HomeMy WebLinkAbout01-31-111505610101
~ REV-1500 EX (oi-so) , OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN Z ~ r Q 0 p ~/
Po Box z8o6o1 RESIDENT DECEDENT 7 T
Harrisbur , PA 1 128-o6oi
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
178-58-4738 09/07/2010 07/09/1961
Decedent's Last Name Suffix Decedent's First Name MI
EARLEY JUDY E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M~_
EARLEY RODGER L
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
210-44-7351 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
r'or to 12-13-82)
O 4. Limited Estate
O 6. Decedent Died Testate
(Attach Copy of Will)
O 9. Litigation Proceeds Received
O 4a. Future Interest Compromise (date of
death after 12-12-82)
O 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95}
P~
O 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
O 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED To:
Name Daytime Telephone Number
THOMAS E. FLOWER (717) 243-5513 ,,
First line of address __ _ _
_.
FLOWER LAW, LLC
Second line of address
10 W. HIGH ST
City or Post Office State .ZIP Code
CARLISLE PA '.17013
Correspondent's e-mail address: 1:01'1'1 flOWt?f-18W.COn1 _
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 PER REyPONSIB~ F~FILI RETURN ~ 9 ~ ^ /~ ~
ADDRESS v
RODGER L. EARLEY, PO BOX 211, PLAINFIELD, PA 17081
SI¢1Q~E OF~~~HER THAN REPRESENTATIVE / //~ ~ATFjI"
ADDRESS '
FLOWER LAW, LLC, 10 W. HIGH ST., CARLISLE, PA 17013
PLEASE USE ORIGINAL FORM ONLY
-,
,;
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--,
Side 1
L 1505610101 1505610101 J
REV-1500 EX
Decedent's Name: JUDY E. EARLEY
1505610105
Decedent's Social Security Number
178-58-4738
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1.
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Closely Held 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. 5,515.03
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-wos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ', 5,505.03 ',
9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 7,196.20
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... ..... 10. ' 15,628.71
11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. ', 22,824.91
12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. ', 0.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................... ..... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. 0.00
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0
00
(a)(1.2) X .0_ 15. .
16. Amount of Line 14 taxable
0
00
at lineal rate X .0 _ 16. .
17. Amount of Line 14 taxable
0
00 '
at sibling rate X .12 17. .
,
18. Amount of Line 14 taxable 0
00
at collateral rate X .15 18. .
19. TAX DUE .................................................... .....19. 0.00'
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610105 1505610105 J
REV-1500 EX Page 3 File Number
r)pcpdpnt's Complete Address:
ZIP
17081
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
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)
o.oo
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
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 :............................................ ^ x^
c. retain a reversionary interest; or .......................................................................................................................... ^ 0
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? .............................................................................................................. ^ x^
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? ........................................................................................................................ ^
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)j. 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)].
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)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Total Credits (A + B) (2)
(3)
(4)
(5)
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
JUDY E. EARL`~'~ 21-10-0943
Include the proceeds of Iftigation and the date the proceeds were received by the estate.
All property Iolntly-owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
JUDY E EARLEY
Account # 591135264
Your account is currently at a zero balance. If your account remains at a zero balance for two entire
statement periods with no activity, your account may be closed. Please deposit funds into this account
quickly to prevent it from closing. If this account is not meeting your needs, it would be our pleasure to
discuss other options with you.
Balances
Beginning Balance 540.03 Current Balance ` $0.00
Deposits/Credfts +5464.01 Average Daily Balance $137.36'
VJrthdrawals/Debits - 5504.04
" This balance was calculated for the period beginning on and ending on
Interest
Paid this Period' `' $ 0.00 ' Annual Percentage Yield Earned ` ' 0.00%`
Earned this Period $ 0.00 Paid Last Year $0.07
Paid'Year-To-Date $ 0.02
`The interest earned and the interest paid may differ depending on when interest is credited to your account.
Overdraft/Returned Item Fee Summary
Fee description
Total for this statement period Total year to date
Total Overdraft Fees $0.00 $175.00
Total Returned Item Fees $0.00 $0.00
Account Activity
Date Description
Additions Subtractions Balance
09-02 Beginning Balance $40.03
09-07 CHK CARD PUR 676964 EXXONMOBI EXXONMOBIL $11.74 $28.29
LIBERTY PA
09-10 HEALTH MANAGEMEN DIRECT DEP 100910 $419.11 $447.40
045032557826YID
09-17 AFLAC INSURANCE 091610 $32.90: 5414.50
PM5363370110259
09-20 CREDIT LINE TRANSFER FROM 68191-04987 $44.90 $459.40
09-20 SWEEP FEE SINGLE SWEEP iN FEE $12.00 $447.40
1 AT $12.00
09-21 MISCELLANEOUS DEBIT $447.40 $0.00
10-03 Ending Balance $0.00
page 2 oj3 591135264
2002 Mercury Mountaineer -Private Party Pricing Report -Kelley Blue Book
Vehicle Condition Ratings
Check Vehicle Title History
Excellent
„ $6.700
• Looks new, is in excellent mechanical condition and needs no '.
reconditioning. ',
• Never had any pain[ or body work and is free of rust
Clean title history and will pass a smog and safety inspection.
Engine compartment is clean, with no fluid leaks and is free of any
wear or visible defects.
• Complete and verifiable Service records.
'. Less than 6% of all used vehicles fall into this category.
6aod
$6,225
• free of any major defects.
:. • Clean title history, the paints, body, and interior have only minor '..
', ' (if any) blemishes, and there are no major mechanical problems.
• Little Or n0 fU5t On this Vehicle.
• Tires match and have substantial tread wear left.
• A "good" vehicle will need some reconditioning to be sold at retail.
Most consumer owned vehicles fall into this category.
Fair
; '~'i`: $5,475
• Some mechanical or cosmetic defects and needs servicing but is
Stilt in reasonable running Condition.
• Clean title history, the paint, body and!or interior need work
performed by a professional.
• Tires may need to be replacetl.
There may be some repairable rust damage.
Poor
...r N/A
• Severe mechanical and/or cosmetic defects and is in poor running
conditon.
'. '. • May have problems that cannot be readily fixed such as a
'. '. damaged frame or a rusted-through body. '.
• Branded title (salvage, flood, etc.) or unsubstantiated mileage. ',
Kelley Blue Book does not attempt to report a value On a "poor" vehicle
', '. because the value of these vehicles varies greatly. A vehicle in poor
'. condition may require an independent appraisal [o determine itr value.
'Pennsylvania 0]!14/2011
Accurate Condition Appraisal Change Condition
'. Accurately appraising the condition of a vehicle Is an important asped~ in
'. '. determining its Blue Book value. Taking our ]6 question condition quiz will
'. '. ensure you know the correct condition rating.
~~~ 3 ] ~ ~ • SEARCH LOCAL LISTINGS
'~i 2011 Xeltey Blue Book Co., Inc. All rights reserved. t %19,,1011-1 /?0,101! L'ditlon.
The specific information required M determine the value /ar this particular vehlrle was
supplied by the person generating this report. Vehicle valuations are opinions and may
vary from vehfc/e to vehicle. Actua! valuations will vary based upon market cond/tinns,
specifications, vehicle conC'Non or other particular cirtumstancc~s pertinent to this
I particular vehicle or the transaction or the parties to the transaction. This report is
intended for the Individual use o/ the person generating this report only and shall not
', be sold ur LransrnRtM to another party. Kelley 8/ue 8cok assurnes nu responsibility fnr
errors or om155/ons. (v.17013)
Page 2 of 2
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httn ~//www_khh_com/used-cars/mercury/mountaineer/2002/private-nartv-value/nricin~-ren... 1 /14/2011
REV-1521 EX+ {10-09)
SCHEDULE H
Pennsylvania
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JUDY E. EARLEY 21-10-0943
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
I' HOFFMAN ROTH FUNERAL HOME, TRADITIONAL SERVICE PACKAGE 4,550.00
2. VAULT 1,220.00
3. DEATH CERTIFICATES 90.00
4. OBITUARY 132.70
5. FLOWERS 159.00
s. '.HAIRDRESSER 40.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) __ __ ___ _ _
Street Address
City _____ State ZIP
Year(s) Commission Paid: _ _ ___ __ _
750.00
2. Attorney Fees:
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: 254.50
S. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL (Also enter on Line 9, Recapitulation) ($ 7,196.20
If more space is needed, use additional sheets of paper of the same size.
i 4:i
. ;,~~ /i
. p ~ ~• ~ ,r
"'~ FUNERAL HOME 6t CREMATORY, INC
Mr. Rodger Earley
PO Box 211
Plainfield, PA 17081
100 Elk Drive
Carlisle, PA 17015
Statement of Funeral Expenses for: Judy E. Earley
Date of Death: September 7, 2010
219 Nash Hanover Street
Carlr~e, Pennsylvanio 17013
717.243,451 1
toll free 1.866.451.451 1
' fax 717.243.3723
www.hoffmanroth.com
in; o~hoffrnonrolh.COm
January 14, 2011
Account Id: 16041-214
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE $ 4 550 00
MERCHANDISE:
Outer Container: Monarch =Concrete Vault
Sub Total: $ 4,550.00
$ 1,220.00
Sub Total:
_ s 1,22o.ao
TOTAL FUNERA! HOME CHARGES: $ 5,770.00
CASH ADVANCES: ,
15 Cert~ed Death Cert~cates at $ 6.00 each $ 90,00
Newspaper Notice -Sentinel ~ ~ :: 132.70:
Flowers ~ $ 159.00
Hairdresser - $ 40.00
Suti Total: ~ 421 70
Total Funeral Expense: $ 6,191.70 .:;
Total Payments Made: $ 6,191.70
Payments Made:
Rodger Earley.. ~ Credit Card Sep 15, 2010 '421.70
Rodger Earley Check ~ 1147. Oct S, 2010 5,770.00
Balance: S 0.00
Please return this portion with your Remittance.
S
Amount Enclosed
Judy E. Earley
Service ID#: 16041-214
SERVING OUR COMMUNITY •$INCE 1 907
i ' d EZGEEbZL T L ' H ' ~ 4021- ueuu,}~oH d60 = b0 i i b T UeC
REV-I512 EX+ (22-0$)
i Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JUDY E. EARLEY 21-10-0943
---.
Report 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.
FORM 93-0. C. DIVISION
IN RE: E
IN THE COURT OF
_::.
~;~:~:
CUMBERLAND OUNTYY`~`~1NSYLVANIA
.~~ r4.
:~:~
~~~,.~° `. ~~~~~ DIVISION
OF
JUDY EARLEY
(Deceased)
}
CLAIM
Estate No. 21-2010-0943
To the Clerk of Orphans' Court Division:
Index and make proper entry in your official records of the claim of WEST
ASSET MANAGEMENT, INC. for CHASE BANK USA, N.A., (Claimant) accou~~t
#4417169371108806, in the amount of $1,345.41, against the above named
decedent.
This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 as
amended.
The said decedent, who resided at PO BOX 211. PLAINFIELD, PA
17081-0211, died on 09-07-2010.
Written notice of this claim was given to RODGER EARLEY. at PO BOX 1 ,
PLAINFIELD, PA 17081 on 11-23-2010. ~~
(Personal representative, if any, or counsel). ~ ~
(Cla?rfant)
West Asset Management, Inc.
7171 Mercy Road, PO Box 6183
Omaha, Nebraska 68106-0183
1-800-878-3317
(Claimant's Address)
FORM 93-0. C. DIVISION
IN THE COURT OF
CUMBERLAND
(2PHANS'
IN RE: ESTTELL``~~~
~~~,=L
~~:,
OF
JUDY EARLEY
(Deceased)
OUN
}
CLAIM
NSYLVANIA
DIVISION
Estate No. 21-2010-0943
To the Clerk of Orphans' Court Division:
Index and make proper entry in your official records of the claim of WEST
ASSET MANAGEMENT, INC. for CHASE BANK USA, N.A., (Claimant) account
#4185863824339253, in the amount of $2,079.99, against the above named
decedent.
This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1,949 as
amended. ~`
The said decedent, who resided at PO BOX 211, PLAINFIELD, PA
17081-0211, died on 09-07-2010.
Written notice of this claim was given to RODGER EARLEY. at O BOX 211,
PLAINFIELD, PA 17081 on 11-23-2010.
(Personal representative, if any, or counsel).
(Claimant)
West Asset Management, Inc.
7171 Mercy Road, PO Box 6183
Omaha, Nebraska 68106-0183
1-800-878-3317
(Claimant's Address)
FORM 93-0. C. DIVISION
- - -~
IN THE COURT OF COaifI~AS
_w;.
.r~. _. ±f~ :~~
CUMBERLAND _ OUN~(=~},NSYLVANIA
IN RE:
S' GQ` DIVISION
}
CLAIM
Estate No. 21-2010-0943
To the Clerk of Orphans' Court Division:
Index and make proper entry in your official records of the claim of UVEST
ASSET MANAGEMENT, INC. for CHASE BANK USA, N.A., (Claimant) account
#4246311908218198, in the amount of $3,269.50, against the above named
decedent.
This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 a~;
amended.
The said decedent, who resided at PO BOX 211 PLAINFIELD, PA
17081-0211, died on 09-07-2010.
Written notice of this claim was given to RODGER EARLE . at PO BOX 11
PLAINFIELD, PA 17081 on 11-23-2010. _
(Personal representative, if any, or counsel).
(Clai nt)
West Asset Management, Inc.
7171 Mercy Road, PO Box 6183
Omaha, Nebraska 68106-0183
1-800-878-3317
(Claimant's Address)
IN THE COURT OF COMMON PLEAS
OF
Cumberland COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: ESTATE
OF No.: 21-10-0943
JUDY EARLEY
(Deceased)
CLAIM
To the Clerk of Orphans' Court Division:
Index and make proper entry in your official record of claim of CAPITAL ONE SERVICES. INC. c/o
Weltman Weinberg, Reis Co L P A 323 W Lakeside Avenue Cleveland. OH 44113-1009, Account. No.:
xxxxxxxxxxxx6852 / Mastercard account unsecured in the amount of b 933.81 against the estate of the above
named decedent. This claim is filed under section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code.
The said decedent, who resided at 100 ELK DR CARLISLE. PA 17015, died on September 7, 2010.
Written notice of this claim was given to RODGER EARLEY Fiduciary at PO BOX 211, PLAINFIELD. PA 17081
on October 18.2010.
Theresa James-Semancik
Authorized Agent for Claimant
Wellman,. Weinberg & Reis Co., L.P.A.
323 W. Lakeside Avenue
Cleveland, OH 44113-1009
Telephone: 1-800-784-0577
WWR# 8733623