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Home My WebLink About04-17-13 REV-1500 EX(01-t0' 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania County code rear File Number Bureau of Individual Taxes M""" W^ Po BOx.280601 INHERITANCE TAX RETURN 21 13 L[ 2 Harrisburg,PA 17128-0601 RESIDENT DECEDENT i J ENTER DECEDENT INFORMATION BELOW 11 17 2012 08 30 1931 Decedent's Last Name Suffix Decedent's First Name MI SEAVERS KENT W (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI SEAVERS JEAN rJ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 2. Supplemental Return ❑ 3. �Rremmai Zr'alu(date of death to 4. Limited Estate L1 4a.Future Merest Compromise) (dots of deeth after t2-lMM 5. Federal Estate Tax Retum Required g. DeeeWm Died Tetlete 7, Oe�csdeMOpy I"n d)a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of wily 1A cMh CC 9. Litigation Proceeds Received 10. nP Frti<-t-B5) death ❑ 11.Election to tax under Sec.9113(A) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JERRY A WEIGLE ESQUIRE 717 532 7388 ti REG @OF WIL::D 1=5'US i First line of address rn n =3 Z; a7 126 EAST KING STREET a a rm -~ rr? ran z rn � z Cs Second line of address O O 3 City or Post Office DATE FIWD r M State ZIP Code a O SHIPPENSBURG PA 17257 f-A 'n Correspondent's e-mail address: Under penalties of pe IY 1 that I have examined this return,including accompanying schedules and stetemer>m,and to the best of my knowledge and balbf, it is true,correct and earriplate�araBon of preparer other than the personal representative Is based on all information of which preparer has arty knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING ETURN OATS — Jean J.Seavers AD sS 18 ast Main Street.Walnut B06M. 17266 SI T OF EP R Q7r R THAN E S A DATE t r Jerry A.Weigle Esquire LI—/Z—� ADDRES 126 East King Street Shippensbui g,�A Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds II(Schedule B)............................................................................. 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3, 4. Mortgages&Note$Receivable(Schedule D)........................................................ 4. 5 Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 0. 00 7. Jointly Ow ed Property(Schedule F) [:1 Separate Billing Requested............ 6. Y &Miscellaneous NnProbate Property (Schedule G) Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1-7)..................................................................... 8. 0. 00 9. Funeral Expenses Administrative Costs(Schedule H)....................................... 9. 12 , 160 . 72 10. Debts of Decedent;)Mortgage Liabilities,&Liens(Schedule 1).............................. 10. 1, 134 . 90 11. Total Deductions(total Lines 9&10)................................................................... 11. 13,295. 62 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12, -13 r 2 95 . 62 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 o Tax(Line 12 minus Line 13)............................................... 14, -13,295 . 62 TAX COMPUTATION- EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 t table at the spousal tax r te,or transfers under Se 9116 (a)(1.2)X.00 1 0 . 00 15. 0. 00 16. Amount of Line 14 taxable 0 . 00 16. 0. 00 at lineal rate X 04 17. Amount of Line 14 t xable at sibling rate X.1 2 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. Tax Due................................................................................................................. 19. 0. 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El Side 2 L, 1505610243 1505610243 REV-1500 EX Page 3 Fite Number 21 Decedent's Complete Address: DECEDENT'S NAME Seavers,Kent W. STREETADDRESS 181 East Main Street CITY STATE ZIP Walnut Bottom PA 17266 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 1 Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box 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) 0"00 Make Check Pa able to: REGISTER OF WILLS,AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decadent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................... x b. retain the right to designate who shall use the property transferred or its Income;.,...............-- ............ c. retain a reversionary interest or.........-.............-.......... ....-....-........................--........................... x d. receive the promise for life of either payments,benefits or care?............................................................ x 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without ❑ ❑ receiving adequate consideration?.............................................................................-........... -....................... x 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 ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE 0 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)(1)]. For dates of death on or after January 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 1,20W: • 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 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 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. R Ov-1608 EX-(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Seavers, Kent W. 21 Indude the proceeds of I8i0etion and the date Ow proceeds were n3caived by the estate. All properly Jo rdly-owned 8t the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ALL ASSETS JOINTLY OWNED WITH SPOUSE-PA Inheritance Tax Return being filed for 0.00 informational purposes TOTAL(Also enter on Line 5,Recapitulation) 0.00 (If more space is needed,additional pages of the same size) Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.6-98) RID/-1151 EX-(10-06) SCHEDULE H COMnW�€L`�i� FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Beavers, Kent W. Y9 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s)attached 12,070.72 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission paid 2. Attomev's Fees Weigle&Associates,P.C. 75.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s)attached TOTAL(Also enter on line 9,Recapitulation) 12,160.72 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1600 Schedule H(Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Beavers, Kent W. 21 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex Hams 1 Fogelsanger-Bricker Funeral Home 12,070.72 H-A 12,070.72 Other Administrative Costs 2 Register of Wills,Cumberland County-filing Insolvent PA Inheritance Tax Return 15.00 H-B7 15.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) R-1512 EX-(12-08) SCHEDULE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA MORTGAGE LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Seavers, Kent W. 21 Report debts Incurred by the decedent prior to death deaf remained,repaid at the dab of death,including unreimimmed medical• Xparnrea. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Community Life Team EMS 61.00 2 Home Instead Senior Care 761.25 3 Home Instead Senior Care 312.65 TOTAL(Also enter on Line 10,Recapitulation) 1,134.90 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX-(11-08) SCHEDULE J °O""J i pe&WWA"r" BENEFICIARIES ESTATE OF FILE NUMBER Seavers, Kent W. 21 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) (gyy) I TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.91 16 a 1.2 Not relevant as estate is insolvent Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. 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-1500 COVER SHE Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev. 11-08) Lu 0 IL /Nn 44 0 w 0) 0 'A Lo CO 4- CL O •CK3 Q) U) Q) ra) 04