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Home My WebLink About07-16-13 � 150561�1�5 R�1/�t C��fXCo'z-aa)(fi)� r �'�� OFFICGIL USE ONLY PA Department of Revenue Pe��Y�Y��a Coun Code Year File Number Bureau of Individua4Taxes ry PO 60X 28060i � AX RETURM - �- � � �- � � � INHERITANCE 7 Harrisburg PA 37i�8-o601 RESIDENT DECEDENT �� -- �� - ��'� ENTER DECEDEMT INFORMA710N BELOW � Sociel Securiry Number pate of Death MMODYYYY Data of Birth MMDDVYYY . . . . . . _. . .. . . __.._ _._ . .. . .. .. . 06t25/2013 d6l067i930 . _ .._ - - _ _ _ DecadenPs tast Name � Suffix DecedenYs First Name M7 ... ... . . . _ . . ... . ... .. _ . . _ _. _ . ,_. ...__ ___ .._._ . _ . . . . .... ._.... Vanderslice � Peggy Jo , _ . _ __. ___ . , _ __ _ __ __ (If Applicable)Enter Surviving 5pouse's Infarmation 8elow Spouse's last Name Suffix Spouse's First Name MI . . .._. . _._ ... . . . ..._ . . Spouse's Socia!Secunty Number �� THIS RETURN MUST BE FILED iN DUPLiCATE WITH THE REGISTER OF WI�LS FILL IN APPROPRIATE OVALS BELOW � 7.Originai Retum O 2.Suppiemsntal Return p 3, Remainder Reium(date of peath Prior to 12-i3-82) p 4. limitetl Estate p 4a.Future Interest Gompromise(date of p 5, Federal Eatate Tax Retum Required death after 12-12-82) p 6.Decetlent Died Tesiate Q 7. Decedent Mainteined a Liv(ng Trust _ 9, Totel Number of 5afe Deposit Boxes (Attach Copy of Wilp (Attach Copy o(Trust.) O 9. Litigatidn Proceeds Received O 10. Spousal Poverty Credit(Date o(peath CI 11. Election to Tax untler Sea 8173(A) Between 12-31-87 and 3-t-95) (Aitacfi Schedule O} CORRESPpNDENT- THIS SECTION MUST BE COMPLE7ED.ALL CORRESPONDENCE AND CONFIpENTIAL TAX INFORMATIQN SHOULD BE DIRECTED Tq: Name _ daytime Teiephone Number . . . . ._. .. . ... . .. . . __ .. __ ..__ .. Patricia J. Rzepela {71 439 726Cf-:= � � . _ _ � a- ,�.,, m-_ . � uRE�STER 0 1131'�$E�NIY (ry^� _L' C� ;` "} .`7 .%C? ?y, (— �y '� � First line af Atldress � � � � ?; c� 545 Brandt Ave. _ _ . _. __ _ __, � v? �� c� : c� C, � --5 -s�r - _. . . . _. _.. _ . . ._._. ._. . .___... .._.. h Q � � .;; "�i Secpnd Line of Address � � � -- . . . . ._ ... . . ._. ._ _.. �--• --- t"� , . _ �' c_ .— r`-� � —t i— � _ .._. ... .. _.__. _: :r d FI4ED � Ciry or Post Offipe � �� State ZIP Code � . .. . ... . _ .. .._ .._ . __. . _ ___. . ._.... ... ..... i New Cumber(and � ', PA ' i 17p70 CorrespondenPs e-mai!address;caflSnyder@Snyderfin&nCi&I.com llnder penaltl of perjury,I declare that I have examined ihig retum,including accorimpanying sChedules and statemenGS,a�d to the beat of my knowledge and beliet, it is trus, and compiete_OeUaration of preparer other than ihe persorcat representative is basetl orr ait informadon of wh'rch prepacer has any krrow�etlge. SIGNA PERSON RESPO IBL OR FILING RETURN DATE �7/�rJ12�13 DRESS 545 Brandt Ave. N umbe n , PA. 1707d SIGNATU PREPAR THERTHANREPRESENTATIVE DATE 07/15/2013 ADDRES 261 York Rd. New Cumberland, PA. 17070 PLEASE IlSE ORIGINA��pRM ONLY Side 1 � y545610105 1505610105 J ��'✓ . J 1505610205 REV-1500 EX(FI) Decedent's Social Security Number oa��ne�rs Name: Peggy Jo Vanderslice RECAPITULATION 1. Real Estate(ScheduleA). . . .. . .. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . 1. �. __._ . _ . ... .. . ... .. �__-_ . ____._..__. ._._. . __._..._.... 2. Stocks and Bonds(Schedule B) . . . . . . , . , 2 . . . . .. . . . . .. . .. . . . �---------�-._._----.._.--- __ _ 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . .. . . 3. '� �---------..___- ._...----------..._. 4. Mortgages and No[es Receivable(Schedule D) .. . .. . .. . .. . . . . . . . . . . . . .. . . 4. ; 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). .. . .. . 5 ,�� --� 17,191.00 --------____.__. _-- --____ 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . .. . .. . 6. �� 7. Inter-Vivos Trensfers&Miscellaneous Non-Probate Property �-��-- --- �--�- --�---- (Schedule G) O Separate Billing Requested.. ... . . . 7. ��.. . .. . .. . .. . .. . 8. '�., ..------....--____- ..____..__.....__ 8. Total Gross Assets(total Lines 1 through 7).. . . . . . . . .. . .. . . 17,191.00 � 9. Funeral Expenses and Administrative Costs(Schedule H). . .. . ... . . . .. . . . .. . g. �li 4,650.00 �. '----------- 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . .. . .. . .. . . . .. 10. � � ��----------------------- 71. Total Deductions(total Lines 9 and 10). . . . . .. . . .. . .. . . . .. . . . . .. . . . . .. .. 1L �� 4,s$0.00 ( ) . . . .. . . . . . . . . . . . . . .. . .. . . . .. . . 12. �, --_.________._-__ 12. Net Value of Estate Line 8 minus Line 11 12,541.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which !-`- '-��-`��--�-� -- -- .___..-_.._ an election to tax has not been made(Schedule J) . .. . .. . .. . . . .. . .. . .. . .. . 13. �� 74. Net Value SubJeet to Tax(Line 12 minus Line 13) . .. . .. . . . . . . . . . . . . . .. . . . 14. '�. -------- -- 12,541.00 TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount ot Line 14 taxable at the spousal tax rete,or transfersunderSec. 9116 �. �� -� �� -- - - - - . -- -._ .. .. . (a)(72)X A- '�. 15. ��,. . .. . .. 16. Amount oi Line 14 taxable '-� ��---�--"�-----------��---�� _.___---__ at�inea� rate x.0 45 12,541.00 ' �g. , 564.34 17. Amount of Line 14 taxable ...-.-.-.._._. _..-_._-.-- ___._ �.. ...�_-_-.-_-. __._.... . -------_: at sibling rate X.12 � '�.. �� '.. 18. Amount of Line 14 tazable ��-� ��--��-��--- "-�-�--"��- � � ..._. 18. -------- _.__._ _.__._: at collateral rete X .15 . . �� -`.-_..___,___._._..__....._______..__.______.__.; �s. rnx oue . . . . . . . . . . . . . . . .. . . . .. . . . . . . .. . .. . .. . . . . . . .. . . . . .. . .. .. . . is. 564.34 _ _ ._ . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 L 1505610205 1505610205 J REV-1596 EX{FI} Page 3 Fiie Number Decedent's Complete Address: �ECEpENT'S NAME Peggy Jo Vandersiice STREETADDRESS ...—._— .._-------_ ----_.—_—....—------_—... .. 545 Brandt Ave. __ _ _. . _ _ — _—_-------------- --- —- — -- ---- _. ClTY TSTATE ...-- i ZIP New Cumberiand PA 17Q70 Tax Rayments and Credits: 1. Tax Due(Page 2,Line 19) (1� 564.34 2. CreditstPayments A.Prior Payments . . .. . _.. . , B.Diswunt 2$.21 _ __ _ _. Totai Cred'ats(A+B} (2) 2$.23 3. �n#erest — (3) 4. If Line 2 is greaier than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. " — Fill in oval on paga 3,tine 24 to request a refund. (4} 6. tf l.ine 1 +Line 3 is grea#er than Cine 2,enter the difterence.This is the TAX 6Uf. {5) 53$.13 Make check payable to: REGISTER OF WILLS,AGENT. PI.EASE ANSWER THE FOLLOWING QUESTIONS BY PI.ACING AN "X" fN THE APPROPRtATE BLpCKS t. Did decedenF inake a transfer and: Yes Np a. retain the use or income of the property tranSferred .......................................................................................... ❑ � b. reta+n the right io designate who shall use the property trans(erred or its inc�me ............................................ ❑ � c. retain a reversionary interest......................................................................._..................................................... ❑ � d. receive the promise for life oF either peyments,benefts or care9...................................................................... ❑ � 2. tt death occ�rzed after Oe¢. 12,1982,did decedent transfer praperty within orre year of death � withaut reoeiving adequate cansideration?......................................................................................................_...... ❑ � 3. Did decedent own an"in trust for"or payable-upon-death bank accouni or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or ot�er non-probate ptopeRy,which contains a benefciary dasignation? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABpVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Qf THE RETURN. For dates of death on or after July t, 1994,and before Jan. t,1495,ths tae rate imposed on Ne net value of transfers to or far the use of the surriving spouse is 3 pernent(72 P.S,§9118(a) (1.1)(i)]. For dates of death on or affer Jan. 1, 1995, the tax rate impossd on the net value of transfers to or for the use of the surviving spouse is 0 percent (72 P.S.§911$(a)(1.1)(ii)�.The statute does not exempt a transfer to a surv+ving spouse from tax,and the sWtutary requirements for disclosure of asseGs and filing a#ax return are stili applicable even if the surviving spouse is ihe only beneficiary. for dates of dsath on or after July t,240�: . The tax rate imposed on the net value of transfers from a deoeased child 21 years of age pr younger at death to or far the use of a naferal parenf, a� adop6ve parent or a stepparent oi ihe child ia 0 percant[72 F.S.§9T18(aj(1.2jj. • The tax rate imposed on the net value of transfers to ar far the use of the decedenYs linea!be+refiaaries is 4.5 percent,except as nated in[72 P.S.§9116(a)(1}). � The ta�c rate imposed on the net value of trans#ers to or for the use of the decedenYs siblings is 32 percent(72 P.S.§9116{a}{1.3}j.A sibling is defined, under Seption 9102, as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-i5o8 EX+(o8az) � pennsylvania SCNEDULE E 6i7 DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. wHentrnNCeTnxaEruan PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Peggy Jo Vanderslice 2013-00744 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. New Cumberland FCU 14,924.50 2, Sovereign Bank, Checking 718.50 3, Sovereign Bank, Savings 1,548.00 TOTAL (Also enter on Line 5, Recapitulation) j 17,191.00 If more space is needed, use additional sheets of paper of the same size. _ REV-1511 EX+ (10-09) � pennsylvania SCHEDULE H DEPAFTMENTOFPEVENI/E FUNERAL EXPENSES AND �NMeannNCer,ixaeruaN ADMINISTRATIVE COSTS kESIDENT DECEDENT ESTATE OP FILE NUMBER Peggy Jo Vandetslice 2013-00744 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIDTION AMOUNT a. FUNERAL EXPENSES: 1' Stone&Murry Funeral Home 3,675.00 e. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) � � Street Address .._. ____._. . . . ___ _._ _. .. _._..____.____.. _._.__ . City .. . .._._ _._._ ._ . .._ ____. State _. .. ... ZIP ___. ._.. Year(s)Commission Paid: 2• Attomey Fees: 3. Family Exemption: ([f decetlent's address is not the same as claimant's,attach explanation.) Claiman[ Street Address City__________. ..___.-- — _ _ ____.__State _ZIP_ ___.._._.. Relationship of Ctaimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Retum Preparer Fees: 375.00 � Ambulance 600.00 TOTAL(Also enter on Line 9, Recapitulation) ; 4,650.00 If more space is needed,use additional sheets of paper of the same size. _ _� REV-1513 E%+ (Old�) � pennsylvania SCHEDULE ) INHERRANCE TAJ(RETU0.N BENEFICIARIES 0.ESIDENT DECEDENT ESTATE OF: FILE NUMBER: Peggy Jo Vanderslice 2013-00744 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBEA NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTA7E I TAXABLE D6TRIBUTIONS[Include outrighf spousal distribu[ions and transfers under Sec. 9116(a) (1.2j.] I. Patricia J. Rzepela Daughter 313525 2. Karla K. Gleim Daughter 313525 3. Ethel A. Davis Daughter 3135.25 4. Samuel D. Vanderslice Grandson 1045.09 5. Joseph W.Vanderslice Grandson 1045.08 6. Leah Kelly Granddaughter 1045.08 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPR[ATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL D[STRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABIE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ¢ [f more space is needed,use additional sheets of paper of the same size.