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Home My WebLink About10-29-09 1505607121 05 REV-1500 EX (06 - ) PA Department of Revenue OFFICIAL USE ONLY - _ Bureau of Individual Taxes County Code yea File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 7$ 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6~ 3 6 7 3 6 1 0 8 0 1 2 0 0 9 0 6 0 3 2 0 0 5 Decedent's 'east Name Suffix Decedent's Firs t Name MI D A I H L V E L V A D (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 OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior tc 1 "C-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Regwred 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 tp tax under Sec. 91 13(A) between 12-31-91 and 1-1-95) (Attach Sph. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ~J O E L R Z U L L I N G E R 7 1 7 2 6 4 6 0 2 9 Firm Name !Jf Applicable} ,-,,~ REGISTER OF WILLS USE;OI?ILY _ _ Z U L L I N G E R D A V I S P , ~ C~ - First line of address l 1 4 N O R T H M A I N S T R E E T Second line of address - , S U I T E 2 0 0 City or Post Office State ZIP Code SATE FILED _ -o C H A M B E R S B U R G P A _ 1 7 2 0 1 T 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 preparenas any knowledge. SI AT_UR~E OF PERSO,~I RESPONSIBLF~OR F~`l(;•IG RETURN DATE ADD ' ~ J-_~ 55 SOUTH MAIN STREET CHAMBERSBURG PA 17201 SIGNATURE OF Pf?~A~ER-¢THEFj-THAN REPRESENTATIVE ,DATE, ADDRESS _ 14 NORTH MALN'STREET, SUITE 200 CHAMBERSBURG PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 i I / L_ PA 177201 1505607221 (t `,`,' i, REV-1500 EX 1505607221 Decedents Social Security Number oecede~t s Name: V E L V A D. D A I H L 1 6 4 3 6 7 3 6 1 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. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) .. .. 5. 6 5 2 3 2 , ~ 0 6. Joint y Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. • ?. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1-7) ....................... .. 8. 6 5 2 3 2, 7 0 9. Funeral Expenses & Administrative Costs (Schedule H) .............. .. 9. u+ 1 2 6 8 . 6 7 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) 10. 2 4 1 8 , 6 1 11. Total Deductions (total Lines 9 & 10) .... ......... ........ .. 11. y ~ 6 8 7 . E 8 12. Net Value of Estate (Line 8 minus Line 11) ...... ........ .. 12. 5 1 5 4 5 , 4 2 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . 13. 4 8 5 4 5 , 4 2 14. Net Value Subject to Tax (Line 12 minus Line 13) ................ .. 14. 3 0 0 0 d 0 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.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .o _ 0. 0 0 16 0. 0 0 17. Amount of Line 14 taxable ~ ~ 0 at sibling rate X .12 17. 0. ~J 0 18. Amount of Line 14 taxable 3 0 0 0 0 Q at collateral rate X .15 18. 4 5 0. G 19. Tax Due .... ............................... .. 19. 4 5 0 . ~' 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REV-? 500 Ea Page 3 Decedent's Complete Address: File Number 21 09 0787 - --, DECEDENT'S NAME ' VELVA D. DAIHL j STREET ADDRESS { 603 East Orange Street CITY STATE ZIP Shippensburg PA 17257 ( Tax Payments and Credits: ~. Tax Due (Page 2 ~ine 19) 2. CreditslPayments 4. Spousal Poverty credit B. Prior Payments ~. Ciscount 22.50 3 ~nterestlPenalty if aop~icable ~. I merest Penalty (~) 450.00 Total Credits (A + B + C) (2) 22.50 Total InterestlPenalty (D + E) (3) 4, !f Line 2 greater trap Line 1 + _ine 3. enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (~) 5. If tine 1 + Line 3 is greater ihan '~_ine 2. enter the difference. This Is the TAX DUE. !:5) A Enter the interes~ on the tax due. (5A) B Enter ^.he total of _ine 5 + 5A. This a the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: ~'es No a retain the use or income of the property transferred : ................................................................. i ... X ts income; .......................... o retain the right to designate who shall use the property transferred or ... ~ ^X ~~ retain a reversionary interest; or ........................................................................................... ... d receive the promise for life of either payments, benefits or care? .................................................. _.. 2. ~,f death occurred after December 12, 1982, did decedent transfer property within one year of death '~ without receiving adequate consideration? ................................................................................. ? " .... ... or payable upon death bank account or security at his or her dealh 3. Did decedent own an "intrust for .., Dic aecedent own an Individual Retirement Account, annuity, or other non-probate property which a , 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 suwiving spouse is three (3) percent [72 P_S. §9116 (a) (1.1) (~)]. 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 ~s zero (0) percent [72 P.S. §9116 (a) (1.1) (nj]. 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 stile applicable even if the surviving spouse is the only beneficiary. For dates of death on or a*ier 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)(" 3 ! A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 0.00 0.00 427.50 427.50 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER VELVA D. DAIHL 21 09 0787 _ Include 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 LATE NUMBER DESCRIPTION OF DEATH 1. Receipt of funds from Revocable Trust of Velva D. Daihl held 28.592.88 with M&T Bank 2. Refund, Comcast Cable 2.11 3. Allstate Insurance, premium refund 128.00 4. Gross proceeds from sale of personal property 12 975.25 by Kenny's Auction 5. Cash found in decedents residence 835.35 6. Checking Account #97200034, M&T Bank, 20 327. ~ 1 including interest accrued to date of death 7. Social Security benefit payment for July 871.00 8. Premium refund state workers insurance, Policy No.03980679 1 501.00 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY TOTAL (Also enter on line 5, RecapiY.;la:ion) I $ 65.232.70 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(~~-06} SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER VELVA D. DAIHL 21 09 0787 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOJNT 4. FJNERALEXPENSES: B ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Manufacturers and Traders Trust Company street Address 55 South Main Street city Chambersburq state PA Z;p 17201 Year(s) Commission Paid: 2. Attorney Fees Joel R. Zullinger 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address a. 5. 5. 7. 8. 9. 10 City State Zip _ Relationship of Claimant to Decedent Probate Fees Letters - 30.00; shorts - 12.00; Will - 15.00; JCP - 10.00; Automation 5.00; additional cost of letters 105.00; filing return 15.00 Accountant's Fees Tax Return Preparers Fees Borough of Shippensburg, dumpster fee for removal of trash Embarq, final telephone expense Penelec, final utility expense Kenny's Auction, commission and expenses sale of personal property 5.000.00 2 500.00 192.00 291.60 10.48 30.77 3 243.82 TOTAL (Also enter on line 9, Recapitulation) I $ 11,268.67 (If more space is needed, insert additional sheets of the same size) REV ' S ~ 2 EX + (12-03 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS is I AI t yr FILE NUMBER VELVA D. DAIHL 21 09 C787 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALU'~ A` DFTE NUMBER DESCRIPTION 0='DEATH 1. Joseph V. Brown, CPA, accounting services 2,255.00 5/1108 thru 8/1/09 2. (Cumberland Valley Medical Services, medical expense due at death 3. ~ Pharmacare, prescription costs due at death 4. Baxter, Drew, Wellmon, D.O., medical expenses due at death TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10.00 1 i 3.61 40.00 2,418.51 REV-' S13 EX r !g-C9) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER VELVA D. DAIHL ~~ na m~~ RELATIONSHIP TO DECEDEf~ T AMOUNT CR SNARE NUMBER PJAME AND P,DDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) 0= ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. James Lesher Collateral 1.000.00 519 East Orange Street Shippensburg, PA 17257 2. Bertha Thompson Collateral 1..000.00 615 Britton Road Shippensburg, PA 17257 3. Dorothy Diehl Wenger Collateral 1.000.00 40 Shuman Road Newbu.Yg, PA 17240 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-" 500 CO'/ER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B CHARITABLE AND GO`JERNMENTAL DISTRIBUTIONS 1. Shippensburg University Foundation 24.272.71 1871 Old Main Drive Shippensburg, PA 17257 50% of residue $24,272.71 2. Messiah United Methodist Church 24.272.71 30 South Penn Street Shippensburg, PA 17257 50% of residue $24,272.71 TOTAL OF PART [I -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE'~T $ 48,545.42 (If more space is needed, insert additional sheets of the same size) 7RZ - 5 . 1. ciai':~~1 .2 Apri 21, 2009 I, 'Veiva De ~~.ik?lY of 603 East Orange Street, Shippensburg, Cumberland Count.yr, Pennsylvania, being of sound and disposing mind, ~~t~er_~or_y and -~anderstandii~g, clo hereby declare this to be my will, hereblr recroking any and all former walls and codir_ils thereto by me heretofore made. .-~\~ ,~ ~~ ~;_. ~;~~,~''~ I direct that all my just debts and funeral expense, .~___, -~~ i ~~.clu.d_i.ng a.;_1. expenses of my 1 ast illness, shall be paid from ;ry - ~~ esca.te as ~oor~ as pract~_cable after my decease as a_ part of the ~~ experyse of the administration of my estate. ___~ _, ~~a I give and bequeath those items listed on a separate unsigned i~:teTnorandum which refers to this my will by date to the individual~> tamed therein. In the event that no such memorandum is found ~~ithin thirty days following my death, this bequest shall. become mull and void. -f ~:~~ o I give grid bequeath the sum of $1, 000.00 cash to James Lesher, ;r he survives me by thirty days. ~Vo _ give and bequeath the sum of $1,000.00 cash to Bertha '~'hompson, if sh.e survives n1e by ttlirty days . u~ =° 3 ~'~, . ~, ~,: "~,- \~ I give and bequeath the sum of $l, 000.00 cash to Dorothy Diehl ~..~ ) ~nleilger, _.f she survives me by thirty days . \~ ~~ ~~, ~' y~~~~ g. ____~~~ ~~-- ~~`'~ I give, devise and bequeaths the residue of my estate of every ,, ~~~~~~;, nature and wherever situate as follows: ra. ~~'iLty percent thereof to the Shippensburg University roundation, Inc., to be used to establish a scholarship fund to be named the Sam•~sel L. and Velv a D. Daehl Scholarship Fund, with the rer_ipient selected by the Shippensburg College Club, (in addition to the existing college club scholarship) or if they should no longer exist, by the board of directors of the Shippensburg Fage 2 University Foundation, Inc. Preference shall be given to ;individuals studying secondary education, preferably English, History or Science from the Shippensburg Area School District based on need and demonstrated academic ability. B. The balance of the residue, being 500, to Messiah United ~~ethodist Church, Shippensbu.rg, Pennsylvania, to be added ~~ to the Sam and Velva Daih1 Endowr~lent Fund of Messiah ,~~ s '~~,~ United Methodist Church for the benefit of Children and ~~ ~i ~`~ ~Zouth Christian Development. ~"'~ --~ ~ ~:C ~ .. ,r `~/ y `J~-a, a r I have in my home various files of information concernincT ., --_-__, `~~" v~,rior_ls families and subjects . These files have no monetary value . !! ,;~ l dize:ct my executor to turn these files over to the individual named in the file and if no individual is named, that file sb.al)_ be given to an appropriate person as determined by my executor in its sole discretion. ~~x~o In the event my personalty is sold at public sale, i request my executor consult with Keith Wenger, Dorothy Diehl Wenger, and James Lecher as to identifying items in my home which are antiques and the best method of selling my antiques. In addition, my Pac1e 3 exec~~~tor may consult with Dorothy Diehl Wenger in locating items descr~'~.bed in paragraphs II and VII herein. ~X, Any fid~acia.ry under this will shall have the following powers in addition to those vested in them by law and by other provisions ~, of :~y will applicable to al.l property whether principal or income, including property held for minors, exercisable without Court la.;~~ ,~ ~~ '._ `~:,~ app:coval., and effective unti_1 actual distribution of all property: 4'~ t.~~ ,;, ~ 1~.. io retain any and all of the assets of my estate, real or '`~~ ~ i , ~`~~~~~~_, personal, without regard to any principle of .`~\j ~~~ ~i diversification of risk. a D, ''o invest in all forms of property _ncluding stoclt, 4- ~ +~~,~~, cor~imon t:r_ust funds az~d mortgage investment funds without restriction to investments authorized for Pez:nsylvar_ia. ^~~, fiduciaries as they deem proper, without regard to any i --~~ principle of diversification of risk, C. To sell at public or private sale, to exchange or to lease for any period of time any real or_ persona.l property and. to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or incorne or partly to each as they from time to time think prope.r~ E. To compromise any claim or controversy, Page 4 F. To distribute in cash or in ]cind or partly in each. G. To hold property iri their names without des-gnation of any fiduciary capacity or in the name of a nominee or unregistered. ~o I direct that all taxes that may be assessed in consequence or_ my death of ~~ahatever nature and by whatever jurisdiction imposed, sha_11 be paid from mv~ reszduary estate as a part of th.e expense of t~;e administration of my estate. 1~ L , ,~ ~~~ ~,, ~~~ ll---~~. ~'~~~ ~ I appoint the Manufacturers a_nd Traders Trust ComL~ary, w_.-Ltn ~i~ of Ekes in Charnbersburg, Pennsylvania, as executor of this ~my -~~i].1 . ~r. H~ ,(1 .d. 1 e `~~~ ~~s~ ~~ No boz,d sha11 be required. of any fiduciary hereunder in any jurisdiction. ~:~ ~dz~':~~SS ~Fi~~~OF°; I hereunto set my hand and seal to this my last vai11 and testament, consisting of seven typewritten pages, the first four of which bear my signature in the margin for the pr;rpose Page 5 i1) i of tdentifi cation this _ ,.F~ day o~~7~ 7~ ;~_._._ '`~ ~ ~`~,, ~\~i~°- ~, ~~ . 4 -- (SEAL'. ", ~,~ Signer_', sealed, published and declared by the ~=above-named testatrix as and for her last wil_1 and testament ire our presence, ~~rcin her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses. e ,N ~ G`~s% - "'~' ~ {.~ t ~1r 32 .~ yam,,,. ~~ T /~ ~ ^~ .<..- .. ~,'^~ i ~.~ ,~ n ~9 ~~ ~ r ~ ~ -~ 7~' y~sp ~~~~ ~~ ~~f~~~%°~G~~~ ,~-< ~'~,~~r~~ the testatrix and the witnesses °spectivel_~, whose names are signed to the attached. or foregoing il~.s~.rumer~t; beinc~r first duly sworn, do hereby declare to the u~sdersigned authority that the testatrix Signed and e:~ecuted the instrument as her last will and testament and that she executed it as her free and. voluntary act for_ the purposes therein expressed and that ear_h of the witnesses, in the presence and hearing of th.e said testatrix, signed the will as witnesses and to the best of their knowledge, said signer was at that time eighteen years of a.ge Page 6 or older , of sound mind anal under no constraint or pundue influence . I~ 1~ ~.~ ~~ ,'a ;i' ///~ = ~ ~~~`~ ~ F,r_ Testatri ~~ ~~ ~ g~~~-- fi ii Witne .~: Witness ~ Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to before me by the above named witnesses this ;,`day of ~`" , ~~ ~~ ,,--~ ~: ~; a, Notary PubJ_iC .!~ ~` C®61~I~OR4~lU~LTF6 QF P~~9S°tt_111~,h~4,pe~< fVotarial peal - Cynthia E. Unge,, fJotary ~ubsic Southampton 7wp. Cumberland CouRfy e My Commtss6on Ettpires Sips. 29, ~0~? P/d®mt1"cP, P~RnSylbBRba ~SSOCiatloh OP WOtai IE: Page 7