HomeMy WebLinkAbout10-07-0915056041158
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
Po Box zaosoi INHERITANCE TAX RETURN 21 0 9 D 6 9 8
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
17D-30-3733 03042009 10181,906
Decedent's Last Name
MILLARD
Suffix Decedent's First Name
ERMA
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE BOXES BELOW
1. Original Return
^ 4. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
^ 9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
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)
MI
I
MI
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
r~
RICHARD C• SNELBAKER 717-697-&~28 `~ _~'?
Firm Name (If Applicable)
SNELBAKER & BRENNEMAN, P•C•
First line of address
44 WEST MAIN STREET
Second line of address
City or Post Office
MECHANICSBURG
State ZIP Code
PA 17055
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L2. -l. 3 r.~_
REGISTER OF YWLLS US
"' E~LY ' )
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DATE FILED
Correspondent's a-mail address:
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 of which preparer has any knowledge.
MYERS, EXECUTRIX 302 N•E• 49TH STREET, OAK ISLAND,
~~fl`iER THAN REPRESENTATIVE DA~E ~ N~ 28465
ADDRESS `-
RICHARD C• SNELBAKER, ESQUIRE 44 WEST MAIN STREET, MECHANICSBURG,
PLEASE USE ORIGINAL FORM ONLY
PA 17055
Side 1
15056041158
6M4647 3.000
15056041158
J
15056042159
REV-1500 EX
Decedent's Social Security Number
17D-30-3733
Decedents Name M I L L A R D E R M A I
RECAPITULATION
1. Real estate (Schedule A) 1.
O.OO
2. Stocks and Bonds (Schedule B) . 2. O , O O
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. (] • D D
4.
5.
6.
7.
8. Mortgages & Notes Receivable (Schedule D).
Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .
Jointly Owned Property (Schedule F) ~ Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested
Total Gross Assets (total Lines 1-7). . . . . . . . . . . . 4.
5.
6.
7.
8. O , O D
6 9 2 9 • O 8
O • O O
O • O O
6 9 2 9 • 0 8
9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 3 7 4 O • 5 5
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10. 2 3 9 O 9 O • 6 2
11. Total Deductions (total Lines 9 & 10) • 11 • 2 4 2 8 31 • 17
12. Net Value of Estate (Line 8 minus Line 11) 12. - 2 3 5 9 0 2 • O 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) • 13• O . O O
14. Net Value Subject to Tax (Line 12 minus Line 13) 14. - 2 3 5 9 0 2 • D 9
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 .OIL O •O O 15. O •O O
16. Amount of Line 14 taxable
at lineal rate X .0'x.5 0. 0 0 16. 0- D O
17. Amount of Line 14 taxable
at sibling rate X .12 D • O O 17• O.O O
18. Amount of Line 14 taxable
at collateral rate X .15 O.O O
18•
D • O O
19. TAX DUE 19. D • O O
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042159 6M46482.000 15056042159
REV-1500 EX Page 3
rlennelnn4~c Cmm~ln+c A!•IfIrGCN
File Number
ai, n9 n~,9R
DECEDENTS NAME
MILLARD ERMA I
STREET ADDRESS
TH
CUMBERLAND COUNTY
CITY STATE ZIP
CARLISLE
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit 0 • 0 0
B. Prior Payments 0 • 0 0
C. Discount ~ • ~ ~
3. Interest/Penalty if applicable
D. Interest 0 • 0 0
E. Penalty ~ • 0 ~
(1) 0 •00
Total Credits (A + g + C) (2) 0 • 0 0
Total Interest/Penalty (D + E)
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.
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.
(3)
(a> 0.00
(5> 0.00
(5A)
(56)
Make Check Payable to: REGISTER OFWILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
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, 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?
0.00
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 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 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. F9116(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.
6 M 4671 1.000
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Erma I. Millard 21090698
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joinUyowned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER f1FCrRIPTI(~N OF DEATH
1 Church of God Home
refund due the Decedent
3W46AD 1.000
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
6,929.08
TOTAL (Also enter on line 5, Recapil
(If more space is needed, insert additional sheets of the same size)
6,929.08
REV-1511 Eh+(10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Erma I Millard 21 09 0698
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~ Cocklin Funeral Home
2 Flowers for funeral
Total from continuation schedules .
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) Ann M Myers
Street Address 302 N. E . 49th Street
City Oak Island State NC Zip 28465
Year(s) Commission Paid:
2. Attorney Fees Snelbaker & Brenneman , P . C .
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4.
5.
6.
7.
1
7W46AG 1.000
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Ann M. Myers
travel expenses from North Carolina (1,050 miles @
.55 per mile)
Total from continuation schedules .
TOTAL (Also enter on line 9, Recapitulation) ~ $
(If more space is needed, insert additional sheets of the same size)
461.02
267.00
200.00
346.00
1,250.00
91.00
577.50
548.03
3,740.55
Estate of: Erma I. Millard
Schedule H Part 1 (Page 2)
Item
No. Description
21 09 0698
Amount
3 Funeral Luncheon 200.00
Total (Carry forward to main schedule) 200.00
Estate of: Erma I. Millard 21 09 0698
Schedule H Part 7 (Page 2)
2 Cumberland Law Journal
advertising Executrix Notice 75.00
3 Patriot News
advertising Executrix Notice 158.03
4 Register of Wills
filing fee for Inheritance Tax Return 15.00
5 Reserve
for filing fees and other costs associated with the
administration of the Decedent's estate 300.00
Total (Carry forward to main schedule) 548.03
REV-1512 EX+ (12-08)
pennsylvania SCHEDULE t
DEPARTMENTOF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RFCIlIFNT !lF!`FfIFNT
ESTATE OF FILE NUMBER
Erma I. Millard 21 09 0698
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ewasAH z o0o If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (11-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
`~ ~ " ~ ` ~~ FILE NUMBER
Erma I. Mil lam ~, nn ncno
RELATIONSHIP TO DECEDENT v + v AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under
Sec. 2116 (a) (1.2).]
1 Ann M. Myers
302 N.E. 49th Street
Oak Island, NC 28465 Daughter 0.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 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 ON LINE 13 OF REV-1500 COVER SHEET. $ 0 . 0 0
If more space is needed, insert additional sheets of the same size.
awasAi 2.000
~,~tt.~'t mill ~tt~ ~~~t~r~~eitt
OF
ERMA I. MILLARD
BE IT REMEMBERED, that I, ERMA I. MILLARD, of 25 Bel Air Arive, Dillsburg,
York County, Pennsylvania, being of sound mind, memory and understanding, do make,
publish and declare this as and for my Last Wi11 and Testament, hereby revoking
and making null and void any and all Wills and Testaments and writings in the nature
thereof by me at any time heretofore made.
ITEM l: I direct that all my just debts and funeral expenses be paid as soon
after my demise as may be convenient.
ITEM 2: All the rest residue and remainder of my Estate of whatsoever nature
and wheresoever situate, whether it be real, personal, or mixed, including property
over which I have a power of appointment, I give, devise and bequeath unto my daugh-
ter, ANN M, MYERS, absolutely, provided she survives me for a period of thirty (30)
days.
ITEM 3: Should my daughter, ANN M. MYERS, predecease me or fail to survive
me for a period of thirty (30) days, I then give, devise and bequeath my entire
residuary estate to be divided in four (4) equal shares as follows:
(a) One (1) share to TERRY L. MYERS.
(b) One (1) share to RANDY L. MYERS.
(c) One (1) share to LORI A. MYERS SULLIVAN
(d) One (1) share to my son-in-law, J. RICHARD MYER5.
ITEM 4: I direct my Executrix to pay all inheritance, estate, succession and
legacy taxes of whatsoever nature and kind, to which my Estate or the transfer of
any property passing hereunder or otherwise passing by reason of my demise, may
be subject and to charge such taxes against my residuary estate, it being my inten-
tion that none of the aforesaid taxes, either federal or state, on any property
required to be included in my gross esL-ate, under the provisions of any state or
,. I
;:
t~ „ ~:
a ., ~ ! ~.-~_ ~:~.___ !~ ~! ~~"~ "'~ ( SEAL )
ERMA I. MILLARD
federal law now in force or hereafter enacted, shall be prorated among the persons
interested in my Estate to whom such property is or may be transferred or to whom
any benefit accrues.
ITEM 5: I appoint my daughter, ANN M. MYERS, as Executrix of this my Last
Will and Testament. Should my daughter, ANN M. MYERS, predecease me, fail to qualify
cease to act or renounce probate, I then appoint my son-in-law, J. RICIiARD MYERS,
as alternate Executor of this my Last Will and Testament.
ITEM 6: I direct that my Executrix shall not be required to give bond for
the faithful performance of its duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,~=~~"~ da of
Y
' r ~, 1989.
~~~~~~
r ` ,_
.~r_ ~i.. ~ ~` ~~ ~ (SEAL)
ERMA I.MILLARD
`j
COMMONWEALTH OF PENNSYLVANIA
5S
COUNTY OF YORK
We, ERMA I. MILLARD, JAN M. WILEY, ESQUIRE and S. DAWN GLADFELTER, the Testatrix
and the witnesses respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority
that the Testatrix signed and executed the instrument as her Last Will and Testament
and that she had willingly (or willingly directed another to sign for her), and
that she executed it as her free and voluntary act for the purposes therein ex-
pressed, and that each of the witnesses, in the presence and hearing of the Testatrix
signed this Last Will and Testament as witness and that to the best of their know-
ledge the Testatrix was at the time eighteen (18) years of age or older, of sound
mind and under no constraint or undue influence.
1
..
1 ~ ~
ERMA I. MILLARD
~`
~ WITNESS
(:~.~
WITNESS
Sworn to and subscribed
~~
before me this ~ day
l Y v y .
o f ~~ t ,~.i.i ~=~~.1, : 19
~~
l~OTARY PUBL C
MY GOMMItiSIQN EXPIRES:
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