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Home My WebLink About04-14-1015056041158 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 09 0774 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 183-12-3001 08072009 09051923 Decedent's Last Name Suffix Decedent's First Name SMITH HOWARD (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 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) MI E MI 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required ~ 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 RICHARD C• SNELBAKER, ESQUIRE 717-697-8~5.~8 ~ ,.~ _ -_-A Firm Name (If Applicable) SNELBAKER & BRENNEMAN, P•C- First line of address 44 WEST MAIN STREET Second line of address P•0. BOX 318 City or Post Office State ZIP Code ~n...i - '.. w~l '»~) r..,=T ....~_, <. ~° .J - :,x ~l --- ~ -~, k. ~ (""') MECHANICSBURG PA 17055 Correspondent's a-mail address: 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.b~sed on all information of which preparer has any knowledge. FILING RETURN 'a AUURESS ~'~ - - - GRAC SCHNEIDER, EXECUTRIX KENNETH E• SMITH, EXECUTOR SIGNATU OF OTHER THAN REPRESENTATIVE DAT. / RICHARD C• SNELBAKER 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA 17055 15056041158 Side 1 6M4647 3.000 15056041158 J 15056042159 REV-1500 EX Decedent's Social Security Number 183-12-3001, decedent's Name:S M I T H H O W A R D E RECAPITULATION 1. Real estate (Schedule A) 1. O • O O 2. Stocks and Bonds (Schedule B) . 2. O • O O 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. O . O O 4. Mortgages & Notes Receivable (Schedule D). 4. O • O O 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 15 8 6 4 • 5 2 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. O • O O 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 800.00 8. Total Gross Assets (total Lines 1-7). 8. 16 6 6 4 • 5 2 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 3 9 8 9 • 4 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . 10. 2 4 3 6 6 • 2 9 11. Total Deductions (total Lines 9 8 10) . 11. 2 8 3 5 5 • 7 ~ 12. Net Value of Estate (Line 8 minus Line 11) 12. -116 91 • 2 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . 13. O • O O 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. -116 91 • 2 5 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.00_ O.OO 15. O.OO 16. Amount of Line 14 taxable at lineal rate X .0~ O.O O 16• O.O O 17. Amount of Line 14 taxable at sibling rate X .12 O.O O 17• O.O O 18. Amount of Line 14 taxable at collateral rate X .15 O.O O 18• O.O O 19. TAX DUE 19. O • O O 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 6M46482.000 15056042159 REV-1500 EX Page 3 Decedent's Comulete Address: File Number ai. n9 n~~u DECEDENTS NAME SMITH HOWARD E STREET ADDRESS M ER A CO NTY CITY CAMP HILL STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments 0 . 0 0 C. Discount 0 • 0 0 3. Interest/Penalty if applicable D. Interest Q . Q Q E. Penalty 0 • 0 0 (1) 0.00 Total Credits (A + g + C) (2) 0 . 0 0 Total InteresUPenalty (D + E) (3) 0 . 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0 • 0 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAx DUE. (5) 0 • 0 0 A. Enter the interest on the tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 • 0 0 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; ^ X^ b. retain the right to designate who shall use the property transferred or its income; ^ c. retain a reversionary interest; or . ^ 0 d. receive the promise for life of either payments, benefits or care? ^ 0 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? ^ 0 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 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)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 6M4671 1.000 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Howard E. Smith 21 09 0774 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-0wned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 HCR Manor Care personal account held at nursing home 2 Highmark refund unused premium 3 Heartland Healthcare Services refund on prescription plan 4 Citizens Bank checking account #6213378034 5 Citizens Bank checking account #6213378069 6 United States Treasury refund on 2008 (form 1040) income tax return 3W46AD 1.000 TOTAL (Also enter on line 5, Recapitulation (If more space is needed, insert additional sheets of the same size) 2,317.59 428.54 954.66 10,389.02 1,474.71 300.00 15,864.52 REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Howard E. Smith 21 090774 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. ITEM NUMBE DESCRIPTION OF PROPERTY INCUAETI-EfWiMEOFTIfTRANSFEREE,THEIRRELATIONSHIPTODECEDENiAND THE DATE OF TRANSFER. ATTA±CHACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD~S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE 1. Auto 800.00 100.0000 0.00 800.00 1994 Ford Ranger Pickup truck transferred within one year of death. TOTAL (Also enter on line 7, Recapitulation) ~ $ 800.00 (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 REV-1511 EX+ (10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Howard E. Smith 21090774 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Gingrich Memorials grave marker/inscription 135.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Grace E . Schneider & Kenneth E . Smith Street Address $ 3 8 9. 0 0 each (2 1 / 2 ~ to each ) City State Zip Year(s) Commission Paid: 2. Attorney Fees Snelbaker & Brenneman , P . C . 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. 5. 6. 7. 1 2 7W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) 778.00 1,750.00 87.00 450.00 13.73 75.00 700.75 3,989.48 City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Citizens Bank check printing charge Cumberland Law Journal advertising Executors Noice Total from continuation schedules Estate of: Howard E. Smith 21 09 0774 Schedule H Part 7 (Page 2) 3 Patriot News advertising Executors Notice 185.75 4 Register of Wills filing fee for Inheritance Tax Return 15.00 5 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the decedent's estate 500.00 Total (Carry forward to main schedule) 700.75 REV-1512 EX+ (12-08) pennsylvania SCHEDULE I DEPARTMENTOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Howard E. Smith 21 09 0774 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. swasAH 2.00o If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (11-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Howard E. Smith 2109 0774 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).] 1. Grace E. Schneider 64 Ashburg Drive Mechanicsburg, PA 17050 None 0.00 2 Kenneth E. Smith 1624 Williams Grove Road Dillsburg, PA 17019 None 0.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. ~~ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 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. $ 0 . 0 0 SCHEDULE J BENEFICIARIES If more space is needed, insert additional sheets of the same size. 8W46AI 2.000 LAST WILL AND TESTAMENT I, HOWARD E. SMITH, of the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby (revoking and making void all former wills and codicils by me at anytime heretofore made. FIRST. I order and direct that all my just debts and funeral,expenses be paid by my Executors, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give and bequeath my motor vehicle and all of my firearms unto KENNETH E. SMITH, absolutely, if he survives me. THIRD. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto the following persons, namely, GRACE E. SCHNEIDER and KENNETH E. SMITH, share and share alike, absolutely and in fee simple. If either of said persons should predecease me, I order and direct that my said residuary .estate shall be distributed unto the foregoing named beneficiary who may survive me. LASTLY. I nominate, constitute and appoint GRACE E. SCHNEIDER and KENNETH E. SMITH to be the Executors of this, my Last Will and Testament, both to serve without bond or other security as a condition of qualification. IN WITNESS WHEREOF, I, HOWARD E. SMITH, have hereunto set my hand and seal HOWARD E. SMITH to this my Last Will and Testament, which consists of two (2) typewritten pages to each of which I have affixed my signature this 5~' day of June, A.D., Two Thousand Eight (2008). °~"~-~ C; ~(S~AL) LAW OFFICES SNELBAKER 8G BRENNEMAN, P.C. • The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by HOWARD E. SMITH, the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his reque , in his and in the presence of each other, have subscribed our names as witnesses h t COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. We, HOWARD E. SMITH, RICHARD C. SNELBAKER and JANE J. GOONEY, the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his 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 a witness and that to the best of his or her knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testator ness tness Subscribed, sworn to and acknowledged before me by HOWARD E. SMITH, the Testator, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J. GOONEY, the witnesses, this 5th day of June, 2008. COMMONWEALTH OF PENNSYLVANIA Natar~al Seal Sandra K Stx+w~, Notary PubNc Mechanic ,1~1, t~umb:~tand County My Commissic{} i~x~ai~s Nov. 22.2011 Member, Pennsylvania Assoclatlon of Notarlee "2 ~" LAW OFFICES ~.. ~~~~ ~~ Notary Public ~NELBAKER 8C NNEMAN, P.C eJ ~~ ~~ ~c~~~~ j~~lCIS,~ APD ~`~ Qll ~a ~5~