Loading...
HomeMy WebLinkAbout03-08-121505611180 --~ REV-1500 E~,°Z_,,,(Fil Pennsylvania OFFICIAL USE ONLY PA Department of Revenue DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2aosal ~ I ~ ~ ~ _,~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 187-16-4561 05032011 02011912 Decedent's Last Name Suffix Decedent's First Name MI MYERS INEZ M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW Qx 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return (Date of Death Prior to 12-13.82) Q 4. Limited Estate Q 4a. Future Interest Compromise (date of Q 5. Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit (Date of Death Q 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G. FREY 7172435838 First Line of Address 5 SOUTH HANOVER ST Second Line of Address City or Post Office CARLISLE State ZIP Code PA 17013 REGISTER OF WILLS USE ONLY r.._; r^ ~. ~ --'•; "z7 :,, g» ~_ ~ ~ rn I :'~ ~ ~ .-.~ I'~ -, ~ -~ i - , ._~: ~ .. Cw~ Correspondent's a-mail address: R F R E Y a1 F R E Y T I L E Y. C O M 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 corn lete. Declaration of re arer other than the ersonal re resentative is based on all information of which pre arer has an knowled e. SIGNAT OF PE.f?SON RESPONSE FOR FILING RETURN ~. CATE SIG T OUR~_ F P~EPARI~R OTHE~THA RESENTATIVE ~ 2 ~ p ADDRESS TJ~/ \.~,-J1 .!J ~ 5 SOUTH HANOVER STRE CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY ],505611180 Side 1 1505611180 J '~-~ i. ~" .mot •, ~~ r~, C~' ;: ;'> _, ~~ -- ;-,-7 ~:,'~ ~ --r1 ,~ 15D5611280 REV-1500 EX (FI) Decedent's Social Security Number I>ecede,raName: INEZ M MYERS 187-16-4561 RECAPITULATION 1. Real Estate (Schedule A) ........................................ . 1. D . O D 2. Stocks and Bonds (Schedule B) ................................... . 2. N 0 N E 3. Closely Held Corporation, Partnership or Sob-Proprietorship (Schedule C) .. . 3. N 0 N E 4. Mortgages and Notes Receivable (Schedule D) ....................... . 4. N 0 N E 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ... . 5. 1 D 8 8 7 5 . 0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ..... .. 6. N 0 N E 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ..... .. 7. NON E 8. Thal Gross Assets (total Lines 1 through 7) ........................ .. 8. 1 O 8 8 75 . O 0 9. Funerel Expenses and Administrative Costs (Schedule H) ............... . 9. 7 4 68 . D 0 10. Debts of Decadent, Mortgage Liabilities and Liens (Schedule 1) ........... . 10. 10 6 . 0 0 11. Total Deductions (total Lines 9 and 10) ............................ . 11. 7 5 7 4 . D 0 12. Net Value of Estate (Line 8 minus Line 11) .......................... . 12. 1 D 13 01 . O 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 9 D 3 01.0 D 14. Net Value Sublect to Tax (Line 12 minus Line 13) .................... .. 14. 11 O O O . O O TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (ax1.2)X.0 0 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 4 5 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 17. D . 0 0 18. Amount of Line 14 taxable at collateral rate x .15 110 0 0.0 0 18. 16 5 0.0 0 19. TAX DUE ...................................................... . 19. 16 5 O.O O 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 1505611280 1505611280 R!'cV-1500 F.X (FI) Page 3 Decedent's Complete Address: File Number 187-16-4561 STREET ADDRESS Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Fill in box on Psgs 2, Une 20 to regwst a refund. 5. If Une 1 +Une 3 is greater than Line 2, enter the difference. This is the TAX DUE (1) 1650.00 (2) 0.00 (3) (4) 0.00 (5) 1650.00 Total Credits (A + B ) 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 o a. rotain the use or income of the property transferred .......................................................................:............... b. rotain the right to designate who shalt use the property trensfened or its income .......................................... c. rotain a roveroionary interost .......................................................................................................................... d. receive the promise for life of either payments, benefits or pre? ................................................................... 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 property, which , ` contains a beneficiary designation? .................................................................................................................... ~ IY``R" IF THE ANSMIER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. >gT` 'bR".'g'1~,~3 k ek rr.,,;a_, W~ `:G"-~ 'Airy;^.d3F .'*.~~' ~.x".}-~rr:<SSFiS '7C'k 3`Idvai~dLtima_e.a~eihl~ti~'Lti&A36:`l~"aX'lfa~FiK=,.i:,:+~'~N7?FklSw~i:ttl §r~"3!f4~~A79RiS ^r'eu.4C' 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. §9116 (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 fhe statutory requirements for disclosure of assets and fliing a tax return are still applipble even H the suMving 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 adopflve parent or a stepparent of the child is 0 percent (72 P.S. §9116(ax1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries is 4.5 percznt, except ~ noted in [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.S. §9116(ax1.3)]. 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. REV-1502 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: Inez M Myers _ All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. If more space is needed, use additional sheets of paper of the same size. REV-, 508 EX+ ~„_, o, SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT -- - ESTATE OF: FILE NUMBER: Inez M Myers _ Include the proceeds of litigation and the date the proceeds were received by the estate. If more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Inez M Myers Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman Roth Funeral Home 549 2. Westminster Cemetery, engraving 210 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Darlene Sheaffer Street Address 40 Wedgewood Drive city Carlisle State PA zIP 17015 Year(s) Commission Paid: 2011 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Advertising in the Sentinel and Cumberland Law Journal 8. Direct Pay withdrawn from account after death 9. Expenses of real estate to be sold. Suspended pending sale TOTAL (Also enter on Line 9, Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. ZIP 3,000 3,000 425 254 30 7 REV-1512 EX+ (12-08 ) pennsylvania SCHEDULE I DE°ARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS -- r~~.c iwmo~r~ Inez M Myers Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: Inez M M ers 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 Eugene Henry -DECEASED. BEQUEST LAPSES nephew 2 Jack Henry 471 Freehold St., Oakhurst, NJ 07755 nephew 1,000.00 3. DARLENE SHEAFFER 40 WEDGEWOOD DRIVE, CARLISLE, PA 17015 FRIEND PERSONAL PROPERTY 4. DANIEL AND DARLENE SHEAFFER 40 WEDGEWOOD DRIVE, CARLISLE, PA 17015 FRIENDS 10,000.CO ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, AS APPROPRIATE. 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. Grace United Methodist Church 1/3 of remainder 2. Carlisle Citadel of the Salvation Army 1/3 of remainder 3. Humane Society of Harisburg Area 1/3 of remainder TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. Ir more space is neetletl, use atltlitional sheets of paper of the same size. .~ 1 ~:- F ~~,r-~-p'~ i -__ 6 ., _ - _ t~ !~ ~ ,~~~ FUNERAL HOME ~' CREMATORY, INC. Attorney Robert Frey 5 South Hanover Street Carlisle, PA 17013 219 Norfh Hanover Street Carlisle, Pennsylvania 17013 717.243.451 1 toll free 1.866.451.451 1 fax 717.243.3723 vv~nv.hoffmanroth.rom info@hoffmanroth.com June 6, 2011 Statement of Funeral Expenses for: Inez M. Myers Date of Death: May 3, 2011 Account Id: 16239-109 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,550.00 Sub Total: $ 4,550.00 MERCHANDISE: Casket: Amherst $ 3,230.00 Outer Container: Monticello $ 1,620.00 Sub Total: $ 4,850.00 TOTAL FUNERAL HOME CHARGES: $ 9,400.00 CASH ADVANCES: Westminster Cemetery $ 1,720.00 5 Certified Death Certificates at $ 6.00 each $ 30.00 Newspaper Notice -Sentinel $ 100.48 Newspaper Notice -Patriot $ 179.17 Clergy $ 100.00 Flowers $ 169.55 Hairdresser $ 40.00 _ Sub Total: $ 2,339.20 Total Funeral Expense: $ 11,739.20 Total Payments Made: $ 11,739.20 Payments Made: Family Service Life Check 519642 May 31, 2011 10,672.34 PreNeed Dics Discount Cont vs PreN May 31, 2011 516.91 Darlene Sheaffer Check 2090 Jun 6, 2011 549.95 Balance: 5 0.00 Please return this portion with your Remittance. $ Amount Enclosed Inez M. Myers Service ID#: 16239-109 SERVING OUR COMMUNITY S I N C E 1 9 0 7 +'u r L J~ L-.' / ~ J L" v ~ ivv ~ ~~iY i~ 'T I L ~ V J L ~ • QPNC •. ~ ~ 7!_ ~ L/ ~ _ _~ ~~ l.F.~4t-ii't~ TFfE IKAY May 25, 2011 Rochelle White PNC $ank Carlisle Branch RE: Inez M Myers SSN: 187-16-4651 DOD: OS-03-2011 Dear Ms. White: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 31200200153 Established: 09-27-2000 INEZ M MYERS DOD balance: $10,062.3 ] + 1.7b accrued interest Checiciag Account Account # 5140431411 Established: 03-03-1989 Il~iEZ M MXERS DOD balance; $ 18,307.b5 + 0.20 accrued interest Savings Account Account # 5003903697 Established: 01-25-2002 INEZ M MYERS DOD balance: $ 41,114.42 + 1.53 accrued interest Please note that this office provides date of death balances for deposit accounts (]ItAs, CDs, Checking and Savings). We do not process any financial trs~nsactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-B,ANK (1-888-762-2265) or stop by your Local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 2 ., , / J/ .; This message is intended for the use of the individual or entity to which it is addressed and may contain information that isprivileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited If you have received this communication in error, please note me immediately by reply or by telephone at 500-762-1775 and immediately destroy this faxed document. Page 2. of 2 3 y ', .-, ~ ~ N N 7 a 77 .l- ~ ~ n c a o ~, ' ~ ~ ~ h ~-J ~ ~ ~ ~ ~rt C ~ J . . ~ Oi O (~ ,..,~ C n O n MM rt = ~ . rt ] e r ( D r.+rt f D ° , °, tD 0 a z ~ o ~ cn " '~ ~ ~ ~ o d ~. K o O m ~~ N O ,~,~, ~ ~' O d ~ rt n X ~ "C ti 5 ~ fR ~ 'r A O F+ W ~ p v~'i ~ ~ .+ ~ d `ti .r m ~a iA ~ N .. .fir n ~+ ~ ~ J~ ' ~ ~ o, o. ~ ~ ~ ~ O ~ ~ O ~ O ~ m ~~+, ~ ~ :J1 Q~ ~~ 0 ~n ~ ~ '7 n 'S7 ~ ~ d ~ ~ ~ rh ~ O d ~ ~ ~ ~ 7 b b n z = ~° c ?- ° o ,~ ~ ~~ o ~O `y V ~~i, N ~ ~ o, a ~ ~ ~ ~ v, ~ W O~ r~ 0~ N ~. W ~ y ~ ~ N ~ 00 ~ "~' ~ ~0 O Oµ ~ ~ ~ N O+ ~ ~ x ~, ~ a n r~ n~~ A r ~ ~ ~ ~ y z c a y ~' ~ °, ~, ~ ' ~ ~ K °~ ~ ~ ~ " O z ~ C ~ ~ o ~ ~ ~/- ~ ~ f9 "' ~ ~e ~ ~ O ~ ~ w ~ N O M LAST WILL AND TESTAMENT OF INEZ M. MYERS I, INEZ M. MYERS, widow, of 56 East Willow Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and malting void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executor or Executrix to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that all inheritance, transfer, succession, estate and death taxes which may be payable on account of my death, including interest and penalties thereon, shall be paid from the residue of my estate regazdless of whether the assets upon which such taxes are based are included in my probate estate. 2. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: a. One-third (1/3) to Grace United Methodist Church, Pomfret and West Streets, Carlisle, Pennsylvania, to be used for such purpose or purposes as the Boazd of said Church shall deem best; b. One-thud (1/3) to the Carlisle Citadel of The Salvation Army, Pomfret and Bedford Streets, Carlisle, Pennsylvania, to be used by it for its various programs in the Borough of Carlisle and in Central Cumberland County, Pennsylvania, as its Board shall deem best; c. One-third (1/3) to the Humane Society of Harrisburg Area, Inc., for such purposes as its Board shall deem best in connection with its operation of its West Shore Shelter located at the intersection of Sinclau and Eppley Roads, Mechanicsburg, Pennsylvania. 3. I hereby nominate, constitute and appoint DARLENE SHEAFFER of 40 Wedgewood Drive, Carlisle, Pennsylvania, as Executrix of this my Last Will and Testament, but should she predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint PNC Bank and its successors, 4242 Carlisle Pike, Camp Hill, Pennsylvania 17011, as alternate or successor Executor, and I further direct that neither of them shall be required to post any bond to secure- the faithful performance of her or its duties in the Commonwealth of Pennsylvania or~n any other jurisdiction. IN WITNESS V~'IIEREOF, I hereur}4o set my hand and seal to [his my Last Will and Testament written on one (1) page, this r9 y~.-day of November, 2002. C~~i (SEAL) Inez M yer ~~ Signed, sealed, published and declared by INEZ M. MYERS, the Testatrix above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. lks'~c. ~ r~~ FIRST CODICIL TO LAST WILL AND TESTAMENT OF INEZ M. MYERS DATED NOVEMBER 19. 2002 I, INEZ M. MYERS, widow, of 56 East Willow Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for a First Codicil to my Last Will and Testament dated November 19, 2002, as follows: 1. I give and bequeath all of my household goods and furnishings and tangible personal property generally in equal shares to my nephew, EUGENE HENRY of 1760 Raleigh Court, E-28-A, Ocean, NJ 07712-2603, my nephew, JACK HENRY, of 471 Freehold Street, Oakhurst, NJ 07755, and my niece, DARLENE SHEAFFER, of 40 Wedgewood Drive, Carlisle, PA 17013, to be divided equally among them as they may agree, but should they fail to agree then as my hereinafter named Executrix shall determine, 2. I give and bequeath the sum of $1,000.00 to my nephew, EUGENE HENRY, 1760 Raleigh Court, E-26-A, Ocean, NJ 07712-2603. 3. I give and bequeath the sum of $1,000.00 to my nephew, JACK HENRY, of 471 Freehold Street, Oakhurst, NJ 07755. Except as herein above provided, I hereby ratify and affirm the provisions of my Last Will and Testament dated November 19. 2002. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this First Codicil to my said Last Will and Testament written on one (1) page this ~. ~ Today of April, 2003. SEAL) Inez M. ers Signed, sealed, published and declared, by INEZ M. MYERS the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. . ~~ SECOND CODICIL TO LAST WILL AND TESTAMENT OF INEZ M. MYERS DATED NOVEMBER 19 2002 I, INEZ M. MYERS, widow, of 56 East Willow Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for a Second Codicil to my Last Will and Testament dated November 19, 2002, as follows: 1. I give and bequeath the sum of $10,000.00 to my friends Daniel Sheaffer and Darlene Sheaffer, husband and wife, as tenants by the entirety, of 40 Wedgewood Drive, Carlisle, PA 17013. provisions of my LastaWheand Testamenot dated INovembert 9 2002, landtthe provisions of my First Codicil to my said Last Will and Testament, which First Codicil is dated April 29, 2003. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this Second Codicil to my said Last Will and Testament, and First Codicil thereto, written on one (1 }page this a, g'~. day of May 2003. .~ ~ EAL) Inez M. yer Signed, sealed, published and declared, by INEZ M. MYERS the Testatrix above named, as and for a Second Codicil to her Last Will and Testament and First Codicil thereto, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses.