HomeMy WebLinkAbout08-15-13 (2) �.---� REV-'�J'����"°'�70' �"��5610143
� PA Department pf Revenue penns�ivania OFFICIA�USE ONIY
euroau of Individual Taxes oer�xiucnrorne.2xue
CouMy oUS Veer iNNUmber
PO 84X.280801 INHERITANCE 7AX RETURN 21 13 0 4 3 2 9
Harriaburg,PA 17128-0801 REStDENT DEGEQEN7
ENTER DECEDENT INF6RMATI6N BEIOW �
Social SecuAry Number Date of Deffih Date of Birtb
03 16 2013 11 30 1929
dacedenYs last Name Suffix DecedenPs Firet Name � MI -
LONG HENRY L
{if Appilcabk)Enter SurvMefg Spouse'8 Infartnatian Beiow
Spouse's Last Name Suffuc Spouse's First Name MI
LONG BETTY 4
Spouse's Sociai Security Num6er
THIS RETURN MUST BE FILED IN dUPLICATE WITH 7HE
REGISTER OF WILLS
FiI1 IN APAR6PWA7E OVAl..S BEIOW
� 1. Odginal Relum ❑ 2. SupplemeMal Relum � 9,Remairitler Retum(tlate ot deaih
pnorto 72�13-82)
� 4. UmNed EstatO � Aa.F��+'b IM��P�'u^ue � 5, fatlerei Esta4E Tvc Retum Ra�'v6d
{aaroae..u,��rax-�z$zt .
� g, DecMsnt oied Tasteie � 7 Aecad�sm M.�ma�ned e�mng'rmat __ 8. Tota1 Number oi Sale Deppsit Boxes
(AItaG�CoPY b�II) ( nacn copy arru.q
� 8. LlUgat�ProCeeds Re�Ved � 14.�en t2-3�3�a�tat�af deaUr � 11.Eiadion to tac unGer S�.9113(A}
(Atfech SCh.O}
CORRESPpNDENT-THIS SECTION MUST BE COMPLETED.ALL CORREBPONDENCE AND CONFIGENTIAL 7pX INFORMATION SHOULD BE DIRECTED TO:
Name Dayt#ma Teisphpne Number
ROBERT 8 KLSNE T17 770 2540
REL,G�lSTER OF V�S USE�ILY
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� Firot line af address � Q � �
G� '� � „7 �
714 SRIDGB STREET r^ z 4"' c' ":�, �
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rZ �i cn ;�: o
Secondiinaoiaddress �'^ Vi :'•:�
PO SOX 4 61 � � �� � �r �
r� ca DATEf�EO ��>. -n
CHy ar P�t frt'fi� State Z!P Code y � N �..° rn
NLW CUMBERLAND PA 17070 � � �y �
F—+
Correspondsnt'a e-mall�address:
�nadVer�pene��d�peq�ury,I dedare thet i have exemined this retum,indumn�accompanying acheawea a�d sietements,ana a tM beat ot my knowledge and beliei,
plate.DedereUCn ot preparur WMr tMn the pereona repreaentetiva Is Caned on al�IMOrmatlon of whkh prepqror has eny krrowledga.
R F FB.Yi� DAT � �
� l�,��,,,,_ �"� Rebeaca Jean Goetz 0� �j + "j
' AODRESS
1838 Sapling Caurt,Mecharslcsburg,PA 17065
NA RE PM R07HERTMANFlEPRESENTA7IVE DATE
� Robert P Kline t�! �, �,0l3
nfloness
714 Bridge Street, New Gumberiand,PA 17p70
^slde 1
� 9505610143 1605610143 �
I
I
J 1505610243
REV-1500 EX
DecedenYs Soeial Security Number
n.�wan.N�a: LONG, HENRY LEWIS
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Coryoration,Partnership or Sole-Proprietorship(Schedule C).......... 3. �
4. Mortgages 8 Notes Receivable(Schedule D).......................................................... 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 6 , 1 2 7 . 0 7
8. Jointly Owned Property(Schedule F) p Separate Billing Requested............. 6. 1 8 , 8 9 4 . 5 6
7. inter-Vivos Trensfers&Miscellaneous Non-Probate Pro(�erty
(SChedule G) ❑ Separete Billing Requeated............. �, 8 , 7 9 5 . 31
8. Tofat Gross AssMs(total Lines 1•7)....................................................................... 8. 3 3 , 816 . 9 4
9. Funeral Expenses 8 Administrative Costs(Schedule H)......................................... 9. B , 5 4 8 . 3 0
10. Debts of Decedent,Mortgage Liabilkies,&Liens(Schedule I)................................ 10. 2 g � 9�4 . B 5
11. Total Deductions(totel Lines 9&10).......................................................�...............11. 3 7 , 5 2 3 . 1 5
12. Net Valus oi Estate(Line 8 minus Line 11).............................................................72. -3 , 7 0 6 . 2 1
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an eledion to tax has not been made(Schedule J)................................................. 73.
14. Net Value Sub)ect to Tax(Line 12 minus Line 13)................................................. 14. -3 , 7 0 6 . 2 1
TAX COMPUTATION•SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rete,or
transfers under Sec.9176
�a���.z�x.00 -3 , 7 0 6 . 21 �5 0 . 0 0
16. Amount of Line 14 taxable
at lineal rete X .045 �6�
17. Amount of Line 14 taxable �
at sibling rate X ,�p »�
18. Amount of Line 14 taxable
at coltateral rete X .15 �8�
19. Tax Due...................................................................................................................J.9 O . O O
20. FILL IN THE OVAL IF YOU ARE REGUESTIN6 A REFUND OF AN OVERPAYMENT. ❑
Side 2
L 1505610243 1505610243 J
REV-1500 EX Paga 3 F��e Number 21 - 13 - 00329
, DecedenYs Compiete Address:
Long, Henry Lewis _ _ __
STREETAD�RESS
700 Walnut Bottom Road _
��7y STATE ZIP
Cariisle PA 17070
Tax Payments and Credits:
t. Tau Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A� Prior Payments
B. Discount
Totel Cred'RS(A +B) (2) 0.00
3. Interest (3) 0.00
4. if Line 2 is greatet than Lina 1 +Line 3,enter the diTference. This ia the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund ---
5. If Line 1 r Line 3 is greater than Line 2,enter the diflerence. This is the TAX DUE. (5) �•�0
Make Check Payable to: REGISTER OF WILLS, AGENT.
��(i;
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS
1. Did decedant make a transfer and: Yes No
a. retain the use or income of the property tranafarced�.................................................................................[,I ❑x
b. retain the ripht to designate who shall use the property trensfened or its income:....................................[� �x
c. retain e revenionary interest;or...............................................................................................................� ❑X
d. receive the promise for life of either payrtrents,benefits or care?.............................................................[f Ox
2. If death occurred efter December 12, 1982,did decedent trensfer property within one year of death without
receiving adequate considaration7.....................................................................................................................� ❑z
3. Did decedent own an"in truat for or payable upon death bank account or security at his or her death?......... � �x
4. Did deeedent own an Individual Retirement Account,annuity,or other non-probate praperty which
contains a beneficiary designation?...................................................................................................................1� ❑
IF THE ANSWER TO ANY OF THE ABOVE�UESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR
. . d � u� � . . . �� i�i.F�zB..�,'- E Etd �����-
For dates of death on or aRer JuN 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of trensfers to or for the use of the surviving
apouse is 3 percent p2 P.S.§9116(a)(1.7)(i)j.
For dates of death on or after January 1, 1995,the tax rate imposed on the net velue oT transfera to or for the use of the surviving spouse is 0 percent
[72 P.S.§9118(a)(1.1)(ii)]. TM statute doea not exempt a transfer to a survNing spouse from tax,and the stetutory requirementa for disclosure of
assets and flling a tax refum aro still applicabie even H the surviving spouse is the only beneficiary.
For detes of death on or after July 7,2000:
•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 t2nsfers to or for the use of the decedenYS lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9716 1.2)[72 P.S.§91 i6(a)(1)1.
•The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings fs 12 percent[72 P.S.§9116(a)(1.3). A
sibling is defined under Section 9102,as an individual who has et least one parent in eommon with the decedent,whether by blo or adoption.
, � � SCHEDULE E
CASH, BANK DEPOSITS, 8� MISC.
���*�����"w PERSONAL PROPERTY
INHFAITIJME TFX RETURN
RE910ENT OECEOEIIT
PILE NUMBER
ESTATE OF Long, Henry Lewis 21 - 13-00329
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointlyowned with the right of
survivorohlp must be discloaed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
------ --
1 Fulton Bank#3632-35289 6,127.07
TOTAL(Also anter on Line 5, Recapftulatlon) 6,127.07
� SCHEDULE F
COMMONKEQTIIOFPENNSVLVANIA �OINTLY-OWNED PROPERTY '
INNERITANCE TN(RETURN �
RESIDEM DECEOENT
ESTATE OF Long, Henry Lewis FILE NUMBER
21 - 13-00329
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
Betty O. Long 3525 Canby Street, Apt 239 Wite
q Harrisburg, PA 17109
JOINTLY OWNED PROPERTY:
ITEM LElTER DATE InGude name o nanaal ins u on an ben account num rDATE OF DEATH °�OF DATE OF DEATH
NUMBER FOR JOINT MADE or similar identifying number.Attach deed far jointly-he�d real VALUE OF ASSET DECD'S VALUE OF
TENANT JOINT estate. INTERES DECEDENPSINTEREST
1 A 07/06/2001 Fulton Bank#3620-91163 �i,9�e.s2 ' 50% 5,987.81
2 A 10/28/2002 Fulton Bank#0691-75780 300.00 50% 150.00
3 A 08/20/2009 Fulton Bank#1371-88585 25,513.49 50% 12,756.75
i �
,
'i
I
-_-;
TOTAL(Also enter on line 6, Recapitulstlon) 18,894.56
� oo�oN��NNSYLVANIA SCHEDULE G
INHERITANCETAXRE�URN INTER-VIVOS TRANSFERS 8
RESIDENTDECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Long, Henry Lewis FILE NUMBER
21 - 13-00329
This schedule must be completed and filed if the answer to any of quesUons 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERiY DATE OF DEATH %OF E%CLUSION
NUMBER InclutlatMnameotMrotnnsfe�ee,tM'rreletbnehiploEeceEenl yq�UEOFASSET DECD'S (�FAPPLICABLE) I TAXABLEVAWE
enE Ne Eale o1 Venslx. Allech e wpy of the tleetl fw reel eelnle. INTEREST
1 ; First Commonwealth Bank IRA#XXX-XX-7721 8��95 3� 100% ' 8,795.31
I '
i
i
I �i
� I
�i
,
I
i
I
TOTAL(Also entar on Ilne 7, Recapitulafion) I 8,795.31
, � � SCF�E H
caan�oxv.fq�rnoFreuwanv,win �'�&
IMfERR�NCE TNI HE1UpN Ary�M9�♦T1/C/'y��i
REBIOEM OFCEOENT /tiA�bl l f W 111IG V\d�71�7
ESTATE OF LOng, Henry LewiS FILE NUMBER
--- 21 - 13-00329
Debta of decedent muat be reported on Schedule I.
ITEM —
NUMBER FUNERALEXPENSES: DESCRIPTION —� AMOUNT
A. 1 Parthemore Funeral Home 8 Cremation Services, Inc. 3,432.97
2 Wildwood Cemetary Company 675.00
3 JaneYs Floral Creation 273.43
4 Mystic Garden , 170.66
5 Lycoming Campus Dining 566.24
B. ADMINISTRATIVE COSTS:
1. Personal Repreaentative's Commissiona
Nama of Personal Representative(s) .
Street Address
i
� City State Zip
Year(s)Commission paid
z. nnorney�s Pees Kline Law Office ' 1,500.00
3. Famity Exemption: (If decedenPs eddress is not the same as claimant's,attach explanation)
C�aimant
Street Address
City State Zip �
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 148.50
5. Accountanes Fees Harshberger 8 Company 140.00
6. Tax Ratum Preparer's Fees
7. Other Administrative Costs
1 Graham Medical Clinic 131.50
TOTAL(Also enter on Ilne 9, Recapitulafion) 8,548.30
. SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
°°�,�,,;,�E�,��;^��^ LIABILITIES, & LIENS
RESIOEM OECEDEM
FILE NUMBER
ESTATE OF Long, Henry Lewis 21 - 13-00329
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 PA Department of Public Welfare-TPL Recovery-Class 3 claim 20,520.57
2 PA Department of Public Welfare-TPL Recovery-Class 5.1 claim 8,454.28
TOTAI(Also enter on Line 10, Recapitulatlon) 28,974.85
REV-067JE7(.fli-0!) �
SCHEDULEJ
COMMOENRwTA�E�AXRNETURN�� BENEFICIARIES
RESIDENTDECEDENT
ESTATE OF Long, Henry Lewis FILE NUMBER
21 - 13-00329
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
—NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (WOrds) i ($$$)
RECEIVING PROPERTY oo Na ua�rwaNq ,
I, TAXABLE DISTRIBUTIONS[indude outnght spousal �
distributions and transfers
under Sec.�116(a)(12)]
1 Betty O. Long Wife Entire Estate
3525 Canby Street, Apt 239
Harrisburg, PA 17109 �
i
i
�
Enter doilar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS: �
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN �
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T 0.00
O�
HENRY L. LONG
�..:
I, HENRY L. LdNG, of the TownShip of Riah�3�1, Cai�r.�m
W � � c' �
County, Pennsy2vania, beinq af sound mind, memoz� mac�x =' � �
r— z r j � i-n r�
understanding, do hereby make, publish and decla.�e��.s `�o �'e�y
� c� � � '*i ',�
Last Will and Testament, hereby ravoking and mak�� ii�IYand: y�ie3
-:i rv r= rri
all formes Wills and Testamentary Writings by me�,�at anyrbime� o
U� �
heretofore made.
FIRST: T direct my personal representati.ve, hereinafter
named, to pay all my just debts, funeral e�spenses, inheritance
taxes and costs of administratian as soan as possib2e after my
demise out of my residuarp estate.
SECdND: AI1 the rest, residue and remaindar af my estate,
I bequeath and flevise to my wi£e, BETTY O. LQNG.
TSIRD: In the event my said wife , BETTY' 0. LONG,
gredeceases me, = begueath and devise said resfdue af my estate,
as follows :
a} 2 devise the cherry Library table to my
daughter, JQANNE FENSTERMACHER.
b) S devise my shaving mug cabinet to my
daughter, CYtdTHIA BROWN.
c) 2 devise the candlestick brass to my dauqhter,
ELIZABETH C. LONG.
d} I devise the oak boakcase to my daughter,
REBECCA J. LONG.
PA6E ONE OF A THREE PAGE WZLL.
. ..
. ,
e) I devise the old-fashioned gitcher and bowl to
my daughter, JENNIFER S. LONG.
f) I devise to each of my children any giits
whictt they had given to me and/or my said wife, HETTY 0. IANG.
FOURTH: A11 the rest, reside and remainder of my estate,
I bequeath and devise to my children, in equal shares, per
stirpes.
FIFTH: I direct that the shar= of my daughtsr, JE?��NIFER
S. LONG, oe held, In Trust, until she reaches the age of 21
years, and I direct my Trustee hereinafter named to use the
principal and income from the Trust for the college education of
my said daughter .
SIXTEi: I constitute and appoint my daughter, REBECCA J.
LONG, Trustee of the Sstate of my daughter, JENNIFER S. LONG, and
give her the power to appoint a substitute Trustee in the event
she is unable, unwilling, or ceases to serve.
SEVENTH: 2 constitute and appoint my daughter, REBECCA J.
LONG, Executrix of this, my Last Will and Testament, to serve
without filing bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I hereunto set my haad to this my Last
Wi11 and Testament, this f� day of June, 1986.
�
Q""'s
Noffirial Ssal �
Linda A.Malfsko,Notary Pubfic
Wind'�er Boro,SomsreeY Coun� .
My Commission Expires Nov.29, 403
AAember,Penn,ryMarJ3Assacia+ionotNotartes
PAGE TWO OF A THREE PAGE WILL.
_ __ . __
_ _ _
. '
SIGNED, PUBLZSHED A?J�7 D�CLA.;ED bV the said HENRY L. �ONG, as and
for his Last Will and Testament, in the presence oi us , who, at
his request and in his preseace an3 in the preseace oi each
oLher, have su'�scribed our names as witnesses hereto.
r-.__
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__ �
�-L���'3�I�:V�!n U���Q�.ti�S� .
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PAGE THREE OF A TtiRSE PAGE WIiL.
� , ,
We, �iEATEtY L. LOIVG � WILLIAM G. SHAHP,DE , ROSEN7ARIE A.
SIGG and �ATRICIA A. SHINGLER , the Testator and the
witnesses, respective2y, whose names are signed to tne attached
or fo:egoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator signed and
execated Lhe instrument as his Last Will an@ Testzment and zhat
he hac� �igned willingly and that he executed it as his free and
voluatary act ior the �urposes therein expressed, ar3 that each
of the witnesses, in the presence and. hearing of the fiestator,
signe& the Will as witnasses and that to the best of their
knowledge, the Testator was at that time eighteen years of age or
clder, of sound mind and under no constraint o undue influence.
tator „
�
� ' .�.
,
witness "
�r�l�.��-c.C.t.ft 1„S , � .t�l.;;��.t Gr,ti,
wi � ss j
,�
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witness J
SUSSCRIBED, sworn to and acknowledged before me by the Testator,
and subscribed and sworn to before ae by j+�ILiI� G. SHA'nADE ,
ROSEMARIE A. SIGG , and PATRICIA A. SHINGLER , the
witnesses this 16th day of June , 1986.
��������� -
,
' ST UYTON �11SCOE, Notery Pu61ic
Johns[own, Cambrta County, PA
i e o _ �