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Home My WebLink About05-23-13 ! 15�5610140 �� REV-1500 Ex �°,.,°> oFFicia�usE aw�v PR Departmeni pf Revenue Coun Cade Year File Number Bureau of Irtdivltluai Taxes � Pp BOX 28060] INHERITANCE TAX RETURN � 1 Z 2 1 2 5 4 Harnsburp.PA 17128-0601 RESiDENT pECEDENT ENTER DECEDENT INPORMATlON BEIOW 1 1 D 9 2 0 1 2 d 7 1 5 1 2 5 4 DecedenPS Last Name Suffix Dacedenfs Firsi Name MI t L I N E G L E N N L (If Appiicable)EMer Surviving Spouse's intormation Betow Spause's Last Name Suffix Spouse's First Name MI S H I R L E Y C l I N E A Spouse's Social Secunty Number TNIS ftE7URN MUST BE FtLHD!N DUPIICATE WITH THE REGiSTER OF WILLS F�LL IN APPR4PRlA7E OVAtS BELOW � t.Original Retum � 2.Suppfementaf Return � 3. Rema'rnder Retum(date of death prior to 12-13-82) � 4. Limtted Estate � 4a, Future tnkerest Compromise(date af � 5. Federal Estate Taz Return ftequired death after 12-12-82} Q 6, Decedent Died Testate � Z Decedent Maintained a living Trast � B.Totai Number of Safe DeppsR Boxes (Attach Copy otWiit) (Aitach Copy of Trust) � 9. Lftigation Praceeds Received � 70.Spousai Povarty Credit(date otdeath � 11. Eiectian to tax undsr Sec.9it3(Aj between 1231-91 and i-t-95} (AHach Sch. 6j-; ny CORRESPOMQENT-THIS SECTION MUST BE COMPIETEQ.AlL CORRESP6NDENCE AND CONFIDENTIAI TAXa01F�tMATipN OULD BE HI&EG7ED 70� Name Dayti�TAtaphone�inbeF'� �r C H R I S T fl P N E R E • R I C E , 7 -�' �„ �'2 ik•.� "3 ;�� 4 1 r . -�- �,,,� �.,i �REtSIST�3 OF WItLS tME O�t.Y .., � '-q7 -s'i "'•i ' -; _ � ,.�_ � �_. � �--t �� First line of addres8 - �"' � f'�., ' i;'t � 1 0 E A S T H I G H S T R E E T +--° �a � . ;;n Seaond Iine of adtlress � Gity or Post OffiCe State ZIP Code �. _ , oATE FlLED �; C A R L I S L E P A 1 7 0 1 3 GorraspondeM`s e-mail address: CR10E(�a,MARTSONLAW.CQM U»der penatt+es of perjury,i deciare that 1 have examirietl this retum,Inciuding accompa�ying seNetlales and statements,and to the best of my krmwle+ige end trelief, it is true,correM and eqmplete,DeUaretion of preparer other than ihe personat representative is based on ail inPormation of w0ich preparer has any knowiedge- SIGNATUR ER ONSIBLE FOR FILlNG RE7URN DATE � �t�l?.� $•23�13 RDDRESS 30 GHELSEA LANE CARLISLE PA 170Z5 SIG R R RER R TNAN ftEPRESENTATIVE DATE �'.�"�'-.�"� �''. Y�'�-- S-2J—/�e ADDRESS 1� EAST HIGH STREET CARLISLE PA 17�13 PIEASE USE OR�GINAL FORM ONI.Y Side 7 � 150561�140 15�56�"b140 J � 15�56Z0240 REV-1504 EX RECApITULATI6N t. Reai Estate(Scbedule A) . . . . . . .. . .. . . . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . 1. � • � Q 2. Stocks and Bonds(5chedule B) . . . . . .. . ... . .. ... . . . . . . . . . . . . . .. . .. . .. 2. 4 3 4 2 . 3 1 3. Ciosely Held Corporation,Partnership or Sole-Proprietorship(Scheduie C) . . . . . 3. • 4. Mortgages and Notes Receivebie(Sohedule D) . . . . . . . . . . . . .. ... ... . . . .. . A. � 5. Cash,$ank Deposits and MisceAaneous Personai Property(Schedule E}. . .. ... 5. • 6. Jointiy Owned Property(Schedule F) ❑ Separata Biiling Requested . . . . . . . 6. • 7. fnter-Vivos Transfers&Miscellaneaus N -Prohake Property (Schedule Gj � Separate Billing Reqoested . . . . . .. 7. . 8. 7otal Gross Assets{totat Lioes 1 through 7j . ... . .. ... .. . . . . . . . . . . . . . .. 8. 4 3 �f t� . � 1 9. Funera!Expenses and Admi�istrative Costs(Schedule H) . ... .. . .. . . . . . . . . . 9. • 10. Debts of Decedent,Mortgage liabflities,and Liens(Schedute�) . . ... .. . ... .. f 0. � 71. Tota!Deductions{totai Lines 9 and 10) . . . . . . . . . .. .. . .. ... . . . . . . . . . . . . i t. � i2. Nek Value of EsWte(Line 8 minus Line 17) . . . . . . . . . ..... ... . . . . . . . . . . . �Z. 4 3 4 2 . 3 Z t3. Chantabie and Governmentai Bequests/Sec 9113 Trests fot which an eieGion to tax has not been made(Schedule J) . . . . .. . . . .. . .. . . . . . . . . 13. . 14. Net Value SubJect to Tax(Line 12 minus Line t3) .. . . . . . . . . . . . . . . .. . .. . 74. 4 3 4 2 . 3 1 TAX CALCUTATfON-SEE INSTRUCTIONS POR APPUCABLE RATES 15. Amount ot Line 14 taxabie at tha spousai tax rate,ar transters under Sec.9178 (a)(t.2ax.o _ 4 3 4 2 . 3 Z ts. p . Q p 76. Amount of Line�4 taxabie atlineairete X .0_ Q . � 0 �6. �7 . 0 � 11. Amount of Line 94 taxabie at sibling rate X.12 � � Q � 17. 0 . � � i8. Amou�t of Line !4 taxabie at collatera!rate X .t5 0 • � � 18. C) . 0 0 i9. TAX DUE . . . . . . . . . . . . . . .. . .. . . .. . . . . . . . . . . . . . . . . . . .. ... .. . .. . .. 19. � • D O 20. F!L!IN THE OVAL iF YOU ARE REQUESTING A REFUND OF AN OVERPAYMEN7 � Side 2 � 15�561D240 150561�240 � REV-+566 EX Page 3 File Number Decedent's Complete Address: 2t t2 �25a DECEDFNT'S NAME GLENN L. CLlNE _ _ STREET ADDRESS - - - - � � � � �� - � � ! 138 MAPLE S"PREGT _ ClTY . . . . . _ . . .. . . . _ ... . . _ . __. _ . . .. .. ..,. _ ._ . _ _ . .. . _ _ . .. . _._ . _.. . . . � STATE Z(P CAKl.LSLI:i ; PA � i7413 Tax Payments and Gredits: �. 7ax Due(Paye 2,Line 19) �� p Qq 2. CreditsiPayments A.Prior Payments B.Discount Totai Credits(A�8} {2) 0.00 3. interest A. li Li�e 2 is greater than Line 1+Line 3,enter ihe difference.This is the OVERPAYMENT. �3� Fiii in oval on Page 2,Line 2U W request a refund. (4) 0.00 5. !f Line 9 +Line 3 is greater than Line 2,enter the difference.Th}s Is the TAX DUE. (5j 0.00 Make check payable to: REGlSTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUES7IQNS BY PLAClNG AN "X" !M THE APPR4PRIATE BlOCKS 1. Did decedent meke a transfer and: Yes No a. retain the use or inaome otlhe properfy fransferred: ..................................................._......_..._.... ❑ (�X b, retain the right to designate who shall use the properly transferred or its inwme; _..............._........... ❑ XQ c. retain a reversionary'rnterest ar ...................._....................._.................................................... ❑ 0 d. receive the pranise for life of either payments,benef ts or care? ....................................................... ❑ [�X 2. If death occurred after December 12,t982,did decetlem transfer property within one year of death withoutreceivingadequatectlnsideraUOn? .........................................................._..._........._..._...... ❑ �]X 3. Did decedent own an°in irust for"or payable-upon-death bank account a security at his or her deaih? ...._... ❑ Q 4. Did decedent own an individuat retirement accpunt,annuity or other npn-probaie property,which contaiasabeneficiarydesignation?...................................._......_.................................................... ❑ � !F 7HE ANSWER TO ANY OF THE A80VE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDUIE G ANd PILE IT AS PART QP TNE RE7URN. For dates of death on or after Jury 1, 1994,and before Jan. 1, 7995,the tax rate imposed on the net vaiue pf transfers to or for the use o!the suroiving spause 3 percent(72 RS.§91�6(a)(t.t)(i)�, For dates of death on or afler Jan. 1,1995,the tax rate imposed pn the net value of transfers to or for[he use of the surviving spouse is 6 percent (72 P.S.§9116(a}(1.1)(ii}].The statute does not exempt a trensfer to a surviving spouse from tax,and ihe statutory requirements for disGosure of assets and filing a tax return are stiil applicable even if the sun+iving spouse is the only beneficiary. Por dates of death on or after July 1,2000: • The tax rate imposed on the net val�e of transfers from a deceased child 21 years of age or younger at death fo or for the use af a naturai parent,an adoptive parent or a stepparent of the cfiiid is 0 percent[72 P.S.§9116(a)(t.2)]. • The tax rate imposed on khe net value of transfers to or far the use oF the decedenfs Iineal beneficiaries is 4.5 percent,except as noted in 72 P.S.§9118(12)[72 P.S.§9916(a)(1}j. • The tax rate imposed on ihe net value of transfers to or for the use of the decedenYs sibiings is 12 percent[72 P.S.§9116(a)(1.3)].A sibting is deftned,unde &ection 91Q2,as an individuai who has at ieast one parent in common with the decedent,whether by biood or adoption. REV-�503^u��X+!a'2; pennsylvania SCHEDULE B DFPARiMF.NTOFREVENUE STOCKS & BONDS iNNERITANCE TAX RETURN RESIDE!!�DECEDENT ESTATP 4f FlLE NUMBER GLENN L. CLINE 2 t i2 1254 A�I properly Jointly owned with right af survivorship muxt be disclosed on Schedule F. ITEPA VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 8A shares,Prudential Financial, Inc.CUSIP 74A320302 �,3423! See attached iOTAL(Also enter on Line 2,Recapitulation) S 4 342.3 I If mors space is needed,insert additionai sheets af the same size . . . _ . _ . . . . . . . . . . . REV-1513 EX�(Ob'4; pennsytvania SCHEDULE J DEPAftTMGNT QP Rf.VEMUE BENEPlCIARIES MHERI7ANCE TA%RETURN RESIDENTDECEDENT ESTATE OF: FILE NUMBER: GLENN L.CLINE 21 12 l254 REL4Ti0NSHIP TQ OECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS QF PERSON(SJ REGElYING PR4PERTY Do Not List Trustee(s) OF ESTATE � 7AXABLEDISTRIBUTIdNS pnGudeout�'qhtspousaldistributionsandtransfersunder Sec.91{6(a)(12j.j 1. Shiriey A. Cline Spoasal 4,34231 1138 Mapie Street CarGsie, PA 1�013 ENTER DOLLAR AMOUN7S POR�ISTRlBUTIONS SHbWN ABOVE ON UNES 15 THROUGH 18 OF REV-15W COVER SHEET,AS APPROPRIATE. [I. NON-TAXABLE DlSTRIBUTlONS: A,SPOUSAL DISTRlBUTlQNS UNDER SECTlON 9113 FdR WHICH AN ELECTION TO TAX IS NOT TAKEN: i. B.CHARITABLE 9,ND GOVERNMENTAL OISTRIBUTIONS: 1. TOTAI OF PART i 1 -ENTER TOTAL NON-TAXABLE QISTRIBUTfONS ON LINE 1J OF REV-1500 COVER SHEET. $ if more space is needed,use adtlitional sheets of paper of the same size.