HomeMy WebLinkAbout02-12-15 � 1505614134
EX(03-14)(FI)
REV-1500 CountyCode Year FileNumber
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 2 1 1 5 0 0 8 5
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MnnDDYYYY
0 1 1 0 1 9 9 6 0 6 2 4 1 9 0 7
Decedent's Last Name Su�x Decedent's First Name MI
H E R S H V E R N A C
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Return � 2.Suppiemental Return � 3.Remainder Return(date of death
Priorto 12-13-82)
� 4.Agriculture Exemption � 5.Future Interest Compromise(date of � 6.Federal Estate Tax Return Required
(date of death on or afler 7-t-2012) death after 12-12-82)
Q 7.Decedent Died Testate � 8.Decedent Maintained a Living Trust _ 9.Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of t�ust)
� 10.Litigation Proceeds Received � 11.Non-Probate Transferee Return � 12.Deferral/Election of Spousal Trusts
(Schedule F and G Assets only)
❑ 13. Business Assets ❑ 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
M U R R E L W A L T E R S , I I I E S Q 7 1 7 6 9 ? 4 6 5 0
First Line of Address
W A L T E R S 8� G A L L 0 W A Y , P L L C
,..,,
Second Line of Address � �� -� �
5 4 E • M A I N S T R E E T ��� ��
�: c> -� ; �a
� a� r� � �.7
City or Post O�ce State ZIP Code �,.'� "'_ �, � � �`�
M E C H A N I C S B U R G P A 1 7 0 5 5 � �� �` '
' :-,
� �:� �, � ,
Correspondent's e-mail address: tllufTel waltersqallowav.com �� :"�
�.:.�
REGISTER OF WILLS USE(�b1IIY +'� r'
REGISTER OF WILLS USE ONLY - ' ~ 1y� �
DATE FILED MMDDYYYY �
DATE FILED STAMP
PLEASE USE ORIGINAL FORM ONLY
Side 1
I IIIIII IIIII IIII)I�I'I IIIII III�I IIIII IIIII IIIII IIIII(III II'I
� 1505614134 15�5614134 �
� 15�5614234
REV-1500 EX(FI) DecedenYs Social Security Number
oecedent's Name: V E R N A C • H E R S H 1 0 5 7 6 4 6
RECAPITULATION
7 4 0 . 0 0
1. Real Estate(Schedule A) �•
. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Stocks and Bonds(Schedule B) 2• �
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. '
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . .. . . . . . . . . . . . . . 4. '
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . . . . 5. �
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. '
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. •
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 7 4 � . � �
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 4 2 S 3 . 0 7
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . .. . . . . . . . . . . 10. '
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . 11. 4 2 5 3 . 0 7
. . . . . . . . . . . . . .
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . .. . . . . . . . . . . . . . 12� - 3 5 1 3 . � 7
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. - 3 5 1 3 . � �
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 _ 0 . � O 15. O . � 0
16. Amount of Line 14 taxable 0 . � 0
at lineal rate X.06 0 • � 0 16.
17. Amount of Line 14 taxable � � � 0
at sibling rate X.12 � . � 0 17.
18. Amount of Line 14 taxable � . � �
at collateral rate X.15 � • � 0 18.
19. TAX DUE O • O O
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. ... . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Under penalties of perjury,I declare 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 person responsible for filing the return is based on ali information of which preparer has
any knowledge.
SIGNATU OF ON PO S LE F FILING RETURN AT �
/
<.�i��---_� /a �v,��
ADDRESS
WILLIAM • HE SH 532 APPALACHIAN AVE MECHANICSBURG PA 17055
SIGNATURE R RE T THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE �
� -/c� -� 5
ADDRES
MURR L R WALTERS, III, 54 E- MAIN ST MECHANICSBURG PA 17055
I IIIIII IIIII IIIII�II�I IIIII IIIII IIIII II�II IIII�IIIII IIII IIII Side 2
L 1505614234 1505614234 J
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address: 2� 15 0085
DECEDENTS NAME
VERNA C. HERSH
STREET ADDRESS
509 GETTYSBURG PIKE
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1• Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments
B.Discount
(See inst�uctions.) 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.
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 prope�ty transferred .•............•---.--.-•••••-••-••••••••-••--•-•-•-•-•••••-••••-•••-•• ❑ ❑
b. retain the right to designate who shall use the property transferred or its income ............................... X
c. retain a reversionary interest .....................................•••••-.............._........•••.........................••••••• ❑ �
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? ...................................................••-...................••••.......... ❑ �
3. Did decedent own an'in trust for or payable-upon�eath 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
(12 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a Vansfer 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 suNiving 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 step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The ta�c rate imposed on the net value of transfers to or for the use of the decedenrs 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.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
VERNA C. HERSH 21 15 0085
Ali real property owned solely or as a tenant in common must be repo�ted at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a wiliing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointiy-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the sefllement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTtON
1 TAX PARCEL NO. 10-D8S5-001-014-000 740.00
UNIMPROVED LOT
HIGGS AVENUE
DALLAS, PA 18612
ASSESSEO AT$100 IN 1996 WITH COMMON LEVEL RATIO VALUE OF 7.4
TOTAL(Also enter on Line 1,Recapitulation.) $ 740.00
If more space is needed,use addibonal sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
VERNA C. HERSH 21 15 0085
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. RICHARD H. DISQUE FUNERAL HOME, INC., DALLAS, PA 3,353.57
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)ofPersonalRepresentative(s) WILLIAMA. HERSH
StreetAddress 532 APPALACHIAN AVENUE
City MECHANICSBURG State PA ZIP 17055
Year(s)Commission Paid: (RENOUNCED)
2 Attomey Fees: MURREL R.WALTERS, III 794.00
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. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 105.50
5 Accountant Fees:
6. Tax Retum Preparer Fees:
7.
TOTAL(Also enter on Line 9,Recapitulation) $ 4 253.07
If more space is needed,use additional sheets of paper of the same size.
REV-7 513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FIIE NUMBER:
VERNA C. HERSH 21 15 0085
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 ouUight spousal distributions and transfers under
Sec.91 t6(a)(1.2).]
1. WIILIAM A. HERSH Lineal
532 APPALACHIAN AVENUE
MECHANICSBURG, PA 17055
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.
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MURREL R. WALTERS. 11I
ATTORNEY AT LAW ..
22 EAST MAIN STREET
..�—-_�
MECHANIC59URG, PENNSYLVANIA 17058
i�ST C'7li,i� �'4�lL '�'E.'^�`P�r'L";.�iv'"
B� I'£ REP�fEMBE£wD TIiAi
I,. VERA7A C. I:E�?SI�, a �esi3ent of TJpper Allen Township, Cur}�er2a.^,c�
�ot:nty, aennsy4vania, being of sound ar(i r,isposing mind, memory and understar,c3�nq,
do make, publish and declare tnis to be my LAST [aTLL �nc? TESTAME�7T, hereby
revofiing a1I 'vlills and Codici2s nr�viouslv *n4;`� b�: ;nP.
T
Z c?eclare that I am married to 47ILLIAM E. FTRSH, ar.d that I have one
(1) chiZd, WILLZAM A. HERSH.
II
I direct that my debts and £unerai expenses be paid as soon aft�r ny
death as is practicable by Executor out of my residuary estate, but not frosa
any assets, funds, death benefits or ins;irance proceeds which are otherv.*ise ex-
cluda�Ye or exempt �rom my cross estate for federal estate valuation ar tax
pesrposes.
III
Z direct that all estate, succession, legacy, 3nhesftance or other
�ransfzr taxes, however designated, that shall become payable 3�y reason of any
death an respect of all property comprising my gross estate for death tax pur-
po�es, whether ar not such property oasses un3er this Li�ST Ti�ILL, shall be paid
�y my Executor out of :rcy residuarp estate, but not from any assets, funds,
death benefits or insurance nroceeds which are otherwise excludable or exempt
from my gross est�te for federal estate valuation or tax purposes.
IV
_T �i_ve� devase ar.d becueath all of my prooerty, wh�the�C real or ne�-
sonal, wnerever situate, includina, any property over w::ich I r�ay have a paw��
a£ a�poir.tr:ent, te my husban3, ,-'TLLIAt�! �'. ITr'PSF?, �+rovided that he SLr'J3V� r;e T�y
uhirtq C3�?i days.
. .,. ..,,,�... �^a,;. . ,u:. .:aF., r ..K.^ ': �4T"�`v�T"(^52".x !vn—+.Y�'w — .. .. -.. ... ...
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,� �,'2.5, MI�I`_r° '.5;4U �I�.:�G,�¢rwe,.:.�
V
If my husband fails to survive me by thirty (30) days, then I gi.ve,
devise and bequeath alI of �y property, whether real or personal, wherever
situate, inclu@ing any property over wh3.ch I xnay have a power of appointment,
to my son, WILLiAM A. FiERSH.
VS
If my husband fails to survive me by thirty (30) days, and my son, �
WILLIAM A. I�RSH likewise fails to survive me by thirty {30) days, then Z
give, devise and bequeath all o£ my property, whather real or personal, wherever
situate, including any pzoperty over which I may have a power of appointment, to
such issue of my son as are living at the time of my death, in egual shares,
pes stirpes.
VII
I nominate, constitute and appoint my husband, WILLIAM E. HERSH as
�ecutor of this LAST WILL to serve without bond. If my husband i.s unable or
unwilling to act in that capacity, then I nominate, constitute and appoint my
son, WILLIAM A. HERSH to succeed as Executor of this LAST WILL to serve
without bond.
IN WITNESS WHEREOF, I, VERNA C. HERSH have set my hand to this
LAST WILL, this l day of 7�l�'�� , 1979.
�-
. +l _ �i ...��j��
���.Y\..� '
VERNA C. HERSH
AcxNosar,E�c,Er�rrr
COMMONWEALTfi OF Ph"NNSYLVA27IA .
Ss.
COUNTY OF CUMBERLAND .
I, VERNA C. E3�RSH, Testatrix, 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 �7ILL; that I
signed it willingly, and ti:at I signed it as my free and voluntary act for the
purposes therein expressed.
, � ;
✓/`,..`'.y�..�_ '��.�i . ;p�✓✓'__.:''(.
VERNA C. HERSH
Sworn or affirmed to and acknowledged before me, by tTERNA C. HERSIi, Testatrix,
this ,'c`�� day of �., - - , 1979.
_�, ,
, -s�, }�.� , .�..-��
Notary Publi�_; " - ;�
Katfileee 1. Lindberg, }latery i�5�c
My Commistion Expirei March 2, E9dl
MectieniuLurq. PA Cumberland County
AFFIDAVIT
COMMONN7EALTFI OF PENNSYLVAPIIA .
ss.
COUNTY OF CUMBERLAPID .
, -- -
� ,,,�,.�.,,�
We, /��i��R'i�&_ 1 _ _ �r.�c�. .� and � 1-:�_�,� _ , ._�, �� �
the witnesses whose names are signed to the attached or foregoing instrument.
being duly qualified according to law, do depose and say that we were present
and saw Testatrix sign and execute the instrument as her LAST WILL; that VERNA
C. HERSH signed willingly and that she executed it as her free and voluntary
act for the purposes therein expressed; that each of us in the hearinq and
sight o£ the Testatrix signed the wILL as witnesses; and that to the best of
our knowledge, the Testatrix was at the time 19 yesrs or more of age, of sound
_ mind and under no constraint or undue influence. � �
/ , , ,
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Sworn or af£irmed to and acknowledged before me� this � v=` day o£ ��� � , 1979.
' _
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NOtary Public �_� %" '
�1 Lin�erg. Ilotary�t�6�C
� �[s�fxfo� E�tpircs IGtmch 2. 198/
��7,PA Cwnberla��pu�q,
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