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Home My WebLink About05-23-11~. y i~~~ 1505610140 '-" REV-1500 ~` ~°'-'°' OFFICIAL USE ONLY PA Department of Revenue Coun Code Year Flle Number Bureau of Individual Taxes tY Po Box 28o6a1 INHERITANCE TAX RETURN 2 1 1 1 0 3 2 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMQDYYYY 1 7 5 0 3 2 3 8 5 0 3 0 5 2 0 1 1 0 2 D 6 1 9 1 8 Decedent's Last Name Suffix Decedent's First Name MI W e n g e r M a r y M (tf Appllcabie} Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL tN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-$2) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will} (Attach Copy of Trust} 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death Q 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O} CORRESPONDENT - TMIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number W i l l i a m S D i c k 7 1 7 ? 6 2 1 1 6 0 First ilne of address 1 3 W Th a i n Second line of address S u i t e 2 1 0 City or Post Office W a y n e s b o r o S t r e e t State P A ZIP Code ~ ], ? 2 6 8 REGISTER OF WILLS USE QNLY ..~... ~C xs -< tw.s +~ DA ~~ -.{ ft? ~ ~ Correspondent's a-magi address: billdsslawt~pa. net t,:,,-3 ~,; ~ :.: r~--~ ~'> ~~~~~ ~~~ :„.;,.~ ~` _~', t ~- ~-- ~~: .~ 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 outer than the personal representative is based on ail intormatton of which preparer has any knowledge. ~„~~~`~ S~ATURE OF PERSON RESPONSi13LE~ OR FIt~1,NG ~ET~1RN DATE _ , _ ~c~ianic~sburQ,D~'A 17050 ~ec an~cs ur~,D~A 17050 1~~Ilersy~~~e;~ ~b ez~ionngGAt30445 ~~ 17551 SIGNATURE pF,R~R` JPARER ~HEf~~~REPRESENTATNE ~ E~~~ ~` ADDRESSh/~~f ~J a~LL/ 13 W• Main Street, Suite 210 Waynesboro PA 17268 PLEASE USE ORIGINAL FORM ONLY ^~~~-~-~--- Side 1 1505610140 7,505610140 J t ~ 1,50561024D REV-1500 EX Decedent's Social Security Number Decedent's Name: ~ r] r y Nl . W e n g e r 1 7 5 0 3 2 3 8 5 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. 9 4 6 5 0 , 8 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 1 2 8 1 6 . 7 9 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 6 9 6 1 7 3. 3 6 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 8 0 3 6 4 ], . D 2 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• ~ 4 8 8 . 2 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 4 2 3 . 2 0 11. Total Deductions (total Lines 9 and 10) ............................... 11. ~ 9 1 ], , 4 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ 12. 7 9 5 7 2 9 . 6 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. 7 9 5 7 2 9 . 6 2 TAX CALCULATION -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 .0 0. 0 D 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 ? 9 5 7 2 9. 6 2 16. 3 5 8 0 7. 8 3 17. Amount of Line 14 taxable at sibling rate X .12 D 0 0 17. 0. O D 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 1 g. 0. 0 0 19. TAX DUE ......................................................19. 3 5 8 0 7• 8 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 150561,0240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: Fi{e Number 21 11 0324 3. Interest Total Credits (A + B) (2) 1,790.39 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) 0.00 (5) 34 017.44 Make check payable to: REGISTER OF WILLS, AGENT I:IId~Si !:I!1. ,11114 N'I ri',~II 'tl I..,!I:;M ,• ..~«...,«,. .... .. _.. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BL I .IVLiIr!LA OCKS 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 ro ert transferred or its income, X p P Y ............................... ^ c. retain a reversionary interest; or .... ^ d. receive the promise for life of either payments, benefits or care? ...... ..... .................................. ^ Q 2. If death occurred after December 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? ......... Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which ^ contains a beneficiary designation? ................................... fY 1 r-~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE ;, N;, ~J II~F~•I~,ri!I~,IHr {;,; 1{, I,J IJ;,i I I,1 p f~;: ,,11 L, ~,, ;N I I I, F I I~'Ir I I , I 1 .,.a. J , RETURN. ;F lli .1,a,1.,5~II~i.I,i.I~il,iA~i.li: F~I f~9. 1'I I.:I .11111J1 1 1'J1,II.h1.I.II,II,;i,~ I~I~I~ I''. I,i'-~I II.~' 1111'li~lli I. jl~.l~llil.l I MI 1..1 ,1114Jilllll J...~..~I.a.V.ll~~~l'I~111;111 .1';I~J~•FFI.11~1':Inl',' ,1. I i, l.. 1 ' .~.. ..,.. .. 11~ ~!I.JI, I II I .,~. ~.. II 11 ~ ~I:'I~i 11 1 tl lei 11.1.1:1 11.1 II I.'I:1'illll,ll 1 '1I'I:II 1 1, 1 1 1 III 11411 I~'117~~,H~IIIII F11 I 1 :1 !:I I I I' I J..1 I; :1 1 I I I~;I'~j0 ..i.. ~ .I I ...... I. 11,:';~;1:~.I I I. ~ ~ I.. .II 11.;1 III I'. 1:11 :I'. :' II II 1. I,.;III 11.111. '. In: FJ 111.41.1':111'I'1j1'1l!III I:I I:111FI ~ f.~:111,1111FriI1 I~IfIIF~.l:f lti'I~~I.f IJtl:11{0IJ,1A I1; :F'J'.I I'1. .1'.I.. .. ~ ~~:1: ~ :.::~ ... 1. 4 lll,~l.il.~l :i 1.~I:~:l:i.l. I I.~in l.. ~,I 1111: Fll 111,1 I.I I' I'i i:' III II II I~I I~I',1 ,111 ~ 111 ~I~F~ I~,.4j, 111111 .111.1:111 111 I111~'lll~~l III1141111^,I I.jj1 ~,I ~,4~j X11 I~.M1,~•111~111 ~1111.1III:It111111A11I''i: •1 A III 1r1.~~, ~, 411, I'.i'1:11; ~ ~. I ~. ~.. I.el llnl I I' 1..:r .1:1 I I ;41:1, i:l.~'~I 11 I I I.~I~.I II II11'~,'I',11 111111111111.1: 11 I1, 1.'.1:1 II'. ',i l; 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 survivi 3 percent [72 P.S. §9116 (a) (1.1) (i)], ng spouse 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 ercent [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 disc osure of assets an filing a tax return are still applicable even if the surviving spouse is the only beneficiary. d 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 arent an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. p • 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 siblin is defined un Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. g dE Tax Payments and Credits: ~• Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 35 807.83 A. Prior Payments B. Discount 1 790.39 REV-1508 EX + (6-98) SCHED 1JLE Epp ~+ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, O~ M~~7C. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER _Mary M. Wenger 21 11 0324 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 7. F&M Bank, money market account #..5226 70,703.89 2. ~ F&M Bank, checking account #..7320 3. ~ US Treasury, 2010 federal income tax refund 4. IPA Dept. of Revenue, 2010 state income tax refund 5- I ROBC, refund of overpayment for nursing care services 19, 742.98 783.00 128.00 3,293.00 TOTAL (Also enter on line 5, Recapitulation) I $ 94 650 87 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT re~r~T'- ..~ SCHEDULE F JOINTLY-OWNED PROPERTY Ma M. Wen er FILE NUMBER: 21 11 0324 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Ronald M. Wenger 23 Creek Bank Drive Mechanicsburg, PA 17050 Son B. Kenneth L. Wenger c 37 Creek Bank Drive Mechanicsburg, PA 17050 Son JOINTLY-OWNED PROPERTY: ITEM LETTER FOR JOINT DATE DESCRIPTION OF PROPERTY NUMBER TENANT MADE JOINT 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 DECEDENT'S INTEREST D VAWE OEFATH DECEDENT'S INTEREST 1. A./B. 11/9/09 Orrstown Bank, checking account #..1581 38,450.35 33.33334 12,816.79 TOTAL (Also enter on Line 6, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 12,816.79 REV-1510 EX+ (08-09) ---- pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF Ma M. Wen er FILE NUMBER 21 11 0324 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % ' THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. OF DECD S EXCLUSION VALUE OF ASSET _ TAXABLE INTEREST (IFAPPLICABLE~ 7. Edward Jones Brokerage Account#403-09105 VALUE 439,506.82 100.00 payable on death to decedent's four sons: Ronald Kenneth 439,506.82 , , David and Ray Wenger, w/dividends accrued to date of death 2. Mass Mutual Annuity #ODY15327326 100,717.42 100.00 payable on death to decedent's four sons: Ronald Kenneth 100,717.42 , , David and Ray Wenger 3. Presidential Life Annuity #479877 146,667.56 100.00 payable on death to decedent's four sons: Ronald Kenneth 146,667.56 , , David and Ray Wenger 4. The Hartford Annuity #191633 9281.56 100.00 payable on death to decedent's four sons: Ronald Kenneth 9,281.56 , , David and Ray Wenger TOTAL (Also enter on Line 7, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 696 173. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT 1"f\T 1 Tr. w SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS w~ty1L Vr Marv M. t FILE NUMBER ~1 11 n~~e Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: ~. 2 Thomas Geisel Funeral Home, additional memorials-for funeral • 3 Thomas Geisel Fuenral Home, additional death certificates • Ronald M. Wenger, purchase funeral bulletins 4• Mechanicsburg Brethren in Christ Church, print bulletins 5• Pastor Kenneth Hepner, funeral services 6• Kevin Witter, funeral service participant 7• Michelle Wenger, funeral service participant 8• Family Traditions Restaurant, funeral meal B• ADMINISTRATIVE COSTS: ~ • Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Cry State ZIP Year(s) Commission Paid: 2. Attorney Fees: DICk, Stein, Schemel, Wine & Frey, LLP 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 Wills 5. ~ Accountant Fees: 6• I Tax Return Preparer Fees: 7• Cumberland County Register of Wills, Will filing fee 8• Cumberland County Law Journal, legal advertisement 9• Sentinel, legal advertisement 10. Ronald M. Wenger, reimburse postage 11. F&M Bank, estate check order fee 12. L. David Wenger, reimburse postage 13. Cumberland County Register of Wills, Inheritance Tax Return and Inventory filing fee 14. Dick, Stein, Schemel, Wine & Frey, LLP, escrow for future expenses, taxes & attys fee TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. AMOUNT 50.00 90.00 26.24 10.00 125.00 75.00 50.00 1,597.80 3,750.00 233.00 28.50 75.00 261.88 42.03 24.75 19.00 30.00 1, 000.00 7,488.20 REV-1512 EX+ (12-08} pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Ma M. Wen er FILE NUMBER 21 11 0324 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical ex enses. ITEM p NUMBER DESCRIPTION VALUE AT DATE ~• Family Home Medical, bed and wheelchair expense OF DEATH 162.00 2• EMS West Shore Ambulance, ambulatory services 227.54 3• Alert Pharmacy, prescription co-pay 33.66 TOTAL (Also enter on Line 10, Recapitulation) $ If more space is needed, insert additional sheets of the same size. 423.20 REV-151' EX+ iC1-14; pennsylvania SCHEDUL DEPARTMENT OF REVENUE E J INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: Mary M. Wenger NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j. TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 • Ronald M. Wenger 23 Creek Bank Drive Mechanicsburg, PA 17050 2• Kenneth L. Wenger 37 Creek Bank Drive Mechanicsburg, PA 17050 3• L. David Wenger 405 Stonegate Court Millersville, PA 17551 4• Ray C. Wenger 346 E. Spring Street Mt. Vernon, GA 30445 FILE NUMBER: 21 11 0324 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Lineal Lineal Lineal Lineal AMOUNT OR SHARE OF ESTATE 202,136.60 202,136.60 195, 728.21 195, 728.21 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 CO I II. NON-TAXABLE DISTRIBUTIONS: VER SHEET, AS APPROPRIATE. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. 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. $