Loading...
HomeMy WebLinkAbout07-08-11 1505610148 1500 EX REV (01-10) - OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN 21 11 0 2 71 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth NIMDDYYYY 188-32-4883 021,82011 1,1071918 Decedent's Last Name Suffix Decedent's First Name' M I PAGE ANNA ELLEN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I 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) ^ A th ^ 11 9113 El ti t t d S ^ 10 di t f d C d 9. Litigation Proceeds Received . ) er ( ec on o ax un ec. re a e o ea . Spousal Poverty t ( 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 Daytirne Telephone Number RICHARD C• SNELBAKER 717-697-8528 _„ 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 17055 Correspondent's a-mail address: ~~ ,~~ REGISTER OFOIIII~S USE ON(~ ~ ~ ~~ ~•- ~ ~ ~ r r ,+' Cri ~ CA , ~~Q~ -, . ~~ ~~ - ~" . __ ~ ~ DATE FILED 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 f preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA r ~ F~ERS~SPON IB F R FI RETURN ~A ~0~~ ADD ESS ~j~ CHARLES - PAGE, JR• 1,10 STANDLAKE WAY, MECHANICSBURG SIGNATURE F f~ THER THAN REPRESENTATIVE DATE pA 17055 '. f- t, ~~ ~ ~ _~:~+ ~~~=~ ,= ~. ~'' i "z"i ADDRESS RICHARD C• SNELBAKER 44 WEST MAIN 'STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY 1505610148 Side 1 9M4647 4.000 1505610148 J~"`~" J 1505610248 REV-1500 EX Decedent's Social Security Number 188-02-4883 DecedenYsName: PAGE ANNA EL LEN RECAPITULATION 1. Real Estate (Schedule A) 1. Q . Q 0 2. Stocks and Bonds (Schedule B) . 2 1, ., 0 9 3 • 8 8 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3. 0 . 0 0 4. Mortgages and Notes Receivable (Schedule D) 4. 0 • 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 8 4 , 5 6 0.6 6 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g. Q . Q Q 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. Q . 0 0 8. Total Gross Assets (total Lines 1 through 7) g. 8 5 , 6 5 4 •5 4 9. Funeral Expenses and Administrative Costs (Schedule H) , , 9. 12 , 8 6 7.7 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 2 0 8 •0 5 1 1. Total Deductions (total Lines 9 and 10) , 11. ~ 3 , 0 7 5 8 2 12. Net Value of Estate (Line 8 minus Line 11) 12. 7 2 , 5 7 8 •7 2 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , , 13. 0 • 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 7 2 , 5 7 8.7 2 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 (a)(1.2> x .o - 0 .0 0 15. 0.0 0 16. Amount of Line 14 t xable 4~ at linealratex.o 72,578.72 16. 3,266.04 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. Q• Q Q 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. Q• Q Q 19. TAX DUE 19. 3 , 2 6 6.0 4 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT X^ Side 2 1505610248 1505610248 9M4648 4.000 REV-1500 EX Page 3 1'lnrpripnt'c C:mm~lptp Orlrirpcc~ File Number DECEDENTS NAME PAGE ANNA ELLEN STREET ADDRESS TOWNSHIP ~ ~ CUMBERLAND CITY STATE ZIP MECHANICSBURG PA 17055- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments 2, 5 0 0. 0 0 B. Discount L 2 5• 0 0 Total Credits (A + B) (2) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 3, 266.04 2,625.00 (3> _ 0.00 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; f i i ^ 0 erred or ts ncome; b. retain the right to designate who shall use the property trans ^ 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? . " " ^ or payable-upon-death bank account or security at his or her death's in trust for 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. X9116 (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 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. 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.:>. ~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. 9M4671 2.000 REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Anna Ellen Pa~c e 21 11 0271 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 3wasss 1.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (11-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Anna Ellen Page 21110271 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Belco Community Credit Union 4,226.13 savings account #121130-S1 2 Belco Community Credit Union 30,174.95 money market account #121130-S14 3 Belco Community Credit Union 23,673.47 certificate of deposit account #121130-66936 4 Belco Community Credit Union 13,359.96 certificate of deposit account #121130-64601 5 Bequest of China Dishes to Pauline Page under codicil dated February 23, 2000 325.00 6 Bequest of Diamond Ring to Nancy Brown under codicil dated February 23, 2000 250.00 7 Cash 630.26 found in decedent's possessions 8 Erie Insurance 44.00 refund on renters insurance 9 Gift cards 92.83 belonging to the decedent as follows: a. Cracker Barrell b. Subway c. McDonalds d. Red Lobster e. Wendys f. Boscovs 1 Household Goods 672.00 proceeds from auction 1 Household items retained by family 475.00 1 Sovereign Bank 10,189.64 checking account #1681720795 1 Sovereign Bank 439.70 savings account #1684008590 1 TV Guide 7.72 TOTAL (Also enter on line 5, Recapitulation) $ 84 , 560.66 ow46AD 2.000 If more space is needed, use additional sheets of paper of the same size. Estate of: Anna Ellen Page Schedule E (Page 2) 21 11 0271 Item Value at Date No. Description of Death subscription refund due the decedent Total (Carry forward to main schedule) 0.00 REV-1511 EX+(10-09) SCHEDULE H pennsylvania DEPARTMENTOF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Anna Ellen Page 2:1 11 0271 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Gingrich Memorials inscription on marker and base 1,440.00 B. 1 Total from continuation schedules ~ 7,770.37 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Persona- Representative(s) Street Address City State ZIP 2. 3. Attorney Fees: Snelbaker & Brenneman, P. C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 2 ,127.50 Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 153.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Belco Community Credit Union check printing fee 12.00 2 Cumberland Law Journal advertising Executor's Notice 75.00 Total from continuation schedules 1,289.40 Year(s) Commission Paid: TOTAL (Also enter on Line 9, Recapitulation) ~ $ 12 , 867.77 9W46AG 2.000 If more space is needed, use additional sheets of paper of the same size. Estate of: Anna Ellen Page 21 11 0271 Schedule H Part 1 (Page 2) Item No. Description Amount 2 Malpezzi Funeral Home funeral services 7,670.37 3 Shiremanstown United Methodist Church funeral luncheon 100.00 Total (Carry forward to main schedule) 7,770.37 Estate of: Anna Ellen Page 21 11 0271 Schedule H Part 7 (Page 2) 3 Register of Wills filing fee for Inheritance Tax Return 15.00 4 Rowe's Auction Service commission on sale of household goods 35.00 5 Sovereign Bank fee to obtain date of death values 20.00 6 The Sentinel advertising Executor's Notice 219.40 7 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the Decedent's estate 1,000.00 Total (Carry forward to main schedule) 1,289.40 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna Ellen SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21 11 0271 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. BwasAH 2 00o If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: Anna E 11 en PacJe ~ 1 1 1 ~ ~ 71 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Pauline Page 649 Picnic Road Claysburg, PA 16625 Bequest of China Dishes to Pauline Page under codicil dated February 23, 2000 Inventory Value: 325.00 Daughter-in-:Law 325.00 2 Joan V. Stare 3915 Brookridge Drive Mechanicsburg, PA 17050 One Quarter of Residue: 18,000.93 Daughter 18,000.93 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER ;'>HEET, AS APP ROPRIATE. II 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. $ 0.00 It more space Is needed, use additional sheets of paper of the same size. 9 W46AI 2.000 Estate of: Anna Ellen Page Schedule J Part 1 (Page 2) Item No. Description 3 Charles H. Page, Jr. 110 Standlake Way Mechanicsburg, PA 17055 One Quarter of Residue: 18,000.93 4 Ronald E. Page 649 Picnic Road Claysburg, PA 16625 One Quarter of Residue: 18,000.93 5 Nancy J. Brown 4070 Rufus King Court Enola, PA 17025 Bequest of Diamond Ring to Nancy Brown under codicil dated February 23, 2000 Inventory Value: 250.00 Son Son Relation 21 11 0271 Amount 18,000.93 18,000.93 One Quarter of Residue: 18,000.93 Daughter 18,250.93 J LAST WILL AND TESTAMENT OF ANNA ELLEN PAGE I, ANNA ELLEN PAGE, of Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils made by me. FIRST: I have four children: Joan V. Stare, of Mechanicsburg, Pennsylvania (born August 20, 1938); Charles H. Page, Jr., of Harrisburg, Pennsylvania (born October 27, 1939); Ronald E. Page, of Claysburg, Pennsylvania (born August 13, 1945); and Nancy J. Brown, of Shiremanstown, Pennsylvania (born January 5, 1947}. These persons and any children born to or adopted by them are described in this Will as "my issue." Provided, however, no adopted person shall benefit hereunder unless the order or decree of adoption is entered before such adapted person attains the age of twenty-one (21) years. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my children who survive me, with such property to be divided equitably among or between them. I have complete confidence that my children or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devises) wherever situate and whether acquired before or after the execution of this Will, absolutely in fee ti.~-w ~ .(~~' -1- .~ simple to my children, in equal shares, if they survive me. If one or more of my children do not survive me, then I give, devise and bequeath such deceased child's share to his or her then-surviving issue, per stirpes. FOURTH: If all the beneficiaries described in Article Third above are deceased and no other disposition of the residue of my estate is directed by this Will, then and in that event only, I give, devise and bequeath such rest, residue and remainder of my estate, real and personal, to those persons living at the date of my death who would be my heirs, their identities and respective shares to be determined in accordance with the law in effect in the Commonwealth of Pennsylvania at my death, as if I had died intestate. FIFTH: If any person under the age of twenty-one {~~~~j ~ears~~st~a~}-tjecorne entitled to any share hereunder, then such share shall immediately vest in such beneficiary, but notwithstanding the provisions herein, my Executor may distribute such beneficiary's share to any adult person standing in loco parentis, or to a legal guardian of such beneficiary, or to a custodian (to be selected by my Executor) under the Pennsylvania Uniform Transfers to Minors Act, without requiring bond of such adult person, guardian or custodian. The receipt of such adult person, guardian or custodian shall constitute a full release of my Executor for any property so distributed. SIXTH: No person shall benefit hereunder unless such beneficiary shall survive me by thirty (30) days. SEVENTH: (1) I name Charles H. Page, Jr. as my Executor. If Charles H. Page, Jr. is unable or unwilling to serve, I name Joan V. Stare as my alternate P ~ q~ 2- Executor. I direct that my Executor, and any alternates or successors, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdic- tion in which called upon to act. (2) Except as otherwise provided herein, if all of the above persons should fail to qualify as my Executor hereunder, or for any reason should cease to act in such capacity, the successor or substitute Executor shall be some attorney or bank or trust company with trust powers, which successor or substitute Executor shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my Executor or if he fails to act, signed by or on behalf of my alternate Executor, or if he fails to act, by the court having jurisdiction over the probate of my estate. (3) My Executor shall be entitled to receive reasonable compensation for services rendered, as well as reimbursement for reasonable expenses incurred. EIGHTH: (1) I give to any Executor named in this Will or any Codicil hereto or to any successor or substitute Executor all of the powers enumerated in this Will and. all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and (Fiduciaries Code, as effective and as in effect on the date of my death, during the administration and until the completion of the distribution of my estate. I direct that all such powers shall be construed in the broadest possible manner and shall be exercisable without court authorization. ~ ~~ 3- (2) My Executor is authorized and empowered to acquire and to retain, either permanently or for such period of time as my Executor may determine, any assets, including the capital stock of any closely held corporation, whether such assets are or are not of the character approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (3) My Executor is authorized and empowered to disclaim any interest, in whole or in part, of which 1, or my Executor, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended, or such similar section as may then be in effect}. (4) My Executor is authorized and empowered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor is authorized and empowered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (5) My Executor is authorized a.nd empowered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. ~~ ~ ~~ ~_ NINTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or~ right of reimbursement. l authorize my Executor to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this 26th day of July , 2000. SIGNED, SEALED, PUBLISHED, and DECLARED by ANNA ELLEN PAGE, as and for her Last Wiil and Testament, on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: ~« ~ -6'~ ts~~~ ANNA ELLEN PAG ~~ -5- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND : WE, ANNA ELLEN PAGE and Stefanie A. Morrison , Cynthia J. Rule ,and Wayne M. Pecht ,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrumen#, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly (willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or old~;r, of sound mind, and under no constraint.nr..~nr~~e ~nfluentrE. ~ -~ ANNA ELLEN AGE/ es Witness Witness P (~ Subscribed, sworn to, and acknowledged before me by ANNA ELLEN PAGE, the Testatrix, and subscribed and sworn to before me by Stefanie A. Morrison Cynthia J. Rule ,and Wayne M. Pecht ,witnesses, thlS 26th day of July , 2000. ~. _ L_. ~07'ARI,~-L SEAL Notary Public j PATFICIA D. OLYARN ! ~~mpdert Twp., Cu ~ Notary Pubic mbe~land Caen , PA . 'rty ~cr*'msssion Expires pwgust 27 2001 6- t ~ ~ ~, f ,. .. ,. ~ ~ ~. r a.~ ° ~ .. ~ , r.- ~ r~; h+_ ,,} g ~ ~ _ f /' Y ~• f n: X . I ~ ~ j ...> ~k } r ~ , <~~ .,„, ! 1 t_." ~ 1.. Vii,.,. L ~. ~ f'/o/_:,/ {{~~ ~ < ~ y' ~ .~ ti„~ N ' ~ / r G- ,. r b( -~C. ~. r .. y, . i C.x-~ ~' L~- (~ . ~~ ~ r~ ~; .1. ~_ G,{_.- -~' .~ _, is _. c ~..-( ~, ..:, ~* 'a ,...,,, t .._. i , i J ~~ ,. l)