HomeMy WebLinkAbout12-11-14` . � 1505610101
REV-1500 Ex�o�_�o, �
OFFICIAI.USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes rINHERlTANCE TAX RETURN
POBOX2806oi RESIDENT DECEDENT 21 13 0587
Harrisburg,PA 1'7i28-o6oi
ENTER DECEDENT INFORMATION BEIOW
Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
05/06/2013 03/05/1931
DecedenYs Last Name Suffix Decedenfs First Name M�
SHEAFFER GAYLE K
{If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M�
Spouse's Sociai Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
p 1.Original Return (� 2. Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-II2)
� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wili) (Attach Copy of Trust)
p 9.Litigation Praceeds 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 Sch.O)
CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INPORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
THOMAS E. FLOWER (717) 243-5513
»-- y
REGISTER Of WILLS USE ONLY
N
C�
n � r�
First line of address C � � �
�
FLOWER LAW, LLC � � � �,�,
Second line of address � ;> � f—r' r'�i
f.._ ^-r C'T'f F-'a :'�
10 W. HIGH STREET ��" �� �' ,-� �
":' DA72'1=tLED. _..,.
City or Post Office State ZIP Code �,
c � E� _r'1 � ;»"'� '*i
CARLISLE PA 17013-2922 r , � " �--� �
:::3 c�.� r" rrt
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�r t.J � �1
CorrespondenYs e-mail address: TOM FLOWER-LAW.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.Declara' n of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGPdAT lCR�F P RE LE FO ILING RETURN DATE
ADDRESS
SANDRA K. SHEAFFER; 1 HOLLOW ROCK; LINCOLN UNIVERSITY, PA 19352
SIG TU OF PR THAN REPRESENTATIVE DATE
// /'� Zo�
ADDRE S
FLOWER LAW, LLC; 10 W. HIGH ST; CARLISLE, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 15�56101�1 15056101,�7, � �
� � 15056101�5
REV-1500 EX DecedenYs Sociai Security Number
�ecedent•s Name: GAYLE K. SHEAFFER 200-24-2356
RECAPITULATION
1. Real Estate(Schedule A). . . .. . .. .. . .. . . .. . .. . . . .. .. . . . .. .. .. . .. . .. . . . 1. '
2. Stocks and Bonds Schedule B 2
� ) .. . . . . . . . .. . .. . . . .. . . .. . .. .. . . . .. . .. . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3.
4. MoRgages and Notes Receivable(Schedule D) .. . .... .. ... .... ..... ... .. . 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... . .. 5. '
1,805.25
6. Jointly Owned Property(Schedule F) O Separate Biliing Requested .... . .. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Biliing Requested.. ... . .. 7.
8. Total Gross Assets(total Lines 1 throu h 7 .. . 8. ' 1,805.25 '
9 ).. .. ... .... ... .. .. ... .. . . .
9. Funeral Expenses and Administrative Costs(Schedule N}. . .. .. .. ... .. . .. . . . 9. 20,237.07
10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I 10. 66.00
9 9 S ) ... .. . .. ... .. .
11. Totai Deductions(total Lines 9 and 10). .. . .. . . . . .. .. . .. . . . . .. . . . . . . . . . . 1t 20,303.07
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . .. . . . .. . . . . . .. . . . . . . . 12. -18,497.82
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . .. .. . .. .. .. .. . .. . . . . . . . 13. 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) . .. . . . ... . .. ... .. . .. . .. . 14. -18,497.82
TAX CALCULATION-SEE INSTRUCTIbNS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
�a)�1.2)X A- 15.
16. Amount of Line 14 taxabie
at lineal rate X.0 45 �6
17. Amount of line 14 taxable
at sibling rate X.12 »�
18. Amount of line 14 taxable
at coilateral rate X.15 �8
19. TAX DUE .. . .. . .. .. ... .. . . .. . . . .. . .. . . . . . .. .. . .. .. . . . . . .. . . . .. . .. . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND dF AN OVERPAYMENT �
Side 2
� 15D5610105 15�561�105 J
REV-1500 EX Page 3 File Number
� Decedent's Complete Address:
DECEDENT'S NAME
GAYLE K. SHEAFFER
STREETADDRESS ,
7 COUNTRY CLUB DRIVE
MIDDLESEX TOWNSHIP
_ _ ___ _ _ STATEPA ziP17015 _
c�CARLISLE
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19} (�? _
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)
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 antl: 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:............................................ ❑ X❑
c, retain a reversionary interest;or.......................................................................................................................... ❑ �
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?.............................................................................................................. ❑ X❑
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 TQ 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 imposetl 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 far 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 tleceased chiltl 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 decedenYs lineal beneficiaries is 4.5 percent, except as noted in
72 P.S.§9116(1.2)[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 intlividual who has at least one parent in common with the tlecedent,whether by blood or atloption.
REV-Ia11 EX+(10-U9j
' � :' pennsylvania SCHEDULE H
° FUNERAL EXPENSES AND
:- DEPARTMENT OPREVENUE
� ���� INHER[TANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GAYLE K. SHEAFFER 21-13-0587
Decedent's debts must be reported on Schedule I.
NUM ER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
i,
g, ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s}
Street Address
City _ _ . State ZIP _ _
Year(s)Commission Paid: _
2. Attorney Fees:
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 _
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Heating fuel oil 2,109.00
s. PPL 393.84
s. Municipal water&sewer charges 315.00
�o. Trash removal fees(net of refund) 23.19
1�. Check printing and bank service charges 25.82
�2. Continuation sheet total 17,370.22
TOTAL(Also enter on Line 9, Recapitulation) $ 20,237.07
If more space is needed,use additional sheets of paper of the same size.
Schedule H Continuation Sheet(Supplemental return)
Estate of GAYLE K. SHEAFFER File no. 21-13-0587
Administration Costs incurred after filing original PA-1500:
Auctioneer commission on sale of personalty 180.50
Auctioneer set-up costs&commission on sale of real estate 5,520.00
Advertising cost, auction sale of real estate 1,200.00
Realty Transfer Tax 1,590.00
Real Estate Taxes, $3,544.76-
Less prorated tax returned at settlement (1,576.82) 1,576.82
Tax certification and copies tax bills 112.00
Scott Lampeter, landscape & property maintenance 1,830.00
John Mohler, labor& material to replace boiler 2,038.02
Fire & hazard insurance premiums 1,374.09
Randy Sheaffer travel costs, for 26 roundtrips of 250 miles,to
perform mold remediation, repairs and cleaning of property prior to sale:
6,500 miles @ .24=$1,560.001
Penske Van rental 181.33
Motel stays(2 nts.) 234.46
Subtotal: 1,975.79
Continuation sheet total: 17,370.22
12013, the standard mileage rates for the use of a vehicle was: 56.5 cents/mile for business miles driven,
24 cents/mile driven for medical or moving purposes.
��v-isi2 ex+(r2-oa}
� � :, ' pennsylvania SCHEDULE I
�����' DEPARTMENT OF REVENU[ DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GAYLE K. SHEAFFER 21-13-0587
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medicai expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1� PA-40-2013 income tax 66.00
TOTAI(Also enter on Line 10, Recapitulation) $ 66.00
If more space is needed,insert additionai sheets of the same size.
A B. TYPE OF LOAN:
U.S.DEPARTMENT OF HOUSING&URBAN DEVELOPMENT �'❑FHA 2.�FmHA 3.�CONV.UNINS. 4.�VA 5.QCONV.INS.
6. FILE NUMBER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT N PATEL-L6-MP-2014
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished fo give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
ltems marked'[POCJ"were paid outside the closing;they are shown here for informational purposes and are not included in the totais.
'I.0 3/98 (N PATEL-L6-MP-2014.PFDM FpSEL-L6-MP-2014/12)
D. NAMEAND ADDRESS OF BORROWER: E. NAMEAND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Nilesh Ramanbhai Patel Estate of Gay�e K.Slleaffer
3725 Rockmart Road SE
Silver Creek,GA 30173
G. PROPERTY LOCATION: H. SETTLEMENTAGENT: I. SETTLEMENT DATE:
Lot 6 and Parts of Lots 1 8 2-Country Club Mid-Penn Abstract Company
Carlisle,PA 17015 October 31,2014
Cumberland County,Pennsylvania PLACE OF SETTLEMENT
1200 Camp Hill Bypass,Suite 205
Camp Hill,PA 17011
J.SUMMARY OF BORROWER'S TRANSACTION K.SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 159,000.00 401. Contract Sales Price 159,000.00
102. Personal Pro e 402. Personal Pro er
103. Settlement Char es to Borrower Line 1400 2,868.50 403.
104. 404.
105. 405.
Ad'ustments For Items Paid 8 Seller in advance Ad'ustments For Items Paid B Seller in advance
106. School Taxes 11/01/14 to 07/01/15 1,425.74 406. School Taxes 11/01/14 to 07/01N5 1 425.74
107. Count Taxes 11/01/14 to 01/01/15 151.08 407. Coun Taxes 11/01/14 to 01/01/15 151.08
108. Cit Taxes • to 408. Cit Taxes 10
109. 409. .
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORRO WER 163,445.32 420. GROSS AMOUNT DUE TO SELLER 160,576.82
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. De osit or earnest mone 20,500.00 501. Excess De osit See Instructions
202. Princi al Amount of New Loan s 502. Settlement Char es to Seller Line 1400 13,447.27
203. F�cistin loan s taken sub'ect to 503. Existin Ioan s taken sub'ect to
204. 504. Payoff of first Mortgage
205. 505. Pa off of second Mort a e
206. 506.
207. 507. De osit disb.as roceeds
208. 508.
209. 509.
Ad'ustments For Items Un aid 8 Seller Ad'ustments For ltems Un aid B Seller
210. School Taxes to 510. School Taxes to
211. Coun Taxes to 511. Count Taxes to
212. Ci Taxes to 512. Cit Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 20,500.00 520. TOTAL REDUCTION AMOUNT DUESELLER 13,447.27
300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower Line 120 163,445.32 601. Gross Amount Due To Seller Line 420 160,576.82
302. Less Amount Paid By/For Borrower(Line 220) ( 20,500.00) 602. Less Reductions Due Seller(Line 520) ( 13,447.2
303. CASH( X FROM)( TO)BORROWER 142,945.3? 603. CASH( 1C TG)( FRONi)SELLER 147,129.55
The undersigned hereby acknowiedge receipt of a completed copy of pages 1&2 of this statement&any attachmenis referred to herein.
Borrowe - Seller Es of Gayle K.Shea er
Nilesh Ramanbhai Patel
, BY:
�_-�--�� -- - •-__ ._
" L. SETTLEMENT CHARGES
' 700.TOTAL COMMISSION Based on Price $ 159,000.00 3.0000% 4,770.00 PfUD FROM PHID FROM
Division of Commission line 700 HS FOIIOWS: BORROWER'S SELLER'S
7O'I.$ 4,770.00 t0 CORE,LLC - FUNDSAT FUNDSAT
• 7OZ.$ t0 SETTLEMENT SETTLEMENT
703.Commission Paid at Settlement 4,770.00
704. to
800.ITEMS PAYABLE IN CONNECTION WITH LOAN
801.Loan Ori ination Fee 1.0000 % to
802.Loan Discount % to
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mort a e Ins.A .Fee to
807. Assumption Fee to
808.
809.
810.
811.
900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From to @ $ /day ( days %)
902. MIP Totins.for LifeOfLoan for months to
903.Hazard Insurance Premium for 1.0 ears to
904.
905.
1000.RESERVES DEPOSITED WITH LENDER
1001.Hazard Insurance months $ er month
1002.Mort a e Insurance months $ er month
1003: School Taxes months $ er month
1OQ4. Coun Taxes months $ er month
1005. City Taxes months @ $ per month
1006. months $ er month
1007. months @ $ per month
1008. months $ er month
1100.TITLE CHARGES
1101. Se4tlement or Closin Fee to
1102. Abstract or Title Search to
1103. Title Certificate to
1104. Title Insurance Binder to
1105. Deed Pre aration to
1106. Notar Fees to Ca oui Adler,PC.
1107. Attomey's Fees to
inc/udes above item numbers:
1108. Title Insurance to FirstAmerican Title Insurance Com an 1 195.00
includes above item numbers:
1109.Lender's Coverage $
1110.Owner's Coverage $ 159,000.00 � 1,195.00
1111. Endo�sements
1112. Closing Protection Letter FirstAmerican Title Insurance Company
1113. Wire Fee to Mid-Penn Abstract Company 25.00
1114. Mid-Penn Abstract Company
1115.
1116.
1117. Disbursement Charges
1118. Mid-PennAbstract Company
1200.GOVERNMENT RECORDING AND TRANSFER CHARGES
1201.Recording Fees: Deed $ 83.50;Mortgage $ Releases $ 83.50
1202.Ci /Count Tax/Stam s: Deed 1,590.00�Mort a e 1,590.00
1203.State Tax/Stam s: 1,590.00;Mort a e 1,590.00
1204. Re ister of Wilis to Re ister of Wills A ent 5,962.27
1205.
1300.ADDITIONAL SETTLEMENT CHARGES
1301. Surve to
1302. Pest Ins ection to
1303. Tax Certification to Frank Roberto 100.00
1304. Escrow for Surve to Mid-PennAbstract Com an 1,000.00
1305.
1400.TOTAL SETTLEMENT CHARGES (Enter on Lines 103,Section J and 502,Section K) 2,868.50 13,447.27
By signing page 1 ofthis statament,the signatories acknowiedga receipt ota completed copy otpage 2 ofthis two page statemenl / J -
��
Mid-Penn Abstract Company
Settlement Agent
Certified to be a true copy.
I�AST" WILL AND T'ESTAIV�ENT
OF
GAYLE K. SHEAFFER
1, GAYI.E K. SHEI�FFER of? Country Club Road, Carlislc, Cumberland
County, Pennsylvania, 17013, being of sound and dispo5ing mind, memory and
understandins�, do make, publish and declare this as and for my Last Will and
Testament, hereby revoking and making void any and all foi-mer Wills, Codicils, or
writings in the nature thereof, by me at any time heretofore made.
FIRST: I hereby order and direct my Executor, hereinafter named, to pay
all m�� just debts, funeral expenses, testamentary expenses and all Inheritance, Estate,
Z'ransfer and Succession Taxes, as soon as may be conveniendy done after my death,
out of m5� residuary estate.
SECOND: I give ali the rest, residue and remainder of my estate be it real,
personal o.r mi�ed, or whatsoever kind, of wheresoever situate, to my children,
SANDRA K. SHEAFFER and RANDY L. SHEAFFER, in equal shares. Should
either of my children predecease me, I give that child's share to my surviving child.
LASTLY: I hereby nominate, constitute and appoint my children, SANDRA
I�. SHEAF�E�t and RAl1TDX .L. SHEAFFER, to be Execu.tors ��f this, my Last
ti`Clill and Testament, they to serve �vithout Bond in the Commonwealth of
I'ennsylvania, or any other jurisdiction. In the event that either ot my said c�uldren
shall predecease me or be utiable to act as Executor of my Estate or comp�ete the
administration thereof for any reason whatsoever, my other child shall act in his or
her place as Executor hereof.
IN WITNESS WHEREOF, I, Gayle K. Sheaffer, have hereunto set my hand and
seal to this my Last Will and Testament, this �day of � ti __, 2012.
�
Gayle . Sheaffer, Testatrix
Signed, sealed, published and declared b5T the above-named Gayle Ii.
Sheaffer, Testatrix, as and for her Last Will and Testament in the presence of us, who
have hereunto subscribed our names at her request as witnesses thereto, in the
presence of said Testatt� and of each other.
� � ~ ADDRESS _.10 W. High Street____
Carlisle PA 17013
ADDRESS _10 W. High Street
Carlisle. PA 17013
COMMONWEALTH OF PENNSYLVANIA :
COUNTY OF CUMBERLAND .
We, Gayle K. Sheaffer, James D. Flower, Jr. and ���vG L , �l�cl��the
Testatri_x and witnesses, respectively whose names are signed to the foregoing or
attached instrument, being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instn2ment as her Last Will and
Testament and that she signed wil.lingly and that executed as her free and voluntary
act for the purpases therein eYpressed, and that each of the witnesses, in the presence
and hearing of �ie Testatrix si�ied the Will as �vitnesses and that to the best of their
knowledge the Testatrix was at the ti.me eighteen (18) or more years of age, of sound
mind and under no constraint or undue influence.
_� — .
G e K. Sheaffer
James D. Flower,Jr.
, �
Witness
�
On this, the /�� da.y of �C�• , 2012, before me, the undersigned
officer personally appeared James D. Flower,Jr., Esquire, known to me (or
satisfactorily proven) to be a member of the bar of the highest court of said state, and
a subscribing witness to the foregoing instrument, and certified that he was personally
present when the testator and witnesses, whose names are subscribed to the foregoing
instrument, executed the same, and that they acknowledged that they executed the
same for the purposes therein contained.
IN WTTNESS WHEREOF, I hereunto set my harid and otficial sea.l.
(SEAL)
Notary Public
t-w�clri MOiV W EALTH OF P���:?��—yAN1A
��� NOTAF;iAL SE��
'�I�QMAS E.FLOWER,t�o����Pubiic
Cariisle 8oro.,Cumberl�: ";�unty
i,�i;ommission Expires Oc: ?5,2014 �