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HomeMy WebLinkAbout10-28-14 1505611101 REV-1500 Ex t02-11, OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes DEPARTIE'T County Code Year File Number PO BOX 28o6o1 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT a � ` L I o ow � 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY �o o ►� a o �{ 0 3 1 3 0 Decedent's Last Name Suffix Decedent's First Name MI Ga. \ � _3C e (� (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI G0. } i bet -�-�_3 Spouse's Social Security Number ` THIS RETURN MUST BE FILED IN DUPLICATE WITH THE i i a a�D w-i ., g REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW fW 1. Original Return O 2. Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) 4M 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O 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 a 1 ► 3-7 Aa`I ' REGISI( WILLS USE ON 3-1 :7) c-D First Line of Addressn L� r ric .o LA 1�c1 W d C O U V- r �' O° t 71 Second Line of Address ::3 City or Post Office State ZIP Code DATE FILED Correspondent's e-mail address: tv 0— 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 personal representative is based on all information of which preparer has any knowledge. SIGN UR PE SON ZONSIBLE FOR FILING RETURN DATE ADDIS � I H X_Jo� � SIGNATURE OF PREPARER OTHER THAN REPRESENTA NE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505611101 1505611101 1505611201 F REV-1500 EX " Decedent's Social Security Number Decedent's Name:'_:3Q'_152ON-1 a . RECAPITULATION 1. Real Estate(Schedule A). ........ ............ ..... . .. . . ... .. .... . .... . .. . 1. . J 1, 0,,, 2. Stocks and Bonds(Schedule B) . ..•.. . ... .. .... . .. .. ..... . .. .. .. .. . ... . 2. Jf-Jf _JL. �• 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . ... . 3. r �I �,�}L� •!��� ` . . .. .. ..... ... ..4. Mortgages and Notes Receivable(Schedule D).. ... . .... 4 } 4� 41_ 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). ... .. . 5. �` ��J� �+-_{��;.__�L_ i� •�F 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ..... . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property Schedule G O Separate Billing Requested.... .. .. 7. 8. Total Gross Assets(total Lines 1 through 7). ... .. .... . ..... ... .. .... . .. . 8. 9. Funeral Expenses and Administrative Costs Schedule H . .. ... . 9. L -�all 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). . .... ... . . ... . 10. -Jl. �{! !�_JL J` 1-11 11. Total Deductions(total Lines 9 and 10). .. . .. .. ...... .... . .. . . . .... .... . 11. I j� M;, �� }�� � -Oi.Q� 12. Net Value of Estate(Line 8 minus Line 11) .. . . . . .. .. . .. .. . .... .... . .. .. . 12. fr[_J[J"rr a 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which -�r'an election to tax has not been made(Schedule J) .. .. . .. .. .... . , 14. Net Value Subject to Tax Line 12 minus Line 13 14. TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 r.--. ' (a)(1.2)X.0_ )5 '�JI�1�. '�1�3�'©Ilq 15. 16. Amount of Line 14 taxable 1- ,• -1: - ,I- --; JJ II ,ff ! `` I + t at lineal rate X.0- +�,-J+_�� J1_ JI _ �L�4 16. Ilia-, I,f�I-_�li_ii_ 17. Amount of Line 14 taxable {F ? �I-Tr, • at sibling rate X.12 �{ `l�.+r� - f� t .�- I 17. +�I 1 { 18. Amount of Line 14 taxable at collateral rate X.15 L�iJC �!�� J� •��}� 18. ll 1 I. 19. TAX DUE . . .. . .. . . . ... . .. . . ... .. ... .. ..... ... .. ... .. ... . . .. .. . .... 19. LJ 1 00, 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT r O Side 2 1505611201 1505611201 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME absn\_1 Q. - QZ7 CO STREETADDRESS t-1 E 1�w C)o d CITY STATE ZIP Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) O� 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 3. Interest (3) 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) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) , L� 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 .......................................................................................... ❑ a b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ c. retain a reversionary interest .............................................................................................................................. ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 9 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ Q 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? ........................................................................................................................ �I ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. L- _ - -- - - ---- - �� � 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 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 1,2000: • 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-1,510 EX+(08-09) i pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND (� INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER 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 INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER, ATTACH A COPY OFT EED FOR REAL ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE -\0 96,~,Li$, to TOTAL(Also enter on Line 7, Recapitulation) $ 9 a 33©Q oil If more space is needed,use additional sheets of paper of the same size. REGISTER OF WILLSCERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA, No. 2014- 00693 PA No. 21- 14- 0693 Estate Of: JOSEPH A GALL jFirst,Middle,Last) Late Of: HAMPDEN.TOWNSHIP . CUMBERLAND COUNTY Deceased Social Security No: WHEREAS, on the 24th .day of July 2014 an instrument dated January 15th 1990 was admitted to probate as .the last will of JOSEPH A GALL !First,Middle,Last) late of HAMPDEN TOWNSHIP, CUMBERLAND County, who died on the 4th day of June 2014 and, WHEREAS, a true copy of the will as probated is annexed hereto. . Register of .Wills in and THEREFORE, I, LISA M,. GRA YSON; ESQ.. , for CUMBERLAND County, in the Commonwealth of Pennsylvania, : hereby certify that I have this day granted Letters TESTAMENTARY:to: BETTY J GALL who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears. of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VA NIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 24th day of July 2014. epi er o Wills , D put **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) <c L LAST WILL OF w"a y JOSEPH A. GALL CD I , JOSEPH A. GALL, of the Township of Hampden, Cumberland , County, Pennsylvania, declare this to be my Last 1?Ii.11 and revoke ,, any Will previously made by me. Item 1: 1 devise and bequeath all of my estate of every ; nature and wheresoever situate, together with insurance thereon, `° to my wife, BETTY J. GALL, providing she shall survive me by thirty (30) days. Should BETTY J. GALL, predecease me or die on or before the thirtieth (30th) day following my death, I devise , and bequeath all of my estate of every nature and wheresoever situate, together with insurance thereon, to my children: : MICHELE 1,5. GALL; JOANNE N. McCARTNEY; and DIANE 14. LONG, share ' and share alike. Provided however, should any of my daughters predecease me or die on or before the thirtieth (3)th) da;- i following my death, I devise and bequeath the share of such :' daughter to her issue, per stirpes, living on the thirty-first (31st) day following ray death. Further, the term "issue" shall not include any children of the rrevi.ous marriage of my daughter' s ; husband, RUSSELL -icCARTNEY. Item 2: Should any of ray issue entitled to a share of my estate not have attained the age of twenty-five (2S) years at the time of distribution to him or her, I devise and bequeath the share of each issue to COMNONTlEALTH NATIONAL BANK, 10 South y--t Market Square, Harrisburg, Dauphin County, Pennsylvania, IN <r tea a SEPARATE TRUSTS, to hold, manage, invest and reinvest the share so received and the accumulation of income thereon, and to use 3 and apply the income and principal, or so much thereof, as in Trustee's discretion, may be necessary or appropriate for each issue's medical care, support and education (including college education, both graduate and undergraduate) without regard to his or her parents ability to provide for such medical care, support or education, and to make payment for these purposes, without ;further responsibility, to such issue or to such issue' s parents taking care of such issue. Any principal or income not so applied shall be distributed to such issue absolutely when he or she attains the age of twenty-five (25) years. If he or she dies before attaining the age of twenty-five (25) years, the trust "shall terminate and such share shall be distributed to his or her personal representative. Item 3: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever ,jurisdiction imposed, shall be paid from my residuary estate as apart of the expense of the administration of my estate. Item 4: I appoint my wife, BETTY J. GALL, Executrix of this , lay last will. Should my wife, BETTY J. GALL, fail to qualify or cease to act as Executrix, I appoint my daughter, `.4ICHELE id. GALL, Executrix of this my last will . Should my wife, BETTY J. GALL as well as my daughter, IMICHELE Mi. GALL, both fail to qualify or cease to act as my Executrix, I appoint my tiro daughters, JOANNE i!. P1cCARTN EY and DIANE IN. LONG, Co-Executors of this my last will. Item 5: I direct that my personal representative or trustee a C or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 7 a It ern u: 1 direct that all my just debts and funeral expenses _ shall be paid from my residuary estate as soon as practicable after mer death. 1 , CO41,10NAVEALTH OF PENNSYLVANIA ) ss: COUNTY OF CUMBERLAND ) ,t ti'Ie, JOSEPH A. GALL, .fr C G . ✓ �. '' i the Testator and the wit- nesses respectively, whose names are signed to the attached or '.. foregoing instrument, being first duly sworn, do hereby declare `',to the undersigned authority that the Testator signed and executed: it :the instrument as his Last Will and that he had signed willingly, ;and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the ':'fill as ; witness and that to the best of his or her knowledge, the Testator . `was at the time eighteen (18) years of age or older, of sound mind, ;'and under no constraint or undue influence. + J.6'sep A. Gall t -'� l^7itnes s :imess Subscribed, sworn to and acknowledged before me, by JOSEPH A. GALL. the Testator, nd subscribed and swo-,n to before me by C=%+'t? % .✓4'�� r�% and rte;r '� the witnesses, this c`'r, day Ile �� of .1 `moi r .1 �"32- _ niotar'y Pu 1 ic\, �; V wr JOSEPH A GALL Balance Information SAV Available Balance $0.00 Mailing Address Current Balance $0.00 MTD Average Balance $0.00 Last Deposit Amount $0.04 4 ELMWOOD CT Last Statement Balance $0.00 CAMP HILL PA 17011-4026 General Information Activity Information Home Phone (717) 737-1275 Last Deposit Dt 08/17/2013 Business Phone 7177371275 Last Activity Dt 09/25/2014 Open Date 06/01/1992 Last Statement Dt 10/06/2014 Account Status ( i. : Routing Number 036076150 Product Code 411 Bank 060 Branch 291 Branch Name Hampden Camp_ Hill Market Western-Central PA Relationship Saulevics, Ravane Manager Recent Transactions Check Debits/ ®ate Description � Additional Description Amount Credits/ Balance All 10/06/2014 34 0000000091634.38 $0.00 .$0.00 10/06/2014 32 0000000091634.38 $0.0()l $0.00 X09 25/2014Internal WITHDRAWAL $91,634.38 D $0.00 Transfer Outs 09/25/2014 INTEREST ADJUSTMENT ($11.01) D $91,634.38 09/17/2014 Balance $1,058.28 D $91,634.38 Transfer 08/27/2014 0.00150000 REN $0.00 $0.00 082714 TRM D 330 08/27/2014 RATE 0.00500000 TO $0.00 $0.00 0.00150000 08/27/20141nterest $39.65 C $92,692.66 08/17/2014 Balance $1,058.27 D $92,653.01 f Transfer 07/27/20141nterest $38.79 C $93,711.28 07/17/2014 Balance Transfer $1,058.28 D $93,672.49 06/27/2014Interest $40.51 C $94,730.77 06/17/2014 Balance Transfer $1,058.27 D $94,690.26 X05/�2r�7./t? 41nterest $39.63 C S$95,748.53 05/17/2014 Balance $1;058.28 D $95,708.90 Transfer JOSEPH A GALL Balance Information SAV Available Balance $®a®0 Mailing Address Current Balance $0.00 MTD Average Balance $0.00 Last Deposit Amount $357.42 4 ELMWOOD CT Last Statement Balance $95,988.41 CAMP HILL PA 17011-4026 General Information Activity Information Home Phone (717) 737-1275 Last Deposit Dt Business Phone 7177371275 Last Activity Dt 10/02/2014 Open Date 10/16/2000 Last Statement Dt 12/31/2013 Account Status l �: � ll Routing Number 036076150 Product Code 460 Bank 060 Branch 291 Branch Name Hain den Camp Hill- Market Western-Central PA Relationship Manager Saulevics, Ravane Recent Transactions Check Additional Debits/D�g� Desccription # DescrOption Amount Credits/ Balance All Transfer Out To, 10/02/2014 = 4— WITHDRAWAL $97,075.34 D $0.00 - Beneficiary F 10/02/2014 Interest-- $7.93 C $97,075.34 09/30/2014 Interest $122.68 C $97,067.41 08/30/201.4Interest $122.52 C $961944.73 07/30/201.4 Interest $118.43 C $96,822.21 06/30/2014 Interest $122.222 C $96,703.78 05/30/2014Interest $118.14 C � $96,581.56 a FROM ti U.s 8RIS9IOSTAGE HARRISURG.PA . �� 17108 OCT 27. 14 AMOUNT p051N1 SERVICE $8,0^' (� 1000 17013 00031225- f t ----- ___ 7013 2250 0000 5625 3412 TO: y u, co MIN _Cr1,51 1 � - RETURN RECEIPT REQUESTED Oda