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HomeMy WebLinkAbout04-02-12 .~ 1505610105 REV-15 !~1 OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes °` "~ "`"T `• County Code Year File Number INHERITANCE TAX RETURN PO BOX z806oi ,~ ~ ~ ~ ~,~ Harrisburg PA >~>z8-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 192-30-4439 04/30/2011 03/07/1940 Decedent's Last Name Suffix Decedent's First Name MI Peffer Eleanor S (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 FILE D IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (,1p 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 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 Rodney Peffer (717) 329-1275 ,,,, First Line of Address 29 Waverly Drive Second Line of Address City or Post Office Hummelstown State ZIP Code PA 17036 r-- ~ REGISTER OF WIE1.3,~SE ONLY ~7 'Q ~ ?? ~ r:--- _ ~.a ""'l _, ~J T "~ . ~~c,~~ ,j.<-i ~v -1 DATE FILED -- -~~ Y.a t 1 r ,.rtT ~y - C"~ ,. --= ; r~ r`. ~~~ t Correspondent's a-mail address: rpeffer@thezenith.COm 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. SIGNS1j~dE_QF PAR RESPONSIBLE FOR FILING RETURN DAT 1~',G 7~3, /v ADDRESS 29 Waverly Drive Hummelstown, PA 17036 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 1505610105 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610205 REV-1500 EX (FI) Decedent's Name: Eleanor Peffel- Decedent's Social Security Number .192-30-4439 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 123,630.08 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. 9 9 ( ) ......................... Mort a es and Notes Receivable Schedule D .. 4. 0.00 _ 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 30,401.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. ( 9 ) ........................... Total Gross Assets total Lines 1 throw h 7 .. 8. 154,031.08 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 15,354.31 10. Debts of Decedent, Mortgage liabilities and Liens (Schedule I) ............. .. 10. 0.00 11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 15,354.31 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 138,676.77 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 138,676.77 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate x .0 45 138,676.77 16, 6,240.45 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... ..19. 6,240.45 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J RSV-; 500 EX (FI) Page 3 File Number -Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0.00 B. Discount 0.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) (3) (5) (1) 6,006.13 0.00 (4) 90.09 6,096.22 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 No a. retain the use or income of the property transferred .......................................................................................... ^ 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? .............................................................................................................. ^ 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. §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 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 death 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 value 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 value 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. REV-iso3 EX+ (~-ii) ~: , ~ : pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Eleanor Peffer 45-6280279 All property jointly owned with right of survivorship must be disclosed on Schedule F. it more space is needed, insert additional sheets of the same size REV-i5o8 EX+ (u-io) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Eleanor Peffer 45-6280279 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. Ir more space is needed, use additional sheets of paper of the same size. REV-1.51.1 EXI-(LU-09j ti pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Eleanor Peffer 45-6280279 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Professional funeral services 4,625.00 2. Casket & vault 6,545.00 3. Newspaper, clergy, opening grave, death certificates, cemetery services 2,021.98 4. Memorial engraving 160.00 B. ADMINISTRATIVE COSTS: I. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City _ _ _ State ZIP _. Year(s) Commission Paid: 2. Attorney Fees: 3. family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City _ _. _ _ _ State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 200.00 6. Tax Return Preparer Fees: ~• Register of wills 343.50 e. Outstanding medical bill- Heritage Medical Group, LLC 100.60 9. West Shore EMS Service 1,358.23 TOTAL (Also enter on Line 9, Recapitulation) I $ 15,354.31 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) ~i pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF: FILE NUMBER: Eleanor Peffer 45-6280279 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Annette Fertenbaugh Daughter 20% 2. Stephen Peffer Son 20% 3. Rodney Peffer Son 2p% 4. Michael Peffer Son 2p% 5. Jody Shaw Daughter 5% 6. Jessica Straight Granddaughter 15% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, 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. 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. REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No . 201 1- 00572 Estate Of : ELEANOR S PEEPER CERTIFICATE OF GRANT OF LETTERS PA No. 21- 11- 0572 IFirst, Middle, Lasrl Late Of: MONROETOWNSHIP CUMBERLAND COUNTY Deceased Soci a I Security No : WHEREAS, on the 13th day of May 2011 an instrument dated October 10th 1994 was admitted to probate as the last will of ELEANOR S PEEPER (First, Middle, Lasrl late of MONROE TOWNSHIP, CUMBERLAND County, who died on the 30th day of April 2011 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: RODNEY L PEEPER who has duly qualified as EXECUTOR(R/Xl and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 13th day of May 2011. ~~ r ~ '~~~, ~ ;~f~ f ,' 'p~ ' eputy /~ **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) COMMONWEALTH OF YENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I ~^~ ~~)~~ i ~'-T ~+'`. -+~~'.- the testaCC'1X ~`J ..J Jr:i 'y Olti, S • Ji i y+.~ , whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed iC as my free and volun- tary act and deed, for the purposes therein contained. Sworn and atLirmed to and acknowledged before me ELL;'!i~?~ S. ~.~~'_ rR the testatrix this ~~_ day of 4ctobor , A. D. ~ 1~9+.~. /i r / COMMONWEALTH OF YENNSYLVANIA ) COUNTY OF CUriBERLANll ) Martlyn Kay Eakin, Notuy i'u~lic M9chat~CStug Ban, Grr~berlazxl Cour~y S S . tih+Ctxmtiss~on Expi~ fJo~r. & i~97 , ~ assaaa~cH~ ' J. R 4~3ku T S`!'ri l! ti r E~3 We, the undersigned, --~;; -,• T :~ -' ~, , the witnesses whose names are and ~; Tf~~ ~~ L, i,~y~I~~~.~2~~i signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatj a.x Eyt':~ZORE S • ?EFl Jn sign and exe- cute the instrument as<hd&/tier Last Will and Testament; that the said r_estatr'~-X _ , E_LE41i'•i0_iE S.__ PE_F_~='1R__. _, executed it as ~4her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testat rix signed the Wilt as witnesses; and that to the best of our knowledge, the testatr~-X was, at the time, eighteen (18) or more years of age, of ennnrj mind_ and under no constraint, duress or undue influence. Sworn and subs-~yribed to befo me this /~ / day of Gctober , 1°91;.. /I~ ~ ~~~ n _: -, •- ~~ -'-- -T ` ~ ~ '~ - -i~_.i - _ j "1 " ~ ~.y -- '7 ~. ;,: . L!1.ST ~~IILL A TdD TES^1~'1T~IENT Oda i~LEATdORE S. ._ ., ..~ ` _` _ PEFF~R' `_~ ~ ~' C `, r ELE;ATdURE S. :I PEFr'ER, of the noroul;h of T-iecha.niesburg, , County of CLU~nberland and State of Pennsylvani a, being of sound and disposing; mind, memory and understa.ndin~, do make, publish and declare this my Last t~dill and Testament, hereby revoking and making; void any and all prior 1~lills by me at any time heretofore made. 1. T direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done . 2. After the payment of all of my just obligations, the costs of administration of my estate and all inheritance and succession taxes, l direct that my entire estate then remaining, of whatsoever nature and wheresoever. the same may be situate, be divided into five (5) equal shares and that the same be paid out and disi;ributed as follows, to wit: A. I dive and bequeath one (1) such equal share to my daul;htor, ATdNETTE S. FT;RTENBAUGH. ~. ~ give and bequeath one (1) such equal share to my Son, aTT;I'HET1 ~4. PPsF'PER. C. I give and bequeath one (1) such equal share to my s on, RODI`1~ L. PEF'FLR . D. I give and bequeath one (1) such equal share to my s on, I'II CI;AEL E . YEFFIaR . E. I give and bequeath one-fourth (%) of a sharp to my daughter, JODY K. AITKIItdS. F. T give and bequeath three-fourth (3/4) of a share to my granddaughter, JESSICA ATTKINS. (a) In the event that my granddaughter, JESSICA AITKINS, has not attained the age of eighteen (18) years at the time of my decease, then its such ev©nt, I give a.nd bequeath her share in my astate, to my son, P~OD11E'~' L. I'EFFER, in trust, nevertheless, to Yzo7_d, manage, invest and reinvest the same, and to use and apply the income and principal, or so much thereof, as in my Tru.stee~s discretion, he may deem necessary or appropriate for th.e comf ortable care and maintenance of my granddaughter, JESSICA .'±TTI'I~7S, without Further rospeonsibility to her or to her guardian, if any, or to any per°on who may be taking care of her. Any income not so used or applied shall be accumulated and added to and thereafter be treated as part of the principal of said trust fund. I~Jhen my granddaughter, JESSICA AITKIPdS, attains the age of e.i_ghteen (18) years, said trust shall terminate and the pr:i.ncipr~l of the trust and any income with xriay have accurnultzted. thoreon, shall be distributed and paid over to my granddaughter, -2- JTSSICA ~ITILTA?S, absolutely and unconditionally, free and clear oi' all further trust provisions . T direct that my son, RODi1EY L. PLFFER, be permitted to serve as guardian and trustee of the estate of my granddaughter, J~~SSTCA AITI~~II'S, without being required to post bond or other security foz° tl~e faithful performance of his duties and that he be excused from filing an accounting; of his trusteeship. LASTLY, Z nominate, constitute and appoint my son, RODr1EY L. P.csht~'F~t, }sxecutor of this m.y Last ti~Ti11 and Testament, and in the event that ;rly said son should predecease me, or should he be unable or urnrilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my daughter, A?~INETTE S. FERTEPIBAUGFi, Executrix of this my Last j'Jill and Testament in his place and stead, and in either instance, I dixect that my said personal representatives be excused from posting bond or other secu:['lt,y Tux' Lilc :raii~hfiil porf'ormc~.raoa of th®a_r d,i~f-iaa i_n Any jurisdiction. IN ~~7ITTdESS i;JIiEIZFOF, I have hereunto set my hand and seal this ~'~ day of October, A. D., 1994. ~ -'g+ ~ (SEAL) Eleanor S. Peff er ~3- Signed, seated, published and declared by the above named, T,~LPAidORE S. PEFFER, as a.nd for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. -4- ~ ~~ n,~ ~~'~(a s aan3aod ssv~~-isni esn I~~~ ~a3n3aoa ssr~~ Tsai, EI ~~~ a ~ - aanaaoi ssv~~isai~ vsn G' i`J '~ a ~~ ~ C' "`d ~ ' +- t. `-_.. ~:. ~"3 t~ ~""3 1 W ~ U - ^ i~ f Cl:. ~ r ~ ~ `` 1 O ~ U M A ~ N ~ ~ 0 o a y ~ ai N 3 .~ ~ ` ~ ei c0 M 0