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HomeMy WebLinkAbout01-13-121505610140 .~ REV-'500 EX `°'-'°' OFFICIAL USE ONLY PA DepartmenK of Revenue County Code Year File Numtler Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 28061 2 1 1 1 0 1 5 8 Harrisbur P ' 17128-D6D1 RESIDENT DECEDENT ENTER DECEDENT INFORMA ON BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 7 3 5 6 7 4'1 7 1 2 1 9 2 0 1 0 1 1 2 6 1 9 6 3 Decedent's Last Name Suffix Decedent's First Name MI V A R N E R T O N Y L (If Applicable) Enter Surviving) Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI V A R N E R D A R L A M Spouse's Sociat Security Numt~er THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVAL$ BELOW 0 1. Original Return ', ~ 2. Supplemental Return ~ 3. Remainder Retum (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 Testat e ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wilq ' (Attach Copy of Trust) 9. Litigation Proceeds R~ ceived ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SEC ION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name ' Daytime Telephone Number W I L L I A M A D U N C A N ? 1 7 2 4 9 7 7 8 0 First line of address 1 I R V I N E Second line of address City or Post Office C A R L I S L I= Correspondent's e-mail R 0 W State P A ZIP Code ~ 1 7 0 1 3 REGISTER f1El~l3 USE f)Nl+ =-~ ;~7 - ~ ~~.~ ~ c.~; • J ~.-q `~ r _~ ~-; ~ - -, :. DATE FILED ~---' _~., ;,; ~ -; ~= C=) -T~ • billaduncanhartmanlaw•com Under penaltbs of perjury, I der9are that 1 have examined this return, irxluding accompanying schedules and statements, and to the beat of my knowledge and belief, it is true, correct and complete. De aretion of preperer other than the personal representative is based on aQ information of which preparer has any knowledge. SJONATURE OF PERSON RESPO'INSIBLE FOR FILING RETURN DATE 1~ n .~ ~1--_1-- lll~ lr~ ADDRESS ~ 1156 ROYER ROAD' CARLISLE PA 17013 SIGNATURE OF PREPARER OTH R THAN REPRESENTATNE DATE PLEASE USE ORIGINAL FORM ONLY Side 1 L 150561~114D 1505610140 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: TON 1f L• V A R N E R 1 7 3 5 6 7 4 1 ? RECAPITU WTION 1. ........................................... Real Estate (Schedule A)' 1. D ' D D 2. Stocks and Bonds (Schec>lule e) ...................................... 2. 4 3 0 0 2 , 7 2 3. Closely Held Corporation,i, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. 5. Cash, Bank Deposits andMiscellaneous Personal Property (Schedule E)....... 5. D ' D D 6. Jointly Owned Property ( chedule F) ^ Separate Billing Requested ....... 6. 7. ~ scellaneous N -Probate Property Inter-Vivos Trans rs Separate Billing Requested ....... (Schedule G) 7. 8. Total Gross Asaets (tot~ l Lines 1 through 7) ........................... 8. 4 3 D D 2 . 7 2 9. Funeral Expenses and Administrative Costs (Schedule H) ......... ......... 9. 1 1 5 7 7. 8 8 10. Debts of Decedent, Mort~age Liabiifties, and Liens (Schedule I) .... ......... 10. 1 2 7 5 . 8 0 11. Total Deductions (total ~.ines 9 and 10) ...................... ......... 11. 1 2 8 5 3. 6 8 12. Net Value of Estate (Lin{s 8 minus Line 11) ................... ......... 12. 3 D 1 4 9. 0 4 13. Charitable and Govemm~ntal Bequests/Sec 9113 Trusts for which an election to tax has no been made (Schedule J) ............. ......... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... 14. 3 D 1 4 9 • D 4 TAX CALCULATION - SEE 19 15. Amount of Line 14 taxab at the spousal tax rate, o transfers under Sec. 911 (a)(1.2) X.000 16. Amount of Line 14 taxab~e at lineal rate X .0 _ 17. Amount of line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 FOR APPLICABLE RATES 3 0 1 4 9.0 4 15. 0 • D 0 1 s. 0 . D 0 17. 0 . 0 0 18. 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT side z 150561040 15D5610240 0. 0 0 0. D 0 0. D 0 0. 0 D 0• D 0 D REV-1500 EX Page 3 rloro~lant'c Cmm~hte Address' File Number 21 11 0158 DECEDENTS NAME TONY L• VARNER STREET ADDRESS 1156 ROYER RAAD CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits f • Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments ~ B. Discount 3. Interest L 4. If Line 2 is greater than Une 1 + Line 3, ~nter the difference. This is the OVERPAYMENT. Fllt In oval on Page 2, ine 20 to request a refund. (1) 0.00 Total Credits (A + B) (2) 0 • 0 0 (3) (a) 0.00 5. If Line 1 + Line 3 is greater than Line 2, ~nter the difference. This is the TAX DUE. (5) 0.00 Fake check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER TH FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a ~ ransfer and: Yes No a. retain the use or in me of the property transferred : ..................................................................... . ^ b. retain the right to ignate who shall use the property transferred or its income; .............................. . ^ c. retain a reversiona interest or ............................................................................................... . ^ d. receive the promi for life of either payments, benefits or care? ...................................................... . ^ 2. If death occurred after December 12,1982, did decadent transfer property within one year of death without receiving uate c~nsideration? ...................................................................................... . ^ 3. Did decedent own an intrust for or payable-upon-math bank account or security at his or her death? ........ . ^ 4. Did decadent own an i ividual retirement acxrount, annuity or other non-probate property, which contains a benefiaary designation? ........................................................ © ^ IF THE ANSWER TO ANY OF THE A~OVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,194, 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. §9116 (a) (1.1) (i)]. For dates of death on or after Jan.1,1 5, 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 eve if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 20 • The tax rate imposed on the net valu 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 th child is 0 percent 172 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of Vansfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)~1)]. • The tax rate imposed on the net valu~ 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 h sat least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS ~ BONDS ESTATE OF FILE NUMBER TONY L• VARNER 21 11 0158 IAIt property jointy-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER ' DESCRIPTION OF DEATH ~. UPS STOCK - 38.95 SHARES X X72.58 2,826.65 [SEE ATTACHED STATEMENT] 2• UPS 401K PLAN TONY L• VARNER 40,176.07 [SEE ATTACHED STATEMENT] ~~ TOTAL (Also enter on line 2, Recapitulation) I S 4 3 , 0 0 2.7 2 (If more space is needed, insert additional sheets of the same size) I REV-1511 EX+ (10-09) pennsylvania DEPARTMENT i~F REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER TONY L- VARNER 21 11 0158 Decedents debts must be reported on Schedule 1. ITEM NUMBER I DESCRIPTION AMOUNT A. ~. FUNERAL EXPENSES: HOLLINGER F~JNERAL HOME & CREMATORY, INC• 6,349.38 B. ADMINISTRATIVE COS S: 1. Personal Representati a Commissions: Name(s) of Pe nal Representative(s) Street Address) City State ZIP Year(s) Commission Paid: I 2, AttomeyFees: DUN AN 8 HARTMAN, PC 1, 50D • 00 3. Family Exemption: (If nts address is not the same as claimants, attach explanation.) 3 , 5 D D • D ~ Claimant D RLA M • VARNER Street Address 115 6 R O Y E R R O A D Cary CARL SLE stagy PA zlP 17013 Relationship o Claimant to Decedent 4. probate Fees: REG~STER OF WILLS 213.50 5. Accountant Fees: 6. Tax Retum Preparer Fes: 7. REGISTER qF WILLS - FILING FEE 15.00 TOTAL (Also enter on Line 9, Recapitulation) ; 11, 5 ? 7. 8 8 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-OB) pennsylvania SCHEDULE I DEPARTMENT ~~F REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, 8 LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER TONY L• VARNER 21 11 0158 Report debts Incurred by the d edent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CARLISLE REGIONAL MEDICAL CENTER 971.83 2• CARLISLE HMAI PHYSICIANS MGMT 74.85 3• CARLISLE HMAI PHYSICIANS MGMT 82.50 4• EAST SHORE O~NOCOLOGY 60.00 5• BLUE MOUNTA~N ANESTHESIA ASSOC 86.62 TOTAL (Also enter on Line 10, Recapitulation) ( Z 1 ~ 2 7 5.8 0 If more space is needed, insert additional sheets of the same sig. REV-1513 EXr (Ot-10) Pennsylvania SCHEDULE J DEPARTMENT i0F REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: TONY L• VARNER 21 11 0158 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRES OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [I cede outright spousal distributlons and transfers under Sec. 91 i6 (a) (1.2).) t. DARLA M• VARNE~ Spousal 99 RIDGE ROAD ~ 100% SHERMANS DALE,'IPA 17090 ENTER DOLLAR AMOUNTS OR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTI NS: A. SPOUSAL DISTRIBUTIO SUNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. i i B. CHARITABLE AND GOVF~RNMENTAL DISTRIBUTIONS: 1. I TOTAL OF PART [I - EN#ER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I ; If more space is needed, use additional sheets of paper of the same size. LAST WILL TESTAMENT I, TONY I~. VARNER, of 1156 Royer Road, Carlisle, South Middleton Township, Cumberland Coun ,Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, p lish and declare this as and for my Last Will and Testament, hereby revoking any and all other w'lls and codicils heretofore made by me. FIRST. I dl rect that all my just debts and funeral expenses be paid from my estate as soon after my dea as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot in accord with my expressed wishes. THIRD. I uthorize my personal representative to expend funds from my estate, in such amounts as my per onal representative shall consider necessary and desirable for the purchase, erection and inscri ion of a suitable marker for my grave. FOURTH. I give, devise and bequeath all of my estate of every nature and wherever situate unto my wif , DARLA M. VARNER, provided she survives me by thirty (30) days. In the event she fails t survive me by thirty (30) days, I give, devise and bequeath all of my estate unto JODI M. MIL ER, MISTY M. WEAVER, VALERIE J. MARTIN and KELLY A. VARNER in equal hares, per stirpes. FIFTH. I erect that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing unde my will or otherwise, shall be paid out of the principal of my residuary estate. SIXTH I reby nominate, constitute and appoint my wife, DARLA M. VARNER as Executrix of this m Last Will and Testament. In the event of renunciation, death, resignation or inability to act for y reason whatsoever of DARLA M. VARNER, I nominate, constitute and appoint KELLY A. ARNER and JODI M. MILLER as Co-Executrixes of this my Last Will and Testament. I hereb relieve my Executrix from the necessity of posting security in connection with her duties, ass ch, in any jurisdiction in which she may be called upon to act insofar as I am able by law to dos In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal pro erty owned by me at the time of my death. IN WITNESS HEREOF, I have hereunto set cry hand and seal to this, my Last Will and Testament, consistin of one typewritten page this `~ day of ~ , 2010. I TONY L. VA ER Signed, sealed published and declared by the above named Testator TONY L. VARNER as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence and in the Sight and presence of each other, have hereunto subscribed our names as witnesses. ~~ COMMONWEALT~I OF PENNSYLVANIA SS. COUNTY OF CU1I~BERLAND . I, TONY L. VA ER, Testator whose name is signed to the attached or foregoing instrument, having been duly q ified according to law, do hereby acknowledge that I signed and 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. ~' TONY L. VARNER __ _ _ __ -- S-worn or affirmed-f ..and acknowledged befor me, by TONY L. VARNER this ~S d Y ~ecembe~ ~ ~ ,aolo. Notary 1~tblic N.euw s..l Kathy L. uteotert. Notary P~lic Carlisk Cumberl~od County, PA My Comm' Bxpitea Augwt 11.2011 COMMONWEAL ~'H OF PENNSYL VANL4 COUNTY OF CUIt~(BERLAND We,. W i 11 i G the witnesses whose qualified according sign and execute the his free and volunta sight of the Testator Testatar was at that constraint or undue c ~__.___ a,~-a- Sworn or affirmed t and subscribed before m b W r t1 iafvl ~ ~cJ/I Ga r~ and t' OGt yi ~ ,r~ q ti~~ S ,witnesses, this ~ s day of ~ ece rh b e ` , 2010. i __ _ __ Not Publi I i No tarial Seal Kathy L. M NlotarY Publ~ Carlisk Cumbetlmtd County, PA ~,ly Cam,' ' Expiry August 11, 2011 :SS. >M ~ ~ ~~/ h G~1 i1 and t~ OA~1 ~ ,~ olq' 19'! 5 names are signed to the attached or foregoing instrument, being duly o law, do depose and say that we were present and saw TONY L. VARNER instrument as his Last Will; that he signed willingly and that he executed as y act for the purposes therein expressed; that each of us in the hearing and signed the will as witnesses; and that to the best of our knowledge, the ime eighteen (18) or more yeazs of age, of sound mind and under no c ... sy~ ~~~ ~~ ~ N C. ; a~~ ~ SS N ~ S' ~ C ~? v $~a' ~~ ~ ~. ~~ ~~~ ~~ ' ~ ~~ 4~ y~ d ~7 7a O m ~ fgl6-1 G m~•~ ~~~ ~~ ~ ~ ~~ ~o ~~~~ ~~R ~_ . ~~ m ~~3~ N3~ 4~ ~'~d QX3 ~g o ~~ 3 c m I y O 3 3 ~ T O T O ~ D ? ~ ~ ii ~ ~ '`• m ~ N O ~ N < ~ 0 ~ m z ~ ~ r D O Z ~e~ `~ o o ~ 'p o° O may` o~m~ o°~~ o ~ ~ A A~~w~ ~p ~ N ~ ~ o. o ~ ~a~.. w. O ~ m N W ~~ s ~" UPS Savings Plan PO Boot 5,68 ~ aaelon. ~-~ e SfaApnn1 A.,tal Or~obar 7,10!0 -.,r„w,,, ~ am 1 Questions? ~Automslsc121.1-o~a- Fb~ L,U~ldiia341d1lFI ^ PaRidpatri Services RepreserNativea are available S HG 13 9 7 Monday Urrot~t FrWay.8:00 a.m. ~ 8.'00 p.m. ET TDD Access is avaiable ffi 1-800579.5708 NNmnf Acasra ah TONY L Vl1RDTSR ~p.,~,c~ 1156 ROYSR RD. ' cuzLisLB, pA l~ol~ Participant Profile ', Plan ~y Deaa+smti,e 12/29f2005/Terrrrlne~led - nce Histor l t B A YourTotalAccount Value y a a ccoun op.~wn~ vffiu.On oclob.r 7, zof o I x~a~~ • ERploy~ ('iOfNf~JllOna . - - _ - 'M" w . ° ~~ ! n ay18~ ',. ~IIN ~ileOAflf7 t W~~ 4 kNNb11MIK ~1 (L.Wa~ '~,. ~~'~ b) ' '6.92 osing Value On Ja 1~~~ In nsusd~lrt~q. ;cun.~tct~wtodpw~aaR~ r '~ `~40,'f ?6:07 . ~~~ t4,S7304 VaMua at d .Aarruary 6, 2Df 1 Your ourwril IIMM YOCwOr1 brrMd o~ rear 10W YourAsset Allocation & Balance by Fund - Mwsbnsnt7ypsfFundNams Mssaun UnIWSfrartrs x Pries . Marlat vMus 0% Short Term Investments 0% Bond Funds 0%, Balanced Funds 87%~ Stock Funds S3P 400 Mldcap Index Fund Unite 413.0964 544.306707 518,302.95 RuaeeM 2000 krdex Fund Units 484.1782 534.757586 518,828.88 0%, Other , 0%~ Self-Managed Account 13%~ Employer Stock UPS Stock Fund Shares 89.1943 572.900000 55,04428 Total Fund Balances $40,176.07 Tobeller rarderslerxi what easel abcdiorr means and which asset aloelion maybe br yea cindxnstanoes. visR yea plan's Web sNe ffi htSlJ/upessvirgs.Y~lar-s.COm or cx11-800 1$154. ING~J ixtrnn ~ ~~ c«ro~ aww. ~'"".«w row ap«+q ~~.. ao~tp