HomeMy WebLinkAbout03-28-13 (2) � � .
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� 1505610105
REV-1500 EX�oz_��,��,� .
enns lvania OFFICtAL USE ONLY
PA Department of Revenue p Y
. �EVAqTMENTOFBEYENUE Caunty Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO 60X 280601 � � � �� � �
Harrisbur ,PA 1'7128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
__ _..__ _ __. _......_... __..._.. __ _ __.___ _... __ __.. _..... ...___ __ ___._.
! 01/06/2013 ! 12/08/1939 '
: __ __ _ ____ _ __ __ . ___._ _._ ___ ___._.. __. ___ . __ __:
DecedenYs Last Name Suffix Decedent's First Name MI
__ .... ..__ _. __.__. _ _ _.._ _..._ ........ ___...... ___ ____. .. ..__._.._. __ __. __.. ___ ._ _.
Barbour Betty i 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
___ _ __ _ _ _ __ ___
REGlSTER 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)
Q 4. Limited Estate Q 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
t� 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust � 8. Tota!Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10.Spousal Poverry Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTtAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
__ ___ __. _ _.. __.... __ ._ __._.. _...__. . ._ __.. .._... . ____ _ _.__. ____. ._..__.. . __
John M. Eakin (717) 766-3172 ...,.,
_ _ __ _ __ . _ . . ___ _ _ _ _ ____� _ _ _ �__ �
�l�R OF WIL�L3 USE1�
� � � � O
"� � Gn %41
First Line of Address � � � � `^� �
n� rn
Market Square Building � � � °O � �'
:,� . � �y rJ
Second Line of Address � � � � �'�
_...... __.. _ . ..... __ � .�
_... .
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_......._. ......_.. .... _.. __..... N �_
City or Post Office State ZIP Code �� DATE FILED � �.
, _.._.._ _........ ..._.�""' �� '"r"t
Mechanicsburg PA 17055
_ _ ___ _. __ __ __. _ .. _ _ __.:
_.__.._ _ .__ __ _ __ _. _..
Correspondent's e-mail address:
Unde�penalties of perjury,I declare that I have examined this retum,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 personal representative is based on all information of which preparer has any knowledge.
SIG�fUR�OF P�RSOIy..RESPO�IBLE FOR FILING RETURN DATE
_,
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ti�
ADDRE�L/ �
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SIGNATURE OF REPAR OTHER THAN REP ESENTATIVE DATE
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ADDRESS
, � r�,
' PLEASE SE ORIGINAL FORM ONLY
Side 1
� 150561,0],05 15�561,0105
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* .
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1517561,0205
�
REV-1500 EX(FI) Decedent's Social Security Number
Decedent�$Name: BettY L. Barbour
RECAPITULATION
1. Real Estate(Schedule A). . ... ... .... . . .. ... ..... ... . .. .. ...... ... . .. . 1. .. ,..w,w, ... .. , ._
2. 17,017.86
2. Stocks and Bonds(Schedule B) .. ...... . ... ...... ...... ... ..... ..... . . �.. ... _ _.. __ _
! 3. Ciosely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. , , ,,, ;
4. Mortgages and Notes Receivable(Schedule D)................. .......... 4. .. _ ._,..,. _.. :
186,455.06
5. Cash,Bank Deposits and Miscellaneous Personai Property(Schedule E).... ... 5. ,
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).. ................ ... ........
$ 203,472.92
9. Funeral Expenses and Administrative Costs(Schedule H) 14,480.46 '
................... 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). ............ . . 10:
10,417.37
__ _.__.. _...._.. __..__ _.___ ._.__..._ _.....
......... 11. '
' 11. Total Deductions(total Lines 9 and 10)...... 24,897 83
__. ...__.._ __._.. _
12. Net Value of Estate(Line 8 minus Line 11) ..... . 12. 178,575.09 '.
_ . _.
' 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. 178,575.09
TAX CALCULATION-SEE INSTRUCTIONS FOR APP�ICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or _ _ ___ ____ _ ___ _
__ .... __._.. _ _.......... __..._ _.......__. ..........._.._
transfers under Sec.9116 ; 119,057.23 15 0.00 '
,
(a)(1.2)X.0� , ;
...:... . ...�. . ..... ...�,. ....
.N,
.
' 16. Amount of Line 14 taxable 2,678 31
59,517.86 16. '
at Iineal rate X.0 45 , ;
_..... ._... ._... �..,.. . .
17. Amount of Line 14 taxable
at sibling rate X.12 17� -
:_ ........ . ......... .. . �.. ..
18. Amount of Line 14 taxable
at collateral rate X.15 ! ... •-... - '
__ _... __. _.. __ __..
1 S.
: 19. TAX DUE ........ ........... ... ................ ................... 19. . . ...... . . . _. _ _ ____ '._ � _
2 678
20. F{LL IN THE OVAL IF YOU ARE REQUESTiNG A REFUND OF AN OVERPAYMENT 0
Side 2
� 150561020
5 150561�205 �
, : ,
. `
REV 1500 EX(FI) Page 3 Fiie Number
Decedent's Camplete Address:
DECEDENT"S NAME
Betty L. Barbaur _�__
STREET ADDRESS
2144 Market Street, Apt. C 'i 01 .
CiTY STATE ZIP �------��___
Camp Hiil PA 17011
Tax Payments and Cre+dits:
1, 'Tax Due(Page 2,Line 19) (1) 2,67$.31
2. Credits/Payments
" A.Priar Payments _...__._............. ..
_.._...._._....._...._..._..___......._...._......._.._._.............
B.Discaunt 133•92
� Total Credits{A+B} (2} 133.92
3. Interest .
(3}
4. If Line 2 is gr�ater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval art Page 2,€.ine 20 ta request a refund. {4}
5. If Line 1 +Line 3 is greater than Line 2,enter the di�erence.This is t�e TAX DUE. � {5} 2,544.39
Make check payable ta: F�EGISTER OF WILLS,A�ENT.
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PLEASE ANSWER THE FO[.LOWING QUESTIaNS BY P�ACING AN "X" IN THE APPRC}PRIATE BLC}CKS
1. Di�clecedent make a t�ansfer and; Yes No
a. retain the use or income of#he property transferred.......................................................................................... ❑ �
b. retain the right ta designate who shall use the property transferred ar its income ............................................ ❑ �
c. retain a reversionary interest.............................................................................................................................. ❑ � �
` d, receive the promise for life of either payments,benefits or care?...................................................................... ❑ �
2. If death accurred after Dec.12,1982,did decedent#ransfer praperty withir�one year�f death
: without receiving adequate consideration?.............................................................................................................. ❑ �
3. Qid decedent awn an"in trust far"ar payable-upon-death bank account or security at his ar her death?.............. 0 �
4. Did deceder�t owr�an individuai retirement account,annuity or other nor�-probate praperty,which
cantains a beneficiary designation? ........................................................................................................................ � �
!F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,Y4U MUST COMPLETE SCHEDULE G AND F(LE IT AS PART OF THE RETURN.
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Fvr dates��death on or a#ter July 1,1994,and before Jan.1,1995,the tax rate imposed or�the net vaiue 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, �995, the tax rate imposed on the net value of transfers t� or for the us� of the surviving spouse is 0 percent
[72 P.S.§9116�a}t1.1)tu}�.The statute does not exempt a transfer to a surviving spouse from#ax,and the statutory requir�ments for disclosure of assets and
fiiing a tax return are stiii appiicabie even if the srarviving spouse is the only beneficiary.
Far�ates of death on or after July 1,2000:
• The tax rate imposed on the ne#value of transfers#rom a deceased child 21 years of age or younger at death ta or for the use of a natural parent, an .
adoptive parent ar a stepparent af the child is 0 percent(72 P.S.�9116(a}�1.2}�.
. The tax rate imp�sed on the net value�f�ransfers to vr for the use of the decedent's lineal ber�eficiaries is�.5 percent,except as noted in[72 P.S.§9�16{a}{1��.
• The tax rate imposed on the net value of transfers to or for the use�f the decedes�t'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 adoptian.
, �
. REy-i5o3 EX+(8-iz)
, pennsylvania SCHEDULE B
DEPARTMENTOFREVENUE ST�CKS & Bt�NDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
Betty L. Barbour 21-30-1752
All property jointly owned with right of survivorship must be disc{osed an Schedule F.
VALUE AT DATE
ITEM OF DEATH
NUMBER DESCRIPTION
1' 881.814 shares PepCo Holdings, inc. 17,017.86
TOTAL(Also enter on Line 2, Recapitulation) $ 17,017.86
�
Tf more space is needed, insert additionai sheets of the same size
, � �
' � AMERICAN STOCK
Pe co Hold�n s, Ine T,�N�T,��r.u°
P � uNK ar�our oarwa
� PO BOX 922
WALL STREET STATION
NEW YORK,NY 10269-0560
INTERNET WEBSITE:
WWW.AMSTOCK.COM
TELEPHONE NUMBER:
866-254-6502
.
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��iil�linii�����iii�n�,i��i�i�ii�„�„I�i�iliiiii�Illnr,Ill'II ' 3800362167 '
130102.0049.4686.01.01
12/10/2012
BETTY L IQiAUB
NOW—BETTY KNAUB BAFLBOUR
2144 MARKET STREET 12/31/2012 '
APT C101 '
CAMPHILL PA 17011 .270000
234.80
� � s
192,000 .000 677.647 .00
i
51.84 .00 182.96. : ,..._ _ __.23.4,.$0. _
.. _�....
't
�
O1/Al/2012 BALANCE FORWARD �> 641.545 51 Prior shara batance
03/30/2012 60 225.06 .00 18.7650 11.994 653.539 60 Shara�purchasod with divtdend
61 3haros purchasod wtth dlvidend
06/29/2012 60 228.30 .00 19.2350 11.869 665.908 dtscount
09/28/2012 60 231.50 .00 18.9150 12.239 677,647 62 shares purchased with optional
12/31/2012 60 234.80 .00 19.2987 12.167 689.814 cash
63 Sha�as purchasod wfth optional•
cash d(scouM
64 Sharos�ocQivad-STOCK pIVIDEND
65 Sharos raceived-STOCK SPUT '
` 66 3hares DEP05RED for safekeepin8 '
6T Sharas DEPOSITED by NAIC or ,
Temper of tha Times ,
68 Sharas TRANSFERRED IN
69 Shans CREDIT adJustmant
TO .PARTIAL WITHORAWAL-certiflcata
issued for whol�sharos
� 71 PARTIAL WITHORAWAL•whole '
' shares sold
72 PARTIAL WRHDRAWAL-certificate � '
issuad for whola sbuas;fraction o
sold �
T3 PARTIAL WITHDRAWAL-shares °•
' sold;�hareholda�remains in plan o
80 PLAN TERMIMATION-corttficate �
issued for whole shares;fracUon .�
sold; Q
81 PLAN TERMINATION-ail shares o5
sold
88 Sharas TRANSFERRED OUT
89 Sharas DEBIT sdjustmqnt
IMPORTANT TAX DOCUMENT
ATTACHED BELOW .
For security reasons,your identification number on this.combined Form 1099/DRIP statement has been masked. .
O �e
� U I �Y
>
,�.� "�.�' �� � <'� '' 17,017.8 6
�� �� 192.000 .000 689.814 881.814 � .
___ �
.-
�
� 919.66 .00 .00 .00
�
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0
� .00
Detach Here � Detach Here
� .� REVas5o8 EX+(08-12)
ns Lvania SCHEDULE E
� pen y
DEPARTMENT OF REVENUE CASN, BANK DEPQSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PR�PERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Betty L. Barbour 21-13-0061
Inciude the praceeds of litigation and the date the praceeds were received by the estate.
Ali property jointly awned with right of survivarship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� �. MARYSVILLE BANK ACCOUNT 5518, SEE ATTACHED 14,522.01
2, MARYSVILLE BANK CD 6525, SEE ATTACHED 37,686.78
3, MARYSVILLE BANK CD 5036, SEE ATTACHED 33,510.02
4, MARYSVILLE BANK CD 6122, SEE ATTACHED 49,668.95
5, PNC BANK ACCOUNT 6693 41,032.42
g. PNC BANK ACCOUNT 4282 9,734.88
7, MISCELLANEOUS FURNITURE 300.00
:
TOTAL(Also enter on Line 5, Recapitulation) $ 186,455.06
_ . .. .
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� neposit Inquiry:-, Accaunt: lnformation
Betky.L Ba�b�ur `ACCOUitt..hlurilbet' 9p5��1�: D Br.�nch : �1
pt C=1 U1 FN B t�f�ri�y M�iket�c�ount.
�1d4 Market�Street ;
Camp Hill PA�1��011-472�::
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. R4`J�1511 EX��ll�J-09}
� ' k�� SCHEDULE H
� " ��pennsylvania
:�:
� ��
: DEPARTMENTQFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FiLE NUMBER
Betty L. Barbour 21-13-0061
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1� Michael J. Shalonis Funeral Home, Inc. 3,808.27
2. Rolling Green Cemetery, marker 510.00
6, ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personai Representative(s).__.___._.
Street Address
___ ____ . __..._. __.._ _.._._.._ _....... __... _._ _.._._.. __ ____.
City _... _ ___ State .... ..__._._ ZIP .. ...
, _... ..... ..... _ _. ._.. .. _. ___...
Year(s)Commission Paid:
: _.... _.___... __ ___._..... _. ._ _...... ..__._ ___.. _...__
Z. Attorney Fees:
6,000.00
3 500.00
3. Family Exemption: (IF decedent's address is not the same as claimant's,attach expfanatian.) '
C{aimant Robert L. Barbour
_. .... ... ....... _.................... ....._._ __.. ...................._. . ._ __... _ __._ _____
street Address _2144.Market Street, Apt._C.101
City_._Camp.Hill---_..................... _. ......._.._....__..._..State_._PA.._..ZIP_1.701._�..._..........._.........
; Relatronship of Claimant to Decedent Husband
4• Probate Fees: 228.50
5• Accountant Fees:
6. Tax Return Preparer Fees:
�. The Sentinel -estate notice 240.19
$. Cumberland Law Journal -estate notice 75.00
s. Register of Wills- Filing Fee 43.50
�o. Reserved for account and release 75.00
TOTAL{Also enter on Line 9, Recapitulation) $ 14,480.46
If more space is needed,use additional sheets of paper of the same size.
€tE.�-1s12 Ex�r(12-12}
� ' pennsytvania S�HEDULE I
DEPARTMENT OF REVENUE DEBTS 4F DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITTES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Betty L. Barbour 21-13-0061
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 DESCRIPTI4N OF DEATH
1� Toyota Financial-2012 Camry 9 791.45
,
2. Erie Insurance-Auto insurance 573.50
3. Penn State Hershey-medical 52.42
�
TOTAL(Also enter on Line 10, Recapitulation). $ 10,417.37 '
If more space is needed,insert additional sheets of the same size,
REV-1513 EX+(01-10)
. ,
� �W pennsylvania SCHEDULE �
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Betty L. Barbour 21-12-0061
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. Robert L. Barbour 2144 Market Street, Apt. C 101 Camp Hill Husband ('.������ �� .��:��-}��.
2. Kathy Leonard 2009 Dickinson Ave. Camp Hill Daughter 10000
3. Cindy Price 36C Springer Lane, New Cumberland Daughter 10000
4. David Knaub 514 Old Limekiln Rd., Newport Son 10000
,.
5. Reign Knaub 3601 March Drive, Camp Hill Gr nddaughter 2500
���Li�
6. Amira Knaub 3601 March Drive, Camp Hill Grar�ddaughter 2500
7. Dylan Knaub 195 Meadow Grove Rd., Newport Grandson 2500
8. Kylie Knaub 779 Hill Street, Lebanon Granddaughter 250b
9. Joshua Knaub 514 Old Limekiln Rd., Newport Grandson 2500
10. Chris Leonard 2009 Dickinson Ave., Camp Hill Grandson stocks
t I, t�'I�c.ha�e! Krtc��.�a 3�o� ll��rr��. ��r� ����;..�� �--4;�,�� ��..�,��.��;,��,
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
�'�7jL��t_�
II NON TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN EIECTION 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, �
If more space is needed,use additional sheets of paper of the same size.
�
• � .
f
Last Will and Testament
of
BETTY L. BARBOUR
I, B�TT�L. BARBUUR, of Camp Hill, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this my Last Will and Testament, hereby revoking and making
void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my
decease as the same can conveniently be done.
2. '
I direct that there shall be paid out of my residuary estate all estate, inheritance
and like taxes together with any interest or penalty thereon imposed by the
Government of the United States, or any state or territory thereof, or by any foreign
government or political subdivision thereof, in respect to all property required to be
included in my gross estate for estate, inheritance or like tax purposes by any of such
,
governments, whether the property passes under this will or otherwise.
3.
I give, devise and bequeath all my personal belongings such as clothing and
personal jewelry, to my two daughters, CINDY PRICE and KATHY LEONARD,
share and share alike.
- 1 -
_ �
s
4.
I give and bequeath the sum of Ten Thousand ($10,000.00) to each of my
three children, CINDY PRICE, KATHY LEONARD and DAVID KNAUB.
5.
I give and bequeath all my stocks which I may own at the time of my decease
to my two grandsons, CHRIS LEONARD and MICHAEL KNAUB, share and
share alike.
6.
I give and bequeath the sum of Two Thousand Five Hundred ($2,500.00) to
each of the following grand-children, JOSHUA KNAUB, DYLAN KNAUB,
KYLIE KNAUB and great-grand-children, RIEGHN KNAUB and AMIRA
KNUAB.
7.
I give, devise and bequeath all the rest residue and remainder of my estate,
real, personal and mixed to my husband, ROBERT L. BARBOUR, absolutely and
in fee simple.
8.
In the event my husband predeceases me I give, devise and bequeath my
entire estate real, personal and mixed in equal shares to my children, CINDY
PRICE, KATHY LEONARD, DAVID KNAUB.
9.
Lastly, I nominate, constitute and appoint my husband, ROBERT L.
BARBOUR, to be Executor of this my Last Will and Testament. In the event my
husband predeceases me, or should he be unable or unwilling to serve in such
capacity, then in such event, I nominate, constitute and appoint my daughters,
-2 -
CIl�D� PRICE artd KATHY LEUNARD, to be Co-Executrices in his place and
stead. I further direct that no bond or other security be required of rny personal
representatives to guarantee faithful performance of their duties.
IN WITNESS WHEF�EfJF I have hereunto set m hand and seal this � �
� Y � �
day af{�ctaber, 2U i 1.
` F �,,� n
... �,rC_, �-_�.___��.�"�„r---1--�G^�`�=,-°.�.�-_z ��L_����
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'Betty L.;,Barbour
;;,F
�.�
Signed, sealed, published and declared by the above narned BETT'� L.
BARBt)ITR as and for her Last Will and Testament, in the presence of us who have
subscribed aur names hereto as witnesses, at her request, in her presence and the
presence of each other.
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