HomeMy WebLinkAbout07-13-10REV~~ ~Q~ Ex (os-o5) 15 0 5 6 0 4115 8
PA Department of Revenue DIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po sox 280601 INHERITANCE TAX RETURN 21 10 016 2
Harrisburg, PA 17128-0601 ~~(~~' ~CEI~ENT
ENTER DECEDENT IM~OM)tlN1ATION BEt.Q'~IY
Social Security Number Date of Death Date of Berth
184-09-1919 01,12010 02071917
Decedent's Last Name
SHEARER
Suffer Decedent's First Name
EVELYN
(If Applicable) Entor Surviving Spouse`s information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number THIS RETURN MUST BE FILEDI,MI DUPLICATE WITH THE
- - REC~~STER C~ 1lV1LLS
FILL IN APPROPRIATE 130XE3 BELOW
MI
F
MI
1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required
death after 12-12-82)
8. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Bares
(Attach Copy of Will) (Attach Copy of Trust)
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - TINS SECTION fME1ST ~ COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL tAX tNFORMAT'iON SHOULD t>IE a~TED TO:
Name Daytime TeHaphone~mber d ~,~
KEITH 0• BRENNEMAN 717-69?- ~'-'
~, ...
Firm Name (If Applicable) ~
SNELBAKER & BRENNEMA N, P • C • REGISTER SE f,~Y
~ ~=~''
" r ~
First line of address ~+ C' j "C1
r-'~C7 ~ "'~i
44 WEST MAIN STREET r
--+
~.•
~
~
~
Second line of address J
'
P•0• BOX 318
City or Post Office State ZIP Code ~`~ ~-ED
.
MECHANICSBURG PA 1?055
Correspondent's e-mail address:
Under penaltles of pery'ury, I decl~a that I have examined this return, including accompanying schedules and sta6emenb, and to the beat of my knowledge and belief,
it is due, correct and complete. DeGaratbn of prsparor other than the personal representative ~ based on all information of which proparer has any knowledge.
s ~ ire ~Q~ rtin
GEOFFREY A• SHEARER, EXECUTOR 1111 TURNBR'IDGE LANE, MECHANICSBURG.
SIGNATUf~ ~ PARER OThIER THAN REPRESENTATIVE ATE ~'~ 17 0 5 0
KEITH 0• BRENNEMAN, Efi~UIRE 44 WEST MAIN STREET, MECHANICSBURG
PLEASE USE ORIGINAL FORM ONLY pA 17055
Side 1
15 0 5 6 0 4115 8 6M4647 3.000
15056041158
J
J 15056042159
REV-1500 EX
Decedent's Social Security Number
184-09-1919
oec.~denra Names H E A R E R E V E L Y N F
RECAPITULATION
1. Real estate (Schedule A) 1. 0 • 0 0
2. Stocks and Bonds (Schedule B) . . 2. 0 • 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) • 3. 0 . 0 0
4. Mortgages ~ Notes Receivable (Schedule D). 4. 0 • 0 0
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) . 5. 715 5.4.2
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested . 6. 0 0
•
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7. 15 3 3 4.3 9
8. Total Groes Assets (total Lines 1-7). s. 2 2 4 8 9.8 ~,
9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 5 0 0 ? • 4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . 10. 2 5 7 8.71
11. Total Deductions (total Lines 9 810) . 11. 7 5 8 6.19
12. Net Value of Estate (Line 8 minus Line 11) . . 12. 14 9 0 3.6 ~
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made (Schedule J) . 13. 4 4 7.11
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . .. 1 a. 14 4 5 6.51
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers un,~er Sec. 9116
15
(a)(1.2) x .0 0.00 . 0.00
16. Amount of Line 14 taxable
at lineal rate x .04.5 14 4 5 6.51 16. 6 5 0.5 4
17. Amount of Line 14 taxable
at sibling rate x .12 0.0 0 17 • 0.0 O
18. Amount of Line 14 taxable
at collateral rate X .15 0 , 0 0 18 • 0 • 0 0!
19. TAX DUE 1 s. 6 5 0.5 4
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042159 eMasass.ooo 15056042159 J
REV-1500 EX Page 3
Deceder>tt's Ccllimc>~ete Address:
FNe Number
2], 1^ ^162
DECEDENTS NAME
R V Y F
STREET ADDRESS
CAMP HILL
CITY
MP H STATE ZIP
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. CreditsJPayments
A. Spousal Poverty Credit 0 • 0 0
B. Prior Payments 5 8 8.0 0
C. Discount 2 9.4 0
(1) 650.54
Total Credits (A + B + C) (2) 617 • 4 0
3. Interest/Penalty if applicable
D. Interest 0.0 0
E. Penalty 0.0 0
Total Inten3st/Penaky (D + E) (3) 0 • 0 0
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line ZO to request a refund. (4) 0 . 0
5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3 3.1 ~+
A. Enter the interest on the tax due. (5A) D • O Q
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3 3.1 M
Make Check Payable to: I~E'CIS7'i~R OF WIL.L~, AGENT
PLEASE 14NSWER THE FOLLOMIIING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: ~
X
0
a. retain the use or income of the property transferred; .
retain the right to designate who shall use the property transferred or its income;
b ^ X
. ^ X
c. retain a reversionary interest; or . ^ X
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
^
0
without receiving adequate consideration? .
"
" ^ 0
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 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 FEE lT 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 j72 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 tart, 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 use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §911ti(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)]. A sib~ng is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
6M4671 1.000
REV-1508 EX + (698)
sc~Eau~E ~
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
1NHERiTANCE TAX RETURN
,~~,,,T ~~~ PERSONA!. PROPERTY
ESTATE OF FILE NUIYEIER
Evelyn F Shearer 21 10 0162
3W46AD 1.000 (If more space is needed, inseR additiatial sheets tithe same size)
REV-1510 EX + (08-09)
pennsyh~~nia
DEPAR'TNENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
OF
Evelyn F . Shear®r 21 10 0162
This schedule must be completed and filed if the answer to any of questions 1 through A on page three of the REV-1500 is yes.
ITEM
IJUAA9E DESCR N OF PROPERTY
r~a.LOE TFf wvNE of ThE TRATI6PEREE, TFEIR RELATIOtJ5~NP TO oECEOErtr AW
Tf£Q47EOFTRAI~6FER. Arraa~AC)OP`l OF THE SEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
IF APPLICABLE
TAXABLE
VALUE
~• John Hancock 15,334.39 100.0000 0.00 15,334.319
amity ~SK2048fl32
TOTAL (Also enter on line 7, Recapitulation) $ I
15,334.39
tf more space is needed, use additional sheets d paper d the same size.
9W46AF 2.000
REV-15t1 EX+(10-09) SCHEDULE H
Pennsylvania
DEPARTNENTOF REVENUE FUNERAL EXPENSES AND
UJF~RiTANCE TAX RETURN ADMINISTRATIVE CONS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Evelvn F. 3h®ar®r 2110 0162
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~, J®ss® H. Geigle Funeral Home
funeral services 374.04
B.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
State ZIP
2. Attorney Fees: Snelbaker & Brenneman, P. C. 3, 750.Op
3. Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation.)
Claimant
Street Address
4.
5.
6.
7.
1
2
83.50
75.00
5.54
719.40
TOTAL (Also enter on Line 9, I~ec~itulation) `$ 5 , 007.48
swa6AG ~.o~o If more space is needed, add additional sheets of paper of the same size.
Year(s) Commission Paid:
City State ZIP
Relationship of Claimant to Decedent
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
Cumberland Law Journal
advertising Executor's Notice
Snelbaker ~ Brenneman, P.C.
certified mail costs
Total from continuation schedules
Estate of: Evelyn F. Shearer
Schedule H Part 7 (Page 2)
3 The Sentinel
advertising Executor's Notice
4 Reserve
for filing fees, accountant fees and other
miscellaneous costs associated with the
administration of the deced®nt's estate
21 10 0162
219.4'0
500.00
Total (Carry forward to main schedule) 719.40
REV-1512 EX + ~~Z_Og~ SCHEDULE t
pennsyfvania
DEPARTMENT of REVENUE ~ DEBTS OF DECEQENT,
It•ANiERITANCE TAX RETURN MC)RTGAGE LIABILITIES ~ LIENS
RESIDENT DECEDENT
ESTATE OF FILE t~11fi~ER
Evelyn F. Shearer 21 10 0162
Report debts incurred by the decedent prior to death that remained unpaid at the dabs of death, including unreimbursed medical expenses.
8W46AH 2.000 If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(11-08) SCHEDULE J
pennsyivania
DEPARTIu~NrOF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RI=:DENT DECEDENT
FILE NUN~ER
Evel F . Shearer 21 10 0162
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ~~ ~ PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (indude outrtght spousal distributions, and transfers under
Sec. 2116 (a) (1.2).)
1. Abigail Best
5 Ascot Lane
Carlisle, PA 17013
One Half of R®sidue per It®m Third
of Will: 7,228.26 Granddaughter 7,228.26
2 Geoffrey A. Shearer
1111 Turnbridge Lane
Mechanicsburg, PA 17050
One Half of Residue per Item Third
of Will: 7,228.26 Grandson 7,228.26
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE.
11 NON-TAXABt.E DiSTRiBUT10N5:
A. SPOUSAL OtSTRIBUTIONS UNDER SEC110N 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1• See Attached
1
TOTAL OF PART tl -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 447.11
awas,ai 2.00o If more space is needed, insert additional sheets of the same size.
~:
21 10 0162
state of: Ev®lYn F. Shearer
chedule J Part 28 tPage 1}
S Amount
Item tion
No. Deacrip
Lutheran Church
Trindle Spring
1 icsbur4~ PA
M~echan $eCand of Will
3~ of my net estat® per Item
447.11
I, EVBLYN F. SHEARIrR, of the Towta~ip of h+tomvo, Cownty of Ccatn~axlead end
~otnq?,OAWealth Of Pennsylvania, being of K-und and df~sintg mind, rtipaOry and
wtdersts»didg, do rnalce, publish and deciaXc this as and for my Last Wfll nxf Testematt, hereby
revolCinB and making void all former wilts and codicil: by me at any timc.ficratofvm roads.
FIRST. 1 order and direct that a!1 my just debts And fund axpensas be paid by my
Executor or Execute, as the case may be, hex~cinaRer named, as soon as convwtiently 1t1ay be
done after xny decease.
.~'~. I give And bcquaAth a sum of money equal to tht+se per aentwn (3°h) of my
net estate (cxciuding credit for payment oi'any death taxes paid by my Esttrte) unto TRINDLE
SFRiNG LUTHERAN CHURCF# at Mocha~icsburg, PeiuisylWania. absolutely.
. a give, devise and bequeath a1i the rest, residue and remainder of my Estate,
real, personal and mixed, whatsoever seed wheresoever situated, iz~ equal sharps unto my two
grandcttildran, namely, ABIGAIL >~EST, And GEOFI~R.EY A. SHEARER, share and share saxke,
absolutely And in lee simple.
if either of said bcneticiaries should prodeccase ma, I older and direct that the
i'oregoing share attributable to such deceased beneficiary smell be distributed unto bier or his issue
pex stirpes by rcprc5e~ttttti~p~q and not per capita. If any such beneficiary shall predecease mt and
leave no issue to survive me, then and in that ultimate event, the shale of such deceased
bencfioially shah 3apae and shall ba distributed to the surviving beneficiary Absolutely,
LASTLY. t nominate, eonstitnte and appoint my grandson, namely, GEOFFREY A.
NW QFFICCD
sae~auc.~,
$q@NNEMAN
~ SP.619S
SHEAEtE)<t, to be the Executor o#`this, my LASt Wald ar4d Testatneilt, but if for any reason he
should fait to quaEfy as such Executor or cease so to servo. tbieq and in such cve~t. I aomirtatG,
constitute and appoint my graaddAughter,lnamcly, AHIGA.IL B~BST, to be the Exocutriuc hereof,
each and bath to serve without bond or other se~uxity as a cotu~ition for qualification horuu~der.
IN WITNESS W'biEREOF, 1, EYELYN F. SHEARER, have hereunto set my hand and
seal to this, my Last Will and Te:tameat which consists of twd (2) typeri page w each of
which 1 have aftlxed my signature this f~, j~ of 3eptecttbar, A.D., Twa Thouasm-3d Twa (2002).
Eve F. S1tea~rx
The pxecedi~g iss~»ent, contristl»g of this and one (1) ether tyQew~titbeaa psg~4, each
idetuilled by tiwe signature arfthe Tic, was an rho dam thereof vigr~+ad, pnblistsed ~
desrlared by E'Vl/'LXN ~'. SH!E~-RER, t1x Test~rix th~citt named, t+s Eof~ bee' i.nt Will sad
Tostnt, in the prese~cc al' us, wfia, at her request, in her ~c and ist ttic praedce of oath
Other, have 31tb~Cfl11~ outT ~eIm08 R6 wttreasses heYe
%1 ~~
~ '+
-a.~.r- l
~ w
COMMONWEALTH OF PENN5YLVAN7A )
SS.
CUUNT'X OF CCTMAI1t1..AN0 )
WG, E'V>rLXN F. SHEq,I~g., RICHARD C. SNF.L,BAKF.R and JANE J. COONEX, the
Testatrix and the witnesses, respectively, whose names arc sagttAd Go the aged t~' foe+agoing
instsumpctt, being first duly sworn, do hereby declare to the underdgeied wititarity da# the
Testatrix signed axut executed the iztstnm:ent ac her Last Will and Tcstairnsnt ~ ~ttt slxe h+ed
:igped willingly, axttt that she exccued it as her free acrd voluntary act far khc Purpcaoea therein
eupreased, ~,cl that each of the witn+~set, in the presence aind hearing of the Testatrix. signed ttte
Will as a witacss and tk~at to the bat ai'his oX her Imowled~e the Testator was at the tirav
eighteen years pg age or oldex. of sound mind at'sd uutcUer tee constraint or undue inAuenct.
.7.
T trix
,-
~~ Witttcss
r'.' n r
_r--
wi'tucss
Subscribed, ewom to and acknowledged before me by EVELXN F• SHEARER, the
Testatrix, and subscribed and swam to before me by RICHARD C. SNELBAKEft ~d 1AN1r Jr.
COONI;X, witnesses, tht'si ~~, day of S~ptembex, 20JJ0~~y2.
IAW 1~hhl(t~J~
$NFI,®4KEF /+ ~ ~,
BMlNNSMAIV ~/ i ~„(~~
~` sNA~t Notary Fublic
;:r~K ~, ~Cyt~y i~'~c