The URL can be used to link to this page

Home My WebLink About06-14-1015056071120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX' RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 10 0091 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 317 09 3415 O1 05 2010 12 02 1917 Decedent's Last Name Suffix Decedent's First Name MI SCHEAFFER LILLIAN A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Sufhx 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 1. Original Return ^ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ qa• Future interest Compromise ~ 5. Federal Estate Tax Return Required ^ (date of death after 12-12-82) g Decedent Died Testate ^ ~• (AttaaheCopy of Trust)a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 44 9. Litigation Proceeds Received ~ 10. b$tweeril2 31 ~~a dt (da95~f death ~ 11,Election to tax under Sec. 9113(A) t (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number GARY L. JAMES ESQ. 717 533 3280 Firm Name (If Applicable) JAMES, SMITH, DIETTERICK & First line of address 134 SIPE AVENUE Second line of address City or Post Office HUNII~+lELSTOWN State ZIP Code PA 17036 REGISTER ~F WILLS USl~NLY .~ G Q ~~... n ., .~,..r cr} ~" ~~ ~~ ~ - `' """ °: • . 4, DATA F~ c 'k ~~:-'. . ,s f._. ~ ;; ~, Correspondent's a-mail address: 911~SdC.COlYi1 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 preparer has any knowledge. 134 Sipe/Ave~tue, INummelstown, PA 17036 15056071120 Side 1 15056071120 ~ a ~~ 862 Country Club Road, Camp Hill, PA 17011 SIGNATUR OF PREPARER O ER THAN REPRESENTATIVE DATE Gary L. James Esq. ~ - '~ - ~~Z-o~ J REV-1500 EX Decedents Name: Lillian A. SCheaffer Decedent's Social Security Number 317 09 3415 RECAPITULATION 1. Real Estate Sched u1e A 1 2 0 3, 8 5 5. 4 0 2. Stocks and Bonds Schedule B 2. 7 3 , 3 01.2 8 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. 81 , 685.3 9 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8~ Miscellaneous -Probate Property ~ Separate Billing Requested............ l G S h d 7 7 5 8 . 4 8 7 2 u ) ( c e e . , 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 4 31 , 6 0 0 . $ 5 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 24 , 8 94 .50 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 9 4 0.0 0 11. Total Deductions (total Lines 9 & 10) ................................................................... 11 2 5 , 8 3 4.5 0 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 4 O 5 , 7 6 6. 0 5 13. Charitable and Governmental BequestsJSec 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. 4 0 5 , 7 6 6.0 5 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 16 at lineal rate X .045 4 0 5, 7 6 6. 0 5 . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ................................................................................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15056072120 0.00 18,259.47 0.00 0.00 18,259.47 Side 2 15056072120 15056072120 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0091 DECEDENT'S NAME Lillian A. Scheaffer STREET ADDRESS 5 Amherst Drive CITY Cam Hill STATE PA ZIP 17011 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 p, Interest E. Penalty 17,300.00 910.53 Total Credits (A + B + C) (1) 18,259.47 (2) 18,210.53 Total Interest/Penalty (D + E} 4. 1f 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. q. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 48.94 (5A) (5B) 48.94 Make Check Pa able 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 x 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? ............................................................ ^ ^x 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?....... ^ ^x Rev-1502 EX+(11-08) SCHEDULE A REAL ESTATE COMMONVIfEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Scheaffer, Lillian A. 21-10-0091 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Improved Real Estate located at 5 Amherst Drive, Camp Hill, Cumberland County, 203,855.40 Pennsylvania -valued per tax assessed value * common level ratio $161,790.00 1.26 = $203,855.40 TOTAL (Also enter on Line 1. Recapitulation) I 203.855.40 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Scheaffer, Lillian A. 21-10-0091 All property jointly-owned with right of survivorship must bedisclosed on Schedule F. ITEM NUMBER CUS1P NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 68 shares of Manulife Financial Corporation -valued 19.56 1.330.08 per public listing 2 1,344 shares of PNC Financial Services Group - 53.55 71.971.20 valued per public listing TOTAL (Also enter on Line 2, Recapitulation) 73.301.28 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ ~6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Scheaffer, Lillian A. 21-10-0091 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 DESCRIPTION OF DEATH 1 Cash -redemption of MetLife annuities # 9200541444 and 9200567274 prior to 74.947.63 death; proceeds received after date of death 2 PNC Checking Account # 5140055399 -valued per letter dated February 16, 2010; 5.588.52 account was made joint on October 20, 2009; 100% is included as taxable Accrued interest on Item 2 through date of death 0.20 3 PNC Savings Account # 5130059783 -valued per letter dated February 16, 2010 147.86 Accrued interest on Item 3 through date of death 1.18 4 Personal Property 1.000.00 TOTAL (Also enter on Line 5, Recapitulation) , 81.685.39 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (1~A6) COMMONWEALTH OF PENNSYLVANIA SCHEDULE H FUNERAL EXPENSES & ESTATE OF FILE NUMBER Scheaffer, Lillian A. 21-10-0091 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT M R A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Persona) Representative(s) Street Address City State Zip Year(sl Commission paid 2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant John E. Scheaffer Jr Street Address 5 Amherst Drive City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent SOn 9,534.00 10,500.00 3,500.00 4. Probate Fees 399.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 333.00 7. Other Administrative Costs 628.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 24,894.50 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Scheaffer, Lillian A. 21-10-0091 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral Exoe, rises Dinner -after funeral 107.00 2 Flowers -funeral 336.00 3 Grave Opening -interment 1.345.00 4 Honorarium -funeral 100.00 5 Musselman Funeral Home -funeral 7.646.00 H-A 9.534.00 Other Administrative Costs 6 James Smith Dietterick 8z Connelly LLP -reserve for estate administration closing 500.00 costs 7 Recorder of Deeds Cumberland County -reserve for filing fees to record new deeds 128.00 H-B7 628.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) June 11, 2010 Glenda Farner Strausbaugh Register of Wills & Clerk of Orphans' Court 1 Courthouse Square Carlisle, PA 17013 RE: ESTATE OF LILLIAN A. SCHEAFFER, DECEASED FILE N0.21-10-0091 Dear Ms. Strausbaugh: Enclosed are the following documents to be filed in the above-referenced Estate: 1. An original and two (2) copies of the Pennsylvania Inheritance Tax Return. 2. An original and one (1) copy of the Inventory. 3. A check made payable to the "Register of Wills, Agent" in the amount of Forty Eight Dollars and Ninety Four Cents ($48.94) representing the balance of Pennsylvania Inheritance Tax due. 4. A check made payable to the "Register of Wills" in the amount of Thirty Dollars ($30.00) representing the filing fee. 5. A copy of the Will. Please time-stamp the additional copies of the Return and Inventory and return them to me in the enclosed self-addressed, stamped envelope. If you have any questions, please feel free to give me a call. Sincerely, .TAME SMITH, DIETTERICK & CONNELLY, LLP ~j Denise M. Long Cc: Janice L. Scheaffer Denise M. Long dml@jsdc.com 134 SIPE AVENUE HUMMELSTOWN, PA 17036 MAILING ADDRESS P.O. BOX 650 HERSHEY, PA 17033 TOLL FREE 1.800.942.3660 TEL. 717.533.3280 FAX 717.533.7771 www.jsdc.com