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Home My WebLink About04-24-121505611180 -~ REV-1500 EX (02-11)(FI) Pennsylvania OFFICIAL USE ONLY PA Department of Revenue DEPARTMENT OFREVENVE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21-11-1008 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 08182011 3//1944 Decedent's Last Name Suffix Decedent's First Name MI STOUGHT GRACE E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW 0 1. Original Retum ~x 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) Q 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS Q 2. Supplemental Return 0 4a. Future Interest Compromise (date of death after 12-12-82) Q 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (Date of Death Between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number STEPHEN D. TILEY 717-243-5838 First Line of Address 5 SOUTH HANOVER STREE Second Line of Address City or Post Office CARLISLE State ZIP Code PA 17013 0 3. Remainder Return (Date of Death Prior to 12-13-82) Q 5. Federal Estate Tax Retum Required 0 8. Total Number of Safe Deposit Boxes 0 11. Election to Tax under Sec. 9113(A) (Attach Schedule O) REGISTER QED I L~E O~Y ~ ~a ~-7 "" J T;~ ~ ~ _ ? m _ .~ =cn~ = _.. ~ ~~ -,., ~; ,-~ - -`7 ~.) ~ -.y .. = - DPT'~E FILED n _ ~~ ~~ 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, corcect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge SIG~URE OF~ SON RESPONSI~ FOR FILING RETURy,`- '~ n ~ A,w DATE ~ ~ ~ ~ ~ ~L ROBERT Cam. ~~STOUGHT ~ KENNETH E . STOUGHT (S~t`E SCHEDULE J FOR ADDRESSES ) SIGNAT,tJ THGN RFPRGCF NTIITn/~ .,.~~ e ADDRESS STEPHEN D. TILEY 5 South Hanover Street Carlisle PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505611180 1505611180 J C~ r `~ t. l~ ~~~ J REV-1500 EX (FI) oecedent's Name: GRACE E S T O U G H T RECAPITULATION Decedent's Social Security Number 1. Real Estate (Schedule A) ....................................... .. 1. N 0 N E 2. Stocks and Bonds (Schedule B) .................................. .. 2. N 0 N E 3. Closely Held Corporation, Partnership or Sole-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. 4 8 5 2 . 0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ..... .. 6. NON E 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ..... .. 7. NON E 8. Total Gross Assets (total Lines 1 through 7) .. ... 8 4 8 5 2 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ............... . 9. 2 O 5 9 . O 0 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........... . 10. 618 9 7 . 0 0 11. Total Deductions (total Lines 9 and 10) ............................ . 11. 6 3 9 5 6 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) .......................... . 12. - 5 910 4 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0 . 0 O 14. Net Value Subiect to Tax (Line 12 minus Line 13) . 14 - 5 9 ], 0 4 0 0 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 0 15. 0. 0 0 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. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate x . 15 18. 0 . 0 0 19. TAX DUE ............. ........................................ .19. 0.00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611280 L 1505611280 1505611280 J REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number 193-36-3842 21-11-1008 DECEDENT'S NAME GRACE E STOUGHT STREET ADDRESS 1 WATERLOO ROAD CITY STATE Zlp CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + B ) 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. (1) 0.00 (2) 0.00 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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)]. Asibling 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-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: Grace Elizabeth Stouaht 21 11 1008 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 Grace Elizabeth Stouaht 21-11-1008 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. 3. 4. 5. 6. 7. State Attorney Fees: Frey and Tiley 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 Probate Fees: Accountant Fees: Frey and Tiley Tax Return Preparer Fees: Frey and Tiley Filing Fee for Small Estate Petition 8. Filing Fee of Inheritance Tax Return 0 0 44 15 TOTAL (Also enter on Line 9 Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ZIP 2,000 ZIP REV-1512 EX+ (~ 2-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8~ LIENS ESTATE OF FILE NUMBER Grace Elizabeth Stought 21 11 1008 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, includiaa unreimbursed medical elcneneoc •~ ~••~~~- „r~..c ~~ ~~cc~.c iacn auwuunai JIIC6l5 VI U76 58816 SIZE. REV-1513 EX+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Grace E lizabeth Stou ht 21-11-1008 NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE TAXABLE DISTRIBUTIONS [InGude outright spousal distributions and Vansfers under Sec. 9116 (a) (1.2).] 1. 1 ~ Robert C. Stought, 17 Ridgeway Drive, Carlisle, PA 17015 Son 50 Percent 2. Kenneth E. Stought, 228 Newville Road, Carlisle, PA 17015 Son 50 Percent 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. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 0.00 it more space Is neeaeo, use additional sheets of paper of the same size. LAST WILL AP1D TES TAI~?EPiT OF GRACE E. STOUGHT I, GRACE' E. STOUCsHT, of South Middleton Township, C~zmberland County, Pennsylvania, declare this instrument to be m Last 3~ii17_ ii"I y ~ f~And Testament, in manner and form following: ~ II`` 1. I hereby expressly revoke all WiJ_ls and Codicils hereto_ fore made by me. 2. I hereby direct my Executors to pay all my just debts, funeral and administrative expenses out of m~,= estate as soon as practicable after my death. 3. I devise and bequeath the remainder of my estate to my issue, per stirpes. - ~. I nominate and appoint my sister in-law, Della S. Stou~;ht ~as guardian of any property which passes to a minor and with respe t to which I am authorized to appoint a guardian and have not other-~ wise specifica7_ly done so. i 5. I nominate anal appoint my sons, Robert C. Stou~mht and ~F{e nneth E. Stought, as Executors of this my Last 6JiJ_1 And Testamen `I`~ providing both or one of them is twenty-one years of ale at the I I'time of my death; and as substitute Executrix I nominate and appoi t my sister-in-law, Della S. Stcught. ~IDI WITTdE`SS WHERL'OF, I have hereunto set my hand and seaJ_ th_s ~ day of /°'irv"::,.,•. ~~~~.~ , 19b3. ~r ~ ~_ °~ ! Grace ~,. Stough,t` Signed, sealed,published and declared by the above named Testa~~t= Grace E, Stought, as and-for her Last Will And Testament, in cur presence, who, in her presence, at her request, and i.n the presence) ~f each other, have hc-reunto subscribed our names as attesting i witnesses, ~ .., ~. j '`. J I i~ /% CORNERSTONE F e d e r a l Credit U n i o n P.O. Box 1181, 5 East Gate Drive, Carlisle, PA 17015 Telephone (7 17) 249- 166 I FAX (7 17) 249-8208 Member founded -Service based vvvvw.cornerstonefcu.coop November 11, 2011 Frey & Tiley Attorneys-At-Law 5 South Hanover Street Carlisle, Pennsylvania 17013 RE: Estate of Grace E. Stought Stephen, At the time of her death, Grace E. Stought was the sole owner of account number 8147. As of November 8, 2011 the savings and checking accounts were closed. Listed below is the additional information requested: (a) Principal and interest balances as of date of death: Principal ~-07 checkin~l Interest $209.64 $0.48 Posted 10/1 Principal ~-01 savings) Interest $4446.49 $3.83 Posted 10/1 $1.43 Posted 11/8 (b) Register owner: Grace E. Stought (c) Date account was first established: February 22, 2001 (d) N/A If you require any additional information, please do not hesitate to contact me at 717-249-1661 ext 240. Sincerely, Laney Bentz Financial Services Administrator ~~~ I"IEMBER SAVINGS ACCOUNTS FEDERALLY INSURED TO $2SO,OOO BY THE NATIONAL CREDIT UNION ADMINISTRATION ••' Pennsylvania DEPARTMENT OF PUBLIC WELFARE November 16, 2011 FREY &TILEY STEPHEN D TILEY ESQUIRE 5 S HANOVER ST CARLISLE PA 17013 Re: Grace Stought CIS # : 680192154 SSN: ###-##-3842 Date of Death: 08/18/2011 Dear Mr. Tiley: Please be advised that the Department of Public Welfare maintains a claim in the amount of $61.896.83 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $29,903.74, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $31.993.09, is to be entered as a priority Class 5.1 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sinc ely, Nicole L..Lipscomb TPL Program Investigator 717-772-6606 717-772-6553 FAX Enclosure ~~ Bureau of Program Integrity ~ Division of Third Party Liability ~ Recovery Section PO Box 8486 ~ Harrisburg, Pennsylvania 17105-8486