HomeMy WebLinkAbout06-09-11 1505610105
REV-1500°`f°'-11'(F"
PA Department of Revenue pennsylvanta OFFICIAL USE ONLY
Bureau of Individual Taxes °"""~"`"'~"`""" County Code Year File Number
INHERITANCE TAX RETURN /y
PO 80x280601 /
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Harrisburg, PA 17128-0601 RESIDENT DECEDENT
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ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW
170-42-9393 05118/2010 07126/1952
Decedent's Last Name
_ _ Suffix Decedent's First Name MI
_
Chatley George
M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
_ _ _.._- Suffix Spouse's First Name MI
Chatley Linda L
Spouse's
Social Security Number
. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
1so-4s-a2oa REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Glp 1. Original Return O 2. Supplemental Retum O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O1Q 6: Deceden4Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy oflNill) (Attach CopyofTrust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12.31.91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
_ _. _ Daytime Telephone Number
__ _ _
.... Ronald•E. Johnson, Esq ,. (717) 243.0123.. ,
..,
First Line of Address
78 West Pomfret Street
Second Line of Address
REGISTER OF WILLS USE ONLY
C
I
tri co
City or Post Office State ZIP Code ~--
_.. __ _ _.
Carlisle PA .17241
P-• s
C..3 '~~',p.
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Correspondent's a-mail address: rejohnSOnQpa.net
Under tties of pery'ury, l dedare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
tt fs t er rred end complete.~edaretictn of prppr~ other than the personal representative is based on ali information of which preparer has any knowledge.
SI RE OP PERSON POPt51 FO I NG RETURN DATE i 1
78 West Pomfret Street,~arlisle, PA(117013
DkTE -
Carlisle, PA 17013
ORIGINAL FORM ONLY
1505610105
Side 1
3
L~
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F~
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1505610105
J ~~
J 1505610205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: ' 170-42-9393
RECAPITULATION
1. Real Estate (ScheduleA) ............................................. 1. ! 41,687.20
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. 1,035.76 j
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ' 42,722.96
9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. . 9. ', 3,514.00
10. Debts of Decedent; .Mortgage Liabilities and•Liens (Schedule I)..... ,•-:..... ... 10. ', 837.27
11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ' 4,351.27
__ _.
12. Nat.Value. of Estate.(t:;iue.a~minus•.Line.la.y ..-. _ .......... . .... ......... ... 12. ' 38,3.71.69
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. 38,371.69 ',
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15: Amount of l:iraa 14 teot®bte•
at the spousal tax rate, or
transfers under Sec. 9116 __ _ _ _ _
(a)(1.2) x .0 0 38,371.69 _
15. _ _
0.00
16. Amount of Line 14 taxable _
at lineal rate X .0 _ 16.
17.
Amount of Line 14 taxable __
at sibling rate X .12 17.
18.
Amount of Line 14 taxable _.,. _
at wllateral rate X .15 18.
19. TAX DUE ....................................................... ..19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
150561025 1505610205 J
REV•1500 EX (FI) Page 3
Decedent's Complete Address:
File Number
DECEDENT'S NAME
George M. Chatley
STREET ADDRESS
42 Big Spring Terrance
CITY
Newville STATE
PA ZIP
17241
Tax Payments and Credits:
1. Taz Due (Page 2, Line 19) (1) 0.00
2. CreditslPayments
A. Prior Payments
B. Discount
Total Credits (A + B) (2)
3. Interest
(3)
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. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
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 ......................................................................................... . ^ ~ .
b. retain the right to designate who shall use the property transferred or its income ........................................... . ^
c. retain a reversionary interest ...........................................................................................................•........_....... . ^
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? ............................................................................................................. . ^
3. Did decedent own an "in trust for" orpayable-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 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 ,}an. 1; 1995; trie 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.chfid 21 years of age cr younger atdeafirty or°for~the use of anatural 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(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)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
LAST WILL AND TESTAMENT
OF
GEORGE M. CHATLEY
A~ %,'~~-
~/~ "F-H,i;:el ~~ C-~"'~lf. " (SEAL )
i . '1_
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I, GEORGE
Pennsylvania,
not acting un~
of any person
AND TESTAMENT
by me.
M. CHATLEY, having my domicile in
being of sound and disposing mind
3er duress, menace, fraud or the u
whomsoever, do declare this to be
and revoke all Wills and Codicils
the State of
and memory and
zdue influence
my LAST WILL
heretofore made
FIRST: I direct and order that all just debts for which
proper claims are filed against my estate and the expenses of
my last illness and funeral, if any, be paid by my personal
representative as soon after my death as is practicable;
provided, however, that this direction shall not authorize any
creditor to require payment of any debt or obligation prior to
its normal maturity in due course.
SECOND: I make no gift, devise or bequest to any child or
person hereinafter referred.to, except as stated.... I give,
devise and bequeath all of my estate, real, personal and mixed,
of whatsoever kind and nature and wheresoever situated,
including any property over which I may have a power of
appointment, to my wife, LINDA L. CHATLEY, if she.surviv.es me.
THIRD: In the event my wife shall not survive me, I give,
devise and bequeath all of my estate, share and share alike, to
my children,,. MICHAEL SCOTT-CHATLEY., LAURIE ANN CHA'TLE.Y,. BRENDA
LEE FOSTER, .and any child or. children who. may be. born to or
adopted by me hereafter; or, if any of these children shall not
survive me, then to the issue, living at my death, of any
predeceased child or children, such issue to take per stirpes
and not per capita. The share of any predeceased beneficiary
herein not survived by issue shall be the absolute property of
the surviving beneficiary(ies) herein. In the event none of
these children or their issue shall survive me, then I give,
devise and bequeath all of my estate to my mother-in-law,
PATRICIA BOWEN.
FOURTH: I designate my wife, LINDA L. CHATLEY, personal
representative of my LAST WILL AND TESTAMENT, to serve without
bond, surety or security, and without the intervention of any
court or courts, save and except as by law provided. I
authori.z.e and. empower my,pers.onal.,,representativ.e,..,in_her sole
discretion, to sell, convey, exchange, transfer, assign,
pledge, mortgage, lease or rent the whole or any part of~my
real or personal estate; to invest, reinvest or retain
investments of my estate; and to perform all acts and execute
all documents which she may deem necessary, convenient or
proper with regard to my estate. In the event she is unable or
11~Kr1~~
' 1.,.-
LAST WILL AND TESTAMENT OF GEORGE M. CHATLEY
unwilling to serve, then I designate my mother-in-law, PATRICIA
BOWEN, personal representative of my LAST WILL AND TESTAMENT,
in like manner. I direct my personal representative to apply
for any U.S. Government survivor's benefits which may be due as
a result of my military service, and for any available social
security benefits and •life-insurance policy proceeds.
FIFTH: In the event my spouse does not survive me and I
die leaving a minor child or children surviving me, I hereby
appoint my mother-in-law, PATRICIA BOWEN, as guardian of the
person and estate of each minor child- during .his.-or her
minority.
I hereby give, devise and bequeath any and all property,
whether real, personal or both, to which my minor child or
children would be otherwise entitled under the terms of this
Will to the said guardian, to be held in trust for the benefit
of the said minor child or children. The guardian shall have
the power to use the property in her sole discretion, but only
for the material and educational needs of the minor(s). When
any minor shal'Y reach the age of majority, any residue corpus
or income remaining attributable to that child's share shall
become the absolute property of that child.
SIXTH: Wherever in this, my LAST WILL AND TESTAMENT, it is
pr.ovided.that..any person shall benefit hereunder if such person
shall survive me, such person shall be deemed not to survive me
if he or she shall. die .within sixty (60) days after my death.
I~ITyEBS WHERE.. I haue,,_..at<,.Fort., Lews~_ Washington, on
this .~ da of _ 'C. , 19 ~~,. set .my hand. and seal to
this, my LAST WI'hL'AND"TESTAMENT, consisting of two typewritten
pages, this included, and the preceding page hereof bearing my
signature.
~j % ,
~% ~ c~_ SEAL)
l
The foregoing instrument (consisting of two typewritten
pages, thi~/,~~, included) was, at Fort Lewis, Washington, this
day of ~L/EC• , 19 ~~,. signed,. sealed, published
and declared by the above-named Testator to be his LAST WILL
AND TESTAMENT, in the presence of all of us at one time. At
the same time, we, at his request and in his presence and in
the presence of each other, have hereunto subscribed our names
as attesting. witnesses. and_ do ver.i.lx.b.elieve..ahat.,the•..sa~id..~., „.
Testator is of sound and disposing mind and memory at the date
hereof.
~~~'~/, ~~.~~,- ~/~~-Ca.,tft;i-~-RESIDING AT ~~~ct~'.~`;~~~.c~ X4.'/7...
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'~~G~•-si G•-f.-~~-~.;~ RESIDING
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AFFIDAVIT OF TESTATOR AND SUBSCRIBING WITNESSES
STATE OF WASHINGTON )
COUNTY OF PIERCE )
Before me, the undersigned authority, on
GEORGE M. CHATLEY ,
known to me to be [he Testator/Testatrix and
whose names are subscribed to the annexed or
respective capacities. All of sc:id persons
the said persons declared as follows:
this day personally appeared
~t.~,-gyn. ~~~-, N1u~~ «~~5~ ,
the witnesses, respectively,
foregoing instrument in [heir
k ing by me first duly sworn,
GEORGE M. CHAT);EY , 1'estaror/Testatrix, declared to me and
to the said witnesses in my presence that he/she had signed and executed the
said instrument as, and the same is, his/her LAST WILL AND TESTAMENT, and that
he/she willingly made and executed it as his/her free and voluntary act and
deed.for the purposes therein expressed.
The said witnesses, each on his oath, stated to me in the presence and
hearing of the said Testator, that each was eighteen years of age oz older,
and not disqualified by reason of mental incapacity, personal interest, or
conviction of crime; that the said Testator/Testatrix had declared to them that
the said instrument is his/her LAST WILL AND TESTAMENT; that at the Testator/
Testatri.x's request and, with each in the presence of the Testator/Testatrix
and the others, they had witnessed at FORT LEWIS, WASHINGTON, COUh}TY°OF~PIERCE,
the Testator/Testatrix's signing and execution of the said instrument as his/her
LAST WILL AND TESTAMENT on the date which it bears; that at the request of the
Testator/Testatrix in attestation thereof to subscribe t„}~,pir names,as witnesses
thereto, they, then and there, on the day,. ~f.t.he date...o.E..sa.id Wi11., in the
presence of the Testator/Testatrix and each other, did subscribe their names
thereto as witnesses to the said instrument; that the Testator/Testatrix was
eighteen years of age or older, was of sound and disposing mind and memory and
not acting under duress, fraud, undue influence or misrepresentation; and that
they make this affidavit at~th~e request of the Testator/Testatrix.
_-----~,~CT~ATOR/TESTATRIX W NESS
•i _
r ~ ~.
1 WITNESS
7
WITNESS
Subscribed, sworn and acknowledged before me by GF.ORC;F. M. CHA Fy ,
Testator, a\ns subscribed and sworn before me by /~hi-}~c~ -~~-~~ /ti~ci,rg: x,~ir~ ,
-J C~~/ ~t:'~t f;~.~~5 ! ~G~J~6E ~ti-%lTi~//~~`~ witnesses,
this ~ day of /~~Ni7J~//~.e' A. D. 19 `~~ ..
My Commissfi. n Expires: ~ ,~,,,f~ .,G+a~ Y~ ,~~""„~[,,M~
.` ~ Notary P.u' is in and, for th~S
Washing on, residing at
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
George M. Chatley 21-10-0678
All real estate owned solely or as a tenant in common should be reported at fair mazket value with is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to sell, both having reasonable knowledge of the relevant facts.
with ltieht of Survivorship must be disclosed on Schedule F.
ITEM I DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
ALL THAT certain parcel of land situate in Jackson Township,
Venango County, PA on Township Road 549 containing 0.897 acres and
improved with a mobile home and 1 1/2 story dwelling house.
See Venango County Deed Book 891, Page 1121
Assessed valuer 38;960
Common Level Ratio: 1.07
$41,687.20
Total (also enter on Line 1, Recap) $41,687.20
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
M.
21-10-0678
Include the proceeds of litigation and the date the proceeds were received by the estate
TOTAL (also on line 5, Recapitulation) $1,035.76
SCHEDULE H
A.
B
FUNERAL EXPENSES, ADMII~IISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF FILE NUMBER
George M. Chatley 21-10-0678
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral Expenses:
1
2
Administrative Costs:
1 Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s) commissions paid:
2 Attorney fees to Andrews & Johnson $3,300.00
3 Family. Exemption
Claimant
Street:
City: State & Zip
Relationship of Claimant to Decedent:
4 Probate Fees to Register of Wills $145.50
5 Accountant Fees to Patricia Rosendale, CPA
6 Tax Return Preparer's Fees
7 Action Closing & Title Co -lien search on Venango County property $53.50
8 Register of Wills -filing fee $15.00
9
10
11
12
13
14
15
16
17
18
19
TOTAL (also on line 9, Recapitulation) $3,$14.00
SCHEDULEI
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF FILE NUMBER
Report debts ineumd by the decedent prior to death which remained mpaid as of the dah of dead[, including unreimbursed medical expenses.
TOTAL (also on line 10, Recapitulation) $837.27
SCHEDULEJ
BENEFICIARIES
ESTATE OF
FILE ~I~FEJ1vFBER
Geor e M. Chatley 21-10-0678
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (include autrig6t epwcd dietriWdons, uid transfers under Sec. 9116(nHl.2)]
I Linda L. Chatley
42-Big Spring Terrace, Newville, PA 17241 wife 100%
II
SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CLaritable and Governmrntal Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0