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J 1505610143
REV-1500 EX�oz_,,, ;,��;
PA Department of Revenue OFFICIAL USE ONLY
pennsylvania co�nt code Year
Bureau of Individual Taxes OEPARTMENTOFREVENUE Y File Number
Po Box.2soso� INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 14 0403
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
Name Suffix DecedenYs First Name
PETCHEL MI
JO p�
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
PETCHEL MI
NICHOLAS
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVA�S BELOW
X❑ 1. Original Return � 2. Supplemental Return � 3, Remainder Return(Date of Death
Priorto 12-13-82)
� 4. Llmlted Estate � qa Future Interest Compromise
(date of death after 12-12-82) ❑ 5. Federal Estate Tax Return Required
� g Decedent Died Testate � Decedent Maintained a Living Trust 0
(Attach Copy of Will) ❑ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
� 9. Litigation Proceeds Received � �p.Spousal Povert Credit/Date of Death
between 12-31�J1 and t-1-95) � 11.Election to tax under Sec.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INF(trF�CIVIATION SHO�BE DIRE�ED T0:
Name
Daytime�je�one NurT�r rn rn
JERRY R DUFFIE cy
(71'7� �61 �'i4 0� ca
z ra `� er, �,
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REGIS'I"ERE���LLS4�aE 0[�l�j
First Line of Address ~ � �-•� �
�� :;.�; � _..� "�'i
3 O 1 MARKE T S T ' '' -"'
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Second Line of Address � ' p--
PO BOX 109
"_ N � "�r�
City or Post Office State 21P Code DATE FILED
LEMOYNE PA 170430109
CorrespondenYs e-maii address:
Under penalties of perjury,1 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.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
ATUR F P RSON RESPONSIBLE FOR F RE RN
� DAT �
Nicholas Petchel
ADDRESS
70 Sharon Road Enola A 17025
SIGNA URE F PR E 0 THAN EPRESENTATIVE
DA E
JERRY R. DUFFIE 'f
AD RES
301 MARKET ST., Lemoyne, PA 17043
L 1505610143 Side 1 �
1505610143 ��
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J 1505610243
REV-1500 EX
DecedenYs Social Security Number
Decedent'sName: PetCFI@I� JO A
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. 14 7 , 7 60 . 2 0
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous t�n,-Probate Property
(Schedule G) U Separate Billing Requested............ 7. $2 , 4 94 . 13
8. Total Gross Assets(total Lines 1 through 7)........................................................ g. 23O,254 . 33
9. Funeral Expenses and Administrative Costs(Schedule H)............ $,353 . 50
........................ 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................
��• 5 ,353 . 50
12. Net Value of Estate(Line 8 minus Line 11)............................. . .. .
. . . ...................... �2. 224 , 900 . 83
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. 224 , 900 . 83
TAX COMPUTATION-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.00 224 , 900 . 83 15. O . 00
16. Amount of Line 14 taxable
at lineal rate X .045 0 . �� 16. 0 . 0�
17. Amount of Line 14 taxable
at sibling rate X.12 � . 0� 17. � . ��
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0� 18. � . 0�
19. TAX DUE................................................................................................................ 19. � . 0�
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
L Side 2
1505610243 1505610243 J
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REV-1500 EX Page 3 File Number 21-14-0403
Decedent's Complete Address:
DECEDENT'S NAME
Petchel,Jo A
STREETADDRESS
70 Sharon Road
CITY
Enola STATE ZIP
PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19)
(1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +g) (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 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. �5�
�.0�
Make Check Payable to� REGISTER OF WILLS, AGENT
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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 property transferred or its income:.................................. � �
c. retain a reversionary interest;or..................................... .. O �
d. receive the promise for life of either payments,benefits or care?...............
............................................. X
. death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?.................................................................................................................... X
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
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.
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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 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 stiil 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 decedenYs 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.
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Rev-1508 EX+�11-1p)
SCHEDULE E
pennsylvania CASH BANK DEPOSITS
DEPARTMENTOFREVENUE � � � MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF
Petchel,Jo A FILE NUMBER
21-14-0403
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-ownedwith the right ofsurvivorship must be disclosedon schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1 Charles Schwab Investment Account No.2345-6439 115,288.89
2 Royal Alliance Brokerage Account No. 034-037234 32,471.31
TOTAL(Also enter on Line 5, Recapitulation) 147,760.20
(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 E(Rev. 11-10)
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Rev-7510 EX+(08-09)
SCHEDULE G
pennsylvania lNTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
Petchel,Jo A FILE NUMBER
21-14-0403
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.
ITEM DESCRIPTION OF PROPERTY
NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
THE DATE OF TRANSFER. ATTACIi A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (�F APPLICABLE) VALUE
1 American Funds IRA Account No. 74392454- 12,494.13
Beneficiary: Nicholas L. Petchel,Spouse 12,494.13
2 American Funds Roth IRA Account No.63118974- 70,000.00
Beneficiary: Nicholas L. Petchel,Spouse 70,000.00
TOTAL(Also enter on Line 7, Recapitulation) 82,494.13
(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)
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REV-1511 EX+(�0-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENTDECEDENT ADMINISTRATIVE COSTS
ESTATE OF
Petchel,Jo A FILE NUMBER
21-14-0403
DecedenYs debts must be reported on Schedule I.
ITEM
M R DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1• Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State
Zio
Year(s)Commission Paid
2. Attorney's Fees JOHNSON, DUFFIE, STEWART 8�WEIDNER
5,000.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State
ZID
Relationshio of Claimant to Decedent
4• Probate Fees
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
353.50
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 5,353.50
Copyright(c)2009 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H(Rev. 10-09)
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SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF
Petchel, Jo A FILE NUMBER
21-14-0403
ITEM
NUMBER DESCRIPTION AMOUNT
9ther Administrative Coctc
1 Cumberland County Register of Wills Office-Probate Fees
353.50
H'B7 353.50
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
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REV-1513 EX+�Ot-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Petchel,Jo A 21-14-0403
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT
(Words) �$$$�
I� TAXABIE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 Nicholas L Petchel Spouse Entire Estate
70 Sharon Road
Enola, PA 17025
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 o�easheet,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 II-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)
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ESTATE OF JO A. PETCHEL AIK/A JO ANN MYERS PETCHEL
SCHEDULE OF EXHIBITS
EXHIBIT A Last Will and Testament of Jo Ann Myers Petchel signed and
dated April 12, 1996.
:653933
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Gti'r\B[:D.�1:1'til_{Cy OF COUNSEL
1914-2014 H��tt;�c[�:A J��lt,ti'st�_1�
C. ROy 4�'GIl>NI?R.(h.
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September 24, 2014
Register of Wilts Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Jo A. Petchet a/k/a Jo Ann Myers Petchel
Date of Death: February 22, 2014
Your File No. 21-14-0403
Our File No. 17882-1
Dear Register:
Enclosed for filing, please find the following:
1. 2 Original Pennsylvania lnheritance Tax Returns. There is no tax due. This is a Spousal
Estate.
2. Inventory.
3. One (1) copy of Page 1 of the Inheritance Tax Return that we ask that you time-stamp and
return to us in the enclosed self-addressed stamped envelope. .
4. One (1) copy of the Inventory that we ask that you time-stamp and return to us in the self-
addressed stamped envelope.
Should you have any questions or require any additional information, please do not hesitate to contact
the undersigned. Thank you for your assistance in this matter.
Very truly yours,
NS N, F �E, TEWART &WEI[�i�JER ° �„ �
• � � °� `t� � cn.�
ana ieseman � -o � �„ �,
Estate Administration Paralegal ° � � rv �;� °
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Enc. W.._ c� : .�� �:�
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c; Nicholas L. Petchel, Executor ��> �=� �; � �!
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