HomeMy WebLinkAbout05-07-13 � REV-1500 Ex'01 ,0, . 1505610143
l,� OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code vea� Fae rv�mbe�
Bureau of Individual Taxes oevnRrMeN�oraeveNUE
PO BOX 280601 INHERITANCE TAX RETURN 2 1 �� ;',�/�
Harr�sburg, PA 17128-0601 RESIDENT DECEDENT �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
� 12 11 2012 03 09 1922
DecedenYs Last Name Suffix DecedenYs First Name MI
STYDAHAR HELEN M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Soaal Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1 Onginal Return ❑ 2. Supplemental Retum � 3 Remainder Retum(date of death
prior to 12-13-82)
� 4 l.imited Estate � 4a Futura Interest Compromise � 5 Federal Estate Tax Retum Required
(date of death afler'�2-12-82)
1
� g Uecede�t Uied iesiate � � Decedent Maintained a Lrving Trust 8. TOtdl NumbBr of Safe DBpOSIt BOx05
IAttach Copy M Wdl� - (Attach Copy of Trust)
� 9 LrtigaUOn PrOCeeds Received � 10. Spousal Poverty Credit(date of death � ��_Election to tax under Sec 9113(A)
between 12-31-91 and 1-�-95) (At18Ch SCh.O)
CURRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIR�CTED TO:
Name Daytime Telephone mber ``:. � '�
TERRENC� J KERWIN 7 17 3 6 2 � �5 `'' � �
� {'�� �cy
"- %-' y :� -.;�
_ _,� �=:
REGISTER OF WIL�L�E�NLY P;; c°F�
g� � �" � �
First line of address � `f� %"� ��.'', �g
`� �7 t-s - '�'.E
4 2 4 5 S T A T E R O U T E 2 0 9 �` ,_,, -,-; - R.; �
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Second line of address ' -�; � a
.....� " ,-r,1
:,;,
Cit or Post Office DATE FILED
Y State ZIP Code
ELIZABETHVILLE PA 17023
Correspondent�se-maiiaddress: tjk@kerwinlawfirm.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 r�eclaration of preparer other than the personal representaUve is basetl on all mformation of which preparer has any knowledge
S�G�AI�Rb O�rE-RSON RFSPONSIEI F FOR FIL WG RETURN DAiF
� �f�,.�-�._- Terrence J. Kerwin, Esq. c.f���������
nrn�z[ss
4245 Stat� Route 209, Elizabethville, PA 17023
SIGNA'i�RE OF ��!dF�'ARf-R O�HF�2 1�-iAN HFPRFSENTATIVE
UATE
!���-. �`:_..-..._ Terrence J Kerwin �- %-j �-- A �
-t-- , �/�;� , '•,
Ai)UH1-SS `�
4245 Stats Route 209, Elizabethville, PA 17023
Side 1
� 1505610143 1505610143 J �,
�
ADDITIONAL Personal Representatives
Stydahar, Helen M. SS# 12/11/2012
Under penalties ofi perjury, the undersigned declare that they have examined this return,
including accompanying schedules and statements, and to the best of their knowledge and
belief, it is true, carrect and complete.
i � � A
� '
2 Signature -d�G�-'
Name ohn Schneiderhan
Address 45 Devonshire Square
City, State, Zip Mechanicsburg PA 17050
Date
3 Signature
Name
Address
City, State,Zip
Date
4 Signature `
Name
Address:
City, State, Zip
Date
5 Signature
Name
Address:
City, State, Zip
Date
6 Signature
Narne
Address:
City;State,Zip
Date
� 1505610243
REV-1500 EX
DecedenYs Social Security Number
�>e��d���SNam� STYDAHAR, HELEN M.
RECAPITULATION
1 Real Estate(Schedule A) . . _ .................................._..........._..... ..... . . . .. ........ 1.
98 , 396 . 50
2 Stocks and Bonds(Schedule B) ... . . . .. ............. .._.._._.. . __... . _. _ _ _ . 2.
3 Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C).. .. _ 3.
4 Mortgages&Notes Receivable(Schedule D)... ..................... ...... ...................... .. 4.
1 , 114 , 115 . 78
5 Cash;Bank Deposins&Miscellaneous Personal Property(Schedule E).._............ 5.
6 Jointly Owned Property(Schedule F) ❑ Separate Billing Requested.... ..... .. 6.
7 Inter-Vivos Transfers&Miscelfaneous Non-Probate Property 1 6 , 5 8 5 . 2 9
(Schedule G) � Separate Billing Requested... __ __ 7.
g Total�ross Assets(total Lines 1-7)....................................................................... $ 1 , 2 2 9 , 0 9 7 . 5 7
- _ .
55 , 674 . 08
9 Funeral Expenses&Administrative Costs(Schedule H)..... .. .... .. .._ __. __ _ 9.
10 Debts of Decedent, Mortgage Liabilities,&�iens(Schedule I). ___.. ._ _..._..._ . 10.
i� Total Deductions(total Lines 9& 10)......................................................... ............ 5 5 , 6 7 4 . 0 8
11.
12 1 , 173 , 423 . 49
Net Value of Estat�(Line 8 minus Line 11)................_........__..._..........._..__....... 12
13 Charitable and Govemmental Bequests/Sec 9113 Trusts for which 1 4 5 , 5 1 6 . 3 8
an election to tax has not been made(Schedule J)........................................ .... ... 13.
14 Net Value Subject to Tax(Line 12 minus Line 13)_............................... .. ..._ . __ 14.
1 , 027 , 907 . 11
_ _--
TAX COMPUTATION-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 00 15.
16 Amount of Line 14 taxable
at lineal rat�X 045 16.
17 Amount of Line 14 taxable
at sibling rate X �2 ��
18 Amount of Une 14 t,axable 1 , 0 2 7 , 9 0 7 . 1 1 �g. 1 5 4 , 1 8 6 . 0 7
at collateral rate X .15
19. Tax Due.__ _._. . ................................................................................._....... .__.. 19. 1 5 4 , 1 8 6 . 0 7
20- FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Slde 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21
DecedenYs Complete Address:
DECEDENT'S NAME
Stydahar, Helen M.
__ - - __ ____
STREET ADDRESS
45 Devonshire Square
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
�. Tax oue(Page 2 �ine �9) (�> 154,186.07
2 CreditslPayments
A PriorPayments 153,000.00
B. Discount 7,709.30
Total Credits(A +B) (2) 160,709.30
3 Interest
(3�1 0.00
4. If Une 2 is greaier than I_ine 1 +Line 3,enterthe difference. This is the OVERPAYMENT. (41 6,523.23
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. �51
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 I
b retain the right to designate who shall use the property transferred or its income;..... . __ __. _ _ _ _ � x'�
c retain a reversionary interest;or........................................................ ........ ........ ......_.. ..._..... ... __ . .. � x i
d receive the promise for life of either payments,benefits or care?................ _...._ __ _ ! i X I
2 If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?......................... ................................ ... ... ...... ..............__ _ __._ _ _ _ . J i X�I
3 Did decedent own an"in trust for" or payable upon death bank account or secunty at his or her death?.__ . I � �x
4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which
contains a beneficiary designation?......................._............................._...._.......... _. ......................... ...__ x_,'I ; _'
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�n 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 1,2000:
•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 decedenYs 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 decedenYs siblings is 12 percent[72 P S §9116(a)(1 3)1. 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.
SCHEDULE B
��" STOCKS & BONDS �
COMMONWEALTH OF PENNSVLVANIP. �
INHERITANCF TAX RETURN i
RESIDF:N7 DECEDFNT �
. . . .. I_ _._____. _ - __-__.__ ..._..
. . .___. .-___.... . . . .
. _. ___-_- _____._ .-_______- __._____- ___. _._. _..
.. _-_ - �- _-.:..�_:._._ .._. ..
ESTATE OF I FILE NUMBER
Stydahar, Helen M. � 2�
_— __ _ _ _ i __
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
_ _ _ _ _ _
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
__ _ __ ,
1 2,371 Shares First Energy Corp. (Account#700034916) ' 98,396.50
valued at$41.50 per share equals total value of$98,396.50. '
TOTAL(Also enter on line 2, Recapitulation) 98,396.50
' SCHEDULE E
� �::. , CASH, BANK DEPOSITS, & MISC, �
�°"'"'°"'"FH'",°F`>tNNS��-�^N° ' PERSONAL PROPERTY '
�NF�F�R':•ANCF ��XRFr•JRN ' �
izF5lnf:Nl UFCf�f)f�N� �� '�
. .. i _.. .... ..._. . . __ _.. . .. ._ .. . . . _ . . . .
. .... ...... . . ....____ _-_.___ ___. .. .. ..._.._ .__._ . ..._ . . . . .
FILE NUMBER
ESTATE OF Stydahar, Helen M. i 2�
__ __. _ _ l
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
_ ___— - ----- -___ __ _ - _
1 Ameriprise Financial Services - Mutual Fund Account#020145353643002 122,722.19
2 DWS Investments -Account#26088573 10,464.28
3 Invesco Account#0671416864 86,430.69
4 MFS Investment Management-Account#0026-09896328654 259,809.05
5 Merrill Edge -Acrount#2AT-40843 88,992.36
6 Wells Fargo Advantage Funds - Municipal Bond A-Account#3317-1009178694 287,573.54
7 Welis Fargo Advantage Funds - Strategic Municipal Bond A 26,004.23
Account#4313-10Q9178694
8 Franklin Templeton Investments - Franklin Income Fund - Class A 79,920.00
Account#109-90219626164
9 CWV TEL Feder<31 Credit Union -Account#0000001465 5,605.45
10 M & T Bank Checking Acct. #33396795 17,259.56
11 M & T Bank Savings Acct. #15004226637378 106,053.19
12 Refund - Harmer Funeral Home 235.72
13 Refund - Country Meadows 3,045.52
14 Charity Gas, Inc - royalty interest 10,000.00
15 Exco Resources (PA), LLC - royalty interest i 10,000.00
�I
TOTAL(Also enter on Line 5, Recapitulation) 1,114,115.78
+�1'�..: �, I'�
COMMONV�'FAIiHOF Pk`NNSYLVAN!A � SCHEDULE G �
�NF{F��TAN��_ ��X fzt T��N i INTER-VIVOS TRANSFERS 8�
�E=s'°F"�°`��°E"` � MISC. NON-PROBATE PROPERTY
__ __ _
ESTATE OF Stydahar, Helen M. I FILE NUMBER
21
_— ---
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DE SCRIPTION OF PROPERTY � , �OF ��..
I�,r,iude th�name cf the transferee,their relationship to decedent � DATE OF DEATH ', DECD'S � FXCWSIOIv TAXABLE VALUE
NUMBER va�uE oF nssFT 'iiF n�Pi.icnHi E_,
� a��d me 7a�e o�t�anster Attach a copy of the daed for real estate �� ��� INTEREST �
1 Ameriprise Financial Services ',� �i.osa.9� ' 100% 11,068.91
RiverSource Life Insurance Co. '
Annuity Account#931011654981004 '
Beneficiary: Estate of Helen M. Stydahar
I o
2 Diocese of Harnsburg 5,5is 3a 100/0 5,516.38
Annuity Account#08-69472 '
Beneficiaries: Diocese of Harrisburg and
St. Katharine Drexel Parish
i '
i '
, �
TOTAL(Aiso enter on line 7, Recapitulation) 16,585.29
I SCHEDUIF H
�`�. FUNErtAL ExPENSES&
COMMONWEAl1H 01=NFNNSVI VFNIn � /����w,'c�'p/�'��/�^�( �
INF�tf21�1l:NCf_�AY.R[7l;RM1 . F�L/�rA1�1�71�11�/GV�J��
Rt51DFM Ut:CFUEN!
.: . __ ..__..._ . ._.. . ._. ._ _....... .. . .. . ..._. . . . .. . ..
I FILE NUMBER
ESTATE OF Stydahar, Helen M. 2�
_ _-- --- _ _
Debts of decedent must be reported on Schedule I.
ITEM _ _ __ __ _
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A.
B. ADMINISTRATIVE COSTS:
1 Personal Representative's Commissions
Name of Personal Representative(s)
' Terrence J. Kerwin, Esq. 10,578.20
Street Address 4245 State Route 209
c�ry Elizabethvilie state PA zip 17023
Year(s) Commission paid 2013
2 Attomeys Fees Kerwin & Kerwin, LLP --Terrence J. Kerwin 42,312.81
3 Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Gaimant
, Street Address
I City State Zip
Relationship of Claimant to Decedent
4 ' Probate Fees 493.50
5 Accountant's Fees
6 Tax Return Preparer's Fees H & R BIOCk 388.00
7 , Other AdministraUve Costs
1 Notary fees 20.00
TOTAL(Also enter on line 9, Recapitulation) 55,674.08
', Schedule H '
� Funeral E�enses&
COMMONWf AI Th+Of PFNNSYI.VANIA /��
WHE.-I'r21TANCF IAXRETURN . /�,�m�nisaaitiv�eCosisc�ntinued �'
RI SIDFN7 Ui_CE Of'N1 �
ESTATE OF Stydahar, Heleri M. i FILE NUMBER
---__ _--- - _ __
_ i21
2 U S. Postmaster- express mail 19.95
3 Cumberland Law Journal - Estate Notice 75.00
4 The Sentinel - Estate Notice 189.54
5 ! Diamond Pharmacy - prescription bill 345.00
6 Special Event Emergency Medical - ambulance 100.00
7 Paul D. Dalbey, DPM 25.00
8 M & T Bark - estate check fee 12.75
9 M & T Bank -Visa credit card payment 35.98
10 U.S. Treasury - 2012 Income Taxes 210.00
11 Alpha Diagnostics, Inc. 20.00
12 Register of Wills - Releases 75.00
13 PA Department of Revenue -2012 estimated income tax payment (check issued prior 325.00
to death and check cleared after death)
14 Orthopedic Institute of PA (check issued prior to death and check cleared after death) 23.35
15 Register of Wills - additional probate fees 400.00
16 Closing costs, e.g copies, postage 25.00
Page 2 of Schedule H
REV-1513 EX+(1�-08) I
' �.. ' SCHEDULE J �
COMMONWEA,_�i"ff OF P!.NNSVi.VANIA � �
,NF,E�,rAN�E ,AX RE,�RN BENEFICIARIES
HFSi�ENr i�E_cEOF:Ni
— _._ _ _ _ __ __ _ . _. __ - — --
__ — —-- _--- -- —_ __ __
ESTATE OF FILE NUMBER
Stydahar, Helen M. I�
. __ ___ _
21
RELATIONSHIP TO SHARE OF ESTATF_ AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECE:IVING PROPERTY ' �o Not�ist Trustee(s�
�
�. TAXABLE DiSTRIBUTIONS[inctude outright s�ousal
distributions,and transfers
under Sec.9116(a)(1 2)]
1 David F Stydahar nephew $5,000 bequest
34117 Picciola C>rive
Fruitland Park, FL 34731
2 Joseph Stydahar , nephew ' $5,000 bequest
329 North Avenue '
Libertyville, IL 60048-2064 '
3 George Stydahar nephew $1,000 bequest
32 Rivervi�w Trail
Croton-on-Huds��n, NY 10520
Enter dollar amounts ibr distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate
,
I I. '�ON-TAXABLE DISTRIBUTIONS
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WH�CH AN ELECTION TO TAX IS NOT TAKEN
i
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 '�, Diocese of Harrisburg 42,758.19
4800 Union Deposit Road, Harrisburg, PA 17111-3710
2 I, Diocese of Wheeling-Charleston 25,000.00
1300 Byron Street, Wheeling, WV 26003
3 Saint Katharine Urexel Parish 27,758.19
1 Peter Drive, Mechanicsburg, PA 17050
4 , St. Ann's Catholic Church 50,000.00
' 610 Pike Street, Shinnston, WV 26431-1424
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV-1500 COVER SHEET 145,516.38
_
REV-1513 EJ(+(9-00)
� �� SCHEDULE J
`°"^""°"`"E"`,"°' PF'""s�`�A"'" BENEFICIARIES continued
INHFRITHNCEIAXRE7URN � ��
RESIDf�N7 DECEDEN�i i
ESTATE OF FILE NUMBER
Stydahar, Helen M.
21
. _ _ _-_ __ --- _ -- _ _ _
' RELATIONSHIP TO SHARE OF ESTATF AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) ' DECEDENT (Words) ($$$)
RECE:IVING PROPERTY oo Not�ist Trustee�s)
]. TAXABLE DISTRIBUTIpNS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)] '
4 Barbara Ann Cooper ' niece $3,000 bequest
1935 Alonzavilie Road I
Woodstock, VA 22664 I
5 Mar Kath n Whitehair niece $3 000 be uest
Y rY , Q
560 John K Drive, Unit 103
Long Beach, CA 90803-6349 '
6 Alice Hood $2,500 bequest
153 Salem Ridge Drive
McDonou�h, GA 30253
7 ' Robert Hood ' $2,500 bequest
153 Salem Ridge Drive ,
McDonough, GA 30253
8 Shinnston High School $5,000 bequest
Alumni Association, Inc.
P O. Box 352 ;
Shinnston, WV :?6431 '
!
9 ' Mr. and Mrs. Richard P. Swiger j ' $5,000 bequest
: 1125 Little Laurel Run Road I
Lumberport, WV 26386-8136
10 John Schneiderhan $5,000 bequest plus
45 Devonshire Square 100% residue
Mechanicsburg, PA 17050
I
_
Page 2 of Schedule J
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