HomeMy WebLinkAbout05-03-13 J 1505610140
REV-1500 EX (01-10)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 260601 INHERITANCE TAX RETURN 2 1 1 3 0 1 2 6
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 1 0 7 2 0 1 3 1 0 2 6 1 9 1 5
Decedent's Last Name Suffix Decedent's First Name MI
S H U G H A R T M A R Y 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
FXJ 1.Original Return 2.Supplemental Return 3.Remainder Return(date of death
prior to 12-13-82)
4.Limited Estate 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required
death after 12-12-82)
QX 6.Decedent Died Testate F] 7.Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9.Litigation Proceeds Received 10.Spousal Poverty Credit(date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
S U S A N J H A R T M A N 7 1 7 2 4 9 7 7 8 0
REGIS? OF WILLS USE.ONLY-'
r n
C.
First line of address m y c7 to
- > r M
:� M W
1 I R V I N E R 0 W U � T o
Second line of address ra —IJ
1 _3
City of Post Office State ZIP Code DATE FILED
C A R L I S L E P A 1 7 0 1 3 y CO
Correspondents e-mail address: susanaduncanhartmanlaw- 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 preparer has any knowledge.
SIG;>gURE OFPE RSOfA RES PO'NS7g�E FOA LING RETURN DATE
AD RE OVO r0, Sro
53 LADNOR LA E CARLISLE PA 17015
SI A URE OF PREPAR THER TH N REPRESENTATIVE DATE
G
AD S
85 B ET EM HOLLOW ROAD NEWVILLE PA 17241
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140 J
J 1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: MARY L . SHUGHART
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 7 5 0 0 0 . 0 0
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. 7 5 5 5 • 3 2
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 2 2 7 9 4 , 6 9
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) Separate Billing Requested . . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 0 5 3 5 0 , 0 1
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 4 1 1 7 . 3 1
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . .. . . 10. 6 8 5 9 . 1 6
11, Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 0 9 7 6 . 4 7
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 8 4 3 7 3 . 5 4
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. 8 4 3 7 3 . 5 4
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 _ 0 . 0 0 15. 0 , 0 0
16. Amount of Line 14 taxable
at lineal rate x.045 8 4 3 7 3 . 5 4 16, 3 7 9 6 . 8 1
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 0 0
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 19. 3 7 9 6 . 8 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X
Side 2
1505610240 1505610240
REV-1500 Ex Page 3 File Number
Decedent's Complete Address: 21 13 0126
DECEDENTS NAME
MARY L • SHUGHART
STREETADDRESS
81 BEETEM HOLLOW ROAD
CITY STATE ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
I. Tax Due(Page 2,Line 19) (1) 3,796 -81
2. Credits/Payments
A.Prior Payments 3,800 - 00
B.Discount 189 - 84
Total Credits(A+B) (2) 3,989 .84
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) 193 - 03
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0 . 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; ...................................................................... ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑X
c. retain a reversionary interest;or ................................................................................................ ❑
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? ....................................................................................... ❑ Q
3. Did decedent own 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
172 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 decedents 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 decedents 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-1502 EX*(01-10)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT -
ESTATE OF: - FILE NUMBER:
MARY L . SHUGHART 21 13 0126
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 fads.
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 • 81 BEETEM HOLLOW ROAD 751000 . 00
NEWVILLE, PA 17241
[SEE HUD SHEET ATTACHEDD
TOTAL(Also enter on line i,Recapitulation.) $ 75,000 -00
If prom space is needed,use additional sheets of paper of the same size.
REVA508 EX t(6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY L . SHUGHART 21 13 0126
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
t. PROCEEDS OF PNC BANK ACCOUNT X51-4041-0995 ?1100.57
QSEE DOD LETTER ATTACHED]
2 . HIGHMARK REFUND 161.39
3. COUNTY TAXES ADJUSTED 124 .76
[SEE HUD SHEET ATTACHED3
4 . SCHOOL TAXES ADJUSTED 168 . 60
[SEE HUD SHEET ATTACHED]
TOTAL(Also enter on line 5,Recapitulation) E ?1555 -32
(If more space is needed.insert additional sheets of the same size)
REV-2508 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY L . SHUGHART 21 13 0126
If an asset was made Jointly owned within one year of the decedents date of death,It must be reported on Schedule G.
SURVIVING JOINT TENANTS)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. PEGGY C. GRIEST 53 LADNOR LANE DAUGHTER
CARLISLE, PA 17015
a RUBY J • RHOADS 85 BEETEM HOLLOW ROAD DAUGHTER
NEWVILLE, PA 17241
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESOMPTIONOF PROPERTY %OF DATE OF MATH
ITEM FORJOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY�HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
�. A&B. 11/11 WELLS FARGO ACCT. It 8431260887 101.01 33. 3 33.64
[SEE DOD LETTER ATTACHED]
2. A&B 11/11 WELLS FARGO ACCT. # 8431260887 68;351.50 33.3 221761.05
[SEE DOD LETTER ATTACHED]
TOTAL(Also enter on Line 6,Recapitulation) ;
I 22,794 .69
It 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
RESIDENT ED RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENr
ESTATE OF FILE NUMBER
MARY L . SHUGHART 21 13 0126
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1. EWING BROTHERS FUNERAL HOME 71919 .56
2 - WESTMINISTER CEMETERY 1101600
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Years)Commission Paid:
p. AttomeyFees: DUNCAN & HARTMAN, PC 41500 .00
3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.)
Claimant
Street Address
City state ZIP
Relationship of Claimant to Decedent
4. Probate Fees: REGISTER OF WILLS 303. 50
6 Accountant Fees:
6. Tax Rehm Preparer Fees:
7. CUMBERLAND LAW JOURNAL — LEGAL NOTICE 75 .00
8 - NEWS—CHRONICLE — LEGAL AD 88 . 25
9 - FILING FEE 15 . 00
10 - HELD IN RESERVE 200 . 00
TOTAL(Also enter on Line 9,Recapitulation) $ 14 ,117 -31
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-0e)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY L . SHUGHART 21 13 0126
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. SHIPLEY' ENERGY 39 . 00
2 - SHIPLEY ENERGY 533 . 52
3- APRIA HEALTHCARE 45. 54
4 - PPL 23 . 57
5 - MABLE STITT, TAX COLLECTOR 176 . 50
6 - MABLE STITT, TAX COLLECTOR 9 -.80
7 - SHIPLEY ENERGY 39 .00
8 - SHIPLEY ENERGY 39 . 00
9 - PPL 23 . 63
10 -. REALTOR COMMISSION - SALE OF PROPERTY 41500 .00
[SEE 'HUD SHEET ATTACHED]
11- TILE SERVICES - SALE OF PROPERTY 10 .00
ESEE HUD SHEET ATTACHED]
12 - STATE TAX/STAMPS - SALE OF PROPERTY 750 .00
ESEE HUD SHEET ATTACHED]
S EQT 1 C-
13- SF1ER - SALE OF PROPERTY 419 . 60
ESEE HUD SHEET ATTACHED]
14 - ATTORNEY FEE - SALE OF PROPERTY 250.00
[SEE HUD SHEET ATTACHED]
TOTAL(Also enter on line 10,Recapitulation) $ 6,859 -16
If more space Is needed,insert additional sheets of the same size.
REV-1513 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY L . SHUGHART 21 13 0126
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include out,ht Spousal distdbutionsand transfers under
Sec.91T16(a)(1.2).)
1. PEGGY C . GRIEST Lineal
53 LADNOR LANE 1/3 SHARE
CARLISLE, PA 17015
2 . RUBY J . RHOADS Lineal
85 BEETEM HOLLOW ROAD 1/3 SHARE
NEWVILLE, PA 17241
3 . JUDY A . WELKER Lineal
2514 D SHIPPENSBURG ROAD 1/3 SHARE
BIGLERVILLE, PA 17307
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 11 -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 TESTAMENT
OF
M. LUCILLE SHUGHART
I, M. LUCILLE SHUGHART, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking all other wills and
codicils heretofore made by me.
FIRST
I direct the payment of my debts and the expenses of my last illness and
funeral from my estate as soon after my death as conveniently may be done.
Further, in this connection, I authorize my personal representative to
expend funds from my estate, in such amount as my personal representative shall
consider necessary and desirable for the purchase, erection and inscription of a suitable
marker for my grave.
SECOND
I give, devise and bequeath my entire estate to my children PEGGY C.
GREIST, RUBY J. RHOADS and JUDY A. WELKER, per stirpes. Should I own the
property that I currently reside in, adjacent to my daughter, Ruby and her husband, Roy,
then, I direct that the following be done with the property.
Ruby and Roy shall have the option to purchase the land valued without
any of the improvements thereon such as the mobile home, well, septic, macadam drive,
basement and back porch. In the event that my Executrixes are unable to agree upon
the fair market value, then two appraisals shall be secured and averaged. The mobile
home shall be removed from the property and sold separately and the net proceeds
placed in the estate. The reason for these directions is the proximity of my home to
Ruby and Roy's home. In the event Ruby and Roy do not exercise this option, then the
property shall be sold with all improvements thereon so to maximize its value.
THIRD
I nominate, constitute and appoint my children, PEGGY C. GREIST,
RUBY J. RHOADS and JUDY A. WELKER as Co-Executrixes of this my Last Will
and Testament. I relieve my personal representatives from the necessity of posting
security in connection with their duties as such in any jurisdiction in which they may be
called upon to act insofar as I am able by law to do so.
FOURTH
In addition to the powers conferred by law, I authorize my Co-Executrixes
in their absolute discretion:
A. To retain in the form received, and to sell either at public or private
sale any real or personal property.
B. To manage real estate.
C. To invest and reinvest in all forms of property without being confined
to legal investments, and without regard to the principal of diversification.
D. To exercise any option or rights arising from ownership of investments.
E. To compromise claims without court approval, and without the consent
of any beneficiary.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,
my Last Will and Testament, consisting of three (3) typewritten pages, the first two (2)
which bear my signature in the margin for the purpose of identification, this the /-r-41
day of 4Y4'4- 1992.
f�L'd.A Ad- (SEAL)
M. LUCILLE SHUGHART
Signed, sealed, published and declared by the above named testator M.
LUCILLE SHUGHART, as and for her Last Will and Testament, in the presence of us,
who, at her request, in her sight and presence, and in the sight and presence of each
other, have hereunto subscribed our names as witnesses.
ADDRESS
(/� S ADDRESS Ord( PA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We, M. LUCILLE SHUGHART, 4- and
the testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the testatrix signed and executed the
instrument of her Last Will, and that she signed willingly and that she executed as her
free and voluntary act for 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 the time eighteen (18) years of age or older,
of sound mind and under no constraint or undue influence.
Sworn to a4pbscribed before me
this �z day of
1992. 7
Notarial eat rr Publla
Renee L Mwny.
Carlisle Boro. Walotrlan! Caunty
My Commission E%it" on 13. 1993
em . ennsyrama 0 ma ion o cranes
Feb- 21. 2013 9: 36AM PNC Bank No- 7951 P. 1/1
OPNC-
l�11WUV
February 21,2013
Susan J Hartman Esquire
Duncan &Hartman PC
1 Irvine Row
Carlisle, PA 17013
RE: Name: M Lucille Shughart
SSN: 186-38-0492
DOD: 01-07-2013
Dear: Sir/Madam:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Checking Account
Account# 5140410995 Established: 03-12-1984
M LUCILLE SHUGHART
DOD balance: $ 7,10055+0.02 accrued interest
Interest paid 01-01-2013 thru 01-07-2013 $ 0.00 'YTD
Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and
Savings). We do not process any financial transactions or provide statements. If you need assistance with
any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A.
Member FDIC
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged, confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient,you are hereby nottfied that any dissemination,
distribution or copying of this communications is strictly prohibited If you have received this
communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
Page I of 1
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1101.Tioeotut, m The law Ogee d MOOw H Sher PC
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1109. m S O.00
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P Ious eeltmns am nbe0lele Page l0l MUPI
REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death: 3,800 - 00
Discount: 189 - 84
Interest Table
Year Days Delinquent Balance Due Interest
this time period this year this period
Before 1981
1982
1983
1984
1985
1986
1987
1988 through 1991
1992
1993 through 1994
1995 through 1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
TOTALS
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17, 1996:
Penalty: