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
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9. Litigation Proceeds Received .
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. Spousal Poverty
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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:
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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
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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
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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.
~ ~~
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(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.
~.
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~07'ARI,~-L SEAL Notary Public
j PATFICIA D. OLYARN
! ~~mpdert Twp., Cu ~ Notary Pubic
mbe~land Caen , PA
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