The URL can be used to link to this page

Home My WebLink About10-28-0815056041147 ~ -- REV-1500 EX (06-05) OFFICIAL U PA Department of Revenue E ONLY County Code Bureau of Individual Taxes Vear File Number INHERITANCE TAX RETURN PO BOX.280601 2 1 H i b - RESIDENT -- 0 8 ~ ~ ~~ arr s urg, PA 17128-0601 DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 171284474 01222008 10131935 Decedent's Last Name Suffix Decedent's First Name MI MYERS GLORIA S (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 DUPLI ATE WITH THE REGISTER OF WIL S FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remai der Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa Future Interest Compromise ^ 5. Feder I Estate Tax Return Required (date of death after 12-12-82) ® g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 8. Total (Attach Copy of Will) (Attach Copy of Trust) umber of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (date of death 11. Electi between 12-31-91 and 1-1-95) ^ n to tax under Sec. 9113(A) (AttaC SCh. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INF Name MATION SHOULD BE DIRECTED TO: Daytime T lephone Number GREGORY M KERWIN 7173 23215 Firm Name (If Applicable) KERWIN & KERWIN REGIST R OFFALLS USE ONLY = ~ First line of address t i ;'-, - 4245 ROUTE 209 ,1,.f ,, Second line of address City or Post Office State ZIP Code DATf:F1t~D .^ _~ ELIZABETHVILLE PA 17G23 ~.~` Correspondent's a-mail address: g m k e r W i n@ h o t m a 11. C O m Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge anri belief it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of whic , preparer has any knowledge. SIGNATURE OF„R~RSON RESPONSIBL FO I RETURN ( ~~ DATE /] ti' Richard E. Myers ~ ~ 2 7-d~ ADDRESS 109 South 17th Street, Camp Hill, PA 17011 U_-~ SIGNATUR F P PARER OTHER TH REPRESENTATIVE DATE Gregory M Kerwin ADDR SS 4245 Rout 209, Elizabethville, PA 17023 Side 1 15056041147 15056 41147 J REV-1500 EX 15056042148 oecedarn'S Name: M Y E R S, G L O R I A S RECAPITULATION 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) ^ Separate Billing Requested ........... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ........... .. 7, 8. Total Gross Assets (total Lines 1-7) ..................................................................... .. g. 9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... .. 9. 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/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. 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 .00 8 4, 1 8 6 2 4 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15056042148 15 Decede 's Social Security Number 171284474 87,302.24 87,302.24 3,116.00 3,116.00 84,186.24 84,186.24 0.00 0.00 148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 08 Myers, Gloria S TREET ADDRESS 109 South 17th Street ITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty STATE ZIP PA 17011 (1) 0.00 Total Credits (A + B + C) Total InteresUPenalty (D + 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. (2) 0.00 (3) 0.00 (4) (5) (5A) (5B) 0.00 ~.~0 Make Check Payable to: REGISTER OF WILLS, AG NT a... r .~ . ...._...... ,. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN TH APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................................................................. ~ ~ z ~ 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 o death without receiving adequate consideration? .................. ................................................................................................ ~~ ~ XJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or h r death........ ~-' [x . _ J ~~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property w ich contains a beneficiary designation? .................................................................................................................... ~.~ ~~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AN 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 t ansfers 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 us 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, a d the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficia 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 eath 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 a done-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) perce t [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. SCHEDULE B COMMONWEALTH OF PENNSYL ANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT __ I ESTATE OF Myers, Gloria S UMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION U~ NUMBER -- - - -- -- - - -.- r. __ 1 14 Series HH Bonds dated from 07/1997 and 08/1998 total face value $39,500.00 I 2 1081 Shares AT&T 3 140 Shares Vodafone Group PLC '~, 4 5 shares Fairpoint Communications, Inc. 5 ~ 174 shares Qwest Communications i 6 ' 29 shares Lucent Technologies Inc. 7 197 Shares Comcast Corporation 8 144 Shares Verizon Communications, Inc. ~' 9 j 14 shares Idearc Inc. IT VALUE VALUE ,AT DATE OF DEATH 39500. 39, 500.00 35.96 I 38, 872.76 3.51 491.40 11.01 55.05 5.44 ~ 946.56 5.70 ~ 165.30 16.65 1,615.05 37.83 5,447.52 14.90 208.60 TOTAL (Also enter on line 2, Recapitul tion) i 87,302.24 SCHEDULE H FUNERAL DCPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN A X111 AINIC~Tfl A Tr /C ~+~1C~1Y RESIDENT DECEDENT /'~LJIr~ h7 ~ rW ~ NYC VW ~ J ESTATE OF Myers, Gloria S Debts of decedent must be reported on Schedule I. ITEM - - - ---- -_ -- - NUMBER I DESCRIPTION FUNERAL EXPENSES: A. B. ~ ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s)' Street Address City State Zip Year(s) Commission paid 2. ~ Attorney's Fees Kerwin & Kerwin -- Gregory M Kerwin 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 a. Probate Fees Register of Wills 5. Accountant's Fees 6. III Tax Return Preparer's Fees 7. ~ Other Administrative Costs 1 Notary fee on Affidavits of Domicile FILE UMBER 21 - 08 AMOUNT 2,750.00 144.00 45.00 TOTAL (Also enter on line 9, Recapitulation) 3,116.00 I~ Schedule H Funeral E~er~ses & COMMONWEALTH OF PENNSYLVANIA /~~ INHERITANCE TAX RETURN /~,~~n~~ ~'~ confinued RESIDENT DECEDENT ESTATE OF Myers, Gloria S 2 Register of Wills, short Certificates 3 Mid Penn Bank, signature guarantees 4 Register of Wills, filing inheritance tax return 5 ,Reserved for closing costs FILE UMBER 21-0 -- 12.00 35.00 30.00 100.00 2 of Schedule H REV-1513 EXr (9-OO) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE UMBER Myers, Gloria S ~ 21 - 08 RELATIONSHIP TO 1 SHARE OF ESTATE AMOUNT OF ESTATE NUMBER I. 1 NAME AND ADDRESS OF PERSON(S) DECEDENT RECEIVING PROPERTY Do Not List Trusteels) - - _ _ _--- rt- --. ___- -- . TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Richard E. Myers Spouse 109 South 17th Street Camp Hill, PA 17011 Entire E Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 c 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 rds) ~I ($$$) sheet SHEET 0.00 LAST WILL AND TESTAMENT I, Gloria S. Myers, a resident of the Borough of Camp Hill County, Pennsylvania, being of sound and disposing mind, memory ing, do make, publish and declare this as and for my last Will hereby revoking and making null and void any and all Wills and writings in the nature thereof, by me at any time heretofore ma Cumberland and understand- and Testament, Testaments, or de. I. I nominate, constitute and appoint my husband, Richard Myers, to be Executor of this, my last Will and Testament. Should a substit to or successor be required, I nominate, constitute and appoint as such my son, Jeffrey S. Myers. I direct that neither. my said husband nor my said son shall be quired to gives bond for the faithful performance of his duties hereunder in t 's or any other jurisdiction, and that if, notwithstanding this direction, any and is required by any law, statute or rule of court, no surety be required the eon. II. I give, devise and bequeath all of my property and est te, of whatsoever kind and wheresoever situate, of which I shall die seized or po sessed, or of which I shall be entitled to dispose at the time of my death, t my husband, Rich- ard E. Myers, the same to be his absolutely, provit3ing my said usband survive: me by a period of three (3) months. III. In the event my said husband, Richard E. Myers, shoul fail to survive me by a period of three (3) months, then I give, devise and be eath all of my property and estate, of whatsoever kind and wheresoever situate of which I shall die seized or possessed, or of which I shall be entitled to dis ose at the time of my death, in equal shares to my son, Jeffrey S. Myers, and daughter, Vic}ci L. Mathias, the same to be theirs absolutely. IN WITNESS WHEREOF, I have hereunto set my hand and seal t this, my last Will and Testament, this ~ day of August, 1989. .-'~ ~- ~ ~ ~ ~ i e~ ~- , ~ , '_ ~ cv °- ~ -, ~ ~ ( Seal ) ~. - L ~` Gloria S . M e -- ~ ' ~ _. ~--~ ~ :: _ ~ _ J'". - J L~ -~ .. - c:~ ,~~ L~ CV