HomeMy WebLinkAbout03-31-05 (3)
"-<y_: ,~'1 IT. if; -
REV-1500
'*' COMMONWEALTH OF
. PENNSYLVANIA
. ~ . r DEPARTMENT OF REVENUE
DEPT 280601
,. . HARRISBURG, PA 17128.{)EOl
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FilE NUMBER
21 05
0075
CO!JNTYCODE YEi\R
NiJi-f5E.R
SOCIAL SECURITY NUMBER
208-24-4314
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DtCEDEIJrS: NAME (LAST. FIRST, AND MIDD_E INITIAL)
YOHE, KATHRYN R
D.c\TE OF JEATH IMr\iWD-YEAR) - ----1 DATE-oF BIRTH (~'IM~-D.'y;EAR)
12/29/04~03/~~34_
(IF APPLlCA.5L..E\ SURVIViNG SPOUS€:S NAME. {LAST, FIRST, AND MIDDLE INITIAL')
SOCIAL SECURITY NU~1BER
THIS RETURN MUST BE FlLEO IN DUPLICATE WITH 1H\;
REGISTER OF WILLS
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o 6 ~>(.~::en\ Dle~l Testate (;l,",K~,~,)\}p(Wi\11
o 9_:..i!'gaiicn?roceedsReeeived
o 2. Supplemental Retum
o 4a. Future Interest Compromise (doh) 0' JI\fllh fif:er 12-12_~2)
o 1, Deced~li\ Maintained a Uv:ng Trus\ iAc"G~ ,;opy ,,:T,td)
o 10. Spousal Pcvl'lrtyCredit (~":,) Qfdeil:~ bdwoon 12-31-91 and 1,1.95)
o 3 Remainder Return iu" ,i ;),."J, pri(~ -I) :2-lo.s2j
o 5. Federal E;;ta:e Ti1~R(~tL :1 Require~:'
g, Total r~u:l1bp.1 ofS:,,18 [J'W1)s:! 30xes
o 11, Elec!~on to [.JX undel SRC, S<113(A) (A"Vd '.;~r, I:,
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THIS SECTION MUST BE COM~LETED.'ALI.CORRES"ONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED Tb:
NAME COMPLETE MAILING ADDRESS
Andrew C. Sheely,Esqu~e Andrew C Sheely, Esquire
fIR\'1 NNit=: i1-!\:"jlicClblel 127 South Market Street
Andrew C. Sheely, Att",neY_at Law PO Box 95
TE:..EP~('N~ NUMBER Mechanicsburg, PA 17055
(717) 697-7050
Re8::s~~te ISchedule A)
2 S\IY,~; 3',1:1 B"r,d" (Schedule B)
(1)
(2)
3 GinSf':. Held Corporation, Partnership or Sole.Proprietorship
(3)
(4)
(5)
4 MGrlgago:-s & ~otes Receivable (SChedule OJ
31,87121
Casil 3al1k uerosits & Miscellal1eoLJs Personal Property
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(6}
\J JC:'1t:,' C'w~,sd Pr0;::erty (Schedule F)
D;i:,p,,~ate 8:iiir\g Requeste1
Inter-'liv('s :ransfers & Miscellaneous Nor,.Probate Property
(Sd,eju;e G or L:
(7)
9 FU~.FH'l1 bp?nSAS & Administriltive Costs 'Schedule H)
(9)
Ie)
4,635 DD
20,83660
31,871.21
Total Gross Assets (total lines 1-7j
(10)
10. Deb!:' rf:"',,::::-;edeI1L Mortgage Liabilities, & Liens (Sclledule I)
11 Total Deductions (tctal Lines 9 & 10)
(11)
'.12)
(13)
25,471.60
12 Net Value of Estate (Une 8 minus lii18 1t)
13 C~,,,r:' "DO' :,'10 Covernmental Bequests/SI,e 9113 Trusts for wr,ich an election (0 tax has noi been
r'IJrJ? :SC:l"~Ui? J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
6,399.61
..--- -_.."._-_.~,._--
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES
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15 t\n1C'I:nt (if :...:rle 14 taxable at thespcusallax
r,,:c_ :l~ t'Jnsfers LJnde~ Sec_ 9116 (a)(1.2)
X.o (15)
_~399,61 x.o 45 (16)
287.98
------....----.--.-
Hi Aw_',t'.fLins 14 'axabie at iineal rate
x.12 (17)
1? A.~ll'V,~ d :..:ne 14 taxab!e at sibling rate
x .15 (16)
18 AI110L'1t o! !..;'-.e 14 taxable at collateral ratf~
119)
....__287~98_
19 Tax rue
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET AOQRESS 900 North Ha~over Stre~t,u Cpuxch of God Home
CITY.
-I STATE ~~
,,,Ca.rlisle
Tax Payments and Credits:
1. Tax Due (Pagf~ 1 Lille 19)
2, Credlts/Pay'mf,nts
A. Spousal Pov€r"ty Credit
S. Prior PayrMnls
C. Discount
(1)
15.16
Total Credits ( A , 6 , C )
(2)
3. interest/Penaily if aopllcable
O.lnterest
E. Pel1aity
Tota! !nteresVPena!ty ( 0 + E ) (3)
4. If line 2 is greater than Line 1 + line 3, enter the difference. This is tile OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If U!l€ 1 + Lln~, :3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
A. Enter thp, irlerest on the tax due.
(5A)
(56)
B. Enter the teta! c/ Lir:e 5 + SA. ThiS is t!1€ BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
l ZI'P.
17013
287~!1
1516
~1l2
2721J.~
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT Mi PART OF THE RETURN.
2
Did tleceC\ent make a transfe~ and:
a retain the use or income of the property transferred;..
[\ retam the right to designate who shall use the property transferred or Its income:.
c retain a reversionary interf!st; or...
d. receive the promise for lik of either payments, benefits or caJe?..
!f death occurred after December 12, 1982, did decedent transFer property within one year of death
without receiving adequate c['flsideralion? " .
O:d decedent own an "in trust for" or payable upon death bank account or security at ilrs or her death?..
Old decedent own an IndividLal Retirement Account, annuity, or other non-prObate property which
contains a beneficiary deslgn;:ltion?
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Unde.r penalties of perJuf'. I decli\re that I have examined this rerum, including accompanying schedules and statements, and to the best of my ~nowledge and belief it is true. correct
md compl*'
Declaration Jipreparer olhertl',an the personal representative is bCised on all information ofwhicn preparer has anymowledge
SpGN TURE OF ~~s N ESPONS!~LE FOR FILING RETURN
~ 1 -//I'm - --
AD RESS
Russell F. Yohe, Administrator, 713 Hamilton Ave.,Mechamcsburg, PA 17055
S~Rf!~REPR,ESENiATNE-- -- --
ADDRESS
Andrew C. ShE,ely 127 S. Market St, P.O. Box 95, Mechanicsburg, PA 17055
D\TE5))~) J9F
DJEjl7/0S-
For dates of death C:1 or after Juiy 1 1994 and before January 1, 1995, the lax rate imposed on the net value of transfers to orfor the use of the SIWlfiVlr)Q ~,poUse IS 3S'~
[72 P.S, S9116 (a) (1.~,\ (i)),
For dates of dealh':1l 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% [72 P.S, ;W116 ~a) (', .'1) IPI
The statute does ;1(:U.~~ a transfer to a survivln,~ spouse from tax and the statutory requirements for disclosure of assets and filing a tax return (1,"6 s/i,'! appii::ab!e eve'l
lne survIving SPOU5f :5 (:1e only beneficia!)'.
For dates of death (:1 0' after July 1 2000
Tile tax rale :mpcsf-d (':) the net value of lransfers from a deceased child twenty-one years of age or younger at death to or for lhe use of a n, tural O;:FE::l1 an adc'ptlve par,~n
or a stepparent Of Ih3 chl:d IS 0% [72 PS. ~9116(a)(1 ,2)].
The lax l"8\e ::npose 1 0:1 (;1E net va!ue of transfers io or for the use of the decedent's linea! beneficiaries JS 4,5%, except as noted in 72 P.S, ~911611 2) (72 F'S \)9116(a)(1)]
The lax rate :mVjsf:d 8:"1 the net value of transfers!o or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(13)]. A sibling is d~~~ned, u:lde:" Seclicll19102 as a
individual wiw has E,\ :eas\ one parent In common with the decedent whether by blood or adoption.
REV-15% EX+ it" ~12)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
C<)M1V'~~i\;\I\lEA:_TH OF PENNSYLVANIA
!W';U~ITANCE TAX RETURN
;::;::>=:,SIDENT DECEDENT
ESTATE OF
FILE NUMBER
K~THRYN R. YOHE 21 05-007~
Include the proceeds of litigation and the dale the proceeds were received by the estate
All property jointly-owned with right of survivorship must be disclosed on Schedule F
ITEM
NUMBER i
DESCRIPTION
VALLJE AT DATE
OF DEATH
1.
PNC Bank
Checking Account #5140071006
Principal balance at date of death
Accured interest
Date of Death balance
$ 5,480.19
$ .53
5,480.72
2.
MetLife Annuity,
Contract Account #a2069443
Date of Death value
23,696.37
3.
MetLife Stock
Investor ID Number 806355485696
Date of Death value $40.82/share
66 shares
2,694.12
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
31,871.21
.JAN-30'-2005 22:1114
PNCBANK
412 768 3458
P.01/01
~PNCBAN<
January 31, 2005
A!l4y Sheely
127 S. Market Street
Meehanlcs'burs. PA 17055
RE: &tate of Kathryn R. Yobe. dllceued
SSN: 208-24-4314
DOD: 12/2912004
Dear Mr. Sheely:
In response to your lllqlUllt for Date of Death balances for the cuatomer noted above, our
reconIa show the followilla:
Cbeckball AeCOUDt
Account #5140071006
Established 10/01/1963
KATIIRYN YOHE
DOD balaru:e: $5,480.19 + $.53 accnmd interest
The decedent maintalned Inveslment Account (INV #88553246). For further lnfolIllation
YOIl may contact the.Brobrage Department at 1-800-762-6111.
Please note that this oflioe OIlly provides da~ of death bahlnoes for dopoait lCCounts
(IRA!, CDs, Checkina and Savlnp aooounts). We do DOt pl"Ollee. any flnaal
traauctlou or prlMde nateme..... If you need auistance with any of theso items,
please call1.888-PNC-BANK (1-888-762-:2265) or stop by your local PNC Bank braneh
office.
Sinc.<<ely,
~~
Rachelle WoIls
1-800-762-1775
P7-PFSC.Q4-F
500 tilll Ave.
PllllburpPAU219
Member PIlIC
TOTAL P.01
.03/1572005 12: 28
71 77308254
,. PNC
,._..~-",=~..,.,.
.., l!1!TUJ1E INV"STOlt5
OalU,.'O/i TI'F. 10':7 /:',U HI~4~7HO~
MetLife
Mell\~h 15. 2005
AM: BOI"nie Snyde'
Fax: 7177300254
RE: Contr:lC\ Number: a2(lt;~3
DI'<lr Ms, Snyder:
'fhank you for your recent re(1liEillt regarding the abOve referenc.ed contract. Cur
records Indicate t'1u ace-cont va!u" on too date oi death as follow",:
Date of Pl!~1h, 12r.l9/2004
Acr;ount Val<Je: $:n.6'163'7
If you h!lV8 any questions regarding the Ilbo~ please contact an Anl"lulty Service
RepresentatIVe 111.1-800-284-4536, Our slaff w"' gladly help you be1ween me
hours of ":30 ..m and 5:~Q p,m., Central Time, Monday throtJgh Thur$dl:lY and
7:30 ".m to 5:00 p.m, on Friday,
S,ncer&ly
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R~~gan lfigla
Annuity Pr~licy Servic.ll Department
Pl_w .",ct All C-"tU.~,_,.1IIU ~,
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MlMLlflIlM'WlIIOn """ tr..urClftc.. ("''PGrrt
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PAGE 01
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REVW1 EX' i"~'''''lJ<,.~Q~
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COM!v!CI\;','Vt.ALTH OF PENNSYLVANIA
IW-iU~:TANCE TAX RETURN
RtSIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
KATHRYN R. YOHE
FILE NUMBER
21-05-0075
ESTATE OF
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A FUNERAL EXPENSES:
1
MUSSELMAN FUNERAL HOME
I
B ADMINISTRATIVE COSTS:
1 Personal Representative's Commissions
Name of Personal Representative(s) RUSSELL F. YORE, ADMINISTRATOR
Social Security Number(s)/EIN Number of Personal Representalive(s)
- -
StreelAddress 713 HAMILTON AVE.
City M.r.;~a.IU't.lt,;t;DU.Kb State~Zip 1"J (}:i:i
Year(s) Commission Paid:
2 Attorney Fees ANDREW C. SHEELY, ESQUIRE, PER AGREEMENT
3 Family El(emption: (If decedent's address is rial the same as claimant's, attach explanation)
I Claimant
Street Address
City State _Zip
Relalionship of Claimant to Decedent
4 Probate Fees
CUMBERLAND COUNTY REGISTER OF WILLS-PROBATE FEES
5 I Accountant's Fees
6 Tax Return Preparer's Fees
7
FILING FEES FOR INHERITANCE TAX RETURNS
Reserves too conclude Est.at.e administrat.ion
I
,
TOTAL (Also enter on line 9, Recapitulation) I
1 .
(If more space is needed, insert additional sheets of the same size)
^lvIOUNT
$3,499.00
$ 0.0(1
$ 500.0('
$ 121.00
15.00
500.00
4,635.00
',. ,. ...111
-~ ..,;.~ ~~
.MI.u s selman
Fumeral HOJllll.e
& Crelllll./lttrroR
SeJ'viees, be.
Established 1895
Brian C. Musselman, ED.
SupeNisor
William G. Pegan. ED.
P.O. Box 137
324 Hummel Avenue
Lemoyne. PA 17043-0137
1717) 763-7440
Fax: 717-730-9798
www.musselmanluneral.com
To Funeral Expenses of KATHRYN R. YOHE
Jan.10,2005
Russell F. Yohe
713 Hamilton Ave.
Mechanicsburg, PA 17055
2005
January 8
PROF. SERVICES FOR CREMATION & MEMORIAL SERVICE
"Union" cloth-covered cremation unit
"Mer lot" cultured marble urn/vault
$2,450.00
295.00
325.00
$3,070.00
Cash Advance Items:
Flowers
Certified copieS
Newspaper notice
Cremation authorization
Gold picutre frame (deluxe)
$53.00
4{) . 00
1116.00
25.00
95.00
$429.00
total
$3,499,00
fOR APPOINTMENT PHONE 717-763-7440
RECEIPT FOR PAYMENT
-----------------~-
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Receipt Date:
Receipt Time:
Receipt No.:
1/25/2005
10:1)8:54
1039252
YOHE KATHRYN R
Estate File No. :
Paid By Remarks:
2005-00075
KATHRYN YOHE
JA
Fee/Tax Description
PETITION LTRS ADM
SHORT CERTIFICATE
JCP FEE
AUTOMATION FEE
Check# 6816
Total Received..... ....
Receipt Distribution ------------------------
Payment Amount Payee Name
90 . 00 CUMBERLAND COUNTY GENERAL FUl\
16.00 CUMBERLAND COUNTY GENERAL FUN
10.00 BUREAU OF RECEIPTS & CNTR M.D
5 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
$121. 00
$121.00
I<EV-ISlnx'I1-97i
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVAN1A
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KATHRVN R VOHR
FILE NUMBER
21-05-0075
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
he Church of God Home, Iue. - fiual bill 20,836.60
TOTAL (Also enter on line 10, Recapitulation) $ 20,836.60
(If more space is needed, insert additional sheets of the same size)
03/12/2005 15:06
2541125
CHJRCH OF GOD HO
PAGE 02/02
t:!1
00004550
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WoC;
"\~~ltll~ft(I,{
THE ClflJJ:CB OF GOD aOME, INC.
1101 N, IIJ\"'OV~R STREET
CARllSLE,I'A li01.1
n, 7l24'iw53J2
t\MOllNTClF ) s J
PAVM~Nr,,_~",
rSl,.TEMENT ;:lATE[
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! "!SI09IT NU"'"' "I
I OOOO~246Tl
~"KATlIRY!Il 'R
RES1PE,..<r r..IAMI!
nl
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I RUSSELL YOllii:
I 713 !lJ>.MILTOlil AVENIlS
. MECHANICS2URG PA 170~5
L
'--1 ' "r"
UNITS
n
E~~IOlin'"^Nc~1 $ ~~BJ6. 60 \
REF~~~~'t_~ ~~::~oj
PLEAS!; D!;TAC~I AND R!;TURN THIS PORTIDN WI1M YOUR PAYMENT
, 'OA1;;"["- TRANSACTION DESCRIPTION
I~I'IOS .~~ /\JV:c' J 1
.'
gmnM!NT DATE PFlEVIOf,l$1/iW.ANCE
CURRiN't CHAfL'lQES
'~ 0
F!\vMIM'S
ADJWSl'MI!NTS
J.6D3'.iSO
~ B
L-
TR:t C1<<JRCB OF GOTlllO:ME, INC.
TO !'I1IOJ!1:I[1I..1Jlt!T^GT.I'(IM~OL.DITlItl ~~HIC C~l~~t(lI\TlONPl'llrWlI\IIIlI>lIll' f~7111 ~!"Ml~
REV-1513 EX+ 11-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
KATHRYN R. YOHE
FILElIUMBI;fl
zl-u5--0075
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)
1. RUSSELL F. YOHE SON 100% of Rest
713 Hamilton Ave. Residue and
Mechanicsburg, P A 17055 Remaindel'
,... .
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DtSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARtT ABLE AND GOVERNMENTAL DISTRIBUTIONS
1
TOTAL OF PART n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space IS needed, insert additional sheets of the same size)