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HomeMy WebLinkAbout04-30-1015056051047 --~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN ~J J ~G ©3 ~--- Po Box zaosol RESIDENT DECEDENT 4` Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW pate of Birth Social Security Number Date of Death j ~--y ©~--3 >r 3 f' o ~ o Leo o' q m ~ ~- ~' ~ `~ ~ `~ Suffix Decedent's First Name MI Decedent's Last Name !~ duo" /¢-,~ s ~7 o z / -s' (If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name MI Spouse's Last Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 2. Supplemental Return O 3. Remainder Return (date of death ~ 1. Original Return prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes ~ 6. Decedent Died Testate O Attach Copy of Trust) (Attach Copy of Will) ( O 9. Litigation Proceeds Received O 10• betweenP2-3 91 and 1tl1t95) death O 11 ~ (Attach SchaO) nder Sec. 9113(A) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIALDaytimFe TelephOoneHNumbeE DIRECTED T0: N~ ' l ~ ~ ~~" L-S' ~ ~ ` c- ! ~e-~+~t ~9, ~-- l ~' Z ~ ..3 3 c~ ~3 / `.~' Firm Name (If Applicable) WILLS l4S>E ONL~F~-t , First line of address U N C 1'/G ~S" t ~ / Second line of address Sk..~ ~~ ZOO City or Post Office ~ ~,c._ c, ~ S L ~ State ZIP Code ~° ~-- REGIS ~, ~_. l-7 yr --~ ce :T7 C. i '" ~' W E , ~ ~~ -~ C17~ - ~~ C~ -v 'DATE FILED ~ j ~i r 3 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 based on all information of which prepay DATE /any knowledge. SIGNATURE OF PE ON RESPONSIBLE F FILING RETURN 7 2 ~~fCJ ~ 5j' ADDRESS ~~ ~-~.o-e,~ v-7'~S Lr~~/ C~iz~ ~~j DATE 2 ~~ SIG TIjR REPARER O R ~+R RESENTATIVE~ ,.-- AD®//~_ _ ' ?~~ ~ CJ ~ ~ ~7.t. Lr/.~ ~ 'Ca1J2.U.Y~ ~ J~~T ~~l 3 PLEASE USE ORIGINAL FORM ONLY 15056051047 Side 1 15056051047 J 15056052048 REV-1500 EX D/ecedent/~s Social Security Number Decedent's Name: ~iS~O~~s f ~G~iZ1S ~'y / ~~/ ~T~ ~ v RECAPITULATION 4 l 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 lc ~ . l 8 6. Jointly Owned Property (Schedule F) p Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. , 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. ~ ~ ~ / ~~ / 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. ~ , 7~ .~l 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. ~p (~~~ , ~~ 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. /3~ ~ q ~~ 12. 13 Net Value of Estate (Line 8 minus Line 11) ............................ Ch it bl .. 12. 2 ~ ~ ~ C~~Q ~J . ar a e 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. ,3 ~ /~ ~ ~ ,Q 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 _ 16 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable / ~ at collateral rate X .15 ~ 4a z f ~ Q 1 g ~ ~ ~ c~ ~ • 19. TAX DUE ....................................................... .. 19. ~ ~ ~ ~ .C~ b 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 J REV-1500 EX Page 3 File Number Decedent's Complete Address: ~IOg ~~/3 ~ ~ DECEDENT'S NAME r - -__ __ _ _ __ STREETADDR SS - _ _. -_ ___ __ - - CITY - __ ~2~-~~~„~j STATE ZIP /°~ l ~~ ~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit __ B. Prior Payments ~3~' oz. o, 0O ~ ~ ~ p. ~(' C. Discount - ~ `~' ~~ Total Credits (A + B + C ) 3. Interest/Penalty if applicable D. Interest E. Penalty -- Total Interest/Penalty (D + E ) 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. 2 ~.~' 2 O ~ () ~~y2/ i (3) (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. (5B) Make Check Payable fo: 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 transferretl :.......................................................................................... ^ 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 "intrust 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? ........................................................................................................................ ^ 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. REV4 WB EX « (1-97, COMMONWEALTH OE PENNSYLVANIA INHERITANCE TAX RETURN RESICENT CECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ~/~i/~~S c.1~a2i.r ~ ~~/o g -- d3 G ~S_ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule f. ITEM VALUE AT DATE NUMBER ,t~~y, ~, ~+ j DESCRIPTION `~ / OF DEATH 1. ~G. "'/t~L'/G.~ / ST ~.G e~~t r iy./~rrt ~ / G/ ivy C ~ ~ C~~i~rG -~, yo.~, O Z TOTAL (Also enter on line 5, Recapitulation) I $ ~~ ~{G a ~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) ~ seNE~u~E ~ COMMONWEALTH OF PENNS`(LVANIA Fl1NERAi. EXPENSES & INHERITANCE TAX RETURN ADIVIINiS~RATIiI'E CC7STS RESIDENT DECEDENT ESTATE t~F FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ,~` Gr///1/G d /-GS'. ~cr~G izg-~- /~~ c~ .~fG/ lZ /~c sue, `f~~'~ v2~rc ~,~~oAl ~ /~i.~ ff~~o~sT /av , od ~ ~~~~ B. I ADMINISTRATIVE COSTS 1. Personal Representative's Commissions Name of Personal Representative(s) ~Oh~t__ ~ f~Y ~~G l c..'~ Street Address -_ ~,~~_ ~~-~~<~1~ _-_~~+~ ---- --- - --- / City G~2 L <,1' L~ State ~ Zip 1'~O/S- Year(s) Commission Paid: 2~ Attorney Fees ,/~/h ~~ r ~ ~9N~~ LS 3 ~ 2.3,00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) ~ Claimant _ __ __ __~~__ Street Address City State Zip __ _ _ Relationship of Claimant to Decedent 4. Probate Fees ~,S.r~ ^ / ~,, %~ ~z'Y~ GG 5~ Accountant's Fees r 6. Tax Return Preparer's Fees 7. nj a~Y.cn7~/ti~/J ~m~/trJ 7~esf~r~uN~~ C L T ~S, o ~'t°jvTiJr~ L ~ t G'G.j. L, / ~ ~. ,,, j'trc 8 E~J'T~T.~ C yr-c.~c.~..G i~-ecou./~ ~4~¢.~.5~ ~J,t~.r~s~' -~~k ~i ,SZ"i ~ - ~~~ ~-~ y 2. oc , c TOTAL (Also enter on line 9, Recapitulation) $ ~'~ ~ ~,~ l.b (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~, FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OI= DEATH ~i mss. Go ~ ~ ~_ Sf' r l TOTAL (Also enter on line 10, Recapitulation) $ ~~ `~~ 9~ (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) , ,, a COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ,. ~~ ~ ~~ c, ~rre~L ~ ~ ~~-~~~`w ~s ~ LS_ ,( , ~/ ~~Y/VYrCJ I"G'O'~ ~~r c~2~s-/~ ~~ l~~ 3 ~ _ Cow sr~.~rc-c~ ~~ ~Z~t~~~c ~ ~i fc~ ~3 ~ G ~2 t~.r'/l ~~ / ~~,~ .~/S ~.r2r.~rrJ ~ °~ - ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ~~ r C~Op17 I, DORIS I. BROADS, of the Borough of Carlisle, Cumberland County:, Pennsylvania, declare this to be my last will and revoke all-wills and codicils previously made by me. I. I direct my executor hereinafter named to have my funeral and burial conducted in accordance with the pre- arrangements made 'and paid for by me through the Ewing Brothers Funeral Home of .Carlisle, Pennsylvania, including cremation and the interment of my remains beside those of my husband, Kenneth V. Rhoads, at the Westminster Cemetery of Carlisle, Pennsylvania. . ~ II. I give and bequeath certain articles of my tangible personal property to those individuals designated as set forth in a separate letter~of instructions that may be found with my other important papers . - , , _ : III. I direct my executor to convert into cash and sell at either public or private sale all the rest, residue and remainder of my real and tangible personal property not otherwise disposed of, and to add the proceeds therefrom to my residuary estate which I give and bequeath as follows: A. Fifty (50%) percent in equal shares to my nephew, EUGENE C. NICKEL, JR:, and my niece, CONSTANCE J. RUN11`~L, as survive me by thirty days; and provided ~ ~aa .n that if either of them fails to so survive me but is represented .by descendants who survive me, such. issue living on the thirty-first day following my death shall receive, per stirpes, the share such deceased beneficiary would have received had he or she so survived me. B. Fifty (50%) percent in equal shares to my nephew and niece-in-law, ROBERT A. WEIGLE, SR. and BETTY WEIGLE, husband and wife, by the entirety, if either of them survives me by thirty days; if not, in equal shares to such of their two adult children, ROBERT A. WEIGLE, JR. and CYNTHIA BLACK, as survive by thirty days, and provided that if any 'such child fails to so survive me but is represented by descendants who. survive me, such issue living on the thirty-first day following my death shall receive, per stirpes, the share such deceased child would have received had he or she so survived me. IV. I direct that all taxes that may be assessed in consequence of my .death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. V. I appoint my nephew, ROBERT A. WEIGLE, SR., executor of thus my last will. Should Robert A. Weigle, Sr. fail to qualify or cease to act as executor, I appoint my grandniece, GINA SNYDER, executrix of this my last will. V.%. I direct that neither my executor nor his successor shall be required•to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal .this ~3~day of ~t- 2004. ~c Od ~_ ~ S EAL ) DORIS I. RHOADS The preceding instrument, consisting of this and two other typewritten pages identified by the signature of the testatrix, DORIS I. RHOADS, was on the day and date thereof signed, published and declared by DORIS I. RHOADS, 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 h ~/ subscribed//% /.names as witnesses hereto. ~~ ~„ ~~~~~~~ ,~ctic ~~a~s~~N i~ . ~~~~'~~ ~~ 1 ~a z y ;~ N W - x Send Inquires to: 5000 Louise Drive PO box 40 Mechanicsburg, PA 17055 www.membersl st.org Main Switchboard: (800) 283-2328 EZ Call: (717) 697-4372 or (800) 283-4372 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 TeleBraneh: (800)237-7288 4728 1 AV 0.324 9455-4728 I~~~III~~~111„~~~~ll~l~l~l~l,~~~I~III,~~I~~I~~~~II~I~I~~~~III DORIS I RHOADS C/O ROBERT A WEIGLE 515 LEREW ROAD CARLISLE PA 17015 Statement of Accounts Mar 25, 2009 thru Apr 24, 2009 Account Number: 127756 Balances at a Glance Checking: 0.00 Savings : 0.00 Certificates : 0.00 Loans: 0.00 Money Management: 0.00 Swipe 5 YTD Reward : 0.00 Page : 1 of 2 Your current Member Loyalty Rewards level-is Platinum~~~~/! Your aggregate balance as of April 1st is $47,891.69. An aggregate balance of $75,000 and havik~g 3 prodyct~ _ - will n-iove you to the Titanium ieveF--`"`" Want to earn some extra cash? Take advantage of our CASH4U referral program. Ask an associate for details. ~= ~':: CHECKING ACCOUNTS 11 -CHECKING Date Transaction Descri lion Additions Subtractions Balance Mar 25 Apr 01 Balance Forward Deposit Transfer From Share 00 816.76 1,573.97 2,390.73 Apr 01 Deposit Transfer From Share 00 12.34 _ 2 403.07% 7 Apr 03 Deposit Transfer From Share 00 544.00 ,~~ ~ 2,947.0 Apr 06 Withdrawal Transfer To Share 00 544.00- -_ -~~~ 2,403.07 -C71ON DATE -0410312009 ' Apr 06 De o it by Check ~` ~ 547.00 ,) 950 07- --`' 2 ~~ 2,950.07 00 0 Apr 16 Withdrawal_T~Osfer To Share 00 . , -...---- . C ~ KING Closed *"This is the frna/ statement presenting infomration on this product"* "* Please retain this final statement for tax reporting purposes.- "' SAVINGS ACCOUNTS 00 -REGULAR SAVINGS Date Transaction Descri lion Additions Subtractions Balance Mar 25 Balance Forward 816 76 6 ' ~ 823.14 Apr 01 Deposit ACH CIVIL SERV . ~`'` ID: 3121736156 CO: CIVIL SERV ~ 816 76- 38 6 Apr 01 Withdrawal Transfer To Share 11 . 12 34 . 18 72 Apr 01 Deposit ACH GENESCO INC . ~ . TYPE: RETIREMENT iD: 1626219052 \ DATA: UP GRP ANNUITY TRUST CO: GENESCO INC Apr 01 Withdrawal Transfer To Share 11 12.34- 00 544 _ __ 6.38._ ~ 550.38 Apr 03 Deposit ACH SOC SEC . ID: 3031036030 C(1 SOC SEC 00- `- 544 38 6 Apr 03 Withdrawal Transfer To Share 11 . 544 00 . 550.38 Apr O6 Deposit Transfer From Share 11 . . TRANSACTION DATE -04103/2009 '`=-,~ Apr 06 Withdrawal ACH SOC SEC 544.00- 6.38 RETURN ACH CREDIT AS R15 (04103/09) --- Continued on following page --- St Send Inquires to: Main Switchboard: (800} 283-2328 5000 Louise Drive EZ Cail: (717) 697-4372 or (800) 283-4372 Mar 25, 2009 thru Apr 24, 2009 PO Box 40 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 9456-4728 Account Number: 127756 Mechanicsburg, PA 17055 TeleBranch: (800) 237-7288 F1tS P' ~tEV>B memberslst.org www Page: 2 of 2 ~ . ~R.,,o., Date Transaction Descri lion Additions Subtractions Balance - Apr 16 Deposit Dividend 0.02 6.40 Annual Percentage Yield Earned 0.420' from 04/01/2009 through 04/30/2009 Apr 16 Deposit Transfer From Share 53 45,524.86 45,531.26 Apr 16 Deposit Transfer From Share 11 2,950.07 48,481.33 " Apr 16 Withdrawal by Check 48,481.33- 0.00 _. REGULAR SA t//NGS Closed { ~~ *"This is the final statement presenting information on this product*'* N e * * * P/ease retain this final statement for tax reporting purposes * * N i_ c.1 ~~ W=_ CERTIFICATE ACCOUNTS 53 - 9 MONTH NO PENALTY CERT Date Transaction Descri tion Additions Subtractions Balance Mar 25 Balance Forward 90 82 45 , 394.34 482..24_ _ 45 _._ _ .. 31 _. Deposit_Dividend_228.O1a__.____ .. ____ _-- _ Mar , . Annua/ Percentage Yie/d Earned 2.300'% from 03/D 9/2009 through 03/31/2009 Apr 16 Deposit Dividend "''-°° "~ -'- 42.62 45,524.86 Annua/ Percentage Yie/d Earned 2.3911 from 04109/2009 through 04/95/2009 Apr 16 Withdrawal Transfer To Share 00 45,524.86- 0.00 9 MONTH NO PENALTY CERT Closed '**This is the final statement presenting information on this product*** * * Please retain this final statement for tax reporting purposes * * * YTD SUMMARIES TOTAL DIVIDENDS PAID 00 REGULAR SAVINGS 1 •~ 11 CHECKING 1.42 53 9 MONTH NO PENALTY CERT 240.90 Total Year To Date Dividends Paid 316.35 NOTE: Total includes closed shares Don't forget about our new Member Loyalty Rewards Program. The more products you have with us, the more benefits you'll receive. Ask an associate for details or visit our website at www.members1 st.org for details.