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Home My WebLink About10-15-14 (2) � 1505610143 REV-1500 EX�°2_,,, � PA De artment of Revenue y OFFICIAL USE ONLY p penns Ivania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 11 0530 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 07 18 2010 12 23 1932 DecedenYs Last Name Suffix DecedenYs First Name MI MESSICK BETTY A (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 Priorto 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise � 5. Federal Estate Tax Return Required (date of death after 12-12-82) � 6 Decedenl Died Testale � � Decedent Maintained a Living Trusl � 8. Total Number of Safe Deposit Boxes (Attach Copy of W II) (Attach Copy of Trust) 9. Litigation Proceeds Received �p, Spousai Povert Credit(Date of Death 11.Election to tax under Sec.9113(A) between 12-31�1 and T-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 EDMUND G MYERS (717) 761 4540 � REGIST�2 OF WILLS�ON�Y � � c� �".� First Line of Address � -� � � _`°? ca _.�, - 3O1 MARKET STREET _J �„ r- F--, � `-�=' . r'"' � ( I'"+i , :'_7 Second Line of Address . � �^, PO BOX 10 9 � � � i `'� '�r Cit or Post Office DATE FILED _'`� -- Y State ZIP Code _ _i j-- �., LEMOYNE PA 17 0 4 3 �--• G c� � -°� CorrespondenYs e-mail address: egm(aajdsw.com Under penalties 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.Declaration of preparer other than the personai representative is based on all information of which preparer has any knowledge. S TURE OF O SPON IBLE FOR FILING RETURN DATE � Sue A Quarterson �� u I Z(�� 0 ADDRESS 333 Andersontown Road, Mechanicsburg, PA 17055 SIGNAT OF PREPARER OTHER THAN REPRESENTATIVE DATE G�d�� f/IG+I' EDMUND G. MYERS �DI I D I�I� ADDRESS 301 MARKET STREET, Lemoyne, PA 17043 � � Side 1 � � 1505610143 1505610143 J � 1505610243 REV-1500 EX DecedenYs Social Security Number Decedent'sName: MESSICK, BettyA 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. 15 , �� . �0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�aq Probate Property (Schedule G) U Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ g. 15 , 0 0� . 0 0 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 5 , 0 95 . �0 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ ��. S , 0 95 . 0� 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 9, 905 . 00 �3. 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. 9, 9 0 5 . 0 0 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0 . �� (a)(1.2)X.00 15. 16. Amount of Line 14 taxable 9� 9 0 5 . 0 0 16. 4 4 5 . 7 3 at lineal rate X .045 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................................................................................................................ 19. 445 . 73 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-11-0530 Decedent's Complete Address: DECEDENT'S NAME MESSICK, Betty A STREET ADDRESS 17 Hunter Lane CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 445.73 2. Credits/Payments A. Prior Payments B. Discount Total Credits(A +B) (2) 3. I nterest (3) 46.64 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) 492.37 Make Check Pa�rable to REGISTER OF WILLS, AGENT. ,''`-` "Hl�l�i , -,-='� ::�%/i�i�////�� xa i ..i" ,.,,n_ . .: ..,n.� � :: , �, . '�, ., , _ , �,//,�� ,,,,'�.: ,.,,,o.:,,,,,, -: ;';� .,l,vHs , „„ ., :.,,. , � , ,. 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:.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ ❑x d. receive the promise for life of either payments,benefits or care?............................................................ ❑ Ox 2. If 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?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑ containsa 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. ir�� y,� ' i�„_.� ,�"'�1 ..xF. . . . .Mm"r,s,,,,a w,s.,,a,.,.. . .. . . .. ... .,f�!.i.✓n„ . . . �.��..,,nn,.,,, . ,,,,i-y.xF, . . ...,,,,,,, . . 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 still applicable even if the surviving spouse is the only benefciary. 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 decedenYs 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+(11-10� SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OFREVENUE �NHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MESSICK, Betty A 21-11-0530 Include the proceeds of liligation and the date the proceeds were received by the estate. All property jointly-ownedwith the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Estate of Betty A. Messick v. Kathy E.Walbridge-Settlement of Automobile Account 15,000.00 TOTAL(Also enter on Line 5, Recapitulation) 15,000.00 (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) REV-1511 EX+�10-09) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND RESIDENTDEC D NT URN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MESSICK, Betty A 21-11-0530 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MBER q, 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 5,000.00 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 95.00 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 5,095.00 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 MESSICK, Betty A 21-11-0530 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Cumberland County Recorder of Deeds Office-Filing Fees for Deed from Estate to Mr. 80.00 Messick 2 Cumberland County Register of Wills Office-Filing Fees 15.00 H-67 95.00 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1513 EX+(07-10) pennsylvania SCHEDULE J DEPARTMENT OFREVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER MESSICK, Bett A 21-11-0530 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) Not ist te I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 7 John W Messick Son 1/2 of Residue 17 Hunter Lane Camp Hill, PA 17011 2 Sue A Quarterson Daughter 1/2 of Residue 333 Andersontown Road Mechanicsburg, PA 17055 Total Enter dollar amounts for distributions shown above on lines 15 throu h 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 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) ESTA TE OF BETTY A. MESSICK SCHED ULE OF EXHIBITS EXHIBIT A Copy of Settlement Worksheet � Sue Quarterson, Administratrix for the Estate of Betty A. Messick v. Kathy E. Walbridge :657761 September 11, 2013 Sue Quarterson 333 Andersontown Road Mechanicsburg, PA 17055 Re: Sue Quarterson, Administratrix of the Estate of Betty A. Messick v. Kathy E. Walbridge Dear Sue: Below please find our firm's Settlement Worksheet. It sets forth the total settlement in this case at $15,000. Our firm's 1/3 contingency fee is $5,000. Our office did not pay for any expenses and there are no expenses outstanding. Accordingly, you will receive a check totaling $10,000. SETTLEMENT WORKSHEET Total Settlement Amount $15,000.00 JDSW 1/3 Contingency Fee $5,000.00 Minus Costs Advanced: Itemize Costs Advanced $0.00 Plus Credits Owed to Client: Itemize Refunds $0.00 Total Settlement Owed to Client $10,000.00 Please review this settlement worksheet. If you are satisfied that it accurately sets forth the calculations of this settlement on the agreed-upon 1/3 contingency basis, please sign and date below: Dated: September 11, 2013 Sue Quarterson Sincerely, Julia A. Morrison :16792-2/547100 EXH�B�T A