HomeMy WebLinkAbout02-18-09 5056051047
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Coun Cade Year File Number
Bureau of Individual Taxes .. ~..~~ ~~~.. ~~~~~I~~~
PO BOX 280601 INHERITANCE TAX RETURN
. .• HemsburQ, PA 17128-601 RESIDENT DECEDENT ~ b ~
(If Applicable) Enter Surviving Spouse's Information Below
Date of Birth
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nl~ nR_... siwsma.lo~l_i~s
Decedent's First Name MI
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0lYNlib. ~ OIrA... NIS!'
Spouse's Cast Name Suffix Spouse's First Name MI
E [. ~. o R ~ E
M MRMP ~ M~11~ W.YI111 Itllll
S Ouse's Social Securit Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
~ ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82)
O ' 4. Limited•Estate•, O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
' ~ death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O >9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 CONFID ENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
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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.
AD ESS
7~
P4EASE USE ORI(il AL FORM ONLY
Side 1
15056051047 15056051047 J
SI~T~E~~ PREPARER OTHERRjHAN REPRESENTATIVE ~ r iAI t ~~
15056052048
REV-1500 EX
Decedent's Name:
Decedent's Social Security Numher
RECAPITULATION
- ~ -
1. Real estate (Schedule A): ,:...t ... ~.........:: ............:... . ~,:.. ~. . `1.:i ~'.
2. Stocks and Bonds (Schedule B) .................................... ... 2. ~J
~'..X.'h
3. :~. ~ ..
Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..
... 3.
4. Mortgages ~ Notes Receivable (Schedule D) .......................... ... 4.: ;..~ ,~
' .~~
' S. Bank Deposits & Miscellariebus Personal Property (Sche~ule E) .....
Cash ... 5.
,
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. ~ -'
..., ,~.-.~..~+7Yr~f .
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 & Administrative Costs (Schedule H) ..................... 9. .
9 9 ( ) ..............
10. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I . 10. _ `
~;
11. Total Deductions (total Lines 9 & 10) ................................. 11.
;-
12. Net Value of Estate (Line 8 minus Line 11) ......... .................. 12.
... ,;, ~ ~ s,~:.,gi~
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an etectionao~tax~has not been made (Schedule J) .................... . . . 13 .: t
. ~ ,~~
........................14.
14. Net Value Subject to Tax (Line 12 minus Line 13) ~ ,, .
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.
S'~'s
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17. Amount of Line 14 taxable '
Ir 1irP
at sibling rate X .12 17
18. Amount of Line 14 taxable
15
at collateral rate X
~ ~ 18 ~
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19. TAX DUE .................................................... .....19. '. _ .~_
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Side 2
15D56052048 15D56052048
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
DECEDENT'S NAME
STREET ADDRESS
~' ~ ~lJ~. ,~~W.1~i~/3l,L~Q1 ~ 1 . ~
CITY C AM n
C L ~ STATE ~ ZIP
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Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments _
C. Discount
Total Credits (A + B + C) (2) 0 . ~ ~
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) Z5. ~~
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) p ~ d
A. Enter the interest on the tax due. {5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
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? ........ ...... ^
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)J. The statute does not exem~ 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-hail (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 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-1511 EX+ (1Q-O6)
SCNEDt~LE H
COMMONWEALTH OF iPENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATNE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
~ 1f>R.O ~l~tt E 1fl t/ 'l.l-Dg~r~QG1-~
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
i.
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
2.
3.
4.
5.
6.
~.
9~
9.
{~,
City
Year(s) Commission Paid:
Attorney Fees ,~~ ~ ~
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant L~tN~ ~i~~~-Q 3y~j,~1>~
Street Address L''
City _ ~~ J~+~ P ?~\~~.• State Zip ~ ~~ I ~
Relationship of Claimant to Decedent w~'~
Probate Fees
a<g~~ !7~
Accountant's Fees
Tax Return Preparer's Fees
° ~ ~tL~S - ~ 1tr~ ~1 A~ R~~~vR4~1
~~~
E Ow,~ao Jc,,~`~ "T~ ~ iR ~~ $ ~ an
Po~"~i66
3gy
TOTAL (Also enter on line 9, Recapitulation) I $ 1-y,~,~.., f'~ 7, ~ l~
State Zip
(If more space is needed, insert additional sheets of the same size) `~
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDt~LE J
BENEFICIARIES
ESTATE OF FILE NUMBER
~u~Ait C1 f!' ~ t ~i [?_!t-F f h '~ 4~~ ~ ll~ - t71Y~?:L
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not LfstTrustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under ,
1. Sec. 9116 (a) (1.2)]
L.OR~iN~ /~'• k45GH~p -~Ib 5'EI~cA At1l±.,
WIE~
~P ~11~,
G ~~ _ ~ ~~I I
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I
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
1 A. SPOUSAtL~ DISTRIBsUIT~If~ S_U~I D~ ~ FUCTION 91 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
~ RF.S I'V~+ ~11~I~y ~ ~7.~'T
(~~'~'t!
;
~~1~~f~r.Q~
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U
X03. ~b~~ SHE of $4Ec.YRq ~N~Ca-~P Q~,5.~1 5.4-q
1~64
~ t t ~3 . `bg36 $tl ARIES d f ~ ~'~ ~ t.l.A• 3 3 .
µ~57~•g9
~• l~aws~->= L.~r AaD fi~JofrI~N61-o1'-~g~L ~N~r-A ~1vE . ~d~sER A~.~N Iwo.
~w~~-~.(~-A~ CAw,~ , ~ ~ 0~>r o ,Bops °o~D~ f~. `$~ ~' 24- !Ur ~1
i` '
~~~~r ~
X
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N~M
4P o~
c
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~Scx~,o , th~~ ~ w~ ~ ~a~, 4~ ~~~
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. p,o~
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ~.~,~ 31 ~3
(If more space is needed, insert additional sheets of the same size)
M ' ~S.
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OF
EDWARD A. ELSCHEID, II
I, EDWARD A. ELSCHEID, II, of 3816 Seneca Avenue, Lower Allen
Township, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do hereby make, publish
and declare this to be my Last Will and Testament, hereby revoking
all other Wills and Codicils previously made by me.
ITEM I: I direct the payment of all my just debts,
expenses of my last illness, funeral expenses, perpetual care of
my burial. lot, suitable marker for my grave and the costs of
administrating my estate from my estate as soon after my death as
conveniently may be done.
ITEM II: I give, devise and bequeath all the rest,
residue and remainder of my property, real, personal or mixed,
tangible or intangible, of whatsoever nature and wheresoever
located and all property to which I may be entitled or over which
I may have any power of disposition or appointment and ~.~hether
acquired during or after my lifetime to my wife, LORRAINE A.
ELSCHEID, provided she survive me by Ninety (90) days. In the
event my wife predeceases me or dies within Ninety (90) calendar
days or my death then I give devise and bequeath all the rest and
residue .as follows:
(1} All guns, hunting and fishing equipment to go
equally to EDWARD ELSCHEID, MATTHEW ELSCHEID, my two sons and JASON
PULCHALSKY, my grandson and in the event they cannot divide it
LAST WILL AND TESTAMENT
tl~eees+e2s~es then BDM1~lRD ELSCHEID to make division in his
discretion and it need not be totally equal in values.
(2) In the event my grandson, JASON PULCHALSKY is under
25 years of age at the time of my death then $35,000.00 to go to
CHRISTINE ELSCHEID PULCHALSKY, in trust, to be used for the
educational or occupational training of JASON PULSCHALSKY and in
sole discretion of my Trustee to be used for these purposes even
though.... he becomes older .,
,~
used far this purpose when Jason attains 30 years of age to go
equally to my then living grandchildren and in the event said Jason
Pulchalsky if over 25 years of age at the time of my death then
$35,000,.00 to be divided equally to my then living grandchildren.
(3) All the rest residue and remainder of my property
to go to my three children namely, EDWARD ELSCHEID, MATTHEW
ELSCHEID and CHRISTINE ELSCHEID PULCHALSKY.
ITEM III: I direct that any and all taxes that may be
assessed in consequence of my death, including all Inheritance,
Estate and Transfer Taxes imposed upon my estate passing under my
Will or otherwise, shall be paid out of the principal of my
residuary estate as a part of the expense of the administration of
my estate.
ITEM IV: I authorize and empower my personal representative
andjor said Trustee representative may deem proper, all debts and
claims owed by or to me or my Estate; to sell, lease or exchange
at public or private sale or in such manner, at such prices, and
upon such terms of credit or otherwise, as my personal
representative or said Trustee may deem proper, all or any part of
.ary property, :real or personal; to execute, acknowledge and deliver
instruments of conveyance, including deeds in fee simple; to borrow
money for the purpose of paying estate, inheritance or other taxes
which are required to be paid and to secure any such loan by pledge
or mortgage of all or any part of my property and to execute the
necessary instruments to carry out such powers; to distribute my
estate in kind or partly in money or partly in kind, and to
deter~aine the fair value at ..which .aa
kind shall be received by the distributees; to conduct any business
in which I have an interest at the time of my decease, for such
period as my ;personal representative may deem proper, power to
borrow money and pledge assets of the business and the power to do
all other acts that I, in my lifetime could have done, to delegate
such power to any partner, manager or employee without liability
for any loss occurring therein and to organize a corporation to
carry on said business as capital to such corporation and accept
stock in the corporation in lieu thereof and hold such stock for
the uses of this my Will, and to vote said stock or sell the same
as to my personal representative may seem best; to retain all
stocks, assets, bonds and investments owned by me without being
confined to what is known as legal investments; to execute any
options to purchase, to apply for stocks, bonds or otner
investments, to purchase or otherwise acquire real estate and to
execute the same powers thereover as hereinbefore provided, to
retain indefinitely any part of my assets, real or personal, which
is or may become unproductive or to make sale thereof; to pay
carrying charges and expenses of the property out of other
~~~.1 as ix~caorae of sry estate; to invest and reinvest in a21
forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to
the principle of diversification or risk; to exercise any law-given
option to treat administrative expenses either as income tax or as
estate tax deductions, without regard to whether the expenses were
paid fz•om principal or income. The powers herein conferred shall
bQ to sy aa~d per;~~.~?
successors thereto and shall be in addition and not in limitation
of other powers conferred on said fiduciaries.
Any and all payment or payments of any sum or sums,
whether in cash or in kind and whether far principal or income,
payable to any beneficiary shall be made upon the sole receipt of
the respective beneficiary to whom the payment is made, and free
from anticipation, alienation, assignment, attachment, and pledge
and free from control by the creditors of any such beneficiary.
All shares of principal and income hereby given shall be free from
anticipation, assignment, pledge or obligation of the beneficiaries
and any of them and shall not be subject to any execution or
attachment, levy or sequestration or other claims of the creditors
of said beneficiaries or any of them.
ITEM[ V: All shares of principal and income hereby given
shall be free from anticipation, assignment, pledge or obligation
of the beneficiaries and any of them and shall not ~be'subject to
any execution or attachment, levy or sequestration or other claims
of the creditors of said beneficiaries or any of them.
' I'!!~t YI: I nominate, constitute and appoint ay wife,
LORRAINE A. ELSCHEID, as Executrix of this my Last Will and
Testament, to serve without bond. In the event of the
renunciation, death, resignation, refusal or inability of my wife
to act for any reason whatsoever I nominate, constitute and appoint
EDWARA ELSCHEID, MATTHEW ELSCHEID and CHRISTINE ELSCHEID PULCHALSKY
sole Executors of this my Last Will and Testament to serve without
bond.
IN WITNESS WHEREOF, I, EDWARD A. ELSCHEID, II, have, to this
my Last Will and Testament, set my hand and seal this ~~.a~
day of v~ , 1995 .
z ~
(SEAL)
EDWARD A. ELSCHEID, II
Signed, sealed, published and declare by EDWARD A LSCHEID, II,
the above-named Testator, on the d) day of ,
1995 , as and for his Last Will and Testament in he presence of
us, whop, in his presence and in the presence of each other have,
at his request, subscribed our names as witnesses hereto.
.~_.~~n~ residing at ~~ ~ ~~~
residing at ~''
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,;:
,~.-~r,~4'."~ ~~' F'E ~l~iS'r t;: ;lAi~i I A )
) SS:
COUNTY <7F _~~~~~_~~ )
~~
We, the undersigned, the Testator and the witnesses,
respectively, whose names are signed to the foregoing instrument,
3y
i
being first duly sworn and qualified according to law, do hereby
declare to the undersigned authority that we were present and saw
~~~. _ ~IrM1 '~rt~l-~u' and e~ute use., instr~a~xrt , as b~„[~ii2.l r arai that
:°te tsar ss~~nec~ ~.4zT.~inc~ly and that he executed it as his free and
voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the Testator, signed
the Will as witnesses and that to the best of their knowledge the
Testator was at that time eighteen (18) years of age or older, of
sound mind and under no constraint or undue influence; and I, the
said Testator, do hereby acknowledge that I signed and executed
the instrument as my Last Will and Testament, that I signed it
willingly, and that I signed it as my free and voluntary act for
the purposes therein expressed.
Sworn .to and subsc be before me this
~_ day o f , 19 9 ~.
„. ~
otar Public NOTARIAL SEAL
y Mary D. VerHage, Notary Public
My Cammislsion Expires : Dillsburg aoro, York County
M Commission Ex Tres Ma 7, 1998
f ~ ~~' / r.
Testator