HomeMy WebLinkAbout12-30-0815056051058
' REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue Coun Code Year File Number
Bureau of Individual Taxes ~
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 °~ RESIDENT DECEDENT 21 08 0554
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
203-10-5237 05/03/2008 ' 05/07/1920
Decedent's Last Name Suffix Decedent's First Name MI
Stahl ', George R
(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
M' 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required
death after 12-12-82)
1> 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 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
John M. Eakin (717) 766-3172
Firm Name (If Applicable)
REGISTER OF WILLS USE ONJ,Y~
First line of address ~ ~ ?
~__
Market Square Building -
Second line of address .,
~=>
City or Post Office State ZIP Code DATE FIL€D ~.
Mechanicsburg PA 17055 - •--•
1
Correspondent's a-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,
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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
L , DAT
/~
ADDRESS ///r~
601 Whitetail Drive, Lewisb rry, PA 17335
SIGNATURE OF PREPAR~R OTHE N EPRESENTATIVE DATE
~ y f ; y -- - - - - - ~-1 [y-c~ a G
ADDRESS
Market Square Building, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
I~
REV-1500 EX
15056052059
Decedent's Social Security Number
Decedent's Name: G@Org@ R Stahl 203-10-5237
RECAPITULATION
1. Real estate (Schedule A) . .......................................... .. 1.
2. Stocks and Bonds (Schedule 6) ..................................... .. 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) .................................. .. 8.
9. Funeral Expenses & 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 .0_ 15.
16. Amount of Line 14 taxable
at lineal rate x .0 45 3,430.09.
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
15056052059 Side 2
L~
1,200.00
5,369.75
6,569.75
1,551.00
1,588.66
3,139.66
3,430.09
3,430.09
154.35
154.35
15056052059
REV-1500 EX Page 3 File Number
uecealenrs wmpie><e f-aaress: ~ ~ ~o ~~~~+
DECEDENT'S NAME DECEDENT'S SOCIAL SECURfTY NUMBER
Geol-ge R Stahl 203-10-5237
STREET ADDRESS
107Ei-13 Lancaster Boulevard
- - -- -
CITY ~ STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Clue (Page 2 Line 19) (1) 154.35
2. Credits/Payments
A. Spousal Poverty Credit _ _
B. Prior Payments
C. Discount _ _ _ _ _ -
Total Credits (A + B + C) (2)
3. InteresUPenalty if applicable
D. Interest
__
E. Penalty
Total InteresUPenalty (D + E) (3)
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 Lines 1 + Llne 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 154.35
A. Enl:er the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 154.35
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 .......................................................................................................................... ^
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? ........................................................................................................................ ^ 0
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 ar 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 isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV 158 EX+ (6-98}
~~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
S~FIEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
George R. Stahl 21-08-0554
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.
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (5-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE 7AX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
George R. Stahl 21-08-0554
SCHEDULE F
JOINTLY-OWNED PROPERTY
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Christine Stahl
820 Lisburn Road
Camp Hill, PA 17011
Daughter
B.
C
JOINTLY-OWNED PROPERTY:
ITEM
NUMBEiR LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NA69E OF FINANCIAL INSTITUTION AND BANK ACCOUNT NU618ER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET °/ OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
~ ~ A' 12/15/79 PSECU Account # 0203105237 10,739.49 50 5, 369.75
TOTAL (Also enter on line 6, Recapitulation) I $ 5,369.75
(If more space is needed, insert additions{ sheets of the same size)
COMMOlJWEALTH OF PENNSYLVANIA
DEPAR1fMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRI::BURG, PA 17128-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV-1543 EX AFP (p9-pp)
FILE N0. 21
ACN 08124094
DATE 05-28-2008
CHRISTINE D STAHL
820 LISBURN RD
APT 714
CAMP HILL PA 17011-7470
TYPE OF ACCOUNT
EST. OF GEORGE R STAHL ~ SAVINGS
S.S. N0. 203-10-5237 ® CHECKING
DATE OF DEATH 05-03-2008 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0203105237-S4 Date 12-15-1979
To insure proper credit to your account, two
Established (2) copies of this notice must accompany your
Ac(:ount Balance 10,739.49 payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to TaX 5, 369.75 NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
Ta,( Rate X .045 You may deduct a 5; discount of the tax due.
Potential Tax Due 241 .64 Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
C H E(:K a discount or avoid interest, or you may check box "A" and return this notice to the Register of
0 NE= Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0(:K ~ B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania
0 N L Y to be filed by the decedent's representative. Inheritance Tax return
C. ~ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART If you indicate a different tax rate, please state your
relationship to decedent:
TAX RETURN
- COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE ]_ Pita Fstablished
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
0
DATE PAID PAYEE
2
3 X
4
5
6
7 X
8
DEBTS AND DEDUCTIONS CLAIMED
nGCrororrn.r
-- -- -•• - ~ wmputailon/ $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
HOME ( )
WORK ( )
TAXPAYER SIGNATURE rrr rounr.i~ .,,~..,,~.,
EV-1511 EX+ (12-99)
SCHEDULE N
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
George R. Stahl 21-08-0554
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t' Cremation Society, death certificates 55.00
2. Mechanicsburg Cemetery, burial 250.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) Marcia Draisey
street Address 601 Whitetail Drive
c;ty Lewisberry state PA zip 17339
Year(s) Commission Paid: 2008
2. Attorney Fees
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. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Register of Wills -Filing Fee
s. Haar's Auction, automobile auction
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
450.00
450.00
91.00
15.00
240.00
1,551.00
~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
~eclrge R. Stahl 21-08-0554
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
If more space is needed, insert additional sheets of the same size.
pennsylvania SCHEDULE ]
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ge~xge R. Stahl ~~_nR_n~~d
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not List Trustee(s) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 2116 (a) (1.2).]
1. Christine Stahl 820 Lisburn Road Apt. #714, Camp Hill, PA 17011 Daughter Entire Estate
I
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN A80VE ON L1NES 15 THROUGH
18 OF REV-1500 COVER SHEET, A
S APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS;
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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.
LAST WILL AND TESTAMENT
OF
GEORGE R. STAHL
I, GEORGE R. STAHL, of the Township of Upper Allen, County of Cumberland
and State of Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament, hereby revoking and making
void any and all former Wills by me at any time heretofore made.
1.
Upon my death, I direct that my body be cremated by the Cremation Society of
Harrisburg and my ashes be interred on my daughter's grave Lot 22, Row E, Section 12,
in the Mechanicsburg Cemetery. I want cremation without embalming or display of the
body; I want no funeral or memorial service. If the Cremation Society is non-existent,
then Nei11 Funeral Home, Harrisburg, Pennsylvania, can perform the service. I am a
member of the Memorial Society of Harrisburg, Pennsylvania.
2.
I direct the payment of all my just debts and funeral expenses as soon after my
death as the same can be conveniently done, including the payment out of the principal of
my general estate of all inheritance, estate and succession taxes which may be assessed in
consequence of my death.
3.
I give, devise and bequeath all the rest, residue and remainder of my estate, real,
personal and mixed, whatsoever and wheresoever the same may be situate, to my
-I-
daughter, CHRISTINE D. STAHL, absolutely and unconditionally.
In the event that my daughter, CHRISTINE D. STAHL, should predecease me,
or should she die within thirty (30) days from the date of my death, then in either such
event, I give, devise and bequeath all the rest, residue and remainder of my estate, real,
personal and mixed, whatsoever and wheresoever the same may be situate to my good
friend, MARCIA DRAISEY, absolutely and unconditionally.
LASTLY, I nominate, constitute and appoint my good friend, MARCIA
DRAISEY, to be Executrix of this my Last Will and Testament and direct that she be
excused from posting bond or other security for the faithful performance of her duties, in
any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this !t~'~
day of April, 2008.
~''%~
~~~~. ~ ~ (SEAL)
George R. Stahl
-2-
COMMONWEALTH OF PENNSYLVANIA )
SS
COUNTY OF CUMBERLAND )
I, GEORGE R. STAHL, the testator, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the same instrument as my Last Will and
Testament; that I signed it willingly, and that I signed it as my free and voluntary act and
deed, for the purposes therein expressed.
~~~~ ~ ~'` EAL)
Geor e R. Stahl
Sworn and subscribed to before
me this «~1' day of April, 2008. ..
NOTARWL SEAL
~,t~ HEIDI M NELSON
~~/ /~~. ~~~~ Notary Public
Notary Public M~+~cu~nrooot~nny
My Commission Expires Jun 27, 2011
COMMONWEALTH OF PENNSYLVANIA )
SS
COUNTY OF CUMBERLAND )
I, the undersigned, JOHN M. EAHIN, the witness whose name is signed to the
attached or foregoing instrument, being duly qualified according to law, depose and say
that I was present and saw the testator, GEORGE R. STAHL, sign and execute the
instrument as his Last Will and Testament; that the said testator executed it as his free
and voluntary act for the purposes therein expressed; that I, in the hearing and sight of the
testator, signed the Will as witness; and that, to the best of my knowledge, the testator
was, at the time, eighteen (18) or more years of age, of sound mind, and under no
constraint, duress or undue influence.
~`Y ~ ,
Sworn and subscribed to before
me this ~5~~ day of April, 2008.
Notary Public
_~
NOTARIAL SEAL
HEIDI M NELSON
Notary Public
MECfYVVCS8lJt2GBOROUG!{
My Commission Expires Jun 27, 2011
-3-