HomeMy WebLinkAbout09-11-14 (3) REV-1500 EX(02-11) 1505610143 11) ti' OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County code rear Fee Number
Bureau of Individual Taxes DEPARTMENTOFRUENUE
PO 60x.280601 INHERITANCE TAX RETURN 21 14 0646
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12 12 2013 04 25 1921
Decedent's Last Name Suffix Decedent's First Name MI
RUPP JOHN 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
n Return 2. Supplemental Return 3. Remainder -82) (Date of Death
1. Original Retu
❑ ❑ Prior to 12-13 3-82)
4. Limited Estate ❑ 4a.Future Interest compromise
❑ ❑ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
B Decedent Died Testate ❑ 7. Deahenopy Wgned a Living Trust B. Total Number of Safe Deposit Boxes
(Attach copyof Will) -
❑ 9. Litigation Proceeds Received ❑ 10.bemmen l2 31 V1 iit IDOa15of Death ❑ 11.Election to tax under Sec.9113(A)
T 9 (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOLI,4D BE DIRECTED TO:
Name DaytimecTplephone Noiaer M MY
I'M rn
DAVID J LENOX 717 �7Q 717A U� 0 )
-o
x Q ;
REGISTER*PWILL"SE O-PjLrrrl
74:
i) T
n
First Line of Address C, -TI -n
8 TRISTAN DRIVE SUITE 3 " ry
rn
Second Line of Address
DATE FILED
City or Post Office State ZIP Code .x
DILLSBURG PA 17019
Correspondent's e-mail address: lawodavidilenoz comcastbiz net
Ulsdtrue,correct and crlomplette declare of have other than the personal accompanying is based on allll information and hich preparerfhas any knowledge.belief,
it SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DAT ,/
exe Thomas E mod'Rupp Q 67`
ADDRESS
1 id e d We ville PA 17
SI NATUR OF P EP E THAN REPRESENT E AT
David J. Lenox
ADDRESS
8 Tristan Drive, Suite 3, Dillsburg, PA
L.
1505610143 Side 1 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
DecedenrsName: Rupp, John M.
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&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 654 . 78
7. Inter-Vivos Transfers&Miscellaneous h{oDrProbate Property
(Schedule G) u Separate Billing Requested............ 7. 45 ,789. 08
8. Total Gross Assets (total Lines 1 through 7)........................................................ 8. 46, 443 . 8 6
9. Funeral Expenses and Administrative Costs(Schedule H)........................ ........ 9. 3 ,220 . 08
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 3,220 . 08
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 43 ,223 . 78
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. 43 ,223. 78
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 43 ,223 . 78 16. 1, 945 . 07
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 00 18. 0 . 00
at collateral rate X.15
19. TAX DUE................................................................................................................ 19. 1 , 945 . 07
20, FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
REV-1504 EX Page 3 File Number 21-14-0646
Decedent's Complete Address:
DECEDENT'S NAME
Rupp,John M.
STREET ADDRESS
770 Poplar Church Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,945-07
2, Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 28 to request a refund
5, If Line 1 +Line 3 is greater than Line 2,enter the difference. This Is the TAX DUE. (5) 1,945.07
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;_.____........._............... .......................
b, retain the right to designate who shall use the property transferred or its income;.........._....._...............
c. retain a reversionary interest;or,................ .................. ........................................................................ z
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?....... ❑ Q
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................._.._............--......._...--....._..------...............-----.........._.----.... 7 ❑
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 3 percent[72 PS.§9116(a)(1.1)(}j.
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 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[72 P.S.§9116(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-1609 EX+(0110)
Pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Rupp,John M. 21-14-0646
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Thomas E. Rupp 1960 Ridge Road Son
Wellsville, PA 17365
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH VALUE OF
ITEM LETTER DATE NUMBER DR FINANCIAL INSTITUTION AND
IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH DECD'S DECEDENTS INTEREST
NUMBER FOR JOLT MADE ALUE OF ASSE
TENANT JOINT aoiunr-HEiDREAI-ESTATE, � INTEREST
1 A 01115/2011 Citizens Bank Account 6100747065: 1,309.56 0.500% 654.76
TOTAL(Also enter on Line 6,Recapitulation) 654.76
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10)
Rev-1510 EX-(08-119)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Rupp John M 21-14-0646
This schedule must be completed and Bled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DEWS EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFERSATfACh THEIR OPY OF THE DEED FOR TATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Riversource Life Insurance Co. Policy#9920-5873698 45,789.08 45,789.08
Thomas E. Rupp,decedent's son,is the beneficiary:
TOTAL(Also enter on Line 7, Recapitulation) 45,789.08
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09)
REV-1511 EX+(1009)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT ED RETURN ADMINISTRATIVE COSTS
ftE51DENT DECEDENT
ESTATE OF FILE NUMBER
Rupp, John M. 21-14-0646
Decedent's debts must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 575.58
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representatives)
Street Address
City State ZiD
Years)Commission Paid
2. Attorney's Fees David J. Lenox 1,750.00
1 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 168.50
-5. Accountant's Fees
6, Tax Return Preparer's Fees 550.00
T Other Administrative Costs 176.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9,Recapitulation) 3,220.08
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Rupp John M 21-14-0646
ITEM AMOUNT
NUMBER DESCRIPTION
Funeral Expenses
1 Cocklin Funeral Home: 240.68
2 Funeral luncheon: 334.90
H-A 575.58
Other Administrative Costs
3 Federal Income Tax: 176.00
H=137 176.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev.6-98)
REV-1513 EX+(01-10)
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Rupp, John M. 21-14-0646
NAME AND ADDRESS OF - RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT s (Words) ($$$}
I. TAXABLE DISTRIBUTIONS (include outright spousal
distributions,and transfers
under Sec.91 16 a 1.2
1 Jennifer L.Martin(formerly Markey) Granddaughter 16.666%probate
248 Pleasant View Road estate
Strasburg, PA 17579
2 Thomas E.Rupp Son 50%probate
1960 Ridge Road estate and
Wellsville, PA 17365 beneficiary of
non-probate
3 Thomas E.Rupp,Jr. Grandson 16.666%probate
1965 Ridge Road estate
Dillsburg, PA 17019
4 Tammy L.Wagner Granddaughter 16.666%probate
28 Nailor Road estate
Dillsburg,PA 17019
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as a- ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART H-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
LAST (JILL AND TESTAP EFT OF JOAN 14. RUPP
I, JOHN M. RUPP, of the Township of Washington, County of
York and State of Pennsylvania, being of sound and disposing mind,
memory and understanding, do make, publish and declare this my
Last Will and Testament, hereby revoking and making void any and
all prior Wills by me at any time heretofore made.
i.
I direct the payment of all my ,just debts and funeral
expenses as soon after my decease as the same can be conveniently
done.
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever
and wheresoever the same may be situate, to my wife, PAULINE
M. RUPP, absolutely and unconditionally.
3•
In the event that my wife, PAULINE M. RUPP, should predecease
me, or should she die within thirty (30) days from the date of my
death, then in either of such events, I direct the settlement and
distribution of my estate to be made in the following manner, to
wit:
_7 _
( a) I give and bequeath fifty (50M per cent. of my
estate to my son, THOMAS E. RUPP, absolutely and unconditionally.
(b) I give and bequeath the remaining fifty (5(yP per cent.
of my estate to my three ( 3) grandchildren, to wit, TAMMY L.
WAGNER, THOMAS E. RUPP, JR. and JENNIFER MARRY, share and
share alike, per stirpes .
( c) For the purpose of facilitating the settlement of my
estate, I authorize and empower my Executors hereinafter named,
or any substitute -personal representatives of my estate, to sell
any and all real estate which I may own at the time of my decease,
at either public or private sale or sales.
LASTLY, I nominate, constitute and appoint my wife, PAULINE
M. RUPP, Executrix of this my Last Will and Testament, and in the
event that my said wife should predecease me, or should she be
unable or unwilling to serve in such capacity for any reason, then
in such event, I nominate, constitute and appoint my son, THOMAS
E. RUPP, Executor of this my Last Will and Testament, in her place
and stead, and in the event that my said son should predecease me,
or should he be unable to serve in such capacity for any reason,
then in such event, I nominate , constitute and appoint my
granddaughter, TAMMY L. WAGNER and my grandson, THOMAS E. RUPP,
JR. , Co-Executors of this my Last Will and Testament, and in all
instances, I direct that my said personal representatives be
-2-
excused from posting bond or other security for the faithful
performance of their duties in any jurisdiction.
IN WITNESS IdMEREOF, I have hereunto set my hand and seal
this g day of January, A. D. , 1999.
pw, (S],
John M. Rupp
Signed, sealed, published and declared by the above named;
JOHN M. RUPP, as and for his Last Will and Testament, in the
presence of us, who have subscribed our names hereto as witnesses ,
at the request of said testator, in his presence and in the
presence of each other.
�G
�J�
COMMONWEALTH OF PENNSYLVANIA ) -
SS.
COUNTY OF CUMBERLAND )
I JOHN M. RUPP the testator
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 the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary act and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me by 7
JOHN 11. RUPP the testat or this ._
Tay of January A. D., 199 (A
John M. Rupp
&otary Public
Notarial Seal Public
Marilyn E.WiNiarns,Notary
COMMONWEALTH OF PENNSYLVANIA ) Mechanicsburg.eoro. Tres N[w 6 2CO11o01
• SS. MYCommisstonExp'
COUNTY OF CUMBERLAND ) Member,Pennsylvania Association of Notaries
We, the undersigned, J. ROBERT STAUFF[ER
and SUSAN A. MCCOY , 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 the
testator , JOHN M. RUPP , sign and exe-
cute e instrument as his/�L Last Will and Testament; that the
th
said testator >
JOHN M. RUPP , executed it as
his/ free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testator , signed
the Will as witnesses; and that to the best of our knowledge, the
testat or was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
/ y ,
Sworn ancli u�bs�ed to before:'
me this
37422 0(1/0{7)
r ; t RiverSource i
({{ , 9920.58 398 �- 2:0.3 5 4 3 9
P6�.NUm Life Insurance Company , E a. r I -s
829 Ameriprise Financial Center / y _ • - ,
Minneapolis, MN 55474 Date 87/21714 %,
$45, 789.08***
PAY Forty Five Thousand Seven Hundred Eighty Nine and 08/100 Dollars****
. r
Pa tothe Thomas E Rupp `,
Y 1960 Ridge Rd f j
order of Wellsville, PA 17365 .ter � .� l.J ��= A `
u e.�
- Treasurer,,8iver3oeroe
Life insurancell,C` pan
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Bank of America _r
Tampa,Florida 10)
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