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15056051058
REV-1500 EX (os-05) OFFICUIL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 21 1 O 0075
Narichum_ PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
160-68-0286 12/16/2009 06/25/1982
......_..........._ .............
Decedent's Last Name Suffix Decedent's First Name
Vaughan _ Phillip __
___ __
(If Applicable) Enter Survlving Spouse's Information Below
MI
J
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
~° 1. Original Retum
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MI
2. Supplemental Retum 3. Remainder Retum (date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required
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)
g`:-:;:"::;'• 9. Litigation Proceeds Received i 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
Esq.
Lisa Marie Coyne (717) 737-046'`"f„
,
Firm Name (If Applicable)... _ ~
REGISTER S USE OjMK ~ ~s
rY't ~`7
...
__ "'D ~f ~:
Coyne & Coyne, P.C. ~
1 c.~ ~~
-~ n`
~
First line of address _ is :~ t:' )
3901 Market Street ~ ~.
~ ~
ddress
d li
f
S ' ~
ne o
a
econ ~ .....
City or Post Office
'' Camp Hill
Corcespondent's a-mail address:
State ZIP Code --
PA 17011
.. ..: t7
DA~ FILED ~
.._
Under penalties of perjury, 1 declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and Dever,
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.
TORE OF PEgspN RES~gNSIBLE FpR FILING RETURN ~ g~ ~~0/O
..,_ r _ / 1 lam/ //1AiII7i'1//.ti _ /
Li~ida J. Vaughan U 3902 Church Street, Camp Hill, PA 17011
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIf31NAL FORM ONLY
15056051058
Side 1
15056051058
15056052059
REV-1500 EX Decedent's Social Security Number
Phillip J Vaughan 160-68-0286 ',
Decedent's Name:
_.____ ......~..,.......__. __..._ . , ~.~.. , ..,._ ~,._w
_.___ _
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. 7,096.68
6. Jointly Owned Properly (Schedule F) -..".~i 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) .................................... 8. ' 7,096.68
9. Funeral Expenses ~ Administrative Costs (Schedule H) ..................... 9. 15,579.76
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 4,500.00
11. Total Deductions (total Lines 9 & 10) ................................... 11. 20,079.76 :
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. -12,983.08
...
13. Charitable and Governmental BequestslSec 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) ........................
w~.~........~..._.. ..........-___.._..~..w~... 14. ',
_._..~ 0.00 ',
.~.._ ~._.
~. __.,,._...__..__....._ .~..,....
TAX COMPUTATION SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or _ _ _ _ __ __
Vansfers under Sec. 9116
(a)(1.2) X .0_ 15.
_.
16. Amount of Line 14 taxable
at lineal rate X .0 0 0.00
16.
_ 0.00
. _ _
17. Amount of Line 14 taxable _ _ _
at sibling rate X .12 17.
18. Amount of Line 14 taxable ',
at collateral rate X .15 18.
0.00'
19.
..........
TAX DUE ..............................................
. 1s.
.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
~~:.,~,
15056052059
REV-1500 EX Page 3
_ J_~af_ A_.-_r~~aA Aw~dMAl~l~•
Flle Number
... 21... 10 0075
VGVGM~i~R .~ vv"""M"v.v ...~. ~.. ~~~. , ...... ............... ............
DECEDENTS SOCIAL SECURITf NUMBER
DECEDENTS NAME
160-68-0286
Phillip J Vaughan
STREET ADDRESS
1221 Bridge Street
Apt. C.
CITY STATE
PA ZIP
17070
New Cumberland
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 0.00
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + g + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E)
(3)
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)
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)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 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? ......................................................... .............
If death occurred after December 12,1982, did decedent transfer property within one year of death
2
.
without receiving adequate consideration? .................................................................................................
th? ............. ^
^
.
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her dea .............
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
4
.
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.
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDt~LE E
CASH, BANK DEPOSRS, 8~ MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Phillip J. Vaughan 21-10-0075
Include the proceeds of litigation and the date the proceeds were received by the estate.
e11 mm~erfv telnNv-owned with right of aurvivonhip must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
PSEf~k
Coyne & Coyne, P.C.
Attorneys at Law
3901 Market St
Camp Hill, PA 17011-4227
Attn: Lisa Marie,. Coyne
Re: Phillip Vaughan, Deceased.
Account # 0160680286
February 1, 2010
D ~~
' F ~~U
sy FQ ~,Z
0,~
Dear Ms. Coyne: --
The account was opened on October 13, 2000. The Share accounts were held solely by
Phillip Vaughan.
The Visa loan was held solely by Phillip Vaughan.
The following are the Date of Death Balances for Mr. Vaughan's account with PSECU:
Account ~ Date of Death Balances Interest -December 1-16
Savings (S1) $ 637.18 $ 0.11
Checking (S4) $ 2,659.26 $ 0.13
Loans:
Visa Loan ,4:;500.00, , - . , .
Ifyou have any questions,~please contact me at (717) 234-8484 or toll-free at (800) 237-
7328, then press 6, extension 3120. ;
S' rely,
o-~ ~
Roxann Myers
Service Advisor
PSECU
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 • 717.234.8484 • 800..237.7328
Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.777.2100 (TDD) • 800.472.1967 (TDD)
psecu.com
This credit union is federally insured by the National Credit Union Administration. Equal Opportunity Lender
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCMED~ILE N
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FlLE NUMBER
Phillip J. Vaughan 21-10-0075
Debts of decedent must be roported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Neill Funeral Home 10,217.02
2. Rolling Green Memorial Park 1,668.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Soaal Security Number(s)IEIN 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
~. Cumberland Law Journal -legal advertisement
8. Patriot News -legal advertisement
s. Inheritance Tax filing fee
~ o. Short Certificates
~ ~ . West Shore Tax Bureau - 2009 taxes
~ 2. Pennsylvania 2009 Income taxes owed
Zip
.rP
TOTAL (Also enter on line 9, Recapitulation) I S
(If more space is needed, insert additional sheets of the same size)
2,000.00
64.00
75.00
137.24
15.00
64.50
102.00
197.00
14,539.76
ESTATE OF PHILLIP J. VAUGHAN
SCHEDULE H:
FUNERAL AND ADMI1yISTRATIVE COSTS, PAGE 2
Item No. Description
13 Richard Simpson, CPA -tax preparation, individual taxes
14 Final Estate Tax Preparation
15 Postage
16 Reserves
TOTAL FOR PAGE 2:
Amount
$100.00
$400.00
$40.00
500.00
$1,040.00
REV-1512 EX± (3.2-08)
~~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETU0.N
n ccrnGUT nCl'GnFNT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES ~ LIENS
ESTATE OF FILE NUMBER
Philli J. Vau han 21-10-0075
..___~ ~_:.._ :..........a :.,, rti. a.~.d.~r ~rinr to death that remained unpaid at the date of death, including unreimbursed medical expenses.
If more space is needed, insert additional sheets of the same size.
RFV-1513 EX+ (1.L-0$)
~~ pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE gENEFICIARIEs
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
21-10-0075
Phillip J. Vaughan
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).]
mother of residual
100%
1. Linda J. Vaughan _
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.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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.