HomeMy WebLinkAbout12-02-09
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
15056051058
OFFICIAL USE ONLY
INHERITANCE TAX RETURN ,County Code Year File Number
RESIDENT DECEDENT 21 09 0889
Date of Birth
08/30/1942
Suffix Decedents First Name MI
_..
Robert
A
Suffix Spouse's First Name
MI
Lynne
.... H
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_ _ ___ __ _ REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Cft~ 1. Original Return ~'~°~~ 2. Supplemental Retum C~ 3. Remainder Return (date of death
prior to 12-13-82)
~;.. 4. Limited Estate ~;,;~„ 4a. Future Interest Compromise (date of Imo} 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ,,._0 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 T0:
Name
-- ----- Daytime Telephone Number
.,......
_:.
David A. Baric Esquire
(717) 249-6873 ,~.,,
_ ~-
....
Firm Name (If Applicable) - - -
.._._..._..~... ~ ~ z ;
.....
O'Brien Baric & Scherer
__
...,, s _r~---- __._.._....
_ ;
r-~ -L,
3 ~~ ~ C7
.}r'~ ~` ~
.............
~ -~'~
~.. ~_
.......
....
E
.......~
.. .......,, DATE
State ZIP Code € .............................._................ FILED
Carlisle PA 17013
Correspondent's a-mail address: dbarlC@ObSIaW.COm
~~ a
'n
~-~-- --
..
.._ ,
r
,-,
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 knowled e.
SIGN TU OF PERSON RES ONSIB OR FILING RETU
o~ 09
ADD E S
222 Ir Avenue, ~hippensbyrf~j, Pennsylvania 17257
.~
U~ yw ( uarE /~ or O9
ADDRESS
19 West South Street, Carlisle, Pennsylvania 17013
PLEASE USE ORIGINAL FORM ONLY
USE~ILY
r~l
~7
I
fV
IV
Q
1 505605 1 058 Side 1
15056051058
15056052059
REV 1500 EX
Decedent s Name. Robert A Sheppard
..
_.. .,
RECAPITULATION
Decedent's Social Security Number
314-42-4821
1. Real estate (Schedule A) . .........
............................... .
... 1.
2. Stocks and Bonds (Schedule B) ......
............................. .
2~
519,452.43
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. Jointly Owned Property (Schedule F =::
Separate Billing Requested
6
.......
.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) '' Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1-7).. .
~.... w.,..... ...
~ .. ...........~.~.~.w....._~.... _.. ~...~......~ .... ~. 519,452.43
.
9. Funeral Expenses & Administrative Costs (Schedule H)
............. .
'~~~•~~ s.
20,843.30
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I)
........ .
11. Total Deductions (total Lines 9 & 10) .......
................. . ..... . .... 11.
20,843.30
12. Net Value of Estate (Line 8 minus Line 11
.............................. 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 498,609.13
an election to tax has not been made (Schedule J) .
. . . .. . . . ... .
13.
14. Net Value Subject to Tax (Line 12 minus Lme 13)
_ __...
. ...... 14
TAX COMPUTATION -SEE INSTRUCTIONS FOR
~ ~ 498,609.13
APPLICABLE RATES
15. Amount of Line 14 taxable
~ ~ ....
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0 0 498,609.13 15
.
16. Amount of Line 14 taxable --
0.00
at lineal rate X .0 ~,
17. Amount of Line 14 taxable - _ 16.
at sibling rate X .12
18. Amount of Line 14 taxable _ 17.
at collateral rate X .15
_ _ ' 18.
19. TAX DUE ..........
..
.............................................1s.
.................................
...................
.......
0.00
........................ .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
L 15056052059
REV-1500 EX Page 3
Decedent's Complete Address:
21 109 ~ 0889
Robert A Sheppard
STREET ADDRESS
222 Hollar Avenue
DECEDENTS SOCIAL SECURITY NUMBER
314-42-4821
CITY STATE ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
3. Inter~sJPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (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) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56)
Make Check Payable to: REGISTER OF WILLS, AGENT
~:
.Y ,,
9 ~ ~ .~
..r,.
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? ........................................................................................................................ ^ n
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
<.~, _....,.. ~~ ~~. _ s , .. _~.. ,~,.,_,.,w
~~,., r
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value ofxtransfers 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 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 1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF --
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F
ITEM .
NUMBER DESCRIPTION VALUE AT DATE
1.
OF DEATH
AT&T INC COM 100.0
2,519.50
.ALLIED IRISH BKS P L C 800.0
4,636.00
AMERICAN VANGUARD 300.0
2,682.75
CATERPILLAR INC DEL COM 100.0
4,401.50
COLLATE PALMOLIVE CO COM 100.0
7,109.50
CORNING INC COM 300.0
4,608.00
.WALT DISNEY COMPANY HOLDING CO. 100.00
2,521.50
DUKE ENERGY CORP NEW COM 100.0
1,523.50
FIDELITY PA TAX FREE PORTFOLPENN 1,753.5550
18, 622.75
FLOWSERVE CORP COM 200.00
16,542.00
GENERAL ELEC CO 100.0
1,329.00
HARSCO CORP COM 100.0
2,918.00
ING GROEP N V 100.00
1,288.50
JOHNSON AND JOHNSON COM 200.0
11,979.00
MARKET VECTORS ETF TR 100.0
3,739.50
MICROSOFT CO?P COM 200.0
4,683.00
MIDDLEBY CORP COM 100.00
4,796.00
FED MONEY MARKET FUND 851-PRIN 1,227.1700
1,227.17
FED MONEY MARKET FUND INC 2,308.8900
2,308.89
OCEANEERING INTERNATIONAL IN 100.00
5,000.00
ORRSTOWN FINL SVCS INC COM 300
00
. 11,197.50
POWERSHARES WATER RESOURCE ETF 200.0
3,066.10
ROFIN SINAR TECHNOLOGIES 300
0
. 7,090.50
TEAM INC 100
0
. 1,729.50
TOTAL (Also enter on line 2, Recapitulation) a 127,519.66
(If more space is needed, insert additional sheets of the same size)
REV 1503 EX+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
en ~.~s.a, c......... .......J ....iL --_ ~. ~ . .
-• •-• - -r-~~ •~ • •~~~~~, ~~ ~~~~ ~ auunwi iai sneers or me same size)
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
C PT~T~ w~
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
w~n~G yr
Robert A. Sheppard FILE NUMBER
21-09-0889
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A• FUNERAL EXPENSES: DESCRIPTION
~ ~ Fogelsanger Bricker Funeral Home
2. Hartman Graziano Funeral Home
B. ~ ADMINISTRATIVE COSTS:
~ • Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Year(s) Commission Paid:
2~ Attorney Fees
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6• Tax Return Preparer's Fees
7~ Cumberland Law Journal (legal advertising
s. The Sentinel (legal advertising)
Zip
Zip
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
6,535.00
3,679.00
0.00
10,000.00
388.00
75.00
166.30
20,843.30
LAST WILL AND TESTAMENT
I , Robert A . Sheppard, a resident of ~~-~~ l~ S ~ a ~, Commonwealth
of Pennsylvania, do make and publish this, my LAST WILL AND
TESTAMENT, hereby revoking all Wills and Codicils heretofore made
by me.
ARTICLE I - IDENTIFICATION
1.1 E~pouse. My spouse is Lynne Hoy Sheppard. All references in
this Will to my "spouse".shall be to such spouse.
1.2 Children. I have two (2) children, Paul R. Sheppard and Gary
J. Sheppard. All references in this Will to my child or children
shall be to such children and any and all children born or adopted
by me after the date of this Will.
ARTICLE II - DEBTS AND EXPENSES
2.1 Debts and Expenses My debts (other than debts, if any
secured by mortgages of real estate or the assignment or pledge of
life insurance policies), funeral and administration expenses shall
be paid out of my estate.
ARTICLE III - SPECIFIC GIFTS
3.1 Personal Effects. (a) I give, devise and bequeath all of my
clothing, jewelry and personal effects, and all furniture,
furnishings, household effects, and other tangible personal
property (except currency) in accordance with a written list or
memorandum which I may have executed and which may be in existence
at the time of my death.
(b) To the extent that all such property is not effectively
disposed of by such written list or memorandum, or if no such list
or memorandum exists, I devise the same, including insurance
policies thereon, to my spouse, Lynne Hoy Sheppard, if surviving,
or if not surviving, I devise same to Paul R. Sheppard, Gary J.
Sheppard, Thomas C. Hoy, Jr. and Michael D. Hoy, in equal shares.
All costs of safekeeping, insuring and shipping shall be deemed to
be a general estate administration expense.
ARTICLE IV - RESIDUE
4.1 Residue. I give, devise and bequeath all of the residue of my
estate to my spouse, Lynne Hoy Sheppard. If my spouse shall not be
surviving then I devise the residue of my estate to Paul R.
Sheppard, Gary J. Sheppard, Thomas C. Hoy, Jr. and Michael D. Hoy,
in equal shares. In the event that any of these beneficiaries
shall predecease me, then such beneficiary's share shall be
1
distributed to such beneficiary's surviving issue, per stirpes. In
the event that such beneficiary is not survived by issue, then such
beneficiary's share shall pass to my surviving issue, per stirpes.
ARTICLE V - FIDUCIARY APPOINTMENTS
5.1 Executor. I appoint Lyrae Hoy Sheppard to be Executrix under
this my Will. In the event that Lyrae Hoy Sheppard should fail to
qualify or otherwise ceases to act as Executrix, then I appoint
Paul R. Sheppard as successor Executor. No Executor shall be
required to furnish bond or other security.
5.2 Trustee. I appoint Lyrae Hoy Sheppard as Trustee under this
my Will. In the event of the death, resignation or inability to
serve of Lyrae Hoy Sheppard, then Paul R. Sheppard shall serve as
successor Trustee . No Trustee shall be required to furnish bond or
other security.
ARTICLE VI - ADMINISTRATIVE PROVISIONS
6.1 Taxes. I direct that all estate, inheritance or other death
taxes, including interest and penalties, if any, payable by reason
of my death, be paid out of my residuary estate.
6.2 Spendthrift Clause I direct that all legacies, and all shares
and interests in my estate, whether principal or income and whether
IN TRUST OR OTHERWISE, while in the hands of my representatives,
Trustee or Executor, shall not be subject to attachment, execution
or sequestration for any debt, contract, obligation or liability of
any legatee or beneficiary, and shall not be subject to pledge,
assignment, conveyance or anticipation, and the personal receipt by
such legatee or beneficiary shall be sufficient and the only
discharge of my representatives, Trustee or Executor.
6.3 Beneficiaries Under Age of 21. (a) Notwithstanding the previous
provisions of this Will, if a beneficiary under age twenty-one (21)
becomes absolutely entitled to any property under the foregoing
provisions, such property shall immediately vest in such
beneficiary. The Trustee shall hold the property as a separate
trust for the benefit of the beneficiary and shall pay to or apply
for his or her benefit so much of the net income and so much of the
principal at any time and from time to time as the Trustee with
sole discretion believes advisable to provide adequately for the
beneficiary's health, maintenance, education and support in
reasonable comfort.
(b) All funds not paid to or applied for the beneficiary in
accordance with Section 6.3 (a) shall be paid to the beneficiary at
age twenty-one (21) or to the beneficiary's personal representative
in the event of the beneficiary's death prior to age twenty-one
(21) Upon obtaining a receipt from the person to whom distribution
is made, the Trustee shall be relieved of any further obligations
2
with respect to the property distributed.
ARTICLE VII - FIDUCIARY POWERS
7.1 Fiduciary Powers My Executor and Trustee (including any
substitute or successor Executor and Trustee) shall have the
following powers, in addition to, and not in limitation of, all
powers conferred by statute, or similar provision of subsequent
law: to (a) invest, reinvest and retain, abandon assets as long as
shall seem prudent, without restriction to investments authorized
by law; (b) sell, convey, exchange, mortgage, lease or otherwise
dispose of all or any part of my property, real or personal, at
public or private sale, for such prices and upon such terms and in
such manner as such fiduciary may deem advisable (c) receive the
proceeds, rents, issues, incomes and profits therefrom; (d) borrow
money from themselves or others; (e) employ and compensate
custodians, accountants, attorneys and other agents; (f) register
securities and other property, real or personal in nominee or
bearer form; (g) liquidate or compromise any and all claims due to
or by my estate; (h) make distributions of such property in cash or
kind or partly in each, in divided or undivided interests; (i)
exercise federal tax elections under the Internal Revenue Code,
with or without making compensation among beneficiaries; (j) retain
and manage any business; (k) account to adults; (1) pay Executor's
and Trustee's commissions and attorney's fees on account; and (m)
execute and deliver necessary instruments and give full receipts
and discharges.
ARTICLE VIII - DEFINITIONS
8.1 Definitions. The singular shall be deemed to include the
plural, the masculine the feminine, and vice versa. Headings and
captions are for reference only. All references to issue or
descendants shall include persons born or adopted after the date of
this will.
8.2 Survival Presumption. If my spouse and I shall die
simultaneously under circumstances which render it difficult or
impossible to determine the order of death, then my spouse shall be
deemed to have survived me. If any other beneficiary fails to
survive me by thirty (30) days, then such beneficiary shall be
deemed to have predeceased me.
IN WITNESS WHEREOF, I subscribe my name this ~',''~'~'~~day of ~~~Y
1997.
Robert A. Sheppard
3
SIGNED, SEALED, PUBLISHED AND DECLARED by the Testator to be his
Last Will and Testament, in our presence and in the presence of
each of us, we all being present at the same time; and we, at his
request, in his presence and in the presence of each other, have
hereunto signed our names as attesting witnesses.
Karl T. Crytser
Victoria A. Sassi
residing at 717 W. 2nd North St., Morristown, TN
residing at 27 Breece Drive, Yardley, PA
COMMONWEALTH OF NEW JERSEY ~~
COUNTY OF MERCER ~ SS.
I, Robert A. Sheppard the Testator, sign my name to this
instrument this 2nd day of May 1997, and being first
duly sworn, do hereby declare to the undersigned authority that I
sign and execute this instrument as my Last Will and Testament and
that I sign it willingly, and that I execute it as my free and
voluntary act for the purposes therein expressed, and that I am 18
years of age or older, of sound mind and under no constraint or
undue influence.
j ~ "~~
/~ s
ih
Rjobert A . Sheppa
Karl T. Cr tser and Victoria A. Sassi
the witnesses, being first duly sworn, do each hereby declare to
the undersigned authority that the Testator signs and executes this
instrument as his Last Will and Testament and that he signs it
willingly, and that each of us states that in the presence and
hearing of the Testator, he or she hereby signs this Will as
witness to the Testator's signing, and that to the best of his or
her knowledge the Testator is 18 years or older,~of sound mind, and
under no constraint or undue influence. / _
wITlvESs
WI SS
4
COMMONWEALTH OF 'NE.W JERSEY
. SS.
COUNTY OF MERCER ,
Subscribe sworn to and acknowledged before me by
~o~~ ~- .S`le~ ~r~ the Testator, and subscribed and sw rn to bef r
o e me
by Ct. // y' P.!- and ~`C o ~ ~ .~ a S S/`
witnesses this ~~ ~ day of ~~.~,~ 1997.
R~ER J. OSWALD J
NO?ARY PUBUC OF NEW JERSEY ,~
Nit Commis:ton Expires September 9, 2001 NOTAR P L I OF `NEW JERSEY
5