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Home My WebLink About11-10-10 (2)J 1505610101 REV-1500 °` t0i-'°' ~ enn lvania OFFICIAL USE ONLY PA Department of Revenue P SY Bureau of Individual Taxes OEMNINENTOfPEVENUE County Code Year File Number Po BOx Z8o6o1 INHERITANCE TAX RETURN "' ""' " r- Harrisburg, PA 1128-o6oi RESIDENT DECEDENT 2 1 1 0 0 8 6~ 0 ~ Date of Birth MMDDYYYY 0 7 2 8~ 1 9 3 0 " BIEI Ule Decedent's First Name MI ~N~ ' Spouse's First Name t, MI :-,~ ~ ...i.i ~. - i iee~ ~ ~~~ 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 T0: Name Daytime Telephone Number ~ 4 A n t h o~ n~ L~ ~; De ~..L u c a _ E_„s ~:. ~,~_ 7 1 7 2 5 8~ REGISTE E_DVILLS USEaSNLY ~? ~ ~ r First line of address "C C~ ~rn _, f -- 1, 1 3 ~F r> o~ n= t s S t re4~ ~ ~,, ~ ,_ ~ ~ ~Q ..~ C . . Second line of address ~ ~e ~~ ~ - ~-~ City or Post Office State ZIP Code DATE FILED ,~ . ~s - .. ,, ... + ~ -r -. ~.~ +~., ~,. , ' B o i 1 i n a r~>, n s ~ 1 7 ~ P A.~ Correspondents e-mail address: anthonyldelucaesq@embargmail . corn 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. DeGaration of preparer other than the personal representative is based on all information of which prepan;r has any knowledge. SIGNO~SON R~ON E FOR FILI~ RETURN DATE ~ ~ ~c~curo~ N v~rn9El4 4 o7b1o ADDRESS /~1 n~ ~~ ~~ " ~S~ ~>~+n ~b~[ l 'h)l~. LEw~S~it~l2X..~1. '1/ OF DATE PLEASE L 1505610101 Side 1 1505610101 d J 1505610105 REV-1500 EX Decedent's Soaal Security Number i 1~ 9482 2~ 9~9;. 6i 1'~ Decedent's Name: RECAPITULATION t..~ ~ ..y-. , ,.. .,~-: .~. :.,~ 1. Real Estate (Schedule A) ............................................. 1. ~ Y ~ ~ ~ `~ 1 _i Q ~_ Q 2. Stocks and Bonds (Schedule B) ....................................... 2.~ ( ~; 3. Closely HekJ Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ....................... . .. . 4. s 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 6. Jointly Owned Property (Schedule F) p~ Separate Bitting Requested ....... 6. ~ ~ 1 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) p Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. 11. Total Deductions (total Lines 9 and 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 CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unde~Sec. 9116 (a)(1.2) X .0 44_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 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 O Side 2 1505610105 1505610105 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-1 0 - 0 8j 0 DECEDENTS NAME P. Richard Henry, a/k/a Porter Richard Henr STREETADDRESS 1249 Kuhn Road CITY Boiling Springs, srATE PA ZIP17007 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments _ 0 _ A. Prior Payments B. Discount 3. Interest 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) (3) (4) (5) (1) $1 0, 391 .97 519.60 -0- 9,872.37 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? ...................................................................... ^ 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 "in trust for" or payable-upon-death bank account or security at his. or her death? .............. ^ 4. Did decedent own an individual retirement acxount, 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 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 sttrtute 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 appficabfe even 'rf the surviving spouse is the only benef~iary. For dates of death on or after Juty 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 ore stepparent of the child is 0 percent 172 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) p2 P.S. §9116(a)(1)]: The tax rate imposed on the. net value of transfers to or for the use of the decedents siblings is 12 percent 172 P.S. §9116(a)(1.3)]. A sibNng 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) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~~ ~.+~ c yr SCHEDULE A REAL ESTATE P Richard Henr FILE NUMBER y a/k/a Porter Richard Henry 21-10-0860 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. ITEM NONE VALUE AT DATE OF DEATH -0- TOTAL (Also enter on line 1 Recanitulatln~) I $ - 0 - (If more space is needed, insert additional sheets of the same size) REV-1504 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY HELD CORPORATION, PARTNERSHIP OR ESTATE OF SOLE-PROPRIETORSHIP P. Richard Henry a/k/a Porter Richard Henry FILE NUMBER Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partners?p inte1esOt of tOhe$dec0edent sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER ,other than a NUMBER NONE VALUE AT DATE OF- DEATH -0- TOTAL (Also enter on line 3, Recapitulation) $ - 0 - (If more space is needed, insert additional sheets of the same size) ~tEV-1507 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF P. Richard Henry a/jt/a Porter Richard Henry ITEM All property jointly-owned with right of survivorship must be disclosed on Schedule F. NONE VALUE AT DATE OF DFATH -0- FILE NUMBER 21-10-0860 TOTAL (Also enter on line 4, Recapitulation) $ -0- (If more space is needed, insert additional sheets of the same size) REV-1508 EX. (i-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF P. Richard Henry a/k/a Porter Richard Henry FiLENUMBER Include the proceeds of litigation and the date the proceeds were received by the estate Aii ro a 21 -1 0 - 0 8 6 0 ITEM p p rtY 101et1y-owned with the right of survivorship must be disclosed on Schedule F. NUMBER DESCRIPTION VALUE AT DATE ~~ Chehking account, #621043-448-01 OF DEATH 2. $1,500.91 Money Market Checking account, #0206005458, at Integrity Bank. 100,894.32 3• Miscellaneous 2011 Hyundai SonatanLimiteaertSeeiattached a 19,017.00 ppraisal. TOTAL (Also enter on line 5, Recapitulation) 3 1 21 , 41 2.2 3 (If more space is needed, insert additional sheets of the same size) REV-1589 EJ(* (t-91) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF P. Richard Henry a/k/a Porter Richard Henry H an asset ryas made john within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Richard T. Henry B. C. FILE NUMBER 21-10-0860 652 Red Fox Court Lewisberry, PA 17339 RELATIONSHIP TO DECEDENT Son JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE Include name of financial insfitution and bank acxount number or similar identifying number. Attach NUMBER TENANT JOINT deed for jointly-held real estate, DATE OF DEATH ~ OF DATE OF DEATH DECD'S VALUE OF VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1• A. /21/ 8 Regular Savings, Account #43478- X5.00 0001, at AmeriChoice Federal 50$ $2.50 Credit Union 2• B. 7/21/08 Certificate of Deposit, Account #43478-0062, at AmeriChoice 250,961.58 50$ 125,480.79 Federal Credit Union ADDRESS TOTAL, (Also enter on line 6 Recapitulation) I; 1 2 5, 4 8 3 2 9 (If more space Is needed Insert addttlonal sheets of the same size) REV-1510 E%. (1-97) SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF P. Richard Henry a/k/a Porter Richard Henry FILE NUMBER 21-10-0860 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM INCLUDE THE NAME OF THE TRANDSEEREERT}IEIRIROEUT~rFisPR~ pE Ep~ ,qHO THE DATE OF TRANSFER. JMBER ATTACH A coax of THE DEED FDR REAL EsrarE. DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE VALUE 1 • NONE VALUE OF ASSET INTFRFCr _ -0- tlr more space is needed, insert additional sheets of the same size) TOTAL (Also enter on line 7, Recapitulation) I S - 0 - REV-1511 EX+ (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF P. Richard Henry a/k/a Porter Richard Henr FILE NUMBER y 21-10-0860 Debts of decedent must be reported on Schedule I. ITEM NUMBER A• FUNERAL EXPENSES: DESCRIPTION ~~ Cocklin Funeral Home, Inc- AMOUNT 30 N- Chestnut Street Dillsburg, PA 17019 $4,046.72 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative(s) Street Address ---- ---- City - -- - ----- State Zip Year(s) Commission Paid: ---- 2• Attorney Fees Anthon Y L. DeLuca, Esquire 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 8 ~ 5 0 0 - 0 0 Claimant Street Address ------- City ------- State Zip Relationship of Claimant to Decedent - 4. Probate Fees - 5• Accountant's Fees 3 2 7. 5 0 s• Tax Return Preparer's Fees 5 0 0. 0 0 ~• Legal Advertising-Cumberland Law Journal 8- Legal Advertisin 75.00 9- Filing Fees Inheritance TaxtandlInventory 10. Appraisal of 208.75 personal property to Roy D- Gottshall 30.00 60.00 TOTAL (Also enter on line 9. Recaoit~~latl~~i ~ c 1 3, 7 4 7. 9 7 ~~~ more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS P. Richard Henry a/k/a Porter Richard Henry FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursedO ed0a81 a pOenses. ITEM NUMBER 1 Moffit Heart and VascularlPTloMedical VALUE AT DATE OF DEATH 2• Liberty Medical Supply -Medical $13.73 3• Citi Card - Credit :Card 5.14 4• Consumer Cellular -Mobile Telephone 123.94 5• West Shore EMS-ALS-Ambulance 85.00 6• West Shore EMS-Carlisle-Ambulance 977.90 1,009.22 TOTAL (Also enter on line 10, Recapitulation) $ 2 21 4.93 (If more space is needed, insert additional sheets of the same size) ~ REV-1513 ~X+ (g-pp) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF P. Richard Henry a/k/a Porter Richard Henry FILE NUMBER 21-10-0860 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE Sec. 9116 (a) (1.2)] 1~ Richard T. Henry 652 Red Fox Court Son 100$ Lewisberry, PA 17339 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, 0 I 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~ NONE -0- I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) ~ -O LAST WILL AND TESTAMENT l7 ~~. ,;< f":s ,,, ~~ P. RICHARD HENRY td r..-.. i,A ~ -_ " .;'~ ~..~ ~ I, P. RICHARD HENRY, a resident of Boiling Springs,~~mbe~and. -~~~' County, Pennsylvania being of sound mind, memory and understanding, I ,~.` do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ITE-- M 1_ I direct that all my just debts, the expenses of my last illness and funeral expenses be paid as soon after my decease as the same can conveniently be done. ITEM 2; I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes. by any of such gwarnzne,ts, whether the property passes under this Will or otherwise, excluding, however, any property over which I have a taxable power of appointment, provided, however, that no residuary beneficiary shall by reason of this provision be denied the benefit of any deduction, credit, favorable rate of tax or other benefit which by law enures to such beneficiary. g.. t: • HAR HENRY ~, 1 LAST WILL AND TESTAMENT OF P. RICHARD HENRY ITEM 3: I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever kind and nature, and wheresoever situate at the time of my death, unto my son, RICHARD T. HENRY, provided, however, that he survives me and is living sixty (60) days after the date of my death. ITE- M 4_ If and in the event that my son, RICHARD T. HENRY, does not survive me and is not living sixty (60) days after the date of my death, then and in such event, I give, devise and bequeath the interest in my estate, which my deceased son would have received, if living, to the issue of my said deceased son, per stirpes. ITEM 5: I hereby nominate, constitute and appoint my son, RICHARD T. HENRY, Executor, of this my Last Will and Testament, with full power to do any and all things necessary for the complete administration of my estate, and direct that no bond or other surety is required of him in this or any other jurisdfiction for his performance of this office. If and in the event that my son, RICHARD T. HENRY, does not survive me and is not living sixty (60) days after the date of my death, or does not complete his duties as Executor, then and in '~...r.,t,~ l~ P.~ RIC RD HENRY 2 LAST WILL AND TESTAMENT OF P. RICHARD HENRY such event, I hereby nominate, constitute and appoint KAREN E. HENRY, Executrix of this my Last Will and Testament, with full power to do any and all things necessary for the complete administration of my estate, and direct that no bond or other surety is required of her in this or any other jurisdiction for her performance of this office. IT- E- M 6: I wish to acknowledge that I have a daughter, CECILIA JO HENRY, whom I love and care for very much and who is well cared for, but, due to cerebral palsy which seriously impairs her, it is my belief that all of my estate should be bequeathed unto my son, RICHARD T. HENRY. ITE--- M ~- If any provision of this Will or of any Codicil hereto is held to be inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof shall continue to bz fully operative and. effective., so far as is possible ar~d reasonable. IN WITNESS WHEREOF, I, P. RICHARD HENRY, the Testator, have to this my Last Will and Testament t ypewritten on four (4) consecutively numbered pages, subscribed my name and affixed my seal this ~f~~ day of ~.tirf•~~Z-- 1996. /' (SEAL) 3 LAST WILL.AND'TESTAMENT OF P. RICHARD HENRY Signed, sealed, published and declared by the above named P. RICHARD HENRY, as and for his Last Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and of each other. ~~ r r residing at 1' ~ ~ ~ /y- r ~ r ~~( ~ ~ ~ ,1 ~''r ~/~ ~ ~~esiding at .;/ ~ } . / ~ ~ ~C.'' 7 r t ,.-'1 . ~- ~~ mss'" v°` ~ ~ r"" 4 ~ ~.~ r- ~' ~+ ` Y a~ ~, t ._. . .. ~__ _ _ ~~ ~. ~~ .. ~~ ~~ -~ ~~ ~/G ~'~ ~~ ,~` ~ ~~~;~ ,, _. ,, ~~~. - ~ .. ~~~~~~ 5~~~~