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Home My WebLink About04-24-14 � 1505610105 REV-1500�`��11)(FI) . OFPICIAL USE ONLY PA Department of Revenue pennsylvarria County Code Year File Number �P.F.�:..oF A:�:��E Bureau of IndividualTaxes �NHERITANCE TAX RETURN � l PO BOX z8o6o1 RESIDENT DECEDENT �1 : I� �� Harrisburg PA i�1z8-o6oi ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYWY Date of Birth MMDDYYYY _ ___ ' 09/05/2013 ' !,02/10/1923 , DecedenYs Last Name Suffix DecedenYs First Name M� _ _ _ BARNES ' , BETTY C (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse s First Name MI 'N/A , Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (� 1.Original Retum O 2.Supplementai Return O 3. Remainder Return(Date of Death Priar to 12-13-82) p 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after12-12-82) � 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Wiil) (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 T0: Name Daytime Telephone Number __ __ _ _ _ r�s Ann E. Rhoads (717)�2-8392 ° � ' _ � --� �'__rn _ __ rn �-�',IS�ER OF WI USE�O�,VLC� "T7 � ;jy :� First Line of Address � ?' '�'� --� �a � _ . _ `'.' . �. ` � -� , .� 244 W. Main Street ' ' ` � ' "� __ __ CJ K`3 G � """T _ Second Line of Address �� ° — _ , C_7 C —_ C? , ' . �T7 F--• f" t�'1 - - ' � � DATE FIL CJ'� d City or Post Office . State ZIP Code __ _ � Hummelstown _ _ _ ' PA 17036 , CorrespondenYs e-mail address:�h08dsann hotmail.com Under penalties of peryury,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,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU ERSON R�PONSIB FOR FILING RETUR �� a � ADDRESS / 1341 Emerson Dr., Mount Joy, PA 17552-7 8 SI URE OF PREPARER OT THAN REPRESENTATIVE DATE ��--- � �-�c3�1'' '-P}as�a-��l _ ADDRESS 244 W. Main Street, Hummelstown, PA 17036 PLEASE USE ORIGINAL FORM ONLY Side 1 � 150561�1�5 1505610105 � 1 � 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number __ __ �ecedent's Name: BARNES, BETTY C. ', ' RECAPITU LATION __ 1. Real Estate(Schedule A). ............................................ 1. 0.00 2. Stocks and Bonds(Schedule B) . ........... .............. ............. 2. 0.00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 , 4. Mort a es and Notes Receivable Schedule D 4. 0.00 9 9 � )........................... . . _ 5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E)....... 5. 5,136.39 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 4,673.09 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 93,090.17 (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets total Lines 1 throu h 7 .......... ... 8. ', 102,899.65 ' � 9 )................ 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. ' 3,942.50 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. '; 1,141.48 11. Total Deductions(total Lines 9 and 10)................................. 11. 5,083.98 , 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 97,815.67 _.. ... . 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 Sub'ect to Tax Line 12 minus Line 13 ............. 14. ' 97,815.67 1 � ) ........... TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or _ transfers under Sec.9116 . 0.00 ' 15. (e)(1.2)X.0- 0.00 16. Amount of Line 14 taxable 97,815.67 �s. at lineal rate X.0 45 , 4,401.71 , 17. Amount of Line 14 taxable . . . 0.00 ' at sibling rate X.12 , 0.00 17. __ ,_.. �, _..._. �____..., .._.. _.._. . 18. Amount of Line 14 taxable 0.00 �g 0.00 , at collateral rate X.15 19. TAX DUE ........................... ....'............... .......... is. 4,401.71 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1505610205 150561�205 ,� REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENTS NAME BARNES, BETTY C. STREETADDRESS 3609 Kohle Place, #4 CITY STATE Z�P Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 4,401.71 2. CreditslPayments A.Prior Payments 3,800.00 B.Discount 200_00 - Totai Credits(A+g) (2) 4,000.00 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 401.71 Make check payable to: REGISTER OF WILLS, AGENT. � �. �� ,e�z � �,� n�._ \ ' " . ' \ ��,',A;;..� �.,.. "� :'w� :;� �'.�\ ...`"�.. ��.�c.. �,wv,. �_.... .. .„ . „�...... � ,�-.,, .. , , i ..... _..e.,,, . . .,,. . „. . ,,..,, .. . ., . . 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 properry 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?...................................................................... � � 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 containsa 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. �, �, � � � ".� �� „ ...��., ......, :�� .`��' �� :ti��,,, , .,,�, �� ,,. .... � .. ._�.,,. .. ... 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 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-15o8 EX+(08-12) � pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX REfURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BARNES, BETTY C. 21-13-1008 Include the proceeds of litigakion 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 �. AAA membership refund 51.00 2. 2013 federal income tax refund 1,879.00 3. Penn National Insurance premium refund 305.60 4, Riversource Life Insurance Company premium refund 2,380.79 5. Household goods 500.00 TOTAL(Also enter on Line 5, Recapitulation) $ 5,136.39 If more space is needed,use additional sheets of paper of the same size. REV-i5og EX+(oi-io) � . pennsylvania SCNEDULE F DEPARTMENT OF REVENUE �OINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BARNES, BETTY C. 21-13-1008 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(5)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A•William E. Barnes,Jr. 1341 Emerson Drive son Mount Joy, PA 17552-7238 B. C. ]OINTLY OWNED PROPERTY: LE'fTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR]OINT MADE INCLUDE NAME OF FINANCIAL INSTITUTfON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER,ATTACH DEED FORJOINTLY HELD REALESTATE. VALUE OF ASSEf INTEREST DECEDENT'SINTEREST 1. A• 10121110 Wells Fargo Account ending in 0418 9,346.17 50% 4,673.09 TOTAL(Also enter on Line 6, Recapitulation) $ 4,673.09 If more space is needed,use additional sheets of paper of the same size. R�v-asro ex+;aa-oo) % - SCHEDULE G ,� ; � ,: � , pennsylvania ,� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND � INHER[TANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER BARNES, BETTY C. 21-13-1008 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 DATE OF DEATH °!a OF DECD'S EXCLUSION TAXABLE ITEM INCLt1DE THE NAME OF THE TRANSFE0.EE,THEIR RElATIONSHIP TO DECEDENT AND NUMBER THE DATE OFTRANSFE0.. ATfACH A LOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLEJ VALUE 1. Wells Fargo Acct.ending in 1963,transferred to joint names with son,William 3,658.13 100 3,000.00 658.13 E.Barnes,Jr.,on 04/26/13 2, PSECU Acct#856316358745,transferred to joint names with son,William E. 15,024.59 100 0.00' 15,024.59 Barnes,Jr.,on 07/17/13 3 2003 Buick Century Chevrolet automobile,transferred to joint names with 4,798.00 100 ' 0.00 4,798.00 son,William E.Bames,Jr.,on 07/01113 4 NY Life Annuity#N3124 852;Beneficiary:William E.Bames,Jr.,Son g,254.52 100 0.00 9,254.52 5' Ameriprise Certificate#00705169625 001:Beneficiary:William E.Bames,Jr., 58,079.33 100 0.00 58,079.33 Son 6 109 Sh.MetLife,Inc.,@48.40/sh.;TOD:William E.Barnes,Jr.,Son 5,275.60 100 0.00 5,275.60 TOTAL(Also enter on Line 7, Recapitulation) $ 93,090.17 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (08-13) � pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER BARNES, BETTY C. 21-13-1008 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. g, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address ---...... _...- _ _ City _ State .._ _... .._ZIP...._ _—......._-- Year(s)Commission Paid: .....__ --...... _ _........ _ _ -_.......__ _--.... _ 3,420.00 2. Atkorney Fees: 3. Family Exemption; (If decedenYs address is not the same as claimant's,attach explanation.) Claimant Street Address _..._ _ —....... - _...... _ _ _ _........._-......._- ......_ __ City _- State....._— ..ZIP....... _ __ _. _ ...._ _... _— _ _..... _ _....._- _....... __ Relationship of Claimant to Decedent _____...... _____ _.......____....___ 4. Probate Fees: 118.50 5. Accountant Fees: 6, Tax Return Preparer Fees: 1 58.00 �• Cumberland Law Joumal-legal advertising 75.00 s. The Patriot-News-legal advertising 151.00 s. Register of Wills-short certificates 20.00 *"PLEASE NOTE.ALL EXPENSES SHOWN ON SCHEDULES H&I HAVE BEEN PAID BY JOINT TENANT,WILLIAM E.BARNES,JR. TOTAL(Also enter on Line 9, Recapitulation) $ 3,942.50 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+ (12-12) � pennsylvania SCHEDULE I DEPARTMENTOfREVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OP FILE NUMBER BARNES, BETTY C. 21-13-1008 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 1• Cleckner and Fearen-legal fees incurred prior to death 200.00 2. Pine Street Presbyterian Church-Pledge Balance outstanding at time of death 895.00 3. PPL Electric Utilities 46.48 TOTAL(Also enter on Line 10, Recapitulation} $ 1,141.48 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(O1-10) � pennsylvania SCHEDULE � DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BARNES, BETTY C. 21-13-1008 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. William E.Bames,Jr.,1341 Emerson Drive,Mt.Joy,PA 17552 Son entire ENTER DOLLAR AMOUNTS FOR DISTRIBUT10N5 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; L TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ ' 0.00 If more space is needed,use additional sheets of paper of the same size. • . � ��-, LAST WILL AND TESTAMENT � OF ` .�/�:J � BETTY C . BARNES I, BETTY C. BARNES, of 4531 Sequoia Drive, Apartment B-246, Harrisburg, Lower Paxton Township, Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills and Codicils by me at any time heretofore made. ITEM I : I direct that all my funeral expenses and estate or inheritance taxes be paid by my hereinafter named Executor as soon after my death as may be found convenient . ITEM II : I give, devise and bequeath all the rest, residue � and remainder of my estate, both real and personal, wherever � situate, to my son, WILLIAM E. BARNES, JR. , if he survives me. If my son does not survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal, wherever situate, to his wife, LYNN A. BARNES . ITEM III : I appoint RICHARD W. CLECKNER, ESQUIRE, Executor of this, my Last Will and Testament . If he is unable or unwilling to qualify as Executor, or, having qualified, is unable or unwilling to continue to act, I then appoint WILLIAM E . BARNES, JR. , Executor of my Will . , � '.�. ITEM IV: I direct that no personal representative hereunder shall be required to provide security, surety or bond in any jurisdiction for the faithful performance of any duty under this Will . This clause is applicable only to such guardians, personal representatives and trustees as are specifically named in this Will, or an attorney in the law firm of Cleckner and Fearen. IN WITNESS WHEREOF, I, BETTY C. BARNES, have set my hand and seal to this, my Last Will and Testament, this �i��ic.. day of �[/��'e,�-,L��/ , 19 9 7 . L. �A/li1Ux1' (SEAL) BETTY . BARNES * * * * * * Signed, sealed, published and declared by BETTY C. BARNES, the Testatrix, as and for her Will, in the presence of us, who, at her request, in her presence and in the presence of each other, we believing her to be of sound mind, memory and understanding, have hereunto subscribed our names as witnesses . n.c.F oF � c� l 74S ��•y��f�..�4 oF ��.�fu�1,�,� l9 � 7 r � � ' � " �,,... �� COMMONWEALTH OF PENNSYLVANIA . . SS : COUNTY OF DAUPHIN . We, BETTY C. BARNES, Testatrix, ��r�r�� . �� , and ��rU� � �� US� , witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament 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 witnesses and that to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence . � B T C. BARNES - Testatrix s / / �GIU►1.��. `1• �C� (��..�,� �%� � Subscribed, sworn to and acknowledged before me by BETTY C. BARNES, Testatrix, and subscribed and sworn to before me by �Orr,��e �. /��' and _ ��..-G�� J�. /�r'�.r��:s�� , this o?n��C day of ,�e��,.,,j rf-- , 1997 . �-�� i/. T�•-' NOTARY P BLIC My Commission Expires : Notarial Seal Jenny A.Tobias,Notary Public Harrisburg,Dauphin County My Commission Expires Feb.15,2001 Member,P�nn�Ylvania AaaaGiqtion oi NOttfi06 . � : � �� 7 � � �' � � � � � 1 5 �. 0 _ r� � � � �� - � � v = � � � — � N O � �ryUG . . � s � rn �l � 3 � � � � a � w � �_ � rnsr� � � Q � � � �{ -�7 b,, r' N a rj t'�7, ry 0 7 i r" � r�r � -..,, c� 7 'f� � �` u' %= `�-' � , � �y �, �:.:a �-, n 3 . c -.�1 � � � (�► � c � :.T�. c� �, � F--�' �,�, f�1 N � � �l � � � � � O r � � � � � �� (b U � G � o� s I ,�! N�i O �p! � O ^� ` m�� J �� p �� W �� 2 D D � C � � • o�} 3>:��tn-ptn pN C�N��W� C!1 C-W�•C�+� . a• �'+ ci�00 �N -i�a�c� cn cD� a � � D C'f Ann E. Rhoads, Attorney at Law 2�� West Main Street Hummelstoi��n, Penns�-lvania 1703b �.�, Telephonc: 717-482-8392 C ° � �, Facsimile: 717-482-839� � �,° �, rn <<''-, Email; nc��adsann.,�a;hotmail.com rn � � �, �G, � � � r-; N ��;`i rr"! G i 'L --., C� Apri123, 2014 `=� ca �; -� �-�,��, r3 a -,� � ' -�-� o c -- ,:� c� :.� --�'-r �' r rn Office of the Register of Wills �' o "' ° Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Betty C. Barnes No. 2013 —01008 Dear Ladies and Gentlemen: I enclose the following for filing in the above-referenced estate: (1) Original and one (1) copy of Inventory; (2) Original and two (2) copies of Inheritance Tax Return; and (3) Estate check#0997,payable to Register of Wills, Agent, in the amount of$401.71, in payment of the balance of the inheritance tax Please date-stamp the extra copies and return them to me in the self- addressed, stamped envelope provided. If anything further is required to accomplish these filings,please contact me. Thank you. Very truly yours, `,J�-`- � , � Ann E. Rhoads ��C�� Enclosures Cc: William E. Barnes, Jr., Executor(w/encl.)