HomeMy WebLinkAbout05-02-13 1 1505610105
J REV-1500EX(0-11'lF"
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
,
Harrisburg,PA 19128-0601 RESIDENT DECEDENT - a l 13 I ' €
ENTER DECEDENT INFORMATION BELOW
01/16/2013 06/03/1926
Decedents Last Name Suffix Decedent's First Name MI
Yohe Laverne j A
(If Applicable)Enter Surviving Spouse's Information Below _
Spouse's Last Name Suffix Spouse's First Name MI
_ i
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 O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
l'p 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. 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 INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Alexis K Sipe, Esquire (717)8 40-0110
RHQTER OF WILLS ONCE
C= m
2
First Line of Address CD r;0 IW
Swope and Sipe � r m r T
t ------- -.._— — r r 1 a
...._.._._____.._.....___..__....__...._: Z tV
Second Line of Address __ (P C
50 East Market Street o _a
City or__Post Office State ZIP Code (DATE FILE�"` -- n
Hellam PA 17406 v � r o
Correspondent's e-mail address:aksipe @swopeandsipe.com
Underpenalhes of perjury,I declare that I have examined t is return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration o1 preparer er than the personal representative is based on all information of which trapper has any knowledge.
SIG E OF RSO FIB F R FI G RETURN ` _PATE--."
ADDRESS - �^�
12 Pine Street, Fredericksburg, PA 17026
5 M F P DARER T T AN REPRESENTATIVE ATE
ADDRESS
50 East Market Street, Hellam, PA 17406
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
J 1505610205
REV-1500 EX(FI)
RECAPITULATION
1. Real Estate(Schedule A). ...................... ...................... 1.
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)....... S. 11,153.16
6. Jointly Owned Property(Schedule F) 'O Separate Billing Requested ....... 6. 4,350.00
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. 15,503.16
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 13,696.45
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. - 4,285.93
11. Total Deductions(total Lines 9 and 10)................................. 11. 17,982.38
12. Net Value of Estate(Line 8 minus Line 11) ............................... 12. -2,479.22
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has hot been made(Schedule J) ........................ 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. -2,479.22
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_ 16.
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 ......... ......................... ....... ................ 19.1 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610205 1505610205 J
+ REG1500 EX(F) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Laverne A. Yohe
STREETADDRESS
4529 Rolo Court -
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments
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)
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0
c. retain a reversionary interest .............................................................................................................................. ❑ E
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ E
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................__............................................................................. ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation? ........................................................................................................................ ❑ 0
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
fling 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)].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-1508 EX+(n-lo)
pennsylvania SCHEDULE E
�J DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDEW
ESTATE OF: FILE NUMBER:
Laverne A. Yohe 21-13-307
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.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank checking account 2,560.22
2, PNC Bank savings account 1,220.05
3. PNC Bank money market account 7,239.30
4, VNA refund
14.19
5, Cumberland County death benefit 100.00
6, PA Turnpike-EZ Pass refund 19.40
TOTAL(Also enter on Line 5, Recapitulation) $ 11,153.16
If more space Is needed,use additional sheets of paper of the same size.
REV.509 EX.(OT-To) -
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Laverne A.Yohe 21-13-307
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. ,
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A Karen Harbold 4529 Rolo.Court,Mechanicsburg,PA 17055 friend
G — L,
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY - %OF DATE OF DEATH-
MEM FOR JOINT MADE INC U)E NAME OF FINANCIAL INSTMMON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VAWE OF
NUMBER TENANT )OINT - IDEFnFYING NUMBER.ATTACH DEED FOR JOINTLY HERO REAL ESTATE. VAWE OF ASSET INTEREST DECEDENTS INTEREST )
I. A. 11!08/11 (1998 Cadillac Deville 1,300.00 50 650.00
a0 A 1 11/08/11 2000 Chevrolet Silverado •. 3,400.00 50 1,700.00
_ I A 01/26112 1970 Key mobile home T� ^ 2,000.00 100 2,000.00
❑ c❑ ❑—_ c a
❑ �❑ - - o .
El
❑ L ± �- ❑ ❑
❑ ❑ ❑ F=7.
El
❑ ❑
- — TOTAL(Also enter on Line 6, Recapitulation) ;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
INNERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Laveme A.Yohe 21-13-307
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENS ES:
Concklin Funeral Home
B. ADMINISTRATIVE COSTS:
I. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address -
City - State ZIP
Year(s)Commission Paid:
2. Attorney Fees: ..^675.77
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:
S. Accountant Fees:
61 Tax Return Preparer Fees: T_I'
7. 0 hans'Court-filing fee for Petition for Settlement of Small Estate
1I8.E Register of Wills-inheritance tax return filing fee
IL
--- - - -- --'I F- ----�
Lj
TOTAL(Also enter on Line 9, Recapitulation) $ 13,696.45
If more space Is needed,use additional sheets of paper of the same size.
REV-1512 kX+(12-08)
pennsytvania SCHEDULE I
v' DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INMERRANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDEW OECEOEW
ESTATE OF FILE NUMBER
Laveme A. Yohe 21-13-307
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
I. Shepherdstown Family Practice 10.00
2. Discover card 1,948.99
3. Pinnace Health Cardio 25.00
4. PNC Bank credit card 1,635.67
5. Wal-MarUGECRB credit card 29.98
6. GE Company 166.45
7. Holy Spirit Hospital 65.00
8. PP&L 193.85
9. AT&T 8129
10. Verizon 33.70
11. Visiting Nurse Association 96.00
I A
TOTAL(Also enter on Line 10,Recapitulation) $1 4,285.93
If more space is needed,insert additional sheets of the same size. `
REV-1513 EX+(01-10)
pennsylvania SCHEDULE a
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF; FILE NUMBER;
Laverne A.Yohe - 21-13-307
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON($)RECEIVING PROPERTY Do Not List Truste (s) OF ESTATE
1 TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(L2).) _
7
I. 1(aren Harbold;4529 Rolo Ct.,Mechanicsburg,PA 17055 1 Lfdend 100%11
IL -- =
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH IB OF REV-1500 COVER SHEET,AS APPROPRIATE.
iI NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: .
❑
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: -
TOTAL Of PART 1T-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'kNsE,LAiD TESTAMENT
OF
LAVERNE YOHE
I, LAVERNE YORE, of' 4529 Rojo Court, Mechanicsburg, Cumberland Counr;
Pennsylvania 17055, being of sour.- and disposing mind; memory and understanding, do hereby
make, publish and declare the fo!lowing as and for my Last Will and Testament, hereby revoking
and making void any and all Wills and Codicils by me at any time heretofore made.
FIRST: 1 direct that all my just debts and funeral expenses be fully paid as soon after my
demise as may be found convenient.
SECOND: I hereby give, devise and bequeath all of the rest, residue and remainder of
my estate, whether real, personal or mixed, of whatsoever nature or kind and wheresoever
situate, to my companion, KAREN K. HARBOLD, to be hers absolutely.
THIRD: It is my specific intention to exclude my children from any bequest or share to
which they may otherwise be entitled from my estate because I feel that I have adequately
provided .for them during my lifetime.
FOURTH: I hereby nominate, constitute and appoint my son. MICHAEL L. YORE, as
Executor of this. my Last Will and Testament. My Executor named herein shall have full power
to do any and all things necessary ;6r the Coot , 0 d ni, istratior of my Estate, including the
o` Paves
power to sell, at public or private sale and without order of Court, and without the necessity of
filing a bond, any real or personal property (except as otherwise provided herein) belonging to
me, and to compound, compromise or otherwise to settle and adjust any and all claims against or
in favor of my estate, as fully as I could do if living. My Executor shall have the right, but not
the obligation, to distribute property in kind at then current values and on a non-pro rata basis.
FIFTH: I hereby direct my Executor to appoint the Law Offices of Swope and Sipe as
attorney for my estate in the event his services are available.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament this /`/��' day of January, 2012.
L1' (S AL)
LAVERNE YOHE
This instrument, with each page bearing the signature of the above-named Testator, was
by him on the date hereof signed, sealed, published and declared by him to be his Last Will and
Testament, at his request and in his presence and in the presence of each other, have hereunto
subscribe r ii�vnes as witnesses.
//
residing at 620 S. Front St., Wrightsville, PA 17370
residing at 330 Popps Ford Road, York Haven, PA 17370
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF YORK
We, LAVERNE YOHE, Alexis K. Sipe and Michele M. Duncan, the Testator and the
witnesses, respectively, whose names are signed to the attached or foregoing instrument, being
first duly affirmed, do hereby declare to the undersigned authority that the Testator signed and
executed the instrument as his Last Will and Testament and that -he had signed the instrument
willingly, and that he executed it as his free and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as
witnesses and that to the best of our knowledge, the Testator was at the time eighteen (18) years
of age or older, of sound mind, and under no constraint or undue influence.
LAVERNE YOHE, Testat
i
s
Wi ess
i
Witness
Subscribed, affirmed to and
acknowledged before me by
the aforesaid Testator and
witnesses respectively, the
'day of January, 2012.
�C
Notary Public
COMMONWEALTH OF PENNSYLVANIA
XTrARIAL
cRSr,
Sharon L.Swop:Notary Public
Hallam Borough,York County
My common expires Detimber 19,2014
Ps,ge 3 of 3 Pagc:
COCKLIN FUNEtUL HOME, INC.
STATEMENT OF ACCOUNT
SERVICES OF: Laverne A Yohe Statement Date: March 8, 2013 07:06:36
ON: January 16, 2013 Acct: 718489 4997 13
ACCOUNT HISTORY
Posted Description Amount Balance
02/21/2013 Balance Forward 12,720.38
03/08/2013 Unanticipated late charge since 02/21/2013 41.80 12,762.18
ACCOUNT SUMMARY
Unanticipated Late Payment Charge Amount
Account Paid/Discounted Amount Due
Total To Date to Date
12,720.38 41.80 12,762.18
DETACH AND_RETURN _BOTTOM _PORTION WITH. YOUR PAYMENT.
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SWOPE RHO SIPE
RTTORRYS HT LE
April 30, 2013
Register of Wills
Cumberland County Court House
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Laverne A. Yohe
. No. 21-13-307
Dear Sir/Madam:
Please find enclosed an original and two (2) copies of an Inheritance Tax Return which I
wish to file with regard to the above-referenced estate, together with our check in the
amount of $15.00 which represents the filing fee for the same. Please return the time-
stamped copy to this office in the envelope provided.
Thank you for your assistance in this matter. If there are any problems, please feel free
to contact the undersigned.
X Siyours,e, Esq ' e
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50 E.MARKET ST.•HELLAM,PA 17406•P:717.840.0110•F:717.840.0014•swopeandsipe @comcast.net