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Home My WebLink About03-02-1015056041114 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 lI// Harrisbur PA 1128-0601 RESIDENT DECEDENT ~~~ ~ ~ .~. ?~ ~n~_1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 147-07-8938 11302009 02161909 Decedent's Last Name Suffix Decedent's First Name MI OSBORNE, MARY E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 0 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) 0 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 0 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) 0 3. Remainder Return (date of death prior to 12-13-82) 0 5. Federal Estate Tax Retum Required 0 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 STEPHEN D. TILEY, ESQUIRE 717-243 838~,,,~`~'. Firm Name (If Applicable) REGIST ILLS U ... NLY :~ s 'x',~'J ~. .~ PREY AND TILEY ~, ~ *. 3 First line of address ~ N {.:~~ ~""= ~' 5 SOUTH HANOVER STREE ~ ~ _..;, °` Second line of address ~ ,~,r_. "~ ... -- .~' `-'O' DATE FILED City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent's a-mail address: STILEY@ FREYTILEY . COM Under penalties of peryury, 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 SIGNATURE PERSON RESPONSIBLE F/O~R FILING RETURN DATE ADDR~ ' DON NDEN DR., CARLISLE, PA 17013 SIGNAT, E OF EPARE THER THANE ESENTATIVE AT STEPHEN D. TILEY, 5 SOUTH HANOVER ST., CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041114 15056041114 .~ J ` J REV-1500 EX 15056042115 Decedent's Social Security Number Decedent's Name: MARY E OS BORNE , 14 7- 0 7- 8 9 3 8 RECAPITULATION 1. Real estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) ...................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages & Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 16 7 9.61 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ....... . 7. NONE 8. Total Gross Assets (total Lines 1-7) .................................. 8. 167 9.61 9. Funeral Expenses 8~ Administrative Costs (Schedule H) .................... 9. 13 7 8 . 5 0 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............... 10. 3 O 1.11 11. Total Deductions (total Lines 9 & 10) ................................. 11. 16 7 9.61 12. Net Value of Estate (Line 8 minus Line 11) ............................. 12. 0 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 14 0 0 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 .0 0 15. O. O O 16. Amount of Line 14 taxable at lineal rate X .0 4 5 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 0 0 18. Amount of Line 14 taxable . at collateral rate X , 15 18. 0 . 0 0 19. TAX DUE ....................................................... 19. 0 . 0 O 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 15056042115 15056042115 REV-1500 EX Page 3 147-07-8938 Decedent's Complete Address: File Number 21-1 n_nnnl ~ DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER MARY E OSBORNE 147-07-8938 STREET ADDRESS 1 LONGSDORF WAY CITY STATE ZIP CARLISLE PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 0.00 Total Credits (A + B + C) (2) 0.00 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. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT 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? .. ~ ^X 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 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. 217 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY ESTATE OF FILE NUMBER Mary E. Osborne 21 10 0001 Include the proceeds of litigation and the date the proceeds were received by the estate. ~ ~ ~ ~ ~ ivi C sNacC is neeaea, Insert aaaluonai sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mary E Osborne, 21 10 0001 Debts of decedent must be re orted on Schedule I. ITEM NUMBER nGeroioT~nn~ A. (FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Donald P. Osborne street Address 9 East Linden Drive city Carlisle state PA zip 17013 Year(s) Commission Paid: 2. 3. 4. 5. 6. 7. 8. Attorney Fees Frey and Tiley 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 Probate Fees Small Estate Petition filing fee Accountant's Fees Tax Return Preparer's Fees Filing fee, Inheritance Tax Return Reserve to file Family/Creditor Agreement TOTAL (Also enter on line 9, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) Zip $500.00 $800.00 $43.50 $15.00 $20.00 1, 379 REV-1512 EX+ (12-03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RE t ENT D EDEN ESTATE OF FILE NUMBER Mary E Osborne, 21-10 0001 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, includinc unreimbursed medical exoenses_ ~~~ i i ~~~ c .7flgl.G IA I ICCUCU, a wCi t aaUiuonal Sfl@@iS OT ifle SafTi@ sIZ@) 217 REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ma E Osborne 21-10-00011 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Donald P. Osborne 9 East Linden Drive Carlisle, PA 17013 Son ENTER DOLLAR AMOUNTS 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 100% TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) 0 0 ~~G;t~Ui ani~ p~ElblPll~ ' o~ MARY ELIZABETH OSBORNE I, MARY ELIZABETH OSBORNE, currently residing at 1203 Bayberry Road, Borough of Manasquan, County of Monmouth and State of New Jersey, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills and Codicils by me at any time heretofore made, in manner following: FIRST: I direct that my funeral expenses and the expenses of my last illness be paid as soon as practicable after my death. SECOND: All the rest, residue and remainder of my estate, both real and personal, of every kind and nature, and wheresoever situate, whereof I may die seized or possessed, I give, devise and bequeath to my son, DONALD P. OSBORNE, currently residing at 1203 Bayberry Road, Manasquan, NJ 08736, provided that he survives me by thirty days, and if not, then to my daughter-in-law, RUTH M. OSBORNE, currently residing at 1203 Bayberry Road, Manasquan, NJ 08736, provided that she survives me by thirty days. THIRD: In the event that my son, DONALD P. OSBORNE, and my daughter-in-law, RUTH M. OSBORNE, fail to survive me for a period of thirty days, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal, of every kind and nature, and wheresoever situate, to ANNA LOUISE HAWBAKER, the sister of my daughter-in-law, Ruth M. Osborne, currently residing at 20 East Orange Street, Mount Holly Springs, Pennsylvania 17065, or to her issue per stirpes should she not t ~, survive me. FOURTH: I nominate, constitute and appoint my son, DONALD P. 03BORNE, as Executor of this Will. If he should predecease me or fail to qualify or, having qualified, should die, resign or become incapacitated, I nominate and appoint my daughter-in-law, RUTH M. OSBORNE, as substituted Executrix. If my substituted Executrix should predecease me or fail to qualify or, having qualified, should die, resign or become incapacitated, I nominate and appoint ANNA LOUISE HAWBAKER as substitued Executrix in her stead. My Executor and the substituted Executrices herein named shall not be required to furnish bond or other security in any jurisdiction for the faithful performance of their duties. FIFTH: I give my said Executor and substituted Executrices the fullest power and authority in all matters and considerations relating to my estate, and to do all acts which I might do if living, including, without limitation, complete power and authority to sell, at public or private sale, for cash or credit, with or without security, mortgage, lease or dispose of, and distribute in kind, all property, real and personal, at such time and upon such terms and conditions which my said Executor and substituted Executrices may determine without court order, including powers implied in law or granted by New Jersey statutes now or hereafter enacted. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /2, day of April 1993. a:.G~ '~ M Y EL ABETH OSBORNE SIGNED, SEALED, PUBLISHED and DECLARED by the said MARY ELIZABETH OSBORNE as and for her Last Will and Testament in the r ~ presence of us who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses the day and year first above written. 1 ~„_,_, Sea Girt, New Jersey Richard aguire y~T ~~~ ~ . STATE OF NEW JERSEY ) ss.: COUNTY OF MONMOUTH ) We, MARY ELIZABETH OSBORNE, Richard A. Maguire and f `, ~ the testator and the witnesses, respectively, ~`' whose names are signed to the attached or foregoing instrument, being duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witness and that to the best of their knowledge, the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. G~- ~A.~tY LIZA TH OSBORNE ;.. ~ ---_ Rich rd .~~M guire ~/_ ~~ ~ SUBSCRIBED, SWORN TO and ACKNOWLEDGED before me by MARY ELIZABETH OSBORNE, the testator, a d subscribed and sworn to before me by Richard A. Maguire and~,~Q~.-~'T~~-y , the witnesses, this /,2, day of April , 1993. ~' G~ ~ +RAIIaMA CN.A A Ne~y ~ublkd Nww ~~~~