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HomeMy WebLinkAbout09-02-0915056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosol 21 09 00798 Harrisburg. PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Da~ of Birth 046-14-1791 Q ~ ~~~rJ09 x'/22/1918 Decedent's Last Name Suffix Decedent's First Name Dorris 'Marjorie (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name __. 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 Return 3. Remainder Return (date of death prior to 12-13-82) a:w 4. Limited Estate t; "w< 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 G 10. Spousal Poverty Credit (date of death C:,.~ 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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Te{ephone Number Diane SuFlivan (717) 761-2488 __ _ _. _ Firm Name (If Applicable) __ _ _ . r:~ REGISTEI~F WILLS USE~LY ~ _l ~ - ,. _ ~ s Gam, ;~ , ~ - _._._. _. ,t r , 1 ~ ~ 't7 } ~ C First line of address _ _ '~: r - _-rT~ l i .". 2 Redwood Court v>.': ~ } ' Second line of address ~- ~i, -t~ ~.~- ~ ._ , ~ .. ; J.,J [~ D~'E FILED ~ !' City or Post Office State ZIP Code - - - - -- E,J Camp Hifl PA :17011-1549 Correspondent's e-mail address: pCSUII@Verizon.net Under penalties of perjury, I declare that f have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeclaraJjon of preparer other than the personal representative is based on all information of which preparer has eny knowledge. -- SIGNAT • QF PERSON RESPON BL FILING ttETUR DATE t;'~ __ - _ _ - -- ~o77f ADDRESS r r(J r // /~ / ----- - -L--- DAT NATURE OF C~ E HER THRN REP SE T TIVE -- - -- -- onnRFCC _ . ~ A / i / / i/1 ,.-sue .~ .s PLEASE USE ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number __ Decedents Name: Marjorie H Dorris _____... --- . _ 046-14-1791 _ . .___._..~_ ._.~_ _~...__ RECAPITULATION __~__..___.__ __..__,..__.______~~________..___..._.____._.~___.. _.__~. 1. Real estate (Schedule A) . ........................................ .... 1. ' 0.00 '. 2. Stocks and Bonds (Schedule B) ................................... .... 2. ' 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00 I, 4. Mortgages 8 Notes Receivable (Schedule D) .......................... ... 4. ' 0.00', 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 15,438.83 6. Jointly Owned Property (Schedule F) Separate Billing Requested .... ... 6. ! 0.00'. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ,_.~... ~.. , , . _ ._--__... w _ ~ _..._~. .,..~ (Schedule G) t Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1-7) ................................. ... 8.i 15,438.83 '; 9. Funeral Expenses i~ Administrative Costs (Schedule H) .................. ... 9. ' 0.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10, 0.00 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. ' 0.00 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 15,438.83 an election to tax has not been made (Schedule J) ........................ 13. 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 tr~ncfnrc ....ae. c.... ne~c ........... ...._._. ......... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 15,438.83 t,~~:a 15056052059 Side 2 15056052059 ~2EV-1500 EX Page 3 + Decedent's Complete Address: File Number ~ 21 ~ 09 i :00798 Marjorie H Dorris STREET ADDRESS 208 Senate Avenue ~~ ~ ~/(~ CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments 0.00 A. Spousal Poverty Credit _ _ _ _ __ B. Prior Payments 0.00 C. Discount 34.74 DECEDENTS SOCIAL SECURITY NUMBER 046-14-1791 STATE ZIP PA 17011 (1) 694.75 Total Credits (A + B + C) (2) 34.74 3. InteresUPenalty if applicable 0.00 D. Interest E. Penalty 0.00 Total InteresUPenalty (D + E) (3) 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. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 660.01 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56} 660.01 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 :.......................................................................................... ^ 0 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? ........................................................................................................................ ^ 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)]. The statute doss 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)]. 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-1508 EX+ (6-98) ' ; SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Marjorie H, Dorris 2009-00798 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyawned with right of survivorship must be disclosed on Schedule F. {TEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 '' Members 1st FCU 3512 Market Street Camp Hill PA 17011 Account #156580-11 Checking 11,114.07` 2' Members 1st FCU 3512 Market Street Camp Hill PA 17011 Account #156580-00 Savings 4,324.76' TOTAL (Also enter on line 5, Recapitulation) ~ 15,438.83'). (If more space is needed, insert additional sheets of the same size) COPY y LAST WILL ANDn TESTAMENT Or MARJORIE H. DORRIS THE ttiRtt;IroAL OF Tw~ttc !'C~UMENT WIAS B~riv t2Ei'AiIVEp BY US FdR G~-FEKEEPiNG. HOWE TAYBtA & p , ~` E7 ~ I, MARJORIE H. DORRIS, presently residing in the County of Lake, State of Florida,. being possessed of a sound and disposing mind, memory and understanding, and under no restraint whatsoever, do hereby make, publish. and declare this to be my LAST WILL & TESTAMENT, hereby revoking any and all former Wills and Codicils thereto, or testamentary dispositions of whatever nature, which I may have heretofore made. ARTICLE I I desire and direct that all of my just debts and funeral expenses be paid as soon as practicable after my demise by my Personal Representative hereinafter named and appointed. ARTICLE II I further direct my Personal Representative to pay all estate, inheritance, succession, legacy and transfer taxes, if any, imposed by and made payable under the laws of the United States and the State of Florida, or any other State or Country, by reason of my death, and to charge such payments against my residuary estate as a testamentary expense. ARTICLE, SECTION 1. It is the intention of this Testament that after my decease, I give and devise such of my tangible personal property to those persons designated in a separate writing, in existence at the time of my death, which is signed by me, and which describes the items acid devisees with reasonable certainty, except for such items as may be expressly devised hereinafter in my Last Will and Testament, and except for any motor vehicle or mobile home that I may own at the time of my death. t , MARJO E H. DORRIS PANE 1. To the extent that said writing ar my Will., should fail to dispose of any of my tangible personal property, then I give and devise the same unto such of my two children as shall survive me to be disposed of as they shall deem best. The Names and present addresses of my children are as f©llaws: DIANB B. SULLIVAN, 2 Redwood Gaurt, Camp Hill, Pennsylvania 17012; GERALD R. BRADLEY, ?1 Catlin Street, Meriden, Connecticut 06450. SECTION 2. A11 of the rest, residue and remainder of my property, of whatever nature and kind and. wheresoever situated, including all property acquired by me after the execution of this Will, and any real property which is my homestead, I give, devise and bequeath unto my Personal Representative hereinafter nominated and appointed and direct that she or he sell ar liquidate the same for the best prices obtainable, within her ar his sale judgment and discretion, and pay over ar distribute the net proceeds therefrom (after the deduction of all costs and expenses, including the costs of administration} in equal shares to my said children, and to my Sister, LOIS CYPHERS, now of 444 Cook Avenue #2, Meriden, Connecticut 06451-6203, if living, and if not, then to their surviving children, per stirpes. ARTICL$ IV I hereby nominate and appoint my daughter, the said, DIANE B. SULLIVAN to be the Personal Representative of this my Last Will and Testament, to serve without bond, conferring upon my said Personal Representative full power to deal with all acts and things necessary concerning my estate which I could do if living, to-wit: (a} To sell without notice, all or any part of the property of my estate, real or personal, upon such terms as my Personal Representative may deem advisable. tb} To execute deeds, proxies, assignments and any other instruments relating to the assets constituting my estate. t MARJO g H. DORRIS PAGB 2. {c} To compromise or settle any claims in favor of or against my estate. {d} To borrow money for such periods of time and upon such terms and conditions as shall. be advisable and to mortgage or pledge such portion of the estate as she may be required to secure such loan or loans . In the event that my said daughter shall predecease me, be unwilling or unable to serve as such Personal Representative, then and in that event, I nominate and appoint my son, the said f3ERALD R. BRADLEY to act instead and serve without band, conferring upon my successor Personal Representative the same powers and duties as hereinabove conferred upon my primary Personal Representative. The powers and authority herein granted and conveyed to my ~ personal representative{s} shall not be construed as any limitation ~'~,~% upon their powers but shall be in addition to the powers conferred ~``~ ~ by law. All such powers specially bestowed may be exercised ~~without first attaining the approval of any Court. -.-_..~~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my LAST WILL & TESTAMENT, consisting of 4 pages, each page bearing my signature, on this~~~ day of April, 1994. MARJO 8 H. DORRIS This instrument bearing the signature of the above Testatrix was signed, sealed, published and declared in the presence of each of us, who, at her request and in her sight and presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto, we and each of us believing the said Testatrix to be of sound and disposing mind and memory at the date hereof. ~- residing i `~°'~--~,~ residing in .~~d~ C./ pAaE ~. STATE OF FLORIDA COTJNTY OF LAKE ~/ We MARJORIE H . DORRI S , ,/ J`J,,~"~~7Y~ ~. ~ , and !~/~,,r~ ~':•~ ~'' the Testatrix and the witnesses respectively, whose names are signed to the attached and foregoing instrument, being first duly sworn, do hereby declare to the undersigned officer that the Testatrix signed the instrument as her Last Will and Testament and that she signed voluntarily and that each of the witnesses in the presence of the Testatrix signed the Will as Witnesses and that to the best of the knowledge of each Witness the Testatrix was at that time eighteen (18) years or more of age, of sound mind and under no constraint or undue influence. MARJO E' H. DORRIS Subscribed and acknowledged before me by the Testatrix and subscribed and sworn to before me by the following witnesses: ~.~~~_~ ~ 4~d~+- and. f all personally known to me, this da of April, 1994. ~. A '.'SOT NOTARY PUBLIC ~/~--/ NOTARY f'U9I.lC STATE C3F FLORIDA COMM1551C~N NO. CC2!?G93 j MYCOMM! t0,~(fiXn, AUG. 1996 ( Printed Name of Notary PANE 4. ~~ ~Q foG ~~~ ~~ ~~~ - ~ ~l APB