HomeMy WebLinkAbout12-22-14 J1505610105
REV-1500�"Oz_ll"�'
enns lvania OFFICIAL USE ONLY
PA Department of Revenue P Y County Code Year File Number
Bureau of Individual Taxes Ea.A,nE.,oFaIE E�E
NHERITANCE TAX RETURN
PO BOX 28o6o1
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
^ �- I' 10/11/2013 i F01/211/1954 !
Decedent's Last Name _ Suffix Decedent's First Name MI
Trayer (Susan F�
(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 THE
I _ T_ _ _ ____j REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CIOD 1.Original Return p 2.Supplemental Return C=:) 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 12-12-82)
OIIID 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.)
C=) 9.Litigation Proceeds Received C=:) 10.Spousal Poverty Credit(Date of Death C-n 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 TO:
Name Daytime Telephone Number
William S. Daniels, Esqui 1(717)243-3831
REGISTM.Q[WILLS USEANLY
G7
'0
First Line of Address -T- n '
One West High Street
Second Line of Address 0.^-a �-
c.a
cite 205 _ � -7
City or Post Office _ _ _ State ZIP Code 6RTE FILED f"-
Carlisle j I PA.� I�17013
Correspondent's e-mail address:humeranddaniels@outltl�ook.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.
SIGNAT&OF PERSON RESPON•SIBL OR FILING RETURN e DAT
ADDRESS ���►►hh//%% /�(
G rge YY.Tra , 1376 oiling Springs Road, Boiling Springs, PA 17007-9243
U OF P RER OT 11ER TUAN REPRESENTAT, TE
ADDRESS
William S. Daniels, Esquire, One West High Street, Suite 205, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
a
1505610205
REV-1500 EX(FI)
RECAPITULATION
1. Real Estate Schedule A. ............... ...................... ... . ... 1. { 176,200.00
( ) 1
2. Stocks and Bonds(Schedule B) ....................................... 2. 104.40
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00
4. Mortgages and Notes Receivable Schedule D 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. ..... 5. 11,635.86 ,
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. , 0.00 i
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property - �
(Schedule G) O Separate Billing Requested........ 7. ; 83,325.36 j
8. Total Gross Assets(total Lines 1 through 7)... . ....... . . . ... ............ 8. 271,265.62
9. Funeral Expenses and Administrative Costs(Schedule H)................ .. . 9. ' 20,005.00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 7,844.02
11. Total Deductions(total Lines 9 and 10)....... . ......................... 11. i 27,849.02
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. ' 243,416.73
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. 243,416.73
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.
i
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.1
17. Amount of Line 14 taxable 243,416.73 i 17. 29,210 00
at sibling rate X.12 i
18. Amount of Line 14 taxable
at collateral rate X.15 i 18.
19. TAX DUE .. . . .. . ................. . . .. . ... . ....... ................ . 19.1 29,210.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Susan R. Trayer
STREETADDRESS
201 High Street, (P.O. Box 215)
CITY STATE ZIP
Boiling Springs PA 17007
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 29,210.00
2. Credits/Payments
A.Prior Payments 29,325.00
B.Discount 1,543.42
Total Credits(A+B) (2) 30,868.42
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) 1,658.42
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.......................................................................................... ❑ 0
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?...................................................................... ❑ 0
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?.............. ❑ E
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)].
• 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.
01coC?
I, SUSAN R. TRAYER, of South Middleton Township, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by me.
I. I give, devise and bequeath all of my estate of every nature and wherever situate
to my brother, GEORGE W. TRAYER providing he survives me by thirty
days.
II. Should my brother, George W. Trayer, predecease or die on or before the
thirtieth day following my death, I give, devise and bequeath all of my estate of
every nature and where situate in equal shares to my nephews, JASON L.
TRAYER, and JOSHUA H. TRAYER, or the survivor of them living on the
thirty-first day following my death.
III. I direct that, should my nephews be the direct beneficiaries of my estate, my
nephew, JOSHUA H. TRAYER, shall first be given the opportunity to purchase
i my home, our family residence known as and numbered 201 High Street, Boiling
Springs, Pennsylvania 17007, at the appraised value for inheritance tax purposes,
in order to enable that real estate to remain in further further possession of the
Trayer family.
i
i
IV. All federal, state and other death taxes payable because of my death, with respect c\
i
to the property forming my gross estate for tax purposes, whether or not passing
-.
under this will, including any interest or penalty imposed in connection with such -j
L
fi
i
31
f
tax, shall be considered a part of the expense of the administration of my estate
and shall be paid out of the principal of my estate without apportionment or right
of reimbursement.
V. I appoint my brother, GEORGE W. TRAYER, executor of this my last will.
i
Should my brother, George W. Trayer, fail to qualify or cease to act as executor, I s
appoint my sister-in-law, CAROLYN V. TRAYER, executrix of this my last
I
will. If both of the above executors fail to qualify or cease to act as executors, I
appoint the CITIZENS BANK OF CARLISLE, PENNSYLVANIA, or its
I
f
successor in business executor of this my last will.
VI. I direct that my executor or'his successors shall not be required to give bond for
the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this. e day of
2005.
Q. (SEAL)
S�USAN R. T ER
The preceding instrument, consisting of this and one other typewritten page
identified by the signature of the testatrix, SUSAN R. TRAYER, was on the day and date
thereof signed, published and declared by SUSAN R. TRAYER, the testatrix therein
named, as and for her last will, in the presence of us, who, at her request, in her presence,
and in the presence of each other have subscribed our names as witnesses hereto.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Susan R. Trayer 21 131105
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 sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 Single family dwelling,Cumberland County,tax parcel number 40-29-2484-060,201 High Street 176,200.00
Boiling Springs,PA 17007,values at FMV assessment(see Cumberland County print out,
attached).
TOTAL(Also enter on Line 1, Recapitulation.) $ 176,200.00
If more space is needed,use additional sheets of paper of the same size.
REV-1503 EX+(8-12)
jpennsylvania7 SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Susan R. Trayer 21 131105
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' U.S.Savings Bond,Serial Number 516652101 104.40
TOTAL(Also enter on Line 2, Recapitulation) $ 104.40
If more space is needed, insert additional sheets of the same size
REV-15o8 EX+(o8-i2)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Susan R. Trayer 21 131105
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
1. Ewing Brother Funeral Home,Refund 13.00
2. UNUM Short Term Disability Insurance,Refund 1,063.88
3. Vectron Benefits,Refund 105.92
4. Blue Cross/Blue Shield First Ambulance,Refund 647.41
5. Blue Cross/Blue Shield Second Ambulance,Refund 1,113.40
6. AAA Membership,Refund 79.00
7. Leffler Energy,Refund 379.00
8. VISA Credit Card,Refund 5.25
9. Homeowners Insurance(Liberty Mutual/0hio Casualty),Refund 308.00
10. Pennsylvania State Tax(2013),Refund 38.00
11. Federal Tax(2013),Refund 1,619.00
12. Tangible Personal Property 6,264.00
TOTAL(Also enter on Line 5, Recapitulation) $ 11,635.86
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+(08-09) ,
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERAANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Susan R. Trayer 21 131105
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDEW AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
Lio
10,375.33 10375.33
2.i 401 K72,950.03 ._ 0 72,950.03 t
{
L_ �
�---- —
E 7
TOTAL(Also enter on Line 7, Recapitulation) $ 83,325.36
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Susan R. Trayer 21 131105
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Funeral Home 9,259.00
Baughman Memorials(Grave Stone/Marker) 2,000.00
George W.Trayer(Balance on Grave Stone/Marker) 1,938.00
Reception 50.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2• Attorney Fees:
5,130.00
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
4• Probate Fees: 108.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7• BK Charges 9.50
Recording of Two(2)Deeds 135.00
Advertising 375.00
Reserve(Includes Filing Fees and Miscellaneous Costs) 1,000.00
Additional Probate Fee 240.00
TOTAL(Also enter on Line 9, Recapitulation) $ 20,245.00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsytvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Susan R. Trayer 21 131105
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. Robert C.Cairns,Tax Collector(Property Taxes) 1,947.34
2. South Middleton School District Authority W/S 131.51
3. Met Ed,Electricity 4727
4. Kohl's Heating Oil 130.53
5. QVC,Account Number xxx2326 1,131.00
6. Century Link,Telephone,Account Number xxx4287 69.42
7. Cumberland EMS 647.41
1,569.34
8. Carlisle HMA 150.00
124.84
10. Hershey Medical Center 1,645.36
11. Carlisle Regional Medical Center 250.00
TOTAL(Also enter on Line 10, Recapitulation) $ 7,844.02
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
ASj^pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Susan R. Trayer 21 131105
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• George W.Trayer Brother 100%
1376 Boiling Springs Road,Boiling Springs,PA 17007-9243
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.