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Home My WebLink About05-07-12 15!15611180 -~ REV-1500 ~ (°2-,,, (F.) Pennsylvania OFFICIAL USE ONLY PA Department of Revenue orvu~nen,craer~ County Cooe Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Hartisburc, PA 17128-0601 RESIDENT DECEDENT ~~ ~_) ( - ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMODYYYY Date of Birth MMODYYYY 04192011 07301920 Decedent's Last Name Suffix Decedent's First Name MI SHATTO MARIE L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Narne MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTE R OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return Q 2. Supplemental Retum 0 3. Remainder Retum (Date of Death Prior to 12-13-82) 0 4. Limited Estate Q 4a. Future Interest Compromise (date of Q 5. Federal Estate Tax Retum Required death a8er 12-12-82) ® 6. Decedent Died Testate [~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Dapoeit Boxes (Attach Copy of Will) (Attach Copy of Trust) Q 9. Lidgatlon 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 TO: Name Daytime Telephone Number ROBERT G FREY 7172435838 ._} -~ . REOI R9F WILLS USE ON r_==.~ j _ 00 '~ < i , ~ . TJ "~ ~ . ;;7 i i c7 . .1 } First Line of Address ~? ~ ~ ! ~, i , c.:7 C"7 - 5 SOUTH HANOVER ST o~~ -~ "_~_i Second Line of Address '-?t'-~' ~ ~~~ L ro.~ -.- SATE FILED __I City or Post Office State 21P Code CARLISLE PA 17013 Side 1 1505611180 1505611180 Correspondent'sa-mail address: KFKtYNrKtY11LtY.CO~ Under penalties of perjury, l declare that 1 have examined this return, Including accompanying schedules antl statements, and to me best of my knowledge and belief, 1505611280 REV-1500 EX (F1) Decedent's Social Security Number Decedent's Name: MARIE L SHATTO RECAPITULATION 1. Real Estate (Schedule A) ......................................... 1. 8 ~ 0 ~ ~. 0 0 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) ....................... . 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ...... . 6. N 0 N E 7. Inter-Uvos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ...... . 7. NONE 8. Total Gross Assets total Lines 1 throw h 7 ........................ .. 6. 8 6 8 7 6.0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ............... . 9. 5817 • ~ ~ 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........... . 10. 2 ~ 4 41 . ~ ~ 11. Total Deductions (total Lines 9 and 10) ............................ . 11. 2 6 2 5 8 . D ~ 12. Net Value of Estate (Line 8 minus Line 11) .......................... . 12. 64618 . OQ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~ ~ ~ an election to tax has not been made (Schedule J) ..................... . 13. • 14 Net Yatue Subject to Tax (Line 12 minus Line 13) .................... .. 14. 60618 . OO 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~ 16. Amount of Line 14 taxable at linealratex.o 45 60618.00 ts. 2727.81 17. Amount of Line 14 taxable at sibling rate X • 12 17. ~ • ~ ~ 18. Amount of Line 14 taxable at collateral rate X . 15 18. ~ • ~ ~ 1s.rax DuE ....................................................... 1s. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 2727.81 L 1505611280 15E5611280 J REV-1500 EX (FI) Pa9e 3 Decedent's Complete Address: File Number 21-11-0548 DECEDENTS NAME MARIE L SHATTO STREET ADDRESS 82 COLD SPRINGS ROAD CITY CARLISLE STATE PA ZIP 17015 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2727.61 2. CreditslPayments A. Prior Payments 5400.00 B. Discount Total Credits (A + B) (2) 5400.00 3. Interest (3) 4. If Lina 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) 2672.19 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: transferred i of th th rt t i Yes ^ No ................................................................................. a. re e use or ncome e ProPe Y a n ...... 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 occurced 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" orpayable-upon-death bank account or security at his or her death? ...... ...... ^ 4. Did decedent own an individual retiremem acwunt, annuity or other non-probate properly, which contains a beneficiary designaticn? .............................................................................................................. ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MU5T 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 tnansfers 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 far the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P,S. §9118(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 fax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [7'2 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. R£V-1502 FJC* (01-70) pennsylvania SCHEDULE A ~ DEPARTMENT OP REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Marie L Shatto _ _ _ 21-11-0548 All real propeM1y owrxd solely or as a tenant in common must be repoRetl 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 relavam facts. If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+117-10) SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMEM OF REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT Marie 1. Shatto 21-11-0548 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 t (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDEM DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF rl~e n~mocn; Marie L Shatto 21-11-0548 Decedent's debts must be reported on Schedule 1. A. 1. B. 1 2. 3. a. 5. 6. 7. 8. 9. FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Ciry Year(s) Commission Pald: Anorney Fees: Family F~cemption: (If decetlent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ReWtionship of Claimant to Decedent Probate Foes: Accountant Fees: Tax Retum Preparer Fees: ;rtising in the Sentinel and Cumberland Law Journal ~nses of maintaining real estate sold. Itemization attached ~nses of sale of real estate from HUD-1 settlement statement attached TOTAL (Also enter on Line 9, kE If more space is needed, use additlonal sheets of paper of the same size. State ZIP ZIP 2,000 108 275 2,344 1,090 REV-1512 EX+(12-08) Pennsylvania SCHEDULE I DEPARTMENT DF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS ESTATE OF FfLE NUMBER Marie L Shatto 21-11-0548 Report debts incurtatl by fhe decedent prior to death that remained unpeW at the date of death, including unrelmbur:ed medical expenses. PrN-nu¢eO-IlwnsmolfaMe A. Settlement Statement 8. T e of Loan 1. FHA 2. pPmHA 3. ^Gonv. Unins. 6. File Number 4 pvA 5 Con Ins 1214 -rM1~IT~f41~ 26 Fi I r peZl C. Note. Ire rkee lP. 1 wean wrwv rte uuy ere Mw,m nemta nnwnn w4RNMGnL ~ k,w+aN ekef I mb eMSlo meu ibtl some onm wmetim wnnclWealne aM nwnm nlf aleile eee'. TNe 1B U. 5. C.le& D. NAME OF BORROWER: David J. Houston and Laurie Ann Houston ADDRESS: 113A Cold S rin s Road Carlisle PA 170'. E. NAME OF SELLER The Estate of Marie M. Shatto ADDRESS'. F. NAME OF LENDER. (ortn HUO-1(&95)M wenEaoo4tSC52 U.S. Department of Housing entl Urban DeveloFment OMB A royal No. 2502-0265 7. Loan Number 6. Mortgage Insurance Case Number v rte ame~snra~nr.~e rte. oorwen ana are nm na„aee n me romM TitleExpress 3el0ement System ADDRESG'. ---- G. PROPERTY ADDRESS: 82 Culd Springs Road, Carliafe, PA 17015 Dickinson Townahi H. SETTLEMENT AGENT: A One Settlement Services, LLC PLACE OF SETTLEMENT: 337 Lincoln Street Carisle PA 17013 I. SETTLEMENT DATE: 0311412012 J. SU M RY OF 0 R 'S NSAC ION: 100. GROSS AMOUNT DUE FROM BORROWER 101. Gontrad sales 'ce 80 000.00 U M Y F ELL R' RAN A 'fl- 400. GROSS AMOUNT DUE TO SELLER 401. Contract sales ice 80 000.00 102. Personal P 402. Personal Pro art _ 103. Settlement cha es to borrower line 1400 1 670.75 A03 104. 404. 105. 405. Adustments for items aid b seller in atlvance Ad'ustmenl5 for items eitl b seller in advance 107. Count t es 03114!12 to 12131112 211.58 106. School Taxes 0311N12 to06130112 413.43 407. Coon taxes 031141121012131112 211.58 406. School Taxes 031141121096130N2 413.43 169, 409. 110. 410. 111. 411. 11 120. GROSS AMOUNT OUE FROM BORROWER 82 295.76 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 412. 420. GROSS AMOUNT DUE TO SELLER 80 625.01 506. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De it or earnest mono 202. Pdnci !amount of new loans 501. Excess De 11 seelnstmdions 502. Setllemant cha to seller line 1400 26751.85 203. Existin loan s taken suoect to 503. Existi loan s taken su ~ t to 2pq. 504, Pa off of First Mon loan 205, 505. 206. 506. 201. 507. 208. `~ 209. 509. Ad'ustments for hems un aid b seller Ad'ustments for Items un aid b seller 213. 513. 21q. 514. 215. 515. 216. 51fi. 217. 517. p1g. 518, 219. 220. TOTAL PAID BYIFOR BORROWER 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 26 757,85 300. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLE R 301, Gross amount tlue from borrower line 120 82 295.76 601. Gross amount tlue to seller line 420 80 625.01 302. Less amounts id b /for bonowar line 220 602. Less reduction amount tlue seller line 520 26 757.85 303. CASH FROM BORROWER 82295.76 603. CASH TO SELLER 53 867,16 SU85TIlUTE FORM 1CW SELLER STATEMENT' Tn IMmnation wMelrotl MMin 4 knyM1nt tae {nlameliMeM b wbp hmieMOlo IM InINMI Rbrenue Ssniw. If you to requirM b IIM ri,el,m. e mglgem pxNly IX Wwr urclbn vnll Pe ImWaeO on)ou flMU ilem'o n4iM to be rrywne0 eM th IR8 Eele,mlwe IIIM a IW nM Cep! nwneC_ TM CaM,ecl SWe Pry2 tlewlps]m Nro i01 eNVe m'ulnNee IM Gmq Prnetle NmM tlvlNgicn. SELLER INBTRUCTIONB' ttNM rte! eWle w pur gMCipsl,eNOenu, rYe Fwn 3f 1B, 5Bk al Exdmnae N Pnnc,pal Rec~Oenw~fa My ym, WMya,r Ywvme m[ rpNln; M Onbr tte,uaCllone, pMe me eryryIM10 {W of Fnrn R9i. Fam8152 MWIX SNMUq D lFa,m tU1pJ. Vcu we repuirMgW bpmmtle tlb ea0bnelil eaeR(Fed Tax lO W: 1WCt tlMVwNrltlwkMwlnn nunper.X)9u EO nd P~o•'Ine MUrmrW levpeyli]eM?mlion arcnw,yw mgee wgea ro V,IlwaM'mel wnenkm imPmeE MIw. na~nw.~~mM me numur+nammm:.wmema mr waewu.Pa~e, ~eeminman nunur. TIN: / BELLERIa)sIGNhTURE(s[ SFALFRI9) NEW MAILING ADpREBa 1001. HazaM Insurance mo. /mo 1002. Mort elnsurance mo. /mo 1003. CA Pr h Tax mo. /mo 1004. Count Pro a Taz mo. 22.iD /mo 1005. School Taxes mo. '156.76 !mo I 1009.A r ate Anal sis Adustmem 0.00 0.00 1100. TITLE CHARGES 7101. Sefllement or closin fee 1102. A0.stracl or title search to BeGCi Dowell 90.00 I nww amuuy revMwelreNUO-l smbm.N S1M.m.n~~.narolre s.M OfmylmwMM..Ae ab+1n,..na..w.1.. mll ~wnmb aai. men( e. onm .cca loran me m(NU Va~Wmon.Ifu~MerutliH Vall MVe ramlv.0• gNIM UO-1 m15'NNn \ I A 11 T- ~.~ WARNINGITISAC0.ME TD IWOLMNGIYMAKE FALSE STATEMENTS TO THE iM HU0~1 SWbrMnl SbMmM.MItl'INw pnC.Mb.Me.M.~curM. aawYOf tN'rs tnrncCwn. \RIITEO STATES ON TNIS OR ANY SIMIL4R FORM. PENALTIES UPON CONVICTION I~rv.dw.tl swill uuw N.hmdnb Md.bul.etl ln.p'arynn wM lNq.IMm.nl. CAN INCLUOFAFME ANO IMPRISONMENT. F00.0ETg0.S SEE TTLE 1e'. (~~ (((1 11.5. CODE SECTION 1 Wt ANO SECTION 1014 ~t{~d\nA af~1 '~L ~~ t_ K~1/'q 1 r X' YI IV) Pnvnw edM1mne KmwMM - - loan HUO-1 (a4P6( re' NenObook t3C5,~ Date Payee Expense Account Amount 6/20/11 Three Springs family Practice medical $ 105.80 7/6/11 Kinetic Imaging medical $ 1.75 10/27/11 Alexander Spring Emergency Phys. medical $ 65.27 Total Medical Expenses $ 172.82 7/18/11 Borough of Mt. Holly 7/18/11 Met Ed 8/24/11 Met Ed SJ25/11 Carolyn McQuillen, Tax Collector 9f 26f 11 Met Ed 10/14/11 Borough of Mt. Holly 1Of24/11 Met Ed 11/28/11 Met Ed 12/12/11 The Hartford 12/23/11 Met Ed 1/11/12 Borough of Mt. Holly 1/24/12 Met Ed 2J17/12 Met Ed 3/7/12 Met Ed Total Real Estate Expenses real estate real estate real estate real estate real estate real estate real estate real estate real estate real estate real estate real estate real estate real estate $ 5.00 $ 37.92 $ 48.96 $ 1,401.09 $ 37.01 $ 5.00 $ 29.50 $ 34.06 $ 649.00 $ 32.39 $ 5.00 $ 36.48 $ 10.96 $ 11.46 $ 2,343.83 Pennsylvania DEPARTMENT OF PUBLIC WELFARE March 28, 2012 FREY & TILEY ROBERT G FREY 5 S HANOVER ST CARLISLE PA 17013 Re: Marie Shatto CIS #: 840270876 SSN: ###-##-8121 Date of Death: 04/19/2011 Dear Attorney Frey: This is to acknowledge receipt of payment in the amount of X20.267.65 regarding the above-referenced estate. The Estate Recovery Program's claim is satisfied. Your cooperation in resolving this matter is appreciated. Sincerely, ~~ Debra J. Kochel Claims Investigation Agent 717-772-6616 717-772-6553 FAX Bureau of Program Integrity I Division of Third Party Liability I Recovery SeUlon PO Box 8486 1 Harrisburg, Pennsylvania 17105-8486