HomeMy WebLinkAbout06-05-14 � 1505610105
REV-1500Ex�oz_��,�F�>... ,
enns lvania OFFICIAL USE ONLY
PA Department of Revenue P r Y County Code Year File Number
E,A�E� �R��F��E
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po BoX z$oso� ' 21 /� l�yi
Harrisburq,PA i�i28-o601 RESIDENT DECEDENT '
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
'; ' 12/16/2013 ' 08/02/1926
DecedenYs Last Name Suffix DecedenYs First Name MI
Shearer ; Evelyn _ __ M '
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return p 2.Supplemental Return p 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.�imited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
m 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.)
� 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 ,-�,
Thomas P. Gleason (717) 532-3270c�-_- o � � rn
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REGISTER OFr�N�LC�U�ONL� ,.j ;;�
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First Line ofAddress �,; � i � = � �
.. ... ...... .... .... . . .. ... ...... ..... . ............. . . i : .�': r-, r,..,a
49 West Orange Street ' c, ��, —cr •., -�:-�
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Second Line of Address t.y *� _ �
_. . � ►--+ �_:�: <'a
Suite 3 ' -� � " rn
c.n cn o
City or Post Office State ZIP Code DA�FILED p 'T1
Shippensburg ' PA , 17257
CorrespondenYs e-mail address:
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.
SIGNAT E�O�F�P RSON R PONSIBLE FOR FIIING RETURN DAT�E/
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AD/D�T� ��r��- ��.E- �� ���� /
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIV DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610105 150561D1D5 �
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� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs rvame: Evelyn M. Shearer '
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. I 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. Mortgages and Notes Receivable(Schedule D)........................... 4. ' 0.00 ',
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. ' 18,574.83 '
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ', 0.00 '
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets(total Lines 1 through 7)............................. 8. ' 18,574.83 '
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. ' 13,561.76 '
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. 16,895.27 '
11. Total Deductions(total Lines 9 and 10)................................. 11. , 30,457.03 '
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. ' -11,882.20
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ........................ 13. I 0.00 '
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. , 0.00 ,
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0- 0.00 15.' 0.00
16. Amount of Line 14 taxable " '
at lineal rate X.0 45 ', 0.00 '!, 16. 0.00 '
.
17. Amount of Line 14 taxable '
at sibling rate X.12 ', 0.00 ' �7,' 0.00
18. Amount of Line 14 taxable _ ___
at collateral rate X.15 0.00 ' �g 0.00
19. TAX DUE ......................................................... 19.' �.00 '
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
� 1505610205 1505610205 �
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Evelyn M. Shearer
- -- -..___------ -____-
------- _--_ __-------- ----
STREETADDRESS _ -- ---_.. ._.-----.. _____- ------- -__
The Episcopal Home
206 East Burd Street
- -- - ---
CITY ', STATE ^ ZIP
Shippensburg ', PA 17257
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments
A.Prior Payments __._..___ 0.00
_---.._._._- ---
B.Discount 0.00
Total Credits(A+B) (2) 0.00
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) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
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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 ............................................ ❑ �
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
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.
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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 suroiving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)J.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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)J.
. 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 decetlent,whether by blood or adoption.
REV-i5o8 EX+(o8-1z)
� pennsylvania SCNEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Evelyn M. Shearer
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 P.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Sale of mobile home located at 133 Shippensburg Mobile Estates 12,000.00
2. M&T Bank CD Account No.31003911817195 6,000.00
3, M&T Bank Checking Account No.9850440208 118.32
4. Refund from The Episcopal Home 227.11
5, Refund from Adams Electric Cooperative 19.42
g, Proration of 2014 Countyltwp.taxes at sale of mobile home 67.38
7, Proation of 2013-14 School taxes at sale of mobile home 24.24
g, Proration of May 2014 lot rent at time of sale of mobile home from Shippensburg Mobile Estates 118.36
TOTAL(Also enter on Line 5, Recapitulation) $ 18,574.83
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
RES[DENT DECEDENT
ESTATE OF FILE NUMBER
Evelyn M. Shearer
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES;
1' Fogelsanger-Bricker Funeral Home 5,482.70
2. Weis Markets food for Memorial Lunch 89.62
s. Giant Food Store food for Memorial Lunch 181.30
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 1,000.00
Name(s)of Personal Representative(s) Linda L. Somers/Barry D. Shearer
street address 1049 Ashton Drive/108 Locust Street
city Shippensburg state PA ZIP 17257
Year(s)Commission Paid: 2014
2, Attorney Fees:
2,250.00
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: 138.00
5. Accountant Fees:
6. Tax Return Preparer Fees:
�� The News Chronicle for publication of estate 104.75
s. Cumberland Law Journal for publication of estate 75.00
9. Sailhamer Real Estate for commission to sell 133 Shippensburg Mobile Estates 2,000.00
�o. Tanner Home Energy for oil from DOD to settlement on 133 Shippesburg Mobile Estates 503.39
��. Adams Electric Cooperative for electric from DOD to settlement on 133 Shippensburg Mobile Estates 272.00
12. Shippensburg Mobile Estates for lot rent from DOD to settlement on 133 Shippensburg Mobile Estates 1,465.00
TOTAL(Also enter on Line 9, Recapitulation) � 13,561.76
If more space is needed,use additional sheets of paper of the same size,
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REV-1512 EX+(12-12)
� pennsylvania SCHEDULE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Evelyn M. Shearer
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• M&T Bank Loan No. 10000139286880001 (Secured by M&T CD Acct.No.31003911817195) 4,795.23
2. One Main Financial Account No.67380316-0381467 9,859.85
3. M&T Visa ending 4544 1,842.89
4. JC Penney Account No.ending 098 21 98.91
5. Instant Dignostics Testing 4.39
6. Century Link for final phone bill 40.68
7. Alert Pharmacy 111.32
8. State Farm Insurance for homeowner insurance until time of sale of mobile home 142.00
9. Suburba Propane 76.32
TOTAI(Also enter on Line 10, Recapitulation) $ 16,971.59
If more space is needed,insert additionai sheets of the same size,
REV-1513 EX+(01-10)
� pennsylvania SCHEDULE �
DEPARTMENT OF REVENUE
� INHERITANCE TAX REfURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF; FILE NUMBER:
Evelyn M. Shearer
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTR[BUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(11).]
1• Linda L.Somers Lineal-Daughter 50%
2. Barry D.Shearer Lineal-Son 50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPR�PRIATE.
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, $
If more space is needed,use additional sheets of paper of the same size.
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LAST WILL AND TESTAMENT -
I, EVELYN M. SHEARER, of 120 South Prince Street, Shippensburg, Cumberland
County, Pennsylvania, being of sound mind, memory and disposition, do hereby make,
publish and declare this my Last Will and Testament, hereby revoking and making void
all wills by me at any time heretofore made.
FIRST. I order and direct the payment of all my just debts and funeral expenses as
soon as may be convenient after my decease.
SECOND. I give, devise and bequeath all my estate, real, personal and mixed,
� whatsoever and wheresoever situate, to my beloved children, LINDA L. SOMERS and
IBARRY D. SHEARER, on a per stirpes distribution basis.
'
THIRD. In the event that any beneficiary of this my Last Will and Testament is
under the age of twenty-one (21) years, I then give and bequeath said beneficiary's
share to and appoint as Guardian of any property which passes under this Will or
otherwise, LINDA L. SOMERS, of 115 North Penn Street, Shippensburg, Pennsylvania, AS
GUARDIAN, NEVERTHELESS, to invest and re-invest the same until the said beneficiary
reaches the age of twenty-one (21) years, with the following powers in addition to
those presently given by law:
A. The power to expend the income towards the health, support and maintenance,
and education, including a college (both undergraduate and graduate) ,
trade, business or technical school education, of the said beneficiary;
IB. The power to expend the principal, within the discretion of the said
Guardian, if the income is insufficient, towards the health, support and
maintenance, and education, including a college (both undergraduate ar.d
� graduate), trade, business or technical school education, of the said
beneficiary;
I � , - J . ° (s�.)
I
�1 MARK. WEIGLE AND PERKINS - ATTORNEYS AT LAW - 775 EAST KING STREET - SHI?PENSBURG, PA. 17Z5?
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C. The power to sell any and all real estate, within the discretion of the
said Guardian;
D. The power and _ obligation to distribute the balance of principal and
interest, if any remaining, when the said beneficiary reaches the age of
twenty-one (21) years, without the necessity of a formal adjudication of
the Guardian's account in the Court of Common Pleas of Cumberland County,
upon the receipt of a good and valid release;
E. The principal of the Guardianship and the income therefrom shall be free
from the debts, liabilities, and engagements of those beneficially
interested therein, and shall not be subject to assignment by him or her,
nor to attachment or execution under any legal, equitable or other process
for the enforcement of judgments or claims of any sort against them, either
individually or collectively;
F. In the event the above-mentioned Guardian is unable to accept the
Guardianship, I then name, constitute and appoint BARRY D. SHEARER, of 108
Locust Street, Shippensburg, Pennsylvania, as Guardian, with the same
powers hereinbefore stated.
FOURTT3. I nominate, constitute and appoint LINDA L. SOMERS and BARRY D. SHEARER, or
the survivor thereof, to be the Co-Executors of this my Last Will and Testament.
FIFTH. I direct that neither my personal representatives nor Guardians shall be
required to give bond for the faithful performance of their duties in any
jurisdiction.
IN WITNESS WHEREOF, I, EVELYN M. SHEARER, have hereunto set my hand and seal to
this my Last Will and Testament, written on two pages, the first page signed for
identification only, this ��y of , 1987.
(SEAL)
-2-
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW �- 115 EAST KWG STREET - SHIPPENSBURG. PA. 17257
�
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This instrument was by the Testatrix, EVELYN M. SHEARER, on the date hereof,
signed, published and declared by her to be her Last Will and Testament, in our
presence, who at her request and in her presence and in the presence of each other,
we believing her to be of sound and disposing mind and memory, have hereunto
subscribed our names as witnesses.
I �
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I COMMONWEALTI3 OF PENNSYLVANIA .
. SS.
COLTNTY OF CUMBERLAND .
I, EVELYN M. SHEARER, the Testatrix whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged
before me by EVELYN M. SHEARER, the Testatrix,
this�TL day of 77�c,j�pti� , 1987.
� � � ��� .
r�uy �. �e2V�;s, �{o:�y Public
Shippensburg, PA Cumberfand County
i My Commission expires July 27, t°90
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i± MARK. WEIGLE AND PERKINS - ATTORNEYS. .4T LAW - 715 cAST KING STREET - SHIPPENSBURG-, PA. 17257
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COMMONWEALTH OF PENNSYLVANIA .
. SS.
COUNTY OF CUI�ERLAND .
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We� � � and e �_ (1" �
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the witne ses who e names are signed_ to the foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw Testatrix
sign and execute the instrument as her Last Will; that she signed willingly and that
ishe executed it as her free and voluntary act for the purposes therein expressed;
Ithat each of us in the hearing and sight of the Testatrix signed the will as
witnesses; and that to the best of our knowledge the Testatrix was at the time
eighteen (18) or more years of age and of sound mind and under no constraint or undue
influence.
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Sworn or aff ed to a� su s ribe
before me by �
and �a,c ,
witnesses, this 3o day of
�ctiu�mc.lc..2l_, , 19 8 7.
� G. �QVLCQ��
Niary . Seavers, Notary Pubfic
Shippens6urg; AA Cumberland County
� h;y Commission Expires July 27, 1990
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I` MARYC. WEIGLE AND PERKINS — ATTORNEYS AT LQW — 775 EAST KING STREET — SHIPPENSSURG, ?A. 7?257
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