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Home My WebLink About02-23-15 (2) J REV-1500 EX(02-11) 1505610143 PA Department of Revenue S OFFICIAL USE ONLY p Pennsylvania County code Year File Number Bureau of Individual Taxes dePARTverrrorRMWE PO 60x.280601 INHERITANCE TAX RETURN 2 1 14 0 1 2 1 9 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 29 2014 09 25 1929 Decedent's Last Name Suffix Decedent's First Name MI STAMBAUGH KATHRYN G (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. Supplemental Return ❑ 3.priori 1erRetur(Date of Death ❑ 4. Limited Estate ❑ 48.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required (date of death after 12-12.82) ® 6. (Attach Decedent Died of estate E37. (A nt py of Tned) �e Trust 9• Total Number of Safe Deposit Boxes ❑ 9. Litigation Proceeds Received ❑ 10.Spousal potwe l Poverty 2 3 r9Creddit(Date Death ❑ 71•Election toohtaxunder Sec.9113(A) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD G SCHEIB 570 523 3200 .., REGISTk-OF WILLS ustbNLY First Line of Address C-) cY) f_-) t 11 REITZ BLVD SUITE 102 ' = 7i w I t rn Second Line of Address -Tf DATE FILED } City or Post Office State ZIP Code LEWISBURG PA 17837 CLD Cf) Correspondent's e-mail address: tehoover@dejazzd.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, h is true,correct and complete.Declaration of preparer olhe n the personal representative is based on all In of which preparer has any knowledge. StGNA RE OF PE SON RESPONSASF FILING ETU ATE STANLEY R.STAMBAUGH , ADDRESS S V4 713 SH WOOD RD,NE UMBERLAND,PA 17070IV, ,vJKu StGNAT PREPARER O ER N A GATE Richard G Scheib AD R SS Scheib Law Offices 11 REITZ BLVD SUITE 102,LEWISBURG, PA 17837 Side 1 L 1505610143 1505610143 a�� J 1505610243 REV-1500 EX Decedent's Social Security Number DecedeM•sName: STAMBAUGH, KATHRYN G RECAPITULATION 1. Real Estate Schedule A 1 0 00 2. Stocks and Bonds(Schedule B)............................................................................... 2. 0 00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 0 00 4. Mort a es&Notes Receivable Schedule D 4, 0 00 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 1 1 , 53 9 5 0 6. Jointly Owned Property(Schedule F) [3 Separate Billing Requested............. 6. = :•a . ..�:�: !y c�Q- 0 0 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) E] Separate Billing Requested............. 7. 2 3 9 3-0'9 . 0 2 8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 2 50 8 4 3 5 2 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 7 3 2 7 1 5 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 11. Total Deductions(total Lines 9 and 10).................................................................. 11• 7 3 2 7 1 5 12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 24 3 5 1 6 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. 2 43 5 1 6 3 7 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rale,or transfers under Sec.9116 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 4 3 , 5 1 6 . 37 16. 10 9 5 8 . 24 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE................................................................................................................... 19. 10 9 5 8 . 24 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 - 01219 Decedent's Complete Address: DECEDENT'S NAME STAMBAUGH, KATHRYN G STREET Abmb§§ 1000 WEST SOUTH STREET CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due.,(Page 2,Line 19) 10,958.24 2. Credits/payments A.. Prior Payments & "ount 547.91 Disc Total Credits(A +B) (2) 547.91 3. Interest (3) 0.00 4. If Line 2 is greater than Line I +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) 10,410.33 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;................................................................................. F, 0 b. retain the right to designate who shall use the property transferred or its.income:................................... ',J Fx_1 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?....................................................................................................................... 1 Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... 1-i 0 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ( - contains a beneficiary designation?.................................................................................................................... J� 1-1 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. qj- 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 21ears 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)J.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 172 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 decederl wkether y NO or adoption. Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 -14-01219 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 which 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. Include a copy of the deed showing decedent's interest if owned as tenant in common. NUITEM MBER DESCRIPTION VALUE AETATH DATE OF 1 0.00 TOTAL(Also enter on Line 1,Recapitulation) 0.00 REV-1503 EX*(6.98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 - 14-01219 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUEATTATE OF 1 0.00 TOTAL(Also enter on line 2,Recapitulation) 0.00 pennsylvania SCHEDULE C DEPARTMENT OF REVENUE INHERRANCE TAX RETURN CLOSELY-HELD CORPORATION Li , RESIDENT DECEDENT PARTNERSHIP or SOLE-PROPRIETORSHIP FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 -14-01219 Schedule C-1 or C-2(Including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent,other than a sole-proprietorship.See instructions for the supporting information to be submitted for sole-propnetorships. ITEM NUMBER DESCRIPTION VALUE AT TATATE OF 1 0.00 TOTAL(Also enter on Line 3,Recapitulation) 0.00 r pennsylvania DEPARTMENT OF REVENUE SCHEDULE D RESIDENT EDEN TURN MORTGAGES & NOTES RECEIVABLE RESIDENT DECEDENT FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 -14-01219 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AETATH DATE OF 1 0.00 TOTAL(Also enter on Line 4,Recapitulation) 0.00 pennsylvania SCHEDULE E DEPARTMENT OFCASH BANK DEPOSITS AND MISC. INHERITANCE TAXAXRETURN � RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 -14-01219 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 he disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT TATATE OF 1998 OLDSMOBILE 400.00 UNITED HEALTH CARE REFUND OF UNUSED PREMIUMS 530.83 SANTANDER CHECKING ACCOUNT 1161133437 3,576.11 1 MEMBERS IST CHECKING ACCOUNT 2185786924 7,032.56 TOTAL(Also enter on Line 5,Recapitulation) 11,539.50 REV-1509 EX*(01-10) Pennsylvania DEPARTMENT OF REVENUE SCHEDULE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF STAMBAUGH, KATHRYN G (FILE NUMBER 21 -14-01219 If an asset was made joint within one year of the decedent's date of death,It must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT JOINTLY OWNED PROPERTY: �FPRO R %OF DATE OF DEATH ITEM LETTER DATE Include name AiNnant=ialms uon anbannumbe,DATE OF DEATH VALUE OF NUMBER FOR JOINT MADE or similar ldentiyng number.Attach deed for jointly-held real VALLIEOFASSET DECD�S DECEDENTS INTEREST TENANT JOINT estate. INTERESTI 1 0.00 50% 0.00 TOTAL(Also enter on line 6,Recapitulation) 0.00 REV-1610 EX+(0&08) �T;► ;I pennsylvania 14 DEPARTMENT OF REVENUE SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF STAMBAUGH, KATHRYN G FILE NUMBER 21 -14-01219 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 Is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION NUMBER Include the"erne of the transferee,their relationship to decedent VALUE OF ASSET OECUS (IF APPLICABLE) TAXABLE VALUE and the dela of transfer. Attach a copy of the deed for rent estate. INTEREST AMERICAN GENERAL LIFE INS ANNUITY 30,279.69 30,279.69 BA033303 TITLED TO THE KATHRYN G. STAMBAUGH IRREVOCABLE TRUST JOHN HANCOCK SAFE ACCESS ACCOUNT 11,300.51 11,300.51 88000161271185 TITLED TO THE KATHRYN G. STAMBAUGH IRREVOCABLE TRUST SANTANDER BANK ACCOUNT 768153081 TITLED 139,311.95 139,311.95 TO THE KATHRYN G.STAMBAUGH IRREVOCABLE TRUST SANTANDER BANK ACCOUNT 2841055140 TITLED 28,707.18 28,707.18 TO THE KATHRYN G. STAMBAUGH IRREVOCABLE TRUST LINCOLN FINANCIAL IRA 0007585803 TITLED TO 8.811.75 8,611.75 THE KATHRYN G. STAMBAUGH IRREVOCABLE TRUST NATIONWIDE FINANCIAL 016181798 TITLED TO 21,092.94 21,092.94 THE KATHRYN G.STAMBAUGH IRREVOCABLE TRUST TOTAL(Also enter on line 7,Recapitulation) 239,304.02 REV-15i 1 EX+(1"9) pennsylvania SCHEDU-E��p�� ,�HCcw�'n DEPARTMENT OF REVENUE f VIL DGIEWSESA W INHERITANCE TAX RETURN wry��n�.M7M RESIDENT DECEDENT rWlllar�lh7�IV1 COM FILE NUMBER ESTATE OF STAMBAUGH, KATHRYN G 21 -14-01219 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 PASTOR AND CHURCH 300.00 2 MUSSELMAN FUNERAL HOME 315.00 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 RICHARD G. SCHEIB 5,500.00 3. Family Exemption: (if decedent's address is not the same as daimant's,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 240.50 THE PATRIOT-NEWS EXECUTOR'S NOTICE 214.86 CUMBERLAND COUNTY LEGAL JOURNAL EXECUTOR'S NOTICE 75.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs DISCOVER CREDIT CARD PAYMENT 439.23 See attached 242.56 TOTAL(Also enter on line 9,Recapitulation) 7,327.15 C Sdinwal od�ulo Hca COMMONWEALTH OF PENNSYLVANIA /�� ru ",,,,y, •,,,,� INHERITANCE TAX RETURN �� codnued RESIDENT DECEDENT ESTATE OF STAMBAUGH, KATHRYN G FILE NUMBER 21 -14-01219 DIAMOND MEDICAL SUPPLY 30.16 COMMUNITY LIFE TEAM 212.40 Page 2 of Schedule H REV-1513 EX+(59.901 pennsylvania DEPARTMENT OF REVENUE SCHEDULE WKERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF STAMBAUGH, KATHRYN G FILE NUMBER 1 21 -14-01219 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY W Not Ust Tnwteo(s) TAXABLE DISTRIBUTIONS[include outright spousal distributions and transfers under Sec.4116(a)(1.2)) 1 STANLEY R.STAMBAUGH Son 81.172.12 713 SHERWOOD RD NEW CUMBERLAND, PA 17070 2 CRAIG STAMBAUGH Son 81,172.12 8 FIREHOUSE DRIVE LITTLE EGG HARBOR, NJ 08087 3 MARK D. STAMBAUGH Son 81,172.13 517 SUSAN RD CAMP HILL, PA 17011 Enter dollar amounts for distributions shown above on lines— 1-through 18 on Rev 1500 cover sheet,as appropriate. 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 It-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 0.00