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HomeMy WebLinkAbout03-29-10. 15056051058 REV-1500 ~ c06-05) tctAt_ usE ONLY PA DepartrneM of Revenue bureau of Indlrldual Taxes INHERITANCE TAX RETURN Code Year ~~ Nub PEA 17128-0601 RESIDENT DECEDENT t~ ~ r~ ~J~ ENTER DECEDENT INF Soda/ Security Number 189-18-6414 Decedent's Last Name BELOW Date of Death Date of Birth ', 01/04/2010 02/01/1926 ~ II' Suffix Decedent's First I Name MI Meredith William '~I H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First N me MI Spouse's Sodal Security Number THIS RETURN MUST BE FILED IN UPUCATE WITH THE REGISTER OF ILLS FILL IN APPROPRIATE OVALS BELOW ~I • 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death I prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (dabs of 5. Federal Estate Tax Return Required death after 12-12-82) 'I • 6. Decedent Died Testate 7. Decedent Maintained a LiYing Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of trust) 9. Litigation Prooeede Received 10. Spousal Poverty Credit (date of death ~ 11. Election bo tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - TtN8 8ECTION MU8T BE COMPLETED. ALL CORRE8PONDENCE AND CONRIDENiiU-L AX INFORMATION 8lbULD BE DIRECTED TO: Name aytime Telephone Number Gloria M. Wagner ' (717) 779-8~6 Firm Name (If Applicable) C ~~; ° REGISTEt~J1~11LLS US~ILY i _,? - IL First line of address ' ~ ~ rn N _... _-~ ~ ~ _,, _ ~; 3330 Grandview Drive ~~-~ ~ 1 ~-~ ~„ `-~~ Second line of address ~ ~ r `~ --t ~ _. ~ ~ City or Post Office State ZIP Code 'I, DATE FILED (~ York Haven PA 17370 ~I ~I Correspondent's e-mail address: elw48t~ptd.net I __---__ Under penalties of perjury, I Qedaro that 1 have examined thfa return, including gooompanying schedules aril sl and to the hest of my krawledge and belief, it is true. correct and corrtplebe. Dedaratbn of preparer other than the persons rtlpreserrtative is tensed on all 1 I PIII I\ 1 11\ I of which preperer has any knowledge. ~ ~ SIGNA PERSON R N LE FLUNG RE RN ! DATE 03/26/10 AD ESS 3330 Grandview Drive, rk Ha n, P 17370 S RE OF PREPAR O TH REP TATIVE DATE 03/26/10 RESS 3330 Grandview Drive, York Haven A 17370 ~ ^~~.~ ~ ~I~ I D~ FA~tC ~~~C AQ~R~YA~ CAQY AYE V I a:::- ___~ _~, ~-- . -~' ~- __r.~ Side 1 'I 15056051058 III 15056051058 I J 15056052059 REV 1500 EX William H Meredith D~ceaenrs Narne: 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 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits S Miscellaneous Personal Property (Schedule E) ........ 5. 6. Joirrtly Owned Property (Schedule F) Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) Separate Bill~g Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ................ 10. 11. Total Deductions (total Lines 8 8 10) ................................... 11. 12. Net 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) ........................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 4,005.88 16, 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at cdlateral rate X .15 18. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 Decedent's Social Security Number 189-18-6414 0.00 0.00 0.00 0.00 4,293.74 130,000.00 134,293.74 12,956.48 32,317.71 45,274.19 89,019.55 0.00 89,019:55 4,005.88 4,005.88 15056052059 REV 150U. EX Page 3 Decedent's Comalete Address: Flla Nutnl~vr DE EDENTS NAME EDENTS SOCIAL SECURITY NUMBER William H Meredith 189-18-6414 STREET ADDRESS 950 S. 28th Street CITY Camp Hill STATE A ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) ' (1) 4,005.88 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 210.83 Total Credits (A + + C) (2) 210.83 3. Interest/Penalty if applicable D. Interest E. Penaity Total InteresUPenaliy ( + 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) 3,795.05 A. Enter the interest on the tax due. ' (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 3,795.05 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" I 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 sha8 use the property transferred or its mcome• ............. { ......................... ^ c. retain a reversionary interest; or ............................................................................................ ......................... ^ d. receive the promise for life of either payments, benefds or care? ........................................ ......................... ^ 2. If death occurred after December 12,1982, d+d decedent transfer property within one year of ath without receiving adequate oonsideration? ................................................................................. ......................... ^ 3. Did decedent own an "in bust for" or payable upon death bank account or security at his or he death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property ich contains a beneficiary designation? ........................................................................................... ......................... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHED LE 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 valu 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 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 th statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefiaary. 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 youn er at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (O) 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 i 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) pe nt [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 r adoption. LAST WILL AND TESTAMENT OF WILLIAM H. MEREDI I , WILLIAM H . MEREDITH, o f Camp Hill, Cumberland County, Pe nsylvania, make, publish and declare t is as and for my Last Will and Testam nt, hereby revoking all other Wills an Codicils heretofore made by me. F2RST: I devise and equeath all the rest residue and remain er of my estate of whatever nature a d wherever situate, including any pro rt over I~ Y o~ . ~ which I hold power of appoi tment and together with any insurance polices thereon: (A } Forty ( 4 0 % ) perc nt thereo f to my daughter, GLORIA M. W GNER, pro- vided that should she predecease me then to her issue per stir~es by repre- ~- sentation. (B ) Thirty ( 3 0 % ) pe cent thereo f to my son, ROBERT A. MERED TH, provided that should he predecease e then to his issue per strrpes by r presenta- tion. (C ) Thirty ( 3 0 % ) pe cent thereof to my daughter, CHERI M. RITTNER, pro- vided that should she predecease me then to her issue per stripes by repre- sentation. SECOND: No provision this, my Last Will and Test grandson, BRIAN WEBER. THIRD: In addition t granted to them by law and provisions o f this Wi 11, I fiduciaries acting hereunde is made in ent, for all powers other ive the the fol- 2 lowing powers, applicable ~o all property, exercisable with ut court approval and effective unt'l actual distribution of all property (A) To sell at public or private sale or to leas I' ' e, for any period of time, any real or personal property and to give options for sales, ~exchan es or g 1 eas es , f or such prices ands upon such terms ( including credit , with or wi th- out security) or conditions as are deemed proper. This includ s the power • III -~ to give legally suf f iclent ~.nstruments for transfer of the propert and to receive th.e proceeds of any disposition ~ of it. (B) To partition, su~divide, or improve real estate and to nter into • agreements concerning the p~rtition, 3 subdivi i ' s on im rovement lonin or I~ g management of real estate nd to impose or extinguish restrictions on real estate. '~~ C To I ' ( ) compromise a ~y claim or controversy and to abandon any property which is of little or n o value. (D ) To inves t in al 1~ forms o f property, including stocks, common trust funds and mortgage investment funds, without restriction to invest- ments authorized for Pennsy~.vania fiduciaries, as are deemed ro er ~ p , without regard to any princ'ple of diversification, risk or pr ductivity. (E) To exercise any ptlon, right or privilege granted n insurance policies or in other investr~.ents. 4 i i (F) To exercise any lection or privilege given by the Fede al and other tax laws, including, ut not necessarily being limited t personal income , gi f t and estate or ~.nheri tance tax laws. (G) To make distribu ions to my herein named beneficiaries in kind or partly in each. (H) To borrow money selves or others in order t taxes, or estate or trust a tion expenses, to protect o any property held under my for. investment purposes. n cash or rom them- pay debts, inistra- improve ~i 11, and (I) To select a mode o f payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any 5 other type o f qualified pl n ) to the extent the plan or the law permits them to do so, and to exercise ny other rights which they may have under the plan, in whatever manner t ey consider advisable. ~!~~ FOURTH: I direct that all inher- itance, estate, transfer, succession and death taxes, of any kind whatso- ever .which ma be a y p yabl e Eby reason o f my death, whether or not wish respect to property passing under t is Will, shall ~' be paid out o f the pr nc zpa 1 o f my residuary estate. FIF ~ ~I~' TH: I nominate and appoint GLORIA M. WAGNER Executrixl'of ' thz s , my Last Will and Testament. Ii r~i the event of the death, resi nation of inabi ' g ~' 11 ty ~~ to serve for any reason whatsoever of 6 the said GLORIA M. WAGNER,~iI nominate and appoint ROBERT A. MERE ITH . '. Executor of this, my Last ill and Testament. Further, in th~ event of the death, resignation or 'nability to serve for any reason whatsoever of the said GLORIA M. WAGNER and OBERT A. ~~ MEREDITH, I nominate and a 'point , CHERI M . RITTNER, Executrix o f tl~i s , my Las t Will and Testament. I direl~~~ct tha t my Executrix and her successor's, as the case may be, shall not be r'~equired to pos t security or a bond f or the perf or- mance of their duties in anl'~ 'urisdic- ~ ~ tion. 3 IN WITNESS WHEREOF, ~ have here- unto set my hand and seal too this m y ~~~ Last Wi 11 and Testament , t i s ~~f day o f ~t,~,~..1~, 2 0 0 9. III'~~, ~~ R1( (SEAL ) WILLIAM H. MER DITH 8 Signed, sealed, publ ~ shed and declared by the above-name Testator as and f or his Las t Wi 11 and ~'es tament in our presence, who, at his z~equest, in his presence and in the pr sence of each other, have hereunto s'iubscribed our names as attesting wit~esses. Addr e s s Addr e s s 9 ~~ REV 1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER William H. Meredith 1u~ u-vuuab InGude the proceeds of litigation and the date the proceeds were received the estate. A11 property jointly-owned with right of survivorship must be dfsdo6ed Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION ' OF DEATH 1 M 8~ T Bank 3,758.74 1200 Market Street, Lemoyne, PA 17043 Acd. # 59646241 2. Bedroom Suite 150.00 3. Love Seat 8~ Foot Stool ' 50.00 4. Love Seat 35.00 5. Grand Mother Clock (not working) 150.00 6. 2 end tables, Coffee Table ~ 2 table lamps I 100.00 7. Kitchen Table 8~ 2 Chairs ', ~~ 50.00 TOTAL (Also enter on line ,Recapitulation) i 4,293.74 SCf1Ep~ILE E CASH, BANK POSITS, & MISC. PERSONAL PROPERTY (if more space is needed, insert additional sheets of the same six{ee) REV-1510 EX+ (08-09) pennsylvarria SCHEDULE G DEPARTMENT OF REVENUE INT^ER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FIRE NUMBER William H. Meredith 2010-00046 This schedule must be wmpleted and filed if the answer to any of questions i through 4 on pa a three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INa.uDE THE N!1ME OF 7HE rwwsFEaEE, THEIR ~EUnoNSHIP TD DECEDENT AMD THE DATE OF TRAHSFER. ATIACH A COPY OFTHE DEED FoR REAL ESTATE. DATE OF DEA VALUE OF AS ~ °/6 OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Gloria M. Wagner, Daughter, March 31, 2009 130,00O.pO I ~, ~, 100 0.00 130,000.0( TOTAL (Also enter on line 7, Reicapitulation) $ I 130,000.00 If more space is needed, use additional sheets of paper of the same 4ize. ~~~ `7~ ~ e ' [~ ~~/~~v BIININIGI~~~III~ OOOXRL Tax Parcel No. 13-23-0551-077 THIS DEED, MADE THE BETWEEN and 31st` day of N~t~„~~(, in the year two thousand nine (2009) WILLIAM H. MEREDITH, single person, of Camp Hill, Pennsylvania, Grantor, WILLIAM H. MEREDITH and GLORIA M. WAGNER, as joint tenants with the right of survivorship, of Camp Hill, Pennsylvania, Grantees: WITNESSETH, that in consideration of One Dollar and No/100 Dollar ($1.00), in hand paid, the receipt wheareof is hereby acknowledged, the said Grantor does hereby grant and convey to the said Grantees, their heirs and assigns: ALL THAT CERTAIN piece or parcel of land situate in Lower Allen Township, Cumberland County, Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the westerly line of 28th Street (40 feet wide) which point is on the line dividing Lot Nos. 8 and 9 on the hereinafter mentioned plan; thence south eighty-three (83) degrees thirty (30) minutes west along said dividing line one hundred fifty-seven and forty-five hundredths (157.45) feet to a point; thence north three (3) degrees twenty-seven (27} minutes west, a distance of seventy-five (75) feet to a point; thence north eighty-three (83) degrees thirty (30} minutes east along the line dividing Lot Nos. 7 and 8 on said plan one hundred fifty-two and nine tenths (152.9) feet to a point in the westerly line of 28th Street; thence south six (6) degrees thirty-eight (38) minutes east along said line of 28th Street seventy-five (75) feet to a point, the place of BEGINNING. The within described lot is known as Lot No. 8 on an unrecorded Plan of Lots laid out for Ivan R. Fulkroad, Inc. The starting point on the west line of 28th Street is four hundred thirty-five (435) feet south of the southwest corner of 1Wlorningside Drive and 28th Street, being on the dividing line between Lot Nos. 8 and 9 on said Plan. HAVING ERECTED THEREON a dwelling house being known as 950 S. 28th Street, Camp Hill, Pennsylvania. . BEING the same premises which Ivan R. Fulkroed, Inc., a Pennsyl- vania Corporation, by deed dated June 23, 1959 and recorded July 10, 1959 in the Cumberland County Recorder of Deeds Office in Deed Book "G", Vol. 19, Page 116, granted anc~ conveyed unto William H. Meredith and Myrtle C. Meredith, his wife. The said Myrtle C. Meredith died March 12, 1995, whereupon full and complete title to the within described real estate became vested solely in William H. Meredith, surviving spouse, the Grantor herein. THIS IS A CONVEYANCE FROM PARENT TO PARENT AND CHILD, GLORIA M. WAGNER, I3 THE DAUGHTER OF WILLIAM H. MEREDITH, AND IS, THERE- FORE, EXEMPT FROM THE PAYMENT OF REALTY TRANSFER TAX. AND the said Grantor hereby covenants and agrees that he will warrant specially the property hereby conveyeid. IN WITNESS WHEREOF, said Grantor has hereunto set his hand and seal the day and year first above written. Sigaed, Sealed and Delivered in the Presence of V Y ~Gti'~'Y,~"-~ EAL) William H. Meredith COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF C U m $~i~ ~~N ~ On this, the ,,3~5~' day of ~QrCh 2009 , before me. the undersigned officer, personally appeared WILLIAM H. MEREDITH, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. seal. IN WITNESS WHEREOF, I~hereunto set my hind and official ( ,.~ (SEAL) Notary Public My Commission Expires: ;. coMMOnw~uTM o~ rEtr~srwa' ~a NoraRia~ sE~. eETM e. tENGEI, NotAR1t Pug SItiREMANSTOWN BORQ., CUM8ERl14N~C0UliC1Y , MY COMMISSION EXPIRES DEC. 12 2011 I do hereby certify that the precise residence and complete post office address of the within named grantees is 950 S. 28th Street, Camp Hill, Pennsylvania 17011. r6~- 3~ 2 0 0 9 J S D. BOG Attorney for cantor (N.T.S.) ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 200911072 Recorded On 4/9/2009 At 8:38:08 AM * Instrument Type -DEED Invoice Number - 41086 User ID - JM * Grantor -MEREDITH, WILLIAM H * Grantee -MEREDITH, WILLIAM H * Customer -JAMES BOGAR * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $10.00 JUSTICE RECORDING FEES - $11.50 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEE S AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 WEST SHORE SCHOOL $0.00 DISTRICT LOWER ALLEN TOWNSHIP $0.00 TOTAL PAID $48.50 * Total Pales - 4 C~ertifcation Page DO NOT DETACH This page is now part of this legal document. I Certify this t+o be recorded in Cumberland County PA cE cv~yd s~ o ~_ ~ /° ~ RECORDER O D DS »ao * -Information denoted by an asterisk may change during the verification process and may not be reflected on this page. VI IAI~IVI~IQIIIIIII~ J REV-1511 EX+ (10-09) . pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF (FILE NUMBER William H. Meredith 2010-00046 Decedent`s debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Codclin Funeral Home, Dil , PA See Attached 8,431.98 Rolling Green Cemetary, C~np I, PA, Granit Marker, See Attad~ed 541.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) GlOrla M. Wagner Street Address 3330 Grandview Drive C;ty York Haven state PA zIP 17370 Year(s) Commission Paid: 2010 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as daimar~t's, attach explanation.) Claimant Street Address 4. 5. 6. 7. City State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Retum Preparer Fees: TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. ZIP 3,500.00 408.00 0.00 75.50 0.00 0.00 12,956.48 C~~ ~ _ • + ~ "..,~ m as w ~dC m ~~py Y a ~;~ .Z ~ ~ ~ ~ gao o ~ ~~ "W y Q m ~ dV~ ~ °~ a n n Q ~ m t m ~ ~` 69 69 ~~. ER 69 69 ~g Z £ ~ p Q ~ ~ `m a m ~ c~ -..,- ~.. ,~. m ~ m U = Vaw ~ Et°~ LL +.f O p Z ~ ~ 'C ~i ~'~ Q ~ H ~- J C~ m N m F~ ... G 6R (A 6R EA EA 69 /f) ffl EA 69 Ei? fA t!3 (f) ~ ~" 7 d ~ ~ ~ W 4- !~~ w ~ C Q r ~ 4. ~ y .. r «~# V ~ 'Q Z$ m N Q~~ ~a m ~oL a a a E _o ., o ~ N ~ ~ °~° E E E 3 ~ E _ ~ '~ aim ~ -~~"$ ~ q a m m m o m H ~ U ,~ ~z `o ~ ~ w ~ o c~3 ~c~c~c~zUU o - Z ... .. _ .... ~. ,,. J ° 3~. _ ~_ u- ~ m V W ~ ~ ~ W c `o ~: c. ~ ~ .~ ¢ f-~~ 1- co .~~a~~~a vi 3 U ~^ ~- ..~ ._ .~ ~ . ~~ ~ ~~ ~ ~ ~ -~ 1 ~~ ~~ ~~~~ ~~ .5 ~ ~ '. G O~ O 0 Q ~ '8 ~Q g ~ Z ~ w g ~ " u. ~ B ° ~ ~ `' In u. a a O 4. ~ ca m m dC ~ ... a a. ., 3 a/ ~ ~ ~' ~ w v .~ m ~ a, w '= a ~- '~ a `° ~ ~ `° ~o d w U U ~ J ~ co ~ !a ~g ~j ~, O -~ 3 i ~ .n ,~ u a d ~ $ ~- oC w W ~ ~ a~i O ~ u, ~ ~ Z O ~ w g € ~ ru ~ ri ~ Q Q ~ ~ cn u. > ~ ~ LL > ~ C7 Q ~ U U ti ~ N Q > ~ F~ Y ~~.- c ~ m W r a o .~ O> > F- Q ~ V g ~ a 3WOH Tdti3Nftd - 31V~1'lal{kil ~ ° 1N311~ - 31~I1~i f10 a w z O U Q m H 0 c m •~ ~ 3 ::Q _ _ O O Q ~ W W - LL LL ~ : ~ ~ O O ~ ~d O z ~ ~ ~ ~ o ¢ ~ ~ c7 O a z w U Q ~ ~j O ~ V W W ~ ~ o ~ o z a `~ ~. ~-- ~~ N O V 6 ~~ ~~ A n r~ Ii7 7 ~- i I ~ ~ •O ~ ~ t ~ ~.; '~?. ~~ ~~ CD 1-~ REV-1512 EX+ (12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES 8F LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER William H. Meredith 2010-00046 iReport 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. REV-1513 EX+ (01-10) ~ Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INMERTfANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William H. Meredith 2010-00046 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not Ust Trustee(s) OF ESTATE i TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Robert A. Meredith Son 30% 721 Welsh Drive, Ruther Glen, VA 22546 2 Cheri D. Rittner Daughter 30% 526 Kraybill Church Road, Mount Joy, PA 17552 3 Gloria M. Wagner Daughter 40% 3330 Grandview Drive, York Haven, PA 17370 0.0 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; 1 • None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. None TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ ~ If more space is needed, use additional sheets of paper of the same size. ~`~ ~~,~ `.~1 ,~ci a c~ . c/J P,~ ~~.~