HomeMy WebLinkAbout11-21-12 (2)' 1505611185
EX (02-11) (FI)
REV-1500 OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN 2 ~, 1, 2 0 3 21,
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1,75-18-2025 0224201,2 1,025],922
Decedent's Last Name Suffix Decedent's First Name M I
JONES HARRY D
(If Applicable) Enter Surviving Spouse's Information Below MI
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES 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 ^ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
Attach Co of Trust.
(Attach Copy of Will) ( pY )
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death ^ 1 1. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Daytime Telephone Number
Name
DAVID C WERTIf~E ESQUIRE 717-597-~~-`~ ~'
First Line of Address
35 N CARLISLE ST STE A
Second Line of Address
City or Post Office State ZIP Code
GREENCASTLE PA 17225
~~ T
~_:
REGISTER Q~~, J-LS USE Ot~'~„. `' .-:'
~.I-~ ..-.~.
'~.~ ,- --
C~ ~ -_;~
.~~ ~ -
DATE FILED
.a,~
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c.
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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 true, correct and complete. Declaratidn of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG RE~C~'PE~ON ESPONSIBLE FOR FILING RETURN DATE
~-I.il Personal Representative 11/20/12
ADDRES
~5 N C L E S STE A
SIGNATU OF REf~ OT R T AN REPRESENTATIVE
ADDRESS i
55 N CA LE ST STE A
1505611185
GREENCASTLE PA 1,7225
GREENCASTLE PA 17225
SE ORIGINAL FORM ONLY
Side 1
OM4647 3.000
DATE
11/20/12
1,505611,1,85
~~~
y
1
J
1,505611285
REV-1500 EX (FI) Decedent's Social Security Number
1,75-1,8-2D25
D
HARR
Decedent s Name J O N E S
Y
RECAPITULATION
0•DD
....
1. Real Estate (Schedule A) ~ • 1
D•DO
2. Stocks and Bonds (Schedule B) . 2
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3.
0•DD
.
4. Mortgages and Notes Receivable (Schedule D)
4.
D•DD
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5.
47,595•D8
2,184.63
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
~ Separate Billing Requested
G
l 7 6 , 2 3 8 • D D
)
e
(Schedu
56, D1,7.71,
8. Total Gross Assets (total Lines 1 through 7)
8
9 8,244.09
g. Funeral Expenses and Administrative Costs (Schedule H). .
.
751.88
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10.
11 8,995.97
11. Total Deductions (total Lines 9 and 10) , .
.
12. Net Value of Estate (Line 8 minus Line 11) .
12.
47, D21, • 74
Charitable and Governmental Bequests/Sec 9113 Trusts for which
13 D • D D
.
an election to tax has not been made (Schedule J) , . 13.
. 14.
14. Net Value Subject to Tax (Line 12 minus Line 13)
47,D21, • 74
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers unSler Sec. 9116
D • D D
16. Amount of Line 1 4t~xable
0 - 4 7 , D 21, • 7 5
t linea- rate X
16. 2 ~ 1,1, 5 . 9 8
.
a
17. Amount of Line 14 taxable
D • D 0
17. D . D D
at sibling rate X .12
18. Amount of Line 14 taxable D • D D 18 D • D D
at collateral rate X .15
2,1,1,5.98
. 19.
19. TAX DUE .
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1,5D561,1,285 J
1,5D561,1,285
OM4646 3.000
2
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 9 ~ ' 3 9
B. Discount 4 • 9 2
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box 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 TAX DUE.
(1) 2,1,1,5.98
98.31,
(3) 0 •0 0
0.00
(5) 2,01,7.67
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
1. Did decedent make a transfer and: ^
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" or payable-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. X9116 (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. X91 16 (a) (1.1) (ii)j. 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)]. 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.
Total Credits (A + B) (2)
OM4671 2.000
3
REV-1500 EX (FI) Page 3 File Number
-„ , ~ n ~
REV-1509 IX+ (01-10)
pen.nsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
SIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
RE FILE NUMBER:
ESTATE O F
21 12 0321
Harr D. Jones
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
ADDRESS RF1AT10NSHIPTO DECEDENT
SURVNINGJOINTTENANI•(S) NAME(S)
A Currie, Sally J
JOINTLY OWNED PROPERTY:
398 Adams Road, Carlisle, PA
17015 Daughter
OF
DATE OF DEATH DECEDENTS
VALUE OF ASSET INTEREST
U=TTER DATE DESCRIPTION OF PROPERTY
~~ FOR JOINT MADE INCLUDE NAM= OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIM LAR
NUMBER TENANT JOINT IDENTIFYING NUI+B ER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE.
1 A 2/13/1999 Members 1st Federal Credit
Union, Checking Account
171534-11, registered in
the names of Decedent and
Sally Jones Currie,
Decedent's daughter
Interest accrued to
2/24/2012
2 A 10/20/1997 Members 1st Federal Credit
Union, Savings Account
171534-00, registered in
the names of Decedent and
Sally Jones Currie,
Decedent's daughter
Interest accrued to
2/24/2012
9W46AE 2.000
2,796.49 50.0000
0.48 50.0002
1,572.01 50.0000
0.25 50.0003
TOTAL (Also enter on Line 6, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
1,398.25
0.24
786.01
0.13
2,184.63
5
REV-1510 EX+(08-09) SCHEDULE G
pennsylvania
INTER-VIVOS TRANSFERS AND
DEPARTMENTOF REVENUE
NON-PROBATE PROPERTY
RN MISC
.
INHERITANCE TAX RETU
RESIDENT DECEDENT FILE NUMBER
ESTATE OF 21 12 0 3 21
Harr D. Jones
ted and filed if the answer to any of questions 1 through 4 on p
l
age three of the REV-1500 is yes.
e
This schedule must be comp
DESCRIPTION OF PROPERTY o ~
T AND DATE OF DEATH ~o OF DECD S EXCLUSION TAXABLE
VALUE
ITEM INCLUDETFE NAME OF TI-ETRANSFEREE, THEIR RELATIONSHIP TO DECEDEN
ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST
SFER IF APPIJCABLE
.
NUMBS THE DATE OF TRAN
1. Cash to Donna Sue Moyer,
Decedent's daughter, in
2,239.00 100.0000 2,239.00 0.00
December, 2011
2 Cash to Sally J. Currie,
Decedent's daughter, in October 3,000.00 238.00
3,238.00 100.0000
and December, 2011
3 Cash to Sally J. Currie,
Decedent's daughter, in 8,000.00 100.0000 3,000.00 6,000.00
February, 2012
4 Cash to Sandra L. Membrino,
Decedent's daughter, in 1,889.00 0.00
1,889.00 100.0000
November and December, 2011
5 Cash to Shelly A. Schubert,
Decedent's daughter, in
September, November and 2,204.00 0.00
December, 2011 2,204.00 100.0000
TOTAL (Also enter on line 7, Recapitulation) $ I 6 , 2 3 8 . 0 0
If more space is needed, use additional sheets of paper of the same size.
9W46AF 2.000 ~`
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
RESIDENT DECEDENT FILE NUMBER
ESTATE OF 21 12 0 3 21
Harr D. Jones
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
p,. FUNERAL EXPENSES:
1 Myers-Durboraw Funeral Home P.A. 548.20
Balance of funeral expenses
g. ADMINISTRATIVE COSTS:
~ , Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
State ZIP
City
Year(s) Commission Paid:
5,500.00
2. Attorney Fees:
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
3.
Claimant
Street Address
State ZIP
City
Relationship of Claimant to Decedent
187.50
4. Probate Fees:
5. Accountant Fees:
g, Tax Return Preparer Fees:
7.
1 AGIA 50.50
Insurance premium
2 Cumberland Law Journal 75.00
Advertising Letters
1,882.89
Total from continuation schedules
8,244.09
TOTAL (Also enter on Line 9 Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
9W46AG 2.000
7
Estate of: Harry D. Jones
Schedule H Part 7 (Page 2)
21 12 0321
3 The Sentinel 232.02
Advertising Letters
4 USA.A 284.76
Automobile insurance premium
5 USAA 254.79
Automobile insurance premium
6 USAA (188.68)
Automobile insurance premium refund
7 Wertime & Guyer LLP
Miscellaneous office expenses for long distance
telephone calls, photocopies, postage, notary fees,
recording Releases and preparation of income tax 1,300.00
returns
1,882.89
Total (Carry forward to main schedule) $
REV-1512 EX+(12-08) SCHEDULE
pennsylvania
DEPARTMENT OF REVENUE DEBTS O F DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT FILE NUMBER
ESTATE OF
21 12 0321
Harr D. Jones
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1• CenturyLink 22.16
Telephone bill
2 Chapel Pointe at Carlisle 609.93
Monthly fee
3 George T Hicks Jr., Tax Collector 4.90
2012 Per Capita Tax
4 Members 1st Federal Credit Union 114.89
Visa Credit Card Account Number 4672090000442400
751.88
TOTAL (Also enter on Line 10 Recapitulation) $
If more space is needed, insert additional sheets of the same size.
8W46AH 2.000
9
REV-"'513 EX+ (L11-10)
pennsylvania
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
Harrv D ._ Jones
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
~ TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1 Donna Sue Moyer
54 Festival Drive
Voorhees, NJ 08043
25~ of Residue: 9,649.78
2 Sally J. Currie
398 Adams Road
Carlisle, PA 17015
Jointly-Owned Property (Schedule F):
2,184.63
Transfers (Schedule G): 6,238.00
25~ of Residue: 9,649.78
FILE NUMBER:
21 12 0321
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Daughter
Daughter
_.._ _..,.,.,.~ ,,,..~~~~ n~i i inicc ,STNRnI IC,H 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
9,649.78
18,072.41
9W46A1 2.000
10
Estate of: Harry D. Jones
Schedule J Part 1 (Page 2)
Item
No. Description
3 Sandra L. Membrino
457 South Old Middleton Road
Media, PA 19063
25~ of Residue: 9,649.78
4 Shelly A. Schubert
24694 Nettle Mill Square
Aldie, VA 20105
25~ of Residue: 9,649.78
Relation
Daughter
Daughter
21 12 0321
Amount
9,649.78
9,649.78
11
;t ~.' ,.
Harr D. Jones. of Ham ton Township, Cumberland County, Pennsylva'riia, `with post office
I, y p
address at 3614 Kohler Place, Apartment 1, Camp Hill; Pennsylvania 17011, ,~ec;l~r~_ this to be my
wi11. I revoke all of my prior wills and codicils. r ;~t~-~ `~.= '~!.~='T
ITEM 1. I direct all my debts not barred by a statute of limitations, ~~~eral expen5e~.and cost
of placing a grave marker shall be paid out of my residuary estate as soon as may be convenient
after my death.
ITEM 2. All estate, inheritance and other death taxes, together with interest and penalties,
payable •y°Jith respect to property or interests passing under my will or any codicii, othe tthan property
over which I have a general power of appointment, shall be paid out of the principal o; my residuary
estate before its division into shares in the same manner as an administration expense.
ITEM 3. I give and bequeath my tangible personal property to my four (4) daughters, Sandra
L. Membrino, Donna Sue Moyer, Shelly A. Schubert and Sa11y J. Currie, in substantially equal shares.
The division of my tangible personal property between my daughters shall be made in such manner
as they shaii agree upon, or if they shall be unable to agree, according to the following procedures:-
a) The value of each item shall be the appraised vaiue for Pennsylvania inheritance tax
purpose;
b) My daughters shall each select, in the order of their ages, oldest to youngest, one
item at a time, until the value of the items selected by her totals the value of her
share; and if any of my daughters selects an item which exceed her share, she eaa
have fihe item allocated to her share on the condition that she pay to my esta
sufficient amount to equalize the shares of my other daughters;
c Any iter ns not so selected shall be soid and the proceeds of saie shaii be divided
among my daughters so that the total value of items selected and any proceeds of
sale shaii be divided in substantially four (4) equal portions;
d) ~houid any of my daughters be deceased at the time of the distribution of my estate,
terest under this ITEM 3. shall be distributed to her issue per stirpes, provided
her ~r
however, the issue of such deceased daughter shall not participate in the selection
_~ of items under ITEM 3.b).
ITEM 4. The remainder of my estate shall be liquidated, including the saie of my real estate,
li uidated estate to my four (4) daughters,
_- . in such manner as may be deemed best.. and I give my q
andra L. Membrino, Donna Sue Moyer, Shelly A. Schubert and Sally J. Currie, in equal shares per
S
stirpes. .
ITEM 5. Any property passing under this will to a person under twenty-one (21) years of age
shall be aid to my daughter, Sally J. Currie, as custodian under the Uniform Transfers to Minors Act
p the custodian
for tr-at beneficiary. Ifi Sally J. Currie is unable to serve, fails to act or ceases to serve,
shall be m~ daughter, Donna Sue Moyer. The custodian shall manage any property, rights, claims to
y
- causes of action that may pass to her under the following terms and conditions that are ~n addition
_-- ~- _those powers given by law:- .
- _ a` To have broad powers to use the income and principal for the health, maintenance,
- ~
- support and education of such beneficiary; rinci al~
b) To apportion receipts and disbursements between income and p p ,
c) To add excess income to principal and invest it as such;
~.~ to the erson having custody of such beneficiary, without liability on the part
d) To pa, p
of the custodian to see to the application thereof, such income or principal as it
12
deems advisable for the health, maintenance, support and education of such
benefici=ry;
e) To expend income and principal directly as it deems advisable for the health,
maintenance, support and education of such beneficiaryof this m will, and should she be
ITEM 6. I appoint my daughter, Sally J. Currie, executrix y
una!~le to service ir: such capacity, I appoint my daughter, Donna Sue Moyer, executrix of this my will,
and direct that letters testamentary in my estate be granted without the requirement of bond.
iN WiT~'ESS Wl~E~EGF, I hereunto set my hand to this my will, typewritten on two (2) sheets
of paper phis 13th day of February, 2002.
Si ned, sealed, ublished and declared by the above named testator, Harry D. ,!ones, as and
g P
for his will, in the presence of us, who, at his request and ~n :t~is presence, and in the presence o
each other, have hereunto subscribed our names as witnesses. __ _ __
~: ~,
/~~ /f
/ Y,.~
j ~
13
COMMOh!WEA?.TH OF PENNSYLVANIA .
SS.
COUNTY CF FRA.N~~LIN
r ~- the testator whose name is signed to the attached or foregoing instrument,
I, I-~a~ry D. gone ,
~: talified according to law, do hereby acknowledge that I signed the instrumen Tess d
havirg be~;~ gu
d that I si ned it willingly and as my free and voluntary act for the purposes therein exp
will, an 0
Sworn to or Gff firmed and acknowledged
before me this 13th day of FEbruary,
2002.
~(~F1 ru.~:+C Lr~7ii, r~`~tF~it ~i1t~y~
~ - - - --_-
COMMONWEALTH OF PENNSYLVANIA ~.
SS:
COUNTY OF FRANKLIN
i and Sandra M. Leydig, the witnesses whose names are signed to the
We, David C. Wert me
r - ~ instrument, being duly qualified according to iawi do depose and say testator
attached o. fog ego~ng
~ ~ nd saw Har D..lones sign and execute the instrumen~ as his will; that fessed; that
were pre..er,t a ry erein exp
ned willin I and executed it as his free and voluntary act for the purposes t as a witness; and that
sig 9 Y
subscribin witness in the hearing and sight of the testator signed the w~l e of sound mind and
each g
the best of our knowledge tl~ie testator was at that time 18 or more years of ag ,
to
under no constraint or undue influence.
Sv~!orn to or affirmed and subscribed to
before me this 13th day of February;
2002.
- - ~ S
?~C.~:.~' Ste!
j~sP' Pc,^ 'hd`a~:i?/~`:'"~~:1~Ciir`~^~JL~f`-.:~'
^1D ,
~ ~ ." , /
"r`~
,~ ~,, f
14
Estate: Jones, Harry D.
Date of Death: February 24, 2012
File No: 2112-0321
Explanation of Attorney Fees
The attorney fee payable in the Estate is based upon hourly rates incurred to date, with
an estimate of remaining fees to be paid. Detailed time records have been kept. The
total amount of attorney fees is for staff time only and does not include attorney time.
Due to time expended collecting information about, marshalling, collecting and
separating assets and debts; collecting information about and administering non-
probate assets (please note non-probate assets have been separately reported and
assessed and are not reflected in the Return); preparing documentation; preparing the
Pennsylvania Inheritance Tax return; collating information for preparation of income tax
returns; and assisting with the administration of the Estate, the total amount of attorney
fees is less than the amount calculated under the fee schedule of the Johnson Estate.
15