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Home My WebLink About11-07-08 (2)i 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes .`~'~~ "' f"mom' "M'°a'~I PO BOX 280601 INHERITANCE TAX RETURN ~ ~ ~ ~I; '~ Hamsburg PA 17128 0601 RESIDENT DECEDENT ~ ~ ~~, ~' 3 12 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 'l ~ a I ~~1 ~ ~ o a'~ ~..5 ~ o o g + trut~~° ~ ~~ t e Decedents Last Name Suffix Decedents First Name MI (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 IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 4. Limited Estate O 4a. Future Interest Compromise (date of death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return (date of death prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 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 l~I4-~ 1 D ~vNOE_~.i r-R 3~ ~ ~'s~~(~~~ Firm Name (If Applicable) REGIST ILLS US~NLY __ First line of address 3 .~ t ~ s~ 1 ~- ~~, Second line of address Ci11ty or Post Office L ~ N ~ 1 w ( -2 A State !ti D ZIP Code ~ ~~ ~ ~ Y Correspondent's a-mail address: ~y ^' l ~ ~ ~ Q ~- `~, /~-' ~-- C.a ~'^- ~~~ ~ 3 -DATE FILED ~ 'C t'r1 1 _`"S f t1 _,4..1 C;~) •r 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 Uue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG TURE OF~PpERS RESPONSIBLE FOR FILING RETURN DATE ~~ ~'~~~ 1(~eblu~ ADDRESS c ~ ~ -~ S h~~~ Ise D 2 ~1)cx~~.,.~(, 14 ~) ~ ~ > i Y SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 15056051047 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 J 15056052048 REV-1500 EX Decedent's Name: ~~ ~, ` ~ ~ ~ ~ `~ ~'L~N Decedent's Social Security Number ~ C~ . ~ ~ ~ ~, ~ t RE CAPITULATION 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. ~ _I ~ ~~ ~ ~ l 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. , 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. , 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. ~ ~ ~ ~ ~ 9. Funeral Expenses 8 Administrative Costs (Schedule H) ................... .. 9. 3 j `{ ~ *~ S' `~' 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. t (o,. ~ 0 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 3 j ~ ~ C~ 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ~ ~ ~ ~{ ~~ 3 tj 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. y V ~- ~(, 3 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_ . 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ . 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 y ~ ~- ~~. 3 ~ 18. ` (, 3 , L ~" 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 J 2 REV-1500 EX Page 3 llnrnrion+'c f'_mm~la~+P_ O['~[~1'ESS: File Number DECEDENT'S NAME - -- - - __ __. STREET ADDRESS ~3~ wask.cl ~2 /~Pr:.- von'- -- - _ --- CITY STATE ZIP ~~ ~ 7o~-s IH e c,~~ti-mss ~ w- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~ G 3 , G ~ 2. Credits/Payments A. Spousal Poverty Credit --- B. Prior Payments - -- C. Discount -- - -- - - - Total Credits (A + B + C) (2) C7 3. InteresUPenalty if applicable D. Interest __ --- - E. Penalty - - Total InteresUPenalty (D + E) (3) C7 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) ~ 6 3. ~ ~~ A. Enter the interest on the tax due. (5A) ~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ 6 3, 6 ~ 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 : ............................................ ^ 0 c. retain a reversionary interest; or .......................................................................................................................... ^ 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? .............................................................................................................. ^ 3. Did decedent own an "intrust 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)J. 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, whether by blood or adoption. REV-1508 EX+(137) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~.~ ~ ~,~ ~ ~... (< s~ q w . t ~~~ 5 f . I~ M. ~ w ~~ ~~ ch~,lc~ as ~y ~~ ~~ a, ~ i ~ .1 ~ F,.,~l ~..~ (~.~k 5~t9 n,. f~K s r, ie ~~~r., /'A . s.a~«~3 9q~3 -~v t1'~ ~{~ t"~~ ( ~? e~, ~ ~ ~ cx„ Q+~rs lv'~-r• ~ 4~ S-4.h, ~ 3 3 S 4,0> (et o d~ . 1 1. 3 . c~-o TOTAL (Also enter on line 5, Recapitulation) I ~ ~ ~ ~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. ~. FUNERAL EXPENSES: IMu>,lec..~,.~ I-~~.Jt t~c~ ~kaw1«~~~ t ~ ari6.~3 Ra., ,S. f3~~w-,,., 17. ~awett ~ ~rati~ ~~~-~i.. ~~..e_ ;~.ao. Qo ~ ~ ~9 ~ C.u Yu tU O~ r A ~ 5 4 .1-c. r ~ ~~J ~o ~~w~.~, ~~,,,>,.,~t, - ~ ~~.~I~~ a~ ~.~a r!~~ 1~c w ~ C4 v. , l l -~..,ea. ~ Vie t*~ ~ 4 u.c-~.-1 ~ a.l J`, ~- Q I c ~.W wRrs 1 ~( dy . a' 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 Relationship of Claimant to Decedent _ __ __. 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. S~oJ2T G21r~~ ~c~. i~os~Se ~pG~+a r Zip ~S,~O ta~ o~ 1~ -~~ a~.~- ~~ TOTAL (Also enter on line 9, Recapitulation) ~ $ S. S y- ~'. ~ ~ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ~___.. ~_~._ :........sa ti...tie ae,.e,~o~+ ~.~~. f~ dpa~n which remained unsaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) ' REV-1513 EX+ (9-00) SCI~IEDVLE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. ~~~ \o~u~~ (~t~ [x.14 5t-~~~ D2_ ~~~~ ~--yq..~n~....s 1 ~~- !J ~~Y ~~ol ~~.s~,~ ~~~ ~~ S~ . ~JGI ~/ Mp~L./-4n.ic36~ Q/~- IZ4S~ j3Q 1, w ~ ~- ~ ~~~ ~ \ b' l S t ~~ 1-l , l t 2.a °"~ alb I-1a~,~a3~,lte c Pp . I ~ `l3~ ~ `` /f~J y~ f ~~~O112G ~~ tT~ . O~S~~J l ~~tIQ ~H~4~~.,~. ~3' ~1 Slttt~0.~e~`la., ~Q, ~`~ ~~~ D~kM~ ~ M.A zO~~ ~( ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 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. 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) 13EGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2008- 00392 PA No . 21- 08- 0392 Estate Of : PAUL E MCCLAREN 1Frrsr, Midge caul Late Of : COjMBER ND COUNTY l P Deceased Social Security No : 162-12-7410 WHEREAS, on the 7th day of April 2008 an instrument dated November 22nd 2000 was admitted to probate as the last will of PAUL E MCCLAREN (Fsst, Middle, LesU late of LOWER ALLEN TOWNSH/P, CUMBERLAND County, who died on the 28th day of March 2008 and,. WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: DA V/D L FONDEL/ER who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VAN/A. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 7th day of April 2008. * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ~:, .. ~~.~# `~U1i1~ ~.~z~ `~' .e~~~ttt.~zt.~ OF PA~tJ L L. 1VICCLAi~r:N I, PAUL E. McCLAREN, of the Lower Allen Township, Cumberland o .r s. ,_s .~~ County, Pennsylvania, being of sound and disposing mind, memory a~ ~ ~ ,_ - din do hereby make, publish and declare this my Last Will~.a~t~ ~ ~ `: understan g, .._ ~, ~ r : j Testam ~ ~ ent. t ~~ o , - '~~' v~ ~ I direct the payment of all my just debts and funeral expenses as soon afterQ' my decease as the same can conveniently be done. 2. 1 direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreitJn s~overnment or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, in'r-eritance or like tax purposes by any of such govvrtunents, whether the property passes under this will or otherwise. 3. I give, de~,~ise and bequeath to my ent~'re estate, real, personal and mixed in equal shares to my nieces and nephews as follows: AL~REY L(?WRY, -~- pass instead to his or her heirs. 5. Lastly, I nominate,. constitute-and appoint my nephew, DAVID FONDELIEI:t, to be Executor of this my Last. Willard Testament- I further direct.. that no bond or other security be required of my personal representative to guarantee faithful performance of his duties. IN VVI'rNESS WHEREOF, I have hereunto set my hand and seal -this ~ 2 r~ day of November, 2000. y {SEAL) a wren Signed, sealed, published. and declared by the above named PAUL E. McCLAREN as and for his Last Will and Testament, in the Presence of us who have subscribed our names hereto as witnesses, at his request, in his presence and in the presence of each other.. ~. -2-