HomeMy WebLinkAbout01-23-15 1505610143
REV-1500 Ex(o2_„>
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 60x.280601 INHERITANCE TAX RETURN 21 14 0495
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
04 09 2014 '10 08 1919
Decedent's Last Name Suffix Decedent's First Name MI
SWEITZER BLAINE W
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
SWEITZER BARBARA A
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
R 1. Original Return 2. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
8 Decedent Died Testate 7• DecedenMaintained
inaint in sd a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) Copy )
9. Litigation Proceeds Received 10,Spousal Povert Cresit(Date of Death 11.Election to tax under Sec.9113(A)
between 12-31. and T-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
ROBERT C SAIDIS (717) 243 62,22
REGIS&W WILL E QM_1P
_1 C co =J
First Line of Address r- q
co C"I
26 W HIGH STREET :,, ca
Second Line of Address
4 V. r M
DATE FILE (—
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's e-mail address: rsaidis@ssr-attorneys 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.
SIGNATURE OF PER ON RESPONSIBLE FOR FILING TURN DATE
`f Barbara Ann Sweitzer
ADDRESS
194 North Middles Ro arlisle, PA 17013
SIGNATURE OF PREPARER,6THER T A R ENTATIVE DATE
Robert C. Saidis
ADDRESS
26 W. Hi treet, Carlisle, PA
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
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. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 24 , 966 . 40
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Nm-Probate Property
(Schedule G) n Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 24, 966 . 40
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 4 , 183 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 4 , 183 . 00
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 20, 783 . 40
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. 20, 783 . 40
TAX COMPUTATION-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.00 20 , 783 . 40 15. 0 . 00
16. Amount of Line 14 taxable
0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-14-0495
Decedent's Complete Address:
DECEDENT'S NAME
Sweitzer, Blaine W.
STREET ADDRESS
194 North Middlesex Road
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
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;............................................................................... ❑
b. retain the right to designate who shall use the property transferred or its income;..................................
ncome:.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑ ❑x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
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?....... ❑ ❑x
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 January 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)J.
• 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-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sweitzer, Blaine W. 21-14-0495
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
1 Orrstown Bank Checking Account No. 143001665-See attached letter dated June 18, 2014 24,966.40
from Orrstown Bank
TOTAL(Also enter on Line 5, Recapitulation) 24,966.40
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
ORRSTOWN
BANK
A Tradition of Excellence
June 18,2014
Saidis, Sullivan&Rogers
A Professional Corporation
26 W High St
Carlisle, Pa 17013
Fax: 717-243-6486
Re., Estate of Blaine W Sweitzer
Social Security Number 219-03-9428
Date of Death 04/09/2014
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE
FOLLOWING ACCOUNT WITH ORRSTOWN BANK;
CHfCKLVC7jCC0UNT
Account No- 1.43001665
Account Type- 50+Interest Ched.kiag
Account Title- Blaine W Sweitzer f Barbara N Sweitzer as POA
Date Opened- 03/22/13
Joint Account(name/date) No
Balance- $24,966.40
Accrued Interest $0.07
Best Regards,
A
\_&0J1__
Lisa Kline
Deposit Processing Clerk
2695 Philadelphia Avenue Cbambersbmg,PA 17201.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Sweitzer, Blaine W. 21-14-0495
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 2,145.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State ZiD
Year(s)Commission Paid
2. Attorney's Fees Saidis, Sullivan & Rogers 1,700.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 150.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 188.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 4,183.00
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Sweitzer, Blaine W. 21-14-0495
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Auer Cremation Services of Pennsylvania, Inc. 2,145.00
H-A 2,145.00
Other Administrative Costs
2 Cumberland Law Journal-advertise letters 75.00
3 The Valley Times-Star-advertise letters 113.00
H-67 188.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sweitzer, Blaine W. 21-14-0495
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT
Do Not List Trustee(s) (Words) ($$$)
TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Barbara Ann Sweitzer Wife 100%residue
194 N.Middlesex Road
Carlisle,PA 17013
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1560 cover sheet,as appiopriate.
NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART If-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule 3(Rev.01-10}
..........
Department of Veterans
s Affairs and the Social Security Administration
to ascertain if there are any benefits to which my family members are
entitled by virtue of my military service.
f. I may leave a letter of intent with the executed copy of
this will for the purpose of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. -I request, but do not require, that my Personal
Representative honor my wishes therein expressed.
SECOND: I give, devise and bequeath, absolutely and forever, all
of my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my Wife, BARBARA
ANN SWEITZER, as her sole and absolute property if she shall survive
me.
THIRD: In the event that my Wife, BARBARA ANN SWEITZER shall not
survive me, I give, devise and bequeath, absolutely and forever, all of
my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my children,
DALE B. SWEITZER, SALLY K. TOVREA, STEPHEN D. SWEITZER, MIGNON PYSELL,
and THOMAS M. KELLY, or to the. survivor, in shares of substantially
equal value, to be divided as they may agree. If they are.unable to
agree, the division shall be made by my Personal Representative, in
that person's sole and absolute discretion. I empower my Personal
Representative to sell any or all of such property, if such property is
not distribut-ed -in-kind-hersuffd-arT-��i-i7d7-t--o- die Er-iBtit7e--Efie--proceeds"- among
the persons named in this paragraph, or the survivor, in substantially
equal shares. Any determination of my Personal Representative as to
what should pass or be sold under this paragraph and to whom it should
pass or be delivered or -at what price it should be sold shall be
conclusive.
FOURTH.- Except as otherwise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not, Insofar as I
have failed to provide in this Will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake.
FIFTH: Any beneficiary who fails to survive until one hundred
twenty (120) hours after my death shall be deemed to have predeceased
me, and the gift to that beneficiary shall be disposed of accordingly.
-1 74
PAGE 2
42,fi OF 4. PAGES
SIXTH: Definitions:.
a. The term "children" as used in this Will includes adopted
and afterborn persons. The term "children'! as used in this Will shall
also include step-children, the natural born or adopted children of a
person's spouse who are not the natural born or adopted children of the
person. A relationship by or through legal adoption shall be treated
the same as a relationship by or through blood for purpose of
succession to property under this Will .
b. The term "descendants" as -used in this Will means the
immediate and remote lawful, lineal descendants by blood or adoption of
the person referred to who are in being at the time they must be
ascertained in order to gave effect to the reference to them.
c.- The term "Personal Representative" as used in this Will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such 'a fiduciary.
SEVENTH: In addition to any powers granted by the laws of the
state in which this Will is probated, I hereby 'authorize and empower
the fiduciaries named in this Will, to the extent of the discretion
herein granted, . to sell., exchange, convey, transfer, assign, mortgage,
pledge, lease or rent the whole or any part of my real or personal
estate, to invest, reinvest, or retain investments of my estate, to
perform-all -acts-and to-execute-all-decuments-which-my-f-iduciax±es-may
deem necessary or proper in regard to my property. If any of my
fiduciaries elect to receive compensation for services, such
compensation will be that allowed by law.
EIGHTH: If any part of this Will -shall be invalid, illegal, or
inoperative for any reasoiT, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Perspnal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this Will as .shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
PAGE 3
A24 e� OF 4 PAGES JV•t
IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this
1 day of T 19 set my hand and seal to
this my LAST WILL TESTAMENT, consisting of 4 typewritten, pages,
each .page bearing my handwritten signature.
This document was prepared under the authority of 10 U.S.C.
section 1044, and implementing military regulations and instructions,
by Captain John T. Rothwell, who is Licensed to practice law in the
State of Arkansas.
V-zl *0 (SEAL)
SrAINE W. SWEITnR
The foregoing instrument was, at Carlisle Barracks, Pennsylvania,
this day of19 , signed, sealed, published
and declared by BLAINE WV SWEITZER, the testator, to be his LAST WILL
AND TESTAMENT in the presence of all of us at one time, and at the same
time we, at his request and in his presence and in the presence of each
other, have hereunto subscribed our names as• attesting witnesses, and
we do so verily believe that the said testator is of sound and
disposing mind and memory at the date hereof.
Soc.Sec.No. Soc.Sec.No 4, 1
OF � L tfrr ice. OF� Yid- OF
t
5
I •
^ • PAGE 4
Af OF 4 PAGES
COMMONWEALTH OF PENNSYLVANIA
CUMBERLAND COUNTY
ACKNOWLEDGMENT
I, BLAINE' W. SWEITZER, testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law, do hereby acknowledge that I signed and executed the instrument
as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expres ed.
A
.::�; V"
�1
�SF AT,)
BLAINE W. SWEITZER
AFFIDAVIT
We, 5141 ►� � ��9 �rew P!! " , and
the witnesses, sign our names to this
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his Last Will; that the testator signed willingly and
executed it as ,his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witness; and that to the best of' our
knowledge the testator was at that time 18 or more years of age, of
sound iriirid arid Under= -c-z7un ue influence.
Wi ness Witness Witness
Subscribed, sworn to and acknowledged before me by BLAINE W.
SWEITZER, the testator, and subscribed and sworn to before me by
and
the witnesses, this 156 day of
J NO ARY PUBLIC My Commission Expires:
Notarial Seal
Betty R.Standridge;Notary Public
Carlisle Boro,Cumberland County
My Commission Expires May 14,2001
MemNr.Pennsylvania Association of Notaries