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Home My WebLink About11-19-14 � 1505610105 REV-1500 Ex�az_��>�Fr, � PA Department of Revenue Pennsylvania OFFICIAI USE ONLY Bureau of Individual Taxes J`�"N,�", `�V`"°` County Cotle Year File Number PO BOX 28o6oi INHERfTANCE TAX RETURN Harrisburg,PA 1'7128-o6oi RESIDENT DECEDENT � � �y ��B� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY �ate of Birth MMDDYYYY 166-70-9265 04/17/2014 09/14/�986 DecedenYs Last Name Suffix C7ecedPnYs First Name MI Stager Alex � {If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� Spouse's Social Security Number THIS RETURN MUST 8E FILED IN DUPLICATE WITH THE �� c�� w��L� FILL IN APPROPRIATE OVALS BELOW ff� 1. Originel Return p 2. Supplemenlal Retu�n O 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 Return Required death after�2-12-82) O 6. Decedent Died Testate p 7. Decedent Maintained a Liviny Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wiii} (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death Q 11. Election to Tax under Sec.9113(A) Between 12-31-9�! and 1-1-95} (Attach Scheduie O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDEN7IAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ,.,, n _.� Andrew C. Sheel , Es uire ��. -� z� Y Q 717-697-70�D n ,. m :... �? --,, rn � �-�-�--�-. - REGISTEi�OF`W�S U -S�QNLY�'� [� -.., - :. r._ �J ,...y ::3 First Line of Address : �� i 127 South Market Street � ,-, -_n , -;j _ ' ,� ..._3 -;� _.. Second Line of Address ' r� ,,� � r P.O. Box 95 ` - _ _.r ��, City or Post Office State ZIP Code DATE FILED�''� Mechanicsburg PA 17�55 CorrespondenYs e-ma�i adaress:andrewc.sheely@verizon.net 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[rue,correct and complete.Declaration of preparer other than the personai representative is based on all information of which preparer has any knowiedge. SIGNATU OF PERSON R NSIBLE FOR FILING RETURN DA E r � i AQDRES Eliza th A. Stager nistratrix, 140 Reeser Road, Camp Hill, PA 17011 SIGN,�T RE OF EP R REPRESENTATIVE � '7 A D ESS Andrew C. Sheely, Esquire, 27 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM QNLY Side 1 � 7,505610105 15056101,05 � ` � �505610205 REV-1500 EX(FI) Decedent's Social Security Number DecedenYs Name: St8g2f,Alex C. RECAPITULATION 1. Real Estate(Schedule A). . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 1. 2. Stacks 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(Schedi�le G}. . . . . . . 5. 6,602.31 6. Jointly Owned Property(Schedule F} O Separate Billing Requesie-.d . . . . . . 6. 7. Inter-Vivos Transfers&Miscelia�eous Non-Probat:;ProF;erty (Scheduie G) O Separate Billing Requested.. . . . .. . 7. 8. Total Gross Assets(total Lines 1 through 7). . . .. .. . . . . . . .. . . . . . . . . . .. . . 8. , 6,602.31 9. Funeral Expenses and Administrative Costs(Schedula H). . . . . . . . .. . . . . . .. . . 9. 11,311.92 10. Qebts of Decedent, Mortgage Liabilities and Liens(Schedule I}.. . . . . . . . . . . . . . 10. ' 11. Total Deductions(total Lines 9 and 10}. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. ' 11,311.92 12. Net Value of Estate(Line 8 minus Line 11) .. . . . . .. . . . . . .. . .. . . .. . . . . . . . 12 0.00 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. 0.00 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 lineai rate X.0 45 0.00 ' �g 0.00 17. Amount of Line 14 taxable _ _ at sibling rate X.12 17. 18. Amounk of Line 14 taxabie at collaterai rate X.15 18. 19. TAX DUE . . . . . . . . . . . . . . . .. . . . . .. .. . .. .. . . . . . . .. . . . . . . .. . . .. . .. . . . . 19. 0.�0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A FtEFUND OF AN OVERPAYMENT O SIC�@ 2 � 15056102�5 15Q5610205 � REV-1500 EX(FI) Paye 3 File Number Decedent's Complete Address: a � - �`� - �y� y DECEDENT'S NAME Alex C. Stager STREETADDRESS ___ _. _ __ __ __ _ __ _ _ _ _ 140 Reeser Road __ __ __ _ GITY __ __ _ _ __ _ __ _ _ _ _i STATE _ _ ZIP Camp Hill PA i 17011 Tax Pa ments and Credits: Y 1. Tax Due(Page 2,Line 19) t ( ) 0.00 2. CreditslPayments A. Prior Payments __ _ _ __.. B.Discount __ -- -— -- -- Tctal Credits(A+Q) (2) 3, interest -- (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the tlifference. This is the OVEIZPAYMEN7. — -- Fill in ovai 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 QUE. (5) 0.00 Make check �ayable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUE5TlONS 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 transfer�ed or its income ............................................ ❑ � c. retain a reversionary interest .................................................. ....................................................................... ❑ � d. receive the promise for life of either�ayments,benefits ar 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-tleath bank account or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,��vhich contains a beneficiary designatian? .............................................................. ❑ � _....................................................... IF THE ANSWER TO ANY OF THE ABaVE Qtic$TIONS 15 u�S,YQU Ml!ST COMPL��E SCHE�UIE G AIdD FILE IT WS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a}(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spause from tax,and the statutory requirements ior tlisclosure of assets and filing a tax return are still applicabls even if the surviving spouse is the only beneficiary. For dates of death on ar after July 1,2000: . The tax rate imposed on the net value of transfers from a deceased chiid 21 years af age or younger at death to or far the use of a naturai parent, an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2}]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)J. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, untler Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1$o8 EX�-(11-i0) �� ;, pennsylvania SCHEDt�LE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Alex C. Stager 21-14-0484 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 Savings Account#xxxxxxxxx1729,date of death value $g02.18 2 Wells Fargo Checking Account#xxxxxxxxx5310,date of death value $5,700.13 TOTAL(Also enter on Line 5, Recapitulation) $ 6,602.31 If more space is needed, use additional sheets of paper of the same size. PMA account 2110240674 ■ May 21,2014-May 31,2014■ Page 3 of 6 Did you know that you can review your safe deposit box information through Wells Fargo Online Banking?Sign on to online banking and go to your account summary page.Check it out today. PMA° Premier Checking Account Activity summary Account number: 2110240674 Balance on 5/21 0.00 ESTATE OF ALEX C STAGER Deposits/Additions 6,602.40 ELIZABETH A STAGER PREP Withdrawals/Subtractions -0.00 We1lsFargoBank,NA. (MemberFDIC1 Bala�ce on 5/31 $6,602.40 PENNSYLVANIAaccount terms artd conditions apply Questions about your account: 1-800-742-4932 Worksheet to balance your account and General Statement Policies can be found towards the end of this statement. Interest you've earned � � Interest earned this month $0.09 � Average collected balance this month $6,60231 = Annual percentage yie�d earned 0.05� � Interest paid this year $0.09 � � 0 Transaction history Z Deposits/ Wiihdrawals/ Ending Daily Z Date Description Check No. Additions Subtractions Balance z z Beginning balance on 5/21 0.00 Z _ S/21 Transfer From Stager A Checking Ref#Opetrycksc 5,700.13 Z Xuxxuxxxx5310 z 5/21 Transfer From Stager A Savings Ref#Opek4Sx9Jn 902.18 6,60231 Z Xuxxxxxxx1729 Z 5/30 Interest Payment 0.09 6,602.40 z Ending balance on 5/31 6,602.40 N Totals $6,602.40 S0.00 w w A tJY N Important Account Information o v As a reminder,PMA Package monthly service fees are calculated using the combined month end balances of all � � qualifying accounts linked to your PMA Package relationship.If you do not meet the minimum balance � requirements*,the standard monthly service fee of$30 will be assessed to your primary checking account on the °' 3rd business day following month end.This fee will appear in the transaction history section for the primary � checking account on your next month end statement. *$25,000 in any combination of qualifying linked bank deposit accounts(checking,savings,time accounts(CDs) FDIC-insured IRAs)or$50,000 in any combination of qualifying linked bank,brokerage(available through Wells Fargo Advisors,LLC)and credit balances(including 10%of mortgage balances,certain mortgages not eligible). Important Account Information REMINDER:Unless you have at least$10,000 in qualifying relationship balances in accounts linked to your PMA Package on the last day of the third monthly statement cycle after your PMA Package was opened,your PMA Package will be terminated,all your accounts will be delinked from your PMA relationship and your PMA Premier -�" Checking account will be converted to a non-interest earning checking account as described in the addendum to the Consumer Account Fee&Information Schedule provided to you when you opened your PMA Package. RE4°-?511 EX+�1C-091 �`� �� pennsylvania SCHEDULE H ��'I�� DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX REfURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FIIE NUMBER Alex C. Stager 21-14-0484 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1' Neill Funeral Home, Inc. $10,888.42 e. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: $0.00 Name(s)of Personal Representative(s) Elizabeth A. Stager__ _ street address 140 Reeser Road City_.Camp_Hill ___.._.__ ----- _____State .._PA_ZIP__17011 Year(s)Commission Paid: 2. Attorney Fees: �7nC1�rC w C� .�.5��'��Y, L=s�v>��.��s�'�� '��,-�'r''�� 300.00 3. Family Exemption: (If decedent's address is not the same as ciaimant's,attach explanation.) Claimant Street Address __ __._ __._... __.._ _..__ __.._. _.___.... _...__ __ City -_ _ -- _State_._______ZIP____. Relationship of Claimant to Decedent 4 Probate Fees: 123.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ 11,311.92 If more space is needed,use additional sheets of paper of the same size. 05I19I2014 e9:43 17175619918 NEILL FUNERAL HOME PAGE 01i02 Neilf Funeral H4me,InC. 3401 Market Straot Camp Nill,pA 1 701 1 4428 (717)737-8726 SRIpoMsor:Kewln J.Shfllabeer The a�Ilowing la e detalled bal for the prote�lor�al servloes anNor meldl8ndise srtan(�ed br Alex Chdstopher Stager Rate of serwce:aprii zz,zoTa Roben A.Stager S��pg� 1Nay 19,20tA 140 ReeSer Rd Caihsc:t Numb�r 7411010Q0484 Camp Hill,PA 17011-1929 Arrer�ger Neme Kevfn J Shillabeer Iltitl8l S9ledlorl Fl1181 S818Ci�on DiFF91�9f1C9 �d�� Dlgr�+Memor�Trlduoe F�mersl Servlce Se,sso.oa SB,sso.00 _ Basic Servicx�s Funeral DireCtor and Ststf Inci Incl ... Embalming InCI Ind — Dressing end Caskeifng of Deceased lncl lnCl ._ USe pf FaCilities and Staff fOf�eWing Ind Inci _ Staff Serofces for Funerat Service Ocher Facliity Inci InCI ._ Tr6nsfer of Remalns to F�,rnerel Home �� I�G� _. Funeral VehlcleMear3e Inc! InG _. A Life Reme�tlbered Book'�(HCj InCI Incl ..-.. Evehssting Mamprfalt�(Intemet Memorial/Arrhlve) Ind 111CI � Servico Vehide Incf InG — Dignity TrlbUte Burlal Memorl�l PaCitage Inci Incl �. 146853 Delrey Wood Hardwood Crepe InCI Inc) ... Tolel Packa[�e Uilerings $8,96o•OD 58�960.00 ._ Other Go0d9 end Servlces Silver Rimmed Pendarn $�5�p $�� _� F�a'^'� $380.00 $300.00 _. 7atel Other l'aoods snd SefvlCe9 5525.00 $525.00 __. Merdmr�cHse Std Guardian peluxe Sltver Concrete $i,095.00 $1,095,00 — T01�1 Mer�handFs9 $1,095.Q0 51.095.00 � C88Fi A�dvap� c�ergy!Religious Faciliry �300.00 $150.00 ($150,00} e5119l2014 09:43 17175619918 NEILL FUNERAL HOME PAGE 02/02 It�dal Selec�tlon F1r�al SelecUon AIFI'erence Cerlified Copies of the Death Certificate $36.00 �36.Q0 -- Music!Singers $125.00 $i25.00 -- Newspaper NoUceiPatriot News $332,42 $332.42 M- t0tel C99h AdVAM58 $793.42 s643,42 {�150.UD) Totel SerNoes,Merc�ndlse arxl Cash Advsr�e 511,373.42 $17,223.�{2 ($150.00) Alic7w8r�ces Dlgnity Dfscount ($485.00) ($485.00} — Totat Allowanoes (5�485.04} (5485.00) �-. Total Charges(fotsl senloes+J-Alfowatxas+1'axes) $i0,888.42 S7 D,738.42 (S15P.00) I.ess Cia�Rer�lved {�10,738.42) UnpaM ealar�ce Dua �0.00 Ps(�a 2 c�2 RECEIPT FOR PAYMENT ------------------- ------------------- LISA M. GRAYSON, ESQ. Receipt Date : 5/16/2014 Cumberland County - Register Of Wills Receipt Time : 13 :48 : 54 One Courthouse S quare Receipt No. : 1078032 Carlisle, PA 17613 STAGER ALEX C Estate File No. : 2014-00484 Paid By Remarks : ELIZABETH A STAGER WZ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM 45 . 00 CUMBERLI�ND COUNTY GENERAL FUN RENUNCIATION 5 . 00 CUMBERLAI�TD COUNTY GENERAL FUN SHORT CERTIFICATE 15 . 00 CUMBERLAND COUNTY GENERAL FUN INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 8691 $123 . 50 Total Received. . . . . . . . . $123 . 50 ` RE�V-1�L3 EX+ (01-10) �� ' pennsylvania SCHEDULE � DEPAPTMENT OF REVENUE WHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Alex C. Stager 21-14-0484 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. Elizabeth A. Stager, 140 Reeser Road, Camp Hill, PA 17011 Mother 50% Rest, Residue 2. RobertA. Stager, 140 Reeser Road,Camp Hill, PA 17011 Father 50% Rest, Residue 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 addi;ional sheets of paper of the same size.