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Home My WebLink About11-10-10 (3)'~ 15D56101D1 REV-1500 ~x `ol-lo, . enns lv OFFICIAL USE ONLY PA Department of Revenue P y ania Bureau of Individual Taxes OEPoIRTMENTOFREVENUE County Code Year File Number INHERITANCE TAX RETURN i PO BOX 280601 Z ~ ~ ~1 L 5 `~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ~ ~ Pct _3~ ~, ~J~ ~ ~ 03!29/2009 05/19/1920 Decedent's Last Name Suffix Decedent's First Name MI ___ Mefferd Violet M (If Applicable) Enter Surviving Spouse's Information Beiow Spouse's Last Name Suffix Spouse's First Name MI Spouse's Socia! Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return C~ 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82} O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number o1' Safe Deposit Boxes (Attach Copy of Wifi) (Attach Copy of Trust} O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 Andrew C. Sheely, Esquire ::717-697-7050 First line of address 127 South Market Street Second line of address P.O. Box 95 City or Post Office State ZIP Code Mechanicsburg PA :17055 Correspondent's a-maul aaaress: andrewc.sheely@verizon. net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of may 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. SI ATUR OF PERSON RE ONSlBLE FO FILING ETURN ~n.Tc -" /~ _ ~_ AnnRF~~ Trudie M. Seagrist, Adm., 316 South York St., Mechanicsburg, PA 17055 SIGNAT OF PRE A R T N EPRESENTATIVE (IATF /l~ rG`~ / ~ ~ ,t~' ~t/ pnnp cc Andrew C. Sheely, Esquire, 1 .Market St., P.O. Box 95, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY 1505610101 Side 1 REGISTER OF WILLS USE ONLY rya n i _ aj -~ f: r r --1 ~~ ~:. ~ ' ~. " ~r-r~ ._.... F _, P~ C~ _ ~ _ '' r .:.~ ,,:..1 _...p.~ ~~ r .___ ,~ ~ .. ~a 'ICED .,.~ . r ' 'ti _ k. } LJ ~ (A_ I"^. J ," 150561D101 W J REV-1500 EX i~acPrlPnYs Nr'3f4',P.' Mefferd, Violet M. RECAPITULATION 1505610105 Decedent's Sacial Security Number 1. Rea{ Estate (Schedule A) ......................................... .... 1. `, 2. Stacks and Bonds (Schedule B) ................................... .... 2. '' 3. Closely Heid Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. 4. Mortgages and Notes Receivable {Schedule D) ....................... . . .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. _ .... 5. $20,562.56; 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. __ 7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property {Schedule G) O Separate Billing Requested.... . , .. 7 $. Total Gross Assets (total Lines 1 through 7) ......................... .... 8. $20,552.56' 9. Funeral Expenses and Administrative Costs (Schedule H) ............... .... 9. i $1,084.30' 10. Debts of Decedent, Mortgage Liabilities, and Liens {Schedule 1) .......... .... 10. ' $78$.00' 11. Total Deductions (total Lines 9 and 10) ............................. .... 11. $1,872.30` 12. Net Value of Estate {Line 8 minus Line 11) .......................... .... 12. $18,680.26 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. ' $1$,680.26; TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. or transfers unc+nr cec. 9116 16. Amount of Line 14 +~~abie at lineal rate X .045 $18,680.26 16 $840.61 17. .. Amount of Line 14 taxable _ __ at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. $840.61 19. TAX OUE ..................................................... .... 19. 20. FELL !N THE OVAL {F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 ],505610105 O 150561015 J 1 , REV-1500 EX Page 3 Decedent's Complete Address: File Number ~Ff'.FnFNT'C NAAAF Violet M. Mefferd SroGCT nnnaGCC - -~ -- ~J! J 100 Mt. Allen Drive (Messiah Village) C~T~i STATFpA ~; zi 17055 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) $840.61 2. Credits/Payments !- ~~ A. Prior Payments _ B. Discount Total Credits (A + B) (2) 3. Interest (3) $29.44 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $870.05 Make check payable to: REGISTER OF WILLS, AGENT. .,$ a ~~ ~~ ;~~ 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 : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "intrust 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 contains a beneficiary designation? 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use 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 surviving 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 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 21 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 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, 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 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-1503 EX+ (6-98) , ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Violet M. Mefferd 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. FILE NUMBER 21-09-0594 (If more space is needed, insert additional sheets of the same size) p ~s~ ~~ Mitchel! Ittyad, Mill''>bbto, DE ]94b6 Adjustm~aat s~rvicts T-463 P~~~Z?~D~~3 F-~~~,- Pf-one $SS-SQL-~,'~44 ~ ax (3Q2) y34-955 Nbve4pbe~ 3„ 2010 .~tt~]naey ~hee1~Y ~'Q $ox 95 Mechanicsburg, PA x70S~ Re: estate of Violet M Mefferd Social Secu~city: 19$-~0-449 Late of Z]eat~.: March ~9, 200 Dear Sir or Madam: In zespc~n~e to your request, please be advised that at the tzzlo~e of death, the above-named dacedent ~tl on deposit with this bard the fo~l+~wirng accourns: 1. T ~vpe of Account Checking Acc~tsnt Accartnt Number 5~430~028 C.~x-nership {Nc~rnes df} VfD~et 1V1~ 1~~`erd C?pening Dcue 08~~i'~4 Balance an Date o, f ,death $2, c~42.31 Accrued Interest $' (~. tip 2. Tylre of Aecaunt Savings Account Account Number 1'S0~4~1513~.137 mership {Nantes o~ Violet ,~(.Nlef j`~rd Q,penin,~ Date 11/37 Balance vn Date of .Detrxh $17, . ~S Accrued lntere~st $ ..~Q Total $17,91 01.25 r~. ~ 4r' ~~~ :'. Z L ~'~'" ~ l Q ~ 4C ~~ ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Violet M. Mefferd SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER 21-09-0594 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: ;~ 1. Persona4 Representative Commissions: Name(s) of Personal Representatives} Trudge M. SeagrlSt street Address _316 South York Street ~;ty Mechanicsburg _ __ state PA zIP 17055 Year{s) Commission Paid: Z. Attorney Fees: Andrew C. Sheely, Esquire $500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach exp{anation,) Claimant Street Address _ City _ ___ State ZIP Relationship of Claimant to Decedent 4. Probate Fees. $190.50 5. Accountant Fees: Boremand & Babb, CPA $370.00 6. Tax Return Preparer Fees: 7. Misc. Postage $8.80 8. Filing Fee $15.00 1,084.30 TOTAL (Also enter on Line 9, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 1.0/28/2010 Cumberland County - Register Of Wills Receipt Time: 09:32:47 One Courthouse Square Receipt No.: 1063100 Carlisle, PA 17613 MEFFERD VIOLET MAE Estate File No.: 2009-00594 Paid By Remarks: TRUDIE M SEAGRIST HMW ------------------------ Receipt Distribution Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM 135.00 CUMBERLAND COUNTY GENERAL FUN RENUNCIATION 15.00 CUMBERLAND COUNT' GENERAL FUN SHORT CERTIFICATE 12.00 CUMBERLAND COUNT' GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIP'T'S ~ CNTR M.D AUTOMATION FEE 5.00 --- CUMBERLAND COUNTY GENERAL FUN Check# 193 - ------------ $190.50 Total Received......... $190.50 r[E~/-1.512 EX+ (1.2-08) r pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Violet M. Mefferd 21-09-0594 Resort debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (9-00; COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Violet M. Mefferd SCHEDULE J BENEFICIARIES NUMBER ~ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Trudie M. Seagrist, 316 South York Street, Mechanicsburg, PA 17055 2. Theodore C. Mefferd, 237 Timber Road, Mount Gretna, PA 17064 3. Bonnie D. Schaeffer, 17 Schaefers Cove Lane, Ohiopyle, Pa 15470 4. Steven Mefferd, 2343 Greenwich Street, Falls Church, VA 22046 FILE NUMBER 21-09-0594 RELATIONSHIP TO DECEDENT I AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Daughter Son Daughter Son 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) 25% 25% 25°l0 25%