The URL can be used to link to this page

Home My WebLink About03-12-15 t J � pennsytvania 15 0 5 61410 5 DEPA1iTMENTOFPEVFNUE EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO Box 280601 INHERITANCE TAX RETURN � � �� I� Q � Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 179-12-3524 12122014 05021919 DecedenYs Last Name Suffix DecedenYs First Name MI YOHE ANNA MAE (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 � 1. Original Retum p 2.Supplemental Return p 3. Remainder Return(date of death prior to 12-13-82) p 4.Agriculture Exemption(date of p 5.Future Interest Compromise(date of p 6. Federal Estate Tax Retum Required death on or after 7-1-2012) death after12-12-82) � 7. Decedent Died Testate p 8.Decedent Maintained a Living Trust � 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) � 10.Litigation Proceeds Received � 11.Non-Probate Transferee Return p 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 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 WAYNE NEFF (717)497-8061 First�ine of Address 757 COLLINA DRIVE Second Line of Address City or Post Office State ZIP Code LEWISBERRY PA 17339 CorrespondenYs emaii address: MWNCFP@COMCAST.NET REGISTER OF WILLS USE QN�Y c_, :.� REGISTER OF WILLS USE ONLY �� "'�� `1 DATE FILED MMDDWYY �� `� � .� c > . ,:_ =� � " ,t ,,,, . ..,_. ..,, , i .... a , r_. � � - . .. ., � DATE FILECf STAMP —�-. – –� _ ' _ t.� ' CS.� _. C:� r C:'% C'`ID PLEASE USE ORIGINAL FORM ONLY ��, -r7 Side 1 ��)��,I�� 15 0 5 61410 5 J � � u � , � J 1505614205 REV-1500 EX(FI) DecedenYs Social Security Number oecedent's Name: ANNA MAE YOHE 179-12-3524 RECAPITULATION 1. Real Estate(Schedu�e A). ......................... ........ .. ....... .. 1. 151,000.00 2. Stocks and Bonds(Schedule B) 2, 441,696.91 ........ ............ ... ............ .... 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 4. Mort a es and Notes Receivable Schedule D 4. 0.00 9 9 � ) .... ............ . ........ .. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 54,440.41 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. .. ... 6. 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... .. . 7. 90,325.88 8. Total Gross Assets total Lines 1 throu h 7 8, 737,463.20 � 9 )..... ..... .. ... ........... ... 9. Funeral Expenses and Administrative Costs(Schedule H). ........... ....... 9. 6,974.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I).... .. ......... 10. 1,430.00 11. Total Deductions(total Lines 9 and 10).. ............ ... .. ......... ..... 11. 8,404.00 12. Net Value of Estate(Line 8 minus Line 11) .. ... .......... ........... .... 12. 729,059.20 13. Charitabie and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) .......... .. ........... . 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) .. .......... .. .......... 14. 729,059.20 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_ 15. 0.00 16. Amount of Line 14 taxabie at lineal rate x.0 45 729,059.20 �g. 32,807.66 17. Amount of Line 14 taxable at sibling rate X.12 0.�� 7. 0.�� 18. Amount of Line 14 taxable 0.00 0.00 at collateral rate X.15 18� 19. TAX DUE ..... ......... ... .............. ............. ............. 19. 32,807.66 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 retum is based on all information of which preparer has any knowledge. SIGNATU F PE �G RETURN D TE 3 !! / "-'" ADDRESS �y'� Ca�Nti�- ?1.t'. LE'�t�r�"i2RY .n/r /�-3.�� SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS � i iiiiii iiiii iiiii i�i��ii��i�i�i�i�i�iiiii iiiii iiii iiii Side 2 1505614205 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME ANNA MAE YOHE STREET ADDRESS 34 GARLAND COURT CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 32,807.66 2. Credits/Payments A.Prior Payments 0.00 B.Discount 1,649.38 (See instructions.) Total Credits(A+g) (Z) 1,640.38 3. Interest (3) 0.00 4. If Line 2 is greater than line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fiil 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) 31,167.28 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.............................................................................................................................. ❑ � 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 containsa 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 [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 retum 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 step-parent 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. REv-isaz Ex+ {lz-1z� � pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA MAE YOHE 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 that 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. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' 34 GARLAND COURT,CARLISLE,PA 17013 151,000.00 TOTAL(Also enter on Line 1, Recapitulation.) $ 151,000.00 If more space is needed,use additional sheets of paper of the same size. 'lll'I'IIIII I'I� 2014 Statement of Real Estate Taxes Bontrol No:040%01 2014 PAYABLE , � Aaseased Land Improvement Mineral Total To: values 40,OOp 111,000 0 151,000 JENNIFER VARNER TAX COLLECTOR xomaetesd Exc�naion 9- PO BOX 40 � BOILING SPRINGS PA 17007 0040 SOUTH MIDDLETON S.D. Discount Face Penat Rates .00915490 .00915490 2Ac 10+k oesc: ASSESS.NO-40003185 SCHOOL R/E 1,354.74 1,382.39 1,520.63 MAP NO: 40-23-0602-162. xomesteaa creait 12�.38- 34 GARLAND COURT ACRES .070 DEED 00361/979 TAX AMOUNT DUE----> $1,235.79 $1,261.01 $1,387.11 GARLAND COURT II =f Paid on or Aftar �/oi/zoia 9/O1/2014 ii/oi/2oia LOT 34 PB 55 PG 111 If Paid On or Before 8/31/2014 10/31/2014 ia/si 2oi4 RESIDENTIAL 1 FAMILY IF TAXES ARE IN ESCROW FORWARD TO MORT6AGE CO Tax YOHE ANNA MAE IF NOT PAID BY 12f31/2014 THIS BILL WILL BE RETURNED TO TAX PAYER 34 GA�iLAND COURT TWO CLAIM BUREAU FOR COLLECTION CARLISLE PA 17013 NOTICE OF PROPERTY TAX RELIEF Your enclosed tax bill inc�udes a tax reduction fo�your homestead andlor farmstead o��ce TUE-WED-THU 9:30 AM-3:00 PM property. As an eligible homestead and/or farmstead property owner,you have received r,ouRs: 520 PARK DRIVE(TOWNSHIP BLDG) tax relief through a homestead and/or farmstead exciusion wh�ch has been provided PHONE:717-258-0127 under the Pennsylvarna Taxpayer Relief Act,a law passed by the Pennsylvarna General JVARNER@SMIDDLETON.COM Assembly designed to reduce your property taxes. _J� $ Ta�c Collector Signature Date Paid Amount Pa�d If navinn in inetallmenfe�ieo fheiennc+neQhqlnw tn_m�hm",t nsvreontg.lf_nnv—inn ir�full ucn ANI_V_�bq�QT eni�r.n�Hnlnw fn crd+mif navn+en*,_ _-_ � REV-i5o3 EX+(8-iz) � pennsylvania SCNEDULE B DEPARTMENT Of REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA MAE YOHE All property jointly owned with right of survivorship must be disciosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' INVESCO PA TAX FREE INCOME FUND#1324427 238,791.73 2 PERSHING LLC INVESTMENT ACCOUNT#5HT101052 202,789.54 3 SERIES EE US SAVINGS BOND#C442173196EE 115.64 TOTAL(Also enter on Line 2, Recapitulation) $ 441,696.91 If more space is needed,insert additional sheets of the same size H istoric Accou nt Values 11:35AM CST,Tue,Dec 16,2014 Account#: 1001324427 Mgmt CO: INVESCO BIN: C5474505 : Fund Name: INVESCO PENNSYLVANIA TAX FREE INCOME FD-CL A Registration: ANNA MAE YOHE TOD ACCOUNT Fund Code: 1767 34 GARLAND CT TWO Ticker: VKMPX Total Shares: 14,3332370 CARLISIE PA 17013 CUSIP: 00142J255 Account Value: $238,791 J3 Phone#: ' Account Type: 65-TRANSFER ON DEATH-INDIVIDUAL -Day: (717)258-3286 . Aaa Current Price Date: 12/15/2014 ; Price Date : 12/12/2014 Cu�rent Net Asset Value: $16.6600 Net Asset Value : $16.6600 Current Total Shares: 14,333.2370 ': Total Shares: 14,333.2370 Current Value: $238,791.73 ' Value: $238,791.73 tnformation contained herein is based an sources and data believed reliable, but is not guaranteed by us,and is not to be construed as an ofFer or a solicitation of an offer to buy or sell securities mentioned herein.This is for information purposes oniy and is not intended to satisfy any compiiance or regulatory conditions set forth by any goveming body of the securities industry. The user is responsible for verifying the accuracy of the data received.These reports are not to be used as a substitute for any reports disfibuted by your mutual fund or insurance companies nor any monthly or annual statements by the broker dealer that maintains custody of your account. Copyright O 2014 DST Systems, Inc.All Rights Reserved. Covered by US Patent No. 7,275,046 ___ __ _ _ — _ . . _ ___ ____ _. _ _ �, .w. . __ �,. _ ___ �_ �_ .. - � � . _ .k: _. ,--� � �, � _ _. __ o x o � = a t > o 0 ,_., u, ;; a� € a ; '; ' ._.._ _. _ __ . .. .. _. � a� � - *% � : ... � � � � N � � v V N ; � "t q .__,, r, a a ? I Q ; �. U � � 7 � _ � - `I .�i . � � � J � J G ` __ t ], r ^• � � ttf � .�+ , '� � � ! � E �,,., G3 � � C � �' � � � � � � � � � � > ; � �.J 4 � . ,� .� �� .., . � Q U y '�!' �!1( �} `C3 �.. � �i �.. Q i, ; ` y « � W � .CJ �t � � , ' _ _ rt `��" � a < � E � LL � �, �i � � o o M � � �._.�. w rv � � IA O O N s o � f O� O G � �11 � us � � � � ; Z � k�-I � n 00 � � � ; rr � � i ; a i� � x ; ev .•� ; '�° � � u � N L � � �; tC U v � � .� � � � i � � q�j a � � C� ! 2 � Q � V � ` J � 1 � � ' ,,� � 3 R = : , ' o cC � � � , a � � � � � � LL- ' '+d � � r1 cv W �- � ��. '� - � L . � � a '- t4 � ' Vf ; z � �OQO W)�sa�DeleA l�t � � � � � � ''-..---� __ �_______._� __....�.�.___.� e�._.�_..� _�__� � M � ' (�'� � x v � � { : _ � ; . � � Y :t7 {� �?r 3J V � ^ � ; Q � N � � B � � a � s - - Q � � .�j . � tn ^_i t � � $ . ��fN � � �^ � ' i i � � ro � a � � J . � �7 f d9 t�`y � v � � v f � � ; ; � r+ � z u r- -F ; � � G ' i 4 s i � � IA ' O O G1 ` p � � # N � Ci � � C1 O O N � � �� ! S/1 � 1� O O N � v i-Z+ ,~`t iO { Q � � � ' a i v ` p € t0 f� + ; E71 r"�; � ` ` � �„� _ 1� � � {,~V € M ' p ' � i N � i .�. O� Q � �. � � � �' '�y � W {�� = jN ; N . C j ttiv 0 � ` z 4..i �� I \ ; � � ..�i�O '`� Z •� i � >• � u� ; o � �, ao in o� �' � t _ ; .i o e" � E ! Vf Q � t�j : * ��.{ M +-� ry l�1 W M � i � � S( r'! ' ' � � � � iL ' ? i [ i9 Q ( (� ' v � O N W 0 +� Z ' � N ` t ii ! E u % CT \ I� \ C1 Q � ; � ! � � . i ; Q Z,' € Q ` � ; � OI� O O .�iF�- e} ? � t , �„� � � qp �f' ° � cCt i Q � � � o�M 3 £ bA ( .0 � m O o..',..� � � � � � N ° tLD : � � @ s w c� �o :r . ' � � ' o ! � � ` � � m �, �- � O = �n �� ;� 7, y � € � i Q ' � r�1 � � > ��,, �., �'L' Q } � i i�Q � � y. ;; �s = O ; ? 0 � 3 � n� i� ; t0 a : it1 �7 � .� z a � t-- c ,� • s U y � � ,.� � �+ A d M Q �Q� � � � r� � �� : O � # *+ : �- R 3 V t � = F � �i `L 1'� �Vl � n '� (6 � � \Q ~ C `r7 ' � ,� �t 3 , � � Q � a p Q J , � � a�- vy y c ; M _ � 3 L � t!} � : � V ; Z Z � �� '� rt x G� e3 � t . � x Lti � > � c � � � oz - � c. u 2 zO �t¢ fl � � r- v �a � � � V � ' � � V �- . Q ` r,( � Q E- M C� C� ��T _. cY ,u E u ; Q � Q : � U� ', i— � ':, i_ i __ ._ .._ _.._ _.._ '___ __. _. . ; _ . _.__ __ _�.... �y , _ 3____�__.�._�. __ _ _ _ � � r � � � � r � � � i. q � �+ Z � � ��` � - . , — - '� � : e t �� — _ e► — e r_ � r� — -- —„— ;�. , ��€�FaiL:��'l�Sj�;,ys,tn+�� . ' '_ ' �, , . u----------- ••• • �.. I Y�� Y� �.: �1��cc��:��:��r��J�►��.�r;..��t�.,�� SERIES �E - t��f�!y�1.�Z#,r..�.�^� " (F�y�yill��f•�l�i�lil�i7��y��j.#�\�IYiIi.�Y;`�� -' INTEREST-CEASES 90 YEARS � � I :,-• Y�.1 • _ �•• ••• �••. • , •• , 5_- iRON 155UE UATE S'+iJ � ,�'�` 179 �2 3�Z4 30 ' 1493 � ,� Y` r � _ _-- -- : , ,�� /i. q�NA �la� Yi?NE ,•fR8 MPLS , ,, r � ' ; 1.�� 1�3�;. E ' ' t 34 GAR�AI�D CtJU�t� T�Jfl t�� _�°��,�; �#1itLI5LE PA 170i3 �t o,.T��3T,,,.P ��. , 50R O�UO �i}� �30t312�4 26i193—� `b=4§_217319u � k �` �, . � :� ��`i�3Y{��aTl �. . . . ! , �'��,�� C4421�3196EE � I �-�.-� µ ' �:00009000?�:04 � 7044 2 � 73 L96i�' �� I `�Z_�Z'�Y�dbY�1tl+�xs�amba.rrruir�ws,vada—sa:ab.anxMra�n>t�__.�«ta�.oaone.o.�u,xr.�.c<±:ou.tte.a:,- �� --—,vb,�„u�autu:7tsL'atL2�'ra�2YSr7�d,�t'yrN�9 Su��'�,s2isU'�k_ . s 1� � y� ,; t �`. i , _ .. .� . n�` � ,�' . . � , �. .. . �,; .. . � '. �i _ � �� , �� . � �� , �� ` � �; � �� .. REV-i5oq EX+(g-iz) scNE�u�E c � pennsylvania CLOSELY-HELD CORPORATION, . DEPARTMENT OFREVENUE INHERITANCE TAX RETURN PARTNERSHIP OR RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER ANNA MAE YOHE Schedule C-1 or C-2(including all supporting information)must be attached for each closely-heid corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. NONE 0.00 TOTAL(Also enter on line 3, Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1507 EX+ (04-13) � pennsylvania SCNED�ILE D DEPARTMENT OF REVENUE MORTGAGES & NOTES INNERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA MAE YOHE All property jointly owned with right of survivorship must be disciosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH NONE I 0.00 I I I I I I I I I I ( I I I I ( I TOTAL(Also enter on Line 4, Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size.) REV-i5o8 EX+(08-i2) � pennsylvania SCNEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA MAE YOHE Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owaed with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. MEMBERS 1 ST CREDIT UNION CHECKING&SAVINGS ACCOUNT#2182216974 40,440.41 2 2011 CHEVROLET CRUZE CAR 11,000.00 3 HOUSEHOLD PROPERTY-FURNITURE,CLOTHING,APPLIANCES,ETC 3,000.00 TOTAL(Also enter on Line 5, Recapitulation) $ 54,440.41 If more space is needed,use additional sheets of paper of the same size. REV-150g EX+(oi-1o) � pennsylvania SCNEDULE F DEPARTMENTOFREVENUE �pINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA MAE YOHE If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• NONE B. C. ]OINTLY OWNED PROPERTY: LETTER DATE DESCRIP7ION Of PROPERTY °/OF DATE OF DEATH [TEM fOR lOINT MADE INCLUDE NAME OF FINANCIAL INST1TlJTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT lOINT IDENTIFYING NUMBER.A'fTACH DEED fOR]OINTLY HELD REALESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL(Also enter on Line 6, Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+ (OS-09) � pennsylvania SCHEDULE G DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON—PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA MAE YOHE This schedule must be compieted and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,TNEIR RELAIIONSHIP TO DECEDENT AND DATE OF DEATH °/o OF DECD�S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATfACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. PROTECTIVE LIFE DEFERREF ANNUITY#FK4057494 7g,g0p.00 100 0.00 78,800.00 2 IRA-INVESCO US MORTGAGE FUND#2036716 11,525.68 100 0.00 11,525.68 BENEFICIARY OF BOTH:M WAYNE NEFF,SON TOTAL(Also enter on Line 7, Recapitulation) $ 90,325.68 If more space is needed,use additionai sheets of paper of the same size. Historic Account Values 11:36AMCST,Tue,Dec16,2o,4 Account#: 2036716 Mgmt CO: INVESCO BIN: C5221280 Fund Name: INVESCO U.S.MORTGAGE FUND-CLASS A Registration: ITC CUST IRA R/O Fund Code: 1774 C/F THE IRA ROLLOVER OF Ticker: VKMGX Total Shares: 916.2070 ANNA MAE YOHE CUSIP: 00888W619 Account Value: $11,498.40 34 GARLAND CT TWO Account rype: 09-IRA-ROILOVER CARLISLE PA 17013 Phone#: ' -Day: (717)25&3286 Op Current Price Date : 12/15/2014 Price Date : 12/12/2014 Current Net Asset Value : $12.5500 Net Asset Value : $12.5800 Current Total Shares : 916.2070 Total Shares : 916.2070 Current Value: $11,498.40 , Value: �11,525.88 Information contained herein is based on sources and data believed reliabie, but is not guaranteed by us, and is not to be construed as an offer or a solicitation of an offer to buy or sell securities mentioned herein.This is for information purposes only and is not intended to satisfy any compliance or regulatory conditions set forth by any goveming body of the securities industry. The user is responsible for verifying the accuracy of the data received.These reports are not to be used as a substitute for any reports distributed by you�mutual fund or insurance companies nor any monthly or annual statements by the broker dealer that maintains custody of your account. Copyright O 2014 DST Systems, Inc.All Rights Reserved. Covered by US Patent No. 7,275,046 REV-1511 EX+ (08-13) � pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA MAE YOHE Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' HOLIINGER FUNERAL HOME 4,018.00 2 1ST CHURCH OF GOD, MECHANICSBURG, PA-SERVICES 1,000.00 3 1ST CHURCH OF GOD,MECHANICSBURG, PA-FOOD SERVICES 975.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 0.00 Name(s)of Personal Representative(s) Street Address City ___ State ZIP Year(s)Commission Paid; 0.00 z. Attorney Fees: 0.00 3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation.) Claimant Street Address City__ _. State ZIP _ Relationship of Claimant to Decedent 4. Probate Fees: 626.00 5. Accountant Fees: 6. Tax Return Preparer Fees: �. LEGAL ADS-CARLISLE SENTINEL&CUMBERLAND COUNTY LAW JOURNAL 216.00 8 AUTO TRANSFER FEES 139.00 TOTAL(Also enter on Line 9, Recapitulation) $ 6,974.00 REV-1512 EX+ (12-12) � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA MAE YOHE Report 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• ANNUAL PLEDGE-SHIPPENSBURG UNIVERSITY 400.00 2 UNPAID UTILITY BILLS 430.00 3 ESTATE PROPERTY CLEANING BILLS 600.00 TOTAL(Also enter on Line 10, Recapitulation) $ 1,430.00 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(O1-10) � '� pennsylvania SCHEDULE � �� DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BE N E FICIARIES RESIDENT DECEDENT ESTATE OP: FILE NUMBER: ANNA MAE YOHE RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(5)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] i. M WAYNE NEFF,757 COLLINA DRIVE,LEWISBERRY,PA 17339 SON 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUT10N5 A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: i. 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. REV-1514 EX+(1-15) � pennsylvania SCHEDULE K DEPARTMENTOFREVENUE LIFE ESTATE, ANNUITY PO BOX 8060DIVIDUALTAXES &TERM CERTAIN HARRISBURG PA 17128-0601 ESTATE OF FILE NUMBER ANNA MAE YOHE This schedule shouid be used for all single-life,joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuaria) factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. ❑ Will ❑ Intervivos Deed of Trust ❑ Other . NAME OF LIFE TENANT DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH LIFE ESTATE IS PAYABLE ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑Life or ❑Term of Years 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Actuarial factor per appropriate tabie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest table rate- � 3.5% ❑ 6% ❑ SO% ❑Variable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ • NAME OF LIFE ANNUTTANT DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATW ANNUITY IS PAYABLE ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Check appropriate block below and enter corresponding number . . . . . . . . . . . . . . . . . . . . . . . . . Frequency of payout- ❑ Weekly (52) ❑ Bi-weekly (26) ❑ Monthly (12) ❑ Quarteriy (4) ❑ Semi-annualiy (2) ❑ Annually (1) ❑ Other( ) 3. Amountofpayoutperperiod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . • . • • • • • • , •$ 4. Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor(see instructions) Interest table rate- � 3.5% ❑ 6% ❑ 10% ❑Variable Rate % 6. Adjustment Factor(See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity-If using 3.5, 6, or 10%, or if variable rate and period payout is at end of period, calculation is Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . .$ If using variable rate and period payout is at beginning of period, calculation is (Line4xLineSxline6) + Line3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return.The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. REV-1644 EX+ (01-10) �.� . pennsylvania lNHERITANCE TAX DEPARTMENTOFREVENUE SCHEDULE L INHEfiITANCETAXRETURN REMAINDER PREPAYMENT RESIDENT DECEDENT OR INVASION OF TRUST CORPUS I. ESTATE OF FILE NUMBER ANNA MAE YOHE This schedule is appropriate only for estates of decedents dying on or before Dec. 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust corpus (principal). II. REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of Wills on (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income or Annuitant(s) of Election or Annuity is Payable C. Assets: Complete Schedule L-1 1. Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2, Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . .$ 3. Closely Held Stock/Partnership . . . . . . . . . . . . .$ 4. Mortgages and Notes . . . . . . . . . . . . . . . . . . . .$ 5. Cash/Misc. Personal Property . . . . . . . . . . . . . .$ 6. Total from Schedule L-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ _ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities . . . . . . . . . . . . . . . . . . . . . . .$ 2. Unpaid Bequests . . . . . . . . . . . . . . . . . . . . . . .$ 3. Value of Non Includable Assets . . . . . . . . . . . . .$ 4. Total from Schedule L-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ E, Total Value of Trust Assets (Line C-6 minus Line D-4) . . . . . . . . . . . . . . . . . . . . . . . . . . .$ F. RemainderFactor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G. Taxable Remainder Value (Multiply Line E by Line F) . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ __ (Also enter on Line 7, Recapitulation) III. INVASION OF CORPUS: A. Invasion of Corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income or Annuitant(s) Corpus or Annuity is Payable Consumed C. Corpus Consumed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ --- -- -- D. RemainderFactor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E. Taxable Value of Corpus Consumed (Multipiy Line C by Line D) . . . . . . . . . . . . . . . . . . . .$ (Also enter on Line 7, Recapitulation) REV-1647 EX+(01-15) � pennsylvania SCHEDULE M DEPARTMENTOFREVENUE FUTURE INTEREST COMPROMISE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FI�E NUMBER ANNA MAE YOHE This schedule is appropriate only for estates of decedents who died after Dec. 12, 1982. This schedule is to be used for all future interests where the rate of tax that will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the tax return. ❑ Will ❑ Trust ❑ Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY 1. 2. 3. 4. 5. II. For decedents who died on or after]uly 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within nine months of the decedent's death, check the appropriate box below and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ❑ Unlimited right of withdrawal ❑ Limited right of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of future interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) . . . . . . . . $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check one. ❑ 6%, ❑ 3%, ❑ 0% . . . . . . . . . . . . . . . . . . . . $ (Also include as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Check one. ❑ 6%, ❑ 4.5°!0 . . . . . . . . . . . . . . . . . . . . . . . . . $ (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) . . . . . . . . $ 6. Value of Line 1 taxable at collateral rate (15%) (Also include as part of total shown on Line 18 of REV-1500.) . . . . . . . . $ 7. Total value of future interest (sum of Lines 2 thru 6 must equal Line 1) . . . . . . . . . . . . . . . . . . . . . . $ REV-1649 EX+(01-14) � pennsylvania SCHEDULE O DEPARTMENT OF REVENUE DEFERRAL/ELECTION OF INHERITANCE TAX RETURN RESIDENT DECEDENT SPOUSAL TRUSTS ESTATE OF FILE NUMBER ANNA MAE YOHE ❑ PART A - DEFERRING STATEMENT For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is chosen, the personal representative responsible for filing the return and the trustee(s) of the trust in question hereby acknowledge the department's Statement of Policy set forth at 61 Pa. Code § 94.3 concerning any potential termination of the trust under 20 Pa.C.S. § 7710.1 that occurs after the return was filed. ❑ PART B — ELECTION TO TAX AMOUNTS Complete this section only if making the election to tax the sole use trust. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, bypass, unifled credit, etc.). Enter the description and value of all interests for which the election is made. DESCRIPTION VALUE Total o.00 If more space is needed, insert additional sheets of the same size.