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Home My WebLink About08-29-13 � Lsas61o1uo REV-1500 EX `°z-,,,{F`> PA Department of Revenue OFFIGAL USE OHLY 8ureau ot Intlividuai Taxes County Code Year File Number po sax zaoso� fNHERITANCE TAX RETURN 2 1 1 2 1 1 $ 5 Harrisbura PA 17128-06�1 RE5IDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Numbar Date of Death MMOOYYrY Date of Birth MMODm'Y 1 � 1 6 2 Lt 1 2 0 1 � 7 1 9 2 8 DecedenPS�ast Name Suffix DecedenPS First Name MI S H E I P E L L 0 Y D V (If Applicable)Enter Surviving Spouse's Information Below Spouse's�ast Name Su�z Spause's First Name MI S H E I P E M A R Y J 3pouse's Social Securfty Number THIS RETURN MUST BE FILED tN DUPItCATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 1.Originai Return � 2.Suppiementat ftetum � 3.Remaittder Retum(Date flf Death Pnorto 12-13-82) � A.lirnited Estate � 4a.Future interest Compromise(date of � 5.Federai Estate Tax Retum Required death after 12-12-82) QX 6.Decedent Died Testate � 7.Decedent Maintained a Living Trust �. 8.Totai Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Gopy ai Trust.) � 9.Litigation Proceeds Received � 10.Spausai Poverty Credik{Date af Death � �1.Election ta Taz under Sec.9113{A) Batween 12-31-91 and 1-1-95) (Attach Schedule O} CORRESPONDENF-THIS SECTIQN MUST BE COMPLETED.AtL CORRESPONDENCE AND CONFIDENTiAI TA7(INFDRkIATWN SHOULD 8E DH2ECTE0T0: Name Daytime Telephone Number M U R R E L R • W A L T E R S , I I I 7 1 � 6 9 '7 4 6 5 p ---s —-�- .. iREEil9�pFWILLSU$E�NL��,' l � � � � m � Frst Line at Address I t-- '� ?"�.* ' I � � � 5 4 E • M A 2 N S T ft E E T �`� • - � Second Line of Address I __, I � ' c.� `� � DAT£ i D City or Post Office Siate ZIP Code I -+r-�� —�-..—�-.�--I r--+ , t1 E C H A N I t 5 B U R G P A 1 7 4 5 5 CorrespondenYs e•mail addresx: 01 U Y'Y'e 1 a�W 81 t 21'S Q d 11 O W A Y •c o m Untler penalties of perjury.I deplare that I have examined ih(s return,including accompanying schedules and stataments,and to the best of my knowledge anG tseiief. it is true,correct antl complete.DeclaraUOn of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBJ.E PoF�FILING ftETURN / DATE `7�r �:� -�, - �f'�s,�;,� �'f �3 /3 DA ORESS U' MARY ANE SHEIP , GINCK4 DRIVE MECHANICSBURG PA 17C155 SIGNATURE OF AR R N REPRESENTATNE , �� ADDftESS t1URRE ALTERS, III, 54 E• MAIN ST ME�HANILSSURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 � 15Q561�14� 15t1561[]14� � v1 "' J 15�561�24Il REV-15�Q EX{�1} pecedenPS Soaai Security Number oecedenrsName: LLflYI} V- SHEIPE RECAPITUlAT10N '1. Reai Eslate{Scht�dule A} . .... ...... ... .... .... ....... ... .. . .... ... . 1. L 5 0 0 0 . l] 0 2. Stocksand Bonds{Schedule B) . ... ... ... .... .... .... ... ... .... ... ... z� ' 3. Giasely Heid Corporation,Partnership or Sole-Proprietorship(Schedule C) ... .. 3. • A. Mortgages and Notes fteceivabie{ScheduVe D} ... . ... . .......... ... . .... 4. - 5_ Cash.Bank Defmsits and Misceilaneous Persanai Property{Sd�edule E)... .., . 5. ' 8. JoiMiy Owned Property(Scheduie F) ❑ Separate 8iifing ftequested . ... ... 8_ • 7. Inter-Vivos Transfers$Miscellaneous N n-Probate Property (Schedute G} � Separate Biiling Requested . .... .. 7. . S. Tota{Gross Assets(totai Lines 1 through 7} ......... ............. ..... 8. 1 5 � � � . � � 8. Funarai Expenses and Administre#ive Costs{Schedule H} . ... ..... .. ... .... 9_ 1 4 6 4 5 . 5 � 16. De6ts of Decedent,Mortgage Liabitities,and liens(Schetluie 1} ... ... . .. . ... �6. � 9 5 . n � ��, Totai Deductions(totai Lines 8 and�0} .. . . ... .... . . .. . . . . _. ... ... . .. 5�. 1 5 D 4 � . 5 0 12, NeC Value of Estate(line 8 minus Line 15} . . .. . . ... . ... . ... . . . . . . .... . 12. " 4 � = 5 � �3. ChadtabVe and Governmental BequestslSec 9113 7rusts for which an election to tax hae not been made(Scheduie J) . . . . . . . . . . . . ... . . .. . .. 13. . 14. Net Value Subject to Tax(Line 12 minus Line 13} . . . . . . . . . . . . . . . . .. .. .. 14. � 4 0 . 5 fl T1VC CA�CULATiON-SEE 1NSTRUCTION3 FOR APPUCABIE RATES 15, Amount of Line 14 taxable at the spausai tax rate,or transfers under Sec.9116 (a7(t-�)X.0 _ � . � 0 '15. ti . � � 18. Amaunt of Line 14 taxable at�inea�rate X.�` d . D 0 �g. � . � � 17. Amount of Line 14 tattable at sibling rate X.12 � • d � �7, � � � � '18. Flrrtouot of Lin�14 taxable at collaterai rate X.15 � � � � 18. � � Q � 19. TA7C DUE . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . .. .. . .... . '19. fl . � � 26. FlLL IN THE 6VAL IF Y6U ARE ItE4t1ESTING A REFUND OF AN OVERPAYA9ENT � Side 2 � 15[1561�240 1505610240 � REV-1504 EX{Pi) Pa9e 3 File Number �I DecedenYs Complete Address: 21 12 1185 DECEOENT'SNAME LL4YD V• SHEIPE — — — __ _- - _ ------— — _— -- ---— --- -- STREETADDRESS 912 GINKGO DRIVE ___ _. _ ..._ _- — —_---- --- —. _ -_------ - — - -- CITY TS7ATE --�� ---- � ZIP MECHANICSBURG IPA 17055 Tax Payments and Gredits: i. Tax Oue(Page 2,Line 19} (1} ��00 2_ Credils/Payments A.Prior Payments B.Oiscflunt Totai Credits{A+g} �p} a.o 0 3. inte�est i�) 4. if Lina 2 is greater than Line 1 +tine 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4} 0�00 5. It Line 1 +�ine 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5� 0 •0 Ll Make check payabie to: REGISTER OF WIL�S, AGENT PLEASE ANSWER?HE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLQCKS 1. Did tlecedent make a trensfer end: Yes No a. refiain the use or income of the property hansferred ................................�............................... .... ❑ 0 b. retai�the right to desig�ate who shall uss the propedy transferretl or'ds income ............................. ❑ � a retain a reversionary inierest ................................................................._.................................. ❑ 0 d. �eceive the promise for life of either payments,benefiis ar care? ....................................................... ❑ � 2. If death occurred after pecem6er 12,1982,did tlecedent transfer propedy within one year of death without r�eiving adequate corrsideratian? ............................................................._........................ ❑ � 3. Did decedent own a�"in hust for'or payable-upon�death bank accounl or searity at his or her death? ......... ❑ � 4. Did decedent own an individuai retiremeni account,annuity or oiher non-probate property,which containsabeneficiarydesignation?..................................._.................................._.,..................,..... ❑ 0 1F THE ANSWER TO ANY OF THE ASOVE QUESTIONS IS YES,YOU MUST CQMPIETE SCHE4ULE G AND PtLE IT AS PART OF THE RETURN. For dates of death on or after July t, 1994,and before Jan. 1, 1995,the tax rate imposed on the net vaiue of hansfers to or for the use of the surviving spouse is is 3 percent[72 P.S. §9118(a){1.1 j{i)]. Por dates af death on or after Jan. 1, 1995,the tex rate imposed an the�et velue of transfers to or for the use of ths surviving spnuse is 0 percent [72 P.S. §9116(a}(1.1}(ii)].The statute does nof exempt a transfer tp a surviving spouse from tax, and the statutary requirements for disckssure of assets and filing a tax return are s6ll applica6fs even if the surviving spouse is the only beneficiary. For dates of death an or after July 1,2000: • The tax rate imposed an the net vaiue of transfers trom a deceased child 21 years af age or younger at death ta or for the use af a naharal parent,an adopGve parent nr a stepparent of the child is 0 percent[72 P.5.§9116(a)(1.2)]. • The tax rate imposetl on the net value of transfers to or for the use of the decedenYs lineai beneficiaries is 4.5 percent, except as noted in[�z as �9t isia)(t)�. • The tax rate imposed on the nei value of trensfers to or for the use of the decedenYs siblings is 12 percent(72 P.S.§9i 18{a}(1.3}].A sibling is defined, under Section 91Q2,as an individual who has at least pne parent in common with the decedent,whether by blood or adoptipn. REV-1502 EXt{52-12j I pennsylvania SGHEDULE A DEPARTMENT OF REVENl1E REAL ESTATE INMERITANCE TAX ftEiUFN RFSIDENT DECEDENT ESTATE OF: FlLE NUMBER: �L4YD V . SHEIPE 21 12 1185 All real property owned solely qr as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property wauld be exchanged between a witling buyer and a will4ng selter,neither beiog compe!Ied ta buy or seli,both having reasona6la knowiedge of the retevant facts. Real property that is jointly-ovmed with right of survivorship must be disclpsed on Schedule F. Attach a copy of the settiement sheet if the property has been soid. iTEM indude a copy of ihe deed shaving decedenCs interest if owned as tenant in common. VAIUE AT DATE NUMBER dF DEATH pESCRIPTION 1 • RIDGE ROAD, LEWTSBERRY, PA 17339 15,000• 00 VACANT L4T - APPRAISED VALUE TQTAL(Aiso enter on Une 1,Recapitulatio�.} S 15,D fl�•C!0 if more space is�eeded,use additional shee4s ot peper ot ihe same s¢e. i REV-0St7EX%{10-09) pennsylvania SCHEDULE H °��"RT""`"T°F RE�E""E FUNERAL EXPENSES AND INNERI7ANCE iAXRE7URN ADMINISTRATIVE COSTS RESIDENT DECEpEM ESTATE OF FILE NUMBER L�OYD V• SNEIPE 21 12 1185 4ecedenPS de�s muxt be refwrted on Schedule[. ITEM NUMBER DESCRiPTION AM4UNT A. FUNERA�ExPENSES: t MYERS—BUHRIG FUNERAL HOME & CREMATORY, MECHANICSBURG 12,993.00 B. ADMINISTRATIVE COSTS: 1. Personsl Representffiive Commissions: Hame(s)of Persana�ttepresentative{s) M A R Y J A N E $H E I P E sveetnddress 912 GINGKO DRIVE c;ry MECHANICSBURG state PA zia 17055 Year(s)CommissionPaid: (REN4UNCED7 y. nnomeyFees MURREL R • WA�TERS, III 1�600� Od 3. Famity Exemption:(If decedenPs address is not me same as oIa'imani's,attach explanatioa` Cbaimarrt Street A¢dress City State ZIP Relationship of Claimant to�acedent 4, probateFees CUMBERLAND COUNTY REGISTER OF WILLS 152•Sq � AccountanlFees: 8. Tax Retum Preparer Fees: 7. TOTAL(Also enter on Lina 9,Recapitulation} E 14,6 4 5-50 If more space is needed,use addltional sheets of paper of the same size. REY-�J�2�4{�2-121 pennsytvania SCHEDULE I �°"RT""E"�"F RFVE"°E QEBTS OF DECEDEN7, INHERITANCETAXReTUFN MORTGAGE LIA8ILITIES&LIENS RESIDENT OECFGENT ESTATE OF EIf.E NllPABER LLOYD V . SNEIPE 21 12 1185 RepoR debts incurred by the decedenC prior to death that remained unpaitl at the tlate of dea#h,including unreimburaed medical expenses. tTEM VALUE AT DATE NUMBER DESCRIPTION OF DEATN t. S • lil• BARRETT ftEAL ESTATE & APPRAISAL 300 -00 APPRAISA� - RIDGE ROAD, LEWISBERRY, PA 2 . MURREL R • WALTERS, III 95-00 DEED PREPARATION TOTAL(Atso enter on Line tQ,Recapitulafion} $ �95•00 if more space is needed,insert additionai sfieets of the same size. RF.V4513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENf OF REVENUE BENEfICIARIES MHERIThNCE tAX RE7UnN RE$l�GN7 QECE�ENT ESTATE OF: FILE NUMBER: �l4YD V . SNEIPE 21 12 1185 RELATIONSHIP T6 DECEDENT AMOUNF 4R SHARE NllRABER NAME AND A4DRESS OF PERSON{S)RECEIVlNG PROPERTY Do Not List Trustee(s} OF ESTATE j TAXABLEDISTRIBUTiONS Qnciudeoutrighispousaitlistnbutronsandtransfersurtder Sec.9116(a){7.2).] t. SC4TT A • SHEIPE l.ineal 25 NAIl4R LANE NEWVILLE, PA 17241 ENTER OOLLAR AMOUNTS FOR 6SSTRtHUTiONS SHOWN ABQVE ON L1NES 15 THR4UGH 18 QF REV-15D6 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLEDISTRIBUTIONS: A.SPOUSAL DIS7RI8UTIONS UNDER SECTION 9113 FpR WHICN AN ELECTION Td TAX IS NdT TAKEN: 1. H.CHARITAS�E AND�OVERNMENTAL DIS7RI6UT10NS: 1. T4TAl4F PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1566 COVER SHEET. $ it more space is needed,use additional sheets ot paper of the same size.