HomeMy WebLinkAbout04-29-10 (2)J 1505607120
REV-1500 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes county code Year File Number
Po Box.2sosoi INHERITANCE TAX RETURN ~ ~~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
203 10 9210 Ol 27 2010 08 14 1919
Decedent's Last Name Suffix Decedent's First Name
MI
SPANGLER D~R~THY C
(If Applicable Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X ~ 1. Original Retum ~ 2. Supplemental Retum ~ 3_ Remainder Retum (date of death
X^ 4. Limited Estate
~ prior to 12-13-82)
qa Future Interest Compromise r-7
5
F
.
ederal Estate Tax Retum Required
(date of death aver fz-t2-82) LJ
8. Decedent Died Testate
~-- ~ (Attach Copy of WiN) f ~
L_ ~ Decedent Maintained a Uving Trust
(Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received ~ 1 D Spousal Poverty Credit ((date of death
between 12-31-91 and i-i-s5) n 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO S
Name
HOULD BE DIRECTED TO:
JAN M W I L E Y Daytime Telephone Number
717 432 9666
Firm Name (If Applicable)
THE WILEY GROUP, PC
First line of address
130 W. CHURCH STREET
Second line of address
City or Post Office
DILLSBURG
State ZIP Code
PA 17019
Correspondent's e-mail address:
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vrruer penatues or peryury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the best
it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which prepan
SI TURE OF PFRS(1N wcac~ucror r~o ~~. ~.~.....-_.._-.
ADDRESS
712 M
OF PREPARER OTHER THAN
PA 17019
Edward L. Shaffer
r my knowledge anri holiof
Ias any knowledge. '
DATE
13 W. Church Street, Dillsburi
L 15D56D712D
Jan M Wiley
PA 17019
Side 1
15D560712q
REGISTER OF WILLS USE ONLY
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J 15D56D722D
REV-1500 EX
Decedent's Social Security Number
oeceaerrrsName Dorothy C. Spangler
-- 2 0 3 1 0 9 2 1 0
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) ....................................... .
5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............. ... 5. 7 1 7 0 7 0
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ........... ... 6. 5 6 4 0 1 3
Inter-Vivos )ransfers 8 Miscellaneous N
Probate Property
Schedule G
~I Separate Billing Requested ........... .. 7.
8. Total Gross Assets (total Lines 1-7) .................................................. g. 1 2 8 1 0 8 3
9. -
Funeral Expenses & Administrative Costs (Schedule H) ....................................... ---- -----
-
.. g.
-_
3 5 6 0 7 8
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10.
11. Total Deductions (total Lines 9& 10) .................................................................... ..
11. 3 5 6 0 7 8
12. Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 9 2 5 0 0 5
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) ..... .......................
......
.............
.. 1a.
9 , 250.
05
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 .o0 0 0 0 15- 0 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 9, 2 5 0. 0 5 16. 4 1 6 2 5
17. Amount of line 14 taxable .
at sibling rate X .12 0 0 0 17. 0 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0 18- 0 0 0
19. Tax Due .......................................................... 19
................ ............................. ............. .
.
416.
25
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
15D5607220
1505607220 J
REV-1500 EX Page 3
Decedent's Complete Address:
Dorothy C. Spangler
- - --
STREETADDRESS
801 N. Hanover Street
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
20.81
File Number 21-10-
ST
Total Credits (A + B + C)
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1) 416.25
(2) 20.81
(3}
(4) - -
(5) 395.44
(5A)
(5B> 395.44
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 :.................................... ^
x
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 tran
f ^
x
^
,
,
s
er property within one year of death without
receiving adequate consideration?
............
.......................................................................... ^ i^
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ l
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.
- - --- ...,~...~.,~e ...
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 exemot 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)]. 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.
___
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PA 17013
Rev-7508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSriVANIA
INHERITANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF FILE NI~MBER
Spangler, Dorothy C. 21-10-
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyowned with the right of survivorship must be disclosed on schedule F
ITEM
NUMBER DESCRIPTION
1 AARP (refund):
2 Church of God Home (refund):
VALUE AT DATE
OF DEATH
175.25
6,995.45
TOTAL (Also enter on Line 5, Recapitulation) I 7 170 70
(If more space Is needed, addlttonal pages of the same size) '
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15010 Schedule E (Rev. 6-98)
Rev-1509 EX+ (6-98)
SCHEDULE F
COtAMONV4EALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
is i ArE vF FILE NUMBER
Spangler, Dorothy C. 21-10-
rt an asset was made joint within orre year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Edward L. Shaffer
B
C.
712 Mumper Lane Son
Dillsburg, PA 17019
JOINTLY OWNED PROPERTY:
DESCRIPTION
ITEM LETTER DATE OF PROPERTY
NUMBER
FOR JOINT
MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT
DATE OF DEATH % OF
' DATE OF DEATH
TENANT
JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLY-HELD REAL ESTATE.
VALUE OF ASSET DEGD
S
INTEREST VALUE OF
DECEDENT'S INTEREST
1
A 8/11/2008 Members 1st Checking Account 4,644.10 0.500% 2.322.05
247161-11:
2 A 6/30/2004 Members 1st Savings Account 2.134.52 0.500% 1
067
26
247161-00: .
.
3 A 3/21/2008 Members 1st Savings Account 4,501.63 0.51)0% 2
250
82
247161-47: ,
.
TOTAL (Also enter on Line 6, Recapitulation) I 5.640 13
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-750D Schedule F (Rev. 6-98)
REV-1151 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES ~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Spangler, Dorothy C. 21-10-
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION
NUMBER AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
295.78
B.
1. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Edward L. Shaffer
Social Security Number(s) / EtN Number of Personal Representative(s):
Street Address 712 Mumper Lane
City Dillsburg State PA zip 17019
Year(s) Commission paid 750.00
2. Attorney's Fees The Wiley Group, PC 2,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Clty State zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 3 560.78
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15Q0 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Spangler, Dorothy C. 21-10-
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Cocklin Funeral Home: 295.78
H-A Subtotal 295.78
Other Administrative Costs
2 Filing Fee: 15.00
H-s7 subtotal 15.00
Copyright (c) 2002 form softwan: only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
REV-1573 EX+ (g-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Spangler, Dorothy C. 21-10-
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY RELATIbNSHIP TO
DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
I~
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
Do Not List Trustee(s) (Words)
($$$)
under Sec. 9116(a)(1.2)]
1 Mary E. Kretsinger Stepchild 1 203
31
21915 Martin Circle .
'
Hagerstown, MD 21742
2 Edward L. Shaffer Son 6
843
44
712 Mumper Lane ,
.
Dillsburg, PA 17019
3 George M. Spangler Stepchild 1 203
31
31 Homestead Drive .
'
Greencastle, PA
Total 9,250.06
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
III NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0 00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)
±~~~z~st mill ~z~t~ ~Ps~~~tmen~
DOROTHY C. SPANGLER
I, DOROTHY C. BPANGLER, of Camp Hill, Lower Allen
Township, Mechanicsburg, Cumberland County, Pennsylvania, being
of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this writing to be my Last Will ana
hereby revoke and make void any and all former Wills or Codicils
made by me at anytime prior hereto.
ITEM I: I direct the payment out of my estate of all
my just debts and funeral expenses as soon after my death as
convenient.
ITEM II: I direct that my mortal remains be interred
next to my husband in my family plot at the Air Hill Cemetery and
an appropriate inscription be placed on the marker erected
thereon.
ITEM III: I direct that the rest, residue and
remainder of :~y eStatE3 be divided into three (3) equal shares and
I give to each of the following who survives me the number of
shares set forth below:
A. To my son, EDWARD L. SHAFFER, one (1) share;
B. To my step-son, GEORGE M. SPANGLER, one (1) share;
K'. _ _ ~+
d„ ~ _ Y~11>_ ~- ,~ ~`~' 1 ~ _ . /~.>.- ( DEAL)
Dorothy ~. Spangler -~~~
C. To my step-daughter, MARY E. KRETSINGER, one (1)
share;
If any of the above-named beneficiaries fail to survive
me, I direct that that beneficiary's share shall descend to that
beneficiary's surviving issue, per stirpes. In the event that
any of the above-named beneficiaries fail to survive me without
issue then surviving, .I direct that his or her share be added to
the shares of the others in the same proportions they now bear to
each other.
ITEM IV: All administrative costs, including
inheritance taxes, estate taxes and tranfer taxes imposed upon my
estate passing under my Will or otherwise shall be paid out of
the principal of my residuary estate.
ITEM D: I appoint as Executor of this, my Last Will
and Testament, my beloved son, EDWARD L. SHAFFER, JR.
ITEM VI: I direct that no trustee, executor, guardian,
or other fiduciary named, nominated, or appointed in this Will
shall be required to give bond or give any security of any type
for any purposes whatsoever.
IN WITN888 WHEREOF, I have hereunto set my hand and
seal this ~~ day of_ o~/,-:c-~~ ~71~~~~ 1998.
~~-z « ~_ <~-T=~ ~ ,~ , -~~ , ~~ ( SEAL)
Dorothy~~ Sp glen
The preceding instrument, consisting of this and two
(2) other typewritten pages identified by the signature of the
Testatrix, was on the day and date thereof signed, published and
declared by DOROTHY C. BgFiNGLEIt, the Testatrix therein named, as
and for her Last Will in the presence of us, who, at her request,
in her presence and in the presence of each other, have
subscribed our names as witnesses hereto:
,t
~.~ ~~ esiding
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ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COtTNTY OF ~ ~j--~~'ttiti
ON THIS, the ~~ t` day of fV~~-~~t~rt~'}c~r-- ~ 19~°~~{ ~
before me, a Notary Public, the undersigned officer, personally
appeared DOROTHY C. BPANGLBR, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the attached
and foregoing instrument, acknowledged that she signed and
executed the instrument as her Last Will; that she signed it
willingly; and that she signed it as her free and voluntary act
for the purposes therein expressed.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
f`~. ( SFAT.)
Nota Public
My Commission Expires:
Notarial Seai
Cheryl A. Ritter, Notary Public
Harrisburg, Dauphin County
My Commission Expires Jain. 3, 2000
AFFIDAVIT
COMMONEALTH OF PENNSYLVANIA
COUNTY OF
SS.
~~~~~L n
WE, ~ L ~ ~ f~i~S EC~'~` and __~1 IR`; r.%.r . c> ~b'~ ~~~Sr ,;
t
the witnesses whose names are subscribed to the attached and
foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the Testatrix sign
and execute the instrument as her Last Will; that she signed it
willingly and that she executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the
hearing and sight of the Testatrix signed the Will as witnesses;
and that to the best of our knowledge, the Testatrix was at the
time eighteen (18) or more years of age, of sound mind and under
no constraint or undue influence.
Sworn to and subscribed
before me this p~I~ day
of .Iv~m~ , 19q~
~.
No ry Public
My Commission Expires:
-r~~~~2~~i~ ~~~ ~c~r~
Witness
,/ ~ - _
Witness ~~
Notarial Seal
Cheryl A. Ritter, Notary Public
Harrisburg, Dauphin County
My Commission Expires Jan. 3, 2000
St
MEMBERS 1't
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Aecourtt Number/Suffix
Date Aaount Established
Principal Balance at Date of Death
Aouued Interest to Date of Death
Total Princpal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
CHECKING ACCOUNT:
Account Number/Suffix
Date Aecaunt Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
CERTIFICATES OF DEP061T:
Account Nurrtiber/Suffix
Date Account Established
Prinapal Salance at Oate of Death
Accxued Interest to Date of Death
Total Principal and Acuued interest
Name of Joint Owner
Oate Joint Ownership Established
247161-00
06/30/2004
$2,133.99
$.53
$2,134.52
Edward Shaffer
06/30/2004
247161-11
08/11/2008
$4,642.98
$1.12
$4,644.10
Edward Shaffer
08/11/2008
247161-47
03/21 /2008'
$4,496.70
$4.93
$4,501.63
Edward Shaffer
03/Z1/2008
M BERS 1S7 FEDERAL CREDIT ON
~. ~~~
Danielle A. Kline
Lending Insurance Support Specialist
March 2, 2010
Estate of: DOROTHY SPANGLER
Date of Death: 01!27!2010
Social Security Number. 203-10-9210
X000 Louise Drive PO. 13ox 40 Mechanicsburg, Pennsylvania 17655 (800) 283-2328 w~~rtv.tnetnberlst.org
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