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HomeMy WebLinkAbout10-14-10 (2)1505610143 REV-150Q ~``°'-'°' ~'` PA Department of Revenue perms Ivania OFFICIAL USE ONLY Bureau Of Individual Taxes y County Code Year FAe Number oe~T a r~ewue PO 80X.280801 INHERITANCE TAX RETURN 21 1~0 0451 Harrisburg, PA 17128-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 182 22 8309 04 10 2010 03 21 1916 Decedent's Last Name Suffix Decedent's First Name ' MI SHETTEL VERA R (If Applicable) Enter Survivir-S 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 DUPLICAI~E ~f11ITH THE REGISTER OF WILLS ~' FILL INAPPROPRIATE OVALS BELOW 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder ~etu (date of death prforto 12-1 a2 4. Limited Estate ~ 4a. Future Irdereat Comgomise (date or desa, attar 2-122) ~ 5. Federal Est ate ex Retum Required ® g aT~sstate D ~ y ~l~ ~~ Livlnp Trust ~ e. Total Numb br of Sefe Deposft Boxea I ~ y 9. litlgation Prtx~eds Received ~ 10. bglwasr11~~191 ra°+n~t-1-95) death ~ 11.E n~t , nder Sec. 9113(A) ~Ix O CORRESPONDENT -THIS SECTION MUBT BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFO Name Daytime T~ WM D SCHRACK III ESQ 717 4 Firet Ilne of address 124 W HARRISBURG STREET Second Ilne of address City or Pont Office DILL38URG State ZIP Code PA 17019 REGISTER $HOULD BE DIRECTED TO: 'Number 933 ~ ~ ~ ~ .-, ~ -,, ~~USE,~ILY ' -> ~ ~r - k ~_j r7 ~ ' ~ 7 ~ '-r ~ N ' r rrn ~ ~ `-' G f4? T@ Correspondents e-mail address: 5C11raCK1aW COmCaeLnei Under penallks of perjury, l dedaro that I have examined Otis return indudir-~ aocompsryring adledlrles and statsrlerns, and to Cts Is true, Correct and complete. DedareCort Of preparer other Clan the personal representadve is t-Eleed or1 all Information Of which of'rtry knowledge and belief, has any knowledge. IGNATURE OF PERSON RESPONSI E F ING RETURN !, ~ DATE ~ Ter L. Shettel ' ~ 1J ~?~ ZOIo ADDRESS 811 School use Road L be PA 17339 SIGNATURE OF E THER THAN REPRESENTATNE ', DATE Wm. D. Schrack III Esq. ~ ZQ~ ADDRESS ~ i 124 W Harrisburg Street, D)Ilsburg, PA 17019 '~ i Side 1 ~~ 1505610143 150561t~1 ~l3 J J REV-1500 EX ~'• Nom: Shettel, Vera R. 1505610243 Decedent's 5bci~l Security Number 182 2~ II8309 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closety Held Corporation, Partnership orSole-Proprietorship (Schedule C)......... 3. 4. Mortgages ~ Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-VNos Transfers & Miscellaneous tyoq Probate Property (Schedule G) LJ Separate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 10. Debts of Decedent, Mortgage Liabilfties, & 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. 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. 9118 15 (a)(1.2) X .00 16. Amount of Line 14 taxable 21 , 160.55 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 , 0 0 17. at sibling rate X .12 18. Amount of line 14 taxable 0 . 0 0 18. at collateral rate X .15 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L 1505610243 1,768.12 '29,890.94 31,659.06 10,255.50 243.01 10,498.51 21,160.55 21,160.55 0.00 952.22 0.00 0.00 952.22 Side 2 150567~0~43 REV-1500 EX Page 3 Decedent's Complete Addll'ess: File Number 21-10-0451 DECEDENTS NAME Shettel, Vera R. STREET ADDRESS Manor Care CITY Camp HIII STATE PA IP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 750.00 38.47 3. Interest q, 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 rotund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make C to: REGISTER OF Total Credits (A + B) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE (~) 952.22 (~) 789.47 (~) (~) (5) 162.75 1. Did decedent make a transfer and: a. retain the use or Income of the property transferred :......................................................................:....... b. retain the right to designate who shall. use the property transfen~ed or its income :...............................i... a retain a reven3bnary interest; or ...........................................................................................................i... 2. If death ~e~ p%mi~ b~eo12d1962~did decedentt transfer property within one year of death v~ith~ut receiving adequate consideration? ......................................................................... 1........ 3. Did decedent own an "in trust for• or payable upon death bank account or security at his or her death....;.. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ry ig ..............................................................................................1.. IF THE ANSVYER O ANY OFTHE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT l~9 TE BLOCKS Yea No ^ ^ ^ ^ a ^ PART 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 ~r fbr the use of the surviving spouse is 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 to or for the use of the $u iving 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 rec~ui manta for disclosure of assets and filing a tax return are still applicable even 'rf 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 21 years of age or younger at death to or fob th~ use of a natural parent, an adoptive parent, or 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 beneficiaries is 4.5 percent, e~CCept 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 12 percent [72 P.S. §~11~ (a) (1.3)]. A sibling is defined under Section 9102, as an indlvidual who has at least one parent in common with the decedent, wh th r by blood or adoption. Rw-1603 EX* (~) SCHEDULE B ~+ STOCKS 8~ BONDS cowrol+uw=~un+ of verwsnv~ s~rteur~nce vvc aeruaN nesioEHr oeceo~r ESTATE OF FILE N~1A1~8ER Shettel, Vera R. 21-1 1 All propfrty JoiMlyownfdwith rl~t of furvivonhip must bedisclosfd on Sehfdulf F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VAL E', VALUE AT DATE OF DEATH 1 Proceeds of sale of 32 shares of common stock of ' 1,768.12 Prudential I I I I III I I I nter on Line 2 Reca itulation II ~I TOTAL (A so e p ) 1,768.12 (if more space is needed, additional pages of the same size) Copyright (c) 2002 brm software only The Lackner Group, Inc. Form PA-1~OD Schedule B (Rev. 6-98) Rw-1lr0a F.Xr (e-aa) ~rn of t~nertvu~ VafERRAMCE TA1(ItE7tJRN REaIDEWT DECEOEMII' SCHEDULE E CASW, BANK DEPOSITS, 8t MISC. PERSONAL PROPERTY ESTATE OF FILE NW ER Shettel Vera R. 21-10 51 IncNxJe tM propsed ~ Ilion and the date the proeesds wen rocsh~sd by lhs estate. ' AH property JofMly aawned with the dpht of survivorship moat be dlacbssdon schedule F. ITEM ' i VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M d~ T Bank -Checking Account #28851611 ' 29,723.76 2 Bethany Towers -refund of security deposit ' ' 54.18 ~~ 3 Bethany Towers -refund of unused rent ', ' 84.00 4 Liberty Mutual Insurance -refund of contents insurance premium ' 29.00 TOTAL (Also enter on Line 5, Recapitulation) I 29,890.94 Qf more apace fa needed, additional pages of the name size) ~~^ Copyright (c) 2002 form software ony The Lackner Group, Inc. Form P~4-1 Pte" Schedule E (Rev. 6-98) REV-1161 EXt (10-08) ~~~ SCHEDULE H FUNERAL EXPENSES & ___ ESTATE OF FILE N M ER Shettel, Vera R. 21-10 1 Debts of decedent must be reported on Schedule 1. ' ITEM DESCRIPTION '~ AMOUNT A, FUNERAL EXPENSES: ~I See continuation schedule(s) attached 7,736.00 B. 1. ADMINISTRATIVE COSTS: i Personal Reprosentative's Commissions Name of Personal Representative(s) ', Street Address City State Zio ' Year(sl Commission paid ', Z. Attorney's Fees Wlrrt. D. Schrack III, Esquire L 2,125.00 3. Family Facemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ~ Street Address , City State Zio Relationship of Claimant to Decedent II I 148.50 4. Probate Fees 5. Accountant's Fees I 6. II Tax Retum Pro aror's Fees P i I I~' 245.00 7. ~ Other Administrative Costs I I See continuation schedule(s) attached TOTAL (Also enter on Tine 9, Recapitulation) ~! 10,255.50 Copyright (c) 2009 form software ony The Lackner Group, Inc. Form P/~-1~0© Schedule H (Rev. 10-06) ~I SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Shettel, Vera R. -. _--- - - __ IFI21- OIER 1 ITEM DESCRIPTION ~ ~' AMOUNT NUMBER Funeral Ex~~ 1 Stone b Murray Funeral Home 7,736.00 H-A ' ', 7,738.00 Other Administrative Costs ', 2 Clerk of Orphans' Court -Fiduciary Release filing fee ', ', 5.00 3 Cumberland County Agency on Aging -reimbursement 200.00 4 Miscellaneous expense during administration ' 25.00 5 Register of Wills -Inheritance Tax Return filing fee Copyright (c) 2002 form software only The Lackner Group, Inc. 15.00 H-67 ' ' 245.00 III I Fonn P~1-1~Oi0 Schedule H (Rev. 6-98) Rev-tb12 EX+t12-Oa) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS cowi~atallwFxni of pt7•+anv~rs~ IW1BaTAgCE TAX RETURN '. RE•IDEHr DECEt)ENT . ESTATE OF FILE N AAI~BER Shettel Vera R. 21-1 1 ', Report Mhte incumd by the decedent prior to Meth that nmalned unpdd atthe date of Math, Including unrelndwrsad • ITEM VALUE AT DATE NUMBER DESCRIPTION ' OF DEATH 1 Family Physician Associates -last illness ', 14.52 2 Special Events Emergency Medical Services -wheelchair van transport from Harrisburg 42.27 Hospital to Manor Care 3 Verizon -final billing 8.72 4 ~~ West Shore EMS -BLS (transport from Holy Spirit Hospital to Manor Care) ~ i i 177.50 TOTAL (Also enter on Line 10, Recapitulati~rn) I 243.01 (If more apace is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn F~A-1600 Schedule I (Rev. 12-08) QFV_1R11 FYI f11.M1 SCHEDULE J 00N1i~~~^"'^ BENEFICIARIES ESTATE OF FILE UII IIBfR Shettel, Vera R. 21-10 1 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTAtE ' OUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ~ ' ($$a) I TAXABLE DISTRIBUTIONS [inGude outright spousal • d~stnbutwns, and transfers under Sec. 9116 a 1.2 Gary E. Shettel Son ~ !, 839 Schoolhouse Lane Lewisberry, PA 17339 Terry L. Shettel Son ~' 811 Schoolhouse Lane Lewisberry, PA 17339 ~I Total !, Enter dollar amounts for distributions shown above on lines 15th h 1$ on Rev 15 00 cover sheet as riate. ~. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT #Af~EN it i i i B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I i I I i i TOTAL pF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15 COVER SH r...,..ri..tit i,•~ Anna ~,R., snflwarn only The LacJcner Grouo_ Inc. Fom'1 P -1 0 Schedule J (Rev. 11-08) Est ~U c~utent of VERA R. SHETTEL I, VERA R. SHETTEL, of Fairview Township, Yorrk', County, Pennsylvania, being of sound mind and memory, do make, ~ul~lish and declare this my Last Will and Testament, hereby revokinglla~d making I void any and all wills by me heretofore made. FIRST: I order and direct that all of my justldebts and funeral expenses be paid by my hereinafter named Execui~or- as soon after my death as may be found convenient. !~ i i SECOND: All the rest, residue and remainder of !,myr estate, real, personal and mixed, of whatever nature and v~h~resoever situate, which I may own or have the right to disposeldf at the time of my death I give, devise and bequeath to my husb~nGi, GEORGE E. SHETTEL", absolutely, pr°cwiding he shal l survive me fc~r'', a period of thirty r~0> days. L TH"IRD~ In the event tl-rat my said husband, GEORGE.'',SHETTEL, should predecease me, or in the event that he does notl,sturvive me for a period of thirty t307 days, then I give, devise arid'bequeath al l the rest, residue and remainder of my estate, real!„ ' per-soi-ral and mixed, of whatever nat~.~re and wheresoever situate, ~±~hlich I rtray i own or have the right to dispose of at the time of my de~th unto my sons, GARY E. SHETTEL anc! i~ERRY L. SHETTEL, in equal ~h~res, per stirpes. ~ ~~ FOURTH;_ I order anti d i:.rF_+ct that my Executor pay ali 1 ~, transfer inheritance, Federal estate, death, succession and legacy taxes to which my estate or the transfer of any property there~rnd~er may be subject and to charge such taxes as a part of the ~xpense of I administration and to pay the same from my residuary ~s~kate. FIFTH: I hereby nominate, constitute and appo'~n~,t my said husband George E. Shettel, as Executor of this, my Las Wiil and Testament, and I do direct that no bond shall be requ$r~d of such Executor hereunder. My said Executor shall have full {~olwer at his ', discretion to do any and all things necessary for t~h~ complete administration of my estate, including the power to sehl'at public I or private sale and without order of Court, any reallo~ personal property belonging to my estate, and to compound, cc~ml~romise or ', otherwise to settle or adjust any and all claims, ch~r~es, debts and demands, whatsoever, against or in favor of my estajt~, as fully as I could do if living. In the event that my husband, George E. Shettel,l'I does not survive me or fails to qualify, then I nominate, cors~itute and appoint my sons, GARY E. SHETTEL and TERRY L. SHETTELp II's the Co- Executors. Said Co-Executors shall have all of~it a powers, privileges, duties and immunities as hereinbefore move fully set forth for my original Executor. IN WITNESS WHEREOF, I have hereunto set my hand''ar this my Last Wi 1 1 and Testarnen t, this ~~ ~~ day of ,~~~•~'' `'; ~ r7 Vera R. Shettel ! -r-- id sea i to tSEAL) Signed , sea 1 ed , ~,~..f, ; ~: shed and dec 1 ared b•y the al~owe r-~amed i Testatrix as and for her Last Will and Testament, in ~h~ presence of us, who at her request and in her presence and in khe presence of each other have hereon __. ___ _ _ ____ __. _ ~T- ~` ~~~ Prudential ~,~~' ~omputershare ~p' Computershare Trust Company, N.A. .~.. PO Box 43033 ~ 0 0 0 7 53 Providence, Rhode Island 02940-3033 . Within. USA, US territories 6 ~an~da 800 305 9404 Outside USA, US territories t"r Canada 732 512 3782 ~ www.computershare.com~nvestor "Ililll'II'II'ii'lilil"li'I'Illllrllninl~~lili~lrlrlill~ll~~ Prudential Financial,Inc.''isorganizedunderthelaws of the State of NJ. TERRY L SHETTEL EX EST VERA R SHETTEL 811 SCHOOLHOUSE LANE - LEWISBERRY PA 17339 Holder Account Number'. 000312457E 1', CompanyiD PRU SSNffIN Certified Yes ~Prudehtial Financial, inc. -Direct Registration (DRS) Advice Transaction(s~ ', Date Transaction Description ' Total ~ C~USIP Class . ~ ShareslUnits ~ I Description 22 Jun 2010 Transfer 32.000000 744201 D2 Common Stock Account Information: Date: 22 Jun 2010 (Excludes transactions pending settlement) Certificate Current Total Balance Direct Shares) Price Value ($) ICUISI'P Class Held by You Registration Units Per Share Description Balance 0.00 32.000000 32.000000 ~7.70890Q 1,846.40 144320102 Common Stock ~ ~~~ ~~~i.~b ~ ~. ~,~• ~ !? 68` ~ - `~~ ~o ~~~~soz NNPORTANT NiFORMATION RETAIN FOR YOUR RECORDS. This advice is your record d the share transaction atfedirg your aocamt on the books d the Company as part d the Direct Registration System It is r1eiU>~ ulsWment nor a secluily, and defvery d this advice does not d itself omfer any rights on the recipient tt shall be kept with your rtrportant docaxrrer~s as a record d your owrlerstdp d 1t1~Se~ No action an your part is required, unless you wish ip deposit your existing cerfificaGas, sett a request a oerfifkate, a harrsier yar txx*•entry shares. Upon request Cre Carperry wrA famish to any sheretldder, witflolt charge, a tuN statement d the designations, rigfls (indtrding rights uxler any Company's ' h. I Agreerrlent, it any), prefererges and liri~tiors d the slgres d each lass and series auQarized to be issued. and the arlhority of the Board d Diredas ro divide the shares info series and to and drange rights, preferences and tirtrt>l~orls d any days a xries. Assets are r>ot deposits d Campu6erst>are and are not insured bY' the Federal Oepoett Irlstrarlce Corporation, the Securities Irnrestor Protection Corporation, a ahy other federal a stale agency. 40UDR ~,/L„ ~~~''P R U ~' --.. _ ... ... ... . _.. ..... .....'~~._/ ~~~~~ 110'ICS009?.D.EOS_1163/D00'It3/OOIIS6 a r ,___._ _ ___. __ _... Q mt~z~~ 499 Mitchell Road, Millsboro, DE 19966 Mai] Code DE-MB-12 Phone (8 8) ~I502-4349 Fax (32)!934-2955 May 5, 2b 10 Schrack & Linsenbach Wm. D Schrack III 124 W Harrisburg St PO Box 310 ', '' Dillsburg, PA 17019-0310 Re: Estate of: Vera R Shettel Social Security: 182-22-3309 ~' Date of Death: April 10, 2010 j Dear Sir or Madam: ' '~, I Per your inquiry, please be advised that at the time of death, the above-named decedent had on depo~it with this bank the following: 1. Type of Account Certificate of Deposit II Account Number 31003911640827 L Ownerslu'p (Names o, fl Vera R Shettel ~! Opening Date 06/t73/85 closed 0223/10 Balance on Date of Death $ 0.00 I', Accrued Interest $ 0.00 ~I Total $ 0.00 2. Type of Account Checking Account ~i Account Number 28851811 I Ownership (Names o, fl Vera R Shettel ' ', i Opening Date 052889 closed 04/30/10 Balance on Date of Death $2972371 ', Accrued Interest $ 0.05 Total $ 29723.76 -"-'"~~"'_.__..... ____.._.___~~__ Please be advised, there was a safe deposit box found for the above decedent at the Queen Street Brand #j~i~-nl-also, box # 242. ~ ~, ' If upon reviewing the information above, you believe there are additional aa:ounts not refe please provide us with an account number and/or name of any possible joint account holder. For any additional ' rmation on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, ,please contact our Mechanicsburg branch at #~n-255-2031. !~ 'I Sinc~+ely, ~'~ II Norissa Sears, ~P ~QG~~if~~l~ ~ ', Adjustment Services i __ __ -- _ __ _ I