HomeMy WebLinkAbout05-02-13 (2) J 1505610105
REV-1500 EX(oz-il)(FI) .
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
�EP�HTMENTOFREVENUE County Code Year File Numb
Bureau of Individual Taxes INHERITANCE TAX RETURN _ ............... ...........................................
PO BOX 280601
Harrisbur ,PA 1 128-0601 RESIDENT DECEDENT �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
.......... ............ ...._.._.....��............,_..,.. ._..:........_.__.__._._.�_�.�._..�..,............_ ..�.. .. .....__._..._._._.............�....,....._._..�..�..�.�_...
Decedent's Last Name Suffix DecedenYs First Name MI
Herr Ronald � L ;
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
n/a
__ _.......
Spouse's Social Security Number
� � � THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
C� 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Baxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty 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 CONFIDENTIAL TAX INFORM4'�ION SHOULD B�ECTED T0:
Name Da i hone N�x�er �
; _ ... __..._._._.___..._. __.. . ....... . _ ___ _ _ __. __._._ _ .�.... ..:..�...._....... ........_.......�!.:... ........._
� � � �
Adam R. Deluca, Esq. ;:(717�4�1177 �
__ _.._ .
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:
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� �CT�OF WILLS U�,
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. �
First Line of Address � � :,� � �
� �
. ................. .. _ _...._.. _ �": �1 ..,„, -� .`'"C
_..____ _........
=61 West Louther Street �"' � r ���� �
. 4 V.. �'�'��:.
;.. ................... ..................... ..... .......,, ._....,:: ......... ........::. .... :.............: �e..2 �—�.�. ..
... ... .. . .. . :. ... .,,+�.
Second Line of Address "' � �"- '��
,, _.......... . _. . _....... _... _ ......, �► F""'' f!3 C�
C� -y�
_....._._.___...._..__......_................._........................_.........................._....._......._ ..
__..._...._....._........ DATE FILED
City or Post Office State ZIP Code
:Carlisle PA 17013
Correspondent's e-mail address:ardeluca85@aol.com
Under penalties of perjury,I declare that I have examined this 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 personal representative is based on all information of which prepare has any knowledge.
S N U O P NSIBLE FOR FILING RETURN E
` f.
�
A DRESS
194 York Road, Carlisle, PA 17013
SI ATURE OF P RE ER T REPRESENTATIVE � TE
DDRESS
61 West Louther St., Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610105 1505610105 �
W
� 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
oecedent's tvame: Ronald L. Het'►'
RECAPITULATION
1. Real Estate(Schedule A). .................:.......................... 1. 35,000.00 ;
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. ; 17,943.78 ;
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ; ;
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property .............:...... ... ...:......::..::.�..H.:w:............:.:.:.. ..:.:...,....
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7)............................. 8. ? 52,943.78
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 3,735.90 ;
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. : 10,979.00 :
11. Total Deductions(total Lines 9 and 10)................................. 11. 14,714.90 :
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. ; 38,228.88 ;
:......::.................:....,...,.,....,..,_._.....:.�..,,...,......,,..._....,.......,.......r...�..................,...........�_.._..r...�r..�.....w...�....�........_..:
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. 38,228•8$ :
TAX CALCULA►TION-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 A_ 15. ;
._...._ ._.. .:.._ ...,:.. � ...:,: , .,.._ . _..._,. _ ; _ _ ..:.. . ._,:.._... . :.. .. ...... . ..._:.�
16. Amount of Line 14 taxable ; " `
at lineal rate X.0_ 16.
::.,:... , : . ...:.,, ,.,: . ..>: .:::.:....:... ,.::.:.: .. �:.�
»:.... : .: ... ,
17. Amount of Line 14 taxable
at sibling rate X.12 17.
.::.�.... .,:,:. ,.::, .:: , _._ ... . .: ,..:_.._ . _..,. . ...., . , .. <
18. Amount of Line 14 taxable
at collateral rate X.15 38�228.88 18 : 5,734 33
19. TAX DUE ......... ................................................ 19.: 5,734.33
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
$lde 2
� 1,5D5610205 150561,0205 J
REV-1500 EX(FI) Page 3 File Number � � ��� ���y
� l
Decedent's Complete Address:
DECEDENT'S NAME
Ronald L. Herr
STREET ADDRESS �
120 Mill Street
CITY STATE ZIP
Mount Holly Srpings PA 17065
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 5,734.33
2. CreditslPayments '
A.Prior Payments
B.Discount
Total Credits(A+B) (2) 0.00
3. I nterest
(3) 0.00
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) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 5,734.33
Make check payable to: REGISTER OF WILLS,AGENT.
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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 own an"in t�ust 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.
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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 chiltl 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)].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.
REV-150Z EX+(12-12)
� pennsylvania SCH E DU LE A
DEPARTMENT OF REVENUE
INHERITANCE TAX REfURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ronald L. Herr 21-12-0984
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1• 120 Mill Street,Mount Holly Springs,PA 17065(see attachment A) 35,000.00 .
TOTAL(Also enter on Line 1, Recapitulation.) $ 35,000.00 '
If more space is needed,use additional sheets of paper of the same size.
REV-15o8 EX+(o8-i2)
� pennsylvania SCNEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ronald L. Herr 21-12-0984
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 DESCRIPTION OF DEATH
�. 'Members 1st Federal Credit Union 5000 Louise Drive PO Box 40,Mechanicsburg,PA 17055 Acct#477067 0.00 '
2.', Inheritance left to decedent from sister in taw's estate 17,943.78 !
TOTAL(Also enter on Line 5, Recapitulation) $ 17,943.78
If more space is 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
Ronald L. Herr 21-12-0984
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
_
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 0.00 '
Name(s)of Personal Representative(s) Kirby T. Hert'
Street,4ddress 194 York Road
city Carlisle state Pp► zIP 17013
_ Year(s)Commission Paid:
2. Attorney Fees:
3,176.63
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: 351.50 '
5. Accountant Fees:
6. Tax Return Preparer Fees:
�� Advertise Estate in Patriot News 99.66
s.' Advertise Estate in Cumberland Law Journal 75.00
9.; Payment of bills requiring certified mail 19.16
' �o. Members 1st Federal Credit Union Estate Account Checks 13.95
TOTAL(Also enter on Line 9, Recapitulation) $ 3,735.90
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
� pennsylvania SCH EDU LE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
, INHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ronald L. Herr 21-12-0984
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• Interstate Waste Services 58.44 !
2.: Met-Ed First Energy 137.67 '
3.' Intemists of Central Pennsylvania 393.33 '
4.' Church of God Nursing Home 2,944.60
5.' WalMart Credit Card(Ascension Point Debt Collectors) 1,662.69 '
6. Shipley Energy 1,034.62 '
7.' Charles Inners,M.D. 740.38 '
8.' Carfisle Regional Medical Center 1,318.53 .
' 9.' Members 1st Federal Credit Union Loan#57603-0008 Payoff 2,665.96 '
10.' Carlisle Physician Services 22.78
TOTAL(Also enter on Line 10, Recapitulation) $ , 10,979.00
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
� pennsylvania SCHEDULE �
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN BE N EFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ronald L. Herr 21-12-0984
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• Kirby T.Herr,194 York Road,Carlisle,PA 17013 'Nephew 50% ' :
2.' 'Clairessa E.Herr, 194 York Road,Carlisle,PA 17013 Neice-in-law 50% '
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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:
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.
�' � � , �
� �
LAST WILL AND TESTANIENT OF
' RONALD L. HERR
I,RONALD L. HERR, of Cumberland County, Pennsylvania, declare tlus to be
my Last Will and Testament and hereby revoke aIl prior tiVills and Codicils.
1. I direct that all my just debts, filneral expenses, and administrative
: e�penses shall be paid from my estate as soon as practicable after my death. It is my
�vish that upon my death my body shall be cremated and the ashes shall be placed beside
my motlier and fathzr, at our plot in Mt. Holly Sprin�s Cemetery.
2. I give, devise, and bequeath all of my real propei-ry and personai property
that I otivn at the time of my death to my nephe`v Kirby T. Herr and my niece-in-law,
Clairessa E. Hei-r, uz equal shares, per capita.
3. I appoint my nephew, Kirby T. Herr, as Executor of this my Last Will and
Testaineni.
`" 4. The Executor of tlus Will shall have the power to distribute my estate in
cash or in kind, or partly in either.
�. I direct that no E�ecutor acting under tlus Will shall be requued to enter
,�-,,
�
bond in any jurisdiction.
�"� 6. I recommend that my Personal Re resentative retain the la�v tirm of Allied
P
Attorneys of Central Pennsylvaiva, L.L.C., to probate my estate.
�y
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IN WITNESS WHEREOF, I have hereunto set my hand this �� day
� of /�1�, ?ol?.
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�'� RONALD L. HERR
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Page 1 of 4
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The precedin�instiltment consisting of this and three other pages was on the day and date
hereof signed, published and declared by RONALD L. HERR, as a11d for lus Last Will
a.nd Testament in tl�e presence of us, who at his request, in his presence and in the
presence of each other have subscribed our nanzes as witnesses hereto.
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ACKI�TOWLEDGMENT
COlV�10NWEALTH OF PENNSYLVANIA :
: SS
COUNTY OF CUl�ERLAND :
I,RONALD L. HERR,the TESTATOR,whose na�ne is si�ed to the attached or
foregouzg instnunent,havulg been duly qualified according to la�v,do hereby ackno�vledge
that I si�ned and executed the instri.iment as my Last Will and Testamellt;that I signed it
willulgly, and that I sioned it as my free and voltultaiy act for the pu�poses therein
expressed.
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L)" � C.r �•,
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RONALD L. HERR
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p' COI�TiVIO��EALTH OF PENNSYLVANIA
��� . S.S.
� COUNTY OF CUMBE
RLAND .
��`� ��j '��' /ji ,
On this Q~ l; / ✓ ���� � �
�- day of_ . � � , �01�, before me ersonall
P Y
`' appeared RONALD L. HERR, l�low-n to me`�(or satisfactorily proven) to be the person
� whose name is subscribed to the within instrumellt; a�ld he acki.lowledged that Ize was the
� declarant who executed the same for the purposes therein contained.
�
�� IN WITNESS WHEREOF I hereto set my hand and official seal.
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Page 3 of 4
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
: SS
COUNTY OF CUMBERL.AND :
,: � „ � f t,.
WE � . � t. ; ��
� � , w�. � � and t ��iLl,��'',���� - t��-�r���.
the witnesses�vhose names are attached to tlZe foregoing document,beina duly qualifie
according to law, do depose and say that we«-ere present and sa�.v testator si�i and
execute the instiliment as lus Last Will; that he sianed ���illin�ly and that he e�ecuted it as
his free and volunta.ly act for the puzposes therein e�pressed; that each subscribin�
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witness in the hearinQ and si�ht of the testator si�ned tlie Last Will and Testament as
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Page 4 of 4
Gary L. Foster, Realtor
SPENCER& SPENCER REALTY
1325 N. West Street, #1
Carlisle, PA 17013
717-386-9221
Apri124, 2013
To Whom It May Concern:
On April 17, 2013 I completed a walk through inspection of the property at 120 Mill
Street, Mt. Holly Springs, PA 17065.
The purpose of the inspection was to determine the value of the property for the Estate of
Ronald L. Herr.
Through the Market Analysis process, I have determined the value of the property to be
$35,000.00.
I do not have any interest in the property except to determine the market value.
Sincerely,
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Gaxy L. Foster,Realtor
Spencer& Spencer Realty
THIS ANALYSIS HAS NOT BEEN PERFORMED IN ACCORDANCE WITH THE
UNIFORM STANDARDS OF PROFESSIONAL APPRAISAL PRACTICE WHICH
REQUIRES EVALUATORS TO ACT AS UNBIASED, DISINTERESTED THIRD
PARTIES WITH IMPARTIALITY, OBJECTIVES AND INDEPENDENCE AND
WITHOUT ACCOMMODATION OF PERSONAL INTEREST. IT IS NOT TO BE
CONSTRUED AS AN APPRAISAL AND MAY NOT BE USED AS SUCH FOR ANY
PURPOSE.
G�.�'�U.
, �Gt.