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Home My WebLink About11-14-14 REVT 1500 Ex(o2-ii) W1 � OFFICIAL USE ONLY PA Department of Revenue pennssayitvania County Code Year Fite Number Bureau of Individual Taxes PO BOX zBDsoi INHERITANCE TAX RETURN [:CO 1 4 8Narrisburgt PA 27128-0601 RESIDENTDECEDENT 2 1 10T ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMMDDD`YYYY Date of Birth MMDDYYYY I7T ' LO I�tB 2 .0. 14 Q6 221 945 Decedent's Last Name Suffix De cedent's First Name +ml [NL0='0ff"0'1' r iUs .- r i M (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name 1VI1 ENour, ri s Mi cha a lel Spouse's Social Security Number THIS RETURN MUST BE FILED IN,DUPLICATE WITH THE " 1 9 2. 3 0 4 7 '8 3 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ r 1.Original Return O 2.Supplemental Return C1 3. Remainder Return(Date of Death Prior to 12-13-82)' C=:) 4.Limited Estate p , 4a.Future Interest Compromise(date of d 5. Federal Estate Tax Return Reouiree death after 12-12-82) - O 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) Q 9.Litigation Proceeds Received C=D 10.Spousal Poverty Credit(Date of Death C=)- 11. Election to Tax under Sea 9113(A) - Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- T141S SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECT§D TO: Name Daytime Tete@bne Number O --�i�'�7'fTl htar l in R Mc Ca le b Esq . Ej:177 SII `,,-`7c � ` REGIST&-CF WILLSSSF ONLY,I . ;•.,, � fll, � rTt First Line of Address 2I9 Eas t Mai n 5tr ee t Second Line of Address ;s --i N rte— rrt ti � C3 1P �( � X 2 3 0 City or Post Office State ZIP Code DATE FILED M e c h a Mn7i s bur g 1 7 0 5 5 Correspondent's e-mail address: marlinmccaleb@msn,.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,9,orrect and coypiet . ecla tion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN OF P SIBLE FOR FILING RETURN Michael -L:'-Nor.'ri s. `• 405 Fairway Drive, Mechanicsburg, PA 17055 ' SIGN EPAR E FENTATIVE ," r I DATE 4�IZA Law" Offices- Mar1jh-.R. 'McCa1eb d1 x /! ADDRESS 219 East Main Street, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY I I Side 1 . •1505611101 1505611101 j ` jr j 1505611201 + REV-1500 EX' Decedent's Social Security Number Decedent's Name: Marilyn M. Norris l $ RECAPITULATION _ 1. Real Estate(Schedule A). ......................................:..... 1. t - 2. Stocks and Bonds(Schedule B) ....................................... 2. - 2- 1t 5!!1 0(,$ 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. . � ' 4. Mortgages and Notes Receivable(Schedule D).................:......... 4. b • _J 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. $ `$_•�R`� 0 6. Jointly Owned Property(Schedule F) t=Separate Billing Requested_..... 6. _ L Liu , 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C!Separate Billing Requested........ 7. 8. Total Gross Assets(total Lines 1 through 7)............................. 8. 1 0 � 6 x.10 $ 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. F i~J 9AY7Z f1 21 All- 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. Wj 11. Total Deductions(total Lines 9 and 10)................................. 11. [EQ3J9 2 7 '7.:•'i k 2� s - 12. Net Value of Estate(Line 8 minus Line 11) ..... .:......................1 12. 1 _, 0 �•9 6 a 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ........................ 13. s. 14. Net Value"Subject to Tax(Line 12 minus Line 13) ........................ . 14. _ (}� Q 19 61 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RAVES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 19 6 (a)(1.2)x.0 00 � 9 l..i9 6 15. E--�R- 0. -- 0 0 16, a mount of lineal rates X e 14 taxable �.jjj 16. LO:D� =o. 0 0 17. Amount of14 taxable at sibling rateto X.12 0 17. 0• 0 0 0 18. Amount of Line 14 taxable ( O 0 O at collateral rate X.15 18. • 19. TAX DUE....... ..... ............... 19.' �'_dl• 0 0 r ' 20, F0-I;IN THE OVAL 1F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ' O S€i8 2 T 1505611201 1505611201 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21-14-00808 DECEDENT'S NAME Marilyn M. Norris STREETADDRESS 405 Fairway Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: I. 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) 0.00 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. 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 .......................................................................................... ❑ K b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 91 c. retain a reversionary interest .............................................................................................................................. ❑ EXI d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 91 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. 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)]. ., e 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-i503 EX+(6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marilyn M. Norris 21-1.44-00808 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. 20 shares common stock of Pepsico, Inc. , @"$ 78,21 1. 1,564.20 2. 8 shares common stock of Yum Brands, Inc. , @ $ 73.36 586.88 TOTAL(Also enter on line 2,Recapitulation) $ 2,151-08 ---(3f-more-space-is needed,insert additional sheets of the same size) -- ( R0.1509 EX (1.97) - SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MSC. INHERITANCE RESIDENT DECEDENT RN PERSONAL PROPERTY ESTATE OF FILE NUMBER Marilyn M. Norris 21=14-00808 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM, VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. Assorted pieces of jewerly, -,as- per apprasial of William F.! 8,218.00 Mumma, Jeweler. 1 s TOTAL(Also enter on line 5,Recapitulation) $ 8,218.00 (if more space is needed,insert additional sheets of the same size) RFV-1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Marilyn M. Norris 21-14-00808. Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Malpezzi Funeral Home, - 8 Market Plaza Way, Mechanicsburg, PA 8,309.74 17055, funeral expense B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Years)Commission Paid: 2. Attorney Fees Law Offices-Marl-in R. McCa leb . 600.00 3. Family Exemption:(if decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent. a. Probate Fees Register of Wills 135.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 11. Cumberland Law Journal , - advertising Letters. 75.00 2. The Carlisl-e Sentinel , - advertising Letters. 156.88 .TOTAL(Also enter on line 9, Recapitulation) $ 9,277.12 (if more space is needed,insert additional sheets of the same size) REV-1513 EX+(11-08) M pennsytvania SCHEDULE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Marilyn M. Norris 21-14-00808 RELATIONSHIP TO DECEDENT I 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.2116(a)(1.2).] I. -Michael L. Norris Husband Entire Estate .405 Fairway Drive Mechanicsburg,• PA '17.055- 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 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN i. B. CHARITABLE AND NO GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART H—ENTERTOTALNON-TAXABLE DISTRIBUTIONS ON,LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,insert additional sheets of the same size. M U M m4 s �zv�G�� Jto�E 34 WEST MAIN STREET MECHANICSBURG, PA 17055 Phone:766-9422 ESTATE OF MARILYN M. NORRIS JEWELRY Ladies Antique Mtg. with 3 old Mive Lot Diamonds with a Total weight of 26 pts in W.G Filigree Mtg: $ 300 . 00 Ladies Diamond Ring in 14KT white gold it has 3 Round Center Stone of 20-20 & 23 Round 10 pieces of side stones : 2, 000 . 00 Gold Filled Black Onyx Bracelet & Oval G. F. Pendant : no value Antique W.G. : no value Ladies Sterling Silver Charm Bracelet & Charms : 150 . 00 Ladies Diamond Ring with Diamond Set in Box Head MTG 14KT YG: 550 . 00 Ladies 14KT Bracelet with 6 Round Emeralds & 1 Diamond: 600 . 00 Ladies 14KT YG Pendant with 2 Diamonds, 4 Emeralds, 1 Ruby & 1 Sapphire on a 14Kt Gold with Chain: 750 . 00 Ladies Diamond Engagement Ring in 14KT YG with a Diamond in a Box Head MTG: 800 . 00 Ladies Wedding Band 18KT W.G. 35 . 00 Ladies Diamond Wedding Ring is Platinum WG Approx. 60 points of Diamonds : 300 . 00 ' Ladies Wed. Band in 14KT W.G. with appr. 50 points of Diamonds : 350 . 00 Ladies Mothers Ring with Emerald, Ruby & Diamond in 14KT YG: 450 . 00 Ladies Gold Filled Black Onyx Bracelet & G.F. Black Onyx: 90 . 00 Ladies White Metal Pulsar Watch: 60 . 00 Ladies Pearl Diamond Necklace in 14 KT W.G. : 350 . 00 Ladies "Linde" Star Style Pendant in 14KT YG on a 14KT' chain: 250 . 00 Ladies Sterling Silver Ring with 2 Opals : 75 . 00 Ladies 10KT Oval Ruby Diamond Ring: 150 . 00 Ladies 14KT Ring with 3 Emerald & 2 Diamond: 250 . 00 Ladies 14KT Wedding Band: 50 . 00 Ladies Plat 18KT W.G. Band: 45 . 00 Ladies Gold Filled Chain Necklace with synthetic white star: 20 . 00 Ladies 14KT YG Ring with Diamond, Sapphire & Pearl : 300 . 00 Ladies Piece of Gold Bracelet with small imperfect diamond: 8 . 00 Ladies G.F. Locket : no value Ladies Pear Shaped Sapphire with small diamond in 14KT setting chain: 200 . 00 Ladies Sterling Chain & Synthetic White Stone Pendant : 20 . 00 Ladies Nugget Pendant- Not Gold no value Ladies G. F. Pendant; Bracelet & Earrings with Synthetic Blue Topaz : 20 . 00 SCHEDULE E.1 Estate of Marilyn M. Norris Jewerly Page 2 Ladies Gold F. Med Link Chain: no value White Metal with Pendant & Earring Not Gold or Silver: no value White Chain with Imitation Pearl : no value Synthetic white stone on sterling necklace filignex pieces : 10 . 00 Synthetic mother of ped. pearl & earring on gold filled chain: no value Jade Elephant on SterlingSilver Chain & Bail : 25. 00 Sterling Pendent chain with synthetic Round Blue Stone & oval chalcedony stone: 20 . 00 Total : $ 8, 218 . 00 William Mumma vrl 77 SCHEDULE E.1 Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Marilyn M. Norris No. 21-14-00808 also known as Date of Death 02/18/2014 Deceased Social Security No. Michael L. Norris, Personal Representative(s)of the above Estate,deceased,verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death,and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct.I/We understand that false statements herein are made subject to the penalties of 18 Pa.C.S.Section 4904 relating to unsworn falsification to authorities. Personal Representative Name of Attorney: Marlin R. McCaleb Esq. Signature: Mi ael L. Norris I.D.No.: 06353 Signature: Address: 219 East Main Street Address: 405 Fairway Drive Mechanicsburg, PA 17055 Mechanicsburg SPA 1705 c X m Telephone: 717/691-7770 Telephone: 717/766-8651 M n rncn c C, --U Dated: &�' Z /�s�� ? r-• --i � c-� C7 Description N f'I't CD 'F7 CD (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 10,369.08 NOTE:The Memorandum of real estate outside the Commonwealth of Pennsylvania may,at the election of the personal representative, ni include the value of each item,but such figures should not be extended into the total of the Inventory. V` Prepared by the Pennsylvania Bar Association Copyright(c)1996 form software only CPSystems,Inc. Form#RW-7(1992) INVENTORY Estate of: Marilyn M. Norris Date of Death: 02/18/2014 County: Cumberland PERSONAL PROPERTY: ------------------ Assorted pieces of jewelry, - 8,218. 00 as per appraisal of William F. Mumma, Jeweler. -------------- 8,218.00 STOCKS/LISTED: -------------- 20.00 shares common stock of 1,564.20 Pepsico, Inc. , - @ $78.21. 8.00 shares common stock of Yum 586.88 Brands, Inc. , - @ $73.36. -------------- 2,151.08 ---------------- TOTAL RECEIPTS OF PRINCIPAL. . . . . . . . . . . . . . . 10,369.08 -1-