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Home My WebLink About11-20-09 (3)i _. ....J 1505605104? ~R E V-15 0 0 EX (06.05, . PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT _ 2 1 0 9 0 7 4 ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death 2 0 4~ 0.1 9 0 2 0 ~~~~~~~~ Decedent's Last Name Suffix H u g h e s (If Applicable) Enter Surviving. Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Beautify Number Date of Birth ~1~~9~1~ Decedent's First Name MI r e d a Spouse's F(rst.Name MI THIS RETURN MUST BE FILED- IN. DUPLICATE 11111TH THE FILL IN APPROPRIATE OVALS BELOW REGISI`ER OF WILLS ~ 1. Orlgtnal Retum O 2. Supplemental Return. O 3. Remainder Return (date of death O ~4. Limited Estate O 4a. Future Interest Com romise date of Prior to 12-13-82) death after 12-12-82) ( O 5. Federal Estate Tax Return Required ~ 6. Decedent Died Testate O 7. Decedent Maintained a L(ving Trust ~ (Attach Copy of Will) (Attach~Copy of Trust) -~--- 8. Total Number of Safe Deposit Boxes O 9. Litigation. Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax between 12-31-91 and 1-1-95) under Sec. 9113(A) CORRESPONDENT - THIS SECTION'MUST BE COMPLETED. ALI. CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIOch. O) Name ~ N SHOULD BE DIRECTEQ T0: Da ime Tele hone Number A n t h o n y D e L u. c a E s q Firm Name If ~ 2 5 8 6 8 4 4 placable) First line of address Second r..a_ REGIS~TgR OF tNILLS ~ ONLY `' Q w ~ 7'7 --; :~' -- ^` ` ~ ' • DATE FiL ED~ ~ ~~~ ' ~4 w ~~ rMV. 'M~ """"' "°"°'°tl~ or pequry, 1 dedare that I have examined this return, InGt~ding accompanying schedules and statements, and to the best of my knowled a ah It Is true, correct and complete. DedaraUon of prepares other than the personal representative Is based on all information of wht~h .,.e....___ ~ _ SIG9IATURE O~F~`QERSON,IRESPONSit31 ~ •~nc ru u~rs~.~-....:~.. . 9 d belief PLEASE USE ORIGINAL L Side , 15056051043 15056051047 J Correspondent's e-mail address: J 15056052048 REV 1500 EX Decedent's Name: Freda M. Hughes rcec~-rI l ULATION' __ 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 8 Notes Receivable (Schedule D) ..................... . 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... ti. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) ........... . . . . . . . ................ 8. 9. Funeral Ex penses & Administrative Costs (Schedule H) ..................... 9. ii~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... i . 10. ~ 11. Total Deductions (total Lines 9 8 10) ................................... 11. 12. ~Nef~Value of Estate~(Line 8 minus Line 11) ................. . ............ 12.. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................. . 19. TAX DUE ... ... . ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQU~STIW~ A REIFUN'[~`OF AN OVERPAYMENT Decedent's Social Security Number CD Side 2 15056052048 15056052048 J ~. ~. REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME _ Freda M. Hughes STREET ADDRESS C/O MCHS Carlisle CITY 940 Walnut Bottom Road Carlisle, Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit __ - 0 - B. Prior Payments p - C. Discount - - ~ 3. Interest/Penalty if applicable D. Interest - 0 - E. Penalty _ ~ - File Number STATE ---~-- PA ZIP 1 7 01 5 (1) $4, 278.82 -0- Total Credits (A + B + C) (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.tal Interest/Penalty (D + E) (3) Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 6. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT -0= ~S, 278.82 -0- $4,278.82 _- PLEASEANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE A 1. Did decedent make a transfer and: PPROPRIATE BLOCKS a. retain the use or income of the property transferred :............................. No b. retain the right to designate who shall use the ro p perty transferred or its income : .......................... c. retain a r ••••••............ ^ eversionary interest; or........... d. receive the promise for fife of either ~'""•~'•"~'~'•~'"•""""""""""""""•'••••••~• payments, benefits or care? ...... 2. If death occurred after December 12 198 •"'~'•~~~•"~~~"••"""~""""""""""""•~•~•••~• ^ ~, 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 SCH EDULE 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 im osed on the is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. p net value of transfers to or for the use of the surviving spouse For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax and the the use of the surviving spouse is zero (0) percent filing a tax return are still applicable even if the surviving spouse is the only beneficiary. statutory requirements for disclosure of assets and 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 a e or oun e adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. g y 9 r at death to or for the use of a natural parent, an The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is f 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. our and one-half (4.5) percent, except as noted in The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve 12 ercent Section 9102, as an individual who has at least one parent in common with the decedent, whether b (blood or [72 P.S. §9116(a)(1.3)]. Asibling is defined, under y adoption. REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS FILE NUMBER Freda M. Hughes All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1• 12,662.67 shares of American Funds Money Market Fund-A @ $1.00 per share 2. 778.87-shares of DWS Cash Investment Trust-S @ $1.00 per share. 3• 1,402.858 shares of DWS GNMA Fund-S @ $14.89 per share. 4. 344.654 shares of DWS Growth & Income Fund-S @ $9.97 per share. 21-09-0274 VALUE AT DATE OF DEATH $12,662.67 778.87 20,888.55 3,436.20 TOTAL (Also enter on line 2, Recapitulation) I $ 3 7 , 7 6 6 . 2 9 (If more space is needed, insert additional sheets of the same size) , REV•1510~EX+11-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY ESTATE OF Freda M. Hughes FILE NUMBER 21-09-0274 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE . VALUE OF ASSET INTEREST 1F APPLICABLE 1. Non-Qualified Fixed Annuity with $72,941.04 100 -0- 72,941.04 Allstate Life Insurance Company _ TOTAL (Also enter on line 7, Recapitulation) I a 7 2 , 9 41.0 4 (If more space Is needed, Insert addltlonal sheets of the same size) REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT pECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Freda M. Hughes FILE NUMBER 21-09-0274 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: AMOUNT ~' Hollinger Funeral Home & Crematory, Inc. 501 North Baltimore Avenue $4,013.42 Mount Holly Springs, PA 17065 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2• Attorney Fees Anthony L. DeLuca, Esquire 3,000.00 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ______ Zip Relationship of Claimant to Decedent 4• Probate Fees 5 284.00 • Accountant's Fees 500.00 s• Tax Return Preparer's Fees ~. Legal Adverti~~ne~-Cumberland Law Journal 8. Legal Advertising - The Sentinel 75.00 339.74 TOTAL (Also enter on line 9, Recapitulation) $ 8 , 21 2. 1 6 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Freda M. Hughes FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimburse0d m- 0 2 7 4 ITEM edical expenses. NUMBER DESCRIPTION VALUE AT DATE 1~ Special Event Emergency Medical Services - Medical OF DEATH $585.56 2. Heartland Pharmacy - Medication 116.68 3. MCHS Carlisle - Nursing Home 6,612.06 4. West Shore Emergency Medical Service - Medical 96.06 TOTAL (Also enter on line 10, Recapitulation) $ ~ , 41 0. 3 6 (If more space is needed, insert additional sheets of the same size) • REV-1513 EX+ (9-00) SCHEDULE ~ COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freda M. Hughes FILE NUMBER 21-09-0274 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Do Not List Trustee(s) OF ESTATE Sec. 9116 (a) (1.2)] 1~ Jeffrey F. Hughes Son 50~ 190 Lindorf Street Ulster Park, New York 12487 2• Daniel J. Wonders Grandson 50~ 219 Lehigh Avenue Pittsburgh, Pennsylvania 15232 ENTER DOLLAR AfvIOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ - 0 - (If more space is needed, insert additional sheets of the same size) ~ ~; ,~,;- ~~~~Xti~~,~., ~ Y _,~,, ~;, ~ a ~~r OF FRIEDA M. HUGHES }, F'1ZI~'~;DA M. HUGHES, a resident of Boiling Springs, Cumberland Count , Y Penns, }van~a E-eing of sound mind, memory and understanding, do hereb make ubl' Y , p ish a~1~} ~ie~.;ar~E~ this to be my Last Will and Testament, hereby revoking all Wills and C'o~iicis heretofore made by me. ~p ~ ~ I'1~1~1 l : I direct that all my just debts, the expenses of m la r ~~~ ~~~~-~~- y st illness and~~W r~~ c-> , un~;ral ex~~enses be paid as soon after my decease as the same can convenient) br_~.r ~ Y !~xne "[,F~ 1~I 2: I direct that there shall be paid out of m residu ~ ~ ~- ~ Y ary estate all esta e, inh~~r~talce ar~d like taxes together with any interest or penalty thereon im osed b the p Y ~cw°rnn~ent of tike United States, or any state or territory thereof, or by any foreign ~ov~~t-Ivr]eia r or political subdivision thereof, in respect to all property required to be ~:rlc; }l~cie~} in my gross estate for estate, inheritance or like tax purposes b an of suc Y Y h ;uvernments, whether the property passes under this Will or otherwise, excluding, [ ~~'~~'~'~'er, any :property over which I have a taxable power of appointment, rovided p , }1c4~•e~~rer, that coo residuary beneficiary shall by reason of this provision be denied the benciit o} any deduction, credit, favorable rate of tax or other benefit which b la Y w cn~~are~ to uch beneficiary. ~~ -. ~ ~, -, ~ ,., ~ r --- ~~ ~. ~. _ .J ~ _ .r, _... __ _' ...... ,. I7C~___1V~i~: I give, devise and bequeath all of the rest, residue and remainder of m Y t.st,te. ~•ea:, personal and mixed, of whatsoever kind and nature, and wheresoever situa ,.~....... y.. ~,_ to FRIEDA M. HUGHES ~/ `~ 1 ~^ ,~~ ~~ f ~~ ~-~,, FRIEDA M. HUGHES at the time of my death, unto my husband, BERNARD F. HUGHES, provided how ever, that he survives me and is living sixty (60) days after the date of my death. ITEM 4: If and in the event that my husband, BERNARD F, HUGHES, does not survive me and is not living sixty (60) days after the date of my death, then and in s uch event, I give, devise and bequeath all of the rest, residue and remainder of m y estate, real, personal and mixed, of whatsoever kind and nature, and wheresoever situate at the ti me of my death, in equal shares, unto my son, JEFFREY F. HUGHES, and m y grandson, DANIEL J. WONDERS, provided however, that they survive me and are liv' mg sixty (60) days after the date of my death. ITEM 5: If and in the event that either my son, JEFFREY F. HUGHES or my grandson, DANIEL J. WONDERS, does not survive me and is not livin six g ty (60) days after the date of my death, then and in such event, I give, devise and be ue q ath the interest in my estate, which such deceased son or grandson would have receive ' d, if living, to the issue of my said deceased son or grandson, per stirpes. IT--E= I hereby nominate, constitute and appoint my son, JEFFREY F HUGHES and my grandson, CHRISTOPHER WOE _ ERS, Co Executors of this my Last Will and Testament, with full power to do any and all things necess axy for the complete ,, F A M. 2 ~ ~~ 4 .:<<~, this or any other jurisdiction ~SJ Y`IH .., f! r r s ,~S !w rety is required of them in r { l* i ` y ~e,~ar~ee of thi office. inoperative, invalid or illegal, it is my intention that all the remainin rovis' g p ions thereof shall continue to be fully operative and effective, so far as is possible and reason able. IN WITNESS WHEREOF, I, FRIEDA M. HUGHES, the Testatrix have to this my Last Will and Testament, typewritten on three (3) consecutively numbered pages, subscribed my name and affixed my seal this C," da of y , 2003. ~..... ~~~ 4,~.' "1 ~._ ~ EAL) Signed, sealed, published and declared by the above named FRIEDA M. HUGHES, as and for her Last Will and Testament, in the presence of us, who have hereu our names at her request, as witnesses hereto, in the presence of the said Testatri bscribed each other, ,and of " .,,,siding at o~~ ~ ~. °,~ ~ ~ 4, ~ ' I / ~ V 'r ~. '~-- ~~'esiding at /"~:~~..~°~,~,,~,, ; ~~2-L._ : , .~ ~d~~ 3 ~. ITEM 7: If any provision: of this W11 or of any Codicil hereto is held to be ~~ ,fie qo .cx~ `~c~ 2 ~u .cx~ ~ ~~n