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Home My WebLink About07-26-12 (2)1505610105 REV-1500 ext°z-'''tF"~~' PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes °` ~"'"`"' County Code Year PO BOX 280601 "INHERITANCE TAX RETURN ,~ ~ ~ J Harrisburg, PA iyi28-0601 RESIDENT DECEDENT i ,;7} ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 180-26-5503 ' 05/01/2012 06/14/1932 Decedent's Last Name Suffix Decedent's First Name 'ANSLEY KATHRYN (If Applicable) Enter Surviving Spouse's Information Below File Number ~ ~; ~• MI A Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 4. Limited Estate O ti. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 2. Supplemental Return O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust.) O 10. Spousal Poverty Credit (Date of Death Between 12-31-91 and 1-1-95) O 3. Remainder Return (Date of Death Prior to 12-13-82) O 5. Federal Estate Tax Return Required CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Thomas P. Gleason ', (717) 532-3270 n •., ~ ~ ~ ~ REGISTER OF ~~USE ' ONL~ =C'~ ~"~ i ~ 7 r 7't- C , ;- First Line of Address •- , ~! ~ ~ r= 49 West Orange Street ', ~ ~C ~~? :7C=` ~ ~ 'T` - - , -~ Second Line of Address - _. r __ Ste 3_ v .. r_ ~'t ClT LF1 Clty Or POSt Office State ZIP COde DATE FILED .,~,~ Shippensburg PA ' 17257 Correspondent's a-mail address: tOmgleaSOn@tOmgleaSOnIaW.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 k nowledge. SIGNATURE OF PERSON RE P NSIBLE FOR FILING RETURN DATE !~ ADDRESS 405 Newville Road, Newburg, PA 17240 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE 8. Total Number of Safe Deposit Boxes ADDRESS O 11. Election to Tax under Sec. 9113(A) (Attach Schedule O) PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 J~~ -- ~,~ ~,{;~( 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: KATHRYN A. ANSLEY '.180-26-5503 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. ' 104,000.00 2. Stocks and Bonds (Schedule B) 2. ' 4,278.80 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mort a es and Notes Receivable Schedule D 9 9 ( ) ......................... 4. .. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. ', 628,651.30 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 109,501.73 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 846,431.83 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 11,553.75 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. , 2,373.23 11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 13,926.98 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 832,504.85 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. ' 832,504.85 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 ' 832,504.85 16, 37,462.72 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. TAX DUE ....................................................... ..19.' 37,462.72 ',. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due {Page 2, Line 19) 2. CreditslPayments A. Prior Payments _.. __ __ _. __ B. Discount 1,873.14 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. (1) 37,462.72 1,873.14 (3) (4) (5) 35,589.58 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" orpayable-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. Total Credits (A + B) (2) REV-1502 EX+ (O1-10) pennsylvania SCHEDULE A REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KATHRYN A.ANSLEY 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 is jointly-owned with right of survivorship must be disclosed on Schedule F. If more space is needed, use additional sheets of paper of the same size. REV-i5o3 EX+ (~-u) ~i, pennsylvania ~: DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER KATHRYN A. ANSLEY All property jointly owned with right of survivorship must be disclosed on Schedule F. If more space is needed, insert additional sheets of the same size REV-i5o8 EX+ (ii-io) Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KATHRYN A.ANSLEY 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, If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) j i, Pennsylvania SCHEDULE G ~~ DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER KATHRYN A. ANSLEY This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF PPPLICABLE) TAXABLE VALUE 1• Merrill Lynch IRA from Decedent to daughter, Barbara A. Myers, as 78,163.24 100 78,163,6 beneficiary upon death (May 1, 2012). 2 ING Annuity from Decedent to daughters, Barbara A. Myers & Jean A. Heer, 24,583.59 100 24,583.55 as beneficiaries upon death (May 1, 2012). 3 Zurich Insurance Co. Annuity from Decedent to daughters, Barbara A. Myers 6,754.50 100 6,754.5( & Jean A. Heer as beneficiaries upon death (May 1, 2012). TOTAL (Also enter on Line 7, Recapitulation) $ I 109,501.73 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~i, Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KATHRYN A. ANSLEY Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Fogelsanger Bricker Funeral Home 6,882.50 2. Wagner Memorials 600.00 B, 1 2, 3. 4. 5. 6, 7. B. s. 10. City __ _ _ ____ State _____ ZIP Year(s) Commission Paid: _ ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Attorney Fees; 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 __ _ _ _ _ _ __ Probate Fees: Accountant Fees: Tax Return Preparer Fees: Fee for appraisal of real estate located at 423 Newville Rd, Newburg, PA Estate Publication cost for News Chronicle Estate Publication cost for Cumberland County Legal Journal Postage & insurance cost for sending Series E bond to Department of Treasury 3,350.00 285.50 250.00 88.25 75.00 22.50 TOTAL (Also enter on Line 9, Recapitulation) $ 11,553.75 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Vii, Pennsylvania SCHEDULE I ~ DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER KATHRYN A. ANSLEY Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses, If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~, j Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF: FILE NUMBER: KATHRYN A. ANSLEY 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 outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• Barbara A. Myers, 405 Newville Road, Newburg, PA 17240 lineal (daughter) 710,589.67 2. Jean A. Heer, 6475 Abisco Road, Cocoa FL 32927 lineal (daughter) 16,113.76 3. Molly Gilbert, 208 Walnutdale Road, Shippensburg, PA 17257 lineal (grandaughter) 702.53 4. JoEllen Gamble, 348 Holswart Drive, Shippensburg, PA 17257 lineal (grandaughter) 102,991.33 5. Lee Myers, 405 Newville Road, Newburg, PA 17240 lineal (grandson) 702.53 6. Andrew Heer, 6475 Abisco Road, Cocoa, FL 32927 lineal (grandson) 702.53 7. Kathleen Heer, 6475 Abisco Road, Cocoa, FL 32927 lineal (grandaughter) 702.53 II ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE 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. TATAI r1F DAQT TT - FNITFR T(1TA1 AI(1Al_TAYARI F r1TCTRiRI ITr(1NC (1N I TNF i'2 (1F RF\/_1 Snn f (1\/FR CHFFT If more space is needed, use additional sheets of paper of the same size. SUBJECT PROPERTY PHOTO ADDENDUM Client Estate of Kathryn A Ansley File No.: 423 Neewville Road Property Address 423 Newville Road Case No.: City Newburg State: PA Zip: 17247 FRONT VIEW OF SUBJECT PROPERTY .,~ , `° ~ ~~'` a~ Appraised Date: May 2s, 2012 Appraised Value: $104,000 REAR VIEW OF SUBJECT PROPERTY STREET SCENE COMPARABLE PROPERTY PHOTO ADDENDUM Client• Estate of Kathryn A Ansley File NO.: 423 Neewville Road Property Address• a23 Newville Road Case No.: City Newburg State: PA Zip: 17247 COMPARABLE SALE#1 6159 Orrstown Road Orrstown, PA 17244 Sale Date: 5/2 6120 1 1 5218 Price: $ 114,900 COMPARABLE SALE #2 ,'k __ .. `_ 10242 Cardinal Drive Orrstown, PA 17244 Sale Date: 1/21/2012 Sale Price: $ 112,900 "..~.~ COMPARABLE SALE#3 1 Deadend Lane Shippensburg, PA 17257 Sale Date: 312/2012 Sale Price: $ 114,900 FLOORPLAN Clien[~ Estate of Kathryn A Ansley File NO.: 423 Neewville Road Propefty Addre55~ 423 Newville Road Case No.: Cit : Newbur State: PA Zi :17247 17.0' 41.0' Bedroom Living Room 0 b ~ Garage X71 °ro N N ~llLLill1J N Dining Kitchen Bath Bedroom sanwa.rr• 41.0' Comments: I i i --~ Code AREA CALCULATIONS SUMMARY Descrlptlon Slze Net Totals GLA1 First Floor 1148.00 1148.00 GAR Garage 476.00 476.00 TOTAL LIVABLE (rounded) 1148 LIVING AREA BREAKDOWN Breakdown .Subtotals First Floor 28.0 x 41.0 1146.00 1 Calculation Total (rounded) 1148 LOCATION MAP Client' Estate of Kathryn A Ansley File No.: 423 Neewville Road Property Address 423 Newville Road Case No.: Cit : Newbur Stale: PA ZI :17247 n 2: '. 1 `_ ', ' ~c~: ' - }~d r ~~~* Heberling ~t? 1 :ter ~~ ~~ _ f= ,_~ Ambersorr ~~n~sywaQia=3P`~e~"" 'o fns ~(~~ ~?. ~,Vap~ ~ '. ti, Green Sprang ~` ~ ~ E 'v~~fl .,9971 ~~ ~,,,V1riZ Rd N Lurgatz j Comparable'Sale 3 ~ I ~ 1 Dead End Ln COmparable Sale 2 Shippens6urg, PA 17257 oakaille ~ 1024? Cardinal Dr a~~Rn ',soli (3.95 tulles WNW) as OrrStOWn, PP. 17244 ~~Wb Mowersv(I1e (10.36 miles lN) Subject 423 Newville Rd :~18~ Shippensburg,PA 17257 Lutgan Twos C .. ~a ~ ~ .~ C ``-", ~~'r'ry ~ '. -. Mic'dte Spr"tng Comparable Sale 1 ~' ~+ 6139~Orrstown Rd ~ ~ ~~'y ~'~~ v ~~a`, Orrstown, PA 17244 - ~ ~`t (10.15 miles WSIhJ) 'sas w ~ O rTStow n `. ~ /~j// Or.~.~,lvn q ~ sr _ ___ u Shi ensbur pp 5 - ~ _ chestnut. Pleasant ball _,.- ~- ~f "" CrPSSroads 'I' - Pinata TuicuWm ~ B„;.~ ''O ~ rte. " ~,~, ~ " ,~,,/ ~.o; :. Ste, ~: pti s696,~/ Aye -' .w to 4 R k t. I PJ ,,;:/ z Southampton Tv.p " ^ t'~~Ayesville /i' ___, ~' '` 997 ; , ,. Spm,o~aa1 "" ..°r'" GreenVillage. ""~ "~~~'~~llo,~. a` :~... ~. rf - y w. l I7%~ 1, ~ •y~'c. i }~ ~ ~ ' ~ N+;~ - ~i Scotland y " ~:. Salem Sp ~ ~ ¢b,. °a",4d ~~ ~~ Pte. ~ ~ ~d ~ S~ ,.. ~ r4 V f A ~ . ~~~U[!Jit,~"JF~{1 ~.<<~ot~ ;'_iJt~i~itCt .~~it~:,r,, FI;I'~t)z " 5:5 mi1e~ _--Chamflersburg waoastoctc ~ _ J