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Home My WebLink About95-0201r k t ~1~r~~~~ REV-1500 ~_//'/` x+ (7-94i ~ / ~ ~ ~ v INHERITANCE TAX RETURN F~A S OUSALDEATH AFTER 12131191 CHECK HERE POVERTY CREDIT IS CLAIMED ^ 9 RESIDENT DECEDENT FILE NUMBER P C MMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (TO BE FILED IN DUPLICATE ~ Z ~ 9S oZ O `'Y?~ T Pa iii WITH REGISTER OF WILLS) ° ARRISBUR , za-oeot COUNTY CODE YEAR NUMBER DECEDENT' NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS to er, F. Arthur 906 Mud Level Road c Soc L SEC ITY NUMBER DATE F DEATH DATE OF BIRTH Ship pensburg, PA 17257 W 96-14-0502 11-16-94 1-4-24 c°°nr Cumberland ~/ p (IF A IGABIE) SURVIVING SPOUSE'S NA/AE (LAST, FIRST A MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) ertrude E. Stayer 174-20-6253 ~ ~J 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return '0aY r (for dates of death prior to 12-13-82) =awo ^ 4. Limited Estate ^ 4 a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required ~~-L (for dates of death after 12-12-82) cm ^ 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust _8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach copy of Trust) t- _ o ° A Jerry A. Weigle, Esquire MPLE MARK, WEIGLE AND PERKINS ~~ ELEPHONE NUMBER 126 East King Street 71 2- 3$8 Shippensbur>7. PA n X7257.: ...,~ 1. Real Estate (Schedule A) (1) - • LJt .~ C) :~ --. 2. Stocks and Bonds (Schedule B) ( 140.00 _ .. 7 ` }- 3. Closely Held Stock/Partnership Interest (Schedule C) 3) _ :x} ~ J ~. '- 4. Mortgages and Notes Receivable (Schedule D) (4) . c U'1 - ?~~~ 5. Cash, Bank. Deposits 8 Miscellaneous Personal Property (5 210 •00 rj __ - ' Z (Schedule E) _ - -` ~~ g 6. Jointly Owned Property (Schedule F) (6) '-~; _~ ,~•~ 7. Transfers (Schedule G) (Schedule L) (7) w ~ f- a 8. Total Gross Assets (total Lines 1-7) (8) 350.00 9. funeral Expenses, Administrative Costs, Miscellaneous (,; 7 .028.00 Expenses (Schedule H) r' 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 7,028.00 12. Net Value of Estate (Line 8 minus Line 1 1) (12) (6 , 6 78 , 00 ) 13. Charitable and Governmental Bequests (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) (6,678.00) 15. Spousal Transfers (for dates of death after 6-30-94) See Instructions for Applicable Percentage on Reverse (15) Side. (Include values from Schedule K or Schedule M ) x._= NONE- INSOLVENT . 16. Amount of Line 14 taxable at 6% rate (16) x .06 = NONE (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rate (17) x .15 = NONE z (Include values from Schedule K or Schedule M.) o 18. Principal tax due (Add tax From Lines 15, 16 and 17.) (18) NONE r ~ 19. Credits Spousal Poverty Credit Prior Payments Discount Interest a 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) r ~ ^ 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) A. Enter the interest on the balance due on Line 21 A. (21A) B. Enter the total of Line 21 and 21 A on Line 21 B. This is the BALANCE DUE. (21 B) Make Check Payoble to: Register of Wills, Agent 4: ' . ! 1 f Under penalties of perjury, I declare that l have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, iT is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI ATURE OF PERSON RES ONSI OR FILING RETURN ADDRESS DATE -` Gertrude E. Stayer, 906 Mud Level Rd., Shippensburg, PA 17257 IGNA RE OF P EPARE HER T N R PRES T E ADDRESS DATE c f' Jerry A. Weigle, 126 E. King St. , Shippensbur PA 17257 2j"`/(1-/~ ,~ ~; f Act $4$ of 1494 provides for the reduction of the tax rates imposed on the net value sf transfers to or for the use s~f ibe spouse. The rates as prescribed by the statute will be: • 39~a (.il-f~ wi$ be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 • R°lf~ (.!$) wiill be ®pplicable for estates of decedents dying on or after 1 /1 /96 and before 1 /1 /97 • 1°i6 (.~1) wiN bs applicable for estates of decedents dying on or after 1/1/97 mnd before 1/1/98 • Spewal tas+~efers occurring on or offer 1/1/9$ wiN be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (r) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: x a. rot®i.n the use or income of the property transferred, ....................................................... x b. retain the right to designate who shall use the property transferred or its income, .. ............. x c. retain a reversionary interest; or ................................................................................... X d. receive the promise for life of either payments, benefits or care$ ....................................... 2. If abat4: occurred on or before December 12, 1982, did decedent within two years preceding x death transfer property without receiving adequate consideration$ If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving x adequate consideration$ ................................................................................................... x 3. Did decedent own an 'in trust for'. bank account at his or her death$ ...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r k ~ REV-1503 EX ~ (4.861 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS r F. Arthur Stayer (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM NUMBER DESCRIPTION ~• Cumberland Valley Cooperative - 14 shares stock TOTOL fAlsn enter nn line 2. Recaoitulationl VALUE AT DATE OF DEATH 140.00 I S 14(Y_ (1(1 ,~ REV-1508 EX+ (2.87) ~~ tfat ~ yr F. Arthur Staver (All property loinfly-owned wNh fhe Riyhf of survivorship must be dlselosod on sehedub F) ITEM NUMBER DESCRIPTION 1• Traveler's Checks Please Print or VALUE AT DATE OF DEATH 210.00 TOTAL (Also enter on line 5, Recapitulation) $ 21 (Attach additional 8!h" x 11" sheets if more space is needed.) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ~~ REV-1511 EX+ (7.88) F. Arthur Stayer ITEM ~ NUMBER .DESCRIPTION A• Funeral. Expenses: ~' Fogelsanger-Bricker Funeral Home Spring Hill Cemetery Association -lot and grave opening B. 2. 3. 4 C. 1 2 3 4. 5. 6. 7. 8. COMMONWEALTH Of PENNSYWANIA INHERITANCE inY acrnor.~ SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or AMOUNT 5,503.00 1,425.00 Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid Attorney Fees Mark, Weigle and Perkins Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code Probate Fees Miscellaneous Expenses: Register of Wills, Cumberland County -filing PA Insolvent Inheritance Tax Return 90.00 10.00 TOTAL (Also enter on line 9, Recapitulation} $ 7 , 0 .00 (If more space is needed, insert additional sheets of same size.) r ~ f _ •. REV-1513 EX+ ~2-E7) i' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER F. Arthur Stayer TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space is needed, insert additional sheets of same size) S ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: