HomeMy WebLinkAbout06-10-10' 1505607121
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
Poeox28oso~ INHERITANCE TAX RETURN 2 1 0 9 0 9 1 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 7 9 3 8 ? 3 2.9 0 9 1 2 2 0 0 9 0 2 0 6 1 0 4 9
Decedent's Last Name Suffix Decedent's First Name MI
G U R L E Y S T E P H E N C
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
1. Original Return
4. Limited Estate
[~ 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
[~ 7. Decedent Maintained a Living Trust 1
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
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 -NFVRMATIVN 5I1ouLD ee D1RtG -t~ i u:
Name Daytime Telephone Number
H U B E R T X G I L R O Y 71 7 2 4 3 3 3 4 1
Firm Name (If Applicable) _.__ __
REGISTER OF WILLS U~60NLY
M A R T S O N L A W O F F I C E S ~p ~-, ~ '~
c_..
First line of address y ~ ~ ~>__-:~ ` ~~;
1 0 E A S T H I G H S T R E E T r~ -p ~
' ~, ~ ;- ,,
~_ ~ ~ _r
Second line of address ' ` ' ~~~ :~'~
... ~'-_~
,-,
ILED N A ~~
City or Post Office State ZIP Code - ----- - _,..I ~ ~,:,,;~
~- ~
`
C A R L I S L E P A 1 7 0 1 3 ~
Correspondent's a-mail address: H G I L R O Y u7 M A R T S O N L A W• C O M
75
slc~
10 EAST HIGH ST
REPRESENTATIVE
CARLISLE
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 1505607121
Under pane{ties of perjury,) declare that 1 have examined this return, including accompanying schedules and statements, and fo the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representatnre is based on all information of which preparer has any knowledge.
J
1505607221
REV-1500 EX
Decedent's Socia{ Security Number
oecedent'sName: STEPHEN C• GURLEY 1 7 9 3 8 7 3 2 9
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. •
8 2 0 9 9 . 6 9
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly Owned Property (Schedule F) ^ 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. 8 2 0 9 9. 6 9
..........
9. Funeral Expenses & Administrative Costs (Schedule H)
.... 9.
.. 9 1 9 9 . 0 8
5 9 0 1 5 1 8
10. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I
9 9 ( ) ...... .... 10.
.. .
11. Total Deductions (total Lines 9 & 10) ..................... ...... 11. 6 8 2 1 4 . 2 6
12. Net Value of Estate (Line 8 minus Line 11) ................... ... ... 12• 1 3 8 8 5 . 4 3
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............ ... ... 13. •
1 3 8 8 5 4 3
14. Net Value Subject to Tax (Line 12 minus Line 13) .................. 14. .
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0 0
0
15
0.
0
0
(a)(1.2) x .0 .
16. Amount of Line 14 taxable
~ ~
~
O.
0
0
at lineal rate X .0 16.
17. Amount of Line 14 taxable 1 3 8 8 5 4 3 17 1 6 6 6. 2 5
at sibling rate X .12 .
18. Amount of Line 14 taxable 0 U 0 0 • U 0
at collateral rate X .15 18.
1 6 6 6. 2 5
19. Tax Due ......................................... .... ...19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
1505607221 1505607221
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 09 0916
DECEDENT'S NAME
STEPHEN C. GURLEY
STREET ADDRESS
1903 CHESTNUT STREET
CITY
CAMP HILL
STATE ZIP
PA 170011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 1,666.25
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + 8 + C) (2)
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.
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 tofal of Line 5 + 5A. This is fhe BALANCE DUE.
0.00
(3) 0.00
(4) 0.00
(5) 1,666.25
(5A)
(58) 1,666.25
Make Check Payable to: REGISTER ~F W-LLS, 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 : ............................ ... ...... ^ 0
b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^ 0
c. retain a reversionary interest; or .......................................................................................... ...... ^
^ 0
0
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
wifhout receiving adequate consideration? .................................................................................
"
" ...... ^
^
or payable upon death bank account or security at his or her death? ...
in trust for
3. Did decedent own an ......
4. Did decedent own an Individual Refirement 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, fhe fax 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 fo 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 beneticiary.
For dates of death on or after July 1, 2000:
The fax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for fhe 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 fax 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 fhe 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)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~t MASC.
IN RES DENTEDECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
STEPHEN C. GURLEY 21 09 0916
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. M&T Bank checking 39177483
(See Attached)
2. Beverly S. Gurley Estate, distribution
3. US Treasury, Social Security received but not yet deposited on date of death
4. Personal property, appraised value
5. 2000 Chrysler vehicle, actual sale value
6. Verizon, refund
7. American Medical Security, refund
8. Sale of personal property
9. Chase, Debt Cancellation Life Policy ,Activation # D7871665, payable to the Estate
(See attached)
10. Spirit Physician Group, refund
11. Social Security Administration, disability benefits due Decedent received after date of death
VALUE AT DATE
OF DEATH
476.30
45,707.18
1,201.00
268.75
2,200.00
2.35
1,169.83
375.00
19,055.28
30.00
11,614.00
TOTAL (Also enter on line 5, Recapitulation) I $ 82,099.69
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES ~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
STEPHEN C. GURLEY 21 09 0916
Debts of decedent must be reported on Schedule I.
1 TEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Musselman Funeral Home, Lemoyne PA 1,926.47
2. Family Reception after burial 200.00
3. Linda Farrell, reimbursemet of funeral luncheon expenses 67.40
4. Mt. Calvary Episcopal Church, columbarium niche 650.00
s.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Streef Address
City
Year(s) Commission Paid:
State Zip
2. Attorney Fees Manson Law Offices (estimated)
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4.
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
5 Accountant's Fees
6. Tax Refum Preparer's Fees
4,900.00
55.00
7. Cumberland County Register of Wills, filing fee, Inheritance Tax return 15.00
8. Ibis Appraisal Services, appraisal fee 60.00
9. Picioniere Realty, rent pending distribution of personal property ~ 650.00
10. The Sentinel, advertising Letters Testamentary 237.99
11. Cumberland Law Journal, advertising Letters Testamentary 75.00
12. PPL, electric pending disbursal of personal property 36.01
13. Valvoline Instant Oil, reparirs necessary for sale of vehicle 85.82
14. Death Certificates 34.00
15 . Postage 16.39
16. Cumberland County Register of Wills, additional probate fee 190.00
TOTAL (Also enter on line 9, Recapitulation) $ 9,199.08
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-Q3)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS 0~ DECEDENT,
MORTGAGE LIABILITIES, ~ LIENS
ESTATE OF FILE NUMBER
STEPHEN C. GURLEY 21 09 0916
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
1 TEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. Bank of America, account # 4313-0703-1441-6782, account payable 12,595.00
3. Chase, account # 5149-2210-0020-8919, account payable 19,055.28
4. Citi Card, account # 5491-4920-1427-3472, account payable 5,658.88
5. Discover Card, account # ************2895, account payble 5,117.79
6. PPL, account payable 38.34
7. Boscovs, account payable 34.40
8. Verizon, account payable 71.49
9. FIA Card Services (PNC account # 5490999018450329 10,987.00
10. AAA Financial Services Visa ****9157 5,457.00
TOTAL (Also enter on line 10, Recapitulation) I $ 59 015.18
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (g-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
F-LE NUMBER
STEPHEN C. GURLEY 21 09 0916
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)]
1, Melissa Hoy Sibling 13,885.43
75 Eagle Lane
Etters, PA 17219
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of fhe same size)
a ~~
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888)502-4349
Fax (302)934-2955
October 5, 2009
Martson Law Offices
10 East High Street
Carlisle, Pennsylvania 17013
Re: Estate of Stephen C. Gurley
Social Securit-y: 179-38-7330
Date of Death: September 12, 2009
Dear Sir or Madam:
Per your inquiry dated October Ol, 2009, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 39177483
Ownership (Names o,~ Stephen C Gurley*
Opening Date 6/28/68
Balance on Date of Death $ 476.30
Accrued Interest $ 0. DO
Total $ 476.30
2. Type of Account Safe Deposit Box
Box Number/Location 0001816/ West Shore Plaza
Ownership (Names o,~ Stephen C Gurley*
Opening Date ~ 3/01150
* If upon reviewing the information above, you believe there are additional accounts not referenced, please provide
us with an account number and/or name of any possible joint account holder. For any additional information on the
above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact
our West Shore Plaza Office # 717-731-1730.
Sincerely, -
._. ~X_.-
Tracie Hare
Adjustment Services
~., a ~
~...........•• FOK
CHAS E
c% Barwt~t Adiwation Dep~rtmsnl, PO Banc 979020, Mrmi, FL 33197-9020
October 28, 2009
ESTATE OF STEPHEN C GURLEY
C/O MARTSON LAW OFFICES
10 E HIGH ST
CARLISLE PA 1 701 3-301 5
I~~~tll~~~lll„~~~~II~~II~~~II~lI~~~~~~II~I~I»,~IIII~~~I~~I,I
Re: Activation Number: D7871665
Account Number: 8919
Date of Occurrence: 09/1212009
Type of Occurrence: Debt Cancellation Lie ,
To the Estate of Chase Cardmember:
We are leased to inform you that the request for Balance Cancellation under the Payment
Protector M Plan has been approved.
A Balance Cancellation benefit in the amount of $19,055.28 will be credited to the above
referenced Account and should be reflected on the next statement. This credit represents the
Account balance as of the date of Death of the primary cardmember.
We always strive to provide our customers with the highest level of satisfaction and service. If
you have any questions, please contact us at the number fisted below. For your convenience,
you may also access your Payment Protector benefit information 24 hours a day at our Benefit
Activation website at http://service.chasepaymentprotector.com.
Regards,
Benefit Activation Department
0888) 314-4371
Monday -Friday 8:00 a.m. - 8:00 p.m. Eastern Time
(„` L