2008032017 ___~50 00~ ___ ~100 EE ~ _~92 36; _ 4 00%_a ~142 36_r,_____ _ _ _ _ ___ ___ Totals for 5 Bonds , 290.00 ~ $403.84. 653.84: Notes NI 'Not Issued ..._..w.....,.. ....................... _.........._............. _---__._...r...._.......e_..... _NE Not eligible for payment________,._._...._.._.__.__.._.... P5 ?Includes 3 month, interest penatty,..._._, .,:..,......,...,,..,...,.,_ .................:........... . .,m.. ..,....... MA Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 4/8/2008 Rev-1508 EX+ (6-88~ COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruby J. FILE NUMBER 21-08-0398 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntlyowned vvitlf fha right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 PNC Bank -Checking Account No. 5140208463; date of death balance $667.41; 667.43 accrued interest $0.02 2 Rite Aid -Rebate 1.00 3 Stonebridge Life Insurance Company -Refund of unearned premium for accidental 23.52 life insurance policy. 4 Personal Properly -Sold at private sale 50.00 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY TOTAL (Also enter on Line 5, Recapitulation) I 741.95 (If more space is needed, additional pages of the same size} Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98} PNCBANC The ihinking Behind The Money Apri115, 2008 Ja~roCS D Bogar Attorney at Law • Jennifer Hipp One W Main St Shiremanstown, FA 17011 RE: Ruby J Myers (Deceased) SSN:181.32.4446 DOD: 02-06-2008 Dear Ms. Hipp: In response to yaur request for Date of Death balances for the customer noted abovo, our records sbow the following: Checking Account Account # 5140208463 Established QS-30.1991 RUBY J MYERS DOD balance: $667.41 + 0.02 accrued iritcrest Please note that this office omly provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process auey ffnancia! ~nsnc~ons or p~v;de 3~tements. L~'yeu nerd sssistsnce with sny of +hese i*.ems, please call 1-888-PNC-BANK (1-888-762-2265} or stop by your local PNC Bank branch of5ce. Sine ly, ~' ~~~%\./~ Co Crow er 1-800-762-1775 P7-PFSC-04-F 500 First Ave Pittsburgh, PA 15219 Member FDIC REV-1151 EX+ (12-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE'TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Myers, Ruby J. 21-08-0398 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL FJCPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Persona! Representative's Commissions Social Security Number(s) i EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorneys Fees Bogar and Hipp Law Offices 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. I Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. I Other Administrative Costs 5,256.00 61.00 TOTAL (Also enter on line 9, Recapitulation) I 5,317.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1502 EX+ t6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Myers, Ruby J. 21-08-0398 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) REV-1613 EX+ (9-0O) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Myers, Ruby J. 21-08-0 398 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not List Tru s) (Words) ($$$) I • TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Sherry J. Cline Daughter One-third of 4 N. Second Street rest, residue Lemoyne, PA 17043 and remainder Ruby L. Fleming Daughter One-third of 20 N. Second Street rest, residue Lemoyne, PA 17043 and remainder Angela M. Myers Daughter One-third of 724 North Front Street rest, residue Lemoyne, PA 17043 and remainder Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r sheet II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO 7AX 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 ~ 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)