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Home My WebLink About06-13-12J 1505610140 REV-1500 ~"°'-'°' PA Department of Revenue - Bureau of Individual Taxes County Code Year File Number Po Box zaosof INHERITANCE TAX RETURN 2 1 1 2 0 3 7 6 Harrisburg. PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDVVVY Date of Birth MIuIDDY1^!Y Decedent's Last Name SufFlx Decedent's First Narne MI U V I C K J U L I A P (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Namf; MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^x 1. Odginal Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death poor to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ ;i. Federal Estate Tax Retum Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust a. 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 ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-t-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL Name CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Dayllime Telepho Number n~ M U R R E L W A L T E R S I I I E S Q 7 1 7 6_'~7 4~ 5 ~~ ~ r = r`rT REGISTE~ USE3~LY :Uj ~,, r..., _ r. ~ _"7 at V.>'.--' ~ r 1 rTl First line of address UC-~'"' - C7 nC~ ~~. Sa. _, : C i 5 4 E A S T M A I N S T R E E T ~?~ ~ ' ~" ~~' Second line of address 3' ~ ~ ~- rT c.~ ~o G"'; City or Post Otfice State ZIP Code L_ DATE FILED M E C H A N I C S B U R G P A 1 7 0 5 5 Correspondent's a-mail address: UMer penalties of perfury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is We, ortect and complete. Declaregon of preparer oUer than the personal representative is based on all information of which preper r has any knowledge. RE OF RSO~ RESPON91~1 ~R FILI RETURN /, ~p ~' THAN REPRESENTATIVE PLEASE USE ORIGINAL FORM ONLY 1505610140 Side 1 PA 17 ],505610140 Continuation of REV-1500 Inheritance Tax Return Resident Decedent JULIA P. UVICK 21 12 0376 Decedent's Name Page 2 File Number Correspondents Name First line of address Second line of address City or Post Office Correspondent's a-mail address: Stale ZIP Code Daytime Telephone Number Under penalties of perjury, l declare that I have examined this return, including aaompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaredon of preparer other than the personal representative Is based on all infonnatlon of which preparer has any knowledge. SIGNATURE OF vERSON RESPONSIBLE FO$ FILING RETURN .DATE ADDRESS DONALD K. UVICK, 1918 PRINCETON AVENUE CAMP HILL PA 17011 1505610240 REV-1500 EX Decedent's Social Security Number oecedeot's Name: JULIA P• U V I C K __ 0 7 7 1 2 3 5 0 2 RECAPITULATION 1 1 5 6 4 0 0. 0 0 1. ......................................... Real Estate (Schedule A . .. 2 1 2 6 0 • 0 8 2. Stocks and Bonds (Schedule B) .................................... . .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. 1 4 5 1 7 • 7 4 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 7 9 1. 6 0 7. Inter-Vivos Transfers & Miscellaneous N-Probate Property ~ 2 2 1 4 5 7 7 8 Separate Billing Requested ..... (Schedule G) .. 7. , 8. Total Gross Assets (total Lines t through 7) ......................... .. 8. 3 9 4 4 2 7 , 2 0 9. ................ Funeral Expenses and Administrative Costs (Schedule H) 9. .. 1 9 1 2 8 . 9 7 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 9 9 ( ) ........... 10. .. 1 4 9 4 . 4 8 11. Total Deductions (total Lines 9 and 10) ............................. .. 11. 2 0 6 2 3 . 4 5 12. Net Value of Estate (Line 8 minus Line 11) .......................... .. 12. 3 7 3 8 0 3 . 7 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 3 7 3 8 0 3 . 7 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal taz rate, or transfers under Sec. 9116 (a)(t.2)x.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x.045 3 7 3 8 0 3. 7 5 1s. 1 6 8 2 1. 1 7 17. Amount of Line 14 tazable 0 0 0 17 D 0 0 . at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 0 0 0 . at collateral rate X.tS 18. . 19. TAX DUE .................................................... ..19. 1 6 8 2 1. 1 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21 12 0376 DECEDENT'S NAME JULIA P. UVICK STREET ADDRESS 118 APRIL DRIVE CITY CAMP HILL STATE PA' ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest (1) 16,821.17 841.06 Total Credits (A +6) (2) 841.06 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. (3) (4) 5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 15.980.11 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 : ................................................................ ...... ^ ^X b. retain the right to designate who shall use the properly transferred or its income : ......................... ...... ^ c. retain a reversionary interest; or .......................................................................................... ...... ^ ^X d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... ^ 0 3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her deaths? ... ...... x^ ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................ ...... ^ 0 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 trmsfers 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 Vansfers 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 benefciary. 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(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or far 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-1502 EX+(01-10) pennsylvania ~ SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JULIA P. UVICK 21 12 0376 All real property owned solely or as a tenant in common must be reported 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 relevant facts. Real property that isjointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the properly has been sold. ITEM Include a copy o(lhe deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 116 APRIL DRIVE 156,400.00 CAMP HILL, PA 17011 COUNTY ASSESSED VALUE TOTAL (Also enter on Line 'I, Recapitulation.) ~ $ If more space is needed, use additional sheets of paper of Ne same size. REV-1503 EX+(6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JULIA P. UVICK 21 12 0376 All property jointlyowned with right of survivorship must he disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. METLIFE 1,260.08 42 SHARES TOTAL (Also enter on line :!, (If more space is needed, insert additional sheek of the same size) REV-1508 EX+(~ ~-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, 8 MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY JULIA P. UVICK 21 12 0376 Include the proceeds of IAigation and the date the proceeds were received by the estate. All propeM lolntly owned wNh right of survNorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS 1ST FEDERAL CREDIT UNION 13,570.90 CHECKING 2. I METLI FE I 36.84 DIVIDEND 3. INTERNAL REVENUE SERVICE I 910.00 2011 INCOME TAX REFUND enter on Line 5, E If more space is needed, insert additional sheets or paper of the same size REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEF JOINTLY-OWNED PROPERTY FILE NUMBER: JULIA P. UVICK 21 12 0376 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. ADDRESS TO DECEDENT SURVIVING JOINT TENANT(S) NAME(S) A. CHRISTOPHER R. UVICK B. DONALD K. UVICK C. JOINTLY•OWNED PROPERTY: ITEM NUMBER LETTER FORJOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE:OF ASSET %OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 2/85 MEMBERS 1ST FEDERAL CREDIT UNION 501.30 50. 250.65 CHECKING ACCOUNT 2. A & B 9/84 MEMBERS 1ST FEDERAL CREDIT UNION 324.76 33.33 108.24 3. A & B 9/85 MEMBERS 1ST FEDERAL CREDIT UNION 958.88 33.33 319.59 4. A & B 4106 MEMBERS 1ST FEDERAL CREDIT UNION 339.38 33.33 113.12 18 APRIL DRIVE .AMP HILL, PA 17011 918 PRINCETON AVENUE .AMP HILL, PA 17011 TOTAL (Also enter on Line 6, Recapitulation) I S 791.60 Ir more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY JULIA P. UVICK 21 12 0376 This schedule must be completed and fled if Ne answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NPME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEOEMANU THE GATE OF TRANSFER. ATfACHACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °6~OF DECD'S INTEREST EXCLUSION ~IFAPRICA&E~ TAXABLE VALUE 1. WADDELL & REED 189,673.99 1(10.00 0.00 189,673.99 ACCOUNT 36 IN TRUST FOR CHRISTOPHER P. UVICK 2. WADDEL&REED 31,783.79 1(10.00 0.00 31,783.79 ACCOUNTIO INTRUST FOR DONALD R. UVICK _ TOTAL (Also enter on Line 7, Recapitulation) I E 221,457.78 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 SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS JULIA P. UVICK 21 12 0376 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. NEILL FUNERAL HOME, CAMP HILL, PA 10,475.47 2. GATE OF HEAVEN CEMETARY-HEADSTONE 1,415.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) CHRISTOPHER R. UVICK Street Address 118 APRIL DRIVE City CAMP HILL State PA ZIP Year(s) Commission Paid: (RENOUNCED) p, AdorneyFees: MURREL R. WALTERS, III 6,800.00 3. Family Exemption: (If decedent's address is not the same as claimant's, atlach explanation.) Claimant Street Address City Slate ZIP_ Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 438.50 6 Accountant Fees 6. Tax Return Preparer Fees: 7 TOTAL (Also enter on Line 9, Recapitulation) $ more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent JULIA P. UVICK Decedent's Name Schedule H -Funeral Expenses 8r Administrative Costs - B1 21 12 0376 File Number ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative Commissions: 2. ~ Name(s) of Personal Representative(s) Street Address City CAMP HILL State PA ZIP Year(s)CommissionPaid: (RENOUNCED) SUBTOTAL SCHEDULE'. H-B1 REV-1512 EX~ (12-OB) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TA%RETURN RESIDENT DECEDENT ESTATE FILE NUMBER JULIA P. UVICK 21 12 0376 Repoli debts Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. GRISWALD SPECIAL CARE 234.00 LLU2 DIPUTADO -HEALTH CARE 2. PA DEPARTMENT OF REVENUE 468.00 TAXES PAID 3. CAMP HILL BOROUGHICUMBERLANDOOUNTY REAL ESTATE TAXES 792.48 HOME SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS TOTAL (Also enter on Line 10, Recapitulation) I $ If more space is needed, insert additional sheets of the same size. REV-1513 EX+i01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (i.2).J i. CHRISTOPHER R. UVICK 118 APRIL DRIVE CAMP HILL, PA 17011 2. DONALD K. UVICK 1918 PRINCETON AVENUE CAMP HILL, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Lineal Lineal OF ESTATE 50.00 50.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN A80VE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. 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 COb'ER SHEET. I E If more space is needed, use additional sheets of paper of the same size. COMMONW EAITH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 ]128-0601 RECEIVED FROM: UVICK DONALD K 1918 PRINCETON AVE CAMP HILL, PA 17011 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT flEV-1162 EX111-961 NO. CD 016101 ACN ASSESSMENT AMOUNT CONTROL NUMBER ----"-- +ola ESTATE INFORMATION: ssN: on-iz-aao2 FILE NUMBER: 2112-0376 DECEDENT NAME: UVICK JULIA P DATE OF PAYMENT: 06/13/2012 POSTMARK DATE: 06/13/2012 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2012 101 ~ 515,980.11 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK#107 INITIALS: HEA RECEIVED BY: 515,980.11 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS