HomeMy WebLinkAbout07-22-14 (2) + � 1505611101
REV-1500 EX�°�_�', ����
enns lvania OFFICIAL USE ONLY
PA Department of Revenue PEOqprMtNY County Code Year File Number
Bureau of Individual Taxes pINHERITANCE TAX RETURN /� � �l ��
PO BOX z8o6oi /,/ � J
Harrisburg,PA 1'7128-0601 RESIDENT DECEDENT (/� ( Z
ENTER DECEDENT INFORMATION BELOW
Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
� � �- � � � c� � '� Oc r � i � 3 �
DecedenYs Last Name Suffix DecedenYs First Name MI
�( V� C. � � �.- �Yl �X C
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
�A- � K � ►Z � � NCy t
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
�� �l 3 t� 5 1 7 � REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Originai Return p 2. Supplemental Return L� 3. Remainder Return(Date of Death
Prior to 12-13-82}
p 4. Limited Estate p 4a. Future Interest Compromise(date of C� 5. Federal Estate Tax Return Required
death after 12-12-82)
� 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 DIRECTEQ T0: �
Name Daytime Telephone Number
vJ � Nvy aN t�� �so N � � , Zsy � o ��
�.�-
REGiBTF�bF VV!LLS US�NLY
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First Line of Address � �� '�. t-�- , L
Z 3 � � �-'(�'� D � 1� V e ���- n� � , E ,,,
Second Line ofAddress ��J' `q , r',.
O� � ._:a, `?
. _y �� t`._- i`�
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City or Post Office State ZIP Code � �A��F���� F' �"`� '
�,.'
C � � � zSC_.. c p � ► � U ► 3
Correspondent's 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.
� SIGNATURE OF PE�R,SON%ES���IBL�E.FOR FILING RETURN � ��� DATE _
A DRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE �� DATE �
ADDRESS ��
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505611101 1505611101 �
�
� 1505611201
REV-1500 EX
Decedent's Social Security Number
DecedenYs Name: � � � � �
RECAPITULATION � ��A
1. Real Estate(Schedule A). . . . . . . . . . . . . .. . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . 1. �. � � � �Q • � (�
2. Stocks and Bonds(Schedule B) . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. � •� �
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. ;J .Q �
4. Mortgages and Notes Receivable(Schedule D) . . . . .. . . . .. . . . . . . .. . . . . . .. . 4. �.O �
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. ' D � � a . �(�
6. Jointly Owned Property(Schedule F) �""�7 Separate Billing Requested . .. . . . . 6. (�. Q�
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) �`� Separate Billing Requested.. .. . . . . 7. �. Ci �
8. Total Gross Assets(total Lines 1 through 7). . . . . . . . . . . . . .. . . . . . . . . . . . .. . 8. � � Q � l � • � �
P9. Funeral Expenses and Administrative Costs(Schedule H)�.TM. .0. M. .�. .`J. . .-_ 9.� jp '� '� �. S�
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I).. . . . . . . . . . . . . . 10. �7 � 7 � 1 . �3
11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . 11. � � � "7 �. Q �
V
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . 12. �� g �� �. ��
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. f\ . � �
�`J
14. Net Value Subject to Tax(Line 12 minus Line 13) . . .. . . . . . . . . . . . . . . . . . . . . 14. � � �� ?� `9 .'� �
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� . :�O 15. O• � �
16. Amount of Line 14 taxable
at lineal rate X.0�2 . 16. C.-
17. Amount of Line 14 taxable '
at sibling rate X.12 . 17. .
18. Amount of Line 14 taxable
at coilateral rate X.15 • 18. .
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. �� V
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2 �
� 150561120�, 1505611201 J
REV-1502 EX+(01-10)
� � pennsylvania SCHEDULE A
, DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN REA L ESTATE
RESIDENT DECEDENT
ESTATE OF: �� � �i �� PILE NUMBER:
l aQl�/- r7C� ���~
All real property owned solely or as a tenant m common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowletlge of the relevant facts,
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
�. �a\ �`�-�c�.�� � ����0 bDt�
,
TOTAL(Also enter on Line 1, Recapitulation.) $ �y� �
If more space is needed,use additional sheets of paper of the same size.
REV-15o8 EX+(ii-io)
� pennsylvania SCNEDt�LE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
� INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE F• FILE NUMBER:
� � � .�1 �
i — �3�
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
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
� �.,,
t a l �—r �c°���� `1'�'-c-k.�v���C'��:.�.��� `�- �
Z �'� �� �y��l�� � c�,�J i��.� C�C.0��.�.Y��. � �J �/`-�/� .�C�
�
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TOTAL(Also enter on Line 5, Recapitulation) $ r(�� `� � �'��
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
� pennsylvania SCHEDULE H
• DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
(�Ic�JC �1.�(��� �=��� y— c..-� ��S
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
�r��d:�-���-�-1c�,� �un�'al �r��� �c�c�c� y , f Sd.G�
C�6KQ.�. :�ie�.l,�ierl�nS i ��s�� C�.�-� 6;2, i �l���c��
er�a��5 �n �..L,���:� �� �a (�.s�c�
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
Z• Attorney 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
� G��4• Probate Fees; n� �,�
5• Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $� �� �
If more space is needed,use additional sheets of paper of the same size.
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����" 219 North Hanover Street
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,�� 4�` ° CCxC�sle.PenruyfvC�niq 17013
5* ���� ; 717.243.4511
... s4'�'#� �`t.
toli f�ee i.866.451.4511
'� �'� fax 717.243.3723
,�� s 1�i�'�'`"'" www.hof(manroth.com
�� , �r ��� FUNERAL�fl1'�+IE�� CREMATORY, INC. �fo�ot�rrotn.com
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Nancy E.Wa�
March 20,2013
219 Marion Aue.
Carlisle, PA 17013 �
- -- _ �tatement of FuneraLExpenses#o�: Ma��lswortke-Walker _ __. - ___ ____�_ -
_ _ �.�: _ .
Date of Death:February 18,2008 Account Id: 15248-42
PACKAGE:
Traditional Service
Traciitiortal Funeral Service Padcage $ 4,150.00
Sub TotaL• � 4,150.00
MERCHANDiSE:
Casket:Steel, Steriing 18 ga Steel Casket $ 2,140.00
Sub Total: � 2,140.00
TOTAL FUNERAL HOME CHARGES: � 6,290.00
CASH ADVANCES:
5 $ 30.00
Newspaper Obituary Notice-Patriot News $ 352.07
Fiowers $ 242.50
Newspaper Obituary Notice-Gettysburg Times $ 60.00
Newspaper Obituary Notice-Sentinel $ 206.48
Sub Total: a 891.05
ALTERATIONS:
Mar 20, 2013: Credit for family car (150.00)
Mar 20.2013: Credit for lead car (115.00)
�'�r� :i
' Sub Totai; $ -265.00
Total Funeral Expense: a 6,916.�5
Totai Payments Made: $ 1�641.05
Payments Made:
Fratemal Order of Eagles Check 4021 Feb 26,2008 500.00
Cumberland County VA VA Benefit 691492 Mar 19,2008 100.00
Crystal Walker Check 510 Jul 3,2008 16.05
Crystal Walker Check 522 Jui 31, 2008 100.00
Nancy E.Walker Check 99 Oct 3,2008 50.00
Nancy Walker Check 136 Feb 3,2009 50.00
Nancy Walker Check 144 Feb 27,2009 50.00
Nancy Walker Check 207 Apr 29,2009 50.00
Nancy Walker Check 162 May 29,2009 50.00
Nancy Walker Check 177 Jun 30,2009 50.00
Nancy Walker Check Jul 29,2009 50.00
Nancy Waiker Check 257 Oat T,2009 50.00
Nancy Waiker Check 301 Feb 3,2010 50.00
Nancy Walker Check 309 Mar 1,2010 75.00
SERVING OUR COMMUNITY SINCE 1 907
�� � • � '�: • �� I
. �—
219 North Hcaiover Street
Ccrlisie,Pennsyivanici 17013
717.243.4511
tall free 1.866_451.4511
.,,.,
fax 717.243.3723
www.hoffrnanroth.com
FUNERAL HOME � CREMATORY, INC. ��@���o�.��
Nancy Walker Check 351 Mar 31,2010 50.00
Nancy Walker Check 375 Jun 2,2010 50.00
Nancy Walker Check 401 Aug 3,2010 25.00
Nancy Waiker Check 414 Sep 8,2010 20.00
Nancy Waiker Check 315 Nov 2,2010 20.00
_ __ __:
Nancy Walker Check 447 Mar 10,2019 30.00
Nancy WaTker _ _ _- �fieck-- ---_ ____3D�—__ __ i�la._y 6;3D1'i�--- _ _ _ --35:00-- - ,__ _
Nancy Waiker Check 3482 Ju114,2011 15.00
Nancy Walker Check 555 Oct 13,2011 10.00
Nancy Walker Check 563 Nov 4,2011 40.00
Nancy Waiker Check 618 Jun 6,2012 20.00
Nancy Waiker Check 634 Sep 12,2012 20.00
Nancy Waiker Check 659 Jan 11,2013 75.00
Balance: s__�
�__� _P SERVING QUR COMIviUNi Y � � �
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�; 01231 �1-2
C�ASE � � MORTGAGE LOAlN STATEMENT
_ Loan Number: 1919977791
Statement Date: 03/03/08
Customer Care Phone: 1-800-848-9136 Payment Due Date: 04/01/08
Please send payments only to: PO BOX 78420 Property Address: 219 Marion Ave
PHOENIX,AZ 85062-8420 Carlisle,PA 17013
Hearing Impaired(TDD): 1-800-582-0542
Loan Information:
Balances:
#BWNJCCL Principal Balance $77,701.33
#31 31 91 9977791 000# Escrow Balance $0.00 ,�
Payment Factors: N
�ni����n�����i�n��������ii��in��i�������nni������������� Interest Rate 6.62500°/u m
Principal&Interest $499.44 �
01281 BOR Z 06308 C-0 BRE TA HEN HG Escrow Payment $0.00 �
MAX E. WALKER Optional Products $0.00
219 MARION AVE Past Due Payment $0.00
CARLISLE PA 1 701 3-1 1 39 Unpaid Late Charges $o.00 �
Miscellaneous Fees $0.00
Total Payment $499.44
Year-to-Date:
Interest $859.34
Taxes $0.00
Principal $160.66
Chase Presents The Following Opportunities To You
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246 Any Road Dec 07 $146,000
321 Any Road Nov 06 $641,000
Activity Since Your Last Statement
TRANSACTION TRANSACTION TOTAL OPTIONAL MISCELLANEOUS
DESCRIPTION DATE RECEIVED PRINCIPAL INTEREST ESCROW PRODUCTS OR FEES
PAYMENT 03/03/O8 $499.44 $69.96 $429.48
PRINCIPAL PMT 03/03/O8 $20.56 $20.56
Important Messages About Your Account
Important information regarding your mortgage interest statement: You can view and print your tax information online by going to the"see
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REV:1512 EX+ (12-08)
� pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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�?�"-�t. u=� -�-�'��-Cc�r���t ������r� 77 ��o� 33
�� �
TOTAL(Also enter on Line 10, Recapitulation) $
If more space is needed, insert additional sheets of the same size.
REU-1513 EX+ (01-10)
, � pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
r
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. ����"��i\��'L1?^
12__
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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:
�. ����C.,�i � �.�.;'0.\� j���t�
J
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.
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ACC�UNT NQ. ACCOWNF 7YPE STATEMENT PERI00 pp�� `;
15004200126826 M8T PERSONAL SAVINGS JAN.04—FEB.03,2008 1 OF 1
00 0 04303M NM 017
45443
MAX E WALKER
NANCY E WALKER
219 MARION AVE
CARLISLE PA 17013-1139
INTEREST EARNED FOR STATEMENT PERIOD 0.09 BOILING SPRINGS
INTEREST PAID YEAR TO DATE 0.30
ACCOUNT SUMMARY
S�GINNING D�POSxTS 8 WITHLIRAWAL&?8 �THER CiIRRENT EIVDING
BALANCE OTN�R Abbl'CYONS SUBtRACTIOMS �Nl'�REST PA�b $at;pMCE
N0. AMOUNT N0. AMOUNT
1,280.68 2 2,709.17 3 1,075.62 0.07 2,914.30
ACCOUNT ACTIVITY
POSTZNG < p�pOSxTS,INTER�ST <W/DRAWALS $ OTHER ' DATLY
DATE 7RANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BA4ANCE
01-04-08 BEGINNING BALANCE 51,280.68
01-07-08 CUSTOMER WITHDRAWAL 1,000.00
01-07—OS MONUMENTAL LIFE INS PREM 70.62 210.06
02-01-08 DFAS—CLEVELAND RET NET 1,889.17
02-01-08 US TREASURY 303 SOC SEC 820.00
02-01-08 INTEREST PAYMENT 0.07
02—01—OS SERVICE CHARGE 5.00 2,914.30
ENDING BALANCE 52,914.30
ANNUAL PERCENTAGE YIELD EARNED = 0.18 %
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COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE
COUNTY OF CUMBERLAND
;
,
I, LISA M. GRAYSON, ESQ.
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 16th day of May, Two Thousand and Fourteen,
Letters of ADMINISTRATION
in common form were granted by the Register of
said County, on the
estate of MAX ELSWORTH WALKER , late of NORTH M/DDLETON TOWNSH/P
(First,Midd/e,Lastl
a/k/a MAX E WALKER
in said coun ty, deceased, to NANCY E WALKER
lFirst Middle,Lastl
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of sai d offi ce a t CARLISLE, PENNSYLVANIA, thi s 16th day of May
Two Thousand and Fourteen.
Fi 1 e No. 2014- 00485
PA Fi 1 e No. 21- 14- 0485
Da te of Dea th 2/18/2008
S. S. # 168-
c
Regist Wi ls
� L�f1�,�P o �r�D.� (����
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
� < ,
REV-1500 EX Page 3 Pile Number
Decedent's Complete Address: �
DECEDENT'S NAME
������ " �ll.��� I�
STREET DRESS —1r� -- - -- _ _ — -- - - - —
CITY�VW I IS� — - —.. --- -STAT �ZIP
� � 17c�)�
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (�) �a �l�
2. Credits/Payments
v
A.Prior Payments �•Q� _
B.Discount _��_ _
3. Interest Total Credits(A+B) (2)_ t�1, (�FV
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3)—' `°"
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) (� �'�"�
Make check payable to: REGISTER OF WILLS, AGENT.
�m � o- ead' Y�=° C�"� !� -a-�`s i,� ,� r� i i rir 4 �e�� � �ar� �°— a -
�:�i �,� .t F�-ia�t��N�+` �. ..ii.ia�'=-.�;�. . �^` . "�" . �,�,�:' u �aa -i� � '� '. ��a .'� ;i +,� = . , . �`" �;, �-71Gat..���.,. " di'��� ,�-� - "5w"` i ..
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decetlent 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. Ditl 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.
! � p•�;� . i, ��" v�. �k� ,��� 7' .�� _ $.� _ - _ - "Y _ -
... .. .. .c..a . " ,. :Y- ., c'uv r ,..a .., , .
For tlates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfefs 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 chiltl 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 tlecedenYs 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 tlecedenYs 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.