HomeMy WebLinkAbout10-03-121505610105
REV-1500 IX (oz-ss) (FI)
PA Department of Revenue pennsylvanla OFFICIAL USE ONLY
Bureau of Individual Taxes ""`" County Code Year File Number
PD BOx a8o6o1. INHERITANCE TAX RETURN ~;-'...... ~ O
Harrisburg. PA rnz8-ohm RESIDENT DECEDENT I ~') i ~., ,
Social Security Number Date of Death MMDDYr'YY Date of Birth MM1fDDYYri
'209-12-9788 ~ ,06/22!2012 ~' ' ~O5108/1924
Decedent's Last Name Suffix Decedent's First Name MI
Snell I ~~ i Robed rt '~ E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
' 1 __ ~ _ i
Spouse's Socal Secudty Number
THIS RETURN MUST BE PILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1. Odginai Return O 2. Supplemental Retum O 3. Ftemainder Return (Date of Death
Prior to 12.13-82)
O 4. Limned Estate O 4a. Future Interest Compromise (tlate of O 5. Federal Estate Taz Retum Required
death after 12-12-82)
0)d 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.}
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
'Lisa Marie Coyne, EsQ. 'i i (717) 737-0464 ~, ~
First Line of Address __
13901 Market Street J
Ciry or Post office State
~ Camp Hill , PA
... .. _
ZIP Code
' N
REGISTER OF Q SE ONL C`1
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DATE FILED
17011
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Correspondent's e-mail address: IISaQCOyneandCOyne.COm
Under pehaRies o} perjury, I degare that 1 have examined this return, Including aaompanying schedules and statements, antl to the best of my knowledge end belief,
a is true, coned and complete. DeGaretion of preparer other than the personal representative is based on all information of which preparer has eny knowledge.
SIC~JATURE OF PERSON RE,$POt~SIBLE FOR FILING RETURN DATE
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David Deibaugh, 34 Gale Roa(f, Camp Hill PA 17011-2619
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 150'i610105
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REV-1500 EX (FI)
ROBERT E. SNELL
)easdent's Social Security Number
209-12-9788
RECAPITULATION
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)........ _ ................................
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2. Stocks and Bonds (Schedule B) _ .................................. ... 2. ~ I
3. Closel Held Co oration, Partnershi or Sole-Pro rietorshi Schedule C
Y rP P P P( )..
... 3.
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4. Mort a es and Notes Receivable Schedule D
9 9 ( ) ........................
... 4.i ~
I
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. j 6,823.53
6. Jointly Owned Property (Schedule F) O Separete Billing Requested .... ... 6. ~ ~
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Pro ert _
(Schedule G) O Separate Billing Requested...... .. 7. ~ '
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. ( 6,623.53
9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 20,708.24 ,
10. Debts of Decedent, Mortgage Liabilities and Linns (Schedule I) ............. .. 10. 35,494.
11.
Total Deductions (total Lines 9 and 10)............
11.
56,202.49
!
12. Net Value of Estate (Line 8 minus Line 11
............................ ..12. ~ -49,578.96
I
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to taz has not been made (Schedule J) ......................
.. 13. ~- ~
14. Net Value Subject to Tax (Line 12 minus Lina 13) ...................... .. 14.
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 _ i6.
17. Amount of Line 14 taxable ',
at sibling rate X .12 ', 17,
18. Amount of Line 14 taxable '. '
at collateral rate X .15 0.00: 18
19. TAX DUE ......................................................... 19.
0.00
______.
(
I 0.00 I
0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 1505610205
1505610205
Side 2
15015610205
O
J
`~~REV-1500 EX (FI) Page 3
Decedent's Complete Address:
File Number
DECEDENT'S NAME
Robert E. Snell
STREET ADDRESS
1700 Market Street
___ _
CITY _.._.- _- ..._ ......_-____ ._._. 'STATE T21P __~.
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 0.00
2. Cn:ditslPaymenis
A. Prior Payments _._.
_. _ ._.._
B. Discount
Total Credits (A + g) (2) 0.00
3. Interest
(3)
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. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the 7AX DUE. {5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
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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 progeny 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, benefts or care? ................................................................ ...... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer properly within one year of death
without receiving adequate consideration? .............................................................._........................................ ._... ^
3. Did decedent own an "intrust 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 benefciary designation? .................................................................................................................. ...... ^
1F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Far 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 Juiy t, 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 [/2 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 p2 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at (east one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
ROBERT E. SHELL 21-12-0732
(If more space is needed, insert additional sheets of the same size)
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August 13, 2012
COYNE & COYNE PC
3901 MARKET STREET
CAMP HILL PA 17011
RE: Robert E Snell Estate
DOD: 6/22!12
SS#: XXX-XX-9788
Tracking # 285648
To Whom It Mav Concern:
Susquehanna Bancshares, Inc.
26 North Cedar Street
P.O. Box 1000
Lititz, PA 17543-7000
Tel 1.800.311.3182
~, Fax 717.625.4478
In response to your letter of August 7, 2012, here is the above customer account information
as of June 22, 2012.
• Account Title:
• Account Type/#
• Date Opened /Maturity
• Interest Rate:
• Account Balance*:
• Accrued Interest:
Robert E SnellDoris J Snell
David L Delbaugh POA
Checking 4502068809
9/4/02
.10%
$6,b23.15
$.38
• YTD Interest: $3.72
*Account balance does not include accrued interest.
® There is no safe deposit box in the name of the decedent.
If I can be of further assistance, please feel free to call.
Sincerely,
1~c ~~.,,: ~-...~
Dawn M Berrier
Deposit Research -Reporting Department Lead
1-717-625-6546
DMB/aed
5t~squeh~»nc~
REV-1511 EX+(12-99)
SCHEDULE N
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NOMBER
ROBERT E. SHELL 21-1:?-0732
Debts of decedent must be reported on Schedule I.
ircu
A. FUNERAL EXPENSES:
t' Funeral Reception
z. Bamers Cemetery Association -Marking of Grave
3.
4.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) Delbaugh, David L.
Social Secudty Number(s)IEIN Number of Pereonal Representative(s) _
Street Address 34 Gale Road
Ciry Camp Hill .state PA Zip 17011
Year(s) Commission Paid: 2012
2. Attorney Fees
3. Family Ezemp[ion: (If decedent's address is not the same as claimant's, attach ezplanadan)
Claimant
Street Address
City Stete
Relationship of Claimant b Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
~. Department of Public Welfare, Class 3 Claim
6. Patriot News, Estate Advertisement
9. Cumbedand Law Journal, Estate Advedisement
to. Postage
t t. Estate Checks
t2. See attached continuation sheet
TOTAL (Also enter on line 9, Recapitulation) I S 20,708.24
40.67
100.00
332.00
1,200.00
.Zip
128.50
500.00
17,977.55
109.52
75.00
25.00
10.00
210.00
(It more space is needed, insert additional sheets of the same size)
A B C D E
1
2 ESTATE OF ROBERT E. SNELL N0.21-12-0732
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SCHEDULE H _.
S
6 -- - _
ContinuaUOn Sheet
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__
7 B.12 Reserves $200.00
8 8.13 Filin Fee: Inheritance Tax Return $15.00
9 Subtotal $215.00
10 __
_ _ -- -.. _
11 _ _ -
REV-1512 E%+ (12-OS)
~ Pennsylvania SCHEDULE I
DEaaRTnE"T Or RrvE"uE DEBTS OF DECEDENT,
'""E"rr""SET"x "EruR" MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT E. SNELL 21-12-0732
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+ (11-08)
~ Pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE iA% RETURN BENEFICIARIES
RESIDENT DECEDENT
FILE NUMBER
ROBERT E. SNELL
21-12-0732
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llet Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS [Include outright spousal distributions and t2nsfers under
Sec. 9116 (a) (11).]
1. David L Delbaugh, 34 Gale Road, Camp Hill PA 17011-2619 Friend 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN A80VE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S 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 OF PART Ii -ENTER TOTAL NON-TAXABLE DISTRIBl1TI0NS ON LINE 13 OF REV-1500 CO'/ER SHEET. #
If more space is needed, insert additional sheets of the same size.
_:_ __
REGISTEiR OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA,
CERTIFICATE OF
GRANT OF LETTERS
No. 2092- 00732 FA No. 21- 92- 0732
Estate Of : ROBERT EARL SNELL
(First, Middle, LasU
Late Of: CAMP HILL BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No
209-72-9788
WHEREAS, on the 17th day of July 2012 an instrument dated
May 11th 2009 was admitted to probate as the last will of
ROBERT EARL SNELL
(First, Midtlle, Lasrl
late of CAMPH/LL BOROUGH, CUMBERLAND County,
who died on the 22nd day of June 2012 and,
WHEREAS, a true copy of the will as probated is annexed .hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in any?
for CUMBERLAND County, in the Commonwealth of Pennsylvania, .he.reb_y
certify that I have, this day granted Letters TESTANIENTARYto:
DAVID L DELBAUGH
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the sea'
of my office on the 17th day of July 2012.
egister o 1/._.
eputy CCClll11J
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, .LAST)
1~12,1UL-3 fMii°!i
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ORPHRN'S CCURr
` ^ G`lIMBEALANQ Cb., Pq
LAST WILL AND TESTAMENT
OF
ROBERTSNELL
I, Robert Snell of 116 Robin Road, Hummelstown, Dauphin County, Pennsylvania ,
being of sound and disposing mind, memory, and understanding, do hereby declaze this
as and for my Last Will and Testament, hereby revoking all Wills and. Codicils
previously made by ma.
1. I nominate, constitute, and appoint my trusted and loyal friend, David Leroy
Delbaugh, presently residing at 34 Gale Road, Camp Hill, Pennsylvania, as the
Executor of this, my Last Will and Testament. He shall be aufhorized to carry out
all provisions of Bus Will and I hereby relieve him from the necessity of posting
security in connection with his duties as such in any jurisdiction in which he may
be called upon to act insofar as I am able by law to do so.
2, I direct that all my debts and funeral expenses be paid as soon. after my decease as
maybe practicable.
3. I direct that inheritance tax on property disposed herein shall lbe paid from my
residuary estate.
4. If a named beneficiary predeceases me, the inheritance shall be issued per stirpes.
5. I leave all the rest and residue of my estate, of every nature and description, and
wheresoever located, to my friend David L. Delbaugh.
6, If any person, group, or beneficiary files, or has filed in their behalf, any legal
proceedings against my personal representative, executor, exa;cutrix, or against
my estate and possessions for what ever reason, then that person, group, or
beneficiary shall not share in any portion of my estate, and appropriate legal
action may be taken to suppress the challenge.
LAST WILL A1~TD TESTAMENT
OF
ROBERTSNELL
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Date Execute~dy-: ,~~( ~ ,
Signature: " ' "`~~~~ ~;
Witness:~Ck/~Qdt~~j~.~i'
Witness: ~~'`(ti~~. ~~-.~.~ ~S c~
COMMONYVEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
Witness my hand and official seal on this
Day of ~~ 2
NOTARY PUBLIC ~Ci.r~~
Cj
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NMK.1' A liRNOCIf
llolay RRNC
LOWER lM1fUQN 1WR fEM/IRMOORHIY
My Ca~Mtirlon 6ggr Oal RL iQ~
COYNE & COYNE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
Henry F. Coyne
Lisa Marie Coyne
3901 Market Street
Camp Hill, Pennsylvania
17011-4227
October 2, 2012
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
717-737-0464
Fax:717-737-5161
www. Coyne andcoyne.com
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Re: Estate of Robert E. 1Sne11, Deceased
No. 21-12-0732
Dear Sir or Madam:
Enclosed please feud an original and iwo copies of the Inheritance T'ax Return for this insolvent
estate. Kindly docket the original Return and return to this office a "clocked-in" copy with the enclosed
envelope.
Return.
Also enclosed is an estate check in the amount of $15.00 which represents the filing fee for this
Thank you for your assistance. If you have any questions, please contact me.
Very truly yours,
COYNE & COYNE, P.C.
isa arie Coyne
LMC/cmc
Encl.
Cc: Mr. David L. Delbaugh, Ext.
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