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Home My WebLink About03-07-14 � 150561�101 REV-1500 EX(oi io; '°�rd OFFICIAL USE ONLY Ti� PA Department of Revenue pennsylvania Counry Code Year File Number �,.,.,,... F :;.,�t �� Bureau of Individual Taxes INHERITANCE TAX RETURN �) r ' '� /_ PO BOX 28o6oi RESIDENT DEGEDENT l�l l!J Harrisbur ,PA i 128-0601 ENTER DECEDENT INFORMATION BELOW MP.4DDYYYY Social Security Number Date of Death MP�IDDYYYY Date of Birth � � _ � �, �- o��o Zoi� oZ � � ��Zo Sufiix Decedeni's First Name M� DecedenYs Last Name - - ' � S�/ / /'1 Gi m f.'�^ �Gl/'rl � (If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name MI Spouse's Last Name spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 3. F�emainder Return(date of death � 1.Originai Return O 2.Supplemental Fteturn 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) 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes �? 6. Decedent Died Testate � (Attach Copy of Trust) (Attach Copy of Will) 10.S ousal Povert Credit date of death O 11. Electian to tax under Sec.9113(A) O 9. Litigation Proceeds Received O P Y � Attach Sch.O) between 12-31-91 and 1-1-95} ( CORRESPONDENT- THIS SECTION MUST BE COMPLETED,ALL CORRESPONDENCE AND CONPIDENTIAL TAX Daytime Te ephone NumbeECTED T0: Name 3G�m�s L✓ �a//�S �/� �3/ /6�J _ REGISTER OF WILLS USE Olql�' � �� _� �� C �'? First line of address _ _ __ ��,--, � �r.1�7 ` x`�;j �. { f`�i"`'s �o ��s f �e�� <,f}, _ ��__ ' _, �-�� -�.� � r �:� Second line of address p�•- - � '� C_3�_: ' � - � -/- (�C... =� 1 l��y �e�l�1/��c7<��`��' � �� . T� l Oy DATE .�� ,,,� l'T'1 State ZIP Code �•'?� City or Post Office _ � fV C,r,��,-� �� ^��'rIC's G�o//.os cr�-,G/`l�P.7.-r P6-ly= co.�•� CorrespondenYs e-mail address: J � Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statemen!s,and to the best of my knowiedge and belief, it is true.correct and complete.Declaration of preparer other than the personal representaiive is based on all information of which prepareDATE any knowledge. ATURE OF PER O ESPONSIBLE FOR FIIWG RETURN� � ` �x� • C� � � A RESS 3o c T,�,6 ..�;�'� / /�� r�e P-9 i�j '��5 H,' � .15'� �o�, p/.J �zs' DATE SIGNAT OF PARER OTH R THAN REPRESENTATI��E DRES f.,, �G' �(7Y �Gr �.�I J� /I p��s j l tr� C7 f t'i'it�✓✓.� B,.t�e PLEASE USE ORIGINAL FORM ONLY Side 1 � 15�5610101 1505610101 � � 150561�105 REV-1500 EX DecedenYs Social Security Number Decedent;Name: �AY.f� �/- /��/��P'� ! � RECAPITULATION 1. Reai Estate(Schedule A). . . .. . . . . .. . . . ... . . . . .. .. . . . .. . . . . .. . . . . .. . . . 1. � 2. Stocks and Bonds(Schedule B) 2� �` . . . . . 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . .. . 3. � 4. Mortgages and Notes Receivable(Schedule Dj . . .. . . . . .. . . . . .. . . . . .. . . . . 4. „� 5. Cash,Bank Deposits and Misceilaneous Personal Property(Scheduie E}. . . . .. . 5. �S� �G.�, j Z 6. Jointly Owned Property(Schedule Fj O Separate Billing Requested . . . . . .. 6. ,� 7. Inter-Vivas Transfers&Miscellaneous Non-Probate Property � (Schedule G) O Separate Biiling Requested.. . . . . . . 7 _ 8. Total Gross Assets(total Lines 1 thrau h 7 . . . . . .. . . . 8. , -�-� � 6-� 3 Z 9 ).. . . . . .. . . . . .. . 9. Funeral Expenses and Administrative Costs(Schedule H). . .. . . . . .. . . . . .. . . . 9. �3� �,53- S �' ' 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . . .. . . . . .. . . . . 10. � 11. Total deductions(total Lines 9 and 10). . . .. . . . . .. . . . . .. . . . . .. . . . ... . . . . 11. I� ��, S�T J 12. Net Vaiue of Estate(Line 8 minus Line 11} . .. . . . . .. . . . . .. . . . . .. . . . . . ... . 12. Z�, 6 �C �S 13. Charitable and Governmental Bequests�`Sec 9113 Trusts for which � an elsction to tax has not been made(Schedule J} . . . .. . . . . .. . . . . .. . . . . .. . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . .. . . . . .. . .. ... . . . . . 14. ' '�� G S�, �S TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousai tax rate,or � � transfers under Sec.9116 �5 (a)t� 2)X A�- ' _ _ 16. Amount of Line 14 taxable �i/ �R� � � at Iineai rate X.0� Z J, �S a�., �7-S"� 16. � � 17. Amount of Line 14 taxable � 17 � at sibiing rate X.12 -- 18. Amouni of Line 14 taxable � �� at collateral rate X.15 � ` 19. TAX dUE . . . .. . . . . .. . . . . .. . . . . ... . . . .. . . . ... . .. . .. .. . . .. . . . . .. . . . . 19. _� � � ? 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O $ide 2 L 150561D1�5 150567,0105 � File Number REV-1500 EX Page 3 z�� _ nQ G�G�6 Decedent's Complete Address: � DECEDENT'S NAME ��rl�, y S�� v�P r _..— —. --- — STREET ADDRESS � �S _ lL��, SfYoe7� _ _. -. —.-.-. — —------STATE � ZIP CITY / --- ---- � ' �� (a Tax Payments and Gredits: �� "y 1. Tax Due(Page 2,Line 19) 2. CreditslPayments 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 OVERPAYMENL ..�-- 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. r57 °I �� Make check payable to: REGISTER OF WiLLS, AGENT. PLEASE ANSWER THE FOLLOWiNG QUESTIONS BY PLACING AN "X" fN THE APPRC?PR{ATE BLOCKS Yes No 1. Did decedent make a transfer and: . .......................................................... ❑ 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;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. Qid 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 C�MPLETE 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 rafe imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(aj(1.1){i)J. For dates af 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 fhe net value of transfers from a tleceased 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 decedenYs 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-15Q8 EX+(6-98) K SCHEDULE E �' � CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT FILE NUMBER ESTATE OF 2013-00996 Sarah H. Seilhamer 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. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 25.00 1 Cash on Hand 25.00 2 Misc.Personal Property 3 Accounts(checking and savings)at M&T Bank 35,513.32 TOTAL(Also enter on line 5,Recapitulation) $ 35,563.32 (If more space is needed,insert additional sheets of the same size) �wv-�5�' x� `LL��-��' SCHEDULE H V � pennsylvania ��ti>AH,MEN,oF HF��ENUF FUNERAL EXPEN6ES AND iriNe�t�.aNCe Tax Re-uRtv ADMINISTRATIVE COSTS RESIDENT DECECENT FItE NUMBER ES7ATEOF 2013-00996 Sarah H. Seilhamer Decedent's debts must be reparted on Schedule f. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES; $,318.00 1 Richardson Funeral Home,funeral goods and services 573.12 2 Enola Sportsman Club,repast 91.00 3 Funeral attire for decedent g, ADMINISTRATIVE COSTS: 1, Persoral Representative Commissions: 0.00 Name(s}of Personal Representative(s) Street Rddress Skate ZIP City Year(s)Commission Paid: 1,000.00 2. Attarney Fees: 3,500.00 3. Family Exemption: (If d2cedenYs address is not the same as ciaimant's,attach explanation.j c�aimant Doris Redfern Strezt Address 1615 Hi h Street City Enola State PA ZIP 17025 Relationship o�Claimant to Decedent Dau hter 371.45 4. Probat2 Fees; 5. Accountant Fees: b. Tax R2turn Prepar2r Fees: 7, TOTAL(Also enter on Line 9, Recapitulation) $ 13,853.57 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+ (01-1d) � � "' pennsylvania SCHEDULE ) � °F'>"'�'",F"'oF�F"�""F BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER: ESTATE OF: 2013-00996 Sarah H. Seilhamer 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 [IncluSec.9116t(a) �15Z��istributions and transfers under 1. Doris Redfern, 1615 High STreet,Enola PA 17025 Daughter ��2 Dau hter ��2 2 Joan Wagner,306 Timber Ridge Rd, Marysville,PA 17053 g ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16 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 ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. �� . .�,..,� a��_ �.: r . . • .. _ 4 .�Y.... .. �� ,y K�n..�, "�$Z .. _..,- .,:.. , � , .e - ,., . . � . . . . - - -� ..�. -g � ,� LAST WILL AND TESTAMENT OF Sp,g,p,,� H. SEILHAMER I, Sarah H. Seilhamer, of 306 Timber Ridge Road, Marysville, Perry County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ITEM I . I direct that all my debts and funeral expenses, including my cemetery lot and grave marker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my death as part of the expense of the administration of my estate. $ ITEM II . I devise and bequeath all of my estate of every �� _ �nature and wherever situate ;equally to Joan. Wagner and Doris � �� . �� # � � �� "�� = Redfern � �� ., ` ��,..� .� >� : �� `� �a � � �� _; � � � �: �� ,�-. ,� � , � + : �. �# ��F��, � �` `�� _�• ,� � � � � ��III �, If� Jc�an�Wagner predeCeases me then in that case her � ��,,.� ��.�� ` r � �� ¢ �� esta�e�shall� gass R�o her children and their issue per 'c�� , � .# � �,� ;; � �ges��I�f Dorzs Redfern pred�cease�s me then in that case her � ��-�� .��,�;�� ; � ��: ��re�"of� my _esta�e shall ��pass�- to the children ��of��Joan ��Wagner and �_ � �� . �� ,� .. . � � � � � I - = their i�ssue �per stirpes. �� ITEM IV. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal of my residual estate. ITEM V. I appoint Joan Wagner and Doris Redfern, or the , survivor thereof, Co-Executrixes of this my Last Will and Testament . I relieve my Executrixes from the necessity of posting . , _ - �-_. � �., _„ � � , _r, �:.; � security in connection with their duties as such in any jurisdiction in which they may be called upon to act. IN WITNESS WHEREOF, I have hereunto set my hand to this mY Last Will and Testament, which consists of two (2) pages, to each of which I have affixed my signature this 28th day of Ap_ril ► two thousand and nine (2009) . ,, r: � �. � , �C �r � ��°�G��;��,h > Sarah H. Seilhamer, Testatrix ,----- D � � ��:' // � /f "�� Witness � � � , � � ; `�i.;'"K... C � wit ess � Subscribed and sworn to and acknowledged before me by Sarah H. Seilhamer, Testatrix and subscribed and sworn to and acknowledged k�efore me� by William C. Dissinger, and �^ L�,�L�, �i� , witnesses this � _�`' '� `; ; 2009 . � day ;� �...�. . ��: , 1 � � ; ,-�'��-: �-1 t.:�'�C: i Notary Public I Hov�uu s� qNNE7iE PERKtNS Notcry Pubiic C�,Hp,J,gpRpUGH,CUMBERIAND COUNN MY Co�ission�pires Ju122,2009 I I � �I . . . .. . . _ i�_ s , ..., I _„ � ' _ �� ii ' IS � COMMONWEALTH OF PENNSYLVANIA . � ' � j i j , SS • • I COUNTY OF CUMBERLAND • We, Sarah H. Seilhamer, and William C. Dissinger, and ��;� f' �f��'��. ;;;�Z��" , the testatrix and the witnesses ] t�. �_ � respectively, w ose names are signed to the attached or foregoing eing first �ul�T sworn, do herebly d°clare to tr� instrurner�t, b 1 undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ��c�y;��:��'� �/ Sarah H. Seilhamer Testatrix ,, i �' . � , � ness - ,�'" ;� ' �/ ,�t / , !, �f Li✓G.' �� 6 '' tness �/ / V Subscribed and sworn to and acknowledged before me by Sarah H. Seilhamer, Testatrix and subscribed and sworn to and acknowledged b fore me by William C. Dissinger, and �;l � �`��- �.��- , witnesses this � day of , 2009. I ' � f� . NorAa�s� l,._,: �Z_ ` ` ' / ,L�z�(C,Gn�-� NETTE PERK�NS Notary Public � Notory Pubtic CAMP HILL BOROUGH,CUMBERIAND COUNIY My Commission Enpires Jul 22,2009 �I iI