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Home My WebLink About06-28-10 (2)r 1505610101 REV-1500 °` ~°'-10} ~#' PA Department of Revenue pennsYtvania Bureau of Indivtduat Taxes °`""'"~"`°~`"`""` PO Box 280601 INHERITANCE TAX RETURN Harristwrp. PA 17128-o6ot RESIDENT IIFr_Ft1PUIT OFFICIAL USE ONLY County Code Year F~ Number _.._.._.._.-._..~ .....__._._ f.__ ._. ___ .......... ... _...__.. ~~/i ~/D~ ~ s7v cn ~ crc ucctutNT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 202-42-6212 09/01/2009 , 06/23/1951 ants Last Name Suffix Decedent's First Name MI .Deli _ ____ ~ ~ ~ , _ __...___ R~__ ~___ _.__ _.__ _ ~ __ ~ _. _ mond ;_T.~_ `.. Y (M Applicable) Enter Survivino Soouse'A Inf,,.~,.ts.,.. ner..... ~ .............................._..: i................ Spouse's Last Name . ..............._................_........._._............................................_................._.......... SuflSx Souse's First Name ......................................................................................., P _. __.______ ___.______.__~_ __ ____ __._~_____. ___.___; ~ t C'1 Spouse's Soaai Security Number ~ ~ - - ----' ~ - i THIS RETURN MUST BE FILED IN DUPLICATE WITH G -.--------.-.-----_._ REGISTER OF WILLS ~ FILL IN APPROPRU\TE OVALS BELOW ~ ~ ~ t~ 1. Original Retum O 2. Supplemental Retum O 3. Remainder R deatf~ O 4. Limited Estate prior to 12-1 O 4a. Future Interest Compromise (date of O 5. Federal Estate Requ lea death after 12-12-82) O 6. Decedent Died Testate (Attach Copy of 1~IQ O 7. Decedent Maintained a Living Trust 0 8. Total Number of (Attach Copy of Trust) ~ fe Deposit Boxed O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax u r Sec. 9113(A) between 12-31-91 and 1-1-95) (A~~ ~. O) CORRESPONDENT - TtMS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAI. TAX INFORMATION 8NOULD BE ECTED T0: Name Daytime Tale hone Nu r Craig Keefauver .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 ( 7) 761-1990 c REGISTE IL 8 USE ONLY G ~? First line of address r-I'i Z f,r, ~__..~_._~._._.___~_~___ __..._ _._-~_ ____ _ 1045 Country Club Rd ________________________`___.__.____..__..__~--- _v7 ice-, .... ... __ .. .................__......... .._................................................_. n T _......_d line of address u s - N ......._...._..........._......._._.........._ ....................._.__.._......_................................_. C' or Post ._._~!............_ .............Oflice ..............................._. __......................_..................__ . _ ............................_............................_...._................................. . _~ t I State ZIP Code O ,- Camp Hill ,~_ PA _17011~~..._.._..... ~__- Correspondent's e-mail atttiross: Under penalties of perjury, I dedsre that 1 have examined this return, including eccompanykrg schedules end statements, and to the hest of R is true, correct and o°rrrplete. Dedaretbn of preparer other than the personal r--Y representatlve is traced on aN iMormetbn of which preperer ha owledge and ballet, a k l SIGNATURE OF PE RES FOR FILING RETURN DA rty now edge. ADDRESS J/~ ~ vv D ~a h ~d ~~ ~}i'll ~A 70 / SIGNATURE OF PREPARER QTHE THAN REPRESENTATIVE DAT ADDRESS 1505610101 Side 1 1505610101 ~~ ~z ~' 7 r'~-.~ ~_'tl c.:}, ;. C"~ "~ -r 'n .. _ r..1 .`mss CT f `~~ sir . -1 _.} tJ -,i -'f l ;~ -~ ~ J 1505610105 REV-1500 EX Decedents Social Security Number DecedenFs Name: R»ymond T. Dell 202-42-6212 ~~ ~ RECAPITULATION li 1. Real Estate (Schedule A) ........................................... _ ........ .. 1. ..................._...................._..............._........._....... I L...._........................_.. 0.00 2. Stocks and Bonds (Schedule B) ...................................... . 2. 0.00 3. Closely Held Corporation, Partnership wSole-Proprietorship (Schedule C) .... . 3. ~ 0.00 4. Mortgages and Notes Receivable (Schedule 0} .......................... . 4. !~ 0.00 5. Cash, Bank De posits and Miscellaneous Personal Property (Schedule E)...... . 5. 4,915.44 6. Join Owned P by ropetly (Schedule F) O Separate Billing Requested ...... . 6. ~ 35,250.00 7. Inter-Vivos Transfers 8 Miscellan N P b eous on- ro ate Property •-,°-•-- -, (Schedule G) O Separate 6116ng Requested....... . 7. 16,174.83 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 56,340.27 9. Funeral Ex uses and Administrative Costs (Schedule H} .................. Pe . 9. I 10,208 00 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule q ............. . 10. I 9,103.17 ~ 11. Total Deductions (total Lines 9 and 10}.., ............................. . 11. 19,311.17 12. Net Value of Estate (Line 8 minus Line 11} ............. ........... . 12. r 37,029.10 ~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... . 13. 0.00 ~ "'""'-"'-- 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. s 37,029 10 TAX CALCULATION -SEE IN3TRUCTION3 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, w ~ transfers under Sec. 9116 _.........._ .................._...................................................._..._. ........._..................................................... (a)(1.2) X .0_ 15.E 16. Amount of Line 14 taxable --- -------- at lineal rate X .0 45 1g, 1,666.31 17. Amount of Line 14 taxable at sibling rate X .12 17 16. Amount of Line 14 taxable at collateral rate X .15 18 19. TAX DUE ......................................................... 19. ~ 1,666.31 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610105 1505610105 O REV-1500 EX Page 3 Decedent's Complete Address Frr• Number DECEDENTS NAME Raymond T. Dell STREET ADDRESS --------- ------- -------- 301 North Second Street c-Tr -- WOnllley8bUrg 'STATE ZIP PA Tax Payments and Credits: 1. Tax Due (Page 2, line 19) 2. Credits/Payments A. Prior Payments _.___ B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the di0erence. This is the OVERPAYMENT: Fill in oval on Page 2, Line 20 to request a refund. 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make check (1) Total Credits (A + B) (2) (3) (4) (5) to: REGISTER OF WILLS, AGENT. 1,666.31 ~I 0.00 0.00 ~, 'i 1,666.31 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROP 1. Did decedent make a transfer and: Yes 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 : .................... c. retain a reversionary irrterest; a' ..................:.................................................. d. receive the promise for hfe of either payments, benefits or care? ........................ ^ .............................................. 2. If death occurred after Dec.12,1982, did decedent transfer properly within one year of death wiUaut receiving adequate consideratron? .............................................................................................................. ^ 3. Did decedent own an "in trust for` or payable-upon-death bank account or security at his or ter death? .............. ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, whid~ contains a beneficiary designation? .............................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE ~ AND FILE R AS BLOCKS No 0 0 OF THE RETURN. For dates of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the u of the surviving spouse is 3 percent (72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su ' ing spouse is 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 disclosure of assets and filing a tax return are st~l applicable even ff the surviving spouse is the only benefaary. i~ For dais of death on or after July 1, 2000: ~~, • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or yourxJer at death to or for the ~ of a natural parent, an adoptive parent ~ a stepparent of the child is 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 benefiaaries is 4.5 punt, excx3pt as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(aK1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)j. Asibling is defined, under Secction 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (B-98) SCHEDULE E COINM~IWEAtTH Cf PENNSYLVANIA CASH BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE t9F FILE NUMBER Raymond T. Deil Mr~de the proceeds of litlgation and the date the proceeds were received by the estate. AN property jolrrtly-ovmed wkh right of survivorship must be disdwed on SchsduM F. ITEM (If more space is needed, insert additional sheets of the same size) REV-s5o9 EX+ (os-io) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: Raymond T. Dell FILE JOINTLY OWNED PROPERTY: ' LETTER DATE DESCRIPTION ~ PROPERTY ,~ 1TEM PoR ,IOUiT MADE INCLUDE NAME OF FINAAIGAL INSTRVTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH NUMBER ]oUIT I091TIfYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF 1 DE .~ 1. A. 11/18/94 ' Single family home - deed at Cumbedar~d Co Deed gook 115 pg 102 70, 500.00 50 /o _. ._ 3 { - _.._ ;,, If more space is needed, use additlonal sheets of paper of the same size. SCNEprILE F 70INTLY-OWNED PROPERTY ' TOTAL (Also enter on Line 6, Recapitulation) ; '~ DATE OF DEATH VALUE OF ~DENT5 INTEREST 35,250.00 35,250.00 ' FEB-02-2010 09:14 T)OWELS.C~ROUP 7177619107 P.007 .~ 3 ~.s+f~ Tac W N4 47.29•!5!8.133 wos~ rra~ ~c.r,ll~`dsMbr~i. ~,. sec ~ frd ... a».wa Hi11Rlf~t rYl1.ISAht J. DHtl oai AlI.>IIYi L kio +.its. d tNe ~Sk o[ Naattlpbr8, GtarbitM~l Cawtty, a:wi~rrotls aad ~ Cy~apba~ihod~.tlZli R H Ids rte. d tM Heteyt a[ ~ ondbWad ot~e-Y.U ~ ~~ lw~a a~°i~ errWl(~ eaoit tn~-Yad Let ~aa !e ~ otltar. ~e joist tanaw wilrt Ass debt d aniroo~, _~+~ aatd Q[aedat~ t~eit~afi~an as aaeraaaii: La~"'wi_7~ jMp~ pfd COwYO~r 1D ALL'1'WT L3ts;i5tiN let o< at Lnd dNslo k tba Batan~ ai aara.ry 1tee.w a. Bed Preaie~ T1~edtp, Crsbm~wd Gouat~. at tUs ootner d 3aoaoed aM lapin 3enes ie a oattaia plao atlas aeNed HSIIVQ Lt Na S7 a e pMe of lest by L C Cos+daw. CArf sad an~aor~~Caaty Y ~~_ tAtd teaoed~d L Ass Brterdue Oda i~ Dealt ~ !a{n'11. Said Lot Na 33 ep soid Fayereter !Ys Na S an.rtiae an 8eosod 91red best sm r .peg o~ v~ieh ~r ~ a asses wl aas~lo~lf (,2t f/11 wb.ad a~ ~R i0d LsMe~ ataef lrfolc dlornNs~ kmowe aed oa a. 301 Norel ~+M AIL'Y'lIAT CQTAM lot d ,posed eltsate ~ eb Ila~a~~di of sae ^ a.t aara.eyr kenwa . >s~at Doaetrero Or.eborliNCoa~ ~~ Lat Na~~ ~!~ ~I~~d~od is d Caowgr io !'lan Hook No. ~ 7L CON7AH~@tG ie [feet an aid Sssand 90nat hue {Z~ fist; and h depth d agwt widik m HJuq Alley op headrad 9E11(i791 fief. maro ar !ea !IR!!!G tre aooe prsaMte•d~is6 )!.ert B el wWoM, by het need dwd tar 9, 1950, ned r.saded ie tr. oaf.. d ffie Aeeera.r aE Ored~ ie .ed for GmretMod meaty ie +~SlesaHB DAN{, hi wifs,~r ~s~>terol~a. ~ ~ recd Wdlioe ). Ddl and 115 lie[ 10~ !~ .~ EXHTHIT "A" FEB-02-2010 09:14 ~OWELLGiROiTP .• 71776191p7 ffiS t70lYVEYA~st2 It tsada mpt~aMlp tab~aat b tha 60110 erstriotioaa, .Ix i. 'f6a p~r tlatl ba awd stNip 6or ratfitathd pacpaaat. Z. ~brgdicj~tWi bs araopd Ihm~aoa tar stab prtpMa at : aott e[ Att 3. ~ a~od Batt~~ taV~~p~ ~ to~a~ ~ eE ai ~ h~ac af~trspaa d Saeaad r6at1 ba ~mted ~+hgta arealr-ew {I~ '1'lit8 [~ A DIOIV-TA~Ii'1'RAIIRIER for taoAtyMeir tsaellar qqc per~oaet [ros aeothar aad 6t6nr to ta.. th h~f ~~~ aa'0~ and a~aa goat ~7' wol rrcletapt gieab{y dla IN RcTNE9~ N'itiR~OS: tlcs raid QOmtats haw hoteaata sat tlutr hmtda aad aaaM tMa dq wtd ~ 6at abora . ~QNBD, SBAIBD AND DBLtVBBED W TH8 ReS~VC$ OF aac . ~-~) J G ~ +~ 1M~i 7 COIcth10NWEAL7fM t~F PBNNSY[.VANfA SS. CO[1NTY OF C[71D ) ON 'TEAS. IMs dap of ~~ 194, br~on auy tM •.amafa.d olSwr. a~r..rd .od ArtL~NB a D~L,L, kaewa io toa (ot w lwo+ww) b bd tis ~twss.rhen aaeat rw w~btar~.i b t, .ed .oi<wMUdpd chat tlth aewaNd dw rns [oe qua nv WlTN85S vYFIB~EOF. ! I~eewato aet cap ham aad oCfoial aoy! ~ ~g -~ 103 P.008 ' FEB-02-2010 09:14 ~OWELI,QROUP 7177619107 P.009 I do baeei~ oaf !~ the pnoiee nuide~.s aM eonptala put aLSee addros of tMe .WYa~waaed OmMe(e) to Jot l~lceq~ grad hws 7Yeoade~rt~, PA 17043 i~ ~ `~ ~~ ~ ~: yro. ~ ~~; s.u., ~: ~' .'• OD4tldON~BAt.1~i O!~ ~INSYI.VAlr1A ) ~ ~ e~ ODUh'CY ~ CLlY~ERLA1dD }~ : 4 N 'r ~, w 1~ IM Reeo~d~t's Ocoee at tt~ mid Contly b DNd Dock , 11i~ ~ ) ~ Olwa sodet eer ltaad ad Ae e.al of the aid Oflies, fN date above em . u.. .~~" ~1 ~ ti.5 IAOE f,O4 i I REV-1510 EX+ (08-09) ~pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT If more space is needed, use additional sheets of paper of the same size REV-1511 EX+ (10-09) pennsyivania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBE Raymond T. Dell Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION A• FUNERAL ~XP~N~ES;__.. 1. ._~.~__. .. _ ...~..~. uneral home invoice ~ ~~ ~ "~"~"~ ,...2 .Cemetery plot invoice B. ADMINISTRATNE COSTS: ..'.... 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Z• ~ Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.} Claimant Arlene Dell street Address c/o Manor Care Carlisle 940 Watnut Bottom Rd ~, Gty Carlisle State PA ZIP 17015 II~~ Relationship of Claimant to.Decedent mother It more space is needed, use additional sheets of paper of the same size. TOTAL (Also enter on Line 9, Recapitulation) ~; 5,385.58 895.00 427.50 3,500.00 10,208.00 Estate of: Raymond T. Dell Supplemental Statement regarding Schedule H, Item B(3) Decendent lived with his mother, Arlene Dell, at their home at 301 North Second S reef, Wormleysburg, Pennsylvania. Due to her age and physical condition, Decedent's other is not currently capable of living alone and now resides at Manor Care Carlisle. The hom~ is in the process of being sold. REV-1512 EX+ (12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBE Raymond T. Dell Report debt incurred by the decedent prior to death that remained unpaid at the date of death, including unreimburaed II expen~ ITEM NUMBER DESCRIPTION VALUE AT DATE ~_-_ _.. _.._.__. ~.. _ OF DEATH 1 • Onstown Bank personal credit line 1,338.31 2 =Chase VISA 7,764.8E I ;; } ,_ TOTAL (Also enter on Line 10, Recapitulation) i ~i, 9,103.17 If more space is needed, insert additional sheets of the same size. i~~ RECEIPT FOR PAYMENT GLENDA FARMER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 DELL RAYMOND T Receipt Date,: 6/28/2010 Receipt Time': 14:08:45 Receipt No.: 1061684 Estate File No.: 2010-00570 Paid By Remarks: DONNA C KEEFAUVER SAP --'------'-------------- Receipt Distribution ----------__ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15.00 CUMBERLAND COUNT ---------------- Check# 8630 $15.00 Total Received......... $15.00 GENERAL FUN