Loading...
HomeMy WebLinkAbout02-13-13_C~r^l ~f ~A.fJ •, 1505610143 ---~ REV-1500 Ex(°2-") PA Department of Revenue Pennsylvania Bureau of Individual Taxes oer~nTMeHrwe~ue Po Box.2soso~ INHERITANCE TAX Harisburg, PA 17128-0601 RESIDENT DECE OFFICIAL USE ONLY County Code Year File Numhm I 21 12 1227 ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death Date of Birth 185 14 6513 11 06 2012 O1 13 1924. Decedent's Last Name Suffuc Decedent's First Name MI PETERS MIRIAM 1, (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death Pnorto 12-13-82) ^ 4. Limited Estate ^ qa_ Future Interest Compromise ^ 5. Federal Estate?ax Return Required (data of deem attar tz-tz-s2) ® g Decedent Dbtl Testate (Attetll Copy of Wa) ^ ~ Decedent Maintained a LNing Trust .(AMerll Capy of Trust) 6. Total Number of Safe De posit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty CredR (Date of Death ^ 11, Election to tax under Sec. 9t 13(A) between 12-31.91 and 1-1-95) (Attach Schedule Ol CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORM/1TION SHOULD BE DIRECT):D T0: Name LISA MARIE COYNE Daytime Telephon bar 71~ 737 6+mu ~ _ A Ri ~, i tom, First Line of Address 3901 YdARRET STREET Second Lane of Address City or Post Office CAMP HILL ~ A r' n a ~ f-+ w ryj rn ao co N Z 7~ O~ ©n b ~ 'r} '~'1 ' n a ~ ~ ~1 ° ~ ~ rn . ~ o N n ~ DATE FiC~D '~ State ZIP Code i- PA 170114227 correspondent's e-mail address: l i s a ~c o ye a n d c o y n e. c o rn Under penalties of perjury, I declare that I have examined this return, inducting aotwmmpanying sdtedules and statements, and to the best of my knowledge and belief, it is true, correcx and complete. Declaration of preparer other than the personal representative Is based on all infomnation of which preparer has arty knowledge. SIGN RE OF PERSON ES~"SI FILING RETURN ATE /oR • Richard B. Peters ~ 2/2//3 ADDRESS / 50 Sandy/Circle, Manchester, PA 17345 SIG(L~TURE OF P1IEPARER 097iER TWAN REPRESENTATIVE LISA MARIE COYNE & Covne. P.C. Hill, PA 170114227 Side 1 1505610143 Z~/ 1505610143 J ~~ ~ ~~ ~~~~~. \~\ `~ ~' ~ ~I •• 3~6A5b~1]~4 ~J REV-1500 EX o.ceasoc•cNer~: PETERS, MIRIAM L ecedent's Social Security Number 18 5 14 6 5 13 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 DeposRs & Miscellaneous Personal Pro e ) p rty (Schedule E ................ 5. 6 9 , 3 2 8 . 8 6 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 4 , 9 8 9 . 0 1 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) p Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1 through 7) .......................................................... 8. 7 4, 3 1 7. 8 7 9. Funeral Expenses and Administrative Costs (Schedule H) ......................... ......... 9. 1 1 , 4 2 6 . 4 0 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............................. 10. 2 , 1 1 1 . 7 6 11. Total Deductions (total Lines 9 and 10) ..........................................: ....................... 11. 1 3, 5 3 8. 1 6 12• Net Value of Estate (Line 8 minus Line 11) ..................................:... ....................... 12. 6 0 , 7 7 9 . 7 1 13. Charitabb 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, 6 0 , 7 7 9 . 7 1 TAX COMPUTATION -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 .00 15. 16. Amount of Line 14 taxable 6 0, 7 7 9. 7 1 at lineal rate X .045 16. 17. Amount of Line 14 taxable 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. 2,735.09 2,735.09 Side 2 1505610243 1505610243 J \. REV-1500 EX Page 3 ' Decedent's Complete Address: File Number 21 - 12 - 1227 PETERS, MIRIAM L STREET ADDRESS 770 SOUTH HANOVER STREET CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments 3,000.00 e. Discount 136.75 Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check boz 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. (5) 2,735.09 3,136.75 0.00 401.66 Make Check Payable to: REGISTER ~F 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 properly transferred :.................................:................................................ x b. retain the right to designate who shall use the property transferced or its inceme :.................................... x c. retain a reversionary interest; or ......................................................:........................................................... x d. receive the promise for fife of either payments, benefits or care7 .............................................................. x 2. If death oocurced 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?......... ~ []x 4. Did decedent own an individual retirement account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ IF THE ANS9NER TO ANY OF THE ABOVE QUESTIONS IS YE5, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after Juiv 1, 1994 and before Jan. 1, 1995, the tax rete imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9196 (a) (1.1) (i)]. For dates of death on or after Januarryy 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) fii)]. The stafute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for d~sGosure of assets and filing a tax rettum are sttll applicable even if the survrving spouse is the ony beheficiary. 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 ars 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 df 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 p2 P.S. G9116 (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether y blood or adoption. . r ADDITIONAL Personal Representatives PETERS, MIRIAM L SS# 185-14-6513 11/6/Z012 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. 2 Signature ~~~~~.~~`-~'~ Name David K. Peters Address 509 Wayne Drive City, State, zip Mechancisburg PA 17055 Date lZ ~~ .i~3 3 Signature Name Address City, State, Zip Date 4 Signature Name Address: City, State, Zip Date 5 Signature Name Address: City, State, Zip Date 6 Signature Name Address: City, State, Zip Date +~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISC. PERSONAL PROPERTY ESTATE OF PETERS, MIRIAM L FILE NUMBER 21-12-1227 Indude 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. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Edward Jones Money Market Account No. XXX-X8171 69,328.86 ~ TOTAL (Also enter on Line 5, Recapitulation) I 68,328.86 r ,, ., N N~j 1 +5~ T I +jS C r >~ ~ ~ ~' ~~. ~ ~~ -~ ~ ~ ~~ ~... ~~ ~ o~:~; . Z ~~ Q o ~~ .~ a ~` . r ~ m C y4 ~ ~ ~~ ~~ ~~ .~ 4 ~ ~~ $~s `° p eo C s Y ~~ -s~ a ~ ~. _ ~ ~~ ~ °,'~ .~~ y N ~ iN V~ (N H 9yC~~ ilk C ~m . ~ ti. p SS ~~rr 0 ~. ~ ,,,7 r ~'7 ~j N ,t m y~ ~ O ~ ,~ c ~ 3 oQ ~ .- ,~ ra as ,. u, ~ ~ ~ ~ ~ o ~ k ~ ~, ~ ~~ ,., J ~ /~~~ 1~ 0 ~ ~ ~ ~ V -j .j e[~] 1~' ~/~S/' ~ ~ /UyS~ /mom ~ , ~~~LLL .75 m ~} ~~ r r W ~~~ =gd m r.+ ow~ Z0fti0 39~dd ~ S3JOP 42itiMQ3 8bL899LLIL L~~iT ZIOZ/BZJTT • Y REV•1808 EX* (01.10) pennsylwania DEPARTMENT OF REVENUE SCHEDULE F INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF PETERS, MIRIAM L FILE NUMBER 21-12-1227 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Richard B. Peters 50 Sandy Circle Son A Manchester PA 17345 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT Indude name o manaal instil Ion an bank account numbs or similar identifying number. Attach deed for jointly-held real state. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VAWE OF DECEDENTS INTEREST 1 A 04/07/1996 M$T Bank, Account Nurnber XXX9871 9,978.02 COs/o 4,989.01 TOTAL (Also enter on line 6, Recapitulation) 4,989.01 • ~ l~l~l DQ11I1 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Coyne & Coyne, P.C. Attorneys at Law 3901 Market Street Camp Hill, PA 17011-4227 Re: Estate of Mariam L. Peters Social Security: 185-14-6513 Date of Death: November 6..2012 G'`~~ n Y' Phone 888-502-4349 O Fax (302) 934-2955 N December 6, 2012 Dear Sir or Madam: Per your inquiry on November 29, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. 7j~pe of Account Checking Account Account Number 1329871 Ownership (Names o~ Mariam L. Peters Richard B. Peters Opening Date 04/07/1997 Balance on Date of Death $ 9,978.02 Accruedlnterest $ .00 Total $ 9,978.02 _ ..-.-_- - ------.----_ _ For any additional intornoatioa ou the shove accouob, ioduding ownership and any changes, dosures aedlor reimbursement of funds, pisses call the Carlisle Park at 717-7951710. We were unable to locate any safe deposit boz for the above-mentioned decedent. This letter does not indude any accounts io which the deceased may have bew listed as Power of Attorney, Custodian of Unikrm Transfers, ltepreeenht[ve Paya, or Trustee under a Written Agreement. Sincerely, Valarie Mercer Adjustment Services REV-7517 EX« (10.09) Pennsylvania DEPARTMENT OF REVENUE INHERRANCE TAX RETURN RESIDENT DECEDENT SCI-®U.E H F1.~~EwR~A~L-.~•Dw~BdSES AND I'~1.~1~~ I IW~ ESTATE OF PETERS, MIRIAM L FILE NUMBER 21-12-1227 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Aver Cremation Services 182 20 2 Aver Cremation Services 22544 3 Reception 440.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Richard B. Peters David K. Peters Street Address 50 Sandy Circle city Manchester state PA zip 17345 Year(s) Commission Paid 2013 2. Attorneys Fees Coyne & Coyne, P.C. -LISA MARIE COYNE 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Patriot News -Legal Advertisement 3,715.88 5, 000.00 89.50 500.00 123.38 TOTAL (Also enter on line 9, Recapltulatlon) 11,426.40 rr'~-~S_-c~h~edu~le Hof COMMONWEALTH OF PENNSYLVANIA - -"---T--i~~~ INHERITANCE TAX RETURN ~ CEO RESIDENT DECEDENT ESTATE OF PETERS, MIRIAM L FILE NUMBER 21-12-1227 2 Cumberland Law Review -Legal Advertisement 75.00 3 Filing Fee Inheritance Tax Retum 15.00 4 Postage 50.00 5 Estate Checks 10.00 6 Reserves 1,000.00 Page 2 of Schedule H Schedule H, Part B1, Personal Representative Commissions PETERS, MIRIAM L SS# 185-14-6513 11/6/2012 1 Name Richard B. Peters soc sac # ~_~_8467 Address 50 Sandy Circle Year Paid 2013 city, state, zip Manchester PA 17345 Amt Paid 1,857.94 2 Name David K. Peters soc sec # XXX-XX-6593 Address: 509 Wayne Drive Year Paid 2013 city, state, Zip Mechancisburg PA 17055 Amt Paid 1,857.94 3 Name Soc sec # Andress Year Paid City, State, Zip Amt Paid 4 Name Soc Sec # Address: Year Paid Clty, State, Zip Amt Paid 5 Name Soc Sec # Address: Year Pald Clty, State, Zip Amt Paid 6 Name Soc Sec # Address: Year Paid City, State, Zip Amt Paid 7 Name Soc sec # Address: " Year Paid City, State, Zip Amt Pald pennsytvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PETERS, MIRIAM L SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8~ LIENS FILE NUMBER 21 -12-1227 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, inGuding unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Home Instead 346.76 2 Alert Pharmacy 66.00 3 Chapel Point 1,699.00 TOTAL (Also enter on Line 10, Recapitulation) I 2,111.76 REV•161~ EX~ 107.10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RE6IDENT DECEDENT ESTATE OF PETERS, MIRIAM L FILE NUMBER 21-12-1227 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Na IJtt rnutssl~) I, TAXABLE DISTRIBUTIONS[ihdude outright spousal distributions and transfers under Sec. X115 (a) (1.2)] 1 Richard B. Peters son 1/4 residue 50 Sandy Circle Manchester PA 17345 2 David K. Peters son 1/4 residue 509 Wayne Dr. Mechanicsburg PA 17055 3 Jonathan S. Peters grandson 1/4 residue 1229 Lincoln Avenue New Castle, IN 47362 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15D0 COVER SHEET 0.00 REV-1615 EX+ (01-101 pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF PETERS, MIRIAM L FILE NUMBER 21 ..-12-1227 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY oo Noe un TnwtH(st I, TAXABLE DISTRIBUTIONS [indude outright spousal di ib ti t d t f r s u ons an rans ers under Sec. X116 (a) (1.2)] 4 David B. Peters grandson 1/4 residue 3954 Winds Ridge Dr. Wilmington NC 28409 Page 2 of Schedule J QIS, GU~DU, ~B~L~'F & iASLAND 9 ivSazket Sweet amp 8ili. PA LAST WILL AND TESTAMENT OF MIRIAM L. PETER5 ; I', MIRIAM L. PETERS of the Borough of Mechanicsburg, Cumber- land County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. r ~.I dirECt the payxnex~t of all my just debts and funeral expenses out of my estate as sbon as may be practical after gay death. II - I devise and bequeath all of my estate of what- ever nature and wherever situate unto my children, Richard B. Peters and David R. Peters, and my grandsons, Jonathan S. Peters and David B. Peters, in dour equal shares, the share of a deceased beneficiary to be divided among those named beneficia-' rise who survive me. III - I appoint my sons, Richard B. Peters and David R. Peters, Executors of this, my Last Will and Testament. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. I~ WITNE'SS WH$REQF, I have here to .set my hand and seal on this; •the ~~}~ ,day of , 1996. a . _ ervc.. ~ '~~~ !~-~a/ ( SEAL ) _ Mi=iam L. Peters Page I f; ~~ ;,H,p, .~. i/rin.vew,x/. nx'^n•~lMa..wi~diu+}9iiM+~nN ry µn, ~~~~i m~f ~, xn ~ ~.hwm n~. ^i. ~e~ .,-rv. ~ .nnwM1~e.uixr~w '~m~ mwi»•"++"~"irlai ~m ~rx ~m~r. inm+a+k~. ~••~:.' ~TMq '~'~ •' SAIDIS, Gi7ID0, SHUFF & 14IASLAIV~ 2109 Mazka saes r,~ ~. ra y Signed; sealed, published and declared by I~fIRIAM L. PETERS, Testatrix ` thertih~ named; an. this and one , (Y) othe,~ sheet of paper as and far her~Last Will and Testament, in our presence, who, in her presence, at her xe~uest, and in the presence of each other, have hereunto subscribed,our names as attesting witnesses. ,~ ate` " .. ... (//~~f~!f'~ 1 /X/1/a+R~ ~ ~ ~•~~yC Y ~ / CQ ~ . A~Tess Addr ~~ ~ ~ ~~ _ Page 2 4 ~. 4 COMMONFIEALTH OF PENI~TSYLVANIA) . SS. COUIJTY OF CUMBERLAND ) SAIDIS, GUIDU, SNUFF & MASLAND 2109 Market strut Came Hi11, FA -wE, the undersigned, the testatrix and the witnesses, respecti~rely, whose names are signed to the foregoing instru- ment,;beirig first duly sworn, do hereby d$clare to the under- signed authority that the testatrix signed and executed the instrument as her Last T~i.ll and T~st~e~t a.~a that she- signed wiilin.gly (or willingly directed another to sign for her), and that she executed it as her free, will and voluntary act fob the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at that time eighteen yeaxs of age or older, of sound mind, and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the testatrix, and`-scribed and swo o before me by both wit- nesses, this v~ day of , 1996. N tary Public _. u NOTARI,Qt SFAt THELMA S. McCAU5l1N, Notary Public Camp Nilt, Cumberland County My Commission Expires July 3, 't9.9R ,~ 11 ,. Testatrix _ _ _ _ ~ __ COYNE & COnvE, P.C. A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne 3901 Market Street (717) 737-0464 Lisa Marie Coyne Camp Hill, Pennsylvania Facs imile (717) 737-5161 17011-4227 www.v~rneandco~tle.com ca ~° ~, as r» February 12, 2013 o m ~ o 0o m ~ c~ c~ ~ ~ ~~~ _ w >5v v' a ~ o ~ Office of Register of Wills ~ o ° ~ ~ Cumberland County Courthouse ° ~ ~-' ~ m ca One Courthouse Square n ~ cn c i ~ Carlisle, PA 17013 '~ Re: Estate of Miriam L. Peters. Deceased No. 21-12-1227 Dear Sir or Madam: We represent the Estate of the Late Miriam L. Peters. Enclosed please find an original and two (2) copies of the Inheritance Tax Return for this Estate. Please docket the original and return to me a "clocked-in" copy with the enclosed envelope. Also enclosed is estate check no. 107 in the amount of $15.00 which represents the filing fee for this Return. Please issue a receipt for payment of this fee. Thank you in advance for your assistance. If you have any questions concerning the enclosed documents, please contact me. Very truly yours, COYNE & C~OiYNE, P.C. !~ ,~ arie Coyne LMC/cmc Encls. Cc: Clients