HomeMy WebLinkAbout11-08-13 M , 1505610149
REV-1500 EX(02-11)p nn7 ma OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN `�1
PO BOX 280601 13 t tq 5
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
03 01 2013 10 25 1948
Decedent's Last Name Suffix Decedent's First Name MI
Ruble Paula M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Ruble Duane R
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
173 34 8921 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
l� 1.Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Prior to 12-13-82)
Q 4.Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
6.Decedent Died Testate Q 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9.Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT—THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORM60N SHOULD BC:D�2ECT%TC
Name Da gjelephone Numb C7
Elyse E . Rogers , Esquire 7 7 6 2 0 0
--a
f- R GI WR 06YILL US NLY
w
First Line of Address CC"> �C:)
635 N . 12th Street , Suite 400
CJJ
Second Line of Address co
DATE FILED
City or Post Office State ZIP Code
Lemoyne PA 17043
Correspondent's e-mail address: erogers @ssr-attorneyS.com
Under penalties of perjury,I declar that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.D c ration of prepare her than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON R S NSI LE FO F NG T N 6 D TE
PERSON / La
ADDRESS
W. Lisburn Road
Mech Icsburg, PA 17 5
SIGNATU F PREPAR OT THAN REPRESENTATIVE DATE
e%i? I t
ADDRESS 6 North 12th t
Lemoyne, A 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610149 1505610149
1505611288
Rev-1500 IX(FI)
Decedent's Social Security Number
Decedent's Name: P a u l a M Ruble
RECAPITULATION
1. Real Estate Schedule A 1. 0 . 00
2. Stocks and Bonds(Schedule B) 2. 0 - 0 0
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . . 3. 0 - 00
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0 . 00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . . . . 5. 163,136 - 83
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . 6. 0 - 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 1431998 . 33
(Schedule G) O Separate Billing Requested . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7). . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 3 0 7 ,13 5 - 16
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 0 - 00
10. Debts of Decedent, Mortgage Liabilities, and Liens(Schedule I 10.
0 . 00
) . . . .. . . . . . . .
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 0 - 00
12. Net Value of Estate(Line 8 minus Line 11) 12. 3 0 7 ,13 5 - 16
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) • • • • . . . . . . . . . . . . . . . . . . . 13. 0 - 00
14. Net Value Subject to Tax Line 12 minus Line 13 14. 307 ,135 - 16
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X.00 307,135 . 16 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X.045 0 - 00 16. 0 . 00
17. Amount of Line 14 taxable
at sibling rate X.12 0 - 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505611288 1505611288
Rev-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Paula M. Ruble
STREET ADDRESS
1576 West Lisburn Road
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2 Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments 0.00
B. Discount 0.00
Total Credits(A+B) (2) 0.00
3. Interest (3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑
b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . . . . . . . ❑
c. retain a reversionary interest . . . . . . . • . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • ❑
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ N
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year
of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . • • • • . . • • • • • • • • • • • • • ❑ N
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?. . ❑ N
4. Did decedent own an individual retirement account, annuity or other non-probate property,
which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S. Sect. 9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. Sect. 9116(a)(1.1)(ii)]. The statue does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 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. Sect. 9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
[72 P.S. Sect. 9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. Sect. 9116(a)(1.3)]. A sibling
is defined, under Section 9102, as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1508 EX+(11-10)
��r pennsytvania SCHEDULE E
�i�l �'�:vnprtirNrrrH[v�HOt;
CASH, BANK DEPOSITS, & MISC.
INHERITANCETAX RETURN
RESIDENTDECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Paula M. Ruble
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Inheritance from Decedent's mother, Edna Priscilla Evans 152,636.83
2 1993 Jeep Wrangler 5,500.00
3 1998 Lincoln Mark VIII 5,000.00
TOTAL(Also enter on line 5, Recapitulation) 163,136.83
If more space is needed, insert additional sheets of the same size
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
t
ur;rn�?rr�[;NT or ut;vt:rvuf:
INTER-VIVOS TRANSFERS AND
INHERITANCETAX
RESIDENT DECEDENT
MISC. NON-PROBATE PROPERTY
RESID
ESTATE OF FILE NUMBER
Paula M. Ruble
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE NAME OFTRANSFEREE,RELATIONSHIPTO DECED ENT& DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE
NUM DATE OF TRANSFER.ATTACH COPYOF DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IFAPPLICABLE) VALUE
1 Wells Fargo IRA 37,614.74 100 37,614.74
Beneficiary: Decedent's surviving spouse,
Duane Ruble
2 PSERS Retirement Benefit 106,383.59 100 106,383.59
Beneficiary: Decedent's surviving spouse,
Duane Ruble
TOTAL(Also enter on Line 7, Recapitulation) 143,998.33
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
ist::t'.nRiraf:nlr ors Ht::v:.�NUt•:
INH ERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Paula M. Ruble
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY Do Not List Trustees OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2).]
Duane R. Ruble Surviving spouse 307,135.16
576 W. Lisburn Road
Mechanicsburg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15THROUGH 18 OF REV-1500 COVER SH EET,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 SHEET.
If more space is needed, use additional sheets of paper of the same size.
15056111101
°``0110'
REV-1500 a
enn lvarria OFFICIAL USE ONLY
PA Department of Revenue P sY County Code Year File Number
Bureau of Individual Taxes
INHERITANCE TAX RETURN
PO BOX28o6o1 n Y
Harrisburg,PA 17128-0601 RESIDENT DECEDENT ��
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
Lg
-mom �--n------ -• �= ��'. --s � .�=� r -=--�.�- ;�. ,,,�..
_ -�•- &t
Decedent's Last Name Suffix Decedent's First Name MI
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's-Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
4 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE Pt REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
qW 1.Original Return Q 2.Supplemental Return Q 3. Remainder Return(date of death
prior to 12-13-82)
Q 4. Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Retum Required
death after 12-12-82)
Q 6.Decedent Died Testate Q 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
Q 9.Litigation Proceeds Received Q 10.Spousal Poverty Credit(date of death Q 11. Election to tax under Sec.9113(A)
between 12-31=91 and 1-1-95) (Attach Sch.0)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
g^.''�
J i/-
,7 1 I 7 .
R N p [
�.�'�' r� af.'__�._-�-.'��3'���,i..�-��5..'r_cT:=ice_x'-".. - ..c"t.r'::.=SS"s..,2C�_�..._�Tn._....� rte..�_.��-�_"_«so��.::_�w:..2u��=s •>��..�:x._
REGISTER OF WILLS USE ONLY
First line of address
Second line of address
.�..:.t,^-°•��-c�^.,� F--' tai.. -k- -�.— �a:.. _ �__— F _ .,.6
DATE FILED
City or Post Office State ZIP Code
_� �' - � �•. ...� S�__moo-. _- �y-• _='3' 'Y!L �, � .� '-.'�'_..+K .��k. �.f _ -
../{/./��." '• �"/ �5,��LJ{/`roS' � E r. � c Lp k/Y �/� � / � /� Vr 4 c
Correspondent'se-mail address:
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
ft is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA RE OF PERSON RESPONSIBLE F FILING R �U DATE
ADDRESS
-,G/L ur�C�J�a �f r'r`ishGcr iTrio
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE J -7 DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101
1505610105
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: _ /�"
RECAPITULATION
1. Real Estate(Schedule A). ........... ................... .............. 1. € r0; Q
tr .°
2. Stocks and Bonds(Schedule B) ......................... ....... ....... 2. i � r 0
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3.i= _
4. Mortgages and Notes Receivable(Schedule D)............................ 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5. 2 � 10f
_ -e- •- _ ��_� r��:rte_�.
6. Jointly Owned Property(Schedule F) p Separate Billing Requested ....... 6. i
7. Inter-Vvos Transfers&Miscellaneous Non-Probate Property -= -
(Schedule G) p Separate Billing Requested........ 7.
S. Total Gross Assets (total Lines 1 through 7).................... ......... 8.
9. Funeral Expenses and Administrative Costs(Schedule H)........ .. ......... 9.ii 7 02=
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ... .. ......... 10. 7
11. Total Deductions(total Lines 9 and 10)............... 11. `
4 f T-7 l
Fn
12. Net Value of Estate(Line q22 /
)................. .... ......... 12.
8 minus Line 11 13. Charitable and Governmental Bequests/Sec;9113 Trusts for which
an election to tax has not been made(Schedule J) ........................ 13. f. s E
14. Net Value Subject to Tax Line 12 minus Line 13 _
1 ( ) ............. .. ...... ... 14. ( oZ. T �J
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 � -
(a)(1.2)X.0- ; 15. _<
16. Amount of Line 14 t xable =
pt
at lineal rate X.O 1 8�7 � j 16. �� x 9 ,� �
17. Amount of Line 14 taxable =µ
at sibling rate X.12 � � N 17. f If
18. Amount of Line 14 taxable -Q `sue
at collateral rate X.15 { r V f 4" 18 f s
ern �1� '�.'�•v.�t�'�r�- �r..�. '�.a,_�:r*-d����`�`--'"'"�"�-�-s-�v'�.�"� .
t�
19. TAX DUE ................. .... ........................ .. ......... 19.E
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND.OF AN OVERPAYMENT p
Side 2
1505610105 1505610105 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
STREETADDRESS
�k.534 LA v kEL W oo R
CITY A� STATE ZIP / 7/ 110
� R/ S v Cs 19A
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) / 11'f 3
2. CreditslPayments
A. Prior Payments
B.Discount �pDO
Total Credits(A+B) (2) O O
3. Interest
(3) O
4. If Line 2 is greater than Line 1 +Line 3,enterthe difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) N/14
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE-ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... ❑ X
b. retain the right to designate who shall use the property transferred or its income;............................................ ❑
c. retain a reversionary interest;or.......................................................................................................................... ❑
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.:............................................................................................................ ❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property;which
contains a beneficiary designation? ........................................................................................................................ ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]:The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• 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 transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent F2 P.S.§9116(a)(1.3)].A sibling is defined, under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-15oS EX+(ii-io)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ARI5C &.4 eVjq A✓5 a '2- 1a - / / & /
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
e
7-/Z &W5 ,Q�Al Acc 6a3Al(P 15"/a-7 64111, 32-4
2. QS-5R�9.Ar6- #..I i L//-Ir - r-/444 A✓C 4- SFev q r/6 30, 031.
Ac-e- 7-
7-
3Xz -q/zzg�-�
3 LV EL L.5 F�RG� �'1�Y/3d R 5 -
�-cc /7 3, 9517
I e.A A/ 0UNo .S
��w- o�
•�l 6 . 5
6• J Ew/Sryn�E
OF
A70.
TOTAL (Also enter on Line 5, Recapitulation) $
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-06)
ab SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
'. PR I.1 4-1-.+ Eiyv+NS a _- IoN - I l L r
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions ,�/
Name of Personal Representatives) !V,+/(lc y L. D(JG- '71 S'QO
Street Address 4 S3 y_4 D A
City AA Rk 4:f,6096- State zip 1711O
Year(s)Commission Paid: 02 3
2. Attorney Fees
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees ie�'Q./y�-`c� OF W/LL-S
7 �iTy
5. Accountant's Fe es C'.EiQ7"/r/ TES 7�• c
C'.lGONL �
M Y , R 5.4
6. Tax Return Preparer's Fees
7. �Dtj�c�iQ?"�5�/lllr G'/el4A/r
TOTAL(Also enter on line 9, Recapitulation)
(If more space is needed,insert additional sheets of the same size)
REV-1512 EX+(12-08)
pennsyLvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF nn FILE NUMBER
e. 11A All a vJ /a� 11 so�
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
} ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
• I R o e K ice-
-r1/-4 E,ur Al T y 5. 00
��veE
1-7A. 00
TOTAL(Also enter on Line 10, Recapitulation) Is /j 7 a 7. /3
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(11-08)
10 pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.2116(a)(1.2).]
1. soak C;. Douc 4e g-1- y CRPttV 0 CIViL0 y 41 5,00
A345-S' O-AAINf} CT.�C-AU�oR�liA,n,t�aob�4
BE rk AIU M C-0 146A)
134Z V"h 5t j MAN ftArfj-d $g��jk) CA go;4 G RAntD c41w> '216-no .
3 Cil iD 9- RLJ$c.E
92t 44ERmr+tJ bk. M97C.A-A-Nia
-5 ia VA&
;�p
4 MP,TT1+ek1 JR. R�d�
5-190 McNDENN�4tL M�C1}�}�/ICS
Pk 1?o So 4UR GRArJg��F1�0 a Soo.
NANe,y 1... iDouCr4ek .c
TS'q L vkal-W000 DA. T� .-0172 of
Pv Rlr� 174 1-7j/0 kA 'S10U4C
PPIULA M. RLJr3Le-
1S74 w. L151joAl-/ AoPr�Al 'DAU&AT'Fp�
Ah9C.4AIC-5(3oA6— pA 1.706- 12c510
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, $
If more space is needed,insert additional sheets of the same size.
NJI IIT/LU IV G.TI .JU r ivi IYR.LLGIVCI rICCmmi VVCEIR11 IVIU I I It 1010 he/ lIL
MCCARVER FREEMAN
WEALTH MANAGEMENT
WELLS FARCIO ADVISORS FINANCIAL NHT1 ORK
602 North Froni 5tivel
WomTlnyaburg.PA 17043
Ron K.KopKiNs
Senior Registered Account,administrator
rose.(mpUi rn;;NTalieLcom
Tel:717-734 4001
Fay:717-76 t-6127
Toll-Fate: 855-366-9776
June 4, 2013
SENT VIA FAX to 717-612-5805
Elyse E. Rogers, Esquire
Saidis, Sullivan & Rogers
635 North 12'h Street
Lemoyne, PA 17043
RE: Paula Ruble, deceased
Date of Death—March 1, 2013
Dear Ms. Rogers;
This letter is to provide you with the date of death values for the IRA Account for Paula
Ruble (shown on page two). Should you have any further questions or need additional
information,feel free to contact me.
Thank you,
Rose Haykins
RA....,U—T7TNM A/CTnr
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Elyse E.Rogers, Esquire
Page Two
June 4,-2013
DOD DOD
Quantity Description Symbol Price Value
121 ISHARES MSCI EAFE INDEX EFA 57,890 7,004.69
66 ISHARES CORE S&P 500 ETF IVV 152.150 10,041.90
20 ISHARES TR-RUSSELL IWD 78,250 1,565.00
62 POWERSHARES DB ETF DBC 26.900 1,667.80
66 SPDR S&P INTLSMALL ETF GWX 29.720 1,961.52
12 VANGUARD TOTAL BOND ETF BND 83.610 1003.32
57 VANGUARD MSCI ETF VWO 43.420 2,474.94
25 VANGUARD REIT ETF VNQ 68.990 1724.75
47 VANGUARD MID CAP ETF VO 88.660 4,167.02
10 VANGUARD SMALL CAP VALUE VBR 78.220 782.20
49 VANGUARD SMALL CAP ETF VB 86.670 4,246,83
CASH 974,77
GRAND TOTAL 37,614.74
The above summary of prices/quotes/statistics has been obtained from sources believed to be relloble,but Is not
necessarily complete and cannot be guaranteed. Prices may not reflect the value at which securities could be
sold. This summary is for information purposes only. Past results do not lndlcote future performance. This Is not
a substitute for Verification of Deposit(or slmi/ar form)or the official statement of account holdings at the firm.
Ma.mhr-.r FTNR A/CiPr
f COMMONWEALTH OF PENNSYLVANIA
' PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM
PSERS Toll-free: 1.888.773.7748 (1.888.PSERS4U)
5 N 5th Street Local: 717.787.8540
Harrisburg PA 17101-1905 www.psers.state.pa.us
May 14, 2013
DUANE RUBLE
1576 W LISBURN RD
MECHANICSBURG, PA 17055
RE: Paula Ruble
SSN: XXX-XX-5667
Dear Mr. Duane Ruble:
The Public School Employees' Retirement System (PSERS) has received notification of the death
Ruble. Please accept our condolences for your loss.
PSERS has completed an initial calculation of the death benefit. The approximate amount payable to
you, or the beneficiary you represent, is $106,383.59. Details of this estimated distribution are as
follows:
1. Gross Amount of Distributions $106,383.59
2. Taxable Amount $106,383.59
3. Nontaxable Contributions $0.00
Enclosed for your review are the available payment plans. In order to process the death benefit, one of
the payment plans must be selected. Please read the enclosed information on the payment plan options
very carefully. Before you make a decision, we strongly recommend that you contact a tax consultant or
financial planner, since the death benefit is subject to federal income tax and the tax consequences will
affect your income.
Please note that interest is credited only to the member's date of death. Once you have elected an
option, complete the applicable forms and return them to PSERS. As soon as the completed application
is received in this office, the benefit can be recalculated and payment sent.
If you have any questions, please contact the PSERS Member Service Center by calling-loll-free
1-888-773-7748 (1-888-PSERS4U). Harrisburg local callers, please use 717-787-8540. To contact
PSERS by e-mail, use the following address: contactPSERS @pa.gov. For your convenience, the
Member Service Center is staffed each business day from 8:00 a.m. to 5:00 p.m. For more general
information, you may visit PSERS online at: www.psers.state.pa.us.
Sincerely,
ja
IIII II III IIII I II III II III II III I III II III II III II Iil I III II III II III II III II II II III II III II III I III I illl I IIIi ll ll II III II III II I I II III II III II III II III II III II III II III II III II III II III II III it 111 it ill ll l I II II Il 111 ll llf l 1111
LAST WILL AND TESTAMENT
OF
PAULA M. RUBLE
I, PAULA M. RUBLE, of Mechanicsburg, Cumberland County,
Pennsylvania, do make, publish and declare this to be my Last Will and Testa-
ment, hereby revoking all Wills and Codicils by me at any time made.
ITEM I: I direct that all inheritance and estate taxes
becoming due by reason of my death, whether such taxes may be payable by my
estate or by any recipient of any property, shall be paid by my Executor out
of the property passing under Item IV of this Will, as an expense and cost of
administration of my estate. My Executor shall have no duty or obligation to
obtain reimbursement for any such tax paid by him, even though on proceeds
of insurance or other property not passing under this Will. In the absolute
discretion of my Executor, he may pay such taxes immediately or may postpone
Y,
the payment of taxes on future or remainder interests until the time possession
thereof accrues to the beneficiaries.
ITEM II: If I predecease my husband, DUA.NE R. RUBLE,
I give and bequeath to him absolutely and in fee simple all of my household furni-
ture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing
apparel and all other like articles of household or personal use or adornment.
If I do not predecease my husband, I make said bequest, in as nearly equal shares
as possible,to my brother-in-law, LAWRENCE S. RUBLE, Fountaintown,
Indiana, my sister-in-law, MRS. JANE ANNE KEIM, West Lawn, Pennsylvania,
and my sister, MRS. NANCY L. DOUGHERTY, Harrisburg, Pennsylvania;
provided, however, that the share to be received by Mrs. Nancy L. Dougherty
shall be reduced by the amount of the appraised value of property specific-
ally bequeathed to her, pursuant to Item III herein. The amount available
for distribution hereunder, resulting from the decrease in the amount payable
to Mrs. Nancy L. Dougherty, as hereinbefore provided, shall be shared
equally by Lawrence S. Ruble and Mrs. Jane Anne Keim.
ITEM III: If I do not predecease my husband,
DUANE R. RUBLE, I make the following bequest to my sister,
MRS. NANCY L. DOUGHERTY:
(a) My Engagement Ring
ITEM IV: I give, devise and bequeath all of my
property, real, personal and mixed, not disposed of in the preceding portions
of this Will, to my husband, DUANE R. RUBLE, if he survives me, but if he
fails to survive me, then to NATIONAL CENTRAL BANK, Harrisburg,
Pennsylvania, INTRUST NEVERTHELE.} S, to be- held, administered and
distributed in accordance with the terms of a certain Agreement of Trust
executed by said NATIONAL CENTRAL BANK, as Trustee, and my husband,
DUANE R. RUBLE, as Settlor, on the day of 1974, and
any amendments thereto effective at the time of my death, said Trust being
for the benefit of myself, my brother-in-law, LAWRENCE S. RUBLE, my
sister-in-law, MRS. JANE ANNE KEIM, my sister, MRS. NANCY L.
DOUGHERTY, and my mother, PRISCILLA E. SWARTZ.
- 2 -
ITEM V: In the settlement of my Estate, my Executor
shall possess, among others, the following powers, to be exercised for the best
interests of the beneficiaries:
1. To retain any investments I may have at my death so long
as my Executor may deem it advisable to my Estate so to do.
2. To vary investments, when deemed desirable by my Executor,
and to invest in such bonds, common trust funds controlled by
the Trustee, stocks, notes, real estate mortgages, or other
securities or in such other property, real or personal, as he
shall deem wise, without being restricted to so-called
"legal investments".
3. In order to effect a division of the principal of my Estate or
for any other purpose, including any final distribution, the
Executor is authorized to make said divisions or distributions
of the personalty and realty partly or wholly in kind. If such
division or distribution is m; de in kind, said assets are
required to be divided or distributed at their respective values
on the date or dates of their division or distribution.
4. To sell either at public or private sale and upon such terms
and conditions as the Executor may deem advantageous to
the Estate, any or all real or personal estate or interests
therein owned by the Estate severally or in conjunction with
other persons or acquired after my death by my Executor,
- 3 -
and to consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers, conveying
a fee simple title, free and clear of all trust and without obli-
gation or liability of the purchaser or purchasers to see to the
application of the purchase money or to make inquiry into the
validity of said sale or sales; also, to make, execute, acknowl-
edge and deliver any and all deeds, assignments, options or
other writings which may be necessary or desirable, in
carrying out any of the powers conferred upon my Executor
in this paragraph or elsewhere in my Will.
5. To mortgage real estate, and to make leases of real estate.
6. To borrow money from any party, including the NATIONAL
CENTRAL BANK, to pay indebtedness of mine or of my Estate,
expenses of administration or inheritance, legacy, estate and
other taxes.
7. To pay all costs, taxes, expenses and charges in connection
with the administration of my Estate. My Executor shall
pay expenses of my last illness and funeral expenses.
8. To vote any shares of stock which form a part of the Estate,
and to otherwise exercise all the powers incident to the
ownership of such stock.
9. In the discretion of my Executor, to unite with other owners
- 4 -
of similar property in carrying out any plans for the reorgani-
zation of any corporation or company whose securities form
a part of the Estate.
ITEM VI: Any person, including DUANE R. RUBLE,
who shall have died at the same time as Testatrix, or in a common disaster
with her, or under such circumstances that it is difficult or impossible to
determine who died first, shall be deemed to have predeceased Testatrix..
ITEM VII: If at any time any minor shall be entitled to
receive any assets, either under this Will or otherwise, and with respect to
which I am authorized to appoint a Guardian and have not otherwise done so,
NATIONAL CENTRAL BANK, Harrisburg, Pennsylvania, shall act as
Guardian of the said assets payable to such minor. Said Guardian may receive
and administer all assets authorized by law, and shall have full authority to
use such assets, both principal and income, in any manner said Guardian
shall deem advisable for the best interests of such minor, including college,
university, post-graduate or other education, without securing court order.
Said Guardian shall have all the rights and privileges as to the Guardianship
and the assets thereof as are herein granted to my Executor as to my Estate
and the assets therein.
ITEM VIII: In the event my husband shall fail to survive
me, I nominate, constitute and appoint my sister, NANCY LOUISE DOUGHERTY,
Harrisburg, Pennsylvania, Guardian of the person of any minor.
- 5 -
ITEM IX: I give, devise and bequeath all property
over which I have a Power of Appointment to NATIONAL CENTRAL BANK,
Harrisburg, Pennsylvania, IN TRUST NEVERTHELESS, to be held, admini-
started and distributed in accordance with the terms and conditions of a
certain Agreement of Trust, and more particularly Article IV thereof,
executed by said NATIONAL CENTRAL BANK, as Trustee, and my husband,
DUANE R. RUBLE, as Settlor, on the day of 1974,
and any amendments thereto effective at the time of my death, said Trust
being for the benefit of myself, my brother-in-law, LAWRENCE S. RUBLE,
my sister-in-law, MRS. JANE ANNE KEIM, my sister, MRS. NANCY L.
DOUGHERTY, and my mother, PRISCILLA E. SWARTZ.
ITEM X: I nominate, constitute and appoint my
husband, DUANE R. RUBLE, to be my "Executor''. In the event of the
death, resignation, refusal or inability of my husband to serve as my
Executor, or to continue to serve, I nominate, constitute and appoint
NATIONAL CENTRAL BANK, to serve as my "Successor Executor". My
Executors, Trustees, and Guardians specifically are relieved from the duty
or obligation of filing any bond or other securities.
IN WITNESS WHEREOF, I have set my hand and seal to this my
Last Will and Testament, consisting of seven (7) typewritten pages, this
S4'-` day of ��
���3-e..m�-�-�i. 1974.
(SEAL)
PAULA � �
PAULA M. RUBLE
- 6 -
We, the undersigned, hereby certify that the foregoing Will was
signed, sealed, published and declared by PAULA M. RUBLE, the afore-
named Testatrix, as and for her Last Will and Testament, in the presence of
us who, at her request, and in her presence and in the presence of each other,
have hereunto set our hands and seals the day and year above written, and we
certify that at the time of the execution thereof, the said Testatrix was of
sound and disposing mind and memory.
SEAL ,
( ) Residing at:
Gf/ (SEAL) Residing at: p
(SEAL) Residing at:
f.
- 7 -
Law Offices of
SAIDIS, SULLIVAN & ROGERS
A PROFESSIONAL CORPORATION
635 NORTH 12TH STREET,SUITE 400 CARLISLE OFFICE:
ROBERT C.SAIDIS LEMOYNE,PENNSYLVANIA 17043 26 WEST HIGH STREET
DANIEL L.SULLIVAN TELEPHONE:(717)612-5800-FACSIMILIE(717)612-5805 CARLISLE,PA 17013
ELYSE E.ROGERS EMAIL:aftorney@ssr7-attorneys.co TELEPHONE:(717)243-6222
JOHN A.FEICHTEL www.ssr-attorneys.com FACSIMILE:(717)243-6486
DEAN E.REYNOSA
TODD F.TRUNTZ Of Counsel
MARYLOU MATAS JOHN E.SLIKE
SEAN M.SHULTZ STEPHEN L.GROSE
r. HANNAH WHITE-GIBSON
November 8, 2013 REPLY TO LEMOYNE
717-612-5801
e rrogers@ ssr-attorneys.com
HAND-DELIVERED ' M
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Register of Wills of Cumberland County m c-, _ '
a
One Courthouse Square oo r� C
Carlisle, PA 17013
E, 71.C>
90 Re: Estate of Paula M. Ruble o N rn
Date of Death: 03/0. 1/2013 cri
SSN: 197-40-5667 ca
Dear Madam:
Enclosed for filing with your office is the Pennsylvania Inheritance Tax
Return in duplicate. Please note that this is a non-probate estate. A check in the
amount of$15 representing payment of your filing fee is also enclosed.
Please time stamp and return the enclosed copy of this letter.
If you require additional information, please do not hesitate to contact me.
Sincerely yours,
Elys E. Rogers
cjr
Enclosures
cc: Duane R. Ruble (w/o enclosures)
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RECEIPT FOR PAYMENT
-------------------
GLENDA FARNER STRASBAUGH Receipt Date : 11/08/2013
Cumberland County - Register Of Wills Receipt Time : 15 :43 : 53
One Courthouse Square Receipt No. : 1076177
Carlisle, PA 1713
RUBLE PAULA M
Estate File No. : 2013-01195
Paid By Remarks : SAIDIS SULLIVAN & ROGERS
DB1
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 34190 $15 . 00
Total Received. . . . . . . . . $15 . 00