HomeMy WebLinkAbout08-15-14 15D561U140
� REV-1500 EX (01-10) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN ZI I �'��
Po sox 2soso� RESIDENT DECEDENT
Harrisbu PA 17128-0601
ENTER DECEDENT INFORMATION BELODate of Death MMDDYYYY Date of Birth MMDDYYYY
Social Security Number
0 6 2 3 2 0 1 4 0 7 0 8 1 9 2 2
2 0 0 9 Mi
Suffix DecedenYs First Name
Decedent's�ast Name M A R V I N �
S H 0 F F N E R
(If Applicable)Enter Surviving Spouse's Information Below Suffix Spouse's First Name
MI
Spouse's Last Name
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
������qop}�Qp�;ATE�VALS BELO�N ❑ 2 Supplemental Return � 3.Remainder Return(date of death
� 1.Original Return priorto 12-53-82)
❑ � 5.Federal Estate Tax Return Required
� 4.Limited Estate 4a.Future Interest Compromise(date of
death after 12-12-82)
� 7.Decedent Maintained a Living Trust __ 8.Total Number of Safe Deposit Boxes
� 6.Decedent Died Testate (Attach Copy of Trust)
(Attach Copy of Wilq + � 11.Elect:on to tax�nder Sec.9'13(A)
� 9.L+tig2±ion Pr^cesds Recs:veC � 1Q.S��usa!P�ve�ty vred�'.(date of dea.h �Attach Sch.O)
between 12-31-91 and 1-1-95)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIA�L��eF�e1�ho�ne N muberBE DIRECTED T0:
Name ? y 7 2 4 9 2, .� 5 3
M A R C U S A • M c K N I G H T � I I I n :-:: ��
ILLS US�LY -� '
REGISTEF� '�?'-_�
�=M- `--._ r i
,'i_}�r 4"') �_ --
]�,�`. - � - I.j-:
� _
First line of address �G� ' _
��� � J
I R W I N & M c K N I G H T , P - C - n r�; � - ���
�T c.,� " r�,
Second line of address A �' � � �
6 0 W E S T P 0 M F R E T S T R E E T DATE FILED �'�
State ZIP Code
City or Post O�ce
C A R L I S L E
P A 1 7 � 1 3
Correspo�denYs e-mail address:
Under penalties of peryury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belie,
it is true,corect and complete.Declaratio�of preparer other than the persoral reoresentative is baszd on all information o�which prepare�DATEny knowl dga.
SIGNATUR OF R SP E F FI ING TURN �
ADDRES ICKESBURG PA 17U37
592 P NING LL RO D DATE ��
RE OF P R HER THAN REPRESENTATIVE
S CARLISLE PA 17013
6 0 W E S T P 0 M F R T R E E T PLEASE USE ORIGINAL FORM ONLY
Side 1 �
1505610140 �
� 1505610140
_
� 15�5610240
REV-1500 EX DecedenYs Social Security Number
2 8 0 8 1
�ecedenes Name: M A R V I N L• S H 0 F F N E R
RECAPITULATION .
1.
1. RealEstate(ScheduleA) . • • • ••• • •• • • •••����" """'� � ��� � �� � �
. . 2• •
2. StocksandBonds(ScheduleB) . . • •• •••••• •• •••� �� � """ " "� � � � � � �
3. Closely Hsid Gor�oration,Partnership or So!e-Pro�r�eto!ship(Schedule C) .• ••
. 3.
4. Mortgages and Notes Receivable(Schedule D) ••••••• • ••• •••• ••'' ' ' ' ' ''' 4� •
5. Cash,Bank Deposits and Miscellaneous Personal PropeRy(Schedule E).. . . .. .
5. �
Separate Billing Requested .. . . . . . 6• �
6. Jointly Owned Property(Schedule F) ❑ 8 p 5 8 3 . 8 6
7. Inter-Vivos Transfers&Miscellaneous N�Prso pat a erBileng Requested .. .... . 7•
(schedule G) 8 0 5 8 3 . 8 6
... . ... . . . . . . s.
8. Total Gross Assets(total Lines 1 through 7) ••• • •• •••• •••• 1 � 0 p , p 0
9. Funeral Expenses and Administrative Costs(Schedule H) .. . ... . .... . .. . ...
9.
10. Debts of Decedent,Mo�tgage Liabilities,and Liens(Schedule I) .. . . ... . . . . . . 10. �
loaa • oo
11. Total Deductions(total Lines 9 and 10) ••••• ••• •••• • •���' ' ' '' ' '' '� ���� 11 7 y 5 8 3 . 8 6
12.
12. Net Value of Estate(Line S minus Line 11) ... .... . .
.. ... .... .... .. . . . . 13.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .
an election to tax has not been made(Schedule J) .• • •••• ••• •
.
14 7 9 5 8 3 . 8 6
14. Net Value Subject to Tax(Line 12 minus Line 1 ••••••••••• ••
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or � � � �
trensfers under Sec.9116 � � � � 15.
(a)(�.2)x•o _ 3 5 8 1 . 2 7
16. Amount of Line 14 taxable 7 9 5 8 3 . 8 6 16.
at lineal rate X.045 O � a 0
17. Amount of Line 14 taxable Q . 0 � 17•
at sibling rate X.12 Q . � �
18. Amount of Line 14 taxable Q . � � 1 S.
at collaterel rate X.15
19. TAX DUE ... ... . .. . .. . . . . . .. .. ...... ... . .. . . ..... ... ... . . . .. ...
19 3 5 8 1 • 2 ?
20. FILL IfV THE OVAL iF YOU ARE REQUESTING A REFUND OF AN OVERPAYfiIiENT �
Side 2 �
� 1505610240
� 150561D240 �
File Number
REV-1500 EX Page 3 � �
Decedent's Complete Address:
DECEDENTS NAME �
MARVIN L. SHOFFNER
STREET ADDRESS
5g2 pLANNING MILL ROAD
STATE Z�P
ciTM pq 17037
ICKESBURG
Tax Payments and Credits: ��� 3 581.27
1. Tax Due(Page 2,Line 19)
2. CreditslPayments •
A.Prior Payments 179.06 179.06
B.Discount Total Credits(A+B) (2)
3. Interest �3�
4. If Line 2 is greatF''thn oval on Page 2,L ne 20 to Irequest aT e'fund.e OVERPAYMENT.
�4� 0.00
��� 3 402.21
5. If L��e 1�-�ine 3 is gr�ater tnan�ine 2,anter the differ�nce,This is the TAX DIiE.
Make check payabie to: REGISTER OF WILLS, AGENT
pLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BL�OCKS
1. Did decedent make a transfer and: ❑
. .... ... ........................................................... o 0
a. retaintheuseorincomeofthepropertytransferred;� transferredoritsincome; •�•••••�••••••••••�••��••••���' � a
b. retain the right to designate who shall use the prope y � ❑
c. retain a reversionary interest;or ......................................... .....................................
benefits or care? ....................................................... ❑
d, receive the promise for life of either payments, �
2, If death occuRed after December 12,1982,did decedent transfer property within one year of death � x
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. Did decedent own an individual retirement account,annuity or other non-probate property,which a ❑
. .. .. . .... . ........................................
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.
For dates of d
eath 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 suroiving 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�ea survivi�n �spouse ftom taxfa d the stat tory qui e e ts forldiscPosuee of assets and
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to 9
filing a tax return are stil�app�icable 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 deceased1 6 a 21,2ears of age or younger at death to or for the use of a natural paren,an
adoptive parent or a stepparent of the child is 0 percent[72 P•S•§9 ( )� )1
• 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(1.2)[72 P•S•§9116(a)(1)]. 9 p A siblin is defined,under
• The tax rate imposed on the net value of transfers to or for th commonhw h the dec,edenitnwhether by blood o?adoption16(a)(1.3)]. 9
Section 9102,as an mdividual who has at least one parent m
REV-1510EX+(08-09) SCHEDULE G
pennsylvania
DEPARTMENT OF REVENUE M SC NON PROB TE PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT FILE NUMBER
ESTATE OF 0 0
MARVIN L. SHOFFNER e three of the REV-1500 is yes.
This schedule must be completed and filed if the answer to any of questions 1 through 4 on pag
DESCRIPTION OF PROPERTY TA�B�E
DATE OF DEATH %OF DECD'S EXCLUSION VALUE
ITEM INCLUDE THE NAME OF THE TRANSFEREE,TNEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST �F���� 8O,583.86
NUMBER THE DATE OF TRAMSFER•AITACH A COPY OF THE DEED FOR REAL ESTATE. $O,583.86 100.00
�, PRUDENTIAL INVESTMENTS
ACCOUNT#2808183914
BENEFICIARY: MARTHA L. NOEL
�
TOTAL(Also enter on Line 7,Recapitulation) 3
80 583.86
if more space is needed,use additional sheets of paper of the same size.
R�_151��(+(10-09) SCHEDULE H
pennsylvania
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT FILE NUMBER
ESTATE OF 0 0
MARVIN L. SHOFFNER
DecedenYs debts must be reported on Schedule I.
AMOUNT
ITEM DESCRIPTION
NUMBER
q FUNERAL EXPENSES:
1.
g ADMINISTRATIVE COST�:
� Personal Representative Commissions:
Name(s)of Personai Representative(s)
Street Address Z�P
S�at�
City
Year(s)Commission Paid:
1,000.00
2.
AttomeyFees: IRWIN &McKNIGHT, P.C•
3 Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.
Claimant
SVeet Address ZIP
State
Cily
Relationship of Claimant to Decedent
4, Probate Fees:
Accountant Fees:
5.
g Tax Retum Preparer Fees:
7.
TOTAL(Also enter on Line 9,Recapitulation) $ 1 000.00
If more space is needed,use additional sheets of paper of the same size.
REV-1573 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDEM DECEDENT FILE NUMBER:
ESTATE OF: 0 0
MARVIN L. SHOFFNER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY
Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [Include outright spousal disVibutions and Uansfers under
1. Sec.9116(a)(12).] 79,583.86
Lineal pRUDENTiAL
�, MARTHA L. NOEL INVESTMENTS ACCT.
5g2 pLANNIlVG MILL ROAD
ICKESBURG, PA 17037
ENTE�DULIAR A�.�OUNTS FOR�!STRiBUTiONS�HUWN ABO�iE ON LIPlFS 15 7HROU�H?9 OF REV-15UU GOVER SHEET,AS APPRUPRIP.TE,
ji. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKE :
1.
B.CHARtTABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
T
OTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 m0 S Ze SHEET. $
If more space is needed,use additional sheets of paper of the sa
,�� P�cu
d�ntial ��c�� , .
"""' �u�. � 1 zo��
July 25, 2014
IRV�N i��icKNIGNT
uw o��ic�s
gZWIN&MCKNIGHT PC
ATTN KAREN
�F�; 717-249-6354
�: prudential
Reference Number: 9607036572/4278640
� Funds/Account:
0028,0322-X����914
Registration: MARVIN I- SHOFFNER
STJLJErT TO STQ TOD RUI•ES-NJ
Dear Karen:
This letter is in regard to the above referenced account.
As of the close of business on June 23,2014 the above iunds/account were valued as foll�ws:
Fund/Account Number Share Balance Net Asset Value(NA� Market Value
0028-XX��3914 4,414.164 $10.05
$44,36235
�X3914 3,604.130 $10.05
$36,221.51
0322-XXXX�
han in market conditions may cause the NAV to fluctuate on a daily basis. Therefore,the fund
C g g
values are subject to change•
lease contact the Prudential Mutual Fund
If you have questions or need further assistance,p be�,�,een 8:00 a.m. and 6:00 p.m-
Service Center at(800)225-1852 Monday through Friday � da s a week,you may
Eastern Time. For account informatioudentialfundsac°m 4 hours a day, Y
access your account online at www•pr
Sincerely,
Bharat Karia
Customer Service Representative
CC: KAREN
prudential Investments
Prudential Mutuat Fund Services LLC
P O Box 9655
Providence,RI 02940
(B00)225-1852
www.prudentialfunds.com