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HomeMy WebLinkAbout05-12-09 505607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN ~ Po sox 2aosol 2 1 0 9 0 0 3 6 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 9 3 2 4 2 3 2 3 0 4 0 2 2 0 0 9 D 1 0 1 1 9 2 8 Decedent's Last Name Suffix Decedent's First Name MI S L Y D E R F R A N K W (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI S L Y D E R M A R Y M 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 4. Limited Estate ^X 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 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 TO: Name Daytime Telephone Number H U B E R T X G I L R O Y 71 7 2 4 3 3 3 4 1 Firm Name (If Applicable) M A R T S O N First line of address 1 0 E A S T Second line of address City or Post Office State ZIP Code REGISTER OF WILLS USE ONLY ~~ c~ ..., C :-ra - ,'~ _~ :, :;-~. -?_ -~'. N DATE.FICED -a ,_ ~ •,= ,_.~., ~ ~ C A R L I S L E P A 1 7 0 1 3 ,,,,,, "~ - _, •• .- -- ~..- ;_> J correspondent's a-mail address: H G I L R O Y a3 M A R T S O N L A W• 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 and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information has any knowledge. SIGNi,TURE OF PERSO~1 RESPONSIBLE FOR FILING RETURN DATE ADDRESS ~ 508 T S BEET MT HOLLY SPRINGS PA 17065 SIGNA~U E PRE R HER THAN REPRESENTATIVE DATE ADD SS 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 j1505607121 L A W O F F I C E S H I G H S T R E E T 1505607121 ~1 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: FRANK W- S L Y D E R 1 9 3 2 4 2 3 2 3 RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 2. Stocks and Bonds (Schedule B) 2 9 9 5. 4 5 .................................. 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. 1 2 6 5 0 • 5 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ...... . 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ...... . 7. 4 2 9 7 2. 8 4 8. Total Gross Assets (total Lines 1-7) .......................... . 8. 5 8 6 1 8. 8 3 9. Funeral Ex enses & Administrative Costs Schedule H P ( ) ............... 9. . 5 0 3 2 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........... . 10. 11. Total Deductions (total Lines 9 & 10) .......................... . 11. 5 0 3 2 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ........................ . 12. 5 3 5 8 6 • 8 3 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. 5 3 5 8 6 • 8 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.ooo 5 3 5 8 6 8 3 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .0_ 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable 0 0 0 0 0 0 . at sibling rate X .12 17. . 18. Amount of Line 14 taxable 0 0 0 0 at collateral rate X .15 18 . 0 0 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 0. 0 0 L 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: 0.00 DECEDENT'S NAME FRANK W.SLYDER STREET ADDRESS 508 CHESTNUT STREET CITY STATE Zip MT HOLLY SPRINGS PA 17065 Tax Payments and Credits: t • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty File Number 21 09 00363 Total Credits (A + B + C) (2) 0.00 Total InteresUPenalty (D + E) (3) 0.00 (4) 0.00 (5) 0.00 (5A) (5B) 0.00 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. 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. 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 : ...................................................................... ^ Q 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? ....................................................................................... ^ 0 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ Q 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)J. 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)J. 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 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 EX + (F-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANK W. SLYDER 21 09 00363 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 700 sh, common, Dendreon Corp (24823Q107) @ 4.265 2,985.50 2 5000 sh, common, Global Technovations Inc. (GTNOQ) @ .0001 0.50 3 14 sh, common, Neurobiological Tech Inc. (64124W106) @ .675 9.45 4 5000 sh, common, Teligent Inc-CL A (TGNTQ) [declared worthless 9/12/02] 0.00 TOTAL (Also enter on line 2, Recapitulation) I $ 2,995 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANK W. SLYDER 21 09 00363 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TD Ameritrade Acct. #872-487811, money market account 5,800.42 2 E*TRADE Financial, IRA Acct. 5739-1504; beneficiary: estate 1 900.12 3 Bankers Health & Casualty, medical insurance, refund of premium 2,250.00 4 1999 Ford Ranger pickup, actual sale price 2,700.00 TOTAL (Also enter on line 5, Recapitulation) I $ 12 650 54 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER FRANK W. SLYDER 21 09 00363 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND THE DATE OF TRANSFER.ATTACHACOPVOFTHEDEEDFORREALESTATE. DATE OF DEATH VALUE OF ASSET %OFDEOD~S INTEREST EXCLUSION (IFAPPLICABLE) TAXABLE VALUE 1. Oppenheimer, IRA Acct. A87-0970298; beneficiary: spouse 42,972.84 100. 42,972.84 TOTAL (Also enter on line 7 Recapitulation) I $ 42,972.84 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FRANK W. SLYDER 21 09 00363 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Year(s) Commission Paid: Zip 2. Attorney Fees Martson Law Offices 1,400.00 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Mary M. Slyder Street Address 508 Chestnut Street City Mt. Holly Springs State PA Zip 17065 Relationship of Claimant to Decedent 4. Probate Fees Register of Wills of Cumberland County 102.00 5 Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills, filing fee, Inheritance Tax Return 15.00 8. Register of Wills, additional probate 15.00 TOTAL (Also enter on line 9, Recapitulation) I $ 5 032.00 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (g-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANK W. SLYDER 21 09 00363 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 outri ht spousal distributions, and transfers under ~ Sec. 9116 (a (1.2)) 1. Mary M. Slyder Spousal 53,586.83 508 Chestnut Street Mt. Holly Springs, PA 17065 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 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. 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) V=/ l u/ L V V J V V. V V a t\ [~ a i l V V U U V U L v v a 11a L CODICIL TO THE LAST WILL AND TESTAMENT OF FRANK W. SLYDER, SR DATED SEPTEMBER 2, 2003 ~VVUi VVV ITEM THREE: I appoint my wife MARY M. SLYDER, Executrix of this my last will. Should she fail to qualify or cease to act as Executrix, I appoint FRANI~ W. SLYDER, JR. and LOU ANN SLYDER to act as Co-Executors with the same rights, powers and duties. It is my direction that the Executrix or Executor shall serve without compensation except for reimbursement of costs. Should any of the Executors I have appointed refuse to serve because of this provision, any other individual who may be appointed to serve by the court may petition the court at that time to act as the Executor. I, Frank W. Slyder, Sr. do hereby replace PARAGRAGH ITEM THREE as shown above with PARAGRAH ITEM 'T'HREE as shown below: ITEM THREE: I appoint my wife MARY M. SLYDER, Executrix of this my last will. Should she fail to qualify or cease to act as Executrix, I appoint LETITIA ANN FULLER and LOU ANN SLYDER to act as Co-Executors with the same rights, powers and duties. It is my direction that the Executrix or Executor shall serve without compensation except for reimbursement of costs. Should any of the Executors I have appointed refuse to serve because of this provision, any other individual who may be appointed to serve by the court may petition the court at that time to act as the Executor. Z'O ~~ Date ~U d~ Date ~~~ Date - a. ~%. `~~ 1. .r' '~~ +~1 / Date S~'d 0~ ~~~ /, / ~ A ~~ ~ ~/~,y r/• / i ~v _/\ ~• `' ~ ~ ` c1~Rrto sMlr~l ~"0~s acnln MY COmmgslon Expires Peb 1 S. 2010 Witnessed ~' (~~~ ' ~,, ~` ~ '~ ~ LAST WILL AND TESTAMENT OF FRANK W . SLYDER I, FRANK W. SLYDER, of Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM TWO: I give, devise and bequeath my entire estate to my wife, MARY M. SLYDER, if she survives me by 60 days. In the event that she predeceases me or is not then living on the 61st day after my death, then I devise and bequeath the rest and residue of my estate to my six children, FRANK W. SLYDER, JR., DAVID A. SLYDER, PATRICIA S. BEAR, LETITIA S. FULLER, JAMES H. SLYDER and LOU ANN SLYDER, share and share a like per stirpes. It is my intention that if any of my children should die prior to my death, their share shall go to their issue. Should they die without issue, their share shall be divided in proportionate shares among the remaining children. ITEM THREE: I appoint my wife MARY M. SLYDER, Executrix of this my last will. Should she fail to qualify or cease to act as Executrix, I appoint FRANK W. SLYDER, JR. and LOU ANN SLYDER to act as Co-Executors with the same rights, powers and duties. It is my direction that the Executrix or Executor shall serve without compensation except for reimbursement of costs. Should any of the Executors I have appointed refuse to serve because of this provision, any other individual who may be appointed to serve by the court may petition the court at that time to act as the Executor. ITEM FOUR: All estate, inheritance, succession and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. ITEM FIVE: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. C~ F W. SLYDE PAGE ONE OF FOUR PAGES COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We i ~.° 3E h )~ x L7 f L1Z C ~ and [~A~,; ~ ~ii~t~~~('~oN witnesses whose names are signed to the attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his last will; that he signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge, the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~''~~~ C~.n~? ~.~ Sworn and subscribed to before me this ~ day of ~~ , 2003. ~J ~~~~ No Public Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission &xpiros June !0, 2006 Member, Pennsylvania Association of Notaries PAGE THREE OF FOUR PAGES COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, FRANK W. SLYDER, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it as my free and voluntary act for the purposes therein expressed. FRANK W. SLYDER Sworn and affirmed to and acknowledged before me this ~~ day of -!~[s~. ~ o~ , 2003. C~r2,~c'~~CA..~~/ otary Pu lie Bridget Ann Corooran,eNotary Public Carlisle Boro, Cumberland County My Commission Expires June 10, 2006 Member, PennsybaniaASSOCiattonotNotaries PAGE FOUR OF FOUR PAGES