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Home My WebLink About06-09-111,50567,0],05 ~~ Y ~ ~ Joo Ex taz-~~; (PP]!~ OFFICIAL USE ONLY PA Department or R?venue Pennsylvania ~ r a~r File Number oF~~_„~F Cc>un_y „ode Y. Bureau cf tndividuatTaxes INHERITANCE TAX RETURN ~ .~ PO BOX z~oGot Harrishu~y P~, t~t28-o6ot RESIDENT DECEDENT ~~ ~ ~ ~% + N ' ENTER DECEDENT INFORMATION BELOW Soc~a± ~>ecu~ity PJumber~ Date of Death MMDDYYYl' Date of Birth ru1ti14C'~`r~'{ 192-~<~-%r ~a1 Decedent's ;_ast Name 01-29-2011 Dyer tlf Appicable) Enter Surviving Spouse's Information Be{ow Soous~.~s La~~t Narr~~e 08-14-1912 Suffix Decedent's First Name "ti''I Mrs Dorothy ~~ Suffix 5oouse's First Name "~'~ sQ~,~~s~~5 ~ot;:ai se~~rity Na~r,her THIS RETURN MUST BE FILED 1N DUPLICATE WIT~i THE REGISTER OF WILLS FILL fN APPROPRIATE OVALS BELOW ~ Gr:ra~nal Return O 2. Supplemental Return O 3. RP!T7afr!CP rr a:r~~ mate of i ~,3±~'i . ~ i _ .:? 3~ ~ or n~ Pr p ~ '~ ~~~~ter~ Estate O 4a. Future Interest Compromise (date of O 5. i=edera? ~- ;ate Tax Petur~i F ~ ~ gyred death after 12-12-82) ~? ii. C=~cedent D~ed Testae O 7. Decedent Mainiained a ~ivinp Trust QJl 8 to a! tiu ~ ~ar :~f Serra De;x~ _-.. (A'tach Coen ot'~~'iil) (Attacn Copy of Trust.) t~aat~on Proceeds Pere!ved Q 9 O 10, Spousal Poverty Credit (Date of Death O 11. Ele ton ax ~;~ er Sec. ~'" 3tA _ Between 12-31-91 and 1-1-95) (A.ta~h ~ F~ule ~? CORRESPONDENT - TNIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SIiC?ULD BE DIRECTED T0~ Daytime Te+er~~ne ~e t~lumhs~ Nam_= JL~ditn Ann Dyor First -_ir,e :~f Address i93 Jackson St. Sea~,,.1 I_~,.~ otAddress ~~;ty c,~ ?cst Gffice Sat Francisco State ZIP Code 415 @A - q~~ a 9 ~G n ..~ ILLS U ; RLY.-, ~"~ J~ , ~ ~ ~ " ' i,.1 : rn _ . . ~sr7 '~7 --I ` `~ ~ ~ ~~ N ~ F -7 ~t'i ~.~~ I DATE FLIED ------___ _-- --__..__.. i ~~r-V-1~ l~ n~ . n~e1' Corr spondent's a-mail address:l~ap ~ „rttii,ni, „~ .1 y~~ Jride~ Pena ties of perj~~ry. I declare that I have examined [his return ~ncluamg accompanying schedules and statements anti ,n , , r4~ ;fi -~ y K ._..~lie~ 3F + ~ ~ , t ~s true. _;~ tact and < ~mple:e- Declaration of preparer other than the personal representative a based on all mformatien +~t ~h.,.~ lacer has anV K i > > I ~ :~E~ S~ ~N ;.l,(f?E O~JP~E,R~~~SrN REc~,P-77ON~SIBLE FOR FI NG RETURN `"''" ,C G~ ]/ Gam/ }' ~' / / - An~r~ c ~~~. i 1 ._ ~..' ..- ;iG~/:T!JR~ GP PREPARER GTiIER THAN REPRESENTPTIVE TATE ADD'<ES: PLEASE USE ORIGINAL FORM ONLY Side 1 ~...~„ 1~5a5~7~o7~05 1,5U51a' C.s1,U5 ,~ ],5Q561,02Q5 REV-150C E)<+F17 Decedents 30;;_.i Sec~._:~ity ^ti.,mb~>~ 192-32-~ %9 ? 1,,,,,,~„~, ~> N~r,e: , ~_~ REC API~iULAT10N ' . Re a?.ate (Sche~,aie A) . . ...... .. .... . . ........ 1. i 35 JC t~. Uv~ ~. vIOCri?. and f3(J r?~~ iSCY39ii Ui!; B'J .. .. .. .. _ .. _ 2. 275, 1~1 `i.~.J ~J 3 C-e ~.,,. Held Corps ,tUn. Partnership or Soie-ProprietorsMp (S;,l~~edule Ci . ~ ~ ~ ~ ~~ 4 F~-iodgages and Notes Peceivab#e (Schedule D) . . ............ .......... .. 4. '~ Cash. Bank Deports ar.d Miscellaneous Personal Property (Schedule E).. .. 5. '~~,,~ ~~tu++~q v Joi~tiV C~wn,ed Property, i,Schedule Fj G~ Separate Billing Requested . - ... .. b. 7 Inter-Jivos Transters ~ C`~tiscellaneous Non-Probate Property (Ccr~~r,dula Gj O Separate Billn,g Requested..... ... 7. 8 Total Gross Assets (tota'. Lines 1 through 7) .......................... ... 3. 44$,145,82 g Fi .era! Expenses ~: ~d t;dmlristrative Costs (Schedule N) ..... .. .... .. . . . C. ~-u ~y_, ~~ L~.~ ,. 'ebt;< oP DE:ceden' Mortgage Liabifitles and Liens (Schecuie Ej 10. 5 nc,~ ~jrj ?' Total Deductions ;tote! I_Ines 9 and 1C) ............. .... ... ....... .. 11. 21,78.07 #2 Net Va#ue of Estate ,L~ne 8 minus Line 11) .... - . _. 42E..:,- ~ >G 13 Cr,ar!table end Gc~.-er~rrriNntai Bequests~'See. 9113 Trusts for which ~•~ 7'~ectlon ha tux n ~~ ~-ct been made (Schedule Jj .... .. ... .. ...... ... 13. !j L,{~1 i+ Net Value Subject to Tax ILlne 12 minus Line 13 : ....... ... .. ...... ... 14. 426,372.76 TA X CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES A~",ol.int of #_,rre 1< taxable ;]t " ~ ::pGusa tax Y'at8.;r 'err u~~~der Seg. ~i116 X . ~~ _.- 15. 1 ~, t .'It ~t t. ~(7e 14 tc~X able a+ ~~,~ rete x Cq~, 16. 42'7 ,, ~ :-;, 17 ~~rrrunt of Line 14 taxable :, >-k;l!;;g rate X i2 17. 1t~ A ~ ;~ir~,t of L~ne ,,c t .xable a? ~'~L~tera~ rate :~ 15 18. 1 TAxDUE. _...... 19 ,_ F#L~. #N THE OVAL #F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT S9de 2 7,5Q563,Q205 1,50561QcC75 15,186.77 ~~ ~',~~ ';iii c { ~ a<,< nP~PriPr,t'S Complete Address: File Number DE~ECEtiT'c Nt P'- ®OrothV M. DVef _-Kr~T~ae~~~ :~02 East ~° ar?caa St. 1 I T ~ STATE L Ir t ~ urn PA_ ~ ,~~i-, Tax Payments and Credits: ,~ _..+_ -~_ t. ax G~~r + 'age ~ _ina 1 ~) ---___.... _____._____ A. ?riot Pa~me,,,s 18,fi13.00 ~. ~15c0U!". 9~~.C.~ Total Credits d A.+ B ? ~2; _-_____--~~__._. -i~,hG~ ~,~ 'merest iii __ __-__ -~ ~f _in~ i grect~=~ than Line 1 ~ ~~r~ ?. enter the difference. This is the OVERPAYMENT. fili in c,~a on Page 2. Line Yq to request a refund. {41 _ - . _ _ _- --- -- - -415-~ 'f Lire ' -Lin s ;,realer t1?ar Lire 2. enter the difference. This is the TAX DUE. ' S' ~______~--_ ^__ ._._____ ____._ Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X°' IN THE APPROPRIATE BLOCKS 1 Di~1 decedent ~~ake a transfer and: ~"" h"" r_., a. retain the use ~r income of the property transferred .............................................................._... _. . ~_; ,--, ~-- h. retain the right to designate who shall use the property iransferreG or its income ............................... L_: E/'. . -, :. retain a revershnary interest .................................................................................................................. . f_, ~ ci receive tre pr;,n?Ise far life of either payments, benefits or care'? ....................................................._ l~' 2 ~f death occurred after Dec. 12, 1982, did decedent transfer property within one year of death 1.._~ without receiv;ng adequate consideration? ....._ ..........................................................................__...._ t___, Did decadent ce n an "in trust for" or payable-upon-death bank account or security at his or her death% ..-_ i ~` ~ D~,d decedent own an individual retirement account. annuity or other non-probate property, which i,cntains a b~, efi i~rj designatior:. ............................ ............... .... _ __.~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS iS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF ~~HE RETURN, E~cr dates ,f ~;eath ~~ or after Juiy 1.199=1, and before Jan. 1, 1995. the tax rate imposed on the net value of transfers tc , r the use cf t[~ .~~~. q ~N~JUre r~ ~ percert~'2P~. §9116 (a) X1.1) ii;]. Fcr dates of ~eut~ on or after pan 1. 1995, the tax rate imposed ar, the net value of transfers to or for the use s_ v4ir~r sk ~ ~ ~ ~ er?t i?2 P.S. ~ a1~., 'sa 1.1 j (ii1~. The statrtte does not exempt a transfer to a surviving spouse from tax, and the statutory reou gas fnr ~~is.;l~ .u : ~~~ .~ .ef~ :rya `L^y a tex e~.,r^ ire still applicabiE ~.ve^ if the surviving spouse is ti~~e only beneficiary. Fc,~ dates o` !eatr <~~~~ or after Jr.~ly i 2'~u0: Ti~~,e tax ~ to mtiosed on the net value of transfers from a deceased child 21 years of age or younger at death to ~. f;,. the t<se o` ~tG~c! .ter t. ~n adoptive ;arer~t cr a stepparent of the child is 0 percent [72 P.S. §9116{a',{1.2)J. s The tax r.~.te :posed on the net v~olue of transfers to or for the use of the decedents i;neal beneficiaries is 4.5 pe~^ent. ?z _.pt as rover r. [~ ~ S =~:~ 1 r a fi't'. The tax ate m~osed on the ~e,. ~Gialue of transfers to or for the use of the decedents s;blings is 12 percent X72 P.' ~?'161~~. ~ .?;. ~ ~I ,,~ ~=tire:. untie 5~..to ~ ?102. as a~~ -^^ivi~.iual who has at least one parent in Gammon with the decedent, whether by „icoe c; co~t~.cr. . ~ ~~ pennsytvania SCHEDULE A DE~M.RTMENT OF ?EVEP+VE _ REAL ESTATE ~,:_ _ _ ~<<.~ 1,T~,.~,~wT ESTATE QF ~ FILE NUMBER -- - -- Dorathv Neer ___ _ 21-1 s-_C ~ ~L -----------_-- A!i real property awned solely or as a tenant in common must be reported at fair market value. Fa'r ma K:et ~.z! : _ ~ ,;,_f : ~ ' .,_ . , -,:,_- .... .. ., ~~ .. _ _ .i tt' ,. .. '7 ,iVC" 2'?U~ c ,N ".a Seel e` ''f':t",e ~~.^.y CTiae' 8d .. Duy G' gel. bCtl" E~".g ..35~"c.-.~. .- ..- .i - - "--- Real property that is jointly-owned with right of survivorship must be disclosed on Schedule i= ~~ ~~~ 4ttach a cow of the settem~e~nt s~eet f tre ~~operty nas bee^ sold. .,_ ~ .,ov of tie deed s~o~`~ma decuae~t's irt. ,.st ~t cv>,.Pd as +e^a~t ~~ o m,... "1 - DF~CA.iP?i~N House at 3~2 past CJrange Street; Shippensburg, PA 17257 TOTAL (Also enter on Lira 1, Recdn ~~at::--~ ~ ,~~ ; ~t~L~ if ~,Ttare soac~; s ~.~.e~ed .1 r:.sert -:~d t cn~ s sets of t~~~e sa~r~e s'~z:e. ~~ ~ i ~~. ~~ ~'~~ ~~ SCHEDULE ~ ~~x~~, . ~.. ~,~ , ~ ~ ~~~~ ~ r Er~~~s r ;A ~,A STOCKS & BONDS .!c~liT4``d~E TAX RE'UFi~d ?FS';C;;"_N r DEOEDE~J? ESTRTE 0~ =1LE NUMBER . _-_._ _ _ _ ___ Dorothy M__[~ti° ---- -----. --- -_~~ __ ----------- -- -- _ '~ ~_t- .~ 142-- A!I property jointly-owned with right of survivorship must be disclosed on Schedule F. T'i,1 ~ 1LilE A C~ NUT`l!B~R DESCRIPTION ~J~= t?EA?-~ ! ?'28 Shares Of International Business Machines common stock; CUSIP 459200-10-1 y ,~,_ ~, ' ~ 4 8 TJTAL (Also enter on line 2. i~eca~ituiat;^r~ 5 -•- - ~ ~- !!f more space is needed. insert adcitional sheets of the same sizei +E -1;~~3 F X- i ~` Pennsylvania SCHEDULE E cE ,a=~.M~r,T ~~~ aevF~,ue CASH, BANK DEPOSITS & MISC. ~~`~ ''~ ' ~ ~'~?'~ PERSONAL PROPERTY ESTATE OF: FILE NUMBER: ~ -,~ i~ , j_. the proceeds of I;tgation and the date the proceeds ~~~ere received 'oy the s+ate. All property jointly owned with right of survivorship must be disclosed on Schedule F huM~BER I DESCRIPTION I {?F LI-a"3 Citizens Bank - 153 V`~est Orange Street; Shippensburg, PA ~ ime Deposit Account Number 6140$97319 j Citizens Bank - 1 r:31~~Jest Orange Street; Shippensburg. PA 2 ~ dime Deposit Account Number 61406?7547 Citizens Bank- 153 G'dest Orange Street; Shippensburg, PA 3 ; Cher~?~ing Account Ni,mber 6100902420 Citizens Bank - 153 ~°~~~est Orange Street: Shippensburg, PA 4 ! t;t?eckin~ Account N~.irrtber 6100793214 `~ P 1isC Household Goods TOTAL .Also ester on ! ine 5, Recapituiencr~ ~? more space is needed, use add+tional sheets of paper of the same s.ze. ~~ ~y .~l ;> .c. ~ t Pennsylvania !;EPA ATM ENT GF r~EtiEPdLE 1 !).C JT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Decedent's debts must be reported on Schedule I. ,,; E ~,~~ ~~tiT1BEF _~_.~_ DESCRIPTION _~_ _____nP~s~Clh___.__._~.. -t- - F~-NERAL EXPENSES: F~~r~~era; Goes and Services - Fogelsanger-Bricker Funeral Home ~ ~' ~'~ 7'U'3 0~? Ft~~,eral Reception -Crider hJ~eats inc. ~ r ~ ~6 I CI~:~rch Hall Rental ~.~ ~~)~ Asti",NISTRi<TtVE COSTS: ~sc~a F .,yes-, ~ _ .,cmm~ssions; ~ ;s; ~ ~ _. a~ R~~~esentatves) S! yet ;~.:i,:i~4s5 Ctv Ye~_~sy t-~~r,~„~,_~ Pa-d: State ZIP th. .p~~ ~~ =~. . ~rr`y E,x mot r~ ' If ~eceuent's add~ess Is nct the same as c a'~rn ~ t's; ottac~ exp'~a ~atien i Cal~;ar. i St°eet =.,,~ _.. ' ~,; State i uc t cn_ ;'alm~~t tc DeceJent. 'f -: zte F::~s: i -, ~ ax Ret~: P~ _~a~~ .~~. ?raperty Tax ~ic~use and Contents t;ppraisal Fees Executrix Travel i=xpenses xecutnx Notices ~cstage StCiCi~ Transfer Fee 'iP TOTAL {Also enter on Line 9, n arrtu ~ _^~~ if mor sa~r_e s ~eeded; ~se add;to a s~eets ;;f paae~ • f tn~ sa~ i~ sze. __. <~~~, .Q r ~t7 , '~i i4 .~ -~`~I" OCR . U ~ G l ~' { 4 a~ !i(~ ti ~n ?`3Ov 5_~ pennsylvania SCHEDULE I ~E~~A ~ MEVr ~F REV~~,~E DEBTS OF DECEDENT, ~~~ ~ r?ve= ~' ~~~~'~- '~~ M(3RTGAGE LIABILITIES & LIENS ESTATE OF FILE i4UMBER Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbr:rsed medicai expenses. ;~r~:, .~~..U F JU~~If3_r DESCRIPTIQN 'Jc DF .. ilO~OFederallncomeTax.es I t i~0"!) State Irrorr~e Taxes 3 ~201~1 Federal ;ncesne Taxes a E20?1 StatelncomeTaxes r '~h, jl To be G~:tC.r.,~;,,„ c' TOTAL (Aso enter cr line 1G, Recap Uiat~;•._ ! S u,E~ ` C~i~ If more scare s r~eede~, nse~t ~d~l to~ ~' s:;^~eets c` tre same size. .'1".. ~ i ~~-1 Pennsylvania SCHEDULE , :,F':aa`~ENT°FRE~~',~~E BENEFICIARIES ,~c _. ,_ .,~, ESTATE OF; "~IUM6Eit "di•f'lt r."~C F.DuRESS OF RECEIVING RRGRERTY I -" --.9 '.E~LE DISrRIBJT;ON~ 1".C'~Ld OJkriQ`'t SpOaSd d St' "Juti:,"5 afld C a ~SY^r5 ;Jri~P.?" sec. 9'_' 6 (aj (' .Z).; ;. F ;Judith Ann Dyer: 193 Jackson 5t: San Francisco. CA 94109 2 ~ P~.,1ar;l~nn Sue Klop~: ~ 6 Goodhart St.; Walnut Bottom, PA 17266 .~ C~hnstopher A. Klopp: 2862 Bafd Eagle Pike; Tyrone, PA 16686 ~ Da~~ki E. Kiogp; 16 Goadhart St.; b'Valnut Bottom. ~A 17266 5 ,le~~nrfer L. Klopp ;Ettinger}; 615 Hummel Ave.; Lemoyne, PA 17043 6 (~.latthea~ V. Kfopp 708 Hummel Ave.'. Lemoyne. PA 17043 II TOTAL OF PART II -ENTER TOTAL NON-TAXABLE CISTRIBUTIJNS ON LINE ? 3 OF REV-! 50C C'UVEK ~-~e ____ If +r~ere space ~~s neede~ se and ~ ,:'~ s"°Pts of pacer cf the sa~~e s ~e. P,ELAiICNSHIP IU ut~:tu-r' Da Not List Trustee(s) Daughter Daughter Grandson Grandson Granddaughter Grandson !. t + c'rt DO~~.R AP1C .Part. FOR DISTRIBUTIONS SH01NN ABG`VE ON LINES 1E THRf7UGH ? 8 OF REV-_50G CVv rt cN,=t `~~ A?vbJ nI ;IF. .~° ~, r i9XA8~' DIS?R'r~ ~ IONS i ^, ~~~7USA~ DiST;iIB'- IONS UNDER. SECTION 9113 FOR J'1HICH AN ELECTION TO TAX Is NOT TAKEN: CHARi?tiBLE AND GOVERNr4ENTAL DISTRIBUTIONS: °'~ ~~ FILE NUMBER;