HomeMy WebLinkAbout06-11-091505607121
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 8 0 1 2 7 2
_ Harrisburg, ~A 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 2 1 0 2 0 0 8 1 1 2 1 1 9 2 0
Decedent's Last Name Suffix Decedent's First Name MI
RUTH MI L DRED M
(11' Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Sociai Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FALL IN APPROPRIATE OVALS BELOW
~~ 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)
~
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 T0:
flame Daytime Telephone Number
f=irm Name (If Applicable)
H ANTHONY ADAMS
f=irst line of address
49 WEST ORANGE STREET
;second line of address
S U I T E 3
City or Post Office
SHI PPENSBURG
State ZIP Code
P A 1 7 2 5 7
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Correspondent's a-mail address:
Under penakies of perjury, I decl2re 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. D :claration of preparer other than the personal representaLve rs based on all information of which preparer has any knowledge.
SIGNATUR StIBLE FOR F ING RETURN DATE 6 ~ -
I~~ ~~
~4DDRESS (~
1505607121
Side 1
1505607121
1505607221
REV-1500 EX Decedent's Social Security Number
oecedenfsName: MILDRED M. RUTH
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 6 7 6 2 ' 9 6
5. Cash, Bank Deposits Z£ 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. 5 6 7 6 2, 9 6
--
................
9. Funeral Expenses 8 Administrative Costs (Schedule H) 9. 1
0
0
8 '
0
0
2 7 9 4 3 $ 1
9 9 ( ) ............
10. Debts of Decedent, Mort a e Liabilities, $ Liens Schedule I 10. •
11. Total Deductions (total Lines 9 8 10) ........................... 11. 2$ 9 5 1 8 1
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•
2 7 $ 1 1 1 5
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 0 . 0 0 15. 0. 0 0
16. Amount of Line 14 taxable 2 7$ 1 1 1 5 1 2 5 1 5 1
at lineal rate X .045 16.
17. Amount of Line 14 taxable 0 0 0 17 0 • 0 0
at sibling rate X .12 ,
18. Amount of Line 14 taxable 0 0 0 18 0 • 0 0
at collateral rate X .15
. 2 7 $ 1 1 1 5
19. Tax Due ................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1505607221
Side 2
1 2 5 1. 5 1
1505607221 J
REV-1500 E:X Page 3
Decedent's Complete Address:
File Number
21 08 01272
DECEDENTS NAME
MILDRE:D M. RUTH
STREET ADDRESS
3 WEST BURD STREET
CITY
SHIPPE:NSBURG STATE
PA ZIP
17257
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 1,251.51
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E )
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.
(3)
(4)
0.00
(5) 1,251.51
(5A)
B, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 1,251.51
Make Check Payable fo: 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 inwme of the property transferred : ...................................................................... ^ ^X
b. retain the right to designate who shall use the property transferred or its income; ...............................
a
c. retain a reversionary interest; or ................................................................................................ ^ ^X
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. §53116 (a) (1.1) (ii)]. The statute does not exemat 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 beneficary.
Frr dates of death on or after July 1, 2000:
The tax rate imposed on the net value of `.ransfers from a deceased childtwenty-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-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 91i 02, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
0.00
REV-1508 EJC + (6-98)
COMMONWEALTH OF PENNSYLVANIA
PNHERITANCE TAX RETURN
OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
MILDRED M. RUTH 21 08 01272
Indude 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. Citizens Checking Account 56,199.75
#6100796531
2. ~ Miscellaneous Refunds and Cash Deposits
563.21
TOTAL (Also enter on line 5, Recapitulation) I S 56
(If more space is needed, insert additional sheets of the same size)
REV-1511 E~; + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES 8r
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
MILDRED M. RUTH 21 08 01272
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees H. Anthony Adams
3, Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5 Accountants Fees
6. Tax Return Preparers Fees to Ruth Ann Mooney
7
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert addftional sheets of the same size)
825.00
143.00
40.00
1.008.00
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERrrANCE TAX RETURN
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE CIF FILE NUMBER
MILDRE.D M. RUTH 21 08 01272
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Department of Public Welfare 17,594.84
Estate Recovery Program
2. Shippensburg Healthcare Center 5,714.50
3. Citizens Bank 4,124.22
Line of Credit
4. Commonwealth of Pennsylvania
(Sales tax-unpaid on business
5. Borough of Shippensburg
(final bill on house sold prior to death)
6. Chambersburg Hospital
7. Penelec
8. West Shore Emergency Services
9. Millennium Pharmacy
TOTAL (Also enter on line 10, Recapitulation) I $
(If more space is needed, insert addfional sheets of the same size)
6.59
43.55
120.00
11.51
277.77
50.83
27.943.81
REV-1513 EX + (g-°p)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE)
BENEFICIARIES
MILDRE
NUMBER
I.
1.
2.
3.
4.
II.
1
1
D M. RUTH
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Suzanne R.Swanger
5727 Roxbury Road
Shippensburg, PA 17257
Richard B. Ruth, Jr.
301 East Garfield Street
Shippenburg, PA 17257
Christine M. Yancisfi
2116 Milltown Road
Camp Hill, PA 17011
Cynthia R. Ruth
19 Briar Close
Magwyr, Monmouthshire NP 263LQ , UK
FILE NUMBER
21 08 012'
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
Lineal
Lineal
Lineal
AMOUNT OR SHARE
OF ESTATE
~ 25%
25%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $
(It more space is needed, insert additional sheets of the same size)
F:\WP5IWILLS\PAYORK\RUTHNFI.YLL 5/23/% 3:38pm Thu
LAST WILL AND TESTAMENT
I, MILDRED M. RUTH of Shippensburg Borough, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and
revoke any Will or Codicil previously made by me.
ITEM I: I direct that all my just debts (except as may be
barred by a Statute of Limitations) and my funeral expenses
(including my gravemarker and expenses of my last illness) shall be
paid from my residuary estate as soon as practicable after my
decease as a part of the administration of my estate.
ITEM II: I give and bequeath all my tangible personal property,
including but not limited to, any and all automobiles and other
motor vehicles, household goods and furniture and furnishings,
china, silverware, jewelry, ornaments, works of art, books,
pictures, wearing apparel and personal effects, but excluding cash
on hand and tangible evidences of intangible personal property to
my children, SUZANNE R. SWANGER, RICHARD B. RUTH,-JR., CHRISTINE M.
YANCISIN an
d CYNTHIA R. RUTH, in as nearly equal shares as is
~~ ....
. ,:
practicabl.~~.
ITEM III: I devise and bequeath the residue of my estate of
` every nature and wherever situate in equal shares to such of my
children, SUZANNE R. SWANGER, RICHARD B. RUTH, JR., CHRISTINE M.
YANCISIN and CYNTHIA R. RUTH, as shall survive me by thirty (30)
days.
ITEM IV: Should any of my children, SUZANNE R. SWANGER, RICHARD
B. RUTH, JR., CHRISTINE M. YANCISIN and CYNTHIA R. RUTH, predecease
me or die on or before the thirtieth day following my death but
leaving descendants who so survive me, such descendants shall
receive, per stirpes, the share that such predeceased child would
have received had he or she so survived me.
ITEM V: I direct that .all taxes that may be assessed in
consequence of my death, of whatever nature and by whatever
jurisdiction imposed-, shall be paid from my residuary estate as
part of the expenses of the administration of my estate.
ITEM VI: I appoint my children, SUZANNE R. SWANGER, RICHARD B.
RUTH, JR. and CHRISTINE M. YANCISIN, Co-Executors of this my Last
Wili.
ITEM VII: My individual fiduciary shall be entitled to
reasonable compensation for his or her services rendered from time
to time and/or to reimbursement of out of pocket expenses.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my
Last Will and Testament, written on three (3) sheets of paper,
~--
dated this `~~ day of Jctiv~~ , 1996.
`..
~ ~ ' (SEAL)
MILDRED M. RUTH
The preceding instrument, consisting of this and two (2) other
typewritten pages, each identified by the signature or initials of
the Testatrix, was on the day and date thereof signed, published
and declared by the Testatrix therein named, as and for her Last
Will, in the presence of us, who, at her request, in her presence,
and in the presence of each other have subscribed our names as
witnesses hereto.
residing at _ /t/P~,,/,~,-,~ /,e _ (/ ~
~~ %`( ~J~~~~ residing at ar
2
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
I, MILDRED M. RUTH, the 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 that I signed it willingly and
as my free and voluntary act for the purposes therein expressed.
L~'~ ' ~~~SEAL)
MILDRED M. RUTH
Sworn to or affirmed and acknowledged
before me by -n ~ ~oaEb m. 2rcr~.( the
Testatrix, this y day. of
~,~.~,.~.~, 19 9 6 .
NOTAiiAI SEAL _
~ 6~ts A. ~a.LHii~A6EA. Notary Public
ry P 1 iC : a+p~ansburp Baro, Cu~berlandQCo•., PA
•. ~ JCIRRIisfi6"A Expires ~~ $, 1~
COMMONWEALTH OF PENNSYI;
COUNTY OF CUMBERLAND
. ss.
We , ~lA rn, ~7-ynl ~. ~A ~ ~S and T~e~ NA /'~ . ~2 0 0 ~ E7v s , the
witness 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 Testatrix sign and execute the
instrument as her Last Will; that the Testatrix signed willingly
and executed it as her free and voluntary act for the purposes
therein expressed; that each subscribing witness in the hearing and
sight of the Testatrix signed the Will as a witness; and that to
the best of our knowledge the Testatrix was at that time eighteen
(18 ) or more years of age and of sound ind and under o constraint
or undue influence. ~ ,,
Sworn to or affirmed and subscribed to
before me by NAmi~7cni C. 7~A/is and
~2~NR m . 3/2ooKE/uS , witnesses,
this day®of ~,„~~ 1996.
Q. NOTARIAL SEAL
Notary Pu is ~~ ~
k!y Co~ssiaa Expires Merdt 3, teal
3