The URL can be used to link to this page

Home My WebLink About03-15-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG, PA 1 71 2 8-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HOFFMAN KATHLEEN 929 BONNY LANE MECHANICSBURG, PA 17055 ~o~a ESTATE INFORMATION: sSN: 209-~ 2-7081 FILE NUMBER: 211 1-0220 DECEDENT NAME: SHEIBLEY RUTH E DATE OF PAYMENT: 03/ 1 5/201 2 POSTMARK DATE: 03/1 5/2012 COUNTY: CUMBERLAND DATE OF DEATH: 02/10/2011 REMARKS: RECEIPT TO ATTY SEAL CHECK# 57 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 572.22 TOTAL AMOUNT PAID: 572.22 INITIALS: HEA RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1162EXI11-96) INO. CD 015705 1505611185 REV-1500 EX (02-11) (FI) PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 260601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY 209-12-7081 02102011 Decedent's last Name Suffix SHEIBLEY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ^ 1. Original Return ® 2. Supplemental Return ^ ~~. Remainder Return (Date of Death Prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ °i. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ EI. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death ^ 1'1. 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 TA}: INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number KEITH 0• BRENNEMAN 71,7-697-8528 REGISTER OF WILLS USE ONLY First Line of Address SNELBAKER & BRENNEMAN Second Line of Address 44 WEST MAIN STREET City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's a-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. ~~~ Date of Birth M1IMDDYYYY 12181924 Decedent's First NamE: MI RUTH E Spouse's First Name M I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE OFFICIAL USE ONLY County Code Year File Number 21 11 0 220 KATHLEEN HOFFMA'tid''; EXECUTRIX 929 BONNY LANE, MECHANICSBURG, PA 17055 Sl~pe~TURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS KEITH 0• BRENNEMAN 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA 17 55 1505611185 Side 1 OM4647 3.000 1505611185 15D5611285 REV-1500 EX {FI) Decedent's Social Security Number 2D9-12-7D81 Decedent s Name S H E I B L E Y RUTH E RECAPITULATION 1. Real Estate (Schedule A) 1 • D ' D D 2. Stocks and Bonds (Schedule B) . 2. D • D D 3. Closely Hetd Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3. D • D D 4. Mortgages and Notes Receivable (Schedule D) 4. D • D D 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 1, 6 0 2 •5 3 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g, D • D D 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property D D D (Schedule G) ~ Separate Billing Requested 7. • 8. Total Gross Assets (total Lines 1 through 7) g. 1, 6 0 2 • 5 3 g. Funeral Expenses and Administrative Costs (Schedule H). g. 15 • D D 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) 1 p, D • D D 11. Total Deductions (total Lines 9 and 10) , 11. 15 • D D 12. Net Value of Estate (Line 8 minus Line 11) 12. ], , 587.53 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , . 13. D • D D 14. Net Value Subject to Tax (Line 12 minus Line 13) . 14. 1, 5 8 7 • 5 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 O D D D• D O (a)(1.2) x .o - • 1 s. 16 . Amount of Line 14 t xable 4~ 71.4 4 at lineal rate x .0 1, 5 8 7. 5 3 16. 17 . Amount of Line 14 taxable D• D D at sibling rate X .12 D• D D 17. 18 . Amount of Line 14 taxable at collateral rate X .15 D• D D 18. D• D ~ 19 71 • 4 4 19 . TAX DUE . 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15D5611285 1505611285 OM4648 3.000 REV-1500 EX (FI) Page 3 File Number 't i. Haan U@Ge(7erIL5~+vmN~cacnuu~c~~. -- -- ---- DECEDENT'S NAME SHEIBLEY RUTH E STREET ADDRESS CARLISLE BOROUGH C M R AND OUNTY CITY STATE ZIP CARLISLE PA 1~013- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments ~ ' ~ 0 B. Discount ~ ' ~ 0 (1) _ 71.4 4 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) ~ • (] (] (3> . 0.78 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. •~~ (5) 72.22 Make check payable to: REGISTER OF WILLS, AGEI~JT. 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 a b. retain the right to designate who shall use the property transferred or its income ^ c. retain a reversionary interest ^ 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? . ~ a 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? 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. §91 16 (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)j. 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 deaath 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 val',ue of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net vdlue of transfers to or for the use of the decedent's siblings is 12 percent [[72 P.S. §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. OM4671 2.000 REV-1508 EX+ (11-10) pennsylvania DEPARTMENrOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER: ESTATE OF: Ruth E. Sheible 21 11 0220 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. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION _. 1. Commonwealth of Pennsylvania 1,602.53 unclaimed property consisting of MetLife, Inc stock and dividends TOTAL (Also enter on line 5, Recapitulation) $ ~ 1 , 602.53 owasAD 2.00o If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10-09) SCHEDULE H Pennsylvania FUNERAL EXPENSES AND DEPARTMENT 0= REVENUE INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT FILE NUMBER ESTATE OF Ruth E. Sheible 21 11 0220 Decedent's debts must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: ~ None B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Persona! Representative(s) Street Address City Year(s) Commission Paid: 2, Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant c..,,e+ o~~~o~~ 4. 5. 6. 7. 1 9W46AG 2.000 City State ZIP _ Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Register of Wills filing fee for supplemental Inheritance Tax Return TOTAL (Also enter on Line 9, Recapit If more space is needed, use additional sheets of paper of the same size. State PA ZIP DESCRIPTION AMOUNT 15.00 g 15.00 REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES FILE NUMBER: ATE OF: 21 11 0220 th E. S heible LATIONSHIP TO DECEDENT AMOUNT OR SHARE RE BER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE UM I ] istributions and transfers under TAXABLE DISTRIBUTIONS [In p 1 (1.2) 16 (a) SeCe 91 1. Debra Ann Wheeler 1261 High Street Boiling Springs, PA 17007 29$ of Residue: 460.38 Daughter 460.38 2 Alicia K. Deardorff 8170 Evelyn Street Humutelstown, PA 17036 29~ of Residue: 460.38 Granddaughter 460.38 3 Kathleen Hoffman 929 Bonny Lane Mechanicsburg, PA 17055 13~s of Residue: 206.38 Daughter-in•-law 206.38 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVEIR SHEET, AS APPROPRIATE. II NON-T~BLE DISTRIBUTIONS A. SPGUSAL 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. If more space is needed, use additional sheets of paper of the same size. 0.00 9 W 46AI 2.000 Estate of: Ruth E. Sheibley Item No. Description 4 Milton K. Sheibley 1300 York Haven Road Lot 49 York Haven, PA 17370 29~ of Residue: 460.38 Schedule J Part 1 (Page 2) Son Relation 21 11 0220 Amount 460.38