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HomeMy WebLinkAbout11-15-10(2)1,5056051,047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue ° Bureau of Individual Taxes ~ County Code Year File Number PO BOX 280601 f, INHERITANCE TAX RETURN ~. /~ /~ Harrisburg, PA 17128-0601 - ~ r RESIDENT DECEDENT ~ ~ ~ (~' ~ ~` ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (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 ~ 1. Original Return O 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) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (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 S ~ E P ~ ~ n~ ~' (~- ~ ~ ~- ~,9-~ ~' 7 / ~ 9~ ~ ~ ~ S" ~ n Firm Name (If Applicable) First line of address Second line of address S~ ~~~ ~ ~ O City or Post Office State ZIP Code ~_: ;. r . __.:., _. ,. ;, __.~ ~.:.~ Correspondent's e-mail address: ~. ~ ~ °` r ~q~~ 9c ~ C ~n ~ ,rz• ~ ~ ~ c: T"i ~, /~~ ~ y.l. Cv.-+1 Under penalties of perjury, I 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. SIGNATUR F SON RESPONSIBLE FOR FILING RETUF,~N AT ~ ~' r ~ r, ~ ~~ I S lG •. ~~ SIGNATURE OF PRE R O THA REPRESENT _ - DATE ADDRESSl11 ~^'/y" PLEASE USE RIGINAL FORM ONL yf 15056051047 Side 1 15056051047 ("' J 1,5056052048 REV-1500 EX Decedent's Social Security Number ' I ~ ~ ~ ~ '~ ~ ~ Decedent s Name: RECAPITULATION 1. Real estate (Schedule A) . ........................................ .... 1. a y2 ~ U ~ O . n ~ 2. Stocks and Bonds (Schedule B) ................................... .... 2 ~ `+ ® ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. ~ • ~ ~' 4. Mort a es & Notes Receivable Schedule D 9 9 ( ) ......................... 4. .... C1 • ~ ' C~ 5. Cash, Bank De osits & Miscellaneous Personal Pro ert Schedule E 5. ~ ~ ~ u ~ • ~ f 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. ©• CJ O 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property O ~ ~' ~ Separate Billing Requested.... (Schedule G) .... 7. . 8. Total Gross Assets (total Lines 1-7) ................................ .... 8. ~ ~ ~ a'- Y ~ .~ ~ ` 9. Funeral Expenses &Administrative Costs (Schedule H) ................. .... 9. ~ S~ ~ ~ sue. I q 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ .... 10. ~ ( / ~ ~ 7 • 11. Total Deductions (total Lines 9 & 10) ............................... .... 11. l ~ a ~ 6 t~ . 7 D 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. ~ ' ~ 9 6 ~ ~~ • ~ ~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~ ~ O O O 'CJ ~ an election to tax has not been made (Schedule J) .................... .... 13. • 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .... 14. ~ I U ~ S~ . e ~ 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 .0_ . 15. 16. Amount of Line 14 taxable ~ _ at lineal rate X .0 ~r ~ 9 ~ s . ~ ~ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT • Y y ~,~.~~ ~ y ~ s~ ~ (o • O Side 2 L 15056052048 15056052048 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME STREET ADDRESS CITY STATE ZIP Tai Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C ) 3. Interest/Penalty if applicable D. Interest ~ ~, -~~ E. Penalty (1) ~ y ~.~ ~~' (2) Total InterestlPenalty (D + E) (3) /~ ~ ~ 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) l L ~`.j ;, ~ A. Enter the interest on the tax due. (5A) ~~ , j' ~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~~ s'J~ , ~ Y 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 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 interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ Q 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 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)]. 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)]. 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)]. 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-1502 EX+ {6-98} SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All properky jointly-owned with the right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH ~, ~ ~.etk-f~r~ /4'~to~~T" ~ !~~ vii, 31~_ 3 ~ ~'/<'ft' ~/ q~ 3r 3 ~, i 6 TOTAL (Also enter on line 5, Recapitulation) $ ~~, o Y~• ~~~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER r -- -- Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSLLES: /^ Q^ f ) ;,•,~ 1. ~ ~ c;~f /~ lTs: r nGr~ (`!~ lJ^ V-~. ~) 7 / ~~ ~ ~~ / ~~ ~ `' G~):~t)~''if. /' ., ~ Y (T- 70' B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address - -- _ City _ State Zip Year(s) Commission Paid: 2. I Attorney Fees ~?;,,,,. tnl ~ ~,-~ z,..-...~ ~ !h ~ 1,. ~'$ y , ~- ~ L' 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. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. ~ /a r,~-~. 3i r TOTAL (Also enter on line 9, Recapitulation} I $ ~~ ca `~,~~ . ~ ~ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03;~ r~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ~cl r n t r- ~ ~o /1 ~ ~. /tit > -- Qon~~ rlchtc inriirrorl by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets at the same size) REV-1513 EX+ (9-00} x. SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J V ~'' r, G r ~.a .~ ~ a, r~ . C FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under 1. Sec. 9116 (a) (1.2)] ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ,. y ~ ca ~ ~ ~ r s ~~d tooCf IIMe~~ ~.. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET v $ r~ ~ ~ ~''~< ~ ~ (If more space is needed, insert additional sheets of the same size) .LAST WILT, AND TESTAI~IENT OF DQNNA M. T~1~NEht I, Donna M. Turner, of lVew Cumberland, Pennsylvania, revoke my former Wills and Codicils and declare this to be my Last Will and Testament. ARTICLE I IDENTIFICATION OF FAMILY The names of my children are Sherise M.1V1cMiehael and Melissa A. Vaccaro. All references in this Will to "my children" are references to the above-named children. ARTICLE II PAYMENTS OF DENS AND EXPENSES I direct that my just debts, funeral expenses, and expenses of last illness he first paid from my estate. ARTICLE III DISPOSITION OF PROPERTY A. S ecific Bequests. I direct that the following specific bequests be made from my estate. $10,000.~U shat l be distributed to Keystone Council of the Boy Scouts of America, ``In Memory of Steven J. Turner." If this beneficiary does not survive ine, this bequest shall be distributed with. my residuary estate. B. Residuary Estate. I direct that my residuary estate be distributed to my children in equal shares. if a child ofmine does not survive me, such deceased child's share shall be distributed in equal shares to the children of such deceased child who survive me, by right of representation. If a child ofmine does not survive me and has no children who survive ine, such deceased child`s share shall be distributed in equal shares to my other children, if any, or to their respective children by right of representation. If no child ofmine survives me, and if none of my deceased children are survived by children, my residuary estate shall be distributed to my heirs-at-law, their identities and respective shares to be determined under the laws of the State of Pennsylvania, then in effect, as if I died intestate at the time fixed for distribution under this provision. ARTICLE IV NOMINATION Off` EXECU'T`OR I nominate James R. Hartline, of New Cumberland, Pennsylvania, and Sherise M. McMichael, of New Cumberland, Pennsylvania, as Co~Executors (the "Executor"}, without band or security. If one of the above nominees does not serve for any reason, the remaining nominee shall serve as sole Executor w ithout bond or security. ARTICLE V EXECUTOR POWERS My Executor, in addition to other powers and authority granted by law or necessary or appropriate for proper administration, shall have the right and power to lease, sell, mortgage, or otherwise encumber any real or personal property that may be included in my estate, without order of court and without notice to anyone. My Executor shalt have the right to administer my estate using "informal", "unsupervised", or "independent" probate or equivalent legislation designed to operate without unnecessary intervention by the probate court. ARTICLE, VI MISCELLANEOUS PROVISIONS A. Para~r~h Titles and Gender. The titles given to the paragraphs of this Will are inserted for reference purposes only and are not to be considered as forming a part of this Will in interpreting its provisions. Ail words used in this Will in any gender shall extend to and include alt genders, and any singular words shall i.nclucfe the plural expression, and vice versa, specifically including "child" and "children", when the context or facts so require, and any pronouns shall be taken to refer to the person or persons intended regardless of gender or number. B. L.iabilit~ of Fiduciary. No fiduciary who is a natural person shall, in the absence of fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shad indemnify such natural person from any and all. claims or expenses in connection with or arising out of that fiduciary's good. faith actions or nonactions as the f duciary, except far such actions or nonactions which constitute fraudulent conduct or bad faith. C;. Beneficiary Disputes. If any bequest requires that the bequest be distributed between or among two or more beneficiaries, the specific items of properly comprising the respective shares shall be determined by such beneficiaries ifthey can agree, and if not, by my Executor. IN WITNESS WI-IEREC)F, I have subscribed my name below, this ~ day of Testator Signature: _~~~~`-~,.--~ ~d~ 't~~ Donna M. Turner We, the undersigned, hereby certify that the above instrument, which. consists of ~„~;`~ pages, including the pages} which contain the witness signatures, was signed in our sight and presence rr rr by Donna M, Turner (the Testator ), who declared this instrument to be his/her Last Will and Testament and we, at the Testator's request and in the Testator's sight and presence, and in the sight and presence of each other, do hereby subscribe our nannes as witnesses on the date shown above. ~, .~ y~; Witness Signature: ~~` ~ '"~ Name: .~~,~~`.~..~.~..--~- - .~..~" ..__~ City: ~ ~~ .~"..,~.,r~:~' ~~~~ -~"~ -. _______ State: ,~ ~ t''~y _.~E?~'~ ._~ r. Witness Signature: __ ~ ~,,.~~.. ~.,,...~.~. ___ Name: _~~~.~ ,•• ^~._._ CY ; ~, ;.~~ w-~.~ city: _!-~s~'c~.~.---- -_____. State: _v~ ~, ~~~ / ,;r J i (-^ Witness Signature: ~~ ~ ~ " ~-~ ~~ ~ ~ ~ ~ J r Name: ; ~~ ,,~ ~~ `" r - State: __ i~~'.7., _,___~. _ PENNSYLVANIA Self-Proving ~Iause COMMONWEALTH OF PENNS'Y'LVANIA COUNT' OF CUMBERLAND I, Donna M. Turner, the Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and. as my free and voluntary act for the purposes expressed in the instrument. Sworn to or affirmed and acknowledged before me by Donna M. Turner, the Testato~•, this _~ day of __._...__~ ~' ~'- ~ , ~- `' C° 1. Testator Signature ~n ~_____~. r' ~' ~~~'`` ____ Donna M. Turner Signature of officer ro ~~- ~~ ~~ ~~~~~ Official capacity of officer ~ttlc ~ . SStfier. Rlot~+ty ~t~blic ~ i;~ fro, C+~mt~~u?d a~:~n`.;~ ~~~~ia~4vn Exp~tes i~1~'~ r4 !`fit 1, 2~1 a ? .... .~~ P6K1~Vr~K'f72 ~':,,iC11;L?ti+Jtt CST {~C<~ti(i? (Seal) AFFIDAVI'C COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ~.~°' ~ _` We, ~,~,,~r.,~ .,%efs and ~.1 ~~~c..~^ ~• ~~c v"qtr, _ and ~.~~~, r~ -.. ~~`(~ ' ' _, the witnesses ~+rhose names are signed to the t bei~-ualified accordin to law do de ose and sa that we attached or foregoing instrumen , g y q g p y were present and saw the Testator sign and execute the instrument as the Testator's Last Will; that the Testator signed willingly and executed it as the Testator's flee and voluntary act for the purposes expressed in it; that each of us in the hearing and sight of the Testator signed the Will as a witness; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~, Sworn to or affirmed ands bscribed to before me by _ ~'.~ ~ • ~Yr .. and ~h Cc.~-~ { V~~~ . _ _ and ._ = '~ ' ~"~ ~'C witnesses, this _ : ~ L ~ day of _~,~~~ ~. i, ~, _ ~ ~ ~ - , .. . _...._._.._.._.w_._ ~~ Witness Signature: Name: City: State: Witness Signature: Name: City: State: Witness Signature: Name: City: State: ~' Signature ~~~I~.T~ Seal and official capacity of officer NSYLY'ANiA Nam Ssai Mark ~. 3ts~r, Notary Public Lemay~e Bono. Cuenbertand County ~y Go+~ur~salar~ MasCh ~ t , 20 g 3 ~e+r~t~, ~nt~ylvanta Asscaci~iio+~ of td<iw~'e~ . ~/ -~ _ __.-t.?~~~T~ _______.___ ___._._.