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Home My WebLink About08-12-14 � 15�5610140 REV-1500 � �02-,,,�F'> PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2aoso� INHERITANCE TAX RETURN 2 1 1 4 0 3 7 3 Harrisburci,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 3 2 2 2 0 1 4 0 6 1 2 1 9 2 1 DecedenYs Last Name Suffix DecedenYs First Name MI M Y E R S A N N A I (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 � 2.Supplemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) � 4.Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required death after 12-12-82) OX 6.Decedent Died Testate � 7. Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) � 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 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 D A V I D R . G A L L 0 W A Y , E S Q 7 1 7 � 9 7 4�6 5 0 '� .�- � REGIST WILLS U NLYr;-=� � �7 . - ,�" s:.�: —. � f_. �Y First Line of Address ��' l�i ' C � - 5 4 E • M A I N S T R E E T n�-� 1° ` � , � O-�-C„_, =� : ; Second Line of Address D �r r�,� r^.r ' . r` J � �.'/ �1 City or Post Office State ZIP Code DATE FILED M E C H A N I C S B U R G P A 1 7 0 5 5 CorrespondenYs e-maii aaaress: david@waltersgalloway.com Under penalties of pery'ury,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,c rrect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI NA E OR PERSON RESPONSIB R FI G RETURN D TE � �� L , _ l RE S LISA M • AUCKER 20 THISTLE DRIVE MECHANICSBURG PA 17� 0 IGNATUR RER OTHER THAN REPRESENTATIVE � � ADDRESS DAVID R • GALLOWAY, ESQ 54 E • MAIN ST MECHANICSBURG PA 170 5 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J � J 1505610240 REV-1500 EX(FI) DecedenYs Social Security Number �ecedenrs Name: A N N A I• M Y E R S RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . ... . . . . . . . . . . . . ..... . . .. ... . . . . . . . 1. 1 7 1 $ � � . 0 0 2. Stocks and Bonds(Schedule B) 2, 2 6 8 9 . 6 0 . . . . . . . . . .. .... ... . . . . . . . . . . . . . . .. . . . . 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. 2 5 6 7 1 3 . 7 7 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .. . . . . . 6. • 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) � Separate Billing Requested . . ... . . 7. . 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . .... . 8. 4 3 0 9 0 3 , 3 7 9. Funeral Expenses and Administrative Costs(Schedule H) . .. .. . . . . . . . . . .. .. 9• 4 3 1 3 1 . � � 10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I 10. 3 1 3 9 9 . 1 � 9 9 ( ) ..... . . . . . . . . 11. Total Deductions(total Lines 9 and 10) ...... ....... . . . . . . . .. .. . . . . . . . 11. 7 4 5 3 � . 1 7 12. Net Value of Estate(Line 8 minus Line 11) .......... . . . . . . . . . . .. . . . . . . 12. 3 5 6 3 7 3 . 2 � 13. 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. 3 5 6 3 7 3 . 2 � 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 . � O 15. O . 0 0 16. Amount of Line 14 taxable at lineal rate X.045 3 5 6 3 7 3 . 2 0 �6. 1 6 0 3 6 . 7 9 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 �g, 0 . 0 0 19. TAX DUE . . . . . . . . ... .... . .... .. . . . . . . . . . . . . . . .. .. . . . . . . . . . . .. . . 19. 1 6 0 3 6 • 7 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X Side 2 � 1505610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 2� 14 0373 DECEDENT'S NAME ANNAI. MYERS STREET ADDRESS 333 EAST MARBLE STREET ��T�' STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: �. Tax Due(Page 2,Line 19) (1) 16,036.79 2. CreditslPayments 16,000.00 A.Prior Payments B.Discount 800.00 Total Credits(A+g) �2� 16,800.00 3. Interest 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) 763.21 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 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 ...................................................................... ❑ OX b. retain the right to designate who shall use the property transferred or its income ............................... ❑ QX c. retain a reversionary interest ..................................................................................................... ❑ ❑X d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ � 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ QX 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑X ❑ 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,antl before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 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 beneficiaries is 4.5 percent,except as noted in p2 P.s.§s��s�a��. • 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. ,:_.. .., . n. ..,,., . ., ,_ _ _ ��- . � �.. . REV-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA I. MYERS 21 14 0373 All real property owned solely or as a tenant in 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 knowledge 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 decedenYs interest if owned as tenant in common. VALUE AT DATE NUMBER OFDEATH DESCRIPTION 1. PRIMARY RESIDENCE—333 E. MARBLE ST, MECHANICSBURG, PA 17055 171,500.00 GROSS SALE PRICE TOTAL(Also enter on Line 1,Recapitulation.) $ 171 500.00 If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENTOFREVENUE STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA I. MYERS 21 14 0373 Ali property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SERIES EE BONDS 2,689.60 TOTAL(Also enter on Line 2,Recapitulation) $ 2 689.60 If more space is needed,insert additional sheets of the same size REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: ANNA I. MYERS 21 14 0373 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. PNC BANK 17,335.39 CHECKING ACCOUNT XXXXXX5561 2. PNC BANK 23,318.07 SAVINGS ACCOUNT XXXXXX3578 3. ALLSTATE 24,350.01 ANNUITY-ACCOUNT XXXX6962-PAID TO ESTATE 4. PNC INVESTMENTS 59,539.46 ACCOUNT XXX-XX6838-PAID TO ESTATE 5. PNC INVESTMENTS 10,794.04 IRA-ACCOUNT XXX-XX6834-PAID TO ESTATE 6. TRANSAMERCIA 116,865.33 ANNUITY-ACCOUNT XXXXXXX5464-PAID TO ESTATE 7. VERIZON-TELEPHONE 1.49 REFUND 8. PERSONAL PROPERTY-GROSS SALES 1,629.50 HAAR'S, INC. 9. COMCAST-CABLE TELEVISION 55.87 REFUND 1 O. DISCOVER-CREDIT CARD 104.29 REFUND 11. ADJUSTMENTS FOR ITEMS PAID BY ESTATE IN ADVANCE-REAL ESTATE 2,615.05 REAL ESTATE TAXES&WATER/SEWER- PRO-RATIONS 12. NORTHROP GRUMMAN 58.89 REFUND OF HEALTH INSURANCE 13. SHIPLEY ENERGY 40.18 REFUND 14. UNITED WATER 6.20 REFUND TOTAL(Also enter on Line 5,Recapitulation) $ 256 713.77 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 RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA I. MYERS 21 14 0373 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS-BUHRIG FUNERAL HOME&CREMATORY, LTD. 12,308.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) LISA M. AUCKER 15,927.10 StreetAddress 20 THISTLE DRIVE City MECHANICSBURG State PA Z�p 17050 Year(s)Commission Paid: 2015 2, AttomeyFees: DAVID R. GALLOWAY, ESQUIRE 12,927.10 3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 558.50 5 AccountantFees: PREP OF FIDUCIARY TAX RETURNS-DWAYNE KELLER, CPA 1,000.00 6. Tax Retum PreparerFees: 2014 PERSONAL INCOME TAX-DWAYNE KELLER, CPA 150.00 7. CUMBERLAND LAW JOURNAL-ADVERTISEMENT 75.00 8. THE PATRIOT NEWS 185.30 TOTAL(Also enter on Line 9,Recapitulation) S 43 131.00 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE 1 DEPARTMENTOFREVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA I. MYERS 21 14 0373 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NORTHROP GRUMMAN 80.31 HEALTHINSURANCE 2. SPIRIT PHYSICIANS SERVICES 115.80 MEDICAL 3. DONEGAL INSURANCE 476.00 HOMEOWNERS INSURANCE 4. VERIZON 33.70 PHONE SERVICE 5. DRAIN DOCTOR 175.00 REPAIR TO DRAIN 6. BARRY HECKARD,TAX COLLECTOR 1,012.55 2014 COUNTY/TWP REAL ESTATE TAXES 7. SHIPLEY 523.74 OIL SERVICE 8. PPL 378.30 ELECTRIC SERVICE 9. HOMESERVICE 82.41 HOME WARRANTY SERVICE 10. FRANK ACRI 724.65 LAWN SERVICE 11. HCR MANOR CARE SERVICES, LLC 18.00 BEAUTY AND BARBER SERVICE 12. UNITED WATER 65.51 WATER SERVICE 13. BOROUGH OF MECHANICSBURG 126.00 SEWER/REFUSE SERVICE 14. BOB BECKER 60.00 LAWN SERVICE 15. LAUER ELECTRIC 1,850.00 ELECTRIC REPAIR TOTAL(Also enter on Line 10,Recapitulation) $ 31 399.17 If more space is needed,insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ANNA I. MYERS 21 14 0373 DecedenYs Name Page 1 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, 8�Liens ITEM NUMBER DESCRIPTION AMOUNT 16. GARY PENN 535.00 JUNK REMOVAL 17. DAVE DANIELS 220.00 HOME REPAIRS-ELECTRICAL,WINDOW LEAK, LANDSCAPE 18. LISA AUCKER 62.07 REIMBURSEMENT FOR DINING ROOM LIGHT AND SUPPLIES 19. DERR'S 240.00 TRASH REMOVAL 20. PERSONAL PROPERTY-EXPENSES&COMMISSIONS 661.80 HAAR'S, INC. 21. REDUCTIONS IN AMOUNT DUE ESTATE-REAL ESTATE 22,208.79 2014/15 SCHOOL TAX, REAL ESTATE COMMISSIONS, SELLER'S ASSISTANCE 22. ASSISTANCE TO BUYERS FOR ADDITIONAL REPAIRS TO REAL ESTATE(POC) 1,749.54 DANIEL J. &AMANDA L. KLINGER SUBTOTAL SCHEDULE I 25,677.20 GRAND TOTAL SCHEDULE I $ 31,399.17 REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA I. MYERS 21 14 0373 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List T�ustee�s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal disVibutions and transfers under Sec.9116(a)(1.2).j 1. MARJORIE A.ZWICKER Lineal 0.25 210 WEST BENTON AVENUE STOCKTON, IL 61085 2. LISA M.AUCKER Lineal 0.25 20 THISTLE DRIVE MECHANICSBURG, PA 17050 3. NICOLE M. KNEPP Lineal 0.25 532 N. REESER DRIVE YORK HAVEN, PA 17370 4. FRANK A.ACRI Lineal 0.25 110 FISHBURN STREET HARRISBURG, PA 17109 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. jI, 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 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. LAST WILL AND TESTAMENT i OF ANNA I. MYERS 1 � I, ANNA 1. MYERS, of the Borough of Mechanicsburg,Cuinberland County, r • Pennsylvania,being of sound and disposing mind,memory and understanding,do hereby make, j'r ,� publish and declare this as and for my Last Will and Testament,hereby revoking and making J void any and all wills by me at any time heretofore made. , � 1. I direct that all my debts and fiineral expenses be paid as soon as practical after my death by my E;cecutrix hereinafter named. I further direct that all taxes that may be assessed in consequence of my death be paid from my residuary Estate as part of the expenses of administration of my Estate. 2. All the rest,residue and remainder of my estate, real,personal and mixed,and wheresoever the same may be situate, I give,devise and bequeath as follows: A. 1 �ive T��enty-Five percentum (25`:0)to my daugiyter, 1�1AR_IORIE A. 7Vb'ICK�;R. B. I give Seventy-Five percentum(75%) in equal shares to the three(3)children of my deceased daughter,NANCY MURPHY; namely,FRANK A. ACRI, LISA M. AUCKER and NICOLE KNEPP. 3. I hereby nominate,constitute and appoint my granddaughter. LISA M. AUCKER, as Executrix under this my Last Will and Testament, but should she predecease me or fail to qualify, then in such event, I nominate,cons[itute and appoint, my daughter,MARJORIE A. ZWICKER as Executrix under this my Last Will and"festament. I further direct that no person serving as Executrix hereunder shall be required to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. LAW OFFICES SNELBAKER 8c BRENNEMAN, P.C. [N WITNESS WHEREOF, I have here�mto set my hand and seal to this my Last Will and Testament written on Two(2)pages this 16`�'day of September,2008. � '�-u�c cG '�-`>��I7 c.� (SEAL) Anna I. Myers Signed, sealed,published and declared by ANNA I. MYERS, the Testatrix above named,as and � for her Last Will and Testament, in our presence, who, in her presence,at her request,and in the presence of each other,have liereunto subscribed our names as attesting witnesses. , � 1 (SEAL) I (SEAL) LAW OFFICES SNELBAKER Bc ^ BRENNEMAN, P.C. —G— COMMONWEALTH OF PENNSYLVANIA) : SS. I COUNTY OF CUMBERLAND ) ( I We,ANNA I. MYERS, KEITH O. BRENNEMAN, ESQUIRE and SANDRA K. SHOWERS,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn,do hereby declare to the undersi�ned authority that the Testatrix signed and executed the instruinent as her Last Wilt and Testament and that she had signed wiliingly,and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing oF the Testatrir,signed the Will as witness and that to tlle best of his or her knowledge the Testatri� was at that time eighteen years of age or older,of sound mind and under no constraint or undue influence. �7 �-�� j. y�-��..� Testatrix �i �� Witness � Witness Subscribed,sworn to and acknowledged before me by ANNA I. MYERS,Testatris,and subscribed and sworn to before me by KEITH O. BRENNEMAN, ESQUIRE and SANDRA K. SHOWERS, witnesses,this 16`�'day of September, 2008. ��_,�__-�. J �� . Notary Public v.w o�ices COMMOP�WEAI.TH OF PENNSYLVANIA SNELBAKER 8t NofarialSeal BRENNEMAN, P.C. SU58f1LM8U3Tj,NotaryPublic Mechanicsburg Boro,Cumberland County My Commission E�ires Nov.24,7J11 Member,Pennsylvania Association of Notaries