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Home My WebLink About08-01-14 (2) _. _ . _. .. a..�,.��.�,.�.�..�. �. � .�� -�-_.. �� 150561�143 REV-1500 . �� PA C3epartment of Revenue � OFFICIAL USE ONLY pennsylvanla co�rny coae Year Fu�Numb�r Bureau of fndividual Taxes ��*�T�� PO BOX.280601 INHERITANCE TAX RETURN 21 1 q 0 0 9 6 Harrisburg,PA t7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Soclal Security Number Date of Oeath Date nf Birth 178 Suffix DecedenPs First Name MI STUPPY RUBY E (If Applfcable)Enter Surviving Spouse's tnformatian Below Spouse's Last Name Su�x Spouse's First Name MI Spouse's Soclai Security Number THIS RETURN MUST BE FILED IN DUPLICATE WiTH THE REGISTER OF Wl�LS FIIL IN APPROPRIA7E OVALS BELOW ❑ 1. Orlgina�Return ❑ 2. Supplemental Retum � 3,Remainder ReGern(Date of Death PrIOt to 12-13-82) � 4. Limitad Estete � 4a.Futura irtdrest C«npromise � 5. Fedefal Estate Tax Retum Required (dete of death aRer 12-12-82) � g, Decedent pied Te�tota � 7 oeceamt Mahtamea a LtvinQ 7ruee g, Totai Number of Safe Deposit Boxes (Attach Capy ot VYiI} (Attach Copy d Tniat) � ❑ 9. UtigaUon Proceeds Recelved � 10.Spouaal Povertv Credit{Date af Death � ��,Eleetio�to tax under Sec.9113(A) between 12-31 b1 and 1-1-85) {Attach 5chedule 0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED,ALL CORRE5PONDENCE ANQ CONFIDENTIAI TAX INFORMATION SHdULD BE DIREG7ED TO: Name Daytlme Telephone Number �_, GREGORY M KERWIN 717 3 62 �3�215 �-�' C _.. --,;-. �-, � s�� -�_�, �"' � ` -� REGISTER dF U�S�J6E ONL1G� '' -`-� ��;�, J r�i_i t�';� First Line of Address �E;-;, '""' r _. ,_., 4245 STATE ROUTE 209 ��"` �'' � `�� n C3 �, .:_;_ :i_� O� '�.�:,i 3eaond Line of Address ��; �.`•'' �� C�,. City or Post Office s�� DATE FILED 21P Code ELIZABETBVILLE PA 17023 Correspondent'se-mailaddress: GMK@KERWINLAWFIRM.COM Under penaliles of perjury,I dedare tliat I have examined this retum,in�uding aCCOmpanying scheduiea and statements,and to the best of my knowiedge and beliaf, it is true,�rrect and complete.DeGaratlon of preparer ottier then the peraonal representative is based on aA in(ormatlon of which preparer hss any knowledge. SIaNATURE OF PERSON RESPDNSIBLE FOR FILING RETURN pq� ��j �F��, y� Fredertck A.Stuppy�Jr. 7�j� ��Q�� aoPRess d76 Endera Road,Halifax, PA 17032 SIGNA U OF PREPARER OTNER N REPRESENTATIVE DATE � Gregory M Kerwin `� �� d p y ADORESS 4245 5tate Route 209,Elizabethvifle,PA 17023 Side 1 \ � 150561i7143 15�56Z0143 � � � � 15p5610243 REV-1500 EX Decedent's Social Security Number oecede�ea Name: S T U P P Y= R U 8 Y E RECAPITULATION 1. Real Estate(Schedule A).......................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................... 2. 5 , 0$5 . 8 7 3. Closely Hetd Corporalion,Partnerahlp or Sole-Proprfetorship(Schedule C)......,... 3. 4. Mortgages 8 Notes Receivable(Schedule D).......................................................... d. 5, Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 1 0 , 0 5 2 . 6 2 6. Joir.tly Owned Property(3chedule F) Q Separate Bllling Requested............. 6. 7. tnter-Vivos Transfers&Miscellaneous Non-Probake Proparty (Scheduit G) p Separate Billing Raquested............. 7. 8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 15 , 1 3 8 . 4 9 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 14 , 4 0 5 . 6 7 1 d. Debts of Decedent,Mortgage Liabilities end Liens(Schedule I}............................. 10. 1 3 , 8 6 9 . S 3 11. Totai DedueUons{totai Lines 9 and 10).................................................................. �1. 2 8 , 2 7 5 . 2 0 '�2. Net Value of Est�te(Line 8 minus Line 11)............................................................. 12. -1 3 , 1 3 6 . 7�. 13. Charftable and Governmental 8equestslSec 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)................................................. �4, -1 3 , 13 6 . 7 1 TAX COMPUTA7lON-SEE INSTRUCTIONS FOR APPLICABLE RATES � 15. Amount cf Line 14 taxabfe at the spousal tax rate,or transfers under Sec.9116 {a}(1.2)X.04 15. 1&. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19, TAX DUE................................................................................................................... 19. 0 . 0(� 20. FILL IN THH OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 � 1505610243 15�56Z0243 � REV•1500 EX Page 3 File Numbar 21 - 14 - 8096 Decedent's Camplete Address: Stuppy, Ruby E STREET ADDRESS -- 100 Mt. Allen Drive CITY STATE ZIP ^� Mechanicsburg PA 17055 Tax Payments and Credlts: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A• Prior Payments B. Discount • Total Crediks(A +B) (2) 0.00 3. Interest (3) 0.00 b. If Line 2 is greater than Line 1+Llne 3,enter the difference. This is the OVERPAYMENT. �q? Check 6ox on Page 2,Llne 2d to request a refund 5. If Line 1+Line 3 is greafer than Line 2,enter the difference. This is the TAX DUE. (5} Q,Q(} Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUEST(ONS BY PLACING AN"X" IN THE APPROPRIATE 8L4CKS 1. Did decedent make a transfer and: Yes No ...... a. reta n t e use or income of the propeAy transfeRed:.................................................................................. �_�] b. retain the right to designate who shali use fhe property transferred or its income:.................................... c. retain s reversionary interest;or.................................................................................................................. d, receive the promise for lile of elther 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?....................................................................................................................... �..^� ❑ . id decedent own an"in trust for" or payable upon death bank accaunt or security at his or her death7......... C �_�� 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?...................................................................................................................... ❑ ❑ IF TNE ANSWER TO ANY OF THE ABOVE QUESTION3 IS YES,YOU MUST COMPLETE 3CHEDULE G AND FILE 17 AS PART OF THE RETURN. ..-.�.�...-.a -- 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 January 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 siafute does not exempt a transfer to a surviving spousa from tax,and the statutory requirements for disclosure of assets and filing a tax refurn ara stili appl(cabfe even if the sunriving spouse is the only beneficiary. For dates of death on or after Juty 1,2000: •The tax rate imposed on the net r+aiue 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 beneficlarles is 4.5 percent,except as noted in (72 P.S.§9116(a)(1)J. •The tax rate imposed on the net value of t�ansfers to or for the use of the decedent's siblings is 12 percent[72 P.S.�9116(a)(1.3)1. A sibiing is defined under Saction 91Q2,es an individual who has at least ona parent in cammon with the decedent,w ether by blood or adoption, REV-1603 E%+(8-98) � SCHEDULE B �«�,,o,,�r„�PE,�.,�,,,�� STOCKS & Bt�NDS INNECiRANCE TAX RENftN REeI�Fl�!'f OECEDENT ESTATE OF StU FILE Nl1MBER� ppy, Ruby E _.�..__...................._—_......��.�.�. 21 - 14-0096 All property jointly-owned with right of survivorship must be dlsclosed on Schedute F. -r._..................--- ITEM � _.................... --- NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE O� DEATH _�__.....................---- 374.8981 shares Mid Penn Bancarp, Inc. 13.566 5,085.87 � � I � i i � � � i ( i E i � i ( I s I I i I ---_...._.._..._�._.,........_..............__. I TOTAL(Also enter on ilne Z,Recapitutatlan) 5,085.87 `�j ; pennsylvania SCHEDULE E �EPARTMENT OF REYENUE INHERITANCE7N(RETURN CASH, BANK DEPOSITS AND MlSC. RESIDENTDECEDENT PERSONAL PROPERTY ESTATE QF StU FILE NUMBER ppy, Ruby E 21 - 14-0096 �_.......... Include the proceeds of litigatian and the date the proceeds were received by the estate.Ail property jaintly-owned with the right of survfvorshfp must be disclosed on schedute F. ITEM � ---- NUMBER DESCRIPTION VALUE AT DATE OF DEATH __�.._........._. _____.._ hecking account#4019311 at Mid Penn Bank, 349 Union Street, Miflersburg, PA 17081 2,591.13 2 {S1)Savings accounf at PSECU, PO Box 67013, Harrisburg, PA 17106 58.75 3 (S4)Checking account at PSECU, Harrisburg, PA 4,511.50 4 (S7)Money Market account at PSECU, Harrisburg, PA 167.66 5 US Treasury, income tax refund 2,517.09 6 Savings Account#2020�5858 at Mid Penn Bank, Millersburg, PA �p�.qg TOTAL(Also enter on Line 5,Reaapitulation) 1Q,Q52.62 n,,n,,�.�..t,�� ,�.,,,� � �, �. ,� � . REVdb11 EXt(70-09J � pennsylvania SCNEDULFH � DEPARTMENT Of REVENUE FUNERAt_�AND RESIDENT DEC pE E�URN �� FILE NUMBER ESTATE OF Stuppy, Ruby E 21 - 14-0096 aecedent's debts must be reportad on Schedule I. ITEM _........— NUMBER FUNERAL EXPEIVSES: DESCRIPTION AMOUNT A. 1 Malpeui Funeral Home, 8 Market Plaza Way, Mechanicsburg, PA 17055 12,246.12 � € � � � � 1 3 3 E B. 'ADMINISTRATfVE COSTS: 1, i Personal Representative's Commissiona ! � Name of Personal Representative(s) I i ` Street Address City State Zip 1 C Year(s)Commission Paid 2. � Attomey's Fees Gregory M Kerwin 1,750.00 � � 3, i Family Exemption: {tf decedenYs address is not the same as claimanYs,attach exptanation) � I i Claimant Street Address i City State Zip Relationship of Claimant to Decedent i 4. � Probete Fees Register of Wiils 163.50 t i � 5. Accauntant's Fees I 6. �! Tax Return Preparers Fees ! 7. � Other Administrative Costs 1 ; Notary fee on Affidavit of Residence-Mid Penn Bancorp 5.00 i ! j � , � TOTAL(Also enter on flne 9,Recapitutation) 14,405.67 Sch�H Fur�ad E�er�s& COMM HERN TA`NCE�AX REfURN��A /�y 1 p,��,►W�� RESIDENT DECEDENT _ -- FILE NUMBER ESTATE OF Stuppy, Ruby E 21 - 14-0096 _._..__.....__....._..._................._.............�.......�. __-- 2 � US Pastmaster-certified maii ' 8.03 � � 3 ( The Sentinel-Estate Advertisement ` 233.Q2 i f I � � I i t ' � � i �i � � E i 7 � � � � i � t � � i I f � � � � s I � ( ; i i � i � i i I � � Page 2 af Schedule H Rov1611 EX+{12-OB) .-� pennsylvania SCHEDULE I � � DEPARTMENT OF REVENUE Ih�HERITANCETAXRETURN DEBTS OF DECEDENT, MORTGAGE j RE5IDENTDECEDENT LlABILITIES & LIENS ; i � FILE NUMBER ESTATE OF Stuppy, Ruby E 21 - 14-0096 Report debts incurred by the decedent prior to dea#h that remained unpaid at the date of death,including unreimbursed medical expanses. ITEM pESCRIPTION AMOUNT NUMBER _ _ 1 Pinnacle Health Hospitals, account payable 226.12 2 Quantum imaging, account payable 80.90 3 Alert Pharmacy Services Inc., account payable for medication 253.03 4 Verizon, account payable far telephone service ��•�� 5 Camp Hili Emergency Physicians, account payabfe for medical services 43.33 6 Physicians of Rehabilitation, accaunt payable for medical senrices 32.�7 7 Haly Spirit Hospital, account payable for medical services 665.84 8 Pinnacle Health Medical Group, account payable for medicat services 356.47 9 Pinnacle Health Emergency, account payable for medical services 25.$2 10 P Department of Revenue, account payable for income tax due 2.00 11 Spirit Physicians Services, account payable for medical services 120.00 12 Messiah Lifeways at Messiah, account payable 11,678.16 13 Hospitalist Medical, account payable 57•8$ 14 West Shore EMS, account payable to transport ��a5 15 Paul Daley Medical, account payable 6.43 16 Kantor&Thatch Medical, account payable 61.96 TOTAL(Also enter on Llne 10,Recapitulation) 13,869.53 . __ __ . REV-161�EXr(01-70) �� pennsylvania SCHEDULE J ��`� OEPARTMENT OF REVENUE �� INHERITANCETAXRETURN BENEFICtARIES RESIDENT QECEDENT �..v,..._.. _ .._.._� �.......µ„„ ESTATE OF FILE NUMBER Stuppy, Ruby E 21 - 14-0096 � � � RELATIONSHIP Tti SHARE OF ES7ATE AMOUNT OF E5TATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words} {$$$) RECEIVING PROPERTY oo Na uat 7tustoe(sy I, TAXABLE DISTRIBUTIONS(include outright spouaal distributions and transfers under Sec.�116(a)(i.2)] 1 Joan R.Van Orman f daughter 1/3rd of estate 5235 Strathmore Drive Mechanicsburg, PA 17050 ` 2 Frederick A. Stuppy, Jr. I Son 1I3rd of estate 476 Enders Road Halifax, PA i 7032 � 3 Janice M. Devers � Daughter 1I3rd of estate 1713 West 24th Avenue ; Kennewick, WA 99337 � ( i Enter dollar amounts for distributions shown above on lines 151hrough 18 on Rev 1500 cover sheet,as appropriate, �I� NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SEC710N 9113 FOR WNICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE ANp GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART il-ENTER 70TAL NON-TAXABLE DI5TRIBUTIpNS ON LINE 13 OF f2EV-1500 COVER SHEET O.bO KERWIN & KERWIN, LLP ATTORNEYS AT LAW 4245 STATE ROUTE 209 GOVERNORS'ROW PATRICK E.KERWIN(1913-1987) ELIZABETHVILLE,PA 17023 27 NORTH FRONT STREET _ HARRISBURG,PA 17101 (717)362-3215 GREGORYM.KERWIN- GMKerwin@HotmaiLcom (717)896-9089 (717)23&4765 TERRENCE J.KERWiN- TJK@Kerwinlawfirm.com FAX(717)362-4459 FAX(717)238-8455 JOSEPH D.KERWIN- JDK@Kerwinlawfirm.com HOLLY McCLURE I{ERWIN-HMK�Kerwinlawfirm.com P[ease Reply To: �!ELIZABETHVILLE OFFICE � HARRISBURG OFF[CE July 30, 2014 c� �x.� _�,� C C7 �. �-r��.� �-z:� c .. . ; , Register of Wills ��; �' `r�,;;1 Cumberland County Courthouse ��,_;'� -- ' '^ One Courthouse Square �<:�� _ -r� ; -��, �.,�Ll__. � �:- Carlisle, PA 17013-3387 p�.y � i'"= ,-,� -o e. `-`7� Re: The Estate of Ruby E. Stuppy D � �� Date of Death: January 17,2014 File No.: 21-14-0096 Dear Sir or Madam: Please find enclosed herewith an Inheritance Tax Return and Inventory for filing in your office with respect to the above-captioned estate. The estate is insolvent. Would you kindly time stamp the enclosed file copies and return them to me in the enclosed, stamped, self addressed envelope? Thank you for your help. Very truly yours, A \. � �/� i � � G RY M. KERWIN GMK:bmk Enclosures � � ,,, 1 il _ r y; �� i�� IvQi �a �� T � � ' 1 � ��'i�l� � a � J a J � � H � Z � Nf� � W � � � r O M M � +-' O Q- v� ,ti' p".-' W � a z cn o Y H � W � � 4? •� 3ocn � � � � � � � pcn � oaxa � Q N N r� ¢� w�' W wa � a E-� x o �n � � W H W U H a Y � U O U � �