HomeMy WebLinkAbout08-13-13 (2) i
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REV-1500�`�°��u>�Fl,�!'
PA DSp31#itt2�t Of R@i2l�U8 Pea�ngYa`�� OFFICIAL USE ONLY
eureauoflndividuatTaxes KNHERItANCfTAXRETURN ���e Year �deNw�r
�,gox�so�i �` �3 ��� _
Harhstwm,PA x7u8-o6ov RESIpBNT DECEDENT
ENTER OECEDENT INFORMATION eELOW �
Scaei Security Number Date of Deaih MM06YYYY Date of Blrth h#AODYYYY �
._. _... _ ...... . . _...._
05114/2013 08/23/1927
_ __ � -- _ . !
DecedenPs Last Name Sufflx DecedenYS FErst Name MI .
--.... ._�..._.__. ....._ _...__.. _. ,_..._. ..,___— —...`--_ ...._____ _ .,
MILLER BETTY L :
_ T _- . __. _- -- __ _ .
pf Applicable)Enter Surviving Spouse's Information Below '��.
Spousa's f.ast Name Sufflx Sp�wse s First Name MI
'. ,, , ,.. ,,'
' -. ' ' -__ __ ... _.___...._. ._..._ ...... ...__. __._...---- . ..
----_......._ ..____.—
Spouse s Social Security Number ��
- - THES RETURN MUST BE FtLED IN DUPLICATE WITH TNE
__ . _ . . ____ .. i REGISTER OF WIIL.S i
FILL IN APpROPRIA7E OVALS BELOW �'''.
Ct! t.Origi�al Retum CJ 2.SuRP�emental Relum O 3. RemalrMer Retum{Oate of pceth ��
Priortol2-t&82} �
O d.Limited Estate Ca 4a.Future Interest Compmmisa(date of p 5. Federaf Estate Tax Retum Required !
deelh after 1242-82) '�.
O 8.Decedenl Oied Testate Q 7.Dacetlant Maintained a Living Trust 0 8. ToWI Number of 5afe Deposit 9oxes '��
(Aitach Copy of Wili} {A#ach Copy of Trust} �
O 9.Litigation Proceeds Raceived Q 10.Spuusal Povarty Cradit(DaW af Death C� 11. Eiection N Tarz under Sec.9713(A} '.
Batween 12-3i-97 and 1-1-95) (AMach SchetlNa O) '�
CORRESPONQENT- TNIS SECTION MU&T 8E CQMPIETED.A!L GORRESPONDENCf AND C4NFlQENTIAI.TAl(INFORMATION SHOULD 8E DIRECTFA T0:
Nsme 4aytime Teiephaie Num6er , ��
-. ____, .._- --.. ._ __ _. .._._ ___ - -- w _ m � !
Thomas P. Gleasan (717G323270 ' -,.� �--. ;
. __ ._ -- ... -....__ .. _ - - v-
a �a oF wai�us�N ;
m � c: `'' `.. ca i
ac� y, r r--. ,i r�.i
FirstLineofAddress �" -"' �',' w >�; c7 �..
._.._.._ _ ._......._ � ....., __...._. ..... ..... �
49 West 4range Street v V? ic r� � j
,�
, . � t� -zs -�. -r�
:__... ..._-__... .....__.__ ......_, ._. .._......__ � �- 'n .
_ ..._. _._. _,. � . ; �,:
Second Line of Addrass � [�� " ' ����
........._- ........�_ ......_—_ ..._....---.. ........._ ..... � c�. .::i: <7 ,
SUite 3 ' ' •'i � � " a
i____.. _.________ __..__. ___..___, _ _._— 'LI DATE � 'st �:
City or Post ONice State ZIP Code ,
—. _ , ........,--- ..,..._..— .._.__ .___.__ ... ._.._.._ . .....
Shippensburg PA 17257 , ,
corresporntenes e•ma��aaarasa:tomgieason(a�t8m ier� asaniaw.com
Under pen9lties ot pe�jury,I declare that I heve examined Nis retum,inclutling aarompanying u;hedules antl Atatemema,end to ihe best bl my WrowbrJge an0 Delief, I
d is Vue,cprteq aM complete.Deduatla�W preperot oMer then ihe personal�epieaeMetive Is baaed nn all iMwmation W w�bh preperer hes a�ry knowledge.
NA RE OF FEl2 IBLE FQR FIIiNC�liETURN pAIE .
i
ES . . � r � t � � ',.
SIGNATURfi OF PREPAREit{?TNER iHAN R PRESEMA DATE ,
ADDRES9
PLEASE VSE ORI6/NA1 FqRM ONLY
Slde 1 '
� 15�56I,0105 15C1S6101�5 ��
��
i
J 150561fl2�5
REV-150Q EX(F7} � DecedenPs Sxiat Security Number
aeceaanes rrame: BETTY L. MILIER ' I
R£CAPfNLATtON �.
. ........ . ._._.. -- ,.
1. Resl Estate(Schedule A). ........ ... ......... . .... .. . ... ... 1. 90,500.00 , �
2 Stqcks and Bands{Sd�eduie B) ....................................... 2.�:.� � 0.44 '... ;
3. Closely Held Corporatlon,Partnership or SolaPrpprietorship(Sohedule G) ..... 3. �; � 0.00 �'�, ��,
4_ Mortge9as and Notes Receivable(Sd�edute D}........................... 4.'.. 4.4Q �.!: i
5. Cash,Bank Oeposits and Miscellaneaus Pereooal Property(Schedule E)....... 5. '��: 16,539.54 � ���
s. Joi�tty�msed Property(Schedu�a F} o ssparate�'ISm�Requextcw .....,. e. `._.__._ ...._._.___. ......__--- _4.44 ! i
7. Intar-Vfvos Transfers$Miscellaneous Non-Pro6ake Property . ' ���
(Schedule G) O Separete Billing Requested........ 7. ! 0.00 ', �
8. Total Grosf Assets{tokal lines 1 iMOUgh 7}............................. 8.� 107.G.39.54 �I, I
9. Funeral 6cpenses and Administrative Costs(Schedule H)................... 9. �'�.. 13,684.18 ', If
'E0. Clebts o#Csecetlent,Mortgage Liabiiides snd liens{Schedvle I)............... 1�.! 4,354.62 ���., i
11. Tatal Deductinns(total Lines 9 and 10)... ........... ................... 11. ; J 18,034.80 �����..." �;
12. Nst Vaiue of Estate{Llne 8 mi(ws tine 11).............................. 12.i^ _� 89,n04.74 '��,., i
i
13. CharifaCie antl Govemmetitai BequeaWSec 9113 Ttusts for which � .� I
en election Qa tax has not been made(Schedule J) ........................ 13. : 0.00 . .
14. Net Value 8ubjeG to Ta7t{Line 12 minus Line 13) ........................ 14. �:..:: 89,OQ4.74 �.���'., (
TAX CALCULA170N•SEE�NSTRUCTIpNS F8R APPUCABLE RATES !
15. Amount of Une 14 tauadle ��,
at the spousal tax rete,or �
transfersund�Sec.9118 _... ...... __.... .., ...,__ . ----- .._--..__ _....._-.. ;
{a){tz)x.o� d.�0 � �5. 4.04 '�
16. Amount of Line 14 taxable " "" �� ����. �� I
at�inea�rete X.o45 89,004J4 � �6.' 4,q05.21 ' i
17. Amount af k.ine 14 taxabb ''� ��� '
atsiblingrate X.t2 � 0.00 �; 17.�: d.d0 i
�
18. Amount of Llne 14 tauable :� � ���� � �
at collateral rate X.15 �� 0.00 ''�. �g '�,� 0.00 ',I
___.. _..... . .__ _.. .� . .
�s. Tanaue .. ....... .... ........ .. �s.;
4,d05.21 !
2d. F1lL EN TFfE OVAL IF Y6U ARE RECtUEST9NG A REFUND OF AN OVERPAYMENT Q
Side 2
� 1505610205 150561a205 �
��� —
REV-i500 DC{Ft} Page 3 Fiie Numbcr
DecedenYs Complete Address:
DECEDENT'S NAME
BET'fY L. M{�tER - --
STREETAWRESS --- -- --
105 N. SENECA STREET
cm " - — sTarE ; zia -
SHIPPENSBURG ' PA 17257
Tax Payments and C�edits:
1. Tax Due(Page 2,Line 19) (i} 4,OQ5.21
2. GedftslPayments
A.PrKK Payments �_. 0.04
B.Discauni 20026
Toql CrediGS(A+g) (2} 20q.26
3. tnterest
{3} OAO
4. If Line 2 is grealer than Line 1+�ne 3,enter the d'rfference. This is the OVERPAYMENT.
Fill in oval pn Page 2,Line 20 to request a retund. (4)
5. If line 4+L'a�3 is greater tt+�r li�2,enter ihe difietence.This is tt�e 7A7t dUE. (5} 3,80?4.85
Make check payable to: REGlSTER OF Wll.i.S,AGENT.
PLEASE ANSWER THE FOLLOVYING QUE3TION5 BY PI.AGtNG AN"X" tN THE APRROPRIATE B�OCKS
1. Did decedent make a Vansfer a�d: Yes No
a. retaln Ne use or incame of the properry transferred.......................................................................................... ❑ �
6. reta�the rigM�designate wfm shaH use ttce praperty transterzed w ib irxvme............................................ ❑ (�
c. retain a 2versionary interest...........................................,.,,.............................................................................. ❑ �
d. receive the promise tor life of either payments�benef�ts or care?.......................:.............................................. ❑ �
2. i(deaih occarred after Dec.12,1982,�d decadent tran�fer propwtY within one year of death
vriitwut receiving adequate consideration?.........................................._.................................................................. 0 �
3. Did decedent own an'in Wst far"or payable-upon-dealh bank account or security at his w her death?............_ 0 �
4. Did decedent own an individual retlremenl account,annuity or other non-pro6ate property,which
t�nt2ins 8 beneficiary�gnation? ..................................................._......................._.»».............._......_............. � �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE�pND FILE IT AS PART OF 7HE RETURN,
Eor dates of deatl�an ar after Juty 1,1994,amf 6efore Jan.5,1995,the tax rate impased on the net vaiue of transfeis to or for ttfe use of#he surrivi�spaxse
is a�ercenc pz p.s.§s»s(a���.�>(ip.
Far dates o(death on a after Jan. 1, 1995, the tax raie impased on the net vakie of Kansfers ta ar(or the use ot the surviving spo�se is 0 percent
(72 P.S.§9118{a}{1.1){ii)].The statute does nar exempt a hansfer to a surviving spausa from tax,and�e sfatutory requirements[or fisdosure af assets ar�
filing a tax retum are slill applicable even if the surviving spouse is the oniy beneficiary.
Par dates of death on or aker July 1,2000:
. The ta�c rete impcued on the net value of transfers fram e deceased chi�21 years of age ar yaurger af death tv or for the use ai a naturai parenk,an
adoptive parent or a stepparent of ffie chi�d is 0 percent[72 P.S.§9N6(a}(},2}j.
• The tau rate imposed on Yhe net value of hansfers to or for the use of lhe decedenfs lineal beneficiarfes is 4.5 perceM,except es rated in[72 P,S.§9118(a)(1)].
+ The faY rate imp�sed on the net va{ue ot trarisfers to w for tlfe use ot the decedenPs siblirx�s is 12 percent{72 P.S.§911$(a}(1.3)].A sib4ng is defined,
wder Section 9102,as an individual who has at least one pareni in mmman wiih ths decedent,wheiher by biqod or adoptian.
R�v-isaz�x+{tz-iza
�pennsytvania $CHEDULE A
DECARTMENTOFREVENOE REAL ESTATE
INMERRAPKE TAX RERIRN
kE^aIDENfDECE�ENT
ESTATE OP� FILE NUMBER:
6ETTY L. MILLER
AIt real property owned aolety or as a tanant in commai must be reparted at fair markR�value.Fair market valag is defined as the price at which prope�ty
wouid be exchanged between a wiiling buyer and a wliling selkr,rreither 6eirg rnmpeiled to buy or seil,hoth having reasonabie knowledge of the reievant Eacts.
Real proparly that ia iointlyownal with dght af nurvfvorshlp mus!be disclosed on Schedule F.
Attach a copy of ihe settlement sheet if the property has been sold.
�M Inc4ude a capy af the sked shawiny decedaM's interest i#owned as tenaM kn cortrrmn. VAIUE AT DA7E
NUMBER DESCRIFRdN OF pEATH
;. Real Estate bcated ai 545 N.Sens�St„Shippensburg(Parce{I0.34-33-1867-012) 90,500.4Q ,
Assessed value is$90,500.00 x 1.0(Cumbedand County Comman Level RaCia)_$90,500.00
TOTAL(Also enter on Line i, Recapitulation.) �.' �4,500A6
If more space is needed,use additional sheets pF paper of the same size.
pEV-iSOH EX+{p8-i2j
�pennsylvania '��H�d1�ILE E
DEPAHTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
w�T^�T^x�� PERSONA� PRdPERTY
r�sroervr�
BSTATE OF: PILE NUMBER:
BETTY L. MILLER
Indude the Draeeds af Iiti9atWn and the dake[he pr�ceeds were received bY the estate.
AA property joiMly owned wkh right of survivorshtp must be diulosed on Scheduk F.
�M VALUE AT DATE
NUMBER DESCRIP'TION OF DEAiH
_ 1. 4rrsfatim Bank Gheckmg Acct.#886198 7,796.88 =
Z, Orrstown Bank Savings Acct.#960278 � 400.31
3, Ottstown Bank(RA Acct,#6030W427 6,663.4A
q PropeAy 7a�c Rebate 504.31
_ 5. Cash and change found in home 175.00
,. .,.. _ . _.
g, Miscellaneous househnld items 1,OOO.pO
TpTAt(Aiso enter on Une 5, RetapituVatian} $ 18,539.54 '
�,� ,.
!f more space is neederl,use additbnal sheeks of paper of the same size.
REV-1511 EX+{10-09)
�pennsylvania SCHEDUL� H
DEPRPTMENT 4F0.EVENUE FUNERAI EXPENSES AND
Uu+EU*an�r,ixa�uus ADMINiSTRAT2YE COSTS
RESIDEM OECEUE(iT
ESTATE OF fICE NOM9ER
BE7TY L. MILLER
6ecede»t`s d�ts must#e reported an Schedule I.
ITEM
NUMBER DESCRIPT]pN AMOUNT
n. FUNERAI EXPENSES:
z. FogeVSanger Bricker Funeral Home ,: 9,8'17A0'
,, _
Z. Spnng Hill Cemetary Associa6on 1,225.00 ;
s. Firsi Wesiey�Ghurch for memari�luncheon 496.78
B. ADMINIS7RATNE COST5: _
i. Personal Representative Commissioost � � � � �
Name(s)of Personal ReOresenWBve(s) � �� � ��� � �
SkreekAddress. _ ,
City - - . --SWte�.,_Z]P^
Year{s}Cammissi�Paid:__. __ _._
, 1,SOq.00 ;
2. AttomeY Fees: _->_.
3. Family Exemption:([f detedenYs address is not tha same as claimant's,attacfi e�tplanatioo.} . .._ ._
Gzimant ____� __ __
SG�eet Address.,_
CitY ____ _ �State__ZIP F.___
Relatlar�ip of Gsimant ta 6ecedertt---- ---- ---
_ .._. .... . .._... .
4. Probate Fees: 373.50 :
5. �ccau�tantfees: ..•rv, ; .�..O.QQ�.:
6. Tax Retum Greparer Fees: � �� 0.00���w
_... ......__ . ._..._.. :� ,. ....
7. Estate Publication in Cumberland l.aw 3oumal „ 75.00;
a. Estate Publicatioo in Shippensburg News Chronicle „ , 96.50 ''
s. Preparatron af Deed for 105 N.Seneca St.real estate 100.00
SQTAL(Alsb enter on tine 9,Retapitulakion} $' 13,684.1$ '
If more space is needed,use addidonal sheets of paper oF the same size.
Rev-isiz ex+�iz-iza
�pennsytvania SCHEDULE I
pEPARlMENTOFPEVENUE DEBTS OF DECEDEN7,
���^�T^x�p" MQRTGAGE LIABILITIES 8c LIENS
a�s�r occeoEHr
ESTATE OP FILE NUMBER
BETTY L. MILLER
Report debts(ncumd by tice darsde�t prior to d�tl+that rema[ned anpald at tl�e date of dtath,i�ladtng unreimbursed maCkal apensts.
REM VALUE AT DATE
NUMBER DESCRIPTION �F DEATH
1 Faibng 5prim3 Nursing&Rehabilitatia�Genter 2,588.54
2. Property Ta�ces paid to Shippensburg Borough for 105 N.Seneca SUeet real estate 771.02
3. Genhal Penn Gas for gas bii{s paki between date of death and transfer a#105 N.Sene.ca pro�rty 498.00
a. Penelec for electric bflls paid between date of death and transfer of 105 N.Seneca St,property 34.33
b. Borough oi Shippensburg fa w�ertsewerltrash bills 6etween date af deaih and transEer of property 131,75
6. Century Link for final t�lephone bill 22.98
7. Gham6ersburg Haspital 212.50
8. Grane Supply for prescriptions while at Falling Spring Nursing&Rehabuitation Center 93.54
TOTAC(Aiso enter on Line 10,Rappitulation} � ` � 4,350�.82 '�-
,.,:,_ ...._,...�.,.,..
If mare space is needed,Insert additlonal shee6 of the same size.
REV-1513 EX+(OS-46}
�pennsytvania SCHEDU�E 3
nv�urArrc�rax R�ruwu BEMfFICIARiES
RESIDEM DECE�EM
ESTATE OF: fILE NUMSER:
BETTY L. MILIER
RELATiONSHIP TO pKEDENT AMOUNT OR SNARE
NllM6ER NAM£AND ADORESS OF PERSON{5)RECENING PR4PERTY Do NoR Llsk Truatea(sj OF ESTA7E
I TAlCAB4E DISfRIBUI'[ONS[lndude ou[right spousal distributions and kransfers under
Sec.9ll6{a){i1j.]
i. Be�H.Miller,5 W.6urd St.,Shippensburg,PA 17257. lineal(son) . . 20% _
2. Sfeven M.Miller,7�22 E.Spring Otive,Canton,MI A8187 lineal(son) 20%0
3. Kimbedy C.Graenawaft,6 Cbver Niil Road,Newburg,PA 17240 iineat(daughter) 20%
4. Wanda B.Brown,4i4 Freedom Drive,3hippensburg,PA 17257 lineai(daughter) 2a°k ,
5. Alvah J.Miller,5 W.Burd St.,Shippensburg,PA 17257 iineai(son} 20°l0
_ _ . __ .. _ .. . _
ENTER DOLtAR AMpUNTS F4R DI57RIBt,iTt�NS SNOWN AHOVE ON IINfS 15 THROU6H f8 OF REV-1500 COVEk SNfET,A5 APPRQPRIATE.
=I NON-TtaYh$tE DISiRI84tRON5
A. SPOUSAL DI5IRIBUTIONS UNOER SECfION 9113 FOR WHICN AN ELECifON TO TAX IS NOTTAKEN:
_._... . . . . . . . .. __.. . .. . . . . ... .. . . . .._... ..._. ,.,:,,..,.,. ..
1.
.... . B. �CHARIIABLE AND G04E0.NMENTAL pISTRI0UT10N5: ..... .. . ... . . . . _... .. ....:. __ . ..
1. .,_.. ........ ..._.. ..... . . ... . . . ._ ___, _._... ,..:, ,_..., �::..,-. ..,
TOFAL OF PART II-EMER TOSAL NONdAXABLE pSSTRiBUII4NS ON ISHE 13 OF REV-2500 COVER SHEET � �. � �
if mqre spate is�eeded,Use addi[ional Sheets of paper of the same size. � �� �