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HomeMy WebLinkAbout10-20-0915056051058 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 280601 a i a9 ©a ~ -r Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 207-22-7812 02/25/2009 12/20/1928 Decedent's Last Name Suffix Decedent's First Name MI Evelyn A Winey (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER O F WILLS FILL IN APPROPRIATE OVALS BELOW r 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) 1 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 TO: Name Daytime Telephone Number Allan K. Winey (717) 579-8722 Flrm Name (If Applicable) (REGISTER OF WIL~~ILSE ONLYu®- I`T`7 + First line of address I~(7 ~ _ ~ ~ <a3C~ ~. 765 Mount Airy Road rT t'\J ~ ; " :z-'-' ~ t - '~ a Second line of address ~ ~ f "> k H; { r DATE ~D fi- r'Tl City or Post Office State ZIP Code ~ ~• =' ~::a _ W S.,y Lewisberry PA 17339 Correspondent's a-mail address: alWiney@yahOO.COfn Under penalties of perjury, 1 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. DeGaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PER/~~SIB O .L,p~p~~~N- / /ATE fff ~ ~ % %~{/'[~ D ADDRESS .. ~ A n i ! / /1i ...__... SIGNATURE OF PREPARER OTHER DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Evelyn A Willey ' 207-22-7812 s Name: Decedent 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 4. 9 9 ( ) ............................ Mort a es 8 Notes Receivable Schedule D . 4. 0'00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 43,115.19 6. Jointly Owned Property (Schedule F) °'~ Separate Billing Requested ...... . 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 00 0 (Schedule G) "Separate Billing Requested....... . 7. . 8. Total Gross Assets (total Lines 1-7) ................................... . 8. 43,115.19 9. Funeral Expenses 8~ Administrative Costs (Schedule H) .................... . 9. 12,103.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... . 10. 1,190.46 11. Total Deductions (total Lines 9 8 10) .................................. . 11. 13,293.46 12. Net Value of Estate (Line 8 minus Line 11) ............................. . 12. 29,821.73 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... . 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... . 14. _ 29,821.73 _, _,_.. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 00 0 00 0 . (a)(1.2) X .0_ 15. . 16. Amount of Line 14 taxable at lineal rate x .0 45 29,821.73 16. 1,341.98 17. Amount of Line 14 taxable 0 00 0 00 . at sibling rate X .12 17. . 18. Amount of Line 14 taxable 00 0 0.00 . at collateral rate X .15 18 19. TAX DUE ........................................................ . 19. 1,341.98 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 flwwe~rlwn4~c f'`~m nlnfo ~rl/'IrOCC' File Number _.. DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Evelyn A Winey 207-22-7812 STREET ADDRESS 765 Mount Airy Road CITY STATE ZIP Lewisberry PA 17339 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 0.00 3. InterestlPenalty if applicable D. Interest E. Penalty 0.00 0.00 (1) Total Credits (A + B + C) (2) Total InterestlPenalty (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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (56) Make Check Payable to: REGISTER OF WILLS, AGENT 1,341.98 0.00 0.00 0.00 1,341.98 0.00 1,341.98 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 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? ................................................................................................................. ....... ~ ^ 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 exemg_t 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)J. 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 p CASH, BANK DEPOSITS, $c MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Evelyn A. Winey Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Belco Community Credit Union -Savings Account 14,928.34 2. Belco Community Credit Union -Checking Account 4,700.00 3. Belco Community Credit Union -Certificate of Deposit 7,199.82 4. Belco Community Credit Union -Certificate of Deposit 4,591.15 5. Belco Community Credit Union -Certificate of Deposit 5,274.80 6. Belco Community Credit Union -Certificate of Deposit 5,141.15 7. PNC Bank -Checking Account 1,279.93 TOTAL (Also enter on line 5, Recapitulation) S I 43,115.19 (If more space is needed, insert additional sheets of the same size) _~ REV-1737-fi EX + (6-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & use scheduie G, Part 2, ONLY for proportionate method of tax computation. MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Evelyn A. Winey Part 1 must include all transfers of real estate and tangible personal property located in Pennsylvania. Complete Part 2 ONLY when the proportionate method of tax computation is elected. i.,~i~ „~o ~~ rhp riwscrlntinn of nrnnertv the date the transfer was made and the name and relationship of the transferee. This schedule must be completed and filed if the answer to questions 1 throu gh 4 on the reverse s ide of the REV-1737 cover s heet Is yes. DESCRIPTION OF PROPERTY the relatbnship to Decedent and the date of transfer. ITEM Include the name of the transferee DATE OF DEATH % OF DECD'S EXC4USION , NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APPI.ICAiBLE) TAXABLE VALUE ~• Allan K. Winey, son, May 11, 2009 27,375.00 100 27,375.00 0.0( 2. Allan K. Winey, son, May 11, 2009 35,794.00 100 35,794.00 0.0( 3. William S. Winey, son, May 11, 2009 27,375.00 100 27,375.00 0.0( 4. William S. Winey, son, May 11, 2009 35,794.00 100 35,794.00 0.01 5. Philip D. Winey, Son, May 11, 2009 27,375.00 100 27,375.00 0.01 g. Philip D. Winey, Son, May 11, 2009 35,794.00 100 35,794.00 0.01 PART 1 TOTAL $ $ $ O.Oi ~ •. DESCRIPTION OF PROPERTY ITEM Indude the name of the transferee, the relationship to Decedent and the date of transfer. DATE OF DEATH % OF DECD'S EXCLUSIDN NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APRLICABLE) TAXABLE VALUE 1. PART S TOTAL $ $ $ O.Oi TOTAL (Also enter on Line 7, Recapitulation.) $ 0.00 (If more space is needed, use additional sheets of paper of the same size) REV-1737 EX + (6.08) REVERSE SCHEDULE N Pennsylvania FUNERAL EXPENSES & Use Schedule H ONLY for proportionate DEPARTMENT OF REVENUE method of tax computation. ADMINISTRATIVE COSTS INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF FILE NUMBER Evelyn A. Winey Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT q, FUNERAL EXPENSES: ~~ Parthemore Funeral Home & Cremation Services, Inc. 11,933.00 2. Gingrich Memorials 170.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commission(s) Name(s) of Personal Representative(s) (Submit requested information for additional personal representative's on additional sheets) Social Security Number(s) or EIN Number(s) of Personal Representative(s) Street Address(es) city(ies) State(s) zIP(s) Year(s) Commission Paid 2. Attorney Fees 3. Probate Fees 4. Accountant's Fees 5. Tax Retum Preparer's Fees 6. Miscellaneous Expenses TOTAL (Also enter on Line 9, Recapitulation.) I $ 12,103.00 (If more space is needed, use additional sheets of paper of the same size) REV-1512 EX+ (12-08) ;...; ~' Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUIWIBER Evelyn A. Winey Revert debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. LAST WILL AND ?ESTAI~.N'P DF EVELYN A. WINEY I, EVELYN A. WINLY, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all by me at any time heretofore made_ 1. I direct that all my debts and funeral expenses be paid as f~• soon as practicable after my death, by my Executor hereinafter named. 2_ All the rest, residue and remainder of my estate, real, ger- sonal and mixed, and wheresoever the same may be situate, I give, deg and bequeath to my husband, William K_ Winey, his heirs and assigns, to the exclusion of my children, born and unborn, provided my said husband, William K_ Winey, shall survive me by a period of sixty (60) days. 3_ Should my husband, William K. Winey, predecease me or fail to iww offices MARTEON Ne) StIR~AKER survive me by the aforesaid period of sixty (60) days, then in such event, all the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to my sons, Allan K. Winey, William S. Winey, and Philip D. Winey, their heirs and assigns. Should any child of mine predecease me, I direct the share such deceased child would have received shall pass to his issue surviving me per stirpes and if there ~ be no such issue then such share shall lapse_ 4. Should any person less than eighteen (18) year of age share in my estate, I nominate, constitute and appoint Dauphfn Deposit Trust Company., its successors and assigns, Harrisburg, Pennsylvania, as guardian of the estate of such minor child, anal I authorize and direct said gu~dia~n ;ta `iru+,~ the same and to pay so much of the income arisin thereon ~~~'~~~ so much of the principal thereof as in the opinion( ..s:1 'j J of said guardian is necessary or desirable to be expended for the proper bS ~ ! l N~ £ I ~~~ ~UBl h - . (1 maintenance. support and education of such minor child, to the person 11 ~~ having custody of such minor child, and upon such child attaining eighteen (18) years of age to pay the then remaining principal togethE with any undistributed income to such child. 5. Should my said husband, William K_ Winey, predecease me, and should I be survived by any child less than eighteen (18) years of age, then in such event, I nominate, constitute and appoint Allan K_ Winey and William S. Winey as guardians of the person of such minor child. b_ I hereby nominate, constitute and appoint my said husband, William K_ Winey, as Executor of this my Last Will and Testament, but should he predecease me or fail to qualify, then in such event, I nomir. constitute and appoint Allen K_ Winey, as Executor of this my Last Wil and Testament, and I further direct that no person serving as Executor shall be required to post any bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania or in any other jurisdiction. ~ WITriESS ~~ I have hereunto set my hared and seal to this my Last W311 and Testament written on two (2) pages this ~ ~~ da y ~.tvw~--- 1975 _ ~~ G Evei A_ Winey ~~ Signed, sealed, published and declared by Evelyn A. Winey, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witness ~ w , ~6"ad ~ ~~ uw oFrxEs Mwtfsow No 5+¢s~.uw¢e~e