HomeMy WebLinkAbout02-02-11REV-1500 Ex(°'-'°' 1505610743
PA De artment of Revenue OFFICIAL USE ONLY
p cerM~s~anv County Code Year FNe Number
Bureau of Individual Taxes
Po Box.2sosot INHERITANCE TAX RETURN 2 1 10 0 0 5 4 5
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Seeuriry Number Date of Death Oate of Birth
155 72 8289 05 23 2010 12 23 1965
Decedent's Last Name Suffix Decedent's First Name MI
CHANCE LIZA
D
(If Appllcabie) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Narne
MI
CHANCE EDWARD C
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ ,qa, Futuro Imeresl ComprwNSe 5. Federal Estate Tax Retum R wired
(date of deem ener 12-12-62) ^ eQ
® g. Decedent Died Taetete
(Aaech Copy of WIN) ^ ~ Decedent Meldalnad a Uvinp Truet 0
(Attach Copy
a. Totai Number of Safe Deposit Boxes
o
f
Tnist)
^ 8. Litigation Proceeds Received ^ e
rt
v
(
70, eee~ni2at §i er~id t ~~5~death ^ t1,Eiedion to tax under Sec. 8113(A)
(Attach Seh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
THOMAS S B E C K L E Y Daytime Telephone Number
7i7 233 7691
REGISTER OF ~[iC USE
First Ilne of address
212 NORTH THIRD STREET
Second line of address
City or Post Office
HARRISBURG
Correspondent'se-mail address: becks~pa.net
State ZIP Code
PA 17101
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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 tru wrzed and complete. Dedaretion of preparer other than the personal ropresentative is based on all information of which preparer has any knowledge.
SIGNA R OF P RSON RESPONSIBLE FOR FILING RETURN
/ DATE
^^'^^ f.~~(j Stuart Ringer 1'-a -- ~ I
307 Glenn Forest Road, Magnolia, DE 19962
Thomas S Beckley I~a~/!I
212 North Third Street, Harrisburg, PA 17101
Side 1
L 1505610143 1505610143 J
.J
1505610243
REV-1500 EX
Decedent's Social Security Number
oeceasnea Name: C H A N C E~ L I Z A D. 15 5 7 2 8 2 8 9
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 & Notes Receivable (Schedule D) ....................................................... ... 4.
5• Cash, Bank Deposits 8 Miscellaneous Personal Properly (Schedule E) .............. .. 5.
26,582.93
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ........... .. 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property 0
0 0
(Schedule G) ^ Separate Billing Requested ........... .. 7, .
8. Total Gross Assets (total Lines 1-7) ..................................................................... .. g. 2 6, 5 8 2. 9 3
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... ... 9.
10,068.30
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. ... 10.
11,488.81
11. Total Deductions (total Lines 9 & 10) ................................................................... ... 11 • 2 1 , 5 5 7 . 1 1
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. 5 . 0 2 5 . 8 2
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. 5 , 0 2 5 . 8 2
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 .00 15.
16. Amount of Line 14 taxable 4 , 0 2 0 . 6 6
at lineal rate X .045
16.
1 8 0. 9 3
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate x .15 1, 0 0 5. 1 6 1 g, 15 0. 7 7
19. Tax Due ................................................................................................................... .. 19. 3 3 1. 7 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L 1505610243 1505610243 J
• REV-1500 EX Page 3 File Number 21 - 10 - 00545
Decedent's Complete Address:
Chance, Liza D.
STREET ADDRESS
511 West Main Street
CITY
Mechanicsburg STATE ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments
B. Discount
3. Interest
750.00
16.59
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Llne 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 331.70
Total Credits (A + 6) (2) 766.59
(3) 0.00
(4) 434.89
(5)
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: Yea No
a. retain the use or income of the property transferred :..............................
.. .................................................. ^ x
b. retain the right to designate who shall use the property transferred or its income :.................................... x
c. retain a reversionary interest; or .................................................................................................................. ^ ^
d. receive the promise for life of either payments, benefits or care? .................. x
............................................
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?......... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designs!ion? ....................................... ~ ^
...............................................................................
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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
p2 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 21 ears 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)].
• sibfrig is definedounder 9ectiont9102 astan indi ,tlual who has at least one p8~ent incommon withthe decedent wfiether by ti ood~oAadoption.
SCHEDULE E
CASH, BANK DEPOSITS, &~ MISC.
COA"101N~"`TMOFPEN"S~`°""" PERSONAL PROPERTY
INNERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Chance, Lila (J. FILE NUMBER
21 - 10 - 00545
Include the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
DEATH
1 Members 1st checking account 17,792.00
2 2005 Acura TL Autmobile 6,000.00
3 Belco savings account 914.23
4 Member's 1st checking account 1,393.39
5 Proceeds from MetLife stock 483.31
~ TOTAL (Also enter on Line S, Recapitulation) I 26,582.93
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS ~
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Chance, Liza D.
FILE NUMBER
21 - 10 - 00545
This schedule must be completed and filed if the answer to any of questions 1 throuslh 4 on nacre 2 is ves_
ITEM
NUMBER DESCRIPTION OF PROPERTY
Indude the name of the trenaferoe, their relatlonship to decedent
end the dale of trenafer. Attach a copy of the deed for real estate. DATE OF DEATH
VALUE OF ASSET %OF
DECD'S
INTEREST EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
1 Individual retirement account (decedent was under iss,ooo.o0 100°/d 169,000.0 ~ 0.00
age 59 1/2 and not disabled)
i
I
i
TOTAL (Also enter on line 7, Recapitulation) I 0.00
SChEDIA.E H p
COMMONWEALTH OF PENNSYLVANIA ~ ~ /~/'~Dr
INHERITANCE TAX RETURN RA 11 YG V~.h7 1 J
RESIDENT DECEDENT
ESTATE OF Chance, Liza D. FILE NUMBER
21 - 10 - 00545
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Myers Funeral Home 3,078.00
Mechanicsburg, Pennsylvania
2 Reception following funeral 1,063.93
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Stuart Ringer 2,000.00
Street Address 307 Glenn Forest Road
city Magnolia state DE zip 19962
Year(s) Commission paid
2. Attorney's Fees Beckley & Madden 2,500.00
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 Cumberland County Register of Wilis 123.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Cumberland Law Journal 75.00
TOTAL (Also enter on line 9, Recapitulation) 10,068.30
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ESTATE OF Chance, Liza D.
2 ~ The Patriot-News
Schedule H
Funeral Eames 8
~1.~
3 I Telephone tolls/photocopying/postage
4 ~ Car payments made prior to sale
FILE NUMBER
21 - 10 - 00545
300.41
75.00
852.46
Page 2 of Schedule H
r
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMAONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS
W HERRANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF Chance, Liza ~. FILE NUMBER
21 - 10 - 00545
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM -
NUMBER DESCRIPTION AMOUNT
1 Autmobile car loan 9,000.00
2 Beckley & Madden (legal fees incurred during Ms. Chance's lifetime) 2,488.81
TOTAL (Also enter on Line 10, Recapitulation) I 11 488.81
itEV•+a~a ex. tt~•oal
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Chance, Liza D.
21 - 10 - 00545
NAME AND ADDRESS OF PERSONS RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER RECEIVING PROPERTY () DECEDENT (Words) ($$$)
0o Na use rruasgsl
I, TAXABLE DISTRIBUTIONS[include outright s ousel
distributions, and transfers
under Sec. 9116 (a) (1.2)]
Pippa Calland
511 West Main Street
Mechanicsburg, PA 17055
2
3
II.
Janice Sutton
15 Cake Road
Bridgeton, NJ 08302
Stuart Ringer
307 Glenn Forest Road
Magnolia, DE 19962
Friend
Mother
Father
1/2 personalty, 20%
residuary
50% residuary
1/2 personalty, 30%
residuary
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate.
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
LAST WILL AND TESTAMENT
OF
LIZA D. CHANCE
I, LIZA D. CHANCE, a resident of Ctunberland County, Pennsylvania, being of sound
and disposing mind and memory, do make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me at any time made.
ITEM I: TAXES. I direct that all inheritance and estate taxes becoming due by reason
of my death, whether such taxes may be payable by my Estate or by any recipient of any prop-
erty, shall be paid by my Executor out of the property passing under this Will, which is not spe-
cifically bequeathed or devised, as au expense and cost of administration of my Estate. My
Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my
Executor, even though on proceeds of insurance or other property not passir-g under this Will.
ITEM II: POWERS OF APPOINTMENT. I hereby exercise all powers of appoint-
ment which I may have at the time of my death in favor of my Executor, and all property subject
to all such powers of appointment shall be included in my Estate.
ITEM III. PERSONAL POSSESSIONS. I hereby give and bequeath all of my house-
hold furniture and furnishings, books, pictures, jewelry, china, linen, silverware, wearing apparel
and all other articles of household or personal use and adornment, in equal shares, to my father,
STUART RINGER and to my friend, PIPPA CALLAND. I hereby give and bequeath my
automobile and my dog, Trixie, to my friend, PIPPA CALLAND. I have intentionally failed to
provide any share in this bequest for my spouse, EDWARD C. CHANCE, III.
Page 1 of 3 pages
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ITEM IV: RESIDUAL ESTATE. I give, devise and bequeath all of the rest, residue
and remainder of my property, real, personal and mixed, as follows:
(a) FIFTY PERCENT (50%) to my mother, JANICE SUTTON;
(b) THIRTY PERCENT (30%) to my father, STU_ART RINGER; and
(c) TWENTY PERCENT (20%) to my friend, PIPPA CALI.AND.
I have intentionally failed to provide any share in this bequest for my spouse, EDWARD
C. CHANCE, III.
ITEM V: EXECUTOR'S POWERS, In the settlement of my Estate, my Executor
shall possess, among others, the following powers:
(a) To sell, either at public or private sale and upon such terms and conditions
as my Executor may deem advantageous to my Estate, any or all real or
personal estate or interest therein, whether owned by me separately or in
conjunction with other persons or acquired after my death by my Executor
and to consummate said sale or sales by sufficient deeds or other instru-
ments to the purchaser or purchasers, conveying a fee simple title, free and
clear of all trust and without liability of the purchaser or purchasers to see
to the application of the purchase money or to make inquiry into the valid-
ity of said sale or sales; also, to make, execute, acknowledge and deliver
any and all deeds, assignments, options or other writings which may be
necessary or desirable in carrying out any of the powers conferred upon
my Executor in this paragraph or elsewhere in my Will.
(b) To pay all costs, taxes, expenses and charges in connection with the ad-
ministration of my Estate.
(c) To distribute my Estate in kind or in money. In the event assets aze dis-
Page 2 of 3 pages
tributed in kind, such assets shall be distributed at their value(s) on the re-
spective date(s) of their distribution.
(d) To do all other acts in the judgment of my Executor necessary or desirable
for the proper and advantageous management, investment and distribution
of my Estate.
ITEM VI: SIMULTANEOUS DEATH. Any person who shall have died at the same
time as me or in a common disaster with me or under such circumstances that it is difficult or
impossible to determine who died first, shall be deemed to have predeceased me.
ITEM VII: EXECUTOR. I hereby nominate, constitute and appoint my father,
STUART RINGER, to be my Executor. My Executor specifically is relieved from the duty or
obligation of filing any bond or other security.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last Will
and Testament, consisting of this and the preceding two (2) pages, at the end of each page of
which I have also set my initials for greater security and better identification this ~ day of
May, 2010.
't_ ,'A'ir,
Page 3 of 3 Pages (SEAL)
Liza D. Chance
.~
We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published
and declared by the above-named Testatrix (Liza D. Chance), as and for her Last Will and Testa-
ment, in the presence of us who, at her request and in her presence and in the presence of each
other, have hereunto set our hands and seals the day and year above written, and we certify that
at the time of the execution thereof, the said Testatrix was of sound and disposing mind and
memory.
%Y .-- (SEAL)
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF ~ ~',1,1~1~~~~,~"~~
We, the undersigned Testatrix (Liza D. Chance) and Witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being duly qualified according to law,
do depose and declare to the undersigned authority that:
The Testatrix signed and executed the instrument as the Testatrix's Last Will and
Testament.
2. The Testatrix signed and executed the Will willingly as the Testatrix's free and
voluntary act for the purposes therein expressed.
3. Each of the Witnesses, in the presence and hearing of the Testatrix, signed the
Will as a witness.
4. To the best of the knowledge of each of the undersigned, the Testatrix was at the
time 18 years of age or older, of sound mind and under no constraint or undue influence.
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Sworn or affirmed and subscribed to before me by the above-named Testatrix and Wit-
nesses, this _7~day of May, 2010.
'`LTH OF~NNSVLV
NOTARIAL SEAL
ELIZABETH S. BECKLEY, NotUry PubNC
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RARRTABUR(li. PENN6YI.vA1~TIA 17108-1998
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50901
January 26, 2011
Glenda Farner-Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Squaze
Cazlisle, PA 17013
RE: Estate of Liza D. Chance, deceased
No. 21-10-0545
Dear Register Strasbaugh:
Enclosed herewith you will find an original and two copies of an Inheritance Tax
Return in the above-referenced Estate. Please file the original and return atime-stamped
copy to our office in the enclosed envelope. Thank you for your assistance, and if you
need anything further, please do not hesitate to call me.
Very truly yours,
BECKLEY & MADDEN
~/
Thomas S. Beckley
Enclosure
Cc: Stuart Ringer (w/encl.)
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