HomeMy WebLinkAbout01-14-11 (2)J
1505610101
-'"' REV- ~ ~oo ~ (oi-io) ® OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes OEPARTMENTOiREVENUE County Code Year File Number
Po Box 28oso1 INHERITANCE TAX RETURN ' ~ -
Harrisbura. PA 17128-0601 RESIDENT DECEDENT_
Date of Birth MMDDYYYY
Decedent's First Name MI
Spouse's First Name MI
VF.,VU.?G A VVl+Ip1 ~~,,,..,~, ,.~,,.,,~. THIS RETURN MUST BE FILED iN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE 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
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V ~+ ~ S L R `7 l 7 ~ 3 ~ 2 ~ ~ ~
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First line of address
Second line of address
Ctty or Post Office State ZIP Code
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REGISTER OF WILLS kJ9~ ONLY
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BIATE FILEC~""
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Correspondent's a-mail address:
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.
SIGNATURE OF PERSON RESPONSIBkE FOR FILING RETURN DATE
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SIGNATURE OF PREPARE OTHER THAN RE ESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 J
J
1505610105
REV 1500 EX
/ ~ ii Decedentos Socia( Securitypty Nqum~b2er
Decedent's Name: ~/1') /~ /L9 h ~ ~p,~~ ~ . l.~- 1 Q ~ c_ ~ Z U ! t Zwxa iU 'r /
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1. ~;
:. ~
,.
2. Stocks and Bonds (Schedule B) ....................................... 2. ire
y ~}l I
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C} ..... 3. A '~ +~ ,w
~. ~~
4. Mortgages and Notes Receivable (Schedule D) ........................... 4. ;; x F
,Y! < .
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. "~
,; ~ ~,
6. Jointly Owned Property (Schedule F) p Separate Billing Requested ....... 6. ` 3' L ~ ~ Z ~ 3 ~~
7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property ~~'~ " ~ ° ~ ~ ~ ~ ~ ~`' ~ -~~
(Schedule G} p Separate Billing Requested........ 7.
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8. Total Gross Assets (total Lines 1 through 7) ......... .................. 8. ~ ~ ' ~
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9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. y
~1
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule i) .............. 10. ~' y.~,_
~ S
11. Total Deductions (total Lines 9 and 10) ................................. 11.
,- ~~
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. ~ ~~j ~, ; 4,
L a
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~~ ~~'~w ...~ r~ ~`- _ -h- ~~ ~ ~°~~$ ~ ~ ` ~~.
an election to tax has not been made (Schedule J) ........................ 13. Mlr°
.. .. .
14. Net Value Subject to Tax (Line 12 minus Line 13) 14. _~ ~, ~ ~, ~ ~ ,
/ ~ ' - i'
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 ~ ~ ~ -~
16. Amount of Line 14 taxable '~ ~ -=1 ~~ ~~ ~~~`
at lineal rate X .0 - t,
~ 4
16.
17. Amount of Line 14 taxable ~"'~"~~ '~"' ~~`*~ >~"'-~~
,
at sibling rate X .12 ~
~ 17,
18. Amount of Line 14 taxable _
"~~~ ~'"`~~
~ ~~~
at collateral rate X .15 ~ 3
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18.
19. TAX DUE .............. ........................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
O
Side 2
L 1505610105 1505610105
RED/-1500 EX''Page 3 File Number
flat-arfpnt'c Cemntete Address:
DECEDENT'S NAME n
STREETADDRESS
try's ~ s S ~ ~, ti (/ ; ~ l a S -~ - _ - -- ---- -
l o o 1~l t r4- l I .~ ,r. 1~ R. - _
CITY ~ STATE /1 ZEp ~ ~ ~ ~~
j~'1 a z~ 4 r. ; c s to ~ n ~ ('~
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
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.
(1 } ~ q z~ g 3
Total Credits (A + B) (2}
(3)
(~)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5} ~ 9 Z . `1~ 3
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:
d Yes
^ No
:...............................................
....................................
a. retain the use or income of the property transferre
i .......
^
ncome : .....................................
b. retain the right to designate who shall use the property transferred ar its .......
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? .......................................................................................................
h?
" ....... ^
^
.......
or payable-upon-death bank account or security at his or her deat
3. Did decedent own an "in trust for .......
Did decedent own an individual retirement account, annuity or other non-probate property, which
4
.
contains a beneficiary designation? .........................................:....................................................................... ....... ^
IF THE ANSWER TO ANY OF THE ABOWE 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 benef~iary.
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(x)(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(x)(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. §9116(x)(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-1509 EX + (1.97j ,
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. ..J a ~ ~ c -c, ~/. ~ ~ ~ S ~ t ,t.. ~ ~ 7 K.; rte, 5rt - ~a ~.~. -'-s 6 ~ ~x- ~ ~~ ~ ~ A ~ ~ 3 3 f~ f v =` e
B
C
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
Include name of financial institution and bank account number or similar identifying number. Attach
deed for jointly-held real estate.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1. A. M+~ ~-~~~~~~`h~ ~cc~~ht GI$Llb 79~,.4~ S(3`1~, 34Q•Z2
'i'h -1- _.r., '~e-R s ° r..~-~l S'a'vr ~ n g- p y Z ~ ~ ,~ . V
TOTAL (Also enter on line 6, Recapitulation) $ ,j~ 2 ~ G . Z 3
(If more space is needed, insert additional sheets of the same size)
+r Est ~tA ttn~ C e~trzment
I, MARGARET RUTH ULRICH, of Middlesex Township,
Cumberland CUUnty, Pennsylvania, declare this instrument to be
my Last Wili and Testament, hereby expressly revoking all Wills
and Codicils heretofore made by me.
~'~_ i c irec~ .;~}' ~xec;~t.~~~ ~, ~a;r U ~ of my
debts, funeral and administrative expenses as soon as may be done
conveniently after my decease.
TWO: I give, devise, and bequeath all of my :'state of
every nature and wherever situate to my husband, John Henry
Ulrich, provided he survives me by thirty (30) days or more.
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THREE: If my husband, John Henry Ulrich, should not survive
me by thirty (30) days or more, then I give, devise and bequeath
all of my estate of every nature and wherever situate as follows:
(a) One half (1/2) to my grandneece, Laura Christine
;diddle P~icNugh, i f she i s t,~,~enty-one yews caf age
or older; and
(b) One half (1/2) to my neice, Janice Vesta Whisler.
FOURS If my husband, John Henry Ulrich, has predeceased me,
and my grandniece, Laura Christine Riddle P1cHugh, has not
attained the age of twenty-one (21) years of age or older, then I
give, devise and bequeath her share of my estate as set forth in
Paragraph Three (3) herein in TRUST ~to FARMERS TRUST COMPANY, of
Carlisle, Pennsylvania, as Trustee, subject to 'the following
provisions:
a. The net income of the Trust shall be applied at the
sole absolute discretion of the Trustee to the
support, maintenance, education and general welfare
of my grandniece, Laura Christine Riddle McHugh, in
i
such manner as the Trustee deems proper, without
regard to the duty of any person to suppart such
'; child if a minor, and without regard to any other
,III,
funds which may be available for Trust purposes, or
the net income may be accumulated in the Trust.
b. The Trustee may not invade the original principal
i
of the Trust for the benefit of my grandniece,
j Laura Christine Riddle McHugh, until she has
~ attained the age of eighteen (18) years. After my
f
said grandniece has attained the age of eighteen
i
(18) years, the Trustee may invade the original
principal of the Trust and use accumulated income,
in, for, or toward the maintenance, support,
~', education and general welfare of my said grandniece
as it shall deem proper.
c. Upon my grandniece attaining the age of twenty-one
(21.) years of age, the Trustee shall distribute all
of the income, accumulated income and principal of
the Trust to my grandniece, Laura Christine Riddle
McHugh.
d. The Trustee shall be authorized to pay fees
required to manage the Trust assets, taxes and
expenses incurred by the Trust.
e. The Trustee shall have the following powers, in
addition to those vested its i t by law fr~r my
property veld for the benefit of my grandniece,
1
i
whether principal or income, exercisable without
I ~
court approval and effective until the distribution
I
of all property under the terms of this Trust. The ~
I
Trustee, a~t its discretion, may compromise claims, '
borrow money, retain property for such length of
time as it may deem proper, sell, lease, pledge,
mort a e transfer exchan e rt r otherwise
g g g conve o ~
~ dispose of or grant options of all or any portion
of Trust property for such prices, on such terms in
i
public or private transactions as it may deem
proper; and invESt Trust property and income
without restriction to legal investments.
i
FIVE: I appoint my husband, John Henry Ulrich, Executor of
this my Last Will. Should my husband die before my death, fail
to qualify or cease to act as Executor, I then appoint FARMERS
TRUST COMPANY of Carlisle, Pennsylvania, Executor in his place.
SIXq My Executor may, at his discretion, compromise
claims, borrow money, retain property for such length of time as
he may deem proper; lease and sell property for such prices, on
such terms, at public or private sales, as he may deem
proper; and invest estate property and income without
restriction to legal investments.
SEVEl~~9: No Executor or Trustee acting hereunder shall
v., ~ - ~ ~..: ..v ;.:uj_ .iG,.~. ,~ :, ., ,. '' ~.,..u j' ~ ..!.`~;5 C~' ar'iy Juris-
ii[
diction.
EIGHT: I hereby suggest that my Executor retain the
I
services of Irwin, Irwin & McKnight, as attorneys in the
settlement of my estate. j
IN WITNESS W~{ERE4F, I have hereunto sei; my hand and seal this
day of November, 1938.
~~-• L~:L~/L.btJ.? (SEAL)
M - GARET RUTH ULRICH~
Si~n~d, sealed, ~uhiished and declur`d by MARGARET
RUTH ULRICM, the above-named Testatrix, as and for her
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Last Wi11 anc~ Testament, in the presence of us, who, at
her request, and in her presence and in the presence of ~
each other have subscribed our names as witnesses hereto.
4
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ACKNOWLEDGEMENT AND AFFIDAVIT
We, MARGARET RUTH ULRiCH, SHARON L. SCHWALM and
KATHLEEN M. KENNEY, the testatrix and witnesses respectively,
1 whose names are signed to the foregoing instrument, being
I
t first duly sworn, do hereby declare to the undersigned authority
ghat the testatrix signed and executed the instrument as her
~~=v ~i , ~i~ r ~- r Si~[~
executed it as her free and voluntary act for the purpose herein
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expressed, and that each of the witnesses, in their presence and
hearing of the testatrix signed the Will as a witness and that
to the best of their knowledge the testatrix was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
~ ~ d
MARGARET RUTH ULR H ~ ~~~
SHARON L. SGHWALM .~.~~~~~~~
KATHLE N K NEY ~ _._~~~~~~
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by
MARGARET RUTH ULRICH, the testatrix, and subscribed and sworn to
before nee by SHARON L. SCHIrdALM and KATHLEEN M. KENNEY, witnesses,
this day of November, 1988.