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Home My WebLink About08-30-12 (2)J 4 1 1505610143 REV-1500 Ex(o,_,o, OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 11 Harrisburg, PA 17128-0601 RESIDENT DECEDENT File Number 1303 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 178 44 1544 11 29 2011 Decedent's Last Name Suffix BYERS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Date of Birth O1 14 1934 Decedent's First Name MI ESTHER H Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required ^ 6 Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe De OSIt BOXeS p 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death between 12-31=91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MARCI S MILLER (717) 626 0291 First line of address PO BOX 16 Second line of address City or Post Office LITITZ State ZIP Code PA 17543 REGISTER O CWILLS USE ON~.Y _ . . C r~-.~ - ,.. ~ ~- A 1 '" wn -,-~ -~- '_ s~ C,~a -. _ =_ C ~" CSC-.;, ~ DAT~F fL~D ~ a ~ Y' - ~ . _ ?> ___ ~-~ ~~ _T .t ~~ --.. _~ _. ~. J ,~ -r`i ~~ -.~.y Correspondent's a-mail address: 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 t and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. S NATURE" RSON RESPO B OR FILING RETURN DA E .RG. c~. .Q.. Randall L. Byers __ ~''" 0?7 /~ 32 N. Chestnut S eet M rietta PA 17547 SIGNATURE 0 T ,REPRESENTATIVE ATE ~; i' ~ ~ ;' °"~~_~ Marci S. Miller ~/.~ ~ %~ . P.O. Box 16, Lititz, PA 17543 Side 1 1505610143 1505610143 ~~,~ J 1,505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Byers, Esther H. 17 8 4 4 15 4 4 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 & Notes Receivable (Schedule D) ........................................................ 4. 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 9 , 8 2 8 . 0 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 0 . 0 0 7. Inter-Vivos Transfers & Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. 2 2 0, 4 8 6. 9 9 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 2 3 O , 315.0 3 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 5 , 668.90 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 17 , 8 8 9.15 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 2 3 , 5 5 8 . 0 5 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 2 O 6 , 75 6.98 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. 2 0 6 , 7 5 6. 9 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 0 0 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 2 0 6 7 5 6. 9 8 16 9 3 0 4. 0 6 at lineal rate X .045 ~ . ~ 17. Amount of Line 14 taxable 0 0 0 17 0 0 0 . at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 0 0 0 . at collateral rate X .15 . . 19. Tax Due .................................................................................................................. 19. 9, 3 0 4. 0 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-1303 DECEDENT'S NAME Byers, Esther H. STREET ADDRESS 100 Mt. Allen Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 8,400.00 442.11 3. 1 nterest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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) Total Credits (A + B) (2) (3) (4) (5) 9,304.06 8,842.11 461.95_ 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 property transferred or its income :.................................. ^ ^x c. retain a reversionary interest; or ............................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ............................................................ ^ ^x 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 death bank account or security at his or her death?....... ^ ^x 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 January 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 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)]. A sibling 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-1508 EX+ (6-98) SCHEDULE E s. CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Esther H. FILE NUMBER 21-11-1303 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) (If more space is needed, additional pages of the same size) Rev-1509 EX+ (6-98) ;; SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Byers, Esther H. 21-11-1303 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Randall L. Byers B. C. 32 N. Chestnut Street Son Marietta, PA 17547 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT 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 ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 07/01/2008 PNC Savings Account #5005706646 -Jointly 0.00 50.000% 0.00 owned with Randall L. Byers, son (added 7/1 /2008) TOTAL (Also enter on Line 6, Recapitulation) I 0.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Byers, Esther H. 21-11-1303 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF RANSFERSATTACii A COPY OF TIOHE DEIED ~OR REAL ESTATD . DATE OF DEATH VALUE OF ASSET °i° OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 MassMutual Annuity # EVN46008581 -Named 117,496.03 100.000% 117,496.03 beneficiaries: Sheryl B. Craun, Pamela L. Musser, Brenda B. Cox. Randall L. Byers, children 2 MassMututal Annuity # EVN46008122 -Named 96,972.59 100.000% 96,972.59 beneficiaries Sheryl B. Craun, Pamela L. Musser, Brenda B. Cox, Randall L. Byers, children 3 PNC Savings Account #5113008589 -Jointly owned 9,018.37 3,000.00 6,018.37 with Pamela L. Musser, daughter (added 12/2110) TOTAL (Also enter on Line 7, Recapitulation) ( 220,486.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06) ,., COMMNHERITANCEOT~ RETURN ANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Byers, Esther H. 21-11-1303 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MB R A, FUNERAL EXPENSES: See continuation schedule(s) attached ~ 1,213.70 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Randall L. Byers Street Address 32 N. Chestnut Street city Marietta state PA zip 17547 Year(sl Commission paid 2012 2. Attorney's Fees Gibbel Kraybill & Hess 3, 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 500.00 3,500.00 4. Probate Fees 150.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 304.70 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 5,668.90 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Byers, Esther H. 21-11-1303 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Messiah Village -funeral expense 1,213.70 H-A 1,213.70 Other Administrative Costs 2 Cumberland County Register of Wills -filing fee 15.00 3 Cumberland Law Journal -legal advertising 75.00 4 The Sentinel -legal advertising 214.70 H-B7 304.70 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER B ers, Esther H. 21-11-1303 Report 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 Alert Pharmacy -prescription expense 432.58 2 Alert Pharmacy -prescription expense 139.36 3 Everence -supplemental health insurance premium 305.78 4 Messiah Village -Nursing home expense 6,178.00 5 Messiah Village -Nursing home expense 339.16 6 Messiah Village -Nursing home expense 74.81 7 Messiah Village -Nursing home expense 8,334.60 8 Pamela Musser -reimbursement tax payment 233.86 9 United States Treasury - 2011 Income Tax 1,851.00 *Transferees listed on Schedule G have actually paid the above-listed debts of decedent. TOTAL (Also enter on Line 10, Recapitulation) I 17,889.15 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) SCHEDULE J COMMNHERITANCEOT~ RETURtJANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Byers, Esther H. 21-11-1303 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) o N to I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 Randall L. Byers Son One-Fourth 32 N. Chestnut Street Residue Marietta, PA 17547 Brenda B. Cox Daughter One-Fourth 21604 320th Street Residue Ollie, IA 52576 Sheryl B. Craun Daughter One-Fourth 11219 Doubletree Court residue Alexandria, KY 41001 Pamela L. Musser Daughter One-Fourth 54 Penn Street Residue Washington Boro, PA 17582 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) b. 2. 2012 11:02AM PNC BANK +~~vc t~an~on~~weY February 2, 2012 Kathy A Mansbery Gibbel, Kraybill & Press LLP 10 S Broad St. Lititz, PA 17543 RE: Esther H Byers SSN: 175-44-1544 DOD: 11-29-2011 Dear Ms. Mansbery: No, 0956 P. 1 In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following; Checkixag Account ,Account # 5005706646 ESTHER PI BYERS R.ANDALL L SYERS DOD balance: $0,00 non -interest bearing Account # 5112999624 ESTHER ~1 B'YERS DOD balance: $9,303.33 + 0.05 accrued interest Interest paid 01-01-2011 thru 11-29-2011 $0.14 YTD ~ Savings Account Account # 5113008559 ESTHER H BYERS PAMELA L MUSSER DOD balance: $9,01 S36S + 0.19 accrued interest `"'"r Interest paid 01-01-2011. thru 11-29-2011 $110.34 ~1TD Established: 07-0-2008 Established: 08-11-2011 Established: 12-02-2010 Please note that this office provides date of death balances for deposit accounts (TRAs, CDs, Checking and ' Savimgs). We do not process any lnancial transactions or provide statements. If you need assistance with any of these items, please call 1-S8S-PNC-BAI~'1C (1-888-762-2265) or stop by your local PNC Bank branch ofFce. Sincerely, . National Financial Services Centex PNC Bank, N.A. Member FDIC ' Page 1 of 2 ~~aSSMlitll~ - ~ Special Statement fINANCiAI GROUP o 71tE SLOE cN1P COMPANIES'" a n. 712 to licable (.I~OI" ? Nt1 pp ) ivt.;ssactxise~ts Itiltrtua( Life Insurance Company and aCiiliate~ companies S~ringUcl~i ;ti1A Oiltl-0:3CI , instructions Please use this form for Estate Tax Purposes covering Annuities and Statement Accounis. This form is to be (•ilcd by the Executor with Federal Estate Tax Return 706. r ;n.-~: c~~~ oECL~~r~T DATE Or n~:1T; Esther H Byers 1 I -24-2011 ___ __ .....~..._w,....... _ . _ ... __......._~.,...w . .-......... --~-- . .. _ . _ _ ___ ................ __ _ ............ !.~ CONTRACT NUMBERS ', f [~: U CGASrD`S P~tYL•:: ACt: t' TAO Evlv~6oos 122 ..... :- s5~r..D air TH LIFE t;I;: Esther H Byers "s ~~'AS THERE ORIGINALLY A CL.4(IvI PRIOR TO THE DEATH OF THE AI30b'E DECEDENT? '~~ No -i Yes By reason of: !.J Surrender ;~~.! Matured Endowment or ~'lnnuity !~/ Death of lns~tt-ed or /11~nuit~tnt __ -~ ~rYE~E o,~ COTJTRACT oa tNSTAI..Ir>,~ETVTs ~Tariable ~~nnuity ~WEI.1T'`'YE'~.C1I~ l•ZIt:rI-IT`-LAID'I'H..I:~ECFDET'.~Tt-A;tE'I'O Vt-ITIDRA`tr.CL`~.~v:1JTE0:? ~C:~.(~;ETDGRCU'*f'('IZAC"E"% -~-~ None ;~1 Full Rights ^ Other (explain): C~ DEATI-( BEI~IEPICIARY(TES~ AND RELATIONS IP TO DECEDEi~lT See attached (lO'v'1 'drit,I.. TI-II~ DEATH I~I~~Irf~~(T BE PAY.A13I.r? tit One Sung InstallTrT,er~ts (as follows): S ti'~'i-IAT TYKE tJF IiI~CI-IT7 D{)EZ Tr.E .E`sEI~iEI'ICI.RI' Hf~VE TC} bVITIDI~.A~';~ PRCC:EEDS Jt't'~i CQIvIIvSJ'I'E Ii`S7'.r.t.L yrT~ITS? Done '~~ Fu11 I~.i~hts J' Other {explain j: .-......... ;} 't/At L'=~ O;~ CON ~ I2ACT AS ,tJr :?r~+TE. Ot: Ditll'H $6,972.59 '~` tiiha c!E+ic iss ~rit`:rcr,! rcfrarl~c~:r, nL~Ftt"S::i!. cauGilgi c !ice M:ncfrii!rv? ____~_ i {; ,~I~I), ; E{TAT:. RE1v4AIZKS: 9A, I;~1C~ICAr"E I3K.SI OC ~'rILU.~"i'IOTv {1F l'`!5I':~LL(viETv"i I3~NGe"('1'S The undersigned officer of the above named Insurance Company hereby certifies that this statement sets forth correct and trae information with respect to the Contract indicated herein. ___ ... SiG'vATURL- TITLE /~t~ Vice President 0~-10-2012 litJ.4' {,C1!!?~7L171)%, vy_ftrrsiishirrg tfae crv~,ve rnjnrn;atint?, CXt)PL'.SS'L'.S lTO nfi11:K:11 G.S' !~ 1P%1Gi~?L'i' (.Y' lit?i :?i( fJ!' Ctfly jJ(,')'r [3~ 1J+e tJJ'Ui.'iL1iP iJ~ 1i14 G!1!f7;'G C;3i?(!';ti:; C LtP;' ;11Cliltt'Li7:!'c' ?li i+ri' i?1?1sC rMassMu~ua1,~ R4ascz: hucctl~ MutuaE 1_ic ir~~u~:3fi:,i: Cc,3lY~acy and afFliaietl can?Manias Slxit~g,.ield 1b4A Dl i l i-0(;0i .v wtv~nnssn'r: ~ni.cocr. ****M356**** SHERYL B CRAUN DAUGHTER PAMELA L MUSSER DAUGHTER BRENDA B COX DAUGHTER RANDALL L BYERS SON