HomeMy WebLinkAbout03-30-121505610140
OFFICIAL USE ONLY
REV-1500 ~` ~°'-'°'
PA Departm nt of Revenue County Code Year E:ile Number
Bureau of In ividual Taxes INHERITANCE TAX RETURN
Po Box 28 sot 2 1 1 2 0 0 1 5 4
Harrisburg. A 17128-0601 r RESIDENT DECEDENT
ENTER DECEDENT INFORM TION BELOW
Social Security Number Date of Death MMDDYYW
Decedent's Last Name Suffix
A N G N E Y ',
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Nurnber
FILL IN APPROPRIATE OVALS BELOW
Date of Birth MMDDYYW
0 4 2 0 1 9 1 6
Decedent's First Name MI
J D O R O T H Y
Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
O 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
t to
t Di
d T
d
D
~ death after 12-12-82)
Decedent Maintained a Living Trust
7
~
8. Total Number of Safe Deposit Boxes
^X es
en
e
ece
6.
(Attach Copy of Will
9. Litigation Proceeds ~teceived
~ .
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
~
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS
Name
I v o V
ACTION MUST BE COMPLETED. ALL GVMMtSr•UIVUCIYGe Anu ~Vrvrivon t iN~ i nw mrvmm~ i wig ~nv~w oc ~mw ~ w ~ v.
Daykime Telephone Number ~;
- °~ ~1"1
O t t o I I I 7 1 7 2 ~#~ 3. 4 ~"`, ~ -_,
First line of address
M A R T S O N L
Second line of address
1 0 E H I'G H
City or Post Office
C A R L I S L'E
~ :tr^ i ~
REGISTER t3'USE ~ Y j ; ~ 7
~ n c~ _ ~' ' ~. ,
`= __" _,.
C"?Ci'r'~ -,-i
A W O F F I C E S ~ _~ ~? `T'
-a C~
~. <
S T R E E T
State ZIP Code L DATE FILED
P A 1 7 0 1 3
Correspondent's a-mail ad ress: IOTTO(cr~MARTSONLAW.COM
Under penalties of perjury, I declar that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief
it is true, co ct and comple . of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE ~F PE SOIp ES NIL LING RETURN DATE
3a
ADDRESS
10 E HIGH STRE T CARLISLE PA 17013
SI;~ QT~1RE OF PREPARER OT ER THAN REPRESENTATIVE DATE
ADDRESS
10 E HIGH STRE T CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
15056110140
Side 1
1505610140
1505610240
REV-1500 EX Decedent's Social Security
RECAPITULATION
1. Real Estate (Schedule Pl) ...................................... ..... 1 • •
2. Stocks and Bonds (Schedule B) ................................. ..... 2• •
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D) ..................... ..... 4. •
3 8 8 9 . 1 0
5. Cash, Bank Deposits anld Miscellaneous Personal Property (Schedule E).. ..... 5.
6. Jointl Owned Pro erty
p Schedule F) ^ Separate Billing Requested .. ..... 6.
7.
(ter-Vivos Tjansfers & ~vliscellaneous N -Probate Property
~ S
uested
Billin
Re
t
7
..
g
q
epara
e
Schedule G .....
.
8. Total Gross Assets (t~'tal Lines 1 through 7) ..................... ...... 8. 3 8 8 9 . 1 0
9.
............
Funeral Expenses and l~dministrative Costs (Schedule H) 9.
...... 8 5 2 8 . 8 4
10. Debts of Decedent, Mo} tgage Liabilities, and Liens (Schedule I) 10. 2 0 6 3 3 2 . 7 5
11.
.........................
Total Deductions (totab Lines 9 and 10)
......11. 2 1 4 8 6 1. 5 9
12. Net Value of Estate (Lane 8 minus Line 11) ...................... ...... 12• - 2 1 0 9 7 2 . 4 9
13. Charitable and Governr~nental Bequests/Sec 9113 Trusts for which
13
an election to tax has n t been made (Schedule J) ................ .
......
14. Net Value Subject to Tax
(Line 12 minus Line 13) ...................... 14. - 2 1 0 9 7 2. 4 9
TAX CALCULATION -SEE DNS
15. Amount of Line 14 taxable
at the spousal tax rate, for
transfers under Sec. 91116
(a)(1.2) X.0
16. Amount of Line 14 taxable
at lineal rate X .0 _'
17. Amount of Line 14 tax~'ble
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15'
FOR APPLICABLE RATES
• 15.
• 16.
17.
• 18.
19. TAX DUE ......................................................19.
20. FILL IN THE OVAL IF ~IYOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
i
I~
150561240
Side 2
1505610240
REV-1500 EX Page 3
filn~nrlon+'c C_mm~lptp AddreSS_
File Number
21 12 OO1S4
................. .....r•--- - -- - ----
DECEDENT'S NAME
J. DOROTHY ANGNEY
STREET ADDRESS
442 WALNUT BOTTOM ROAD
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credit: (1)
~ . Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + B) (2)
3. Interest
(3)
4. If lane 2 is greater than Line 1 + Line 3,j enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,1 Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
',Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER TF~E FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make ~ transfer and: Yes No
b. retain the nsht to come of the property transferred : ...................................................................... ^
'g designate who shall use the property transferred or its income; ............................... ^ ^
c. retain a reversionary interest; or ................................................................................................ ^
d. receive the promi$e for life of either payments, benefits or care? ....................................................... ^ 0
2 w pout receUwnd ad~gDecember 12, 1982, did decedent transfer property within one year of death
.. g uate consideration? ....................................................................................... ^ 0
3. Did decedent own ar[ 'in trust for" orpayable-upon-death bank account or security at his or her death? ......... ^
4. Did decedent own ar~ individual retirement account, annuity or other non-probate property, which
contains a beneficiariy designation? .................................................................................................. ^ ^X
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 1,194, and before Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse i;
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1 95, 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 statut~ 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, 2 00:
• The tax rate imposed on the net val a 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 t e child is 0 percent [72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net val a 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(1.2) [72 P.S. §9116( )(1)].
• The tax rate imposed on the net val a 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 as at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (11-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8~ MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
J. DOROTHY ANGNEY 21 12 00154
Include the roceeds of litigation and the date the proceeds were received by the estate.
All properly ~ointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Resident Funds of hornwald Home 3878.78
2. Cash found in purse
3. MetLife, Group Lift Insurance payable to Estate, $7,000.00 -exempt from tax
TOTAL (Also enter on Line 5, Recapitulation) I $
If more space is needed, insert additional sheets of paper of the same size
10.32
0.00
3
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
J. DOROTHY ANGNEY 21 12 00154
Decedents debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSE
t. Hoffman-Roth Funeral Home & Crematory, Inc. 8,028.04
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2 Attorney Fees: Manson Law Offices
3. Family Exemption: (If ~ecedenYs address is not the same as claimants, attach explanation.)
Claimant
Street Addr~'ss
City State ZIP
Relationshipl, of Claimant to Decedent
4. probate Fees: Register of Wills, Cumberland County 82.50
5 Accountant Fees:
6. Tax Return Preparer ~ees:
7. Register of Wil~s, filing fee, inheritance tax return 15.00
8. Cumberland La{w Journal, advertising Letters 75.00
9. The Sentinel, a vertising Letters 168.30
10. .Register of Wil~s, filing fee, account 160.00
TOTAL (Also enter on Line 9, Recapitulation) I $ 8
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-08)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
J. DOROTHY ANGNEY 21 12 00154
Report debts incurred by the ecedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, Pennsylvania Depar~nent of Public Welfare, Class 3 claim 21,238.90
2. Pennsylvania Depar~nent of Public Welfare, Class 5.1 claim 185,093.85
~~
TOTAL (Also enter on line 10, Recapitulation) $
206 332.75
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT ~`
SCHEDULE J
BENEFICIARIES
ESTATE OF: ' FILE NUMBER:
J. DOROTHY ANGNEY 21 12 00154
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRE S OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1.
ENTER DOLLAR AMOUNT FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUT ONS:
A. SPOUSAL DISTRIBUTIO SUNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART II -ENTER 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.
F.\FILES\DA'FAFILE\WiLLS\9904. W[L
t+a
--~ ~~'
N ; ~'1
^~ :'~ C ~
T ._ .; l'.
LAST WILL AND TESTAMENT ~~~~ w ' ~~ `=
r~ C7 ~ -p -~~+ =r
I, J. DORO'T'HY ANGNEY, of the Borough of Carlisle, Cumberland County., ~ylva~a, r_
being of sound and disposing mind and memory, do hereby make, publish and declaz~tlus to be..my `~' o
~,. .
Last Will and Test~.ment, hereby revoking any and all former Wills or Codicils by me made.
1.
I direct thatll all my legally enforceable debts, funeral expenses, testamentary expenses and
all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property) shall be p~d from my residuary estate as soon as practicable after my decease and as part
of the administration of my estate. My Executor shall have no duty or obligation to obtain
reimbursement for any such tax so paid, even though on proceeds of insurance or other property not
passing under this 1Wi11.
2.
I give the snm of Five Thousand Dollars ($5,000.00) unto EVELYN KELLEY CRAIG, now
of 39 East North Sfxeet, Carlisle, Pennsylvania. This legacy shall lapse if she shall predecease me
or if my net estate', after payment of all administration expenses, debts and death taxes, shall be
insufficient to pay'~,same.
3.
All the resjt, residue and remainder of my estate, both real and personal property, I give,
devise and bequea~h in the following manner:
Fifty percent (50%) thereof unto FIRST UNITED CHURCH OF CHRIST, North Pitt Street,
Carlisle, Pennsylvjania, 17013;
Twenty-fire percent (25%) thereof unto THORNWALD HOME, Walnut Bottom Road,
Carlisle, Pennsylvania, 17013; and
Twenty-fide percent (25%) thereof unto SARAH A. TODD MEMORIAL HOME, West
South Street, Carl~sle, Pennsylvania, 17013.
The share. of THORNWALD HOME and SARAH A. TODD MEMORIAL HOME shall
be used solely at ~he Carlisle, Pennsylvania, facilities.
IIII
~!/~~
J.D.A.
Page 1 of 3 Pages
4.
I nominate, I constitute and appoint KEYSTONE FINANCIAL BANK, N.A. of Carlisle,
Pennsylvania, as E~Cecutor of my estate, and I direct that my Executor shall not be required to file
a bond. to secure th~ faithful performance of its duties in any jurisdiction.
5.
I authorize land empower my Executor, in its sole and absolute discretion, to purchase or
otherwise acquire a~d retain any investments of which I die seized or any real or personal property
of any nature; to s 11, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in
regard to any or all roperty of any kind forming a part of my estate for such terms and such prices
as it may deem ad isable; to borrow money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any real or personal property forming a part of my
estate or to join in~ or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
share to be compo~ed of cash, property or undivided fractional shares in property different in kind
from any other sha~e; to employ agents, attorneys and proxies and to delegate to them such power
as my Executor cdnsiders desirable and to pay reasonable compensation for such services as may
be rendered by su~h agents, attorneys and proxies; and to execute and deliver such instruments as
maybe necessary o carry out any of these powers. In addition, I direct that my Executor shall have
the power to con ct an inventory of any safe deposit box necessary to the administration of my
estate.
IN WITN~SS WHEREOF I have hereunto set my hand and seal this `14' ~ da of
Y
I! , 1999.
~-~~
', , .~/a~-c ~ (SEAL)
J. orothy Angn
SIGNED, ~EALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
for her Last Will d Testament, in the presence of us, who at her request, have hereunto subscribed
our names as wit esses thereto, in the presence of the said Testatrix and of each~o-t~he-r-
~~
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUI~vIBERLAND
. SS.
I, J. Dorot~y Angney, Testatrix, whose name is signed to the attached or foregoing
instrument, having ~een duly qualified 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.
J. Dorothy Angn
Sworn or a ed to and acknowledged before me by J. Dorothy Angney, the Testatrix, this
~`~*dayof , 1999.
Notary Public
NOTARIAL SEAL
COMMONWEALTH OF PENNSYLVANIA ) CORRINE L MYERS, Noqry Public
Carlisle Boro, C+rmberlar~dCw~ty
SS. commission E' M 27, 2003
COUNTY OF CUIMBERLAND )
We, ~G,t: t~L.~ ~n~ ~ • ~ G~ and ~' • ~ . ~7•~'1
the witnesses who a names are signed to the attached or foregoing instrument, being d ly qualified
according to law, c~o depose and say that we were present and saw J. Dorothy Angney, the Testatrix,
sign and execute he instrument as her Last Will; that the Testatrix signed willingly and that the
Testatrix execute it as her free and voluntary act for the purposes therein expressed; that each of
us, in the hearing end sight of the Testatrix, signed the Will as witnesses; and that to the best of our
knowledge the T~statrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
d s ~ ,C~a~ae-
Q~-/~s A /7a/j
// ~
Address .~~ b r ~,U fc~a!, 7
f~~,~~
Sworn or ~ffirmed to and subscribed before me this ~ ~ day of ~-~- , 1999.
Notary Public
NOTARIAL SEAL Pubwc
CORRINE 1. MYERS, Noury
Page 3 of 3 Pages ~,a,' Ex~ MMa~nnddCC~ N