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12-02-13 (2)
r _ n 1505610105 REV-1500 Ex(w-ii)(FI) 1' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes .`1--- County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 02/28/2013 08/29/1922 Decedent's Last Name Suffix Decedent's First Name MI Bell MS Ann M (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW m 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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 INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number David J. Bell (717)737-6729 LISTER OF to USCONP/I t� G? 0 r-� First Line of Address M y t/ p 430 Allendale Way n z � Iv o Second Line of Address - ;K C C7 n CD © C = C7 City or Post Office State ZIP Code DATE D f— Camp Hill PA 17011 c -n Correspondent's e-mail address:jefun @aOI.COm 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, it is true,gorrect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowiedge. SIGN RE OF PERS R N BLE FOR FILING RETURN / DATLr AD R SS /J fja le. ILK. SIGNATURE OF PREPARER OTHER THAN REP SENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Ann M Bell RECAPITULATION 1. Real Estate(Schedule A). .... ........................................ 1. 124,540.00 2. Stocks and Bonds(Schedule B) ....................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 4. Mortgages and Notes Receivable(Schedule D)........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 252,746.00 ' 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets(total Lines 1 through 7)............................. 8. 377,286.00 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 23,940.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 11. Total Deductions(total Lines 9 and 10)................................. 11. 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 353,346.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ........................ 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 353,346.00 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 taxable - - at lineal rate X.0 45 15,900.00 16. 15,900.00 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable �� T at collateral rate X.15 18. 19. TAX DUE ......................................................... 19. 15,900.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J a , r REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Ann M. Bell STREET ADDRESS 1501 Simpson Ferry Rd CITY STATE ZIP New Cumberland PA 17070 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 15,900.00 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 3. Interest (3) 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) 15,900.00 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.......................................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0 c. retain a reversionary interest.............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 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? ........................................................................................................................ ❑ 0 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(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.§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-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ann M Bell 2013-00271 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant fads. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1 1501 Simpson Ferry Rd New Cumberland,PA 17070 (See Attached) 124,540.00 TOTAL(Also enter on Line 1, Recapitulation.) $ 124,540.00 If more space is needed,use additional sheets of paper of the same size. SEC SELLER'S ESTIMATED COSTS thisform n?=hmerided and approved for,but not restricted to use try,mtmbers of the PennW anta Association of RFAt.MW(PART. ADDRESS.. f t a °� ✓ , SELLER Nara r` V,g,V k- j? t- BUYER SETTLEIKENT DATE PURCHASE PRKE$ 1. Broker's Feel �/d S, !'f19 $ X10' 2. Preparatlos:of Dead $ 3. TransferTex $ 4. Seller's Assiet/Cre ditto BUM S- Home watrally $ & Mu dcw tions(s) $ 7. cerWkm ofPi>csscc(CwtdominiumIHomeow,aesAssociations) $ 8. Settle rrt Fee $ 9. Notary Fees $ 10. Stiasrey $ c 11. OMot Severe Sirs tz n Pumping $ 12. $ 18. Tax C,t� $ a y 14. Ovaf�'MaII Cho rges $ r 15. Domescclu=search $ IL nw '" $ 17. Oth z, a�tr�sru tvc -!.� $ ts 3OD IL O0w S t ESTIMATED COSTS(subtotal) $ AdtAtnenuMC24.cMestate taxes,association fees,utilities) $ 1: TOTAL ESTIMATED COSTSrADJUSTMENTS $ �ntiOR6 $ oy b (717}g-9-4702 DIRECT r {717)877-2109 MOBILE 7-11,5`y 0 (717)763.7500 OFFICE jIIMATED PROCEEDS(before Men payafts) $ ILI_ {717)763-0290 PAY LSmtth@CentralpA.00m m ces $ I! PROCEEDS TO SELLER $ I Zit s' xoM�s cnouv ESTIMATED NET PRac 4 sttacr rwrtWo-` 4075 Martcot 51recc 5 Carat+Bill,PA 17011' coca°edz lea ns wu CetttrnlPA.com _ ovm ..,. ter undisdosed mortgage obligation*liens,as si;nmmtst. levied;against the Property or Scher. I i c: Seller esdauftcl costs stated above are based an the bast I fain nation available at signing and may Se1kr Ms Ins a copy of these estimated closing assts before signing Ow Agreement of Sale. SELLER ER DATE _ sum DATE SELLER DATE BROKER tCc=7z=7 Caldwell Banicer Homestead Group Select Professionals DATE 1 r. �6E". sz91 ' 12105 i 2004'Chevrolet Malibu Sedan Base What Your Car is Worth Page 1 of 1 Price Promise- Make Model Year Car Get upfront pricing Type Re Home > Used Cars> Chevrolet> Malibu > 2004 Malibu Sedan > Prices with Options> Prices with Options Results Use Edmunds.com to accurately appraise your used car. 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Enter VIN http://www.edmunds.com/ford/ranger/1998/tmv-appraise-results.html 11/27/2013 REV-1511 EX+ (08-13) �[ i J pennsylvania SCHEDULE H ' DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Ann M. Bell 2013-00271 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Parthmore 13,840.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 10,000.00 Name(s)of Personal Representative(s) David J Bell Street Address 430 Allendale way City Camp Hill State PA ZIP 17011 Year(s)Commission Paid: 1/2 in 2013 and 1/2 in 2014 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: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ 23,940.00 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+(01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ann M Bell 2013-00271 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.9116(a)(1.2).] 1. Robert E Bell Son 25%of 5/6 of estate 2 Mary C Bell Daughter 25% of 5/6 of estate 3 Margaret M(Bell)Woodward Daughter 25%of 5/6 of estate 4 David J Bell Daughter 25% of 5/6 of estate 5 Robert B Bell Grandson - 1/6 of 1/6 of estate 6 Christopher Bell Grandson 1/6 of 116 of estate 7 Nathin Bell Grandson 1/6 of 1/6 of estate 8-9 Eric M and Gregory R Thomas Grandsons 1/6 of 1/6 of estate 10 Michelle Thomas Granddaughter 1/6 of 1/6 of estate 11 Doreen A(Thomas)Sgrinia Granddaughter 1/6 of 1/6 of estate 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 9113 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 ONLINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. . 1 B XT E.mwki ATTORNEY AT LAW 100 YORK ROAD �? NEW CUMBERLAND,PA 17070 LAST WILL AND TESTAMENT OF ANN M. BELL I, ANN M. BELL of 1501 Simpson Ferry Road, New Cumberland, Pennsylvania 17070, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my t Last Will and Testament, hereby revoking all other Y1iSI5 and Codicils previously made by me. ITEM I: I direct that payment of all my just debts, expenses of my last illness, funeral expenses, and the costs of administering my estate from my estate as soon after my death as conveniently may be done. ITEM II: I give, devise and bequeath all of the rest, residue and remainder of my estate, of every nature and wherever situate, together with all insurance policies thereon, to go in six equal shares as follows: One share to each David J. Bell, Mary C. Bell, Jean M. Bell, Margaret M. Woodward and Robert Bell, i who are my children and in the event any of them are not then living then his or her share to go then to my surviving said children. The sixth and last share to be divided equally among my following named grandchildren then living to wit: Christopher Bell, Doreen Sgrinia, Eric Thomas, Michelle Hipple, Gregory Thomas, Nathan Bell and Robbie (Robert Bertram) Bell. ITEM III: I hereby appoint said David J. Bell as sole a?n/j n.: executor and rte even-, he refuses or unabl e tib act fmw, jaw reason then said Mary C. Sell -,o be sole ezxnzor. ITEM IV: All shares of principal and income hereby given shall be free from anticipation, assignment, pledge or obligation of the beneficiaries of any of them and shall not be subject to any execution or attachment, levy or sequestration or other claims of the creditors of said beneficiaries or an-v c= them. ITEM V: No anatomical gifts {organ doinatiCWISj,. autopsy, and no cremation. IN WITNESS WHEREOF, I, Ann M. Bell, have, to this my Last Will and Testament, set c-�my hand this day of Oe Y` 2 0_0 (SEAL) Ann M. Bell Signed, sealed, published and declared by Ann M. Bell, the above named Testatrix on the day of , 20 , as for her Last Will and Testament, in the presence of us, who n her presence, and in the presence of each other, have, at her request, s,:bscr_... or s as witnesses hereto. N IO residing at Name residing at fie... Name r i I i I COMMONWEALTH OF .SS COUNTY OF CUMBERLAND WE, the undersigned, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby declare to the undersigned authority that we were present and say the Testatrix sign and execute the instrument as-, :a that she had signed willingly and that she ere__:_- -_ sz�a free and voluntary act for the cur-p-:s_s - : - that each of the wi - =--' " tc. - � 69 Testatrix, signed the Will as r.: ::esses a=c =`" ; tee_r ,,..s - their knowledge, the Testatrix was at that t-We e=g- „r �,d�E age or older, of sound mind and under no constraint influence, and I, the said Testatrix, do hereby acknowledge that _ 1 signed and executed the instrument as my Last Will and Testament, that I signed it willingly, and that I signed it as my free and j voluntary act for the purposes therein expressed. i estatrix W' ne s c Witness I i Sworn to and subscrabedofbeC YGB�� me this v2 dy 200E f Nom public ;fR �9 �EO� My Commission Expires: PENNSYLVANEIt Robert E.Myers, teot;,y Public Fairview Twp. York County M Commission Expires Jan.19,2009 i I COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE COUNTY OF CUMBERLAND R I, GLENDA FARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, . do hereby certify that on the 6th day of March, Two Thousand and Thirteen Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of ANN M BELL late of NEW CUMBERLAND BOROUGH (First,Middle,Last) in said county, deceased, to DAVID J BELL (First,Middle,Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 6th day of March Two Thousand and Thirteen. Fi 1 e No. 2013- 00271 PA File No. 21- 13- 0271 Date of Death 212812013 S. S. # Register Of Wills L, Deputy NOT VALID WITHOUT ORIGINAL SIGNATURE.AND IMPRESSED SEAL