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HomeMy WebLinkAbout06-15-11 (2)1505610148 REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN ;? 1 1, 0 0 61, 7 Harrisburg, PA 1 7 1 28-0601 RESIDENT DECEDENT _ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth 11AMDDYYYY 0609201,0 1,1,291,929 Decedent's Last Name Suffix Decedent's First Name M I MEREDITH CARL A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I MEREDITH LOURENE D Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 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 0 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 ^ 1 'i . 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 RICHARD C• SNELBAKER, ESQ 71,7-697-8528 First line of address 44 WEST MAIN STREET Second line of address P•0• BOX 31,8 City or Post Office State ZIP Code MECHANICSBURG PA 1?055 Correspondent's a-mail address: REGISTER O~ILLS USE O1` ~ ~ ~ .~~ ~ ,~ ~ ~; ~ ~ ~TE FILED .= ~ ~ S; ., I t C 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 other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR F PERS N P SIBL OR F LING RETURN DATE /''~' ~0 ~/ ~ J / ADDRESS o ee er even Eire i 108E st Earl Street, Boilin S rings, PA 17007 1535 RidgE~ Road, PA 17365 SIGNA SPARE THE AN REPR TIVE DATE ~~~r`~ ADDRESS RICHARD C• SNELBAKER 44 WEST ~1AIN STREET, ~1ECHANICSBURG PLE E USE ORIGINAL FORM ONLY PA 17055 Side 1 15 0 5 61014 8 9M4647 4.000 15 0 5 61014 8 1 1505610248 J REV-1500 EX DecedenYsName: MEREDITH CARL _ A 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, 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1 through 7) 8 16, 359.93 0.00 0.00 71, 413.97 4 , 307.18 56,236.50 148,317.58 9. Funeral Expenses and Administrative Costs (Schedule H) , , g 5 , 4 21.31, 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 2 8 8 • L 4 11. Total Deductions (total Lines 9 and 10) , 11. 5 , 7 0 9 • 4 5 12. Net Value of Estate (Line 8 minus Line 11) 12. 14 2 , 6 0 8 • 1, 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , , 13. 0 • 0 ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. L 4 2 , 6 0 8.13 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 16. Amount of Line 14 t xable 4~ at linealrateX.O 142,608.13 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 ~ . 0 Q 18. 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610248 1~i05610248 9M4648 4.000 0.00 6,417.37 0.00 0.00 6,417.3? X^ J REV-1500 EX Page 3 Der_edent's C~mnlete Address' File Number ~i, i,n n~,i,~ DECEDENTS NAME MEREDITH CARL A_ STREET ADDRESS MIDDLETON TOWNSHIP C M R AND OUNTY CITY STATE ZIP CARLISLE PA_ 17015- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 5, 0 0 0. 0 0 B. Discount 2 5 0. 0 0 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) (1> . 6,417.37 5, 250.00 (3) 0.0 0 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1 , 16 7 • 3 7 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: Yes ^ No a. retain the use or income of the property transferred; retain the right to designate who shall use the property transferred or its income; b ^ . ^ c. retain a reversionary interest; or . ^ d. receive the promise for life of either payments, benefits or care?. 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death ^ without receiving adequate consideration? . " ' " ^ in trust for or payable-upon-death bank account or security at his or her death ? 3. Did decedent own an 4. Did decedent own an individual retirement account, annuity, or other non-probate property, which ® ^ contains a beneficiary designation? 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 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 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 cleath 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 benefici~~ries is 4.5 percent, except as noted in 72 P.S. X9116(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.;i. §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. Total Credits (A + B) (2) 9M4671 2.000 REV-1503 EX + (8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT -- _ __ _ ESTATE OF FILE: NUMBER Carl A. Meredith 21 10 0617 All property jointly-owned with right of survivorship must be disclosed on Scheclule F. 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) ~?~?~lated Value of Your Paper Savings Bond(s) ~~~~~-~- (:~ ~~ ~~ ~ 1 Page 1 of ., ~~ ~~ ~~ Calculated Value of Your Paper Savings Bond(s) `~ """"`" ~" " Calculator Results for Redemption Date 06/2010 T~t~ ~°~~~ Total ~~~~ Totat ~nt~r~st ~T~ nt~r~st $100.00 $181.56 $81.56 _ $2.24 Bonds: 1-3 of 3 ~:~"la ~r~~~ ~nt'4~ u ~l<n~~ Issue ntr°~st nt~E"~~>~ V~~ l~ N'! Da~~ AC~r~a"~ M~t~rl~'~` ~'rpG~ ~ . L588647569EE `' EE $50 08/2000 07/2010 08/2030 $25.00 ' $10.5;2 2.19% $35.52 C607543438EE EE $_1.00: _.04/1997 10/2010; 04/202,7. .__,..$50.,00. _.,,$30.28 2.06% ' $80.28 _ ~~, L495621404EE _ EE $50 12/1991., :.,,,12/2010..;_ 1,2/202,1 .,,.,,$25.00 ._....,$.40.,,76... .4.00% $65.76.... . _ Tota Is for 3 Bonds $100.00 81.56: .. . 181.56 oe NI Not Issued __ _ NE Not eligible for payment _ _ __ _ _ P5 Includes 3 month interest penalty __ __ __ MA Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 3/3/201 REV-1508 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Carl A. Meredith _ 21100617 Include the proceeds of litigation and the date the proceeds were received by the estate. 3W48AD 1.000 (If more space is needed, insert additional sheets of the same size) REV-1509 IX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Carl A. Meredith 2.1 10 0617 If an asset became jointly owned within one year of the decedent's date of death, rt must be reported on Schedule G. SCHEDULE F JOINTLY-OWNED PROPERTY SURVNING JOINT TENANT(S) NAIVE(S) I ADDRESS ~ RELATIONSHIP TO DECEDENT A Meredith, Steven M 1535 Ridge Road, Wellsville, PA 17365 Son B Wheeler, Jody A 108 East Earl Street, Boiling Springs, PA 17007 JOINTLY OWNED PROPERTY: Daughter ~~ NUIVBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME a: FINANCIAL INSTITUTION AND BANK ACCOUNT NUM3ER q2 SIMLAR IDENTIFYINGNUM3ER. ATTACH DEED Fq2 JgNTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °~o OF [)ECEDENT'S INTI7~EST DATE OF DEATH VALUE OF DECmENTS INTT32EST 1 BA 10/5/1990 M&T Bank 10,080.88 33,.3300 3,360.29 checking account #1058010 2 BA 10/29/198 7 M&T Bank 2,840.66 33„3300 946.89 savings account #15004200116893 TOTAL (Also enter on Line 6, Recapitulation) 3 4 , 307.18 9W46AE 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) SCHEDULE G Pennsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT _ ESTATE OF FILE NUMBER Carl A. Meredith 21 10 0617 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 NUMBE DESCRIPTION OF PROPERTY INCU.OETI-EN4MEOFTFETRANSFEREE,TFEIRRELATIONSHIPTODECEDENTAND TFf DATE OFTRAtySFER. ATTPGiACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD~S INTEREST E)CCLUSION APPLICABLE TAXABLE VALUE 1. Prudential Annuties 56,236.50 100.0000 0.00 56,236.50 annuity #E0259654. Beneficiaries are decedent's children (Steven, Michael, Jody and Tonya) TOTAL (Also enter on line 7, Recapitulation) $ I 56 , 236.50 If more space is needed, use additional•sheets of paper of the same size. 9W46AF 2.000 REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Carl A. Meredith 21 10 0617 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Gingrich Memorials inscription on marker 160.00 Total from continuation schedules ~ 839.41 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. Attorney Fees: Snelbaker & Brenneman, P. C. 3 , 000.00 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: 10 4 . 5 0 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Cumberland Law Journal advertise Executors' Notice 75.00 2 Register of Wills short certificates 8.00 Total from continuation schedules 1,234.40 TOTAL (Also enter on Line 9, Recapitulation) $ 5 421.31 swasA~ z.ooo If more space is needed, use additional sheets of paper of the same size. State ZIP Estate of: Carl A. Meredith Schedule H Part 1 (Page 2) Item No. Description 21 10 0617 Amount 2 Lourene D. Meredith reimbursement for funeral expenses paid to Hollinger Funeral Home 839.41 Total (Carry forward to main schedule) 839.41 Estate of: Carl A. Meredith Schedule H Part 7 (Page 2) 3 4 5 Register of Wills filing fee for Inheritance Tax return The Sentinel advertising Executors' Notice Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the decedent's estate 21 10 0617 15.00 219.40 1,000.00 1,234.40 Total (Carry forward to main schedule) REV-1512 EX+(12-oa) SCHEDULE pennsylvania DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 10 0617 Carl A. Meredith Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1• AARP 37.40 premium due on medical RX plan 2 Cumberland Goodwill EMS 130.00 ambulance service 3 Riverside Anesthesia 120.74 medical expenses TOTAL (Also enter on Line 10, Recapitulation) ~$ 288.14 BwasAH 2.00o If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) SCHEDULE J pennsylvania DEPARTMENrOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER: ESTATE OF: 21 10 0 617 Carl A . Meredith RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1, Tonya L. Meredith Motter 408 Kerrsville Road Carlisle, PA 17015 Dau hter 34,575.24 One Quarter of Residue: 34,575.24 g 2 Michael A. Meredith 521 Park Drive Boiling Springs, PA 17007 Son 34,575.24 One Quarter of Residue: 34,575.24 I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. ~[ 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 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. $ 0.00 9W46AI 2.000 Estate of: Carl A. Meredith Schedule J Part 1 (Page 2) 21 10 0617 Item Relation Amount No. Description 3 Jody A. Wheeler 108 East Earl Street Boiling Springs, PA 17007 MST Bank Inventory Value: 473.44 M6T Bank Inventory Value: 1,680.14 Dau hter 36,728'83 One Quarter of Residue: 34,575.24 g 4 Steven M. Meredith 1535 Ridge Road Wellsville, PA 17365 M&T Bank Inventory Value: 473.44 M&T Bank Inventory Value: 1,680.14 Son 36,728.83 One Quarter of Residue: 34,575.24 LAST WILL AND TESTAMENT I, CARL A. MEREDITH, of the Township of South Middleton, County of Cumberland, end Commonwealth of Pennsylvania, being of sound and disposing; mind, memory and znderstanding, do make, publish and declare this as and for my Last ~1Vill and Testament, hereby -evoking ~~nd making void all`formzr ~-~ills and codicils ??y me at an~~time heretofore made. FIRST. I order and direct that all my just debts and funeral e~:penses be paid by my Executors, Executor or Executrix, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wlieresoever situated, in equal shares unto my four children, namely, TONYA L. MEREDITH MOTTER, MICHAEL ~~. MEREDITH, JODY A . WHEELER and STEVEN M. MEREDITH, share and share alike, a~-solutely and in fee simple If any of my said children should predecease me and leave lawful issue to survive him, Iher or them, I order and direct that the foregoing share attributable to any such deceased child shall be distributed unto his, her or their lawful issue per stirpes by rf~presentation and not per capita. LASTLY. I nominate, constitute and appoint my two children, namely, JODY A. WHEELER and STEVEN M. MEREDITH, to be the Executor of this my Last Will and Testanent, to serve without bond or other security as a condition of qualification hereunder. If either of said persons should fail to qualify as my personal representative or cease so to serve, I order and direct that the person so qualifying or remaining shall serve as sole Executor or Executrix, as the case may be. IN WITNESS WHEREOF, I, CARL A. MEREDITH, have hereunto set my hand and LAW OFFICES SNELBAKER & BRENNEMAN, P.C. seal to this my Last Will and Testar Herat, wlllcli consists oI tw~.~ (?} tg-pe«~ritten pages tc each of. which I have affixed my signature this ~ s~day of February, A.D., 'Two Thousand Six (2006). (SEAL) CARL A. MEREDITH The preceding instrument, consisting of this and one other typewritten page, each ientified by the signature of the Testator, was on the date thereof signed, sealed, published and eclared by CARL A. MEREDITH, the Testator therein named, as aald for his Last Will and ,estament, in the presence of us, wlio, at his request, in his presence and in the presence of each LAW OFFICES SNELBAKER & 3RENNEMAN, P.C. Ither, have subscribed our names as witnesse reto. MMONWEALTH OF PENNSYLVANIA) OUNTY OF CUMBERLAND SS. We, CARL A. MEREDITH, RICHARD C. SNELBAKER and JANE J. GOONEY, the Testator and the witnesses, respectively, whose names are signed to tb.e attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Test<~.ment and that he had signed willingly, and that he executed it as leis free and voluntary act ~:or the purposes therein expressed, and that each of the witnesses, in the presence and heari~ag of the Testator, signed the Will as a witness and that to the best of his or her knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. T tator Witness W~ c~.~ _ Subscribed, sworn to and acknowledged before me by CARL, A. MEREDITH, the Testator, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J. GOONEY, the witnesses, this ~ s~ day of February, 2006. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Susan L. Matrazi, NotaryPublic - Mechanicsburg i3oro, Cumberland County Notary Public My Commission Expires Nov. 24, 2007 Member, Pennsylvania Association Of Notaries -2-