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Home My WebLink About01-23-13 (2)J 1505610140 REV-1500 ~` f°'-'°' PA Department of Revenue OFFICIAL U8E ONLY Bureau of Individual Taxes Po sox 280601 Harrisburo. PA 17128.0601 INHERITANCE TAX RETURN RESIDENT DECEDENT County Code Year /~ ( ' ~ pC~ Fla Number ~ Q ~~ ENTER DECEDENT INFORMATION BELOW Sodal Security Number Date of Death IusADDYYYY Date of Birth MMDDYYYY 0 1 3 2 4 1 1 9 9 0 5 0 5 2 0 1 2 0 9 2 0 1 9 3 1 Decedent's Last Name Suffix Decedent's First Name MI W E I D N E R A N N E 11f Applicable) Enbr Surviving Spouse's IMormafbn Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ® 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of prior to 12-13-82) ^ 5. Federal Estate Tax Retum Required death after 12-12$2) ^ 8. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of WIII) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (gitach Sch, O) CORRESPONDENT - TH18 SECTgN MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DStECTED T0: Name Daytime Telephone Number - R O G E R B I R W I N E S Q U I R E i r 7~ 7 2 4~ ~~5 3 'r ~ c_ ~ ~, First line of address I R W I N & Sewnd fine of address 6 0 W E S T City or Post Office C A R L I S L E M c K N I G H T P C P O M F R E T S T R E E T State ZIP Cade P A 1 7 0 1 ~OI(j)TF~OF ~S ~ ~ v r- rv ~ tt rr t ~cr>~ o~ :a r__ c _., . C.J r r"r1 .. - 1_ ~ DATE ~D Correspondent's e~mall addrps: Under psneltles of perjury, l declare bier I have examined this velum, irx9udirg accompanying schedules and statements, and to the best of my knowledge and belief, it f~~correct arW complete. Daciaratlon of preparer other than the personal repreaentetlve is based on all iMOrmatan of whk:h _~_ preparer has any knowledge. ERS 324 3 T POUF PLEASE USE ORIGINAL FORM ONLY P Side 1 1505610140 1505610140 J J 1505610240 REV-1500 EX Decedent's Social Security Number Deoedenre Name: ANN E• W E I D IjE R 0 1 3 2 4 1 1 9 9 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 and Notes Receivable (Schedule D) .................... .... .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E). .... .. 5. 9 9 0 . 2 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . .... .. 6. 7. Inter-Vroos Transfers & MlsceNaneous -PrQkats Prop~Ry (schedule G) ~ Separate BiNNtg Requested . .... .. 7. 2 1 4 4 9 • 5 8 8. Total Gross Assets (total Lines 1 through 7) .......... ........... . ... .. 8. 2 2 4 3 9. 8 1 9. Funeral Expenses and Admin~trative Costs (Schedule H) ............ .... .. 9. 4 8 1 3 . $ 0 10. Debts of Decedent, Mortgage Liabilities, and Liena (Schedule I) ....... .... .. 10. 5 3 . 2 9 11. Total DedueNOns (total Lines 9 and 10) ......................... .... .. 11. 4 8 6 6. 7 9 12. Net Value of Estate (Une 8 minus Line 11) ...................... .... .. 12. 1 7 5 7 3 . 0 2 13. Charitable and Govemmentel 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. 1 7 5 7 3 . 0 2 TAX CALCULATION - SEE INS'CRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 1t3. Amount of Line 14 taxable at lineal rate x .045 1 7 5 7 3. 0 2 1s. 7 9 0. 7 9 17. Amount of Line 14 taxable at sibling rate X .12 ~ 0 0 17. 0. Q O 18. Amount of Line 14 taxable at collateral rate X .15 0 ~ 0 18. 0. D O 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REt9UE3'nNG A REFUND OF AN OVERAAYN~NT 7 9 0. 7 9 Side 2 L 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: FNB Number Do DECEDENT'S NAME ANN E. WEIDNER STREET ADDRESS 230 OXFORD ROAD CITY GARDNERS STATE PA ZIP 17324 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 3. Interest 4. ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIM in oval on Page 2, Line 20 to squat a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 790.79 Total Credits (A + B) (2) 0.00 (3) (4) 0.00 (5) 790.79 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 of income of the propeAy transferred : ...................................................................... ^ b. ret~n the right to designate who shall use the property Vansferred or its incarle : ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for Iffe of either payments, benefits or care? ....................................................... ^ 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-0eath bank account or security at his or her death? ......... ^ X^ 4. Did decedent ovm an individual retirement account, annuity or other non~robate property, which contains a beneficiary designatlon? .................................................................................................. ^ {F 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 rats imposed at 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)J. 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) (n)). 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 beneficlary. 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 m or for the use of the decedents 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 decedents siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling 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+(11-10) . ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDeNr oECEOENT SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ANN E. WEIDNER 0 0 InGude the proo~e of litlgalbn end the dab the were received by the estab. AN oroeab tlfoM r owned ww{tli riuM of wrvF~e~ p ~ be dlecbaad on t~dNduk F. ITEM I VALUE AT DATE Nt1M8ER DESCRIPTION OF DEATH 1. ~ M&T BANK -CHECKING TOTAL (Also enter Dn Line 5, Recapitulation) ~ S If nare space la needed, alseR additional sheet of paper of the same sia REV-1510 EX+ (OB-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER•VIVOS TRANSFERS AND MISC. NON•PROBATE PROPERTY ANN E. WEIDNER 0 0 This schedule moat be completed and filed B the answer to any of questbna 1 thnXgh 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY x+culcETrENwaEOFlHEtaar,nflnaE<aTaNSHIPTCOEC~oBrraNO THE DATEOF1W1rIBF62.arra~NaCOPMOFTHEOffDFORREALESTaTE. DATE OF DEATH VALUE OF ASSET 960FDECD'S INTEREST EXCLUSION nc~wRirAx~ TAXABLE VALUE t. PATRICIA BEECHER -GIFT -APRIL, 2012 24,449.58 100.00 3,000.00 21,449.58 TOTAL (Also enter an Line 7 Recapitulation) ~ 1 21 449 58 H more apace b needed, use additional sheets of paper of the same size. REV-1511 EX+ (10.09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANN E. WEIDNER 0 0 Dsadsrd's debts must be reporbd on &Mduk 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME 4,000.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Canmissions: Name(s) of Personal Representative(s) Street Address CtiY Stalls ZIP Year(s) Commissbn Paid: y, AltorneyFees: IRWIN & McKNIGHT, P.C. 750.00 3. Family Exemption: (It decadence address is not the same es deimanCs, attach explanation.) Claimant Street Address CIA' State ZIP Relationship of Clahrient b Decedent 4• ProbabFees: REGISTER OF WILLS 48.50 5 Accourdant Fees: 6. Tax Retitm Preparer Fees: 7. REGISTER OF WILLS 15.00 TOTAL (Also enter on Line 9, Recapitulation) S 4 813.50 H more apace a needed, use addidonel sheets of paper d the same size. REV-1512 EX+ (12-De) . ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, $ LIENS ESTATE OF _. PILE NUMBER ANN E. WEIDNER 0 0 Report debts Incurred by the decedent prior to dsafh that remained unpaid at the dabs of death, IncludMg unreimbursed medial expemes. ITEM I VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CARLISLE MEDICAL PATHOLOGY -MEDICAL 53.29 TOTAL (Also enter an Line 10, Recapitulation) I = H more space is needed, insert additional sheet of the aame size. REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHEPoTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANN E. WEIDNER 0 0 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lht Trustb~(s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude outrgh~ s 1 d'sMbutbns and traro(ers under Sec. 91 i6 (a (1.2).] 1. PATRICIA BEECHER Lineal 17,573.02 230 OXFORD ROAD GIFT GARDNERS, PA 17324 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S rt more spaCB 18 nee0e0, use adf11s011a1 sheets Ot papal of the SaRle size. a ~ ~ Q ~r 499 Mitdten Road, Millsboro, DE 19966 Adjustment Services j PhoretS86-502349 F me (302)934-2955 I January 3, 2013 Law or>i~eY RECEIVED Irwin & McKnight, P.C. West Pomfret Professional Building 7 201? ~Ald 4 60 west Pomfret street . Carlisle, PA 17013-3222 ~RWIN & McKNIGHi LAW OFFlCES ]te: Estate of Ann E. Weidner Social Security: 013-241199 Date of Death: May 5.2012 Dear Sir or Madam: Per yore inquiry on December 31, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the followill~ 1. Type a,~Aerwtatt Aacowrt Ntonber Ownership (Names aJJ OpenugDate Balance on Date of Death Accrued IrUerest Total ChAtYwemt 1250906 ~~ Ct~ Robert L Weidner ~ ~~' Patricia S 0~) Arm 1: Weidner 0&/31/1995 $ 990.22 $ .Ol $ 990.23 For ary rdditloeal irtorotatba or the above aetorrb, irelydfrg ownaaYlp and aqy durYea, obarea ardlor rd®brrae®nt of tYrdr, pkaae ed tYeMo~tHafb~Spirp m717~4Y6.i03s. We were ruble b bate ary ate deposit boz [or fhe above-~ertlored decedert. 73fs haler dos rot irrlyde ary amoub b whkh the deceassd •taY have been Yard a Pbrer of Atbrrey, Cwttodiu o(lhibrm 'Mrdere, RepeeserhYveP;yce,ar9Yrslceordera WrMOaApe+aat. SlnCerCly, Valerie Mtn Adjustmetrt Services • ®~ ri:; ^;.::`i.C:`n,'"fi'iiii>: .+!'+k ."I,C;:}j]C;:y' j: ;. r••+ .. :..:'.:•:: r.:: n :4 :..:>i::; : ;v. ~. .15004x01816046 Miff pBRBQiN, 8AVI508 ADiN E ~RIDNSR 230 OXFORD RD GARDNER9 PA 17324 00 0 0433141 451 017 57731 (f~.•JJ.W:. ~QJ.Y IMWNN?.4:J .Wll~/N~..,'J.:.J4I.N 1. .VV n'KN+•~":~y:: ~!?._ •.i•$: ff. f ::j .S\+ 1. 'i~;:^<: `i:S M4R.06-MAY.OS,x01x 1 OF 1 03-06-1a 85f4]7a1IY6 BALAS~CS 04-05-1x IXf16t88T PAYMlMIT 0.46 04-16-1x 8raaoh Telephone Transfer/Mithdraral 4,000.00 04-19-1x AITBRSBT PAYl0II1T 0.x0 04-19-1a CLO$SOOT x4,449.58 A55[H1L PSRCBSTAOS YIBLD HARNBD 0.01 t $x8,446.90 18,449.38 x4,449.36 0.00 BPFSCTIVS ,70LY 30, cola, THB F55 8(IR SACH DAY THAT THBRS IS A TRASSFSR FROM Y0164 SAVI508, MOSBY MAR103T, OH CB1~4Q9O ACC00'ST TO COVER OSB OR MORB OV8<2DRAFTB IM YODR CBSC[I11G1 ACCODST MLLL HS $1x.50. THIS F55 HILL 88 CHAR6® TO THB ACCOC+ITf HROM 11HICH THS FOPD9 915RS TRA98BSRRSD. THIB F55 11056 MDT APPLY TO A POMSR Cl18C1a163 ~ MYCHDICS PRSMI011 CRSCICniD ACCOOST. I4Tf5R56T SARSBD P~ STAT8MQi'f PHRIOD 0.68 Mf HOLLY SPRIIRB INTBRBHT PAID YSAR TO DATS a.lx Hollinger Funeral Home & Crematory, Inc. ' ~ Erir L. Hollinger, Supervisor ' Soi North Baltimore Ave. Mount Holly Springs, Pennsylvania r7o65 X717) 4~-3433 STATffi11rBN'r OF FUNSBAL GOODS AND SBRVIC63 SffiBCTBD c]rryn ace ady fa tltaee kmta rho yw xlemed a thu am napilrcd If we ate mqu6ed by law ar by a otmetety ar aemomry to uee any ksme, we wlll e:pLkt dtt aaaan In bebw. Yynu atiecaed a fimerd that mal megttke emba6n6ig, atrL as a funeral vkwlog, Pw amY have m pry for embalming. Yau do sot bm m pay far embalrtr ~g Yau ~ 001 aPP~ ff Ya atraageaheaY aPfit~~aematlan ar hnmetHooe bashl.lE vYe chuged Daee dd Daa14~ ~~ w'hy heba. Fae'the 8enlne d t -1 ~~ Name Ate City 8mre•~ A. C6Nr.$ POL lI~YIf>b Sidi."®Dr 1. 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