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Home My WebLink About02-12-15 -J REV-1500 E"�02-1> 1505610143 �,.�1, f� OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 2 1 14 0 7 2 8 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 03 01 2014 11 06 1979 DecedenYs Last Name Suffix DecedenYs First Name MI GRIFFITH JEANNETTE M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI GRIFFITH JEFFREY J Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE R�GiS�ER OF 'dViLLS FILL IN APPROPRIATE OVALS BELOW � 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) � 6 Decedent Died Testate � � Decedent Maintained a Living Trust 8. Total Number of Safe De OSit BOX2S (Attach Copy of Will) (Attach Copy of Trust) P � 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � ��,Eiection to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Schedule O) ,_.�, c:-_� CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA N SHOULD��91REC1' D�: Name - DaytimeTelep�"ne�umber� •��r�� ELIZABETH H FEATHER 717 23�,,�?6r.5,1-�s ��:�� .._3.. r-� ._.,� s .� :�:7 � r.._ c.�� r�,T��1 � ': _,, a REGISTER OF�WIL.L$.USEfjO�LY ,,.,,-,.�� _n �:.,. � � ,,� First Line of Address i � -�- t t-i� 3 6 3 1 NORTH FRONT STREET � � . ;:t�r r�t?? �r�i Second Line of Address ' ' � ;_ , e�;i � -,� DATE FILED City or Post Office State ZIp Code HARRISBURG PA 17110 Correspondent°se-ma�iaddress: Efeather@cklegal.net 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. SIGNA R :OF PERSON RESPONSIBLE FOR FILING RETURN DATE / Sharon K. Young _ --� — ADDRE S 3021 Raccoon Valley Road, Millerstown, PA 17062 SIGNATURE OF PREPARER OT ER THAN REPRESENTATIVE DATE ti Elizabeth H Feather �� r' ADDRE Cal well 8� Kearns P.C. 3631 North Front Street, Harrisburg, PA 17110 Side 1 � 1505610143 1505610143 � \ \�V \ ` ADDITIONAL Personal Representatives Griffith, Jeannette M. SS# 182-68-6463 3/1/2014 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. _.._- _ _ . _... . 2 Signature -='�"� ' � Name Jatta��A. Young �� Address 304 North Grantham Road City,State,Zip Dillsburg PA 17019 Date 3 Signature Name Address City, State,Zip Date 4 Signature Name Address: City, State,Zip Date � Signature Name Address: City,State,Zip Date 6 Signature Name Address: City, State,Zip Date � 1505610243 REV-1500 EX DecedenYs Social Security Number oeoeeeneSName: GRIFFITH� JEANNETTE 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. 2 , 613 . 80 5 Cash, Bank Deposits&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).......................................................... g, 2 , 613 . 80 2 , 588 . 52 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 25 . 28 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 11. Total Deductions(total Lines 9 and 10).................................................................. ��. 2 , 6 13 . 8 0 12. 0 . 00 Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 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. 0 . 00 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 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 �$• 19. TAX DUE................................................................................................................... 19. � . � � 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 � 1505610243 1505610243 � REV-1500 EX Page 3 File Number 21 - 14 - 0728 Decedent's Complete Address: N ' NA Griffith, Jeannette M, STREET ADDRESS 22 Lebo 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 Total Credits(A +g) (2) 0.00 3. Interest (3) 0.00 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 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:.................................... � � c. retain a reversionary interest;or.................................................................................................................. ❑ 0 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 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 TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. , �, � � �� . .�• � � r �a�� ay.s �� ' ;. ��. y � fi .� � 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 sunriving 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 re�urn 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 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)1. A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption. �� ,e pennsylvania SCHEDULE E �� DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN 7 RESIDENTDECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Griffith, Jeannette M. 21 - 14 -0728 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 OF NUMBER DESCRIPTION DEATH 1 Unisured Motorist Claim -Survival Action net proceeds 2,106.69 2 Unemployment Compensation Benefit 507.11 TOTAL(Also enter on Line 5, Recapitulation) 2,613.80 REV-7571 EX+(�0-09) �� ,a� pennsylvania ��1�H � DEPARTMENT OF REVENUE �NGfAF�L G/�rG1Y�7G+7 F11YD RESIDENT DECEDENT URN �IN�1 fV11 1 V G�+W� FILE NUMBER ESTATE OF Griffith, Jeannette M. 21 - 14-0728 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Ewing Brothers Funeral Home 2,588.52 2 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 TOTAL(Also enter on line 9, Recapitulation) 2,588.52 �� i pennsylvania SCHEDULE I �� DEPARTMENTOFREVENUE DEBTS OF DECEDENT �� MORTGAGE INHERITANCE TAX RETURN f RESIDENTDECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF Griffith, Jeannette M. 2� - �a -o�2s Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Sprint Wireless 25,2g TOTAL(Also enter on Line 10, Recapitulation) 25.2$ REV-7513 EX+(01•10) ��a pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Griffith, Jeannette M. 21 - 14-0728 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY oo Not�ist rrustee(s� I, TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Sharon K. Young Mother 50% of Estate 3021 Raccoon Valley Road Millerstown, PA 17062 2 James A. Young Father 50% of Estate 304 North Grantham Road Dillsburg, PA 17019 Enter dollar amounts for distributions shown above on lines 15 through 18 on 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 B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET O.00 JAMES R.CLIPPINGER C A L D W E L L & K E A R N S JAMES L GOLDSMITH STANLEYJ.A.LASKOWSKI A PROFESSIONAL CORPORATION OF COUNSEL DOUGLAS K.MARSICO 1AME5 D.CAMPBELL,JR. BRETf M.WOODBURN AITORNEYS AT LAW CHARLESJ.DEHART,III MICHAEL D.REED MICHAEL A.FARRELL THOMAS M.FRATICEILI THOMAS D.CALDWELL,JR. PETER M.GOOD 3631 NORTH FRONT STREET (192&2001) ELIZABETH H.FEATHER HARRISBURG PENNSYLVANIA 17110-1533 CARLG.WASS DAVID A.WION � JEAN D.SEIBERT (1937-2010) 7HOMA5 S.LEE 717-232-7661 JESSICA E.MERCY FAX:717-232-2766 RICHARD L.KEARNS JOSEPH S.SWARTZ RETIRED ERIC J.STARK THEFIRMQCKLEGAL.NET February 10, 2015 Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Jeannette M. Griffith No. 2114-0728 Dear Register of Wills: Enclosed please find the PA Inheritance Tax return and Inventory for the above mentioned estate. Also enclosed is a check in the amount of$10.00 for the filing fee. Kindly stamp our file copy and return in the envelope provided. If you have any questions, please do not hesitate to contact me. Very truly yours, �-� :�� N. �� ,� �-� ;_�:� -� �� Elizabeth H. Feather � � �; <<� � Caldwell & Kearns, PC ' c� ; `; I:Feather(c�ckle�al.net � � '��=� b�—� � ; `��-' EHF/dm �- �� ``' � � �� , � �:;a Enclosures � . � ., ��a�, � _.. 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