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Home My WebLink About05-19-11 (2)1505610143 C Fx (ot-to) ~ ~` REV-'I SOO ~ OFFICIAL USE ONLY PA Department of Revenue Pennsylvania county code Year Fib NumSer Bureau of Individual Taxes o~asravrrorsEVSass PO 60X.280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 11 O ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 188 12 3377 O1 21 2011 05 25 1922 Decedent's Last Name MCCLURE Suffix Decedent's First Name MARION (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW 1. Original Return ^ ^ 4. Limited Estate ^ ® g, DacedeM Dlad Testate ^ (Attach Copy of VJIII) ^ 9. Litigation Proceeds Received ^ Spouse's First Name MI I MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ^ 3. Remainder Return (date of death pdorto 12-13-82) 4a. Future Interest Comppremisa 5. Federal Estate Tax Return R ulred (date of death attar 12-12-82) ^ e9 ~, DAecedegpMyin,gjned)a Lwinq Trust ~ 9. Total Number of Safa Deposit Boxes 10. ~~,~~P9~~~~ ~~~~~~~S~f death ^ 11, Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Num(te; DAVID W DELUGE 717 _ 4541~;~ Viz? -~' ~ :-' - ' --- -Yl - _ r'- i C 7 Firat Ilne of address 301 MARKET STREET Second line of address PO BOX 109 Clty or Post OfFlce LEMOYNE Correspondent's e-mail address: aural i~A;11~'.LS US'E ONLY" ;' S .-, - ~. ~ --_~ _~c1-,~ - .... __ _ ~.:, .._ _D __ I . T- r..-,. c~o - -:-r t I DATE FILED State ZIP Code PA 17043 1 have examined this return, includtn~ accompanying schedules and statements, and to the best of my on of preparer other than the persona representative is based on all infomtation of which preparer has M. DAVID W DELUGE ~~~Z 301 Market Street, Lemoyne, PA Side 1 1505610143 1505610143 J 1505610243 REV-1500 EX o~'°m•."ema: McClure, Marion I Decedent's Social Security Number 188 12 3377 RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... .. 1. 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C)....... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................................................... .. 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .............. . 5. 4 , 114.00 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 6, 867.54 7. Inter-Vivos Transfers & Miscellaneous tyoq Probate Property Se arate Billin (Schedule G) Re uested p u g q ............ 7, 8. Total Gross Assets (total Lines 1-7) ................................................................... .. B. 10 , 981.54 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 98 6 . 8 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10. 250.94 11. Total Deductions (total Lines 9 & 10) .................................................................. . 11. 1 , 237.80 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 9 , 743.74 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. 9 , 743.74 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 .oo ts. 0.00 16. Amount of Line 14 taxable 9 ~ '743.74 at lineal rate X .045 16. 438.47 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18. 0.00 19. rax Due ................................................................................................................. . 19. 438.47 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 .J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME McClure, Marion 1 STREET ADDRESS 1719 Locust Street CITY STATE ZIP New Cumberland PA 17070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments e. Discount 0.00 Total Credits (A + B) (2) 3. Interest File Number 21-11 (1) 4. If Line 2 is greater than Llne 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 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make to: OF AGENT. 438.47 0.00 (3) (4) (5> 438.47 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 ............................................................................................................... ^ ^ 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 conaideration? ................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 0 4. Did decedent own an Individual Retirement Account, 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 Juty 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 [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 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-1b08 EX+ (8-98) COMMONWEALTH OF PENNSriVANIA INHERITANCE TA% RETURN RESIDENT DECEDEM SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER McClure, Marion I 21-11 All property Jolntlyo~wnad v~itlrt the right ofdsurvlvo sA p mualebs Elsc webd on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Sovereign Bank Individual Interest Checking Account No. 181118481 4.94 2 Claremont Nursing Home & Rehab - ReimbursementlRefund of Overpayment 2,658.02 3 Musselman's Funeral Home - ReimbursementJRefund of Overpayment 1,162.51 4 Retum of Premium -Blue Cross Blue Shield 288.53 TOTAL (Also enter on Line 5, Recapitulation) I 4.114.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Forth PA-1500 Schedule E (Rev. 6-98) ..,acre-a .~-~~ U14G~-cam ~-1~.~-~' -~-~-s~-~.~..~.~.~.r~ ~~` M GEORGIANNA MOVER CUST ACCOUnf # 181118491 MARION ! MCCLURE BENEF Balances Eamed this Period $ 0.00 Paid Last Year $0.10 Paid Year-To-Date $ 0.01 'The interest earned and the interest paid may d'rffer depending on when interest is credited to your account. Service Fees -Itemized Date # Transactions Fee Total MONTHLY MAINTENANCE FEE 0271i/11 1 1000 E10 00 FEES WAIVED 02/11/11 1 -1000 - $1000 Total $0.00 Checks Posted Cheek # Date Pald Amount Reference Check # Date Paid Amount Reference 532 01/18 52.100.00 982824990 533 01!18 $12.36 992D73075 2 Check(s) Posted = $2,112.36 An asterisk (') indicates a skip in sequential chedr numbers. An (E) indicates check was converted to an electronic item. Account Activity Date Description Additions Subtractions Balance 01-12 Beginning Balance $2,117.30 01-18' CHECK 532 $2,100.00 $17.30' 01-18 CHECK 533 $12,36 $4.94 02-13 Ending Balance $4,94 ~ ~,~~-~ ~o.~i~~39a6 ~~~~ `~ page 2 of 4 18!/!8491 Interest .. Paid this Period' $ 0.00 " Annual Percentage Yield Eamed 0.00% Rav-1608 EX+(8.98) gCNEDULE F COMMONwFALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERRANCE TA%RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER McClure, Marion I 21-11 M ran east was made Joint wNhin one yssrof the decedanl'c daN of death, it must tro reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. M Georgianna Moyer 1719 Locust Street Daughter New Cumberland, PA 17070 B. C JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOIN 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 ALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 1/1/1976 Sovereign Bank Checking Account No. 140.46 50.000% 70.23 1051063906 2 A 1/1/1976 Sovereign Bank Money Market Account No. 13.594.62 50.000°h 6,787.31 1054170185 TOTAL (Also enter on Line 6, Recapitulation) I 6,867.54 (If more space is needed, additional pages of the same size) Copyright (e) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Sovereign 139971 13452 MARION I MCCLURE M GEORGIANNA MOVER 1719 LOCUST ST NEW CUMBERLND PA 17070-1460 MARION t MCCLURE M GEORGIANNA MOVER Statement Period 01/01/11 TO 0113 SOVEREIGN PREMIER CHECKIN~ convenience our Customer Contacf Center , ble from 7 am - 8 pm EST, 7 days a week. Callus at1-877-768-1143. iredmaycalll-800-428-9121 (TTY/TDD). www. sovereignbank. com 0000 70340 100098789 Deposit Accounts Account Number Average Daily Balance Current Balance 'SOVEREIGN PREMIER CHECKING 't051063906 $915.08 $4219.10 MONEY MARKET 1054170185 $13,955.91 $12,097.58 Total Deposit $13,316.68 MAR10N !MCCLURE M GEORGIANNA MOVER Balances Beainnina Balance obits was calculated for the pI Interest -Paid this Period'. $146.95 -Currant Balance + $10563.01 Average Daiy 8alai - $9,490:86.. od beginning on 12/06/10 and ending on 01/03/1 S 0.04 Annual Percentage Paiii.Year-To-Date $ 0.04. 'The interest earned and the interest paid may differ depending on when i Checks Posted Check # Date Paid Amount Reference 2145 01/18 `$5 650:00 982824985 2149 01/10 X500.00 611604400 ' 2150 01/14 $2.265.00 971284765 B Cheek(s) Posted = $9,490.86 An asterisk (') indicates a skip itt sequential check numbers. Sovereign is part of Santander, "Global Bank of For your is avails Hearing imps Account# 1051063906 Yield Earned O:a~% $1.03 to your account. Check # Date Paid Amount Reference 2151 01!18 $155 DO 982824995 2152 01113 - $499 00' 971048945 2153 01/27 $421.86 985053265 An (E) Indicates check was converted to an electronic item. t-L nnov 1 of 4 ~ sQ'"~" e.nt r • ANmer Fgc..m • whony awn.d anrd.n of B.nco s.wbr, sA l Soru~ uitl Ik bpo and Scib,drt.ntl b ~, p,p,p„tl r,e„„„a w s~ s.~k e,a san.na.r,,«a.eMh~, a mr.no.r. «wnrm.n.. r, m. umm sow..m olnr 1051063906 REV-1181 EX+t10-08) COM~TECE~ANU\ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COST; ESTATE OF FILE NUMBER McClure, Marion I 21-11 ~~..~w v. `.vvv • YV •Yr/V• KV V•• VY••pY Y•O ~• ITEM DESCRIPTION AMOUNT A, FUNERAL EXPENSES: See continuation schedule(s) attached B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 421.88 Street Address City State Zio Yearfsl Commission paid 2. Attorney's Fees Johnson Duffie 450.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 115.00 See continuation schedule(s) attached TOTAL (Also enter on Itne 9, Recapitulation) 888.88 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10.06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER McClure, Marion I 21-11 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exuenses 1 Nick's 114 Restaurant - Funerel Luncheon 421.86 H-A 421.86 Other Administrative Costs 2 Cumberland County Register of Wills Office -Filing Fee for Inheritance Tax 15.00 3 Reserves: Miacellaneous Out Of Pocket Expenses 100.00 H-B7 115.00 Copyright (c) 2002 form software onty The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) Rav1612 EX+~12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8t LIENS COMMONKEALTH OP PENNSYLVANIA INHERITANCE TAX RETURN RESIDEM DECEDENT ESTATE OF FILE NUMBER 21-11 ' Report debt ineun•s0 by the decadent prior to death that remained unpsid at the dste of dseth, Inelutling unnimbunsd medical expenses. REV-161~EX+(11-08) SCHEDULE J coM~;4T~~i~,~w BENEFICIARIES ESTATE OF I FILE NUMBER McClure. Marion I 21.11 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE MOUNT OF ESTATE NUMBER pERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distnbutions, and transfers under Sec. 9116 a 1.2 M Georgianna Moyer Daughter Entire Estate 1719 Locust Street New Cumberland, PA 17070 Total Enter dollar amounts for distributions shown above on lines 1 5 throw h 1 B on Rev 150 0 cover sheet as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1600 Schedule J (Rev. 11-08)