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Home My WebLink About11-01-11J 1505611185 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year Po sox 2sosoi INHERITANCE TAX RETURN File Number Harrisburg, PA t7~2g_0601 RESIDENT DECEDENT 21 11 0261 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW 184-05-1328 Decedent's Last Name 02092011 Suffix 11221915 Decedent's First Name MI EUGENE H STEFFY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Spouse's First Name M I - - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE BOXES BELOW REGISTER OF WILLS ® 1. Original Return ^ 2. Supplemental Return ^ 3 R ^ 4. Limited Estate ^ . emainder Return (Date of Death Prior to 12-13-82) 6. Decedent Died Testate ^ 4a. Future Interest Compromise (date of ^ death after 12-12-82) 5. Federal Estate Tax Return Required 7 D (Attach Copy of Will) ^ 9. Litigation P ^ . ecedent Maintained a Livin Trust ~ (Attach Copy of Trust.) g $• Total Number of Safe Deposit Boxes roceeds Received 10. Spousal Poverty Credit (Date of Death ^ Between 12-31-91 and 1-1-95) 11• Election to Tax under Sec. 9113(A) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INF Name S I RICHARD C- SNELBAKER ORMATION H OULD BE DIRECTED TO: Daytime Telephone Number First Line of Address SNELBAKER & BRENNEMAN Second Line of Address 44 WEST MAIN STREET City or Post Office State ZIP Code MECHANICSBURG PA 17055 r i -T C~ r -.-.~ ~j'T't 4•' CIJ =~ -- : `? ~-, J ~, ,.+ ~,.. 'T7 -- . .~ ~--~ `°":# ,e r `. 4'.' -~-- C __i _ _ ,, _.,~ Correspondents e-mail address: 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. SIG~TU~ pF PERSON RE~NSIg~ FOR FILING RETURN ~n .r.. w ~~-77 PATRICIA S- THOMSON, EXECUTRIX 11 REDBUD DRIVE, MECHANICSBURG PA SIG OF ER OTHER THAN REPRESENTATIVE .` _ _ i RICHARD C- SNELBAKER 44 WEST MAIN STREET, MECHANICSBUR PLEASE USE ORIGINAL FARM ONLY G PA 17055 Side 1 1505611185 OM4647 3.000 717-697-8528 ~. , A~N LS USE ONLY .. ' T) I 1505611185 J REGISTER J 1505611285 REV-1500 EX (FI) Decedent's Social Security Number Decedents Name: 18 4- 0 5 -13 2 8 RECAPITULATION 1. Real Estate (Schedule A) . ............. 1. 2. Stocks and Bonds (Schedule B) . 0.00 . ~~~~~~~ 2. 3. Closely Held Corporation Partnershi 696,634.31 , p or Sole-Proprietorship (Schedule C) , , 3 4. Mortgages and Notes Receivable (Schedule D) 0.00 . ................ a. 5. Cash, Bank Deposits and Miscell 0.00 aneous Personal Property (Schedule E) , " 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 402,554.28 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~ ~ ~ 6. (Schedule G) ~ Separate Billi 0 • 0 0 ng Requested 7 . 8. Total Gross Assets (total Lines 1 through 7) 7+ 0 5 , 8 0 3.8 6 ~~~~~" " e. 9. Funeral Expenses and Administrative Costs (Schedule H). 1,204,992.45 . ~~~~ g. 10 11,624.13 . Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) , ~~~~~•.10. 11. Total Deductions (total Lines 9 and 10) 669.67 , , .11. 12. Net Value of Estate (Line 8 minus Line 11) 12,293.80 , 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. an election to tax has not b 1 , 19 2 , 6 9 8.6 5 een made (Schedule J) , , ..13. 14. Net Value Subject to Tax (Line 12 i Q • Q Q m nus Line 13) 14 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE 1 ~ 19 2 , 6 9 8.6 5 RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~jer Sec. 9116 (a)(1.2) X .0 U_ 16. Amount of Line 14 xable 0 • 0 0 15. at linealratex.o 4~ 0 • 0 0 1,192,698.65 17. Amount of Line 14 taxable 16 . at sibling rate X .12 5 3 , 6 71.4 4 18. Amount of Line 14 taxable 0 • 00 17 at collateral rate X .15 0 ' 0 0 Q'QQ 18 19. TAX DUE,,,,. O.oo .1s. 53,671.44 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX (FI) Page 3 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. (3) 0.0 0 5. If Line 1 + (4) 0 , 00 Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1 1.4 4 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIAT 1. Did decedent make a transfer and: E BLOCKS a. retain the use or income of the property transferred . Yes No b, retain the right to designate who shall use the property transferred or its income ^ c. retain a reversionary interest .: ~ a 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" 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 ro ^ contains a beneficiary designation? P fJerty, which IF THE ® ^ ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS Pq 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 fo RT OF THE RETURN. 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 transf r the use of the surviving spouse [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory r uirem filing a tax return are still applicable even if the surviving spouse is the only beneficiary, ers to or for the use of the survivin s 9 pouse is 0 percent For dates of death on or after July 1, 2000: ~ ents for disclosure of assets and • 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 th 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 4.6 a use of a natural parent, an = The tax rate imposed on the net value of transfers to or for the use of the decedent's siblin s is 12 under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blo dr0 nt, except as noted in [72 P.S. §9116{a)(1)]. 9 percent [72 P.S. §9116(a)(1.3)J. A sibling is defined, adoption. 3. Interest Total Credits (q + g) (2) 53,550.00 44671 2.000 ~ ax uue (Page 2, Line 19) 2• Credits/Payments A. Prior Payments (1) 53 , 6 71 . y 4 g. Discount 51, 000.00 REV-1503 EX + ~~ggl COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEPff ESTeTG nr SCHEDULE B STOCKS & BONDS FILE e All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. Janney Montgomery Scott LLC investment account #7926-1379 2 The CGM Funds investment account ending in account #6752 TOTAL (Also enter on line 2, Recapitulation) $ 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 670,587.39 26,046.92 696,634.31 REV-1508 EX+ (~ t_tp) Pennsylvania DEFAR7MENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ~_ SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ITEM red by the estate. All ro ert 'ointl u owned w thtion ht of survivtorshst pe disclosed on Schedule F NUMBER DESCRIPTION ~• 1998 Buick Lasabre sale value 2 Ally Demand Notes demand note account #90009011398232 3 Brandt Real Estate return of security deposit on apartment 4 Health Insurance Premium refund due the decedent 5 Household goods sale value 6 Internal Revenue Service refund due the decedent on 2010 Individual Income Tax Return 7 Nationwide Fire Insurance Co. Premium refund due the decedent 8 PNC Bank, N.A. checking account #5140061684 9 PNC Bank, N.A. certificate of deposit account #31800316555 10 Susquehanna Bank certificate of deposit account #10004991443 11 Susquehanna Bank checking account #10004991559 12 T. Rowe Price Services investment accounts: Inc. A) #200379599-6 valued at $31,958.29, B) #207013461-6 valued at $51,199.46 N46AD 2.000 TOTAL (Also enter on line 5, Reca If more space is needed, use additional sh sets aF paper of the same size, FILE NUMBER; ------ 11 02 61 VALUE AT DATE OF DEATH 2,000.00 97,921.23 705.00 282.00 175.00 1,761.00 166.10 49,025.68 50,250.96 100,181.23 16,928.33 83,157.75 3I 402,554.28 REV-1510 EX + (OS-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENTDECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY This schedule must be completed and filed if the answer to any of questions 1 through 4 on a 21 11 0261 ITEM ,~,~„f~~ ON OF PROPERTY P ge three of the REV-1500 is JMBE TFE Mn=OF FEREE, 7FEIR RELATIOnstaP TO DECEpEM ANp yeS' ~ AlTpip{A pppy OF TFE DEED FOR REAL ESTATE. DATE OF DEATH o ~ • Ally VALUE OF ASSN /o OF DECD'S EXCLUSION INTEREST IFAppLICgBLE TAXABLE certificate of deposit account 51,151.09 100.0000 VALUE #3013636901. Payable on death 0'00 51,151.09 to Patricia Thomson 2 MetLife Investors USA Insurance Company annuity account #9200512890, 10,444.37 100.0000 Beneficia 0'00 10,444.37 ry is Patricia Thomson 3 PNC Bank, N.A. investment account #5713-9628. 36'892.83 100.0000 Payable on death 0.00 36,892.83 Thomson to Patricia 4 Protective Life Insurance Company annuity account #4037725. 7.315.57 100.0000 Beneficia 0'00 7,315.57 ry is Patricia Thomson TOTAL (Also enter on line 7, Recapitulation) $ '.sAF 2.00o If more space is needed use additional sheets at paper of the same size. 105 803. 8 REV-1511 EX+(~0-09? Pennsylvania DEPARTMENTOF REVENUE INHERITANCE TAX RETURN RESIDENrpECEDENT ESTATE nc SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS " `ate ~ FILE NUMBER Decedent's debts must be reported on Schedule I• 21 11 0261 ITEM NUMBER A• FUNERAL DESCRIPI-ION EXPENSES: AMOUNT 1. Auer Cremation Services funeral services 406.19 Total from continuation schedules 344.12 B• ADMINISTRATIVE COSTS: ~ ~ Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ~_ ZIP Year(s) Commission Paid: 2. Attorney Fees: Snelbaker & Brenneman, P, ~. 3. Family Exemption: (If decedent's address is not the same as claimant's attach 8 ~ 500.00 , explanation.) Claimant Street Address City State ~_ ZIP Relationship of Claimant to Decedent 4• Probate Fees: 5. Accountant Fees: 281.50 s• Tax Return Preparer Fees: 7. 1 Commonwealth of Pennsylvania registration fee for automobile 2 Cumberland Law Journal 49.00 advertising Executrix Noti ce Total from continuation schedules 75.00 1,968.32 W.~,,,.., ...._ If more space is needed, use addit oo I sheets of paperoof the sa a size) 11,624.1 Estate of: Eugene H. Steffy Schedule H Part 1 (Page 2) Item No. Description 2 Trinity Lutheran Church funeral luncheon 21 11 0261 Amount 344.12 Total (Carry forward to main schedule) 344.12 Estate of: Eugene H. Steffy Schedule H Part 7 (Page 2) 21 it 0261 3 Register of Wills filing fee for Inheritance Tax Return 4 Register of Wills 15.00 short certificates 5 Robert Thomson 16.00 removal of furniture from apartment 6 Service, Inspection and advertisin 120.00 required for sale of automobile g costs ~ The Sentinel 97'92 advertising Executrix Notice 8 Reserve 219.40 for filing fees, accountant fees and other miscellaneous costs associated with the administration f o the decedent's estate 1,500.00 Total (Carry forward to main schedule) 1,968.32 REV-1512 EX+ (12-08) Pennsylvania SCHEDULE i OEPARTMENiOF REVENUE INHERITANCE TAX RETURN DEBTS OF DECEDENT, RESIDENTpECEDENT MORTGAGE LIABILITIES 8 LIENS ESTATE OF Eu ene H. Steffy FILE NUMBER Report dQ-,~e :.. ~, , , ' - ---`~ •••~~~~C4 ~y cne aecetlent prior to death that remained unpaid at the date Of death, including unreimbun3ed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE ~ ~ Pennsylvania Department of Revenue OF DEATH 2010 individual income tax due 2 PNC Bank 373.00 visa payment 3 PPL Electric 157.88 electric service 4 Verizon 60.89 phone service 5 Verizon Wireless 41.23 cell phone service 36.67 awasAH 2.000 If more space is needed, insert add t onall sheetseof the same si seta itulation S 669.67 REV-1513 EX+ (01-10) Pennsylvania ~EPPRTMENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT :STATE nr• SCHEDULE J BENEFICIARIES IMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY [ TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Patricia S. Thomson 11 Redbud Drive Mechanicsburg, PA 17050 All of Residue: 1,192,698.65 RELATIONSHIP TO D M Do Not List Trustee(s) Daughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1I8 OF REV-1500 COVER SHEET, AS APP I OPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. FILE NUMBER: 11 0261 AMOUNT OR SHARE OF ESTATE 1,192,698.65 9W46A1 2.ppp TOTAL OF PART II -ENTER more spO e s neededDl seadd~onal sOheets of paper oRthe same sOVER SHEET. g e 0.00 ~~~, . ~~ __ --. LASfi WILL ANI7 fiESfiAMEiJT OF EUGENE H. 'STEFFY I, EUGE2JE H. STEFFY, now of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills or Codicils made by me, specifically revoking hereby my Last Will and Testament dated January 25, 1968. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my estate as soon as practicable after. my decease as a part of the administrative expenses of my estate. 'ITEM II. I give and devise all of my estate of every nature and wherever situate unto my wife, ELEANOR C, STEFFY, provided she shall have survived me by sixty (60) days. 'ITEM III. If my wife, ELEAPdOR C. STEFFY, shall have predeceased me or died on or before the sixtieth day following my death, 'I then give and devise all of my estate of every nature and wherever situate unto my daughter, PATRICIA S. THOMSON, or her issue, per stirpes. ITEM IV. If my wife, ELEANOR C. STEFFY, shall have predeceased me or died on•or before the sixtieth day following my death as aforesaid and in the event that my daughter, PATRICIA S. THOMSON, shall have also predeceased me without issue surviving her, then in such event 2 give and devise all of my estate of every nature and wherever situate in the following manner: A. One-Half (1/2) of the same shall be given unto ~• my daughter's husband, ROBERT THOMSON. B. One-eight (1/8) of the same shall be given unto my sister,; MYRTLE E. MARTIN, now of Ephrata, Pennsylvania, or her issue,; per stirpes. v •-T, w,~~, ~ _ ;.,: .~ __ .. - - ,. C. One-eighth (1/8} of the same shall be given unto my brother,', HARRY L. STEFFY, now of Ephrata, Pennsylvania, or his issue,~per stirpes. b. One-eighth (1/8) of the same shall be given unto the LANCASTER CLEFT PALATE CLINIC, Lancaster, Pennsylvania. E. One-eighth (1/8} of the same shall be given unto SHRINER'S HOSPITALS FOR CRIPPLED CHILDREN, a corporation for the use and benefit of the hospitals owned, operated and maintained: by said corporation. F. If ROBERT THOMSON shall have predeceased me, then the one-half share of my entire estate that he would have received shall be divided equally between the four beneficiaries mentioned in subparagraphs B, C, D and E above. ITEM V. I appoint COMMONWEALTH NATIONAL BANK of Harrisburg, Pennsylvania Guardian of any property which passes, either under this Will or otherwise, to a minor and with respect to which I am authorized to appoint a Guardian and have not otherwise specifically done so, provided that this appointment of a Guardian shall not apply to property distributable under this Will to a minor for whom special provision has otherwise been made herein and provided further, that this appointment of a Guardian shall not supersede the right of any fiduciary in its discretion to distribute such share to another for the minor's benefit. Such Guardian sHa11 have the power to use principal as well as income from time to time for the minor's support and education (including- college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment, for these purposes, without further responsibility, to the minor or to the minors parent or to any person taking care o£ the minor. ~a' -2- ITEM VI. I appoint my wife, ELEANOR C. STEFFY, as Executrix of this my Last Will and Testament. If she should fail to qualify or cease to act as Executrix, I appoint my daughter, PATRICIA S. THOMSON, as Executrix of this my Last Will and Testament. If PATRICIA S. THOMSON should fail to qualify or cease to act as Executrix, I appoint my daughter's husband, ROBERT THOMSON, as Executor of this my Last Will and Testament. If ROBERT THOMSON should fail to qualify or cease to act as Executor, I appoint COMMONWEALTH NATIONAL BANK of Harrisburg, Pennsylvania as Executor of this my Last Will and Testament. No bond shall be required of my personal representative in any jurisdiction. TN WITNESS WHEREOF, I have hereunto set my hand and seal this~;,t,~ day of ~..{~.~+~ ~y a 1977. L'~ " ~ ~ NUsc Eugen H. Ste fy The preceding instrument consisting of this and two other type- written pages, identified by -the signature of the testator, was on the day and date thereof signed, published and declared by Eugene H. Steffy, the testator therein named, as and for his last Will in thy- esence of us, who, at his request, in his presence d '~f} th presence of each other have subscribed our names as wwit e s reto. _.--, r E ,~ ' i ' -.~ .1~;6 ,/^ ~_~-6--~-- ~ r c -3- ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OR DAUPHIN SS: I. Eugene H. Steffy , testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed ar~d executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Euge H. Steffy Sworn or affirmed to and acknowledged before me, by ly uc~ene_ H gteffV , testator , this 2 ~ day of "~`-~-' ~.. ~'~' ~l ~ ~ ~ ~f~l, Notary Pub]~i: My Commission Ex Tres: NOTARY PUdtIC COMMONWEALTH OF PENNSYLVANIA: COUNTY OF, DAUPHIN SS: We, r:, G,~~ P~; ' ~ _.~ ~., ~ ~ ~-~r . ~ yr, ~ ~ ~- ~ ~' ~ '' ~ ~ j``2 ~ th "witnesses whose names are signed to:~~'e attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testat or sign and execute the instrument as his last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the Will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound m2 and under no constraint or undue influence. ~~ .A r? Sworn to and subscribed before m~ this ~-~~ day of ~. 19_x. MY Commission ~Ma-Desem6er 6, 1~l~ ~~~b PA ~~ AFFIDAVIT Notary P~Qic My Commission Expires: NOTARY MIILK IMp ~~~ Egires Deoemier A, 14rf0 9. M ~ to~llr a's -r--- ~~. _ f_? ~