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Home My WebLink About12-03-13 NOU-20-2013(�ED) 13; �2 N � H Columbia (FAX)�1�6846099 P. 001/001 C�1�-f.��/I/�i"L-- --� REV�'�50a��°�',°' � L�oS��o�,�3 PA Oepartmerlt of ReVeltue penr►9ylvsnl8 OFFICIAL ItSE ONLY Bur�au of Individual i`axes ��*��^�� Caunq Coae Yaar Fue Numnar PO BOX.260601 iNHERITANCE TAX RETURN � �, 1 3 0 0 8 3 1 Harrisburg,PA 17128-0801 RESIDEN'r'DECED�NT �NT�R DECEDENT INFGRMATION SELOW Socfal Sewrlty Numbar Date of Death Date of 81r1h 195 34 9218 02 23 2013 OZ ]. 3 1923 oecedent's Lsst Name SuifGc oecedenC9 First Name MI GAUS �y$��, � (ItApplicable}EnterSurvlving SpOUSe'S lnfOrmatlon Solow Spou9e's Laet Name Sutfix Spouse's First Name MI Spousa's Socfal Sacu�iry Number 7Wi�ReYiii�N lViU�u'i'ti�FIL��►iN fDIiF�LtCATE W1TN 7HE R�GISTER OF WILLS FILL IN ApPROPRIATE QVALS BELOW � 1. psiginal Rotum [j 2. Supplamgntal Retum � 3,Remalnder Retum(date af deaih prlorUO 12-15-82) ❑ a. Limhed Eetate � 48,r•uwre imereet Can�nmlw � 5. Fadaral Estata 7au Reiurn ReqWred (dala ef deeth blter 1Y•12�ffi) � g.Doccdont Dlod Teamin � �. 17awaant Malnlafned a��Ing Tniat 8. TOk71 NUnlbef of Sale D8 t 9ox9s (AdecA Copy oT Wllq (�t�eeh Copy of TruaQ � , � 9. �iilpadon Pr�eotla Recelved (] 10•��ani2��i a�m��•i�WSj de�' � 71.Attach h 0)�er Sec.9173(A) COFtR�SpONOENT-THIS SECTIQN MUST aE COMpL�'I'�G.ALL CORRESPONp�NGE AN�CGNFI��N'ClAL TAX INFORIYIATIQN SWOULD 9E C7IRECTED TO: NamB Daytime Tetephone Num6er JOHN F MARKE� 7' 17� 6 8 4 ��:�;2 2 -� c � � m . �+�r�oF wc��,us�� `�� G�a �� v, ;� �irst l�ne of adttress �� { r� , �� . rv'" � �,.a c:� 327 LOCUST STREE�' . � µ`' �, ,., :, �-.: --� , -_,. ,, Second Nne ot addross �^� _ __, a , -- p . , f�.) ' o'�j . 17ATE FI E� , . � x �.'ii�l 4�`r6St^�ICB StrttB �1€�I:Ode . - C:J �'� COLUMSrA PA 17512 Carrospondent's e-mail address: un�er penaltles o}perJury,I daclare tha!I have axamined this retum,Indudl�a�compar►y�np acneaules and statements,and to tha bast ot my knouweupe and beliet, It la true,cort�act end complole.Declaradon o�preparer ather than t�e personal reprcrentallue 1�baeed on au inrormalion ot whlch preparer has any knowleepe. SI TUFiE OF P�R$pN RCSPONSIBLE FOR FIUNO Nt'YW2N pq'r' Jonelle M.Usselman �� RF.$$ ,,� r ' 5903 CaR � 0 0, � arke,V 22015 SIG�TURE PREPAR R TATiVE y,T� - John F Markel /� AOORSSS 327 Lo treet,C�lumbia,PA 17512 S(de 1 � �5056I,01q3 1505b7,Q143 � � � 15D5610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: G A U S� S Y B I L V. 1 9 5 3 4 9 2 1 8 -- ------------- ------- --- --- RECAPITULATION 1. Real Estate(Schedule A).......................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 3 , 5 4 4 . 9 3 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1-7)....................................................................... g, 3 , 5 4 4 . 9 3 9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 1 , 4 1 4 . 0 0 10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule I)................................ 10. 11. Total Deductions(total Lines 9&10)...................................................................... ��. 1 , 4 1 4 . 0 0 12• Net Value of Estate(Line 8 minus Line 11)............................................................. �2. 2 . 1 3 0 . 9 3 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. 2 . 1 3 0 . 9 3 TAX COMPUTATION-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 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 , 1 3 0 . 9 3 �6. 9 5 . 8 9 17. Amount of Line 14 taxable at sibling rate X ,�2 ��• 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due..................................................................................................................... 19. 9 5 . 8 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 � 1505610243 1505610243 � REV-1500 EX Page 3 File Number 21 - 13 - 00831 Decedent's Complete Address: DECEDENT'S NAME Gaus, Sybil V. ------ -------- ____ ----- ----------------------- STREET ADDRESS ------ -------- -- - 2100 Bent Creek Blvd. CITY----- -------- ---------- --- -�STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 95.89 2. Credits/Payments A� Prior Payments B. Discount 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. �4� Check box on Page 2 Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 9 5.$9 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:.................................... ❑ �x c. retain a reversionary interest;or.................................................................................................................. ❑ X❑ d. receive the promise for life of either payments,benefits or care?.............................................................. � � 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... ❑ 0 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... � �x 4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which contains a beneficiary designation?...................................................................................................................... ❑ �I 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 January 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 disciosure 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in 72 P.S.§9116 1.2)[72 P.S.§9116(a)(1)J. •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,wfiether by bloo�or adoption. � I' SCHEDULE E I� jCASH, BANK DEPOSITS, & MISC. ; COMMONWEALTHOFPENNSVLVANIA i PERSONAL PROPERTY I INHERITANCE TAX RETURN RESIDENT DECEDENT � I I I FILE NUMBER ------- __------ ESTATE OF Gaus, Sybll V. 21 - 13 -00831 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Weils Fargo checking account 648.22 2 Wells Fargo savings account 1,181.71 3 Wells Fargo savings account 1,015.00 4 Met Life shares 700.00 5 Decedent resided in nursing home and had no personal property, no motor vehicle and only normal clothing of no value. TOTAL(Also enter on Line 5, Recapitulation) 3,544.93 � , ' SCHEDULE H � ; FUNERAL�CPENSES& �' COMMORES DENT DECEDENT LVANIA II �'N�� INHERITANCE TAX RETURN I � � II _ _-_'- _' �--'__-- -__-__-__-__-_ __- -'__-__-.' ' _-___-- '- ._' FILE NUMBER ESTATE OF Gaus, Sybil V. _ � 21 - 13 -00831 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION I AMOUNT NUMBER � FUNERAL EXPENSES: - -- —�-- -- A. 1 Workman Funeral Home-monument � 286.00 � � �I B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Jonelle M. Usselman Street Address 5903 Carters Oak Court city Burke state VA zip 22013 Year(s)Commission paid 2. Attorney's Fees Nikolaus & Hohenadel 361.50 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cost to open estate 138.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs I 1 Joneile Usselman-reimburse mileage 628.00 TOTAL(Also enter on line 9, Recapitulation) 1,414.00 REV-1513 EX+(��-08) i s � ' � ! SCHEDULEJ � � COMMONWEALTHOFPENNSYLVANIA �'�, BENEFICIARIES I INHERITANCE TAX RETURN ' RESIDENT DECEDENT i . — _.--- --- ----- -------- ---- ------ ._.----. __- _... ESTATE OF Gaus, Sybil V. FILE NUMBER __ i 21 - 13 -00831 RELATIONSHIP TO � SHARE OF ESTATE I AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT , (Words) i ($$$) RECEIVING PROPERTY Do Not�ist Trustee(s) ' — — — -- ----- -- -- --- -- I, TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers i under Sec.9116(a)(1.2)] 1 Jonelle M. Usselman Daughter � 1/3 of estate i 5903 Carters Oak Court I ' Burke, VA 22015 � � � i 2 Richard C. Gaus Son ; 1/3 of estate 15 Woodside Dr. I ; Bumt Hills, NY 12027 i � 3 Kathleen A. Bartch Daughter i 1/3 of estate 201 Beaston Rd. i Blain, PA 17006 � i , I � � , Enter dollar 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 I I � I �B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I � I � , , I � � TOTAL OF PART il-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET' 0.00 ii iI ' �I �I il i I, LAST WILL AND TESTAMENT i OF � I SYBIi, V. GAUS � I, SYBIL V. GAUS, of the Borough of Columbia, Lancaster � � County, Pennsylvania, hereby revoke all Wi11s and Codicils, as I iwell as all other instruments of a testamentary nature heretofore ' made by me, and do hereby make, publish and declare this to be my i Last Will and Testament. I FIRST: I direct that my hereinafter named Executors pay a11 my just debts and funeral expenses as soon after my decease as may be practicable. SECOND: I give, devise and bequeath all of my estate, both real and personal property, to which I may be entitled, or over which I may have any disposing power at the time of my death, in equal shares, to my children, JONELLE M, USSELMAN, RICHARD C. GAUS and KATHLEEN A. BARTCH, or to their issue per stirpes. THIRD: I nominate, constitute and appoint my children, JONELLE M. USSELMAN, RICHARD C. GAUS and KATHLEEN A. BARTCH to be the Executors of this my Last Will and Testament. �=�iPCUtors not required to �ost t�ond, iid �7ITtJESS �v'HEREOr, I� JZISIL `J. GAUS, tne Testatrix, I have to this my Last Will and Testament set my hand and seal this i ! �( .�y of ��,�;lk�,�,,��_�, , 1995. � ' I � � '.!'~ � t� _ (SEAL)I I (Sybil V. Gaus) I I I ; I I � i i I j � ! � I� I I� ' �I I !i I I I i' ; I; �� Si ned sealed Y � � g , , published and declared b the within � named SYBIL V. GAUS as and for her Last Will and Testament in our i I� presence and we, at her request and in her presence, and in the � presence of each other, have hereunto subscribed our names as I �I witnesses. � I . -- _� � �- � , ! � . , , _ , --- . i L . �ti_ ,, , ., . . r• � ��; �,.��_..� � M�. I I `�\_��i\ ` �'•. �\ \`�"^•�.�1'� I �; �. `� \,_��;,y*��1: �� 1/C� i. V �� •\.1�•_'.�., t��.�`: 4 � I I I I� I I � �I I II I �j I II �I - � - i I! � � I I ' 1 I