The URL can be used to link to this page

Home My WebLink About05-25-06 (3)COMMONWEALTH OF REV- o o OFFICIAL USE ONLY ~ PENNSYLVANIA ^ ~/ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 9 ~ ~ - °~ ° ~ 7 ~, - - N R - - DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER F- LZ Herlt Robert W. Sr. 1 7 4- 3 6- 0 2 3 7 ~ DATE OF DEATH (MM-DD-Year) DATE OF 91RTH (MM-D0.Year) THIS RETURN MUST BE FILED IN DUPLICATE YYRH THE V 10/25/2005 10/17/1945 REGISTER OF WILLS C (IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Herlt Nanc C. 1 9 9- 3 4- 9 9 3 4 ~ ®1.Original Retum ~ 2. Suppk~rtlental Retum ~ 3 Remainder Relum (aam oraean ~ora fz-1382) Y 6~y Y ~ 4. Limited Estate ~ 4a. Future Interest Compromise (deleaeealn alEer f2-r2~zJ . p ~ 5 Federal Estate Tax RetUm Required W o0 tai g m X^ 6. Decedent Died Testate (Allacn copy dwlm ~ 7. Decedent Maintained a Living Trust IAmd) copy orTnuU . _ 8. Total Number of Safe Deposft Boxes 9. Litigation Proceeds Received ~ 10. Spousal POVerty Credti (dale of death balween 72-31.81 and 1-I-95) ~ 11. Election to tax under Sec. 9113(A) (Arun scn of NAME _.. ~ OMPLETEMAILINGADDRESS ~ ~~~~ ~~~~ c Richard L. Bushman Es uire 16767 Path Valley Road ~ FIRM NAME (IfApplicaWe) PO Box 51 p TELEPHONE NUMBER 717 349-7657 S rin Run PA 17262 1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY 2. Sbdcs and Bonds (Schedule e) (2) 3. Closely Hekl Corporation, Partnership orSole-Propdetorship (3) '= na ' ~ ~ ^~7 4. Mor(gages & Notes Receivable (Schedule D) (4) ; ~ ..4,,, 5. Cash, Bank Deposits & MLscellaneous Personal PropeAy (5) 816.83 I ~ --c " ' ~~ T ~ -T Z (Schedule E) ~ `TT uT O 6. Jointly Owned Property (Schedule F) (6) 0.00 ~ i ~*^ ~ f Separate Bllling Requested _ -_.' _- t-~--~ . ' ~ 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate PropeAy (7) r r r - ~ ~~ a V W DC rvv„wvrc v w ~/ ~ 8. Total Gross Assets (total Lines 1-7) (8) 816.83 9. Funeral Expenses & Administratlve Costs (Schedule H) (9) 7, 582.47 10. Debts of Decedent, MoAgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductlons (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charttable and Governmental BequesLSlSec 9113 Trusts for which an election to tax has not been made (Schedule J) Z O Q H a t;1 14. Net Value Subject to Tax (Line 12 minus Line 13) (11) 7,582.47 (12) -6, 765.64 (13) (1a) -6,765.64 Stt rNSIRUGTIONS ON REVERSE SDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal ~x rate, or transfers under Sec. 9116 (a)(1,2) 0.00 X _ 16. Amount of Line 14 taxable at lineal rate 0.00 X 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 19. Tax Due 20. (15) 0.00 (1s) 0.00 (17) 0.00 (18) 0.00 (19) 0.00 Decedent's Complete Address: STREETADDRESS 633 Brandy Run Road CITY STATE LP Newville PA 17241 Tax Payments and Credits: 1 • Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InterestlPenalty if applicable D. Interest E. Penalty (1) 0.00 Total Credits (A + g +~) (2) 0.00 Total InterestlPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAY#AENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +SA. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER IONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS THE FOLLOWING QUEST 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ................................................................... ........ ^ ^X b. retain the right to designate who shall use the property transferred or its income : ................................ ........ ^ ^X c. retain a reversionary interest; or .............................................................................................. ........ ^ ^x d. receive the promise for I'rfe of either payments, benefits or care? ..................................................... ........ ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ........ ^ 0 3. Did decedent own an 'intrust for" or payable 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. Under penalties M pery'ury, I declare that I have examined Baia realm, inGuding accom ying schedules and statements, and to the best of my knowledge and belief, it is hue, cared and complete. Declaration of preoarer otlrer than the personal represve is bsaed araM IMomiatlon of vrl~h preparer has ~y knowledge. 164, ADDRESS 16767 ~tb(X/all~4 Road,~'O Box 51 S ri un PA 17262 For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% ]72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0°k [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 twenty-one 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% [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 benefiaades is 4.5°'0, except as noted in 72 P.S. §9116(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°k [12 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. REV-1508 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Indude the prose AH properly joiMF ITEM JMBER 1. Tricare Health Services refund 2. Hewlett Packard refund 3. eMachines refund 4. Hershey Medical Center refund 5. Sprint Nextel refund the date the proceeds were received hY the estate. of sunrhrorship must be d4cbsed on Schaduk F. TOTAL (Also enter on line 5, Recapitulation) ~ S (If more space i5 needed, insert additional sheets of ttm same size) VALUE AT DATE OF DEATH 603.14 50.00 50.00 100.00 13.69 REV-1511 EX + (12-99) • , '7F~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OP SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Egger Funeral Home, Inc. 6,195.00 B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representatlve (s) Nancy C. Herlt Sodal Security Number(auEIN Number of Personal Representative(s) 199-34-9934 streetaddreaa Conodoguinet Mobile Estates, Lot 164 City Nevvville state PA Zip 17241 Year(s) Commissbn Paid: W81Ved 0.00 y. AttomeyFees Richard L. Bushman, Esquire 1,000.00 3. Fatuity Exemption: (If decedent's address is not the same as daimanrs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4• Probate Fees JCP fee - $10, filing fee for Letters Testamentary - $45, Short Certificates - 100.00 $20, Automation fee - $5, filing fee of Will - $15, filing fee for Release - $5 5 Accountant's Fees 6. Tax Retum Preparer's Fees 7. Cumberland Co. Legal Journal -estate advertising 75.00 8. Carlisle Sentinel -estate advertising 93.47 9. filing fee of PA Inheritance Tax Return 14.00 10 notary public 5.00 TOTAL (Also enter on line 9, Recapitulation) I S (If more space is needed, Insert additbnal sheets of the same size) REV-1513 EX + (a~nm ^ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [ndude o ht spousal d~bibutions, and bansfers under Sec. 9116 (a (1.2)) 1. Nancy C. Herlt, Conodoquinet Mobile Estates, Lot 164 Collateral 0.00 Newville, PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS L TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ; (u ~rnnn spacx is neeaea, msen aaamonai sneers m me same size) ~~s~ ~1,~. ~x~d' C~~,~~xn~en~ or - nonanT rums AsnL: BE IT lOiONN that I, ROBERT WAYNB HERLT, a resident o! Putnam County, Florida, do make, declare and ordain, and by theta presents have made, declared and ordained this to be my Last will and Testament, hereby revoking any and all tastasantary 8lspositions heretofore at any time made by me. DIVISIOA I FIRST: I direct the payment of ny funeral expaneas and o! all singular my other just debts and obligations. SECOND: i give and davisa such of ay tangible personal property as say be designated and in the manner so designated in a separate writing in axlatanca at the time of my death which writing shall have base signed by sa and shall have described the items devised and the devisees with reasonable certainty, in accord with the provisions o! chapter 7)2.515, Florida Statutes. THIRD: All the rest, residua, and remainder of my astata, of whatsoever nature and wheresoever situated, lnoluding the proceeds of any policy or policies of insurance on my life and payable to my estate or to my parsoNal representative, I give and davisa to my wife, NANCY CATHERINE HERLT. FOURTH: I nominate, constitute, and appoint my wife, NANCY CATHERINE HERLT, o! Post Oflica Box 467, Georgetown, Florida 321)9, as personal rapresentatlva of thin sy Last Nill and Testament. However, in the event she should bo unwilling or unable for any reason to so serve, than and in that avant, I nominate, aonetituta, and appoint, HETTY-ANH LEB HERUf, of A. D. 1, Sox Sf2, elairs Mills, Pennsylvania 1721) to serve in my wife~^ stead. 3 Tha personal rapruentativa Hamad above, as wall as the ~ alternate personal rapressntativa eased above, shall serve, i! at all, free frw obligation or requirement of giving surety.bond, and shall ba wasted with the broad powers o! aanagament, sale, end disposition of my estate as provided in chapter 7)3.612, 7)3.61)(2), Florida Statutes (1995). DIYIBION II In the svsnt ay wits, NANCY CATHERINE HERLT, should predscaase ma, or i! va each die under circumstances such that the slmultanaous death law, section 732.601, Florida Statutes (1995) would ba applicable, all of my property (real, personal, end mixed) of which I die seised and poasusad or to which i may be entitled at the Lima O! my death, and sth.r than ta~~ daecri~ in Di ~sion L perecranh "aecond•. i give and davisa to epch of my fiw children, MELISSA JO RENAULT, DONNA LEE BIEVENDUR, ROBERT WAYNB HERLT, JR., TRACY LEE SMITH, AND BETTY-ANN LEE HERLT, share and share alike, equally. In the event one or more of my five children should die prior to my death or in the avant one or fore of said ehildran survives ma but disc prior to distribution of my estate, than the share of my astata to which said child would have bean entitled had said child survived ma, shall ba distributed to ml' surviving children share and share alike. In the avant all of my children have died prior to my death or prior to the distribution of ,my estate, then i dirrect that my astata be distributed in accord with the laws of doecant and distribution of the State of Florida. DIVIHION III i hereby declare that in disposing of my estate, I have considered all of my relatives vho era now living and that with the exception of the gifts aada heroin, I intentionally oast making any bequest to them. ZN WITNECS WHEREOF, Z havq hereunto • m hand and seal at Palatka, Florida on thin y'3~_ day of presence of the subscribing witnesses whom i raquastadgto become attesting witnesses hereto. M~-GKRG_L__ nulyaRT wxyNB HERLT Tha foregoing instrument was on the data thereof by ROHERT WAYNE HERLT subscribed, published and declared to ba hie Will in asahca oL us and each of us who, at hie regueet and hie press ca, and in the presence of each other have signed the ease as witnesses hereto,. -ks<'~~-^~/I~~a~L-~ Of Pala ka, Florida lT . YLU ~/ Op of Palstks. Florida E OP FLORIDA COUNTY OP PV~fRNTANIV y l~~.~- /"~ r- ~ 4. ,_ T We, ROH fl!OQI ~A HBRLT _. I.JVrlct~p~ C • I~l~/YICC and ~.tcz1L..L , the Testator and the witnasaoa respectively, whose names are signed to the attached or foregoing instrument, were sworn and doolared to the undersigned oflicar that the Testator signed the Instrument as his last Will, that he signed, and that each of the witnesses, in the presence of the Testator and in the presence of Hach other signed the Will as a witness. ~ ~~ Tea r ~~ ~,,+ Wlr/l\ est~lf a Sll l'YI1. ~ ~c era 60 ~aas HUBSCRIBED ~l~, ,SWORN to be`Tfor,e.^ ae by thn Testator and the witnesses on this ~_-day of ~Je ~ lgg~. Q1.1'{Z.- m .~ ,.,1- Notary Public _ WY Commission Expires: ~p•3-9~ ~uew.lMa1 # ' NsCC<IIW ~•rn•~C:I~" aids aiW~1a0Y9e ( ^V `ADMn-61Ya1onlra~~a~a 4i.Y+n