HomeMy WebLinkAbout06-21-12J 1505610140
REV-1500 EX (°'-'°'
PA Depar: Went of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX e80601 ~~ I' (I 13
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYVV Date of Birth MrdDDYVVV
Decedent's Last Name
Suffix
P P~A su
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
® i. Original Return
4. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
Decedent's First Name MI
f~6 +~ES =
Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4a. Future Interest Compromise (date of ~ :i. Federal Estate Tax Return Required
death after 12-12-82)
7. Decedent Maintained a Living Trust O 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
9. Litigation Proceed:. Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA,X INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
S A-N I N S P S E I L t~-A-mErZ
First line of address
X133. STRf}-(H rnotQE ,DfUv6
Second line of address
City or Post Office
m,~c+t+rt-N> csl~v 12G
Correspondent's a-mail address: J
State ZIP Code
P~+ I~oso
@ Com~gs•tr_n~'t
'~l 1 `I -, (,
~- 341 ~'
~
~- _t~
REGISTER ~AI~LS USE ObILY
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c>C! a, 4.~~~
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C] ~
_ DATE FILED ~"1
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 informatior: of which preparer has any knowledge.
SIGNA URE OF PERSO E~PONS FOR FILING RETURp~ DATE
ADDRESS
Sa3a S~-n~1•Krno*t ~~. ~echanLCa6u.-~ QI'~ 11U5h
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056].0140
1505610140
J
REV-1500 EX
1505610240
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 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.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property
(Schedule G) ~ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines i through 7) ........................ ... 8.
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9.
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10.
11. Total Deductions (total Lines 9 and 10) ............................... 11.
12. Net Value of Estate !Line 8 minus Line 11) ........................ .... 12.
13. Charitable and Governmental Bequests/Sec 9173 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.
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal taz rate, or
transfers under Sec. 9116
(a)(1.2) X • ~ 15.
16. Amount of Line 14 to
7able
~
at lineal rate X • ~`fs 1g
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 ig,
19. TAX DUE ...................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Social Security Number
l 9 I (o . !o ~
3 i 9 . 44
~3~•O
q 7 ~ ~ $O
Q
q,7i6 • So
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• QD
Side 2
1505610240 1505610240 J
REV-1500 EX Page 3 Flle Number
Decedent's Complete Address:
DECEDENT'S NAME
A %~-~ Z__pgGs iti _ - __ - _ -- _ _ _ ---
STREE4'ADDRESS ---
--Sa~a__ S-1ra~.m~re _4-f~ ---
-- _ ___
CITY~~t~~u STATE~n ZIP /.7~,~
Tax Payments and Credits: !!11
~. Tax Due (Page 2, Line 19) (1) QU
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + E3) (2) QD
3. Interest
4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT. (3)
FIII in oval on Page 2, Line 20 to request a refund. (q)
5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
~Q
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 transfened or its income; . ...... ^
c. retain a reversionary interest; or .......................................................................................... ...... ^
d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ ~'
2. If death occurred after December 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~eath bank account or security at his or her death? ... ...... ^ [r{~
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
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 'i 995, 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
f ling 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(1.2) [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, unde
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood cr adoption.
REV-1508 EX« (11-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTAT OF: - FILE NUMBER:
GNES 2' PfMSl,~ ~ I-(I-lll3
InGUde 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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. C~pf~( ~dvw-f~9e ~nsrt~~e Co.-r~~d ~
p2mtcc.T, t i ~, r ~,
I, ~'ea.sa
TOTAL (Also enter on Line ;i, Recapitulation) I S ~ 9 1 ~v .
r
If more space is needed, insert additional sheets of paper of the same size
REV-1509 EX+ (01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY•OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
~-GN~S = Qtq-/fiSln a.l-l1-\It°,
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP T(
A. 7oax~ F.{-ie.~~.s ~l al's (.~tst wor{' ,S'~ Sts~r
I~hoe.n(~X ~Z 85433
B. ~5~¢rr ~ 70/1eS 1 l3 ~/ l-+t.9~ts~Orr~ ~. SStea-
(--Fa.rr is bu rJc P~ I ~ l I I
c.
JOINTLY-OWNED PROPERTY:
DECEDENT
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEEDFORJOINTLV-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET %OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENTS INTERESI
,. A. B 3 ~ s hs . Me;i;. C,~^FeJ Znc . s~rocK g SF(.3 a 33 ? 3l9
, .4 ~,
to-,-, ~ ~~~ ~. aq.v~s
to-t0-t1 tt~t_ A~~ 3a.oa
A1,PxuorL o-~ 1 ~ -~ ~ lo-to- t t a9 .~('i ~S
TOTAL (Also enter on Line 6, Recapitulation) I $ 314 -~ t{
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
14 G N SS /~A~}S (~ SKI- l 113
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 • S-font ~ (Ylwr ~.t,to~a-Q f-f~~-,-e.-~,ti,
~ e
~CQ
•
-•lOO
,
e^,~ p , O L7
d_- Trl~ - Co L~l ay Iryltmo~ta.Q 6ardartS - Ivlemona I- Ma/I~er o?b 35 • o D
B. ADMINISTRATIVE COSTS:
i. Personal Representative Commissions:
Name(s) or Personal Representative(s)
Sheet Address
City Slate 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 Adcress
City State ZIP
Relationship of Claimant to Decedent
4 • Probate Fees: R~ of W~~~ ~ry~,Vl_ J ~
A lr+nr+l --'~ • SO
5 • Accountant Fees:
b • Tax Return Prepare; Fees:
7 • IRe~ls~.r a~ Wt«S - ~-tlino, ~.h. ~- ref cL•d. ?~.v~„~o+y ~ S .od
TOTAL (Also enter on Line <.I, Recapitulation) I $ 9.7p? 6 , 5 Q
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EXa (01-10)
pennsylvania ~ SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
~-r,tii3s -r PI4Rsu a ~-~i-~~1~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outdght spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1 • Sa.n t n t P S-~ I ha-n,e.-- ~a k51~ ~- ~a s~
~
s a3 a .s-~-a-~„„o~e Lk: ..
~
i`Y1es.~an(csbLt,r~, PR- ~~oso
a - L7clvld. P f {.1~e. Son y~ ~
ao i N. ~~ St c-
(-~-a,~-~56~, PA l~t~ I
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, 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 DEPART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
n more space Is neeaeD, use aaolnonal sneers of paper of the same s!ze.
n
LAST WILL AND TESTAMENT ~ -
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Agnes I. Paasu ='
.,
I, AGNES I. PAASU, of Silver Spring Township, Cumberland County, Pennsylvania,
being of sound mind, disposing memory and full legal age, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking all Wills anef Codicils heretofore made
by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession
and other death taxes imposed or payable by reason of my death ;md interest and penalties
thereon with respect to all property composing of my gross estate for death tax purposes, whether
or not such property passes under this Will, shall be paid by the Executors from my estate, and
that none of the aforesaid taxes shall be prorated among those persons or entities named herein or
otherwise beneficiazies hereunder.
2. My Executors may, at their discretion, compromise chinas, borrow money, retain
property for such length of time as they may deem proper; lease and sell property for such prices,
on such terms, at public or private sales, as they may deem proper; and invest estate property and
_ :D
'_ T.,
~.o ~--;
-,
income without restriction to legal investments unless otherwise provided hereunder.
3. I authorize and empower my Executors to sell any realty and/or personalty owned by
me at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could
do if living. My Executors aze authorized and empowered to engage iin any business in which I
may be engaged at my death, for such period of time after my death as seems expedient to said
Executor.
4. I give, devise and bequeath all of my estate of every nature and wherever situate to my
children, JANINE P. SEII.HAMER and DAVID P. ICI,INE, shaze and share alike, the child or
children of any deceased child taking the share their pazent would have i~aken if living.
5. I nominate and appoint JANINE P. SEILHAMER and DAVID P. KLINE to be the
Executors of this my Last Will and Testament.
6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty
(60) days.
7. No Executor acting hereunder shall be required to post bond or enter security in this or
any other jurisdiction.
8. No beneficiary may assign, anticipate or pledge his or her interest in any income or
principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or
otherwise reach any such interest.
9. I hereby suggest that my persona( representatives retain the services of hwin &
McKnight as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ry..~ day of
August, 2007.
~~'„-v~ X /'an-~+ ~ (SEAL)
AGNESI.PAASU
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament, in our presence, who, at her request, in her presence and in the presence of
each other have hereunto set our names as subscribing witnesses.
,1
~~° ~~~
,'
~, ~~ ,~
ACKNOWLEDGMENT AND AFFIDAVIT
WE, AGNES I. PAASU, CHERYL L. CLELAND and TRACI D. SMITH, the
Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will and that she had signed willingly, and that she executed
it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the Will as a witness ;and that to the best of their
knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and
under no constraint or undue influence.
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by AGNES I. PAASU, the Testatrix
herein, and subscribed and sworn to before me by CHERYL L. CLELAND and TRACI D.
SMITH, witnesses, this I_,'•' day of August, 2007.
`R~9f9. Irvk~, Ndary Puck
CaA~le Bao, Qmberland County
My Canmisslan Expires Oct 3, 2008
METRO
BANK
February 20, 20]2
To Whom It May Concern:
3801 Paxton Street 888.937.0004
Harrisburg, PA 17111 mymetrobanl<.com
The balance on Agnes Paasu's account, 513262428, as of October 1 ] , 2011 was
$1802.50.
Sincerely,
udy Hoover
Sr. Customer Service Representative
NMLS Registration: 773802
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MET (Common Stock) /
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October 07 2011 Look Up Price S9 .g 95 `'
Results a 9 . ~ ~ ~S
Date Requested 10/08/1 I
The date you requested
is not available. The
previous trading day is 10/07/11 3p)
Closing Price $28.80 X o~9, 9''~7S ~ Ski
Volume 13,064,600 .~-----
SplitAdjustmentFactor 1:1 ~ (Sg 3oZ-' 3 a ~3/9yt{
Open $30.93
Day's High $30.99
Day's Low $28.76
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October 10 2011 Look Up Price
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