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Home My WebLink About05-11-09 _J 1505607121 REV-1500 EX (06-05) OFFICUtL USE ONLY PA Deparbnent of Revenue Bureau of IndNMual Taws County Code Year Flle Number PO 80X280601 INHERITANCE TAX RETURN y as HaMSbum PA 17128-0601 RESIDENT DECEDENT ~ ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 1 1 6 1 2 7 2 0 9 0 6 2 0 0 8 0 1 0 5 1 9 0 7 Decedent's Last Name Suffix Decedents First Name MI C U R T I S R U T H V (If Appilpble) Enter Surviving Spouse's Information Below Spouse's Last Name Su~x 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 ~ 2. Supplemental Retum ~ 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) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safa 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 CONFIDENTULL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J O H A N N A H R E H K A M P 7 1 7 2 3 2 4 5 5 1 Finn Name (If Applicable) T U R N E R & O' C O N N E L L First line of address 4 7 0 1 N F R O N T Second line of address S T R E E T City or Post Office H A R R I S B U R G Correspondent's e-mail State ZIP Code REGISTER dIF]NILLS USE C ~ .o ~ ~ 2 i-i ,l~r ~ I -gym - rr~ cats c~c~~; $ t~> C ~ IV D FILED OO Y H 1/ 1 1 0 ADDRESS j ~ Y 9917 U O DEPOSIT RD, APT D HARRISBURG PA 17111 NA URA OF PREPARER 07HER THAN RPPRFAFUTerniv N FRONT STREET ~ HARRISBURG PA 17110 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J~f U ~~ ~~0~\~~% ~ ~~a ~.~ o,,, ~~ 1505607221 REV-1500 EX Decedent's Social Security Number Decedents Name: RUTH V. CURTIS 2 0 1 1 6 1 2 7 2 RECAPITULATION 1. Real estate (Schedule A) ..................................... ... t. 2. Stocks and Bonds (Schedule B) ............................... ... 2. 3. Closey Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ..................... ... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .... ... 5. 6. Jointy Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines t-7) ........................ ... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 11. Total Deduedons (total Lines 9 8 10) ........................ ... 11. 12. Net Value of Estate (Line 8 minus Line 17) ....................... .. 72. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an electbn to tax has not been made (Schedule J) ................ .. 13. 1 0 5 1 7, 2 7 1 0 5 1 7, 2 7 3 2 1 9, 2 0 2 9 6 5 1 0, 8 5 2 9 9 7 3 0, 0 5 - 2 8 9 2 1 2, 7 8 14. Net Value Subject to Tax (Line 12 minus Line 13) ......... .. ..... .. 14. - 2 S 9 2 1 2 . 7 8 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.o _ 0, 0 0 75. 0, 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0, 0 0 18 0, 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0, 0 0 17 0, 0 0 18. Amount of Line 14 taxable at collateral rete X .15 0, 0 0 18 0, 0 0 19. Tax Due ................................................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 0, 0 0 J REV-1500 FX Pepe3 Decedent's Complete Address: File Number o a DECEDENTS NAME RUTH V. CURTIS STREET ADDRESS GOLDEN LIVING CENTER 770 POPLAR CHURCH ROAD an CAMP HILL PATE zIP 17011 rax Payments and Credits: t Tax Due (Page 2 Line 19) 2. Credits/Payments (~) 0 00 A. Spousal Poverty Credit B. Pdor Payments C. Discount 3. InterestlPenalty H appliceble Total Credits (A +B +C) (2) 0 00 D. Interest E. Penalty 4. If Line 2 is greater the Une 1 +Une 3, enter the difference. This is the OVERPAYMENT Total InteresNPenalty (D + E) (3) 0 00 FIII In oval on Page 2, Una 20 to request a refund. (4) 0 00 5. ff Line 1 +Une 3 is greater than Line 2, enter fhe difference. This is the TAX W E. (5) 0 00 A. Eller the interest on the tax due. (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (58) 0 00 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 dght to designate who shall use the property transferred or its income : ......................... ...... ^ c. retain a reversionary interest; or ...................... d. recave the promise far life ~ either payments, benefits ar cere7 ................................................. ...... ^ 2. If death oauned after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideratlon7 .................... ...................................................... 3. Did decedent own an'in tmst for' or payable upon death bank account ar secudty at his or her death? .... ^ ... ^X 4. Did decedent awn an Individual Retirement Account, annuity, or other non-probate property which .. contains a beneficiary designation? ............................................................................................. ..... ^ IF THE ANSWER TO ANY OF THE ABOVE QUES710NS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN REV-1508 EX + (8-95) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. tN RES DENT DECEDENT N PERSONAL PROPERTY m ITEM VALUE AT DATE CneCKing aCCOUnt +,vvv.vv account number: 100616462138 2. Wachovia savings account -burial reserve account 5,223.33 account number. 1010008441595 3. Nursing Home Refund 359.90 4. (Prescription Medication Refund I 6.56 5• (Doctor Refund 89.40 TOTAL (Also enter on line 5 Recapitulation) I E apace Is needed, Insert additlonal sheeb of the same size) REV-1b11 EX+(10-Ob) COMMONWEALTH OF PENNSYLVANIA INNERRANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES S ADMINISTRATIVE COSTS RUTH V. CURTIS 0 0 Ds6ts of decedent must be repoMd on ScheduN L REM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Neill Funeral Home 2,030.67 2. Funeral Dinner 3. Funeral Bookmark 361.48 4. Engraving of Tombstone 63.51 185.00 B. ADMINISTRATIVE COSTS: Persons Representative's Commissions Name of Personal Representative (s) StreetAddresa Ciy Year(s) Commgsbn Pald: State Zip 2, atromey Fees Tumer & O'Connell 250.00 3. Fatuity Exemption: (If dewdents address b rwt the same as deimants, atlach explanation) Claimant Street Address Cdy State Zip Relationship of Claimant to Decedent 4• ProbeteFeas Register of Wills 63.00 6. AooouManYs Fees 6. I Taz Realm Preparers Fees 7. I The Cumberland Law Journal I 75.00 8. The Sentinel -Legal 190.54 (Irmora space b needed, TOTAL (Also enter on line 9, Recapitulation) I S sheets of the same size) REV-1512 EX t (12-03) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Report debts Incurred by the decedent prior to death which remained unpaid as of the date of deatFl, including unreimbursed medical expanses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Commonwealth of Pennsylvania Department of Public Welfare 298,510.85 TOTAL (Also enter on line 10, Recapitulation) I s needed, insert additlonal sheets of the same size) REV-7513 EX+(9-0O) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RUTH V. CURTIS 0 0 NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE () r Do Not List Trustea/s) OF ESTATE TAXABLE DISTRIBUTIONS (kldude M spousal dfstrlbutlora, and transfers under Sec. 9116 (a (1. )2 J 1. Betty J. L. Curtis Lineal 4417 D Union Deposit Road O.Oi Harcisbufg, PA 17111 2. Roberta M. Pennington Lineal 353 Cedanvood Drive 0.01 Jackson, MS 39212 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II _ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S Rare space is needed, insert additional sheets of the same LABT RILL AND T88TANEliT ' OF RIITH ~-. CIIRTIB I, RUTH V. CURTIS, of the City of Harrisburg, Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revok- ing all former Wills by me at any time heretofore made. ITHM I. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property shall be paid by my Co-Executrices out of the property passing under ITEM II of this Will, as an expense and cost of administration of my estate. My Co-Executrices shall have no duty or obligation to obtain reimbursement of any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Co-Executrices, such taxes may be paid immediately, or the Co-Executrices may postpone the payment of taxes on future or remainder interests until the time possession thereof accrues to the beneficiaries. Ruth~urtis Page 1 of 2 pages ITEM II. I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate at the time of my death, to my daughters, Betty J.K. Curtis and Roberta M. Pennington, in equal shares, or to the survivor of them. In the event both my daughters should predecease me, I give, devise and bequeath my estate to Brad Pennington, Johnny Pennington and Jesse C. Pennington, in equal shares, or the survivors of them. ITEM III. I nominate, constitute and appoint my daughters, Betty J.L. Curtis and Roberta M. Pennington, as Co- Executrices of this, my Last Will and Testament. It is my desire that my Co-Executrices serve without bond. IM RITN888 WREREOF, I have set my hand and seal to this, my Last Will and Testament, typewritten on one (1) other page, this Rut. Curtis 2 26th day of June, 1998. COMMONWEALTH OF PENNBYLVANIA 88 COIINTY OB DADPHIN _ I, RUTH V. CURTIS, testatrix 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 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 contained. Sworn or affirmed to and acknowledged before me, by RUTH V. CURTIS, testatrix, this 26th day_ off June, 1998. V. / Stacey a. Fo Flamaburg, COMMONWEALTH OB PENNSYLVANIA P+h' ~'t"n'~O" 88 COIINTY OF DAIIPHIN _ We, ~LAA11W rl. ~rYl~f and ~y ~(lr'~~~, the Witnesses, respectively, whose names are s gned to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her Last Will and Testament; that RUTH V. CURTIS signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. ` 1n~,, Sw affirmed to s ~.~-1~ ^ I ~r~C° and witnesses, this 26th day of June, 19 to before me by ~A- the y~a~y romoagnal sealryu rriabAur~g. D~up ~C~ Ha a In My Commissron Ezpres Jan. 2.2061 3 ~4