The URL can be used to link to this page

Home My WebLink About02-03-15 � 1505610143 REV-1500 EX�o2_,,, .:�� OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE Po BOx.2sosol INHERITANCE TAX RETURN 21 14 1204 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 13 2014 08 29 1920 Decedent's Last Name Suffix DecedenYs First Name MI HOLTRY MARIE M (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 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2. Suppiemental Return � 3. Remainder Return(Date of Death Priorto 12-13-82) 4. Limited Estate 4a. Future interesc Compromise � 5. Federal Estate Tax Return Required ❑ ❑ (date of death after 12-12-82) Decedent Died Testate � Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes X❑ 6' (Attach Copy of Will) ❑ (Attach Copy of Trust) � 9. Litigation Proceeds Received � �p.Spousal Povertv Credit(Date�f Death � 11.Election to tax under Sec.9113(A) between 1231�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 FOREST N MYERS 717 532 9046 ;-,� �--�> REGISiTEI�F WILLS,,IrSE C3NLNj _`� :3 � �-� t� p ,� .. . _, y�� CT7 ") .�J � ,.__ � °:;::7 First Line of Address r�— _ . ��.� W , � 137 PARK PLACE WEST � ' . _ :..-;. . -� i:�."3 Second Line of Address �==y �� ' �1 �.� � �,� _::: c> DATE FIL�D '�Yu r'� City or Post Office State ZIP Code _t- Cn � SHIPPENSBURG PA 17257 �� CorrespondenYs e-mail address: fnmyers(a�lawofficeforestmvers 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 com lete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI A URE OF PERSON SPONSIBLE FOR FILING RETURN DATE u Judy STINE z-z -\S ESS 80 Airport Rd, Shippensburq, PA 17257 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE .."�.�._ Forest N Myers z--�`�S ADDRESS 137 Park Place West, Shippensburg, PA 17257 � Side 1 �� 1505610143 1505610143 J � } , ,+ � � 1505610243 REV-1500 EX Decedent's Social Security Number oecedent's Name: HOLTRY, Marie M 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. 9, 651 . 97 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�n,-Probate Property (Schedule G) U Separate Billing Requested............ 7. g. Total Gross Assets(total Lines 1 through 7)........................................................ g. 9, 651 . 97 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 12 ,412 . 25 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 57 ,277 . 40 11. Total Deductions(total Lines 9 and 10)................................................................ ��. 6 9, 68 9. 65 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -60 , 037 . 6$ 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. -60 , 037 . 68 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0 . 0 0 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable 0 . Q Q 16. 0 . �� at lineal rate X .045 17. Amount of Line 14 taxable 0 . 0 0 17. 0 . �� at sibling rate X.12 18. Amount of Line 14 taxable Q . 0 0 18. � . �0 at collateral rate X.15 19. TAX DUE................................................................................................................ 19. � . �0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-14-1204 Decedent's Complete Address: DECEDENT'S NAME HOLTRY, Marie M STREETADDRESS 210 Big Spring Road CITY STATE ZIP Newville PA 17241 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 Pa able 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:.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ ❑X 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?.................................................................................................................... ❑ 0 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?.................................................................................................................. ❑ ❑X 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)j. 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 applicabie 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 decedenYs 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 decedenYs 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. :..,�r . .. -.r..�.,,: ; :::.:il !l:�...! . ._� . ? .. ..'.7s�. `. ... . �3i> ,.�. . .,. . i � �i; � . ,. :;..� � , . • � . � � +. ��frN�� ii�� .`� iY��+.iYiii�* � 1, MARIE M. HOLTRY, of St��ppensburg Borough, Cumberland Caunty, Pennsylvania, revoke rrty prior wills and declare this to be my Last Wil[: FIIZST: PAYMENT OF EXPENS�S - ( c�irect that the ex�eE�se of my last iilness and funeral be paid from my estate as soon as may conveniently be done. SECOND: [3EQUEST- I give, devise and bequeath my estate, real or personal, tangiUle or intangible, together with all insurance policies t��ereon unto my husband, DONA�D S. H�LTRY, provided f�e shall survive me by thirty (30) days. I.n the event rriy husbanc4 fails to survive me by tf�irty (30) days, 1 then give, deviss and bequeath all my estate whether real or personal property, tangible or intangible, together with all insurance policies tl�ereon to GRACE UNITED CHURCH OF CHI2IST, 1 Z1-123 East Orange Street, Sliippensburg, Pennsyivania. THIRD: RESIDUE OF ESTATE - I give, devise and bequeatli all the rest, residue and remainder of my estate unto my husband, DONALD S. HOLTRY, provided he sliall survive me by thirty (30) days. In the event my fiusband fails to survive me by thirty {30) days, I tlien give, devise and bequeath all the rest, residue and remainder of my estate ta GRACE UNITED CHURCH OF CHRfST, 121-123 East Orange Street, 5hippensburg, Pennsy(vania. FOURTH; PROTECTIVE PROV[SfON - To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be (i) assignable to a beneficiary or (ii) available to anyone having a claim against a beneficiary. FIFTH: DEATH TAXES -A!I federal, estate and other deatl� taxes payable on the praperty forming my gross estate, whether or not it passe5 under this wifl, si�al[ be paid out of t1�e principa! af my probate estate just as if they were my debts, ar�d none of those taxes shafl be charged against any benef�ciary. Tl�is provision s�all not apply to any pro�erty over which E have a genera! power of appointment of federal estate tax purposes. SIXTH: MANAGEMENT PROVISIONS- I autl�orize rny Executor, as follows: A. Retain/(nvest: To retain and to invest in all forms of real estate and �ersonaf property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations im�osed by law an irtvestments by executors or any principle of law concerning investment diversification; B. Compromise: To compromise claims and to abandon any property whicfi, in my Executor's opinion, is vf little or no value; C. Borrow: To borrow from and to sell property to my liusband or otilers, and to pledge pr4perty as security for re�ayment of any funds �orrowed; 1 ��•;�.,: :::�.�-,;:�,;�. ,';'.. .�...::. .. .:.:.?�.� l,.:I�:��,.� ....��f!..',` ... r�?s _ .. . �3�... ,..... . ... . !'�'... .. ?.?,..,.... � � � ' . D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any period of time, any reaE or personal property a�d to give options for sales of leases; E. Capital CE�anges: To jain in any merger, reorganization, voting-trust plan or otl�er concerted action of security holders, and to delegate discretionary duties with respect thereto, F. Distribute: To distribute in kind and to aElacate specific assets among the benef#ciaries {including any custaclian hereunder) in such proportions as my Trustee may think b�st, so long as the total market value of any beneficiary's share is nat affected by such a(location. . %Ti�ese authorities sf�all extend to all property at any time f�eld by my Executor or my Trustee and shalf continue in full farce until the actual distribution af all such property. All powers, authorities and discretion granted by this Wfll shall be in addition to those granted by !aw and shall be exercisable withaut court authorization. SEVENTH: EXECUTOR- ! appoint n�y husband, DONALD S. H�LTRY, Executor of my Will. In the event of the death, resignation, renunciation or inab[lity of my husband to act as Executor, I appoint RICHARD S. HOLTRY and JUDY STlNE, Co-Executors of this, my Wiil. Neither my Executor, nor any successor slial) be required to give bond. IN WITNESS WHEREO�, I have hereunto set my hand and sea# this�day of July, 2008. � �% ,�.��•f_c.c� `fJ� �c�1� ��rt (S EA L) MARIE M. HOLTRY, T�e tatrix In our presence, the above-named Testatrix signed this and declared it ta be f�er wi(I, and now, . at her eque t and in ��er presence ancf in the presence af eacl� other, we sign as witnesses: i ; , ,\ � � r � '�� c. _. 2 ;;: , .. ,.. , , - , .t.... . .. . , : __ , � , .! . . >13 . t:: �r .. , . , !�. . . � , � STATE OF P�NNSYLVANIA : : SS COUNTY (?F FRANKLIN . i, MAR(E M. HOL�RY, having been duly qualified according to law, acknowledge t��at { signed tlie foregoing instrument as my Wiil, and that I signed it as my free and volun#ary act for tlie purposes therein expressed. ' � . _-�� `I ,'"�}/��.�� MARIE M. HOLTRY, Testatri `f We, MARIE M. HOLTRY, the Testatrix in and th� undersigned witnesses to the Will, the attached or foregoing instrument, who have signecf the instrument, having been qualified according to law do depose and say: (a) that I, the Testatrix, do hereby acknowledge that I signed the instrument as my Wiil, that I sign�d it willing�y arid as my free and voluntary act for the purposes therein ex�ressed; and {b) tltat we, the witnesses, were present and saw the Testatrix sign and execute the instrument as f�er WiII, that she signec! it willingly and executed it as her free and voluntary act for[he purposes tf�erein expressed; that eacl� o{us in the liearing and sight of t1�e Testatrix signed the Wil! as witnesses and tl�at to the best of our knowiedge, the Testatrix was at t1�at time eighteen or more years ofi age, of sound rnind and under no constraint or undue influence. .%/J,/�f�/�/! � l � / -��. -, i � f��. ! <f 1'--i•f�.1... + .J M R M. HOLT Y, T statri � ness c.,. � ' �./�C� Witness Subscribed, sworn to or affirmed, and acknowledged i�efore me 3�y the abov�-named Testatrix and by t�ie witnesses whose names appear on tl�is 2�-c�lday of July, 200t3. � Not Public COMNfON1 BA T i OF P�?�tNSYL AMA 3 Nvtarial Sea1 Forest N.Myers,Nolary Ptiblic � Shl�pensburg Eioro,Frankiin County My Commtsslon Exp�ros i7ec.19,2009 Rev-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OFREVENUE pE RSO NAL P RO P E RTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER HOLTRY, Marie M 21-14-1204 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 Amalgamated Insurance-paid to estate 250.00 2 Orrstown Bank-checking account;date of death balance 9,139.94 Accrued income on Item 2 through date of death 0.03 3 Donald Holtry-retirement check 262.00 TOTAL(Also enter on Line 5, Recapitulation) 9,651.97 (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) REV-7517 EX+�10-09) pennsylvania SCHEDULE H DEPARTMENT OFREVENUE F U N E RAL EXP E N S ES AN D INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER HOLTRY, Marie M 21-14-1204 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N B R A. FUNERAL EXPENSES: See continuation schedule(s)attached 10,473.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Judy STINE Street Address 80 Airport Rd city Shippensburg state PA zio 17257 Year(s)Commission Paid 500.00 2. Attorney's Fees Law Office Forest N Myers 1,298.75 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 140.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. OtherAdministrative Costs TOTAL(Also enter on line 9, Recapitulation) 12,472.25 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 HOLTRY, Marie M 21-14-1204 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex eq nses 1 Fogelsonger-Bricker Funeral Home-funeral bill 10,473.00 H-A 10,473.00 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+��2-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFREVENUE INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER HOLTRY, Marie M 21-14-1204 RepoR 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 Green Ridge Village-nursing home bill 1,519.90 2 PA Department of Welfare-Class 3 claim 28,502.53 3 PA Department of Welfare-Class 5.1 claim 27,254.97 , TOTAL(Also enter on Line 10, Recapitulation) 57,277.40 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) T,l.�w �� "'"�w�E�� N�. M�z�.�.� 137 Pc�rk �+la�$ V4►�$t. 3hi�aFs+�r�sbur�. P�r,�3ylwr,�i�,i�s 172bT 71?.fs32.4lJ�[fs Fox 7't7�s32.8$7¢ rr�myersGi�Ic�weyF€�+�t�rC+s,lrcc�yers�m February 2, 2015 Register of Wills Cumberland County Courthouse One Court House Square Carlisle PA 17013 Re: Marie M. HOLTRY Estate PA REV 1500 PA No. 21-14-1204 Gentlemen/Ladies: Enclosed please find the original and two copies of the REV-1500 Inheritance Tax Return for the above-captioned estate. Please return the file copy, time-stamped, to me in the enclosed self-addressed, stamped envelope. Sincerely, �'-t-�.— Forest N. Myers e-�, � �� FNM/ash enclosures � c� �' �� ca µ,.� � -_, s;-� ca r�-t �.., "� �� cr� 7 :::3 ="_ � , . � �__ � '_r� � ` +.� ,T ;, ;; �-p � .,i � �,� —=y _.... �:':� �> f� ,.... t.,�'! ; r__ r �� .. � `tl i';;' � 3 , i ' � � _'� � � � � � � � � �' � � � � � � o �d fD � a � � � � z � � � � � � � � � o � = � � � _ � � 3 = N (7 Q = �D � � _ C - � "J � D3 � C_� � .� O a = � �, _� rn �I C (7 = c� s,� c> Oy O = _N: � � -� c� � �D - r� .._ �;.a W N � _ ` � -?-� �� c� !? s.� C � = r� c.a �;:� � � _ . " -, �D � _ � •-D , �'�'� . — ; �� -� _ ' � _ ; � _ _ �� :, c:7 � — f� �_,l � = . , � fJ7 'jl C = y — o�o TC� �'�� A fA .- � � ��o -N.I � p .., o _ r-. ._