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HomeMy WebLinkAbout03-01-13 (3) 1505610105 EV-1500 EX (oz-i ~ i) (FI) ~? . PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 28o6oi ^EPARTMC?ITUFREJCNU'c County Code Year File Number INHERITANCE TAX RETURN ~ j ~ ~ / ~ Harrisburg, PA 1'7128-o6oi ~~ RESIDENT DECEDENT J ` ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 10/17/2012 :10/25/1917 Decedent's Last Name Suffix Decedent's First Name MI SHILEY ;RUBY L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82} m 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. 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. cacti to Tax undr~uSec.~71 ~) Between 12-31-91 and 1-1-95) (~$acchedule f"1'1 ~ CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMR~10 HQI~.D B ECT~t'0~ Name Daytim~'eo-phiDrte Number --f Cf _ . ;ANTHONY T. MCBETH . (7173~3~6 ~' ~ , Q~Ot$,ITE F NIICt~ USE N ~ ~ "~ C7 ..~ --~ ~:;. m ~ ~ DATE FILED ~/ .71Q@ l L 1505610105 1505610105 Correspondent's a-mail address: atmlaw1 @verizon.net Under penalties of perjury, I declare that I have examined khis return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the persona! representative is based on all information of which preparer has any knowledge. J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number __ .. __ __ Decedent's Name: Shiley, Ruby L. ' 204-01-9048 RECAPITULATION _. 1. Real Estate (Schedule A} ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 1,105.00 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. ' 17,503.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. . _" 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property - - " (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ' " 18,608.00 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. ; 11,346.00 10. Debts of Decedent, Mortgage Liabilities and Liens {Schedule I) ............... 10. ! 3,722.00 11. Total Deductions (total Lines 9 and 10) ................................. 11. ",. ,,". 15,068.00 . 12. Net Value of Estate {Line 8 minus Line 11) ............... . .............. 12. _. 3,540.00 13. Charitable 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. ; 3,540.00: 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 45 3, 540.00 1 g, 159.00 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. ' 159.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 ~, 150567,0205 1505610205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME RUBY L. SHILEY STREET ADDRESS 465 STONEHEDGE LANE CITY - STATE MECHANICSBURG ' PA Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 159.00 2. CreditslPayments A. Prior Payments ___ __ ___ B. Discount - __ 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. 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 TAX DUE. (5) 159.00 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 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 awn 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. §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 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)]. 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-15o3 EX+ (8-iz) ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDt~ILE B STOCKS & BONDS ESTATE OF FILE NUMBER SHILEY, RUBY L. 21-12-1165 All property jointly owned with right of survivorship must be disclosed on Schedule F. If more space is needed, insert additional sheets of the same size REV-15o8 EX+ (08-12) ~ Pennsylvania SCHEDULE E DE?ARTMENTOFREVENUE CASH BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SHILEY, RUBY L. 21-12-1165 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTIdN OF DEATH 1_ VARIOUS CASH ACCOUNTS AT WELLS FARGO 8,110.00 2 PREPAID FUNERAL BENEFIT 9 292.00_ INSURANCE OVERAGE RECEIVED.,. 101.00 3. TOTAL (Also enter on Line 5, Recapitulation) $ 17,503.00.; If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) `~ ~~.~ pennsylvarna DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER SHILEY, RUBY L. 21-12-1165 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~' MILLER-SEKELY FUNERAL HOME & CREMATORY 10,301.00' B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) __ Street Address City Year(s) Commission Paid: __ _ State ZIP 750.00'.- 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant __ ._ _ Street Address City ---- ---- - ------ State -----ZIP ---- Relationship of Claimant to Decedent __ __ 4. Probate Fees: 75.00 5. Accountant Fees: 5. Tax Return Preparer Fees: ~~ Advertising 220.00 TOTAL {Also enter on Line 4, Recapitulation) $':' 11,346.00' If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ ;12-12) ~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT - ---- ESTATE OF FILE NUMBER SHILEY, RUBY L. 21-12-1165 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' SOCIAL SECURITY ADMINISTRATION - REIMBURSEMENT OF 10-3-12 RETIREMENT CHECK 1,255.00'' 2. LIFEWAYS OF MESSIAH VILLAGE 2,467.00 TOTAL (Also enter on Line 10, Recapitulation) $ 3,722.00 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) y,,r~. ~ pennsylvania SCHEDULE ] DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SHILEY, RUBY L. 21-12-1165 RELATIONSHIP TO DECEDENT AMOUNT OR 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. .LINDA M. SHILEY DAUGHTER 33.3% 2. JOHN E. SHILEY SpN 33.3% 3. MARK D. SHILEY SON 33.3% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE 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: i 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. W I L L O F RUBY L. SHILEY t..t._ O u~ ~-.. -- a ? O .. t~ !`i., i. :.J 1 J 7 G.:i i- - y ~ ~ ~` Q L1.J ~= t,,, o cam,, U I, RUBY L. SHILEY, of the Borough of Elizabethtown, County of Lancaster and Commonwealth of Pennsylvania, being of sound mind and disposing memory, do make, publish and declare this to be my last Will and Testament, hereby revoking all former Wills by me at anytime heretofore made. FIRST: I direct that all my just debts and funeral expenses shall be paid as soon after my death as conveniently can be done. SECOND: I direct that all the rest, residue and remainder of my estate shall be divided equally amoungst my children, namely: JOHN E. SHILEY, JR., LINDA M. SHILEY and MARK D. SHILEY. In event any of them should predecease me leaving children to survive me, then I direct that the share of said deceased child shall ac to hi. __ her ~hildrer.~ Pre stirpes: otherwise the share of _ald I I ~ deCeaSec~ Chip Thal- _`.~~ di ~11e~~ °_Qlial1V betweeP_ ii1~ J" !Mier Cllr`.; ~ ~. ~1~~~ .irCL.`~_ i and Or sister, d5 the CaSE~i!d:y DE, Or the 1SSUe of dn`,> or them d.ecease'3. I. ~I i„zacT~ T hPYeL'li% r~pm_narc ,~~nStltute dP_Cl aDD01nt 1T~\i ddu~iltcr, ? TjJfJ'~ ~'i, =F`iL,F i; - - ji ~i a5 LxeCUt:-=ri Ci th__ ~~1 _a_~ -•-_1_ 3nCi T'ecLam~'r= i ') Ifd tNITNESS WNERECF: ~ have hereunto signed my name and affixed mj- sea: I I; ~~ this S day of January, A.D. Signed, sealed, published a and for her last Will and Test Sher request, subscribed our na other as witnesses hereto.