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HomeMy WebLinkAbout08-25-09 (2)J 15056041158 REV-1500 Ex c~-D5) OFFICIAL USE ONLY PA Department W Revenue County Cafe Veer Five Number Bureau of lnd'rviduel Tezas 21 09 0043 PO BOX 280801 INHERITANCE TAX RETURN Harrisburg, PA t7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Dete of Birth 222-05-556 1132008 X9231919 Decetlent's Last Name SWARTZ Suffix Decedent's First Name RUTH MI M (If Applicable) Enter Surviving Spouse's Information Below Spouse's last Name Suffix Spouse's Firal Name Spouse's Social Security Number FILL IN APPROPRIATE 130XE5 BELOW THIS RETURN MUST BE FILED !N DUPLICATE WITH THE REGISTER OF WILLS MI ^X 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date M death prior to 12-13-82) ^ 4. Limitetl 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 LMng Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of WIIQ (Attach Copy of Trust) ^ 9. Litigation Proceeds Receivetl ^ 1 D. Spousal Poverty Credit (date of death ^ 11. Election io 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 1NFORMATIg1 SHOULD BE DIRECTED TO Name Daytime Telephone Number RICHARD C• SNELBAKER 717-697-8528 ~ - .,~ z r .. 7 Firm Name (If Applicable) ~ REGISTER OF ~~ USE ON ~ ~ i r ~ ~1 SNELBAKER & BRENNEMAN, P•C• I ''L~ ~' - =. ,SJ . Ri N `~ ~. ,=ri ` ~ First line of atldress ,O CII ~7T - ~ 44 WEST MAIN STREEET c c 'r %c7 S" ~ -`' Second line of address V u 00 ''~a - _n ~ 1. W _7 < ~ .ri .ti State ZIP Gode Or POSt Office Cit DATE FILED . y MECHANICSBURG PA 17055 CorrespontlenYs e-mail atltlress~. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, antl to the best of my knowletlge and oeliaf, it i~.In~, coned and complete, Declaration of prepamr other than the personal representative is besetl on all information of which praparer has any knowledge. $af•.r~ca A. ung 812 West Keller Street, Mechanicsburg, PA 1 OS _~,c~_zo4`f Richard C. Snelbaker Esquire 44 West Main Street, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041158 aM4e479.000 15056041158 J J 150561742159 REV-1500 FJC Decetlent's Social Security Number 222-OS-5506 Decedent s NemeS W A R T Z RUT H M RECAPITULATION 1. Real estate (Schedule A) ................. ......... .. 1. 0 . 0 ~ 2. Stocks and Bonds (Schedule 8) ... .... ...... ........ .. . 2. Q • Q ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (ScheduVe C) . 3. 0 • (] (1 4. Mortgages & Notes Receivable (Schedule D) . ....... ........ ... 4. Q . ~ (] 5. Cash, Hank Deposits & Miscellaneous Personal Properly (Schedule ~ ..... ... 5. 0 • ~ () 6. Jointly Ovmed Property {Schedule F) ~ Separate Biging Requested ... .. 6. 9 518 4 •8 7 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ... .. 7. 6 7 S • 0 0 8 Total Groas Assets (total Linea 1-7). .. .. 8. 9 5 8 5 9. 8 7 9. Funeral Expenses 8 Administrative Costs (Schedule H) ... .. .. .... .. . . 9. 14 512 • 7 7 10. Debts of Decedent, Mortgage LiabilNies, & Liens (Schedule 1). . . 1 D. l) • ~ 0 t t. Totai Deductions (total Lines 9 ~ t0) • ~ ~ ~ 11 14 512 • 77 12. Nst Value of Estate (Line 8 minus Line 11) .... .. 12. 813 4 7 , 1 ~ 13. Cnarltable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) • 13. (] , (] ~ 14 Net Value Subject to lax (Line 12 minus Line t3) .. .. . . 14. 813 4 7 , 1 ~ TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unAer Sec. 9116 (a)(1.2)X.0 ~.OQ 15. Q. QO tfi. Amount of Line 14 taxable at meal rate x .D45 813 4 7.10 1 s. 366 0 .62 17. Amount of Line 14 taxable at sibling rateX.12 p.0~ 17. 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0 . l] O 18. 0 • ~'~ 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 BM494a2.W0 15!156042159 3660.62 REV-150d E7C Page 3 nnrnden}'e Cmm~lnfn Oddrnss: Flk Number 21 ^9 ^043 DECEDENTS NAME T R STREET ADDRESS CITY CH NI R STATE ZIP - Tax Payments and Credits: 1. TaxDUe(PagezLinets) (1> 3660.62 2. Credits/Payments A. Spousal Poverty Credit ~ • l10 B. Prior Payments ~ • ~ ~ C. Discount ~ • 0 ~ TWai Credits (A+B+C) (2) 0 •Ol] 3. InteresVPenalty if applicable D. Interest ~ • ~ ~ E. Penalty ~ • ~ ~ Total InteresVPenelty (O+E) (3) ~ • d(] 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) ~ , ~ p 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This Is the TAX DUE. (5) 3 6 b D • 6 2 A. Enter the interest on the tax due. (5A) 0 • O D B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 3660.62 Make Check Payable to: REGYSTER OFWILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: X 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; - ..... X ~ c. retain a reversionary interest; or .. .................. . d. receive the promise for life of either payments, beneRts or care? .......... X 2. If tleath occurred after December 12, 1982, ditl decedent transfer property within one year of death without receiving atlequate consideration? ...................... . " " X 3. Did decedent own an in trust for or payable upon tleath bank account or security at his or her death? . 4. Ditl decedent own an Indivitlual 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 taz rate imposed on the net value of transfers to or for the use of the surviving spouse is tnree (3) percent [72 P.S. §911 s (a) (1.1) (ip. For dates of death on or after January 1, 1995, fhe 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 tloes not exempt a transfer to a surviving spouse from tax, antl 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 tleath 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 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 taz rate imposetl on the net value of transfers to or for the use of the decetlent's lineal beneficiaries is four and one-haH (4.5) percent, except as noted in 72 P.S. §9118(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to ar for the use of the tlecedent'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. BM98]1 1.000 REV-1509 EXr (&95j COMMOMNEALTH OF R IN~9iRANCETAX SCHEDULE F JOINTLY-OWNED PROPERTY Ruth M. Swartz 21 09 0043 k an asset was made )olnt wkhin one year of the decedent's date of tleath, It m ust lta reported on Schetlule G. SURVNNGJOMfTTBdAM(S) NOME A Young, Patricia A JOINTLY-0WNED PROPERTY: RELATIONSFiP TO DEC®B~IT n~ NUtflER iErrER FgiJgN TENPNT DATE AM DE JAM' DESCRIPTION OF PROPBTfY INDWDENM1f OF FINPNCL1l INSTRUTION AND BANK ACCWNT NUMBER OR SIMI O~IMI IENH'aD REALESIA~TEpTTAGH DEED Fqi DATE OF DEATH VALUE OF ASSET %OF DECUS IMBiEST DATE OF OE47H VALUE OF DECEOBdI'S INfff2EST 1 A 7f1/1995 M6T Sank 13,935.32 50.0000 6,967.66 Certificate of Deposit #31003914503410 2 A 1/1/1999 M6T Bank 10,912.98 50.0000 5,456.49 Certificate of Deposit #31003913914014 3 A 1/1/1999 M&T Sank 9,114.69 50.0000 4,557.34 Certificate of Deposit #31003913913991 4 A Inception PxC investments 24,349.95 50.0000 12,174.97 account #82267490 5 A Inception U.S. Savings Bonds 12,803.36 50.0000 6,401.68 92 EE savings bonds. See attached list 6 A 3/12/2004 PNC Bank, N.A. 3,877.23 50.0000 1,938.62 Certificate of Deposit #210001011469 To al from co tinuati on schedules 57,688.11 ADDRESS 812 West Keller Street, Mechanicsburg, PA 17055 95,184.87 (rc more apace is needed, insert addnional sheets a the same sae) 3WdeAE 1.000 Estate of: Ruth M. Swartz Schedule F Part 2 (Page 2) u 09 ooa3 Item Joint DOD Value of Perc DOD Value of No. Cot. Date Description Asset Int. Interest 7 A 3/12/2004 PNC Bank, N.A. 5,469.62 50. 0000 2,734.81 Certificate of Deposit #31300222349 8 A 2/2/2006 PNC Bank, N.A. 8,308.87 50. 0000 4,154.44 Certificate of Deposit #31200028080 9 A 2/2/2006 PNC Bank, N.A. 6,836.75 50. 0000 3,419.38 Certificate of Deposit #31900178474 10 A 2/14/2004 PNC Bank, N.A. 22,708.94 50. 0000 11,354.47 Certificate of Deposit #31900236813 11 A 2/2/2006 PNC Hank, N.A. 22,132.19 50 .0000 11,066.10 Checking account #5070086113 12 A 2/2/2006 PNC Bank, N.A. 12,761.19 50 .0000 6,380.60 Saving account #5030007601 13 A 2/2/2006 PNC Sank, N.A. 37,156.62 50 .0000 18,576.31 Money Market a ccount #5030123194 Total (Carry forward to main schedule) 57,688.11 Calculated Value of Your Paper Savings Bond(s) .~--~,,~~~.. (~~1 ~alcu{ated Va{ue of Your Paper Savings Bond(s) ~" 1 Calculator Results for Redemption Date 11/2008 _ Page 1 of 2 ~aG l ~~- cg yG~ ' Total price Totai Yalue Total Interest YTD Ynterest $10 800 00 $12 803.36 $2,003.36 $429.68 Bonds: 1-92 of 92 Issue Next Final Interest Serial # Series Denom pate Accrual Maturity Issue Price Interest Rate oa~aatSnFF'' FF a~nniOt/20n8 12/2008'01/2038 $100.00! $1.76: 3.00% 411813EE R1 EE _$20U ;U[JLUU/. 1[JNUrs, u[J[u.~i ~+LUU uu ~~ t R196 411813EE EE ' $200. ,02j2008' :;12j2008„ 02(2038.':,"., ,_ $100_00 _ _$1 5 _ R195978029EE _ _ EE $200 12/2007 . ,.,12/2008 12/2037,'. $100.00 _ $2.C 820117EE R1957 EE ~. $200 " [_11/2007 :"122008; .11/203,7._ _$10[),.00 _ $2.: , R195442259EE EE $200 ,10%2007 ;12/20l)Bj .lOJ2037,;, $100,00 __$2:f _ R195220223EE EE i $200_ TMQ9J2007 12/2006 _09j203T $,100,00.._ ._,_$3,] _ RioSnt »a~FF FF ~200 :oel20a7 '1212008" :08/2037' #100.00 $3.~ Value $105.52 _PS 3 00% ...... _ $101,52 . NE 3.00°!0 $102,00 NE 3:00°/0 $102.24. PS 3.40% $102.80'. PS 3.40% _ _. $103_.12. . P5 ....... R1948564Z4EE EE $200+07J2007 12J2008 07(2037 ,. _ _ _100 00: 3 76: 40 /o ~ ~ „ R194693491EE EE $200; 06/2007: 12/20081 06/20371 $11)0.00 _.. $4 00` 3 40°Jo ~ $104.00 PS R194418918EE . EE , $200 05/2007, 12(2008 05/2037!. $104.00 $4.32 3.40% $104.32 PS R194194948EE EE $200 04/2007 12/2008; .04(2037;" $100.00 $4.96.. 3.60% $104.96 PS R1913175492EE EE ': $200 12/2006 12j2008: ,12/2036;, $100.00 $6.,16 3.60% ' $105.16 PS R193562496EE EE ,. $200': 01(2007 12/2008 "01/20371 $100.00 $5.84 k , 3.60% , $105.84 PS R193948420EE EE . $200" 032007, 12/2008 03(2037'.;,_ _ ,$100 00 .., _, $5 20',,, _3.60°l0 $105.20 p5 R192890415EE . .. EE ' . $200 ~ 11/2006 12~2~Q8,a ,11(2036°.. ,., ,$,100,00 ~6 48r 3,60% , _ ,$106 48 , PS R192692054EE . ._ EE $2QO lOf2006! 12i2006y 10/2036. 100.00 _ $6.96._ 3.70% -" $106.36 PS R1924F18191EE EE $200 09j2006 12%2008 09/20361 $100.00 $7.28 3.70% $107.28 PS R19Z187045EE EE $200: .,, 08/2006; 12/2008: 08/2036'.; $100.00, $7.60 3.70°l0 $107.60 PS R19i992713EE EE , $200; 07/2006 12/2008 07(2036 $100.00 $7.92 3.70°/0 $107.92 PS R191756640EE: _" EE $200 06/2006' 12/2008'. 06/2036, $100.00 __ $8,.24 3,70% $108.24 PS R1910D2768EE EE $200! 03/2006' 12/2008 03(2036 $100.00 $8.00 3.20% ' $108.00 P5 R191247713EE EE $200; 03/2006;: 12/2008 .03/2,036.;, $100.00. _ $8,.00 3.20% _. $108.00„ PS R191496619EE EE $200' ,O5j2006' 12(2008 05/2036 ~100.A0, _, $8 56 ,_ .3.70% , $108,56, PS R188480143EE , EE $200 01/2006_„ 12%2008,! _01%2036.', $10.00 $8.55 3.20°l0' $108.56. PS R190755545EE EE $200 02/2006.; 12/2008! ,02/21736„ $100.00, $8.24'. 3.20% $108.24 PS R1879987SOEE' EE $200' 12/2005 12(2008; 12/2035 $100.00 $8.80 3.20% $108.80 PS R184779675EE EE $200. 11/2005' 12/2008' 11j2035 $100.00 $9.12 3.20% $109.12 PS R187845661EE EE $200'. 1OJ20051 12j2008 10/2035 $100.00 $10.32 3.50°!0 $110.32 PS R187598437EE EE $200''. ,09j2005.! 12/2008, ' 09/203,5. $100.00 __,$10.64 _ 3.50°!°' $110.64 PS R176468131EE _„ EE $2005 01/2003, ,12/2008. 01(2033, . $100 00, . , ,.,._$22.08.__ , 2.74°I° $122.08., R177347294EE _, EE ,$200; 02/2003_ !12/20,08 02(2033 ,$,10000,___ ,. $21.76„ 274%,. $121.76 _~ ... 77521789EE R1 __, EE _ $200 :x03/2003 12/2008 ':03j2033 $100,00 __ .,$21.52r 2.74% $121.52 _. . EE _ ~~ ~ ~ EE $200 :;04/2003 12j2008 04/203 ;;. $ _ .. ° $121.20. F R177956715_ EE _ EE $200 ;OSj2003 12/2008 05/2033 100.00 $ $20.72 ° / o 2.80 $120.7 2 R178489112EE EE $200 ;06(2003 ;,12/2008, :_06/2033 $,100.00 ., _,,,$20.48! . 2.74%' $120.48' R178807012EE __ EE $200 '07/2003 j12/2008. 07/2033 $100.OQ ,,..$20.24:, 2.74°!0 $120.24' EE _, EE 200 $ ~Q8/2003 1.12f2008 '08(2033 $100 00 $19 92~. 2 74% _, $119.92. _„ R179540614 EE , ., EE , $200 r09%20~3 12/2008 ~ ' 09/2033. _ $100..00 _ _ $19 68_';, __,2 74%'", . $119.68_ _ R176311244EE __ ,__ EE _ _ $200 '. 10(2003 2008 v12j r,10/2,033. ,$100.00„ X19.36!_ 2.74% $119..36 R180244931EE ._ EE 200 i1j2003 N12/2008 3 .11/203.,r $10,0 00,_ $19 04 _,2.80°fo_ $119.04 .. R180495239EE _ EE $200 „ 112(2003 :12/2008 3 , 12/203 $100 00, $18 00; 2.74% $118.00 P5 R187092659EE EE $200 107/2005 1,12/2008 07/2035 $100 00, $11.28 3.50% $111.28 PS http:!/www.treasurydirect.govlBC/SBCPrice 4/1 612 00 9 Calculated Value of Your Paper Savings Bonds} R182$66964EE EE $200f06/2005,,12f2( R182640183EE EE $200 04/2005;12f2008,04J2035" R181821197EE EE $200'_04/2004.;12/2008 04%2034 R181624070EE EE $20D:03/2004'12/200803/2034 Page 2 of 2 ).00 $11.601 3.50%' $111.60 PS 00, $10.96 3.50% I $110.96 PS ).00 $13.44 2J4% $113.44 PS ).00 $16.64 2.74%: $116.64- PS ).00 $17.04 2.74% $117.04 _ , _" PS ~ R181164464EE, EE, _ $200'01/2004 12f2008. 01(2034 $10000, _, $17.68 274% $11768' P5 I R181454694EE EE $200 102/2004, ,12/2008.' _02f2034r $100 00.„ ..... .$17 44 „ _ 2,74%_ .. _,.. $117 44 '. PS R183116063EE EE $200 r05/2004 .::12j2008.' OS/2034* $100 00 $16 80 2.80% $116.80; p5 83227697EE EE $200 }06/2004, ; 12/2008. 06/2034 $100 0,0 , , ,, . 16.56 , 2.74°10 $116.56 PS R183336345EE EE $200 , 07/2004 j12%2008 07/2034 $100.00 $16.24 2.74% , $116.24 PS R183438513EE EE $200 '08/2004 ::12/2008.1 ~ 08(20341 $100.00 $16.00;_ 2.74°l0 $116.00 p5 R183555199EE EE $200 k09/2004, 12/2008, 09/2034 $100.00, .,$15.60 2.74% $115.60' PS R185131504EE EE $200 10/2004 '.12f2008' 10/2034;-,. $100.00_ " $15.20 2.74% . $115.20 PS R185314154EE EE . $200 .. „„11/2004„ 12%2008.'.+ _11/2034: X100 OO.m . $15 04I 2 80% $115.04' PS _, 277EE R185571 ___ EE " ~ $200 ~_12f2004. w12/2008.~ 12/2034' 100 00 .. _$14,72„ . .2.74%_, , $114 72 PS R185957037EE EE .$200 ~,01/2005. ',12/2008r 01/2035r .$10,0 00 $14.482 2.74°l0 _ $114.48 PS R173670894EE EE i $200 ti02/2005_ ;_12/2008: 02%2035; X100 00 $14.24 2.74% ' $114.24 PS R186507030EE EE $200 „03/2005 ;12/2008; 03/2035; $100.00 ._$13.84. 2.74% _ $113.84 PS R186900722EE; EE $200 '.05/2005 :12/2008,; 05/2035,! $100.00 $11.92 3.50 % $111.92 PS R171413011EE EE i $200 ;O1j2002, j.12/2008'_ 01J2032_ $100,00, , ,. $26.88 . 2.74 % _ $126.88 R1,72015821EE EE $200 ;,03f20Q2_ ;,12f2008,~ 03(2032.' $100 OQ. _., _$2,6_32 2.74% :,, $126.32 R172015820EE EE $200 03/2002 12f2008_ ,03/2032; $100 00 $26.32! 2.74°/q $126.32: R172015819EE EE ~ $200 i03(2002 w12%2008r 0312032', x,10000 „ 526.32 2.74% ' $126.32 R172915765EE EE $200 05/2002 12/2008_j 05/2032! $100.00 „$25.04 2.80% $125.04 R173098230EE EE $200 ,06j2002 ',12{2008' 06/2032 $100.00 $24.80 2.74% $124.80 R174195397EE EE $200 .07/2002 .;12/2008;,_ 07/2032: $100.00 $24.48 2.74% ' $124.48 R175048870EE EE : $200 10/2002 (12/2008; 10/2032'; $100.00, $23.68 _ 2.74% $123.68 R174580686EE EE $200 09/2002: 12(2008(_ 09/2032 $100.00 ,.,$23.92 2.74% ' $123.92 R174393861EE . EE $200 {08/2002 12f2008 _08%20321, $100 00_ .. .$2424w._ 2J4% $124.24. R175915697EE EE I $200 .11/2002 ' 12/2008 11(2032" $100 00 22.64 __ 2.80° % . _ •64 . R176111302EE _ EE X200 12/2002 _12/2008 12/2032 $100 00 _ 22.32 ° 2.74/0. ~iZZ .32 M79191649 EE _ - EE ',$1,000 02/20D2 :12/2008„ 02%2032_ $500.00 _ $133.20: 2 74% $633.20 M79191650 EE EE $1,000 02/2002; 12/2008 02/20321 $500.00 $133.20 2.74% $633.20 M79191651EE EE $1,000 !02/2002, 12/2008_. 02/20321 $500.00, ,$133.20 „ 2.74 % $633.20' M79191652EE EE $1,000 •..•.02/2002 12/2008, 02/2032 $500.00 $133.20 2.74%' $633.20 R167179540EE EE $200 '02/2001' 12/2008'_ 02/2031' $100.00 $33.04 . 2.74% $133.04: R167360424EE EE $200 '03/2001, ,12/2008' 03/2031 $100.00 _„$32.80 2.74% $132.80 R167548937EE EE $200 ._04/2001, .12/20081„ 04%2031 $100.00 $32.48 2.74% $132.48 R167745882EE EE $200 ;"05/2001: 12/2008', 05%2031' $100.00 $30.40 2.80 % $130.40 R168600763EE EE $200 ;06/2001 12/2008, 06/2031 $100.00 $30.08 2.74% $130.08 R168792517EE EE $200 07/2001; .12/2008. 07/2031' $100.00 $29.84 2.74% $129.84 I R169601202EE EE $200 ,08/2001 12/2008. 08j2031 $100.00 , ,. $29.52 2.74% $129.52 R169778498EE EE $200 09/2001, .12/2008: 09/2031: $100.00 $29.20.. " 2.74 % $129.20 R170179236EE EE $200 10/2001 12/2008 10/2031. $100.00 $28.96 2.74% $128.96 . R161173007EE EE $200 02/2000 12/2008 02f20301 " $100.00 ,.$40.48 2.74% _ ~ $140.48 R171151819EE EE $200 ,12/2001; ,12/2008,_ ,12(2031 I $100 00 $27.20 2.74% $127.20 R1740391830EE EE I $200 11/2001 .12/2008 11/2031' $lOD 00 , $27.52 _ 2.80% $127.52 R161365929EE EE $200 .03/2000? 12/2008 03/20301 $100.00 $40.16 2.74%j $140.16 R162482408EE EE $200 :04/2000:, ,12/20081, 04/2030: $100.00 , $39.84 ,,. 2.74% $139.84 Totals for 9 2 Bonds'$10,800.00 $2.003.36: ' 412.80336 Nates NI Not Issued NE _! Not eligible for.payment _. P5. 'Includes 3 month interest penalty _.. MA `Matured and not earnln interest http://www.treasurydirect.govBC/SBCPrice 4/16/2009 ftEV-1510E%~(&Be) SCHEDULE G COMMONWEALTH OFPENNSYLVANlA INTER VIVOS TRANSFERS Br INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY Ruth M. Swartz 21 09 0043 This schedule must he completetl and tiletl if the answer to eny of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBE DESCRIPTION OF PROPERTY nwnEr~rvvnEOFrarwNaFEaeE TXE~ft fteunorsHr ro oE<EOENr ero nEW1EOFlnNSEI ARPGIACDPI OF TAE DE£O FOR REAL ESTFTE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION FAoPUCABLE TAXABLE VALUE ~~ U. S. Office of Personnel Management 675.00 100.0000 0.00 675.00 1/3 of lump sum death benefit payable to Patricia Young TOTAL (Also enter on line 7, Recapitulation) S ~.,, ~ „~ (If more apace is needed, insert atltlltionel sheals of the same size) 3W48AF 1.000 REV-1511 El(~ (10.08) SCHEDULE H FUNERAL EXPENSES 8r ADMINISTRATIVE COSTS ESTATE OF r""'"'°°`~ Ruth M Swartz 21 090043 Debts of decetlent must be reported on Schedule I. REM NUMBER DESCRIPTION A. FUNERAL EXPENSES: ~, Patricia A. Young reimbursement for following: a. Myers Funeral Home $9,646.00 Total from continuation schedules . B. 1 2. 3. 4. 5. 6. 7, ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Atldress City Year(s) Commission Paid: AMOUNT 10,147.77 Attorney Fees Snelbaker & Brenneman, P.C. 865.00 Family Exemption: (If decedent's address is not the same as Gaimant's, attach ezplanalion) 3 , 500.00 Claimant Patricia A. Young Street Address 812 West Keller Street City Mechanicsburg State PA Zip 17055 Relationship of Claimant to Decedent DAUGHTER Probate Fees Accountant's Fees Tax Return Preparer's Fees None 14.512.77 7W48AG 1.000 (If more space is needetl, insert additional sheets of the same size) State Zip Estate of: Ruth M. Swartz Schedule H Part 1 (Page 2) Stem No. Description 1 b. The Mechanicsburg Clvb -funeral luncheon $371.77 c. Gingrich Memorials - inscription on marker $130.00 21 09 0043 Amount 10,147.77 Total (Carry forward to main schedule) 10,147.77 REV-15131'Xf(17-03) SCHEDULE .! Pennsylvania pEPARTMENrOPREVe"°E BENEFICIARIES INF~RRANCE TAX RETURN RESIDENT DECEDEM FILE NUMBER Ruth M. Swartz 21 09 0043 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Oo Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[InGUde outright spousal distdbutions, antl transfers under Sec. 2118 (a) (1.2).] 1. Patricia A. Young 812 West Keller Street Mechanicsburg, PA 17055 All of Residue: 81,347.10 Daughter 81,347.10 ENTER DOLLAR AMOUNTS FOR DISTRIBUTONS SHOWNABOVE ON LINES 75 THROUGH 18 OF REV-1500 COVER SHEET, AS APP ROPRIATE. 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 ONLINE 13 OF REV-1500 COVER SHEET. $ 0.00 awaeAl z.coo If more space Is needed, insert atlditional sheets of the same size. REV346 EX (8-92) PA DEPARTMENT OF REVENUE ESTATE INFORMATION SHEET County Code ~ Year ~ File Number uat,rur;Nr tlVruxMA77VN: enter data as it will appear on all documents submitted to the department. Name (Last) (First) (Middle) SWARTZ RUTH M• Decedent's Social Secudty Number Date of Death Date of Birth 222-OS-5506 11 30/2008 9/23/1919 TYPE FILING: Enter check / mark to indicate the nature of the return to be filed with the de artment. Probate Retum ~p~.f~int Assets Only ~ Estate Tax Only ®Litigation Purposes (No Oiher Assets) 'ERE GRANTED: Enter check (J) mark to indicate the nature of the proceedings at the Register of Wills Office. Attach additional sheets itez lanation is neceasa ®Testamentary ®Administration ®No Letters ®Other (Please Explain) IRNEY/CORRESPONDENT: Enter all data concerning the attorney or other individual to receive all tax information and comes onaence. Name (Last) (First) (Middle) Supreme Court 1.D. No. Snelbaker Richard C. 06355 Sueet Address Snelbaker & Brenneman, P.C., 44 West Main Street City State Zip Code Telephone Number. Mechanicsburg, PA 17055 (717 697-8528 ONAL REPRESENTATIVE Enter all data concerning the personal representative(s) of the estate authorized by the INFORMATION: Register oC Wills JUlN~I: VWIV r,K Name (LasQ (First) (Middle) Social Security Number Patricia A. Young 188-32-7422 SVeet Address 812 West Keller Street City State Zip Code Telephone Number Mechanicsburg, PA 17055 (717) 766-1363 Executor/Administrator Name (Last) (First) (Middle) Social Seourity Numher Street Address City Slate Zip Code Telephone Number Co-Executor/Ad m in istrato r Name (Last) (First) (Middle) Social Security Number Street Address City State Zip Code Telephone Number Prcpared By Date