HomeMy WebLinkAbout01-22-14 J 1505610101
REV-1500 ax(al-to)
nn varda OFFICIAL USE ONLY
FA Department of RevenueaK,ta
Bureau of Individual Taxes County Code Year File Number
PO BOX 280801 INHERITANCE TAX RETURN
Harrisburg,PA 17128-o6oi RESIDENT DECEDENT T
ENTER DECEDENT INFORMATION BELOW
� o � ,�, o ,LA13 � zD3193 ,2
Decedent's Last Name Suffix Decedent's First Name MI
UW
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
K 1. L L B}e I I I I I I ID ® FEET 171_ ~n E
Spouse's Social Security Number
�kY' MX X !X R��'X X X THIS RETURN MUST BE PILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW T
® i.Original Return G3'� 2.Supplemental Return O 3. Remainder Return(date of death
prior to 12.13-82)
p 4.Limited Estate O 4a.Future Interest Compromise(date of O 5, Federal Estate Tax Return Required
,- death after 12-12-82)
go 8.Decedent Died Testate, C 1 7.Decedent Maintained a Living Trust 0 B. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
p 9.Litigation Proceeds Received C7 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 Sen.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE'94CTEY5
Name Daytime i9lephone Numtt�f m
LI h/A R,L E7,S j 141 j.SjHJ1jj LjD:.51 111/ 111 9;
r 1 REWVT�0 ILL`jbSE 09Dr p
.� CP
First line of address
G1 O t
Second line of address - i --0 C:)
M zr
City or Post Office State ZIP Code t DATE FILED
mFCH-fNI Ic s I B 461
p ► 7oS
Correspondent's e-mail address: ee shle/g1 S 3(j) 0-0rnC QS l
nG t
Under penalties of pequry,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it Is We,correct and complete.Declaration of preparer other than the personal representative is based on all information of which pmparer has any knowledge.
SIGN R OF P ON REPO�NSIBLE FOR Fiti DATE
x
ADDRESS 'Do 2D Y M, rnitLEQ 765' GNk 011Gf �
SIIGrNA 7 FP A�O ER TH SE T ✓ DATEv
ADDRESS Ll/yiT/*aEs I OUSer Ar, Me C S&, ,01
PLEASE USE USE ORIGINAL FORM ONLY tt
77- ,r
7 '
Side 1
L, 1505610101 1505610101
1505610105
REV-1500 EX
RECAPITULATION '
1, Real Estate(Schedule A):.:...:..:.:..:.................'.:.....:.`...-`1. •it7
. ............... 2. / o o g�. y.3 .
, 2. Stocks and Bonds(Schedule B) ...................... .. .
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D)........................... 4. A .'-�O
S. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. .i..7._�t�t'O�Off i Q
6, Jointly Owned Property(Schedule F) p Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers 8•Miscellaneous Non-Probate Property - �'------��---••++
(Schedule G) OSeparate Billing Requested..,..... 7.
8. Total Gross Assets(total Lines 1 through 7).................... ......... 8.
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. / IP -7
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1).... .... ..... . 10.
11, Total Deductions(total Lines 9 and 10).. --�=,k J D
12. Net Value of Estate(Line 8 minus Line it) ...... .... .................... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which �.
an election to tax has not bean made(Schedule J) :.:...........:......'...: 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ....... ........ .... ..... 14. B S
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 ty
(a)(12)X.0� I- p 15.
16. Amount of Line 14 taxable - - - -^--�'
at lineal rate X.O ' ��J2.',D [� 16. , 0 O
17. Amount of Line 14 taxable at sibling rate X 12 17,
18. Amount of Line 14'taxable '�
at collateral rate X.15 . Q 18. b 0
19. TAX DUE ...........................'........:........:...:..i:.... 1IL •+�
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
1505610105 1505610105
REV-1500 EX Rage 3 File Number 2/—13- 795-
Decedent's Complete Address:
DECEDENT'S NAME
R�,� !, W• i�l:ller
STREET ADDRESS
7(o Se— " 01/0,
CITY STATE �� ZIP 1 7o sr
fYlech4rtiGS6u
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (i)
2. Credits/Payments O
A.Prior Payments
B.Discount 0
Total Credits(A+B) (2) O
3. Interest
(3) O
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)
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;............................................ ❑ 9
c. retain a reversionary interest;or.......................................................................................................................... ❑ Ix
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?.............................................................................................................. ❑ Dd
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
containsa beneficiary designation? ........................................................................................................................y]C ❑
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, xcept 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[72 P.S.§9116(a)(1,3)]. og 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-1503 EX+16-98) -
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
t� klpl, W . M� Ilar �I- 13 --795
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
VALUE
NUMBER DESCRIPTION OF DEATH
ATE
OF DEATH
1. 57 Shares�of Cor�mei1 s�foe(' of �rudcn�,al %na�rc,'a/ �,�
k%yA Zou> 56.00 Ale. �V,-ke= X57,�9
($GG Y9AWlahe0 4/4rq A44 i
*4 for
°Z• yy8 �/ia25 0� �DM,rtASf oC'foek of /ylgtu�r� F:�arrc:a/
H, !S.3S Loaf /�l�S.Q e,prv�e = /S"/O X 51Y/d 54 _ /o, 71,9( SO
(see vQ/aQhon �afa a�far�ie./�
TOTAL(Also enter on line 2, Recapitulation) $ O p/8', q3
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Date Open High Low Close Volume Anil Close-
Feb 20,2013 58.17 58.17 56.00 56.05 4,068,300 54,71
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Date Open High Low Close Volume Adj Close-
• Feb 20,2013 15.28 15.35 14.85 14.91 2,919.600 14.58
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-yl "MUIN0 RI¢0 REPRESEMATVE
BY-
A1AytJNO.ADOR�$$ - -
• V .�, : t AUTIiOD11E0 REPIiEb'FIRATWE P �
:4 RALPH W :MILLER 11
710, W KELLER .:S? "• i � '
hEtHANICSBURG',PA 17055
T �
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wE W'm+w�curtnnw ar.MlwamDa NOTE NgEWIg wSTDUTION NO. �',F
REV-1510 EX+ (08-09)
Z b = pennsylvania SCHEDULE G
r
DEPARTMENT INTER-VIVOS TRANSFERS AND
RESIDENT EDENTTURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
This schedule must be completed and fled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME Or THE TRANSFEREE,THEIR REUnoNSOP TO DECEDENT AND DATE OF DEATH % OECD'S EXCLUSION TAXABLE
NUMBER �] ��rxyc Dare or�TRANSFER. Arracxa tour or Txe DEED FDRREAI ESTATE. VALUE OF ASSET INTEREST IF APPLICABLE) VALUE
I. xv cv �a&_5'0n 7; '7Q tic AG./ C�rwGes
1007v -0 -
);;aya ble 16 _�pou,se , Dorpgv 1h. 0"ller
TOTAL (Also enter on Line 7, Recapitulation) $ 3�, OOD-00
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX♦(10-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF rI, mfl�Er FILE NUMBER at_ �3 _ 79s
r hW Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEvPENSES:
1
i
B. ADMINISTRATIVE COSTS:
1'. Personal Representative's Commissions
Name of Personal Representative(s) �p�oro F1) I"hn
• Mr ��P.r _ ��/ve�
Streel Address 7(O S OaK DYa
City 1)7e6han;csbaj-a State PA zip
Years)Commission Paid:
2. Attorney Fees Charles �. osh�e/a/s Z!j" kndetcrm:ne�
3. Family Exemption:(It decedent's address is not the same as claimant's,attach explanation) /
Claimant _ �–�7O x///llel _ WCLz VC01
Street Address .76 �,�/ -- —
/y10�`IGl11/ CS(7ll hR State ✓�/¢ zip
city J
Relationship of Claimant to Decedent AL)i L
4. Probate Fees 41M Or/9��R/ /SS�(e °7� CPf,��hG�/P� �� a7�•.$�
5. Accountant's Fees
Al AIX .4CCOUntun /°yo, Pit ire) y 1
6. Tax Return Preparer's Fees (J°SQ° J, e&• 1(n d Lftrmr�ccl
4
/. Fj) A9 ke {a )(e ;Cter cf w://a fa�epa;cl
8. l�dd/lional Probd�e. Fee g AO, °O
y, Rei.,r6arses>�nf far p�o/vc°�:ts, .rya./.nys,�. esfim. s$" �fFZs
TOTAL(Also enter on line 9,Recapitulation) $ 167, 7S
Qt more space is nbeded,insert additional sheets of the same size)
RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH Receipt Date : 7/22/2013
Cumberland County - Register of Wills Receipt Time : 10 : 40 : 36
One Courthouse Square Receipt No. : 1074931
Carlisle, PA 17013
MILLER RALPH W
Estate File No. : 2013-00795
Paid By Remarks : ATTY CHARLES E SHIELDS III
WZ
-------- -- Receipt Distribution - -- ------ ---- - --- --- ----
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 30 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 20 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
---- ----
Check# 3147 $123 . 50
Total Received. . . . . . . . . $123 . 50
RIE V-1513 EX+(9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER 124/to At N . InXer
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
nS,ec.9116(a)(12))
1. 't�ar�ri'fy lil. fjr r����
7G S Pak avd, Meahamic.sborl, P4taP.s w•clou� loa�
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1560 COVER SHEET
tI NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUT)NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
i.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET $
If more space is needed,insert additional sheets of the same size)
LAST WILL AND TESTAMENT OF RALPH W.MILLER
1,RALPH W. MILLER,currently of 710 West Keller Street,Mechanicsburg,Cumberland
County, Pennsylvania,being of sound and disposing mind,memory and understanding,do make,
publish and declare this my Last Will and Testament,hereby revoking and making void any and all
prior Wills by me at any time heretofore made. _
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
2-
All the rest,residue and remainder of my Estate,real,personal and mixed,whatsoever and
wheresoever situate,I give,devise and bequeath to my beloved wife,Dorothy M.Miller,to her own
use and benefit absolutely.
3
In the event my said wife,Dorothy M.Miller,should predecease me or die at about the same
time 1 do,such as in an accident or disaster common to both of us,I hereby direct all the rest,residue
and remainder of my Estate to be distributed to my son,Barton W.Miller,per stiilD2.S.
In the event any recipient hereunder is a minor at the time of my death,his share is to be
held and administered by a guardian to be appointed upon petition to the Orphans Court.
In the event my said son predeceases me and he is not survived by issue,then I direct that my
estate be divided and distributed,as follows:
A.) One-half(1/2)to the Capital Improvement Fund of St.Paul's United Church of
Christ of Mechanicsburg,Pennsylvania,
BJ One-half(1/2)to the Mechanicsburg Area Foundation to be used at the discretion of
the Advisory Committee in the manner it deems best
4.
I nominate, constitute and appoint my wife,Dorothy M.Miller,to be the Executrix of this
my Last Will and Testament. In the event that she should predecease me or for any reason be
unwilling or unable to act as such Executrix,I nominate,constitute and appoint my son,Barton W.
i Miller,to be Executor in her place and stead. I further direct that they shall not be required to file -
bond or other security in the Office of the Register of Wills for the purpose of administering my c
1_01
Estate. L- c>
rz rv" C 6
�N WffNESS WHEREOF,I have hereunto set my hand and seal this 3d day of m
T�F ew1�ci.�
A.D.2003. r ;1 N .-:i
77
(SEAL)
RALPH W_MILLER
Signed,sealed,published and declared by tite above-named RALPH W.MILLER as and for
his Last Will and Testament,in the presence of us,who at his request and in his presence,and in the C-) �t
presence of each other,have hereunto subscribed our names as witnesses.
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CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG,PA 17055
GEORGE M.HOUCK
(1912-1991) TELEPHONE (717) 766-0209
FAX (717) 795-7473
January 21, 2014
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Ralph W.Miller
No.21-13-0795
Dear Register of Wills:
t
Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Ralph W.
Miller Estate as well as Check No. 3446 in the amount of$30.00 for additional probate due.
Thank you for your kind attention to this matter.
Very truly
Charles E. Shields, III C5 rn w
Attorney-At-Law ° `D " o�
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