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HomeMy WebLinkAbout09-15-14 i �f �"' 15056103,40 REV-1 500 EX (02-111(FI, OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 1 3 3 1 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 1 2 1 8 2 0 1 3 1 1 2 5 1 9 2 9 Decedent's Last Name Suffix Decedent's First Name MI S H A U L L Y V 0 N N E B (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 0 1.Original Return 2.Supplemental Return 3.Remainder Return(Date of Death Prior to 12-13.82) ❑ 4. Limited Estate E] 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12.12-82) 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 E] 10. Spousal Poverty Credit(Date of Death n 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 D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 7 4 3 5 REGI 4R OF WILLS ONLY First Line of Address rn 2 M <-a v to 4 1 4 B R I D G E S T R E E T r F-A Second Line of Address co Gtr C� CLYATE FILE City or Post Office State ZIP Code r N E W C U M B E R L A N D P A 1 7 0 7 0 ry (rn p a3 Correspondent's e-mail address: dstonea9Stonelaw- net Under penaNies 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.Declaratio of parer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA E®F PERSON ES SIB R FILING RETURN D TE ' R S C+� 001 CLARENDON STRE T CAMP HILL PA 17011 SIGNATUR- T RTidREPRESENTATIVE Q DATE II -1 ADDRESS 414 BRIDGE STR NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 `I 1 J 1505610240 REV-1500 EX(FI) 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. 8 4 0 1 ' 7 3 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 5 3 4 7 1 0 . 4 9 (Schedule G) ❑ Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) 8. 5 4 3 1 1 2 . 2 2 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 2 1 4 2 9 . 4 2 10. Debts of Decedent, Mortgage Liabilities, and Liens Schedule I 10, 2 6 1 9 . 5 1 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 4 0 4 8 . 9 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 5 1 9 0 6 3 . 2 9 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. 5 1 9 0 6 3 . 2 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.045 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x .045 5 1 9 0 6 3 . 2 9 16, 2 3 3 5 7 . 8 5 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 18. 0 . 0 0 19. TAX DUE 2 3 3 5 7 . 8 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 REW 500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 13 1331 DECEDENT'S NAME YVONNE 8 - SHAULL STREET ADDRESS 2001 CLARENDON STREET CITY STATE ZIP CAMP HILL PA 17011- Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 231357 . 85 2. Credits/Payments A.Prior Payments 221000 - 00 B.Discount 1,157 - 89 Total Credits(A+B) (2) 23,157 . 89 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 • 0 0 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This Is the TAX DUE. (5) 199 - 96 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 ...................................................................... ❑ ❑X b. retain the right to designate who shall use the properly transferred or its income I.............................. ❑ ❑ 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? .............................................. _...................................... ❑ 0 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,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 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, 2001 • 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 72 P.S.§91 16(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-(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. NTDECEDENT INHERITANCE TAX RETURN RESID ENT D PERSONAL PROPERTY RESIDENT ESTATE OF: FILE NUMBER: YVONNE B . SHAULL 21 13 1331 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 f 2DO3 Chrysler Town and Country Conversion Van sold 31000 . 00 to Charles Can 2 Bethany Village-Refund 486 . 35 3 PNC Bank-Checking Acct #5112009328 41546 . 38 4 US Treasury-Refund on 2013 1040 return 369 . 00 TOTAL(Also enter on Line 5, Recapitulation) $ 8,401 - 73 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEFARTMeNTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANC E TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER YVONNE B. SHAULL 21 13 1331 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. DESCRIPTION OF PROPERTY ITEM waDDETHE NAME OFTHETRANSFERLE,THEIR RELATIONSHIPTO DECEDENT AND DATE OF DEATH % DEC9S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST pF APPHCABI.E) VALUE 1. American Funds #81738172 IRA 51,986. 94 100 . 00 51,986. 94 Lisa S Zoll and Lorie A Shaull beneficiaries 2 Cambridge Acct-Pershing #5DK-280631 2971331 - 15 100 . 00 97,331 . 15 TOD to Lisa S Zoll and Lori A Shaull 3 ING Fixed Annuity #167733 921750 - 92 100 - 00 92,750 . 92 Lisa S Zoll and Lori A Shaull beneficiaries 4 ING Fixed Annuity #167734 92,641 48 100 00 92,641 . 48 Lisa S Zoll and Lori A Shaull beneficiaries TOTAL (Also enter on Line 7,Recapitulation) $ 534,710 -49 If more space is needed,use addiBonal sheets of paper of the same size. REV--7511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER YVONNE B. SHAULL 21 13 1331 Decedent's debts must be reported on Schedule 1. ;7EM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Parthemore Funeral Home-funeral expenses 4,713. 91 Parthemore Funeral Home-death cert 24 .00 Trinity Church-honorarium on behalf of funeral 2,000 . 00 G B, ADMINISTRATIVE COSTS: 1. Personal RepresentativeCommissians: Names)of Personal Representative(s) Lisa S Z o l l 11000 - 00 Streetndress 2001 Clarendon St city Camp Hill State PA ZIP 17011 Year(s)Commission Paid: 2014/2015 p, AttomeyFees: David H Stone, Esquire 7,500 . 00 3. Family Exemption:(if decedent's address is not the same as claimant's,attach explanation.) Claimant Sheet Address City state ZIP Relationship of Claimant to Decedent 4. Probate Fees: Register of Wills, Cumberland County 158 .50 5 Accountant Fees: 6. Tax Return Preprer Fees: 7. ANC Bank-bank charges 13.00 2 US Treasury-Estimated tax paymt on 2013 1040 1,675.00 3 PA Dept of Revenue-Est tax paymt on 2013 PA40 125. 00 4 PA Dept of Revenue-paymt due on 2013 PA40 61 . 00 5 Nettie Stout-services done by caretaker 340 .00 6 PNC Bank-check printing fee 18 .15 7 Nettie Stout-services done by caretaker 500 . 00 8 Nettie Stout-services done by caretaker 500.00 9 UPS-mail service 13.24 10 Nettie Stout-services done by caretaker 500 . 00 11 Nettie Stout-services done by caretaker 500 . 00 12 Nettie Stout-services done by caretaker 500 .00 TOTAL(Also enter on Line 9,Recapitulation) $ 21,429 - 42 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent YVONNE B.SHAULL 21 13 1331 Decedent's Name Page I File Number Schedule H -Funeral Expenses&Administrative Costs-B7, ITEM NUMBER DESCRIPTION AMOUNT 13 PSERS-Reimbursement check due 520 . 77 14 Nettie Stout-services done by caretaker 500.00 is Verizon-telephone services 14 .54 16 Verizon-telephone services 52 . 31 17 Reserve for closing expenses 200 .00 SUBTOTAL SCHEDULE H-87 1,287 - 62 REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER YVONNE B . SHAULL 21 13 1331 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 t Holy Spirit Hospital-debt of decedent 44 . 00 2 Bank of America-debt of decedent 188 . 45 3 Bethany Village-living expenses 2,334 . 50 4 BonTon-credit card expense 52 . 56 TOTAL(Also enter on Line 10,Recapitulation) $ 2,619 - 51 If more space is needed, insert additional sheets of the same size. REV 1513 EX-(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: YVONNE B . SHAULL 21 13 1331 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [Include outrightspousal distributions and transfers under Sec.9116(a)(1.2).1 1 LISA S ZOLL Lineal 2591531 . 65 2001 CLARENDON STREET CAMP HILL PA 17011- 2 LORIE A SHAULL Lineal 2591531 . 64 106 9TH ST SE WASHINGTON DC 20003- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 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, STONE, LAFAVER $t SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET NEW CUMBERLAND PA 17070 LAST WILL AND TESTAMENT OF YVONNE B. SHAULL T YVONNG B. SHAULL, of the Borough of Camp Hill, '_­umberlanci COUnt'y, Pennsylvania, declare this to be my last will and revoke arse; ? I direct that my Executor hereinafter namee.t shall ]. _- rni lust debts and funeral expenses as soon as conveniantiv I;i., . 1n12 ,after my decease from the residue of my estate . .T1.hi II : I devise and bequeath all the rest, residue and :cinder _ my estate of every nature and wherever situate to m;, aband, ri. RICHARD SHAULL, if he survives me . :•I ITT ' Should my husband, K. RICHARD, fail to survive ... , ' !E°IlSP and bequeath all the rest, residue and remainder cf in,,' :.s`nr_ i1 2_r•.r nature and wherever Situate, to lily daughters, :,_�•.?. .� . ._„ nci .-._E SHAULL. Shciid either of my daughters praciecc-aea mom, .- _;�L.eath the share of _u._il ,.e.:,ae;'rrr:' r ,_r, ❑,:- c , ter ;houid any daughter of mine leave no slieh __:;ee L1.-i41IiIQ i :teath, i devaSP_ and bequeath the Share of i`r.r !:-sue,-, I-:eL Jt1rpes . 1 appClnt my Executor and his Sl]CL'eS SO r9 7Ua r_!1.,n property ✓hich passer, either under this will or othar�iise, Page 1 0 f 5 minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor ' s benefit . Such guardian shall have the power to use principal as well as income from time to time for the I minor ' s support and education (including college education, both graduate and undergraduate) without regard to his or her parent ' s ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor ' s parent or to any person taking care of the minor. ITEM V: I appoint my husband, K. RICHARD SHAULL, Executor of this my last will . Should my husband, K. RICHARD SHAULL, fail to qualify or cease to act as Executor, I appoint my daughters, LISA S . ZOLL and LORIE A. SHAULL, Co-Executrices of this my last will . ITEM VI : No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties i I in any jurisdiction . I IN WITNESS WHEREOF, I, YVONNE B . SHAULL, have hereunto set my I hand and seal this day of I�ft�.VFr.� e.._ 2004 . YVONNE B. SHAULL Page 2 of 5 SIGNED, SEALED, PUBLISHED and DECLARED by YVONNE B. SHAULL, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses . vt 0 d.•-� {� Wi ss Address (Uu Witness A dress i I I I Page 3 of 5 COMMONWEALTH OF PENNSYLVANIA: : SS : COUNTY OF CUMBERLAND I, YVONNE B. SHAULL, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. YVONNE B. SHAULL Sworn to or affirmed to and acknowledged before me by YVONNE B. SHAULL, the Testatrix, this day of K1Mua`y�,� 2004 . II CpNJA04WEAL jj OF pEpN9YlVAPAA Notary Public NOTARIAI.�EU po�� CAROL L. TROXELL. Notary MyGommiaaio=+ExD�ea t�.27 2005 I ! ! Page 4 of 5 COMMONWEALTH OF PENNSYLVANIA : SS: COUNTY OF CUMBERLAND t We, ` X 'A6 A -m�''(LQ and the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed 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 signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence . �f7 y witn LD Witness (Sworn to or affirmed to and acknowledged before me by k1 : ��{"��. s and witnesses, this day of 2004 . COMMONWEALTH OF PENNSMVAN1A NOTARIAL SEAL Notary Public CAROL L TROXELL, Notary Public New Cumberland Bard.Cumberland Co. [MY Commission Expires pea 27,2008 Page 5 of 5 E i I Jan. 8. 2014 3 09P PNC Bank No, 3080 P, 1/1 January 08,2014 David H Stone, Esq Stone,Lafaver&Shekletsld 414 Bridge St PO Box E New Cumberland, PA 17070 RE: Name: Yvonne B Shaull SSN: 178-24-9850 DOD: 12/18/2013 Dear Mr_ Stone: In response to your request for Date of Death(DOD)balances for the customer noted above,our records show the following: Checking Account Account# 5112009328 Established. 0511011944 YV"ONNE B SHAULL DOD balance: $4,546.38 non-interest bearing Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC 13ank branch office. Sincerely, National Financial Services Center PNC Bank,N.A. Member FDIC This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient,you are hereby noted that any dissemination, distribution or copying of this communications is strictly prohibited. If you have received this communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this faxed document. Page I of I Page 1 of 2 Secure View Message Msg.Date(Eastern) 3/3/2014 4:25:00 PM From ccmpfi @cambridgesecure.com To imearkle @stonelaw.net Cc scottderr @compfi.com Bcc Subject Encrypt-date of death values for Yvonne Shaull Below please find the date of death values(as of 12/18/13)for Yvonne Shaull's four accounts as requested. If you should have any further questions,please don't hesitate to call Scott Derr at 717-652-2070 x28. 1. Pershing-Individual TOD account-#5DK-280631 $297,331.15 2. American Funds-IRA Rollover-#81738172 $51,986.94 3. ING - Fixed Annuity-#167734 $92,641.48 4. ING-Fixed Annuity-#167733 $92,750.92 Tara Truskey, Service Assistant to Scott A. Derr, CFP Registered Principal Comprehensive Financial Associates 2090 Linglestown Rd., Ste. 201 Harrisburg, PA 17110 Securities offered through Cambridge Investment Research, Inc., a Broker/Dealer, Member FINRA/SIPC. Investment Advisor Representative, Cambridge Investment Research Advisors, Inc.a Registered Investment Advisor. Cambridge and Comprehensive Financial Associates, Inc. are not affiliated. The information in this email is confidential and is intended solely for the addressee. If you are not the intended addressee and have received this email in error, please reply to the sender to inform them of this fact. We cannot accept trade orders through email. Important letters,email, or fax messages should be confirmed by calling 717-652-2070. This email service may not be monitored everyday, or after normal business hours. Report Generated 31512014 10:18.25 AM ET by Jennifer Mearkle https://smarshenerypt.smarsh.com/PRInsite/my/pop_securevieW_printer_friendly.aspx?mes... 3/5/2014