HomeMy WebLinkAbout11-18-14 (3) � 1505610105
REV-1500 EX(oz-si)(FI)��.��
PA Department of Revenue pennsylvania
OFFICIAL USE ONLY
oEo.a,�E�,oF aE�E��E Coun
Bureau of Individual Taxes ty Code Year File Number
INHERITANCE TAX RETURN " �
Po eox zao6o� � j� ��' —!
Harrisbur ,PA i�iz8-o6o1 RESIDENT DECEDENT ��� (
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
— . . _ _.... _
,200-22-6348 08/18/2014 07/15/1928
DecedenYs Last Name Su�x DecedenYs First Name MI
_ --�-
' Snyder • DeVoe -. . _ _ C
___ _ ____, ___ . _
(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 TME
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return p 2.Supplemental Return p 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Retum Required
death after 12-12-82)
O 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 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 T0:
Name Daytime Tel@phone Number
_._ . ... _
. _
`Mark T. Silliker, Esquire � J -� �"'
,��(7�17)67'�-�500�:F� rn
_ _ .-.T. . --,. �
F A _ , _._
- ,.-�
�`� � �EGISc�ER OF�yyILL9 USE ONLY
..,,1 . �,'„�
- .' r.,. F._..�
- ..._ ;.i 3
First Line of Address
' � � ; r-;7
,. __._ _ __ ; , ::.,
'5922 Linglestown Road �=�� -�3
, ,,
-- _..,
t _._._ .... --. � :�
_. — .� �_ _._
Second Line of Address . . — _ ; �--+ - �.�
_
_._._ _
_ _. _ }---' ;-� ��f
C.,'l G� �
Cit or Post Office -- _.._ ' �DATE FIL�
Y State ZIP Code ED
Harrisburg PA � 17112 _ _ _
CorrespondenYs e-mail address:
Under penalties of perjury,I declare that I have examined this retum,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.
SIGNATU RS ONS E F G RETURN DAT
ADDRE � t r
5922 Linglestown Road, Harrisburg, PA 17112
SI N E EPARER OTHER THAN REPRESENTATIVE DATE
l �` ���'�
D E S
1 emlock Lane, Enola, PA 17025
PLEASE USE ORIGINAL FORM ONLY
Side 1 �
� 15D5610105 1505610105 � q, �.•
,��
J 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
oecedent's Name: DeVo2 C. S�yde�
RECAPITULATION
1. Real Estate(ScheduleA). ......................... ................ .. . 1. _ _90,000.00
2. Stocks and Bonds(Schedule B) ............ .......... .. .............. . 2. _
3. Closely Heid 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. , 4,572.66
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. 94,572.66 '
9. Funeral Expenses and Administrative Costs(Schedule H)........... .... .... 9. ', 15,323.46
� � �m. __ �:
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)........ ....... 10. 259.34
„� a .,�. _� � .
_. . ,
11. Total Deductions(total Lines 9 and 10)... .. .. .......................... 1L : 15,582.80
,.. . ... . � , .._. '
12. Net Value of Estate(Line 8 minus Line 11) . .... ......................... 12. �g 989 86 '
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ' °°- • --
an election to tax has not been made(Schedule J) . .............. .. ....... 13. I
14. Net Value Subject to Tax(Line 12 minus Line 13) .. ............ .......... 14. 78,989.86
TAX CALCULATION-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.0_ _
15. ',
16. Amount of Line 14 taxable ` """ ` �` ` '
�__� �_,.� _ _
at lineal rate X.0 45 78,989.86 ` �s, 3,554.54 ''
17. Amount of Line 14 taxable ° -
at sibling rate X.12 �� '
18. Amount of Line 14 taxable � ` ` -
at collateral rate X.15 �$
19. TAX DUE ................... .............................. .... .... 19. , _ . 3,554.54
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
L, 15D56102�5 1505610205 J
REV-1500 EX(FI) Page 3
File Number
Decedent's Complete Address:
DECEDENT'S NAME
DeVoe C. Snyder
STREETADDRESS
6115 Wertzville Road
cirv
Enola STATE Z�p
PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,554.54
2. Credits/Payments
A.Prior Payments
B.Discount 187.08
3. Interest
Total Credits(A+B) (2) 187.08
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �3)
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) 3,367.46
Make check payable to: REGISTER OF WILLS, AGENT.
a, : , �.
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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.......................................................................................... � .
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�. ■
. ..................................................................... ❑ �
2. If death occurred after Dec.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-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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the suroiving 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 decedenYs siblings is 12 percent[72 P.S. §9116(a)(1.3)j.A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the tlecedent,whether by blood or adoption.
REV-1502 EX+(12-12)
�pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DeVoe C. Snyder 2114-0867
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been soid.
ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1• Real estate located at 6115 Wertzville Road, Enola,Cumberland Count Penns Ivania
Y� Y 90,000.00
TOTAL(Also enter on Line 1, Recapitulation.) � 90,000.00
If more space is needed,use additional sheets of paper of the same size.
REV-i5o8 EX+(o8-1z)
� pennsylvania SCNEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX REfURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DeVoe C. Snyder 2114-0867
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
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1. M&Tcheckingaccount 3,754.66
2, Miscellaneous personal property 500.00
3, Reimbursement from real estate settlement error(real estate taxes) 318.00
TOTAL(Also enter on Line 5, Recapitulation) $ 4,572.66
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
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DeVoe C. Snyder 2114-0867
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A• FUNERAL EXPENSES;
1' Richardson Funeral Home
6,559.75
z. Tri-County cemetery 1,245.00
3• Wake refreshments 286 87
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions;
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
z• Attorney fees: 1,600.00
3• Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00
Claimant Sandra L. Green
street address 1327 Durham Road
ciry Clarksville state TN ZIP 37043
Relationship of Claimant to Decedent Dauqhter
4• Probate Fees: 335.50
5• Accountant Fees
6• Tax Return Preparer Fees:
�• Short certificate 5.00
8. PPL 18.98
s. PPL 206.62
�o• Verizon 107.96
��• Settlement costs for sale of real estate 1,333.00
�z. Verizon 124.78
TOTAL(Also enter on Line 9, Recapitulation) $ 15,323.46
If more space is needed, use additional sheets of paper of the same size.
SCHEDULE H
Funeral Ezpenses and Administrative Costs
Estate of DeVoe C. Snyder No. 2114-0867
Egplanation regarding Family Ezemption:
The reason that the Decedent's address is not the same as the Claimant's address is because the
Claimant was residing with the Decedent at the time of the Decedent's death. However, after the
Decedent passed away, her house was sold, and the Claimant needed to move from the
Decedent's home at the time of the sale. After the sale of Decedent's home, Claimant moved to
the address which is listed on Schedule H.
REV-151Z EX+ (12-1Z)
�pennsylvania SCHEDULE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DeVoe C. Snyder 2114-0867
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1� Bank of America credit card 48.01
2. PPL 109.09
3. Culligan water softner treatment 37.56
4. QVC credit card 41.68
5. Apria Healthcare 23.00
TOTAL(Also enter on Line 10, Recapitulation) � 259.34
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(O1-10)
Ti : pennsylvania SCHEDULE �
'� DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DeVoe C. Snyder 2114-0867
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 outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1• Sandra Green, 1327 Durham Road,Clarksville,TN 37043 Daughter 1/3
2. Debra E. Lyons(Snyder),452 Laurel Street, Minersville,PA 19754 Daughter 1/3
3. Karen DiMartile, 1021 Hemlock Lane, Enola, PA 17025 Daughter 1/3
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.
�ros
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V�'��I�I��*,y" A. Settiement Statement (HUD-1) OMBApprovalNo. 2502-0265
I(IlI�II
(�`�4V I)F�E+.�K~
B.Type of Loan
1.❑ FHA 2.� RHS 3.� Conv.Unins. 6•File Number: 7.Loan Number: 8.Mortgage Insurance Case Number.
4.� VA 5.� Conv.Ins.
C.Note:This fortn is fumished to give you a statement of actual settlemerrt cosis.qrrpunls paid to and by the settlement agerrt are shown.Items
marked" .o.c."were id ouTside the cfosin ;th are shown here for infwmationa� r ses and are not included in the totals.
D.Name 8 Address of Borrower E.Name 8 Address of Seller F.Name&Address of Lender
M[CHAEL J.CEKOVIC ESTATE OF DEVOE C.SNYDER
ELISA M.CEKOV[C
IS TEABERRY DRNE 6115 WERTZVILLE ROAD
CARLISLE,PA 17015 ENOLA,PA 17025
G.PropeKy Location H.Settlemerd Agerrt
6115 WERt'ZVILLE ROAD CHARLES E.PETRIE
ENOLA,PA 17025 Place of Settlemant I.Settlemerrt Date
3528 BRISBAN STREET 10/03/14
HARRISBURG,PA 17111
Disburse Date:10/3/2014
J. Summary of Bonowers Ttansaction K. 3ummary of Sellers Transacfion
100. Gross Amount Due From Bonower 400. Gross Amount Due To Seller
101. Contract Sales Price 90 000.0(1 401. Cordract Sales Price 90 000.00
1D2. Personal Property 402. Personal Property
103. SettlemeM charges to borrower(line 1400) 1 924.00 403.
104. �.
7 05. �5.
AdjusbneMs for items paid by seller in advance AdjusUneMs for items peid by seller in advance
106. Ciryrtowntaues 10/3/2014 to 12/31/2014 60.04 406. Cityrtowntexes ►0/3l20t4 to 12/31/2p14 60.04
107. County taxes 407. County taxes
108. Assessments 408. Assessments
109. School Ta�ces 10l3/2014 to 7/1/2015 282.09 409. Schooi Taxes 10/3R014 to 7/I/2015 282.09
11U• sewer 10/3/2014 to l2/3U2014 I3834 410. s�wer IO/3/2014 to l2/31/2014 13834
111. 411.
112. 412.
120.Gross Amount Due From Borrower 92 404.47 420.Gross Amount Due To Seller 90 qgp,q�
200.AmouMs Paid B Or In Behalf Of Bonower 500.Reductan In AmouM Due To Seller
201. Deposi[or eamest rtaney 1 OW.00 501. Excess de
Posit(see instructia�s)
202. Prinapal amourrt of new loan(s) g7 645.71 502. Settlement charges to seller(ine 1400) 1,333.00
203. Existing loan(s)taken subject to 503. Exis6ng loan(s)taken subjed to
2�� 504. Payoff of first mortgape ban
205. 505. Payoff of second mortgage loan
206. �.
207. �7
208. sp8.
209. 509
AdjustmeMs for items unpaid by Seller Adjustments for items unpaid by Seller
210. CityRown taxes 510. Cityftown taxes
211. CouMy faxes 511. County taxes
212. AssessmeMs 512. Assessments
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220.Total Paid BylFor Borrower 88 45.71 520.Total Reduction Amount Due Seller 1 33.00
300.Cash At Setttement fromRo Bonower 600.Cash At Settkment tol/►om Seller
301. Gross amount due from borrower(Gne 120) 92 404.47 601. Gross amouM due to seller(6ne 420) 90 480.47
302. Less artwurrts paid bylfor borrower(�ne 220) gg 645.71 602. Less reductions in amouM due seller(6ne 520) 1 333.0(1
303.Cash �( From ❑ (To) Borrower S 3 758.76 603.Cash 1�( To ❑ (From) Seller S 89 147.47
SELLER INSTRUCTIONS: Hthia reel ertate wes your principel reaidance,fik Fwm 2119,Sak a Exchange of PrinGpal Re�idance,for arry gain,with your irwpne 1�retum;fa
oMer tranmctims,complete the app6cabb parts d Foim 4794.Form 6252 and/a Scheduk D(Form 1040).
SU&STRUTE 1Q99:The infmna6on eaMained in Bbcks E.G,H,I and on qrc 407(a.'rf ine 407 is aslensked,ines I00 and AW)is imporiaM tax inkrmatim and ia beig .
Grrvahed to the Intemel Revernre Service.fl you ere required to fde a retum,a roglipenoe perety or other sarc[ion wiN be impoeed on you i(tNs kem is re�µured to he reported and
the IRS delermines tlnt it hes nd been reported.
Software aM Added FormatUrg m 2014/Va Ster Shcwere,Inc.All RigMs Reaerved.(8T7)279-8898�w�w.MudLite.cam Page 1 O(3
L.Setdement Charges poc(B/S/L)=Paid ouLside of cbsing by:Bortower(B)/Seller(SyLender(L)
700. Total Real Estate Broker Fees $ Paid From Paid From
Division of Commission(line 700)as follows: Borrowers Sellers
701. $ to Funds at Funds at
702. $ to Settlement Setllement
703. Commission pad at SettlemeM
7U4• to
800. items Payable in Connection WiM Loan
BOt. Our origination charge (from GFE#1)
802. Your credit or charge(poirrts)for the specific interest rate chosen (from GFE#�
803. Your adjusted origination charges to (fram GFE A)
804. Appraisal fee to (from GFE iq)
805. Credit report to (from GFE#3)
806. Tax service to (hom GFE 1R3)
807. Flood certification to (from GFE#3)
808. to
809. to
810. to
811. to
900. Items Required By Lender To Be Paid In Advance
901. Daily interest charges from to /da from GFE#10
902. Mortgage insurance premium for rtwnths to (from GFE N3)
903. Homeowner's insurance for years to (from GFE#11)
904. to
905. to
1000.Reserves Deposited With Lender
1001.Initial deposit for your escrow account (from GFE if9)
1002.Homeowners insurance mordhs(� $ per month S
1003.Mortgage insurance moMhs� S per moMh S
1004.Property taues months� $ per moirth $
1005. $
1006. $
1007.A gregate Adjustrnent $
7700.Title Charges
1101.Title services and lender's title insurance (from GFE#4) 250.00
1102.Settlement or closing fee to CHARLES E.PETRIE S 250.00
1103.Owners title insurance to CHARLES E.PETRIE (hom GFE#5) 695.00
1104.Lenders title insurance to
1105.Lender's title poficy limit $
1106.Owners title poGcy limit $
1107.AgerR's portion oi total title insurance premium a
1108.Underwriters portion of total title insurance premium S
1109.Deed preparation to Mark T.Silliker,Esquire 90.00
1110.Settlement fce to Mark T.Silliker,Esquire 200.00
1111. to
1112. to
1200.Govemment Recordin and Tnnsfer Charges
1201.GovemmeM recording charges: (from GFE 7) 79.00
1202.Deed$79.(� Mortgage$ Releases a
1203.Transfer taxes (ftom GFE 8) 9p0.00
1204.Ciry/County tax/stamps Deed E 900.00 Mor�age $ 900.00
1205.State tau/startps Deed 5 900.00 Mortgage S
1206. to
1207. to
1300.Additionai 8ettlement Cha es
1301.Required services that you can shop for (from GFE A�8)
1302.p�t-Nov.-Dec sewer to Hampden Twp 143.00
1303. to
1304. to
1305. to
1306. to
1307. to
1308. to
14�.Total Settlement Charges(enter oo line 103,Section J and 502,Seetion K) 1,924.00 1,333.00
1 have cerefuly roviewed the HUD1 SettlemeM Statamert and W the beW o(my Ivawledpe and belief d ie a lrue ard acarale accart d aA receips aM disb�emeAs made on
my awount a by me i ttws trarqadion.I tuAha certity thet I heve rcceived a copy of the D-t Settlement Slatemert.
/,Y�..�� � CL-�c9� CkFc.
�r�R� MICHAEL J.CEKOV[C � ESTATE OF DEVOE C.SNYDER
�,�'. �
BuyerleoRower ELISA M.CEKOV[C S"�
To the beat of my Iviowledge,the HU0.1 Settlemant Sfatemeit which I have prepared is a true and axurate a000�nf of the funda wfiich were received and have been a wiN be
diaburoed by tlx ude ' ed as ��m of Ntis transaetion.
.<%b IO/03/14
��+CHARLES E.PETRIE �e
WARNING: tt is a aime to laawirgly make falx atatemeiYs to the Urvted States on this or any other amiNr form.PetmMies�pan oorwicbon inchde a 6re and imprieament.
Sdhrara ard Added Form�tirp O 2008 AIa Slar Shcwarc,Inc.(BTn2738898 www.HudLite.com PBge 2 Of 3 Fofm HUD-1(3/8fi)