HomeMy WebLinkAbout06-24-101505607120
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 60X.280601 ~ ~ ~~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 (, ~}
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
204 05 1800 09 08 2009 02 07 1922
Decedent's Last Name Suffix Decedent's First Name MI
Y~HN EARL E
(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
L~ 1. Original Return ~ 2. Supplemental Return ~J~ 3, Remainder Return (date of death
prior to 12-13-82)
^ ' 4. Limited Estate ~ -~' qa. Future Interest Compromise l 5. Federal Estate Tax Return Re wired
(data of death after 12-12-82) ~--J 4
i X -j g. Decedent Died Testate j- ~, ~ Decedent Maintained a Living Trust
u (Attach Copy of Will) ~--~ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
L J 9. Litigation Proceeds Received I --~ 10. Spousal PoveRy Credit (date of death 1- ,~~ 11. Election to tax under Sec. 9113 A
between 12-31-91 and 1-1-95) __, ( )
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JAN M WILEY 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
Correspondent's a-mail address:
State ZIP Code
PA 17019
REGISTER OF WILLS USE ONLY
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Under penalties of perjury, 1 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.
SIGNATURE OF PER ON RESP NSIBL FILING RETURN DATE
itner`~IighyGay, Carlisle, PA 17015
OF PREPAR OTHER THAN REPRESENTATIVE
Jan M Wiley
,~, ,,
130 W. Church Street, Dillsburg, PA 17019
~_-------~ Side 1
1505607120 1505607120
DATE
-S-! 0
REV-1500 EX
decedent's Name: E a r I E. Yoh n
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.
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) I~'i Separate Billing Requested ............. 7,
8. Total Gross Assets (total Lines 1-7) ....................................................................... g.
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
11. Total Deductions (total Lines 9 & 10) ...................................................................... 11.
12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................. 13.
Decedent's Social Security Number
204 05 1800
8,989.01
8,989.01
2,430.00
880.70
3,310.70
5,678,31
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
(a)(1.2) X .00 0 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 5 6 7 8 3 1 16.
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.
1505607220
5,678.31
0.00
255.52
0.00
0.00
255.52
Side 2
1505607220 1505607220 J
REV-1500 EX Page 3 File Number 21--
Decedent's Complete Address:
DECEDENT'S-NAME
Earl E. Yohn
-- -- -___
-- _
STREET ADDRESS -
700 Walnut Bottom Road
Forest Park Health Center
CITY I STATE j ZIP
Carlisle PA ~ 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
- - - --- -
C. Discount 0.00
Total Credits (A + B + C)
3. Interest/Penalty if applicable
p. 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.
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.
(1) 255.52
(2) 0.00
(3)
(4)
(5) 255.52
(5A)
(56) 2 5 5.5 2
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 t e use or income o the property transferred :.................................................................................. ~ I x
--
b. retain the right to designate who shall use the property transferred or its income :.................................... 'I ~ x_'
c. retain a reversionary interest; or .................................................................................................................. ~ ~! j x l
~_ ,
d. receive the promise for life of either payments, benefits or care? .............................................................. ~ =~ j x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................................................................... ~ , ~- -
x
i
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ _ ] I x
~__ ;
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... r~ !~ x
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)j.
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)j.
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.
Rev-1508 EX~ (8.98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Yohn, Earl E. 2~__
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.
(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+ (12.99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Yohn, Earl E. 21 __
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION
NUMBER AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Glenn H. Yohn
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 2655 Ritner Highway
city Carlisle State PA Z;p 17015
Year(s) Commission paid 900.00
2. Attorney's Fees The Wiley Group, PC 1,500.00
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. I Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 30.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 2,430.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF (FILE NUMBER
Yohn, Earl E. 21--
ITEM
NUMBER
DESCRIPTION
Other Administrative Costs
Orphans Court (file Small Estate Petition):
Register of Wills (filing fee):
H-67 Subtotal
AMOUNT
15.00
15.00
30.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+t6-98)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Yohn, Earl E. 21 __
Include unreimbursed medical expenses.
(tf more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98)
REV-1613 EX+ (9A0)
SCHEDULE J
COMMNHER TANCE TAX RETURNANIA BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Yohn, Earl E. 21 __
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO
DECEDENT SHARE OF ESTATE
(W
d AMOUNT OF ESTATE
Do Not List Trustee(s) or
s) ($$$)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
1 Bonnie L. Lowman Daughter 946.39
9708 Locktender Lane
Williamsport, MD 21795
2 Gail M. McClellan Daughter 946.39
9313 Sonoma Dr.
Orlando, FL 32825
3 Carol M. Yohn Daughter-in-Law 946.39
2655 Ritner Hwy.
Carlisle, PA 17015
4 Earl M. Yohn Son 946.39
101 Springview Road
Carlisle, PA 17015
5 Glenn H. Yohn Son 946.39
2655 Ritner Hwy.
Carlisle, PA 17015
See continuation schedule attached Continuation 946.39
Total 5,678.34
Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
The BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Earl E. Yohn 09/08/2009 204-05-1800
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Reiationship (Words) ($$$)
6 Leslie E. Yohn Son yab.sy
7201 Old Harrisburg Road
York Springs, PA 17372
Total 946.39
IO~_Sq~ ILFV .41N~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate t#~is copy by photostat or photograph.
Fee for this certificate, ~6.~0
P 15664694
Certification Number
This is to cenif~~ that the information here given i
correctly co'piedfrom an original Certifirite of Deat
duly filed with ;ne ~~as Local Registrar. The origin
certificate will he forwarded to the State Vitt
Records Oificc for permanent ~ ~ ~ n n
1009
L ~ e~~s r ~ Date ]sued
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~~rst dill tttth ~rskrzmnnt
OF
SARI. E. YOHN
BE IT REMEMBERED, that I, EARL E. YOHN, of 1039 South Mountain Road,
Dillsburg, York County, Pennsylvania, being of sound mind, memory and understanding,
do make, publish and declare this as and for my Last Will and Testament, hereby revoking
and making null and void any and all Wills and Testaments and writings in the nature
thereof made by me at any time heretofore.
ITEM L• I direct that all myjust debts and funeral expenses he paid as soon after
my demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed. including property over which
I have a power of appointment, I give, devise and bequeath in six (06) equal shares, as
follows, per stirpes:
One (01) share to, GAIL McCLELLAN;
One (O1) share to, LESLIE YOHN;
One (O1) share to, BONNIE COWMAN;
One (O1) share to, GLENN H. YOHN;
One (01) share to, EARL M. YOHN; and
One (O1) share to, CAROL YOHN;
ITEM 3: I direct my hereinafter named Executrn- to pav all inheritance, estate.
succession and legacy taxes of whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise passing by reason of my demise,
% ~ ~r . ~
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~~ ~-~-SF;nI.~
EARL E. YOHN
1
WITNESS:
may be subject and to charge such taxes against my residuary estate. it being my intention
that none of the aforesaid taxes, either federal or state, on any property required to he
included in my gross estate. under the provisions of any state or federal 1<3~~~ now in I~orcc
or hereafter enacted, shall be prorated among the persons interested in my estate to whom
such property is or may be transferred or to whom any benefit accrues.
ITEM 4: I appoint, GLENN H. YOHN, as Executor of this my Last Will and
Testament. In the event GLENN II. YOHN should predecease me, cease tr~ ~~ci. nr
renounce probate I then appoint LESLIE YOHN as alternate Executrix of this my Last
Wil] and Testament.
ITEM 5: I direct that my Executor or his successors shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
iN WITNESS WRERF.OF, I have hereunto set my hand an~i se<~l this ? 1st day of
June, 2004.
WITNESS:
/,~- ,, ,
EARL E. YOHN ~~~
2
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF YORK
We, EARL E. YOHN, ,TAN M. WTLEY, EfiQi`iRE and L['vDSAY ~7,
STRATHMEYER, the Testator and the witnesses respectively, whose names ~u~e 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 (or willingly directed another to sign for
him), and that he executed it as his free and voluntary act f~crr the ~nirposes therein
expressed, and that each of the witnesses, in the presence and hearing of the 'hestator,
signed this Last Will and Testament as witness and that to the hest of their knowledge the
Testator was at the time eighteen (18) years of age or older, of sound mind and under nn
constraint or undue influence.
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ARL E. IAN „~
"TNESS
- ~
I ass
Sworn to and subscribed
before me this 21st day of
.Tune, 2004.
NOTARY PUF3T,TC
MY COMMISSION EXPIRES:
--~~~ Notarial Seal -^
S. Dawn Gladfelter, Notary Public
Diitsburg Boro, York Cou~~ 2005
My Commission Expires May 3
Member, Penrsyivania AssociaUOn of Plolanes
Jan M. Wiley
David J. Lenox
THE WILEY GROUP
Attorneys at Law
June 22, 2010
Register of Wills/Orphans Court
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
In Re: Earl E. Yohn Deceased
Dear Sir/Madam:
Enclosed please find the following for filing and processing:
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1. The original and one copy of Petition for Settlement of Small Estate, along with a
check in the amount of $15.00 for the filing fee;
2. The Inheritance Tax Return in duplicate, along with a check in the amount of
$15.00 for the filing fee, as well as a check in the amount of $255.52 representing
the tax due.
Please send a receipt for the above to my attention at your earliest convenience. Thank you for
your cooperation.
ely,
~ rn W ! ~~=
~~
J M. WILEY, ESQUIRE
W/sdg
encl.
cc: Glenn H. Yohn
130 W. Church Street, Suite 101 • Dillsburg, PA 17019 • Phone: (717) 432-9666 (800) 682-4250 Fax: (717) 432-0426
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