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Home My WebLink About02-07-11J 1505610101 REV-1500 ~tO1-1°~ PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes ~.~,~EM~ jNHERITANCE TAX RETURN County Code Year File Number PO BOX 28D6oi Harrisbu PA i i28-o6oi RESIDENT DECEDENT a ~ ~ 1 ~~ 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 182-42-8746 11/23/2009 08/22/1950 Decedent's Last Name Suffix Decedent's First Name Hillegas MI Sharon S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Hillegas Michael Spouse's Social Security Number 182-40-8172 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum O 2. Supplemental Retum O 3. Remainder Retum (date of death O 4. Limited Estate pnorto 12-13-82) O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Livin Trust 0 (Attach Copy of Wiil) g 8. Total Number of Safe Deposit Boxes (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 W. Scott Staruch (717)975-0600 REGISTER OF W~ USE ONLY c-- First line of address ~ O ` Laws, Staruch & Pisarci ~"~ ~' ~ n" _T7 `= Second line of address r ~~s -?' ~ I `-' c!1 20 Ertord Rd., Ste 30 ~ ~' '~ ~ City or Post Office ~~ State ZIP Code DATE FILEG7 Lemoyne PA 17043 .-- c:. Correspondents e-mail address: LSPIaW aol.COm Under penalties of perjury, I declare that I have examined return, including accompanying schedules and statements, and to the best of m know) it is true, correct and complete. DeGaretion of preparer er than the Y edge and belief, personal representative is bas d e on all information of which preparer has any knowledge. S E RE NSIB OR NG RETU ATE ADDRESS 14 Clemsnw ;u v ~ r~ t.%~ ~3 :,.: ~..._. ~~ w ~ . (~_y~-~~j} r~ •' ~'/ y/~i 20 E~rford Rd., Ste 305, Lemoyne, PA 17043 PLEASE USE ORIGINAL FORM ONLY 1505610101 Side 1 1505610101 J ~~ <~ 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: $harOft S. HIII as 182-42-8746 RECAPITULATION 1. Real Estate (Schedule A) .............. ............. . ............. .... 1. 0.00 2. Stocks and Bonds (Schedule B) ........... ........................ .... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . 3 ... . 0.00 4. Mortgages and Notes Receivable (Schedule D) ....................... 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... .... 4. . 5 0.00 6. Jointly Owned property (Schedule F) O Separate Billing Requested .. . 0.00 .... 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule Gj ... 6. 3,400.52 O Separate Billing Requested..... ... 7 8. Total Gross Assets (total Lines 1 through 7) ...... . 0.00 .......... . ......... 9. Funeral Expenses and Administrative Costs (Schedule H). ... 6. 3,400.52 .... . ~~~~~~~"' 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ~~' 9' 5,365.00 ... • 11. Total Deductions (total Lines 9 and 10) .. 10 13,567.32 ............................. 12. Net Value of Estate (Line 8 minus Line 11) ..... .. 11. 18,932.32 ....... . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been d 12 -15,531.80 ma e (Schedule J) ................... . 13 ' 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ... . .................... 1a. 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 16. Amount of Line 14 taxable 15. at lineal rate X .0 - 17. Amount of Line 14 taxable 16. at sibling rate X .12 18. Amount of Line 14 taxable 17. at collateral rate X .15 18. 19. TAX DUE ............................... . ......................... 1s. 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 Decedent's Complete Address: Flte Number Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments (1) 0.00 A. Prior Payments B. Discount _ _ __ _- 3. Interest Total Credits (A + B) (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) 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) 0.00 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: a. retain the use or income of the Yes No property transferred :................................. ^ ......................................................... ^ r< 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, benefds or care?, ....•...•.~.~~..•~.~~~~~.~~~~~~~~~~~~~~~~~~~~~~~•~~~ ^ ..................................................................... ^ Q 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 "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent own an individual retirement arx;ount, 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)j. 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 evenrf 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. REV-1$09 EX+ (01-10) ~i Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEp1~LE ~ JOINTLY-OWNED PROPERTY cD1gIC Vr': Sharon S. Hillegas If an asset became FILE NUMBER: 21-09-1187 owned wItI11n one year of the decedent's date of death, it must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS A• Michael S. Hillegas B. C. ]OINTLY OWNED PROPERTY: RELATIONSHIP TO DECEDENT 14 Clemson Dr. Spouse Camp Hill, PA 17011 ITS NUMBER ~eiiex FOR ~~ TENANT DATE MADE lOINi DESCRIPTION OP PROPERTY INCLUDE NAME OF FlNANCIAL INSTIiIingl AND BANK ACCOUNT NUMBER OR SIMILAR ~' ~ DATE OF DEATH DATE OF DEATH IDENTIFYING NUMBER. ATTACH DEED FOR)OINiLY HELD REAL ESTATE DECEDENTS VALUE ~ 1. A. 01/01!05 . VALUE OF ASSET Ford, Five Hundred, 70,000 miles INTEREST DECEDENTS INTEREST 6,675.00 50 3,337.50 2• B• Fulton Bank, Checking Account #362218781 1~•~ ~ 63.02 TOTAL (Also enter on Line 6, Recapitulation) I ~ 3 400 52 If more space Is needed, use addttional sheets of paper of the same size. REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sharon S. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER 21-09-1187 uecedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: I' Stone & Murray Funeral Home - 408 34d St., New Cumberland, PA 17070 B. ADMINISTRATIVE COSTS: I. Personal Representative Commissions: Name(s) of Personal Representative(s) _ _ ____ _.. _ Street Address __ _ _ __ __ City _ __ State __ ZIP Year(s) Commission Paid: Z• Attorney Fees: 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Michael S. Hillegas __ _ _ _ __ __ Street Address _14 Clemson Dr (formerly 540 Brentwater Rd.) __ -- City Camp Hill __ __ .State PA ZIP 17011 __ ___ Relationship of Claimant to Decedent SpOUSe _ _ _._ ___ 4• Probate Fees: S• Accountant Fees: 6• Tax Retum Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) I; If more space is needed, use additional sheets of paper of the same size. 1,800.00 3,500.00 65.00 5,365.00 REV-ISlz Ex+ llz-osl Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT FCT~Te ne FILE NUMBER Sharon S. Hillegas Report debts incurred by the dated ITEM SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES ~ LIENS ~~~ pnur to aeatn that remained unpaid at the date of death, including unreimbursed medical expenses. DESCRIPTION VALUE AT DATE 1 ~ Ford Motor Credit Company, Installment Loan, joint with spouse, account no. 39011506 - total debt $20,232.35 2. Parthemore Funeral Home, 1303 Bridge St., New Cumberland, PA, Judgment @ District Justice Clement, Jr., CV-0000221-10 10,116.18 3,451.14 TOTAL (Also enter on Line 10, Recapitulation) I; If more space is needed, Insert additional sheets of the same size. 13,567.32 REV-1513 EX+ (O1-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT c~~w~e ur: Sharon S. H SCHEDULE BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• Michael S. Hillegas, 14 Clemson Dr., Camp Hill, PA 17011 Do Not List Spouse FILE NUMBER: 21-09-1187 OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. TT NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. 0 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET If more space is needed, use additional sheets of paper of the same size. ~ • 2005 Ford Five Hundred -Trade In Value, blue book value -Kelley Blue Book Page 1 of 2 Kelley Blue Book 7HE TRUSTED RESOURCE NITRO Standard V 6 Engine with available 260 HP 4.0 life:...... 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(v.11020) On KBB.mm L ere .ar~ ..er f 9 ?.e Ovrned Used (Q,s oa ch Rz „e-rvss Nev.. f)ea ar_ -. dCar~Fnr .,an, !',1 ~.. ,ranee 'r qB". eer •..RF.. •~ ct.,~rr..F. fyr[erye 2011 petro~t quto $hOW 1011 Best Resale Value Awards 10 Comfy Cars Untler ;lOK 10 Coul Cars Under §39K This week's 5 Great Car Deals Aee[A W About Us Contatt us Careers FqQ Media gdvertrsing Linking Privacy Site Map Copvng M1[ b trademarks Tertns o/ Service O 199&1011 Kalay BkN look Co., IM. Business Inpuinez y v~. i*e http://www.kbb.com/used-cars/ford/five-hundred/2005/trade-in-value/pricing-report?conditi... 2/3/2011 20 Erford Road, Suite 305, Lemoyne, PA 17043-1152 (717) 975-0600 Fax (717) 975-3871 LSP1awC aol.com February 4, 2011 Via Overni ht Mail Cumberland County Register of Wills S. Hanover St. Carlisle, PA 17013 Re: Estate of Sharon S. Hillegas No. 21-09-1187 Dear Sir/Ms: Enclosed forfiling are two original copies of the Inheritance tax Return forthe above-referenced estate. Also enclosed is a check in the amount of $15.00 for the filing fee. Please time-stamp the enclosed copy and return it to me in the enclosed envelope. Thank you. Sincere) ~~-~ Mariann L. Stiely MLS Enclosures C o =_ ~, '~ _~ Win-- ~ c:r~ Z~ J ..~_c~~ v ::<:~ ::7 ~ _ c~ ~~ • ' ,, ~=` y. .': ,L .. } _ ~ N 4r O a e a c .~ c c o C ~ c ~ '+,~ H a ~ ,~ +~Y ~ i; -~. '•~~ 4~ 's . ~~ ;'.°-a '`~ ~~~ ~ M ~~ p ~ ~ ,~s ° 'y~ ~-', ~Q. 0~~~~0 ~~ cy ~~ _~ ~~~ ~e§§ ~f3 s ~~_ ~~~ m ~ ~ ~„~^~ ~~ 00 ~~ N g w r ~~ O a C~ c g ~ ~~ ~ $' o W ~~ ~, ~- ~' ~