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Home My WebLink About05-22-13 . _.. .. .. __ .. _ _ _ __ __ . _. _. .. .I � v � REV-1500 EX c°,-,°� 1505610143 � OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau r�f Individual Taxes DEPARTMENiOFREVENUE Po so�:.2soso� INHERITANCE TAX RETURN 2 1 12 0 1 0 6 2 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ._ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 09 17 2012 O1 17 1914 DecedenYs Last Name Suffix DecedenYs First Name MI WILD MARY M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITIH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Originai Return � 2. Supplemental Return � 3.Remainder Return(date of death priorto 12-13-82) 4. Limited Estate � qa.Future Interest Compromise � 5. Federal Estate Tax Return Required ❑ (date of death after�2-12-82) g Decedent Died Testate � 7. �cedenl Maintained a Living Trust 8. Total Number of Safe Deposit Boxes � (Attach Copy of Will) (Atlach Copy of Trust) 9. Liti ation Proceeds Received � �p,spousai Poverty Creait(date of deatn � ��.Election to tax under Sec.9113(A) ❑ 9 between 12-31-91 and 1-1-95) (AHeCh SCh.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number SAMUEL L ANDES 717 �..`�61 5 � 63- .`q � �;; �� .� REGI�q�bF�11LL�E OI�t}�Y`"�� , � �r_ - .�x First line of address °� � �� '' � f\) �� :. 525 NORTH 12TH STREET °� ��: . ` �-� �� ,: :� Second line of address - :.. _�` . _ `�. DAT � ED C;s ,�? City or Post Office State 21P Code LEMOYNE PA 17043 CorrespondenYs e-ma�i address: I aw a n d es @ao I.co m Under es 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 ,corre and complete.Declaration of preparer other than the personal representatrve is based on all information of which preparer has any knowledge. . S NAT SPONSIBLE FOR FILING RETURN D,4TE ��t Roy Allen Harris �a,�.,r 3 _ ADORESS 9865 Diversified Lane, Ellicott City, MD 21042 SIG UR OF RE OT H EPRESENTATIVE D.4TE Samuel L Andes � � � ADDRESS µ' 525 North 12th Street, Lemoyne, PA 17043 Side 1 � 1505610143 1505610143 J �� _. _ ___ _ . . ` � 1505610243 REV�1500 EX ------- - - -- ------�-------- ___ .-__.-..--- RECAPITULATION 1. Real Estate(Sr.hedule A).................. ....................................................................... 1. 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. 5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 1 0 9 , 5 6 5 . 7 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G} � Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1-7)....................................................................... 8. 1 O 5 , 5 6 5 . 7 � 9. Funeral Expenses 8 Administrative Costs(Schedule H)......................................... 9. 1 3 , 6 6 7 . 3 2 10. Debts of Decedent,Mortgage Liabilities,8 Liens(Schedule I)................................ 10. 1 , 1 7 7 . 3 4 11. Total Deductions(total Lines 9&10)...................................................................... 11. 1 5 , 8 4 4 . 6 6 12• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 9 � , 7 2 1 . 0 4 13. Charitable and(3overnmental Bequests/Sec 9113 Trusts for which an election to ta:x has not been made f,Schedule J).................................... ............ �3. 14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. �q. 9 3 , 7 2 1 . 0 4 --- --- - --- -- __--------- __ -- _ ___------- TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousai tax rate,or transfers under Sec.9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable at lineal rate X 045 16. 17. Amount of Line 14 taxable at sibling rate X �2 �7. 18. Amount of Line 14 taxable at collatera�rate:x .�5 9 3 , 7 2 1 . 0 4 �a� 14 , 0 5 8 . 1 6 19. Tax Due..................................................................................................................... 19. 1 4 , 0 5 8 . 16 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 � � REV-1500 EX Page 3 File Number 21 - 1 2 - 01 062 Decedent's Complete Address: DECEDENT'S NAME Wild, Mary Madeline — -- ------_ __ STREET ADDRESS Essex House _ __ _ 20 North 12th Street ---- ---- - ---- _ _ -- ---- - -- -- CITY i STATE �ZIP Lemoyne � PA 17043 _ Tax Payments and Credits: 1. Tax Due(Page 2,Line 19} (�) 14,058.�E: 2. Credits/Payments A. PriorPayments _ 13,000.00 B. Discount 684.21 Total Credits(A +B� (2) 13,684.�11 3. Interest (3) 0.I�C q. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 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. �5) _ 3 7 3.!;��;' Make Check Payable to: REGISTER OF WILLS, AGENT. �` _ �-S' si,d, f•4� �`p.4F,t�`,' t p . `.u.r f,� "kF'y _ , . #*�,. . . . PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. r•etain the use or income of the property transferred:........................................................................ ......... � 0 b. retain the right to designate who shall use the property transferred or its income:.................................... � �x c. retain a reversionary interest;or........................................................................................................ ......... ❑ ❑x d. receive the promise for life of either payments,benefits or care?............................................................. n 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... � X❑ 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 1 contains a beneficiary designation?...................................................................................................................... � 1 ❑X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUi�iIV. �..v.+�,�.....� , , � �, .�'� -� u,_ ,.�,��r-:?� "�-.'' a -.�'i4_n , . . „ �. ,. :_ � .�n �� .� �3�+.,«s..,., ..'`rwi §�€' �!�.:�n.�.�:a��-`�.;��`�� 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 survivir,c; spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)] For dates of death on 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,�3r� 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). A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by bloo�or adoption. � SCHEDULE E � CASH, BANK DEPOSITS, 8� MISC. GOMMONWE.4LTHOFPENNS'�LVAM1IA PERSONAL PROPERTY I INHERITANCE TAX RETURN RESIDENT DECEDFNT -�L-__ -�--__--.._:- -�-'-"_-'-'_----.. __ � _. -- -- -- -------- — FILE NUMBER—�—— _— _ _ ESTA7E OF Wild, Mary Madeline �2� - �2-o�os2 — ---------_—__———-— -- -- --------- -1—---__ —--- 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 DESCRIPTION VALUE AT DA1�F:+"�F NUMBER DEATH -- ------------- -- ---------—— __ _ __ --- 1 Money Market savings account No. 1054168881 with Sovereign Bank 68,30CI 43 2 Checking account No. 9859324361 with M&T Bank 14,380�.05 3 Checking account No. 9386671579 with M&T Bank 5,231.2;:? 4 15 Series EE U.S. Savings Bonds in $1,000 denomination (with accrued interest) 21,354.��)r,) 5 Miscellaneous items of clothing and other tangible personal effects 300 t)(� ----— —-_ -__--- ---- __ ___ _— --- TOTAL(Also enter on Line 5, Recapitulation) 109,565.7G� _ . .___ ... __ _. _ rT ... � SCHEDULE H FUNERALEXPENSES& COMMONWEALTH OF PENNSVi_VANIn. INHERITANCE 7AX RETUF�.N e��ICTOATI�/C^/YCTG� RESIDENT DECEDENT .•�+�■� k��r�r��v��..�ra�a — .__._... _..__.__.._-.__ .____...____ __—_- — _.___.._._._... _-_-__—__.__._.. _ ____._.-__'.__ ESTATE OF Wild, Mary Madeline FILE NUMBER -- _. -____--__- � 21 - 12- 01062 - --__.___ _ -------- __ ._ — - - - Debts of decedent must be reported on Schedule I. T__ _ _--- ----- ITE M - - -----__ _ ----— - ---- NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT ---.. --_.- ---- -- - ------ A. 1 Parthemore Funeral Home &Cremation Services (funeral services) 4,526.32 2 Roy A. Harris - reimbursement for grave opening 500.00 I � B. �ADMINISTRATIVE COSTS: I 1. Personal Representative's Commissions Name of Personal Representative(s) Roy Allen Harris 4,800.00 Street Address 9865 Diversified Lane City Ellicott City State MD Zip 21042 Year(s)Commission paid 2013 i 2. Attorney's Fees Samuel L. Andes 3,000.00 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation) Claimant I Street Address i City State Zip Relationship of Claimant to Decedent a. i Probate Fees Register of W ills i 16.00 I ' 5. I ,4ccountant's Fees 6. Tax Return Preparer's Fees Terry Rlckrode ' 750.00 7. Other Administrative Costs 1 Cumberland Law Journal : 75.00 � -- - _-___ __ __---------- - TOTAL(Also enter on line 9, Recapitulation) 13,667.32 _ ,, . f � SCHEDULEI � DEBTS OF DECEDENT, MORTGAGE � COMMONWEALTHOFPENNSYU�ANIA LIABILITIES, & LIENS INHERITANCE TAX fiETURN RESI�ENT DECEDENT --_--.---.__-___- __ - -�-___'-___.'____.-_._ - _ �--..._-___--`__..____ _-_-' -.�._ _ FILE NUMBER ESTATE OF Wild, Mary Madeline 21 - 12 - 01062 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER — ---- — -- ---- ---__------ -- ---- — - -- - - 1 West Shore Emergency Medicai Services 92 '��' 2 Comfort Keepers (personal care) 56.��(' 3 Special Events Emergency Medical Care 150 ��'� 4 Verizon �79 f='� 5 State Employees Retirement System 504.F1�i' 6 U.S. Postal Service (maifing of life insurance policy) 19.'�;i5 7 CMS (emergency medical transportation} 1,173.i70 TOTAL(Also enter on Line 10, Recapitulation) 2,177.3�a1 _ _ , REV-1513E%+��1-08) �i SCHEDULE J i COMMONWEALTHOFPENNSYLVANIA I BENEFICIARIES I INHERITANCE TAX RE�iURN RESIDENT DECEDENT - -' —-- ——� ----------- --�-- — --- --- —--�----`--- ------ --- �- — ESTATE OF I FILE NUMBER Wild, Mary IVladeline 21 - 12 - 01062 - --T--- --- --__------ --- ------ - ---- RELATIONSHIP TO SHARE OF ESTA7E AMOUNT OF ES7�PTE NAME AND ADDRESS OF PERSON S � NUMBER I � ) I DECEDENT (Words) ($$$) RECEIVING PROPERTY DoNotListTrustee(s) - --- -- -------- ------- --- -- - - -�--------- —_ I� TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 � Susan Marie �loward Niece i Entire estate (formerly Susan Marie Harris) 100 Farley Lane � � Alvaton, Kentucky 42122 j I I � � � � � � � � ! i � I I , i � � I i � i I� � � j i Enter dollar amounts for distributions shown above on lines 15 through 1&on Rev 1500 cover sheet,as appropriate. � II. NON-TAXABLE DISTRIBUTIONS: rr� A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX!S NOT TAKEN I I I � � � I I I B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I � � � I � I I � I I I TOTAL OF PART II-EN7ER TOTAL NON-TAXABIE DISTRIBUTIONS ON UNE 13 OF REV-'1500 COVER SHEET O.00 — - -- ------ --- ----------------- -. �