HomeMy WebLinkAbout04-17-14 1505610105
REV-1500 Ex(02-I1)lrf,
OFFICIAL USE ONLY
PA Department of Revenue pennsylvarda
Bureau of Individual Taxes `M"`"`» Na County Code Year Pile Number
PO BOX 280601
INHERITANCE TAX RETURN
Harrisburg,PA 17128-o6o1 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08/01/2013 07/19/1925
Decedent's Last Name Suffix Decedent's First Name MI
Mahone Dorothy ... Q
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouses Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1. Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
OD 6. Decedent Died Testate O 7, Decedent Maintained a Living Trust 8, Total Number of Safe Deposit Boxes
(Attach Copy of Will) (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 TO:
Name Daytime Telephone Number I
Nicole L. Javitt, Esquire (717) 975-9446
0
REGISTe-,',Q ILLS U9E��INLY� CD ¢
co
O
fTl = C7 _4
First Line of Address Y r- 1'. Rt rTt
_ _. _._ . .. ... ._____...._.... ... . . _ Z M __j
2132 Market Street !
> ° °
� C3 O
Second Line of Address _ _ 0 C7 3 "7 T .I
C
w r rn
City or Post Office State ZIP Code Dl FILED t— p
Camp HIII C
PA 17011
.rT
Correspondent's e-mail address: njayltt @dplglaW.COm
Under penalties of perjury,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.
SIG A UR P S SP SIBLE FOR FILING R TURN DATE
— /0 /
A - 6 1133 `}-iD /
S URREPA ER THERT EPRESENTATIVE DATE
ADAKESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Dorothy Q. Mahone _
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 and Notes Receivable(Schedule D) .. ........ ... ..... . .. ... .. . 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)... ... . 5. 72,399.39
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... ... . 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ---
(Schedule G) O Separate Billing Requested.. .. .... 7 339,509 35
8. Total Gross Assets(total Lines 1 through 7)......... ..... .. . .. ... .. . ... . 8. 411,908.74
9. Funeral Expenses and Administrative Costs(Schedule H). ....... ......... .. 9. 14,733.77
_ m ._. __
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). ... ... ..... ... 10. _i 1,829.16
11. Total Deductions(total Lines 9 and 10).. .. ... ..... ... .. .. . .. . .. . ..... .. 11. 16,562.93
12. Net Value of Estate(Line 8 minus Line 11) . .. . .. .. . .. . .... ... . .. .. ...... 12. 395,345.81
11 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. 395,345.81
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(12)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 395,345.81 16. 17,790.56
17. Amount of Line 14 taxable
at sibling rate X 12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 j 18.
19. TAX DUE 17,790.56
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Dorothy Quinn Mahone
STREETADDRESS
5225 Wilson Lane
CITY - _ STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 17,790.56
2. Credits/Payments
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 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) 17,790.56
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.........................................................................__......_..... ❑ 0
b. retain the right to designate who shall use the properly transferred or its income............................................ ❑ N
c. retain a reversionary interest............................................................................................___......___............... ❑ N
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?.............. ❑ 0
4. Did 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 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)(1)].
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 orforthe use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in 172 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)].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-1508 EX+(o8-u)
Iffpennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Dorothy Quinn Mahone 21-13-1057
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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Prepaid funeral expenses to Parthemore 12,399.39
2. PNC Bank,checking account,account#51-4004-1165 60,000.00
TOTAL(Also enter on Line 5, Recapitulation) $ 72,399.39
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERUANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dorothy Quinn Mahone 21-13-1057
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.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %Of DECO'S EXCLUSION TAXABLE
INlU DE THE NAME OF RHE ERMSFEREE.THEIR REUDDNSHR To DEaDENT AND
NUMBER THE DATE OF TRANSFER. ATTACH A mw OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST fo APPUDRSNE VALUE
1. Allstate through PNC investment services Annuity 339,509.35 100 339,509.35
Transferees:
Dorothy Braun-daughter
Richard A.Mahone-son
Camilla M.Braun-daughter
Patrick B.Mahone-son
:Michael Q.Mahone-Son
Daniel L.Mahone-son
Thomas E.Mahone-son
TOTAL(Also enter on Line 7,Recapitulation) $ 339,509.35
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
i pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERrrANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dorothy Quinn Mahone 21-13-1057
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Funeral expenses for Parthemore 12,399.39
. .. . .......
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees:
1,650.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
city State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 434.38
5. Accountant Fees: 250.00
6. Tax Return Preparer Fees:
7.
TOTAL (Also enter on Line 9, Recapitulation) ¢
14,733.77
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12.12)
Yom' pennsylvania SCHEDULE I
DEPARTMENTOF REVENUE DEBTS OF DECEDENT,
INHOUTANCETAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT OECEOENT
ESTATE OF FILE NUMBER
Dorothy 0, Mahone 21-13-1057
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. Omnicare-prescriptions 202.95
2. Bethany Village Nursing Home payment 1,626.21
TOTAL(Also enter on Line 10,Recapitulation) 1,829.16 -
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
j&''' pennsylvania SCHEDULE J
�7� DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Dorothy Quinn Mahone 21-13-1057
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEPVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distrlbutlons and transfers under
Sec.9116(a)(1.2).]
I. Dorothy Braun,873 Moores Mtn.Rd.,Lewisberry,PA 17339 daughter $56,477.97
2. Richard A.Mahone,1222 Chara CL,Sparks,NV 89441 son $56,477.97
3. Camilla M.Braun,310 Castone Lane,Pittsburgh,PA 15237 daughter $56,477.97
4. Patrick B.Mahone,27748 Patti Lane,Romoland,CA 92585 son $56,477.97
5. Michael Q.Mahone, 1138 Wright Street,Reno,NV 89509 son $56,477.97
6. Daniel L.Mahone,278 S.Lewisberry Rd.,Mechanicsburg,PA 17055 son $56,477.97
7. Thomas E.Mahone,7318 Silverwood Td.,Kingwood,TX 77346 son $56,477.97
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 16 OF REV-1500 COVER SHEET,AS APPROPRIATE.
11 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 11- 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.
LAST,WILL AND TESTAMENT .
OF
DOROTHY QUINN MAHONE
I, Dorothy Quinn Mahone, a resident of 427 Blacklatch Lane, Camp Hill,Pennsylvania,
being of sound and disposing mind and mem-ory,do hereby make, publislf,and declare this_,.z,._. ;.•;. .-,c ..•.-,,,,,m, -
�" — --"instriamei�t`to be m Last`W!f and 7estamsnt.'•"
FIRST. I hereby revoke any and all wills and codicils by me heretofore made.
SECOND. I direct that all my just debts and funeral expenses be paid as soon as
conveniently can.be done after my death.
THIRD. I give, devise, and bequeath all my estate and property,including all
Properly of which I shall die seized and possessed, all property to which my estate shall be 1.t. v otherwise entilled•at the'time of my death; and alt pto"petty"oJer wtiicti I shalt have power of
appointment,of whatsoever kind or nature and wheresoever situated, be it real, personal or
mixed, absolutely and forever, in equal share, to my children Thomas E. Mahone, Daniel L.
Mahone, Michael O.Mahone, Patrick B. Mahone, Dorothy L. Braun, Camilla M. Braun, and
\ � Richard A. Mahone, and any child or children that may be born to me or adopted by me hereafter;
�t but if any of my children predecease me,then to the heirs of such child or children who are Irving
/ - at my death, such heirs to take per stirpes and not per capita.
FOURTH. This Will is hereby made in contemplation of the fad that children may,
be born to me or adopted by me after the execution of this Will and, accordingly, I direct that all
references in this Will to "children"or"child"shall be construed to include those born to me or
adopted by me after the execution hereof, as well as those already barn to me or adopted by me.
In this Will"heir"means the lawful, lineal heirs of the person referred for
FIFTH. Wherever in this my Last.Will and Testament it is provided that any person shalt
benefit Hereunder if such person shall survive me, such person shalt be deemed not to have
survived me if heror she stall die within thirty(30y days after my death. .
_ _ - _.. �.,. ... .+�.+r•, .. .- ._..,. _ ,-, ..-,.« ..Jar
SIXTH. I nominate, constitute and appoint my daughter Dorothy L. Braun,to serve as
Executrix of this Will. I request that the Executrix be permitted to serve without bond and without
furnishing any other security. .1 further direct that.the Executrix be allowed to serve without the u
intervention of any court except as required by law.
SEVENTH. i give my said Executrix,absolute discretion and the fullest authority in all
matters including, but not limited to the following powers:
•.,:r:,,..,,...: ... ...., ..,. , (a), ..,.,.Tq.retain;any.oraii,of.the.assets ofmy,estate-without.regard4o=any:,•,.•,.. . , •.«: c.,
principal,of.diversification;risk-or productivity. . . «s•. ._ ..«�.
(b) To invest in all forms of property without restriction to investments
authorized for any type of fiduciary.
(c.5 To compromise any claim.or.cdntroversy: ;
(d) To loan money to-or to purchase p'r"operty from my probate estate.
(e) To borrow money from any person,including any Executor or
Trustee, and'to.mortcdage or pledge any real or personal property. '
(f) To sell at public or private sale, to exchange or to lease for any
period of time,any real or personal property,and to give options
for sales, exchange or leases, all for such prices and upon such
terms and conditions as they deem proper.
` (g) To allocate receipts and expenses to principal or income or partly
to each as they deem proper.,«
(h) To tepair, alter or improve any real or personal property.
(i) To distribute in cash or in kind or partly in each at valuations fixed
by the Trustee.
{j} To purchase investments at premiums and to charge premiums to
income or principal or partly to each.
(k) To subscribe for or to exercise options for stocks, bonds or other
investments;tojoin in any plan or lease, mortgage,merger,
{ y consolidation,reorganization,foreclosure or voting trust and to
J deposit securities thereunder; and to generally exercise all the rights
of security holders or employees of any corporation.
(1) To register securities in the name of a nominee or in such manner
that title shall pass by delivery.
(m) To add to the principal of any trust created by this instrument and
real or personal property received from any person by Deed,Will or
in any other manner._.
(n) To exercise all power, authority and discretion by this instrument
after termination of any trust created herein until the same is fully
distributed.
(o) To commingle the assets of any trust estate created by the Will in
any one or more common funds for greater convenience and
flexibility.
(p) To employ attorneys, accountants, engineers and other such
persons, professional and otherwise, as may be necessary for the i
proper administration of this estate or trust and to pay their
compensation from such funds.
(q) To pay off the balance of any mortgage and permit my child and
his Guardians to live in the house free of rent.
...r.�.• . _..cam.-. -,.:,..A...; -.,,.�.:�. .- - -- - -- `.--•°.s.>.. -
i c1
i aired that the administration of my'estate be .s independent of probate proceedings as the laws
in force at my death shall permit. If any of my estate passes to a minor, I hereby direct that my
Executrix pay over said portion of my estate to the legal guardian of said minor or minors.
EIGHTH. All estate, inheritance,succession and other death taxes imposed or
�� _r _ :•rccw•a_:,t.'.'.'uTr i', m'�t.rt` r..t:.'wd,.rn.-:_.✓:.r..- v. •:w�. .c ., .�.
•'�tV� f•AR Kwr •.lrr ]± .II:Fi 1,'T� � P Ia.A y„'•!'F� 1. fi"�Y^+•'.- -
,payable by=reason,otmy.dealh,and•interest-and•penalhes°thereon,with respect fo all property
compromising my gross estate for death tax purposes, whether or not such property passes_..
r .
• under this Will,shall•be:paid out of the principal of my general estate, as if such taxes were
administration.expo;ues;.wifhouf apperiio;unent o�righi'of'reimbursement. l authorize my legal
representatives to pay all such taxes at such time or times as may be deemed advisable.
IN WITNESS WHEREOF, I have at Camp Hill, Pennsylvania,this day of January,
2002, set my hand and seat to this, my.Last Will and-Testament consisting of fi0e(4)'pages;' - '
• ..... .... .. _
including the acknowledgment.
C -
Doroth Quinn Mahone �w (3EAL)
SIGNED, sealed, published and declared by Dorothy Quinn Mahone, the above Testatrix,
as and for her Last Will and Testament, in the presence of us, who, at her request, in her
Presence and in the presence of each other, have hereunto subscribed our names as witnesses.
.. ess Residence:Jlr) �."i ,Cif\l1Vf•� .S` �Y`�(-�\�1L:. ..;.y.`..:..,�:./�_� I'`
Witness Residence:nQ �� /� ) _/�h� }�I I,.(O'7�
Witne Residence`F�' �� 1761—Y
_. ��r._r,r•..... -•-'.:..;•ray.,•--°'- tras -0-- - -_- - - - - •;r-----..• —
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,F
GOMMONVVEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
We,the undersigned, being the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,do depose and say that we were
present and saw the Testatrix sign and execute the instrument as her Last Will and Testament,
that she signed it willingly and that she executed it as her free and voluntary act for the purposes
therein expressed;that each of us in the hearing and sight of the Testatrix was at the time
eighteen(18) or more years of age, of sound mind and under no constraint or undue influence.
�( Residence:���-) �� C11\lrV f.�J�.�C_��a ��s1� "1 / l l i fs
ness
• Residence:&Q
Witness
Residence: P Y3 i i !OQ
in
M tUbscribed, sworn to and acknowledged before me by the above-names witnesses,this
day of , 2002.
Not707Vubfic
My Commission Expires:
Notarial Seal
Darrell C.Dethlefa, Not Public
Hampden Twp., Cumberland County
My Commisslon Expires June 14,2004
Member,PennsyNanle A9a0Claflon of NgtanBa