HomeMy WebLinkAbout11-06-14 (2) � 1505610140
REV-1500 EX (02-11)(FI)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 8 7 2
HarrisburQ,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDvvvv Date of Birth MMDDYYYY
0 8 1 3 2 0 1 4 0 8 3 0 1 9 3 1
DecedenYs Last Name Suffix DecedenYs First Name MI
MEHRI NG OWEN H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
MEHRI NG WI N I F RED N
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
a 1.Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
❑X 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
� 9.Litigation Proceeds Received � 10. Spousal Poverty Credit(Date of Death � 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedu��) `"`
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX IR�O�ATION SH$8LD B�IRE�TED T0:
Name Daytim�dephone N�er c;� d
SUSAN H . CONFAI R 71`:T'7� �? 63 �`";�'�83
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——�� �=�-----
REGISfiERAF WILLS U5�"ONCY �
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First Line of Address - :`_y ��
W ��.,_ t`�1
2 3 3 1 MA RKET ST REE T � ' ,._., ��, c, i
Second Line of Address �
co -�,
� DATE FILED_
City or Post Office State ZIP Code
C A M P H I L L P A 1 7 0 1 1
CorrespondenYs e-mai�address: SCONFAIR _REAGERADLERPC.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 personal representative is based on all information of which preparer has any knowledge. _
SIGNATURE OF ERSON RESPONSIBLE�)FOR FILING RETURN ATE
� 71 4� � -���,Y"L �� �) ��� �
ADDRESS
4113 NANTUCKET DRIVE MECHANICSBURG PA 17050
SIGNATURE OF PREP R OTHER THAN REPRESENTATIVE �' � �
ADDRESS
2331 MARKET STREET CAMP HILL PA 17011
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 1505610140 � '
1 �
� 1505610240
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYSName: OWEN H. MEHRING
RECAPITULATION
1. Real Estate(Schedule A) �• '
. . . . . . . . . . . . . . . .. . . . . . . . . ... . . . . . . . .. . . . . . .
2. Stocks and Bonds(Schedule B) .. .. . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . 2• '
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 4 9 9 9 8 � � 6
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .... . . 6. •
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. .
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 4 9 9 9 8 , 1 6
9. Funeral Expenses and Administrative Costs(Schedule H) . ... . . . . . . . ... . . . . 9• $ 5 0 6 . 9 3
10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I 10. � 0 0 6 9 . � 2
9 9 ( ) . . .. . . . . . . . . .
��, Total Deductions(totat Lines 9 and 10) . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . 11. � 8 5 7 6 . � 'rJ
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12• 3 1 4 2 2 . 1 1
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. 3 � 4 2 2 . 1 1
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxabie
at the spousai tax rate,or
transfers under Sec.9116
�a>��.2�x.0000 3 1 4 2 2 . 1 � 15. O . 0 0
16. Amount of Line 14 taxable O . O O
at lineal rate X•0_ � • � � 16.
17. Amount of Line 14 taxable � . 0 �
at sibling rate X.12 � . � 0 17.
18. Amount of Line 14 taxable O . O O
at collateral rate X.15 � • � � �g,
19. TAX DUE O • O 0
. . . .. . . . . . . . . . . ... . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
� 1505610240 1505610240 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 2� 14 os�2
DECEDENT'S NAME
OWEN H. MEHRING
STREET ADDRESS
4113 NANTUCKET DRIVE
CITY STATE ZIP
MECHANICSBURG PA 17050
Tax Payments and Credits:
1• Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments
B.Discount
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.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT
�_ .�-e�,,Y�� �:�, ��, � i��
. , .:-�. � 6.... �m .. wmnr.+x� ..�P�.nr,.�� .,,re,�9i .`�Y��.i ?�s�"`�. F� �•a�� '��k'��5�,� a ?�.'.� ,��s?: . �v. ..��,.nw :.c.�� aa�.��t i.ms��„I ii ..._
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 propeRy transferred ...................................................................... ❑ O
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? ....................................................... ❑ X❑
2. If death occurred after December 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�ieath 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?.................................................................................................. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
x"�':. '�.�aj� . �d°d�f se 5a. ;S .,a.. _ .. . ,.b . .. , . ... . , .. � .. _ a ,. _.,.. . .,,.. � . .�,. ,�'h� . __ .
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
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)J.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 p2 P.s.§s�ts(a)(�)�.
• The tax rate imposed on the net value of transfers to or for the use of the decedenPs 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+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
OWEN H. MEHRING 21 14 0872
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
�. WELLS FARGO, N.A. -ACCOUNT ENDING IN 7232 39,045.52
2. WELLS FARGO, N.A. -ACCOUNT ENDING IN 9958 27.64
3. 2013 CHEVROLET MALIBU 10,925.00
TOTAL(Also enter on Line 5,Recapitulation) $ 4g 998.16
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
OWEN H. MEHRING 21 14 0872
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES; 6,653.93
1. PANEBAKER FUNERAL HOME INC. - FUNERAL
2. E.F. REDDtNG &SON - LETTERING ON MEMORIAL 140.00
g. ADMINISTRATIVE COSTS:
�, Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2 AttomeyFees: REAGER&ADLER, PC 1,517.50
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 195.50
5 Accountant Fees:
g, Tax Retum Preparer Fees:
7.
TOTAL(Also enter on Line 9,Recapitulation) S 8 506.93
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES 8� LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
OWEN H. MEHRING 21 14 0872
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. HUNTINGDON NATIONAL BANK-2013 CHEVROLET MALIBU CAR LOAN 8,676.94
2. WEST SHORE EMS-ALS-CALL NUMBER 1414201A 1,392.18
TOTAL(Also enter on Line 10,Recapitulation) $ 10 069.12
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
OWEN H. MEHRING 21 14 0872
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include out n'ght spousal distributions and transfers under
Sec.91'f6(a)(1.2).]
1. WINIFRED N. MEHRING Spousal 31,422.11
4113 NANTUCKET DRIVE
MECHANICSBURG, PA 17050
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. �
If more space is needed,use additional sheets of paper of the same size.
I, OWEN H. MEHRING, of the Borough of Hanover, York County,
Pennsylvania, being of sound and disposing mind, do make, publish
and declare this as and for my Last Will and Testament, hereby
revoking any and all Wills by me at any time heretofore made.
FIRST: I direct that alI my just debts and funeral expenses
be paid by my hereinafter named exe�utrix as soon a�ter my death
as may conveniently be done.
SECOND: I do give, devise and bequeath my entire estate,
real, personal and mixed, of whatever nature and wheresoever the
same may be located, to my wife, Winifred N. Mehring, subject to
the provisions of Item THIRD, next below.
THIRD: If my wife should predecease me or should she fail
to survive me by thirty (30) days or more, then, on the happening
of either of said events, I do give, devise and bequeath my entire
estate, as aforesaid, in equal shares, share and share alike, to
our two children, David 0. Mehring and Julie A. Krepps; provided,
however, should any of our children predecease me, then his or her
share shall be distributed to his or her issue, per stirp�s;
provided, further, should any of our children predecease me,
leaving no issue to survive, then his or her share shall be
distributed to my surviving child or the issue, per stirpes,
should the other child also be deceased.
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FOURTH: If any beneficiary or distributee hereunder should
be under age twenty-one (21) years, when his or her share would
otherwise be distributable hereunder, I give, devise and bequeath
the share of such distributee to Hamilton Bank, as Trustee, in
trust, nevertheless, upon the following uses and purposes:
A. To invest and reinvest the same and ta receive and
accumuiate the income therean and therefrom for the benefit
of the said beneficiary thereof until he or she attains age
twenty-one (21) years, at which time the trust shall
terminate and the Trustee shall distribute the entire
principal or corpus together with any accumulated and
unexpended income to the beneficiary thereof, absolutely.
Provided, however, that the Trustee may, in its sole
discretion, from income and/or principal, use and expend so
much as shall be necessary for the maintenance, support and
education of the beneficiary, including education at a
college or professional school.
B. Shouid tne beneficiary die before having received
his or her full share of the trust, leaving issue to survive,
the Trustee shall continue to hold and manage the trust
corpus for the benefit of such issue, per stirpes, until they
respectively attain age eighteen (18) years.
(S EAL)
wen H. M hring
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C. Should the beneficiary die before having received
his or her full share of the trust, leaving no issue to
survive, the share of the beneficiary so dying shall
distributed among the then surviving beneficiaries as set
forth in Item THIRD of this, my Will.
AND LA5TLY, I do nominate, constitute and appoint as the
executrix of this; my Last �ill and Testament, my wife, Winifred
N. Mehring; in the event, however, that my said wife should
predecease me or, for any reason, fail to qualify as executrix
hereunder, then I appoint as the executors of this, my Last Will
and Testament, our two children, David O. Mehring and Julie A.
Krepps. I direct that no executor or executrix who qualifies
hereunder shall be required to furnish a bond of any kind.
IN WITNESS WHEREOF, I, OWEN H. MEHRING, testator, have to
this, my Last Will and Testament, contained on this and the
foregoing two pages, set my hand and seal this � day of
�������-�-� , one thousand nine hundred ninety-two (1992) .
! (SEAL)
Owe . Me r ng
-3-
THE FOREGOING INSTRUMENT, contained on three typewritten
pages, bearing the signature of Owen H. Mehring, was by him
signed, sealed, published and declared as and for his Last Will
and Testament in the presence of us, who, in his presence and in
the presence of each other and at his request, have hereunto
subscribed our names as witnesses on this � ��'�� day of
C--'��'i�f_-t.`�-� , one thousand nine hundred ninety-two (1992) .
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COMMONWEALTH OF PENNSYLVANIA .
:ss
COUNTY OF YORK .
We, the Testator and Witnesses, respectively, whose names are
signed to the foregoing Will, being first duly sworn, do hereby
declare to the undersigned Notary Public that the Testator signed
and executed the foregoing instrument as his Last Will and
Testament in the presence and hearing of the witnesses and that he
signed willingly and executed it as his free and voluntary act for
the purposes therein eapressed and tYiat each of the *,aitnesses, in
the presence and hearing of the Testator and each other, signed
the Will as witnesses and, to the best of their knowledge, the
Testator was at that time eighteen years of age or older, of sound
mind and under no constraint or undue influence.
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tator
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� Witness
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Sw�c�rn and s�abscribed to
bef:ore me this o��,�.�
day of �'z ,.r �.,.� , 199� .
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Notary Public
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Hanover.Yotk Counri.PA �
MY t',ommission ExpireS Feb.23,!97�
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