The URL can be used to link to this page

Home My WebLink About10-19-12 (2)J 155610105 REV-1500 Ex(°~-°"c~t~ PA Department of Revenue Pennsylvania OFFICUIL USE ONLY ~~.,.o..~„~, Bureau of Individual Taxes County Code Year File Number PD BOX z8o6ot INHERITANCE TAX RETURN ~ - HaMSburq, PA t2u8-o6ot RESIDENT DECEDENT (~ J '. ~ ~ f ~ 1 crv r en ut~cutNT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY _0318201_2___ 05161913 Decedent's Last Name Su~x ~ Decedent's First Name Crouse _ D__orothy (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI M MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - _ _ ' REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW m 1. Onginal Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Pdor to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) O]D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _p 6. 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 1-1-96) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHO Name ULD BE DIRECTED TO: _ Daytime Telephone Number Courtney. J. Graham 717-264-1100 First Line of Address 223 Lincoln Way East - _. - Second Line of Address City or Post Office Chambersburg Correspondent's a-mail address: Under penalties of perjury, I declare that I ha it is true, correct and complete. Declaretion Robert C. Crouse REGISTER OF I LS USE ONLY ~O ti m Z' n ~7 r -^r c/), j o~-_ ~O 0~ ~ z-, `. DA~FILED ~o ...... __ .. C] d This return, inGuding accompanying schedules antl statements, and to the best of my knowl~ other than the personal representative is based on all information of which preparer has any IARE~URN DATE Side 1 L 1505610105 15[15610105 r fi l L, -Z7 ti r.,,r;. t7 ~ > <'+ _r-~ T `= c` r- rn :rJ `~ PLEASE USE ORIGINAL FORM ONLY Lsos61a2os REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: r~..rv.~ ~ n~ CI'cuCa RECAPITULATION 1. Real Estate (Schedule A) ............................................ . 2. Stocks and Bonds (Schedule B) ............. ............ . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 4. Mortgages and Notes Receivable (Schedule D) ........... , 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... . 1. 2.' 3. _....___...._._ ~....._ .. . __ _w.. _..... .._...-,._._ Q, 4. ', s.....~.._ _..____._._..... 949 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~-" ---~ ~-" --- - Qy (Schedule G) O Separate Billing Requested........ 7. '~, ~' n ®._ _ _._ __ 0' ___. ___. 8. Total Gross Assets (total Lines 1 through 7) ............................. 6. ~ ; 531.849.64' 9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9. _a _ .. _..._ _ _..15,176,:01.... 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ....... ....... 10. __ _ 239.30.'..:: 11. Total DeduMlons (total Lines 9 and 10) .. ......... ........ ...... 11. .... __. _. _ __ ___ .........15,415.31 , 12. Net Value of Estate (Line 8 minus Line 11) .......... . .. .. 12. 13. Charitable and Governmental Bequesis/Sec 9113 Trusts for which "° ~ - 516, 534, 33 °- -° - --- 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 516.534.33. 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 ! - -- , ---- -- __. _.. 16. Amount of Line 14 taxable '` ----• ~ -_..._...._ ... ®_ _. .. ~_ 17. at lineal rate X .04~ 516,534.33 ~ Amount of Line 14 taxable ~~~~" "' "' 16. ®..®..__ 23 244.04' am.. ~_~ _ at sibling rate X .12 ~~~! 17 ! '''.. 18. Amount of Line 14 taxable ~-~~~ ~ ~~~~~®~~ ' ' """ "-' -- at collateral rate X .15 ', 18 19. TAX DUE ......................................................... 19. ',... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 23,244.04 O REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number ZIP Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments -22,DOD.l1Q B. Discount _ __ __ _~S`..R~ 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. (1) ~oee ne Total Credits (A + B) (2) _ ~ ~ F~~d (3) (4) 5. If Line i + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) a~ nn 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 tc designate who shall use the property transferred or its income ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise far life of either payments, benefits or care? ................................................................ ...... ^ 2. If death occurted after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "intrust for" orpayable-upon-death bank account or secudty at his or her dearth? ........ ...... ^ ~ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designafion? .................................................................................................................. ...... ^ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN REV-i5o8 EX+ (u-io) Pennsylvania SCHEDULE E 6~1 DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT FILE NUMBER: Qorothy M_ Crouse 9~1 _pq~t Include the proceeds of litigation and the date the Droceeds were received by the estate. u more space is neeaeD, Use aDDiDDnal sneeLR Dt paper Df the Same size. REV-1511 EX+ (10-09) pennsytvania DEPARTMENT OF REVENDEDEPARTMENT OF NEVENUE INNERRANCE TAx RETURN RESIDENT DECEDEM SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Llorothy nn ~~ouse 2112-Od31 Decedent's debts must be reported an Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fopelsanper-Bricker Funeral Home, Inc. B. 1 2. ~ Kathy's Deli -food for wake ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State Z[P 11,324.55 1,005.94 Z. Attorney Fees: 2,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address 4. 5. 6. 7. 8. City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Cumberland County Law Journal The Sentinel 538.50 75.00 232.02 TOTAL (Also enter on Line 9, kecapitulation) ; If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-OK) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, ESTATE OP ~11z 0431 sport 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+ (0140) pennsylvania L1J DEPRRTMENT OF gEVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES NUMBER: RELATIONSHIP TO DECEDENT I 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. Robert C. Crouse - 3346 St. Andrews Dr., Chambersburg, PA 172021 son one-third (1/3) 2. Delores J. Jacoby - 65 Lenwood Park, Shippensburg, PA 17257 daughter one-third (1l3) 3. Kenneth L. Crouse - 2446 Lindsay Lot Rd., Shippensburg, PA 17257 grandson one-twelth (1/12) 4. Shari R. Gamble - 2525 Lindsay Lot Rd., Shippensburg, PA 17257 granddaughter one-twelth (1/12) 5. Michael D. Crouse -196 Park Heights Ave., Shippensburg, PA 17257 grandson one-twelth (1/12) 6. Abby K. Crouse -10364 Possum Hollow Rd., Shippensburg, PA 17257 granddaughter one-twelth (1 /12) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET; A S APPROPRIATE; II NONTAXABLE 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ If more space is needed, use additional sheets of paper of the same size. ~~~z mill ~~ Z~p~t~m~nt i, Dorothy M. Crouse, of Shippensburg Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my Will hereby revoking any and all former Wills and Codicils thereto by me at any time heretofore made. FIRST: I direct that all my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expanse of the administration of my estate. SECOND: I give, devise and bequeath the residue of my estate of every nature and wherever situate to my husband, Claire M. Crouse, providing he shall survive me by thirty (30) days. TBIRD: Should my husband, Claire M. Crouse, predecease ma, or die on or before the thirtieth (30th) day following my death, I give, devise and bequeath the residue of my estate of every nature and wherever situate to my children, namely, '~ Robert C. Crouse, xenneth E. Crouse, and Delores J. Jacoby, in equal abases, provided j that the share of any child who predeceases me or dies on or before the thirtieth (30th) d ''' day following my death shall be distributed to his or bar issue, per stirpea, living on the thirty-first (31st) day following my death, and in default of any such then living n issue such share shall be added to the share ox shares for my other children. FOORTH: In the event that anyone entitled to a share of my estate should be under the age of twenty-one (21) years at the time for distribution to him or her, I 4' ~; constitute and appoint Tha First National Bank of Shippeneburg, 5hippensburg, Pennayl- _ ~` vania or its successor, Trustee of any property which passes either under this Will or otherwise to said minor. Said Bank, as Trustee, shall in its sole discretion and with- out Order of Court, have the power to retain such property in kind or to sell the same, giving good title to any real estate, to invest and reinvest in stocks, bonds ox other investments, without being limited to investments which would be legal for minors' funds, ane to use principal as wall as income from time to time as ma a y ppear to~be ~.-. .'= education, without responsibility to the minor or to any parson taking care of the minari and any balance in the hands of said Bank, as Trustee, shall be distributed to said minor when he oz she attains the age of twenty-one (21) years. If such minor dies priar to attaining the age of twenty-one (21) years, said Trustee ie authorised in its discretion to pay part or all of hie or her funeral expenses and the remaining balance in the hands of said Bank, as Trustee, shall be distributed to his or her personal xepreaentative. In the event the Punda held by the Trustee for any minor become, in the opinion of the Trustee, too small fox proper and efficient administra- tion, the Trustee, in its sole discretion, may deposit such funds in a savings account in the name of the minor. FIP°PA: My ExecutoY and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my iP3.11 applicable to all property, whathez principal or income, including property held for minors, exercisable pithout Court approval, snd effective until actual diatributioci of all property; A. To retain any and all of the assets of my estate, real or raonal, includin stock of ao orate fiduciar pe q my rp y, without regard to any principle of diversification or risk. C~ v B. To invest in all forms of property, including stock, common ~~ trust funds and mortgage investment funds, whether operated by my corporate fiduciary C` ~~ or others, without restriction to investments authorized for Pennsylvania fiduciaries, '~ as they deem proper, without regard to any principle of diversification or risk. 'I.i C. To sell at public or private sale, to exchange or to lease, ~: ,~ `', for any period oP time, any real or personal property, and to give options for Bales, x exchanges or leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts an8 expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or contzoverey. F. To distribute in cash ar in kinS or oartiv each. SIXTH: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate ae a part of the expense oP the admin:tatration of my estate. SEVENPfis I appoint my husband, Claire M. Crouse, Executor of Chia my Will. Should my husband, Claire M. Cxouae, fail to qualify or cease ito act ae Executor, I appoint my son, Robert C. Crouse, Executor of this my Will. Should my eon, Robert C. Crouse, fail to qualify or Cease to act 8a Executor, I appoint The First National Bank of Shippensburq, S!hippensburg, Pennsylvania or its suaceseox, Executor of this my Will. EIGHTH: No bond shall be raqulred of any fiduciary (hereunder in any jurisdiction. IN WITI~BS WBERECB', I have hereunto set my hand and seal to this, my 'Last Will and Testament consiatiaq of three typewritten pages, the :First two of which bear my signature in the margin for the puxpoae of identification, this 1~ ~ day of Kea.,., ,,,,0a[.,ti) , 1979. .~-r~'U r...~yY~_ ~ys' ;~ _.., a SEAL) C/ _ Signed, sealed, published and declared by the above named Testatrix, Dorothy M. Crouse, ae and for her Last Will and Testament in our presence, who in her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses. l /~~/ ' ~~ ~~!•r R ~ i/ A dre e ... _ _. er, ~ .. n\ ~ 1 dress f J