HomeMy WebLinkAbout03-16-15 J pennsytvanta 1505614105
DEPARIMEM OFF REVENUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601
INHERITANCE TAX RETURN .........
Harrisburg, PA 17128-0601 RESIDENT DECEDENT P'� 13
ENTER DECEDENT INFORMATION BELOW
' I1 - 03 -- 26►3 'L 1;? -Z8 - 1933
Decedent's Last Name Suffix Decedent's First Name MI
_._
m..........._..._.......� ��_.._.___..__...._..___.._.-____.,....__�........, _................... .............._._..,.,.__._..__.....__,,... _..,..,-......._......._.....,.
. ......: ......� � u�lINF
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
i
i
I r .....
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
IM 1.Original Return p 2.Supplemental Return p 3. Remainder Return(date of death
prior to 12-13-82)
C= 4.Agriculture Exemption(date of C=) 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
® 7. Decedent Died Testate O 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received O 11.Non-Probate Transferee Return O 12• Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets C=3 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
C tN/�2�E5 .C. MINI�'LD� i�l -717-.760—oo7,oq
First Line of Address
... _................_..,,
& CGousra ruPu
Second Line of Address p c '
_......
p �
c Uzi
....................................................................._.....................................................................,.,.................................................................................................................................._...............
............._i
City or Post Office State ZIP Code
07
_ �_� ss .
Correspondent's email address: Us 3 40 In C as
.C7
REGISTER O YYILtt SE O T
REGISTER OF WILLS USE ONLY_ � �,•� �
ri
DATE FILED STAMP
co l�
PLEASE USE ORIGINAL FORM ONLY
Side 1
4ii�i� iiiii 1505614105 J
1505614205
REV-1500 EX(FI)
RECAPITULATION W
1, Real Estate(Schedule A). ............................................ 1. 00
2. Stocks and Bonds(Schedule B) ....................................... 2. L19 0
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)....... IE:jUi-5. , S, 3
r__- 401
6. Jointly Owned Property(Schedule F) C= Separate Billing Requested ....... 6.
L__
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) CD Separate Billing Requested..... ... 7. 1 02
8. Total Gross Assets(total Lines 1 through 7)..................... ........ B. 10)
9. Funeral Expenses and Administrative Costs(Schedule H). ................. . 9. 0 7< 3 60
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10-
11. Total Deductions(total Lines 9 and 10)................................. 11. 00
12. Net Value of Estate(Line 8 minus Line 11) ........ ... ............ .. ..... 12. 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.
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.OD-
6
15.
2. Z_
16. Amount of Line 14 taxable
at lineal rate X.0 16.1
17. Amount of Line 14 taxable
at sibling rate X.12 D P1 17.
18. Amount of Line 14 taxable 1
at collateral rate X.15 18.
19. TAX DUE ....... .... .... ........... ... .... ... .... ....... .... .. 19. 0,0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=:)
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 all information of which preparer has
any knowledge.
SIGNATIgRE,OF PERSON DtESP NSIBLE F FILING RETURN DATE
ADDRESS A.M.S.,A JAii-,V- f 9" Dr... Mee4onjGs&r5 A4 170-5*.
SIGNATUROF.REP ER OFR T R�80 �PBL�E FOR FILING THE RETURN DATE
ADDRESSMecAx4;c5o�mj Alt /7a_,r5-
e
771
iiii�i ii�ii�i�ii Mi ��i ���i�i��ii �i�ii Hifi iiia iii Side 2
4 1505614205
REV-1500 EX (FI) Page 3 File Number 213 -1,9163
3 _��G 37
Decedent's Complete Address:
DECEDENT'S NAME
STREET ADDRESS V
road MOO r' Dr.
CITYSTATE ZIP
h'lech.�.ics bre r �� /705-,s7
Tax Payments and Credits: 00
1. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments
A.Prior Payments
B.Discount Dy
(See instructions.) Total Credits(A+B) (2) 00
3. Interest
(3) 00
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) O
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) y
Mak11e check payable to: REGISTER OF WILLS, AGENT.
,.
... t! :.,.I�4 ...r. :..,. .. .�..., .' ..� ..., 3>, i
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.......................................................................................... ❑ V
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ R1
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
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.
"'"tt III r I I m47'- „' �,,� :�
�.,,
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 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 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 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[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-15o8 EX+(ii-io)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. -
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
1.1-13- i2l03
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. c��iaems 130.rik ;
A. Ch ee*;na Arch• No• (91 o0 18 61657 X8, 87-1, 01
Acer. Zvt f. on =.�,Q-A o
CSee i-44,-c S n sheetell Ackw)
TOTAL(Also enter on Line 5, Recapitulation) $ 8 � '. L
If more space is needed,use additional sheets of paper of the same size.
-V f[
ize-ps Bank-
One Citizens Drive
ROP 112
Riverside,RI 02915
March 17, 2014
Charles E Shields III
Attorney at Law
6 Clouser Rd
Mechanicsburg PA 17055
Estate of Jacqueline A Stumpf
Date of Death:Nov 03, 2013
SSN: 211-26-0037
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of his/her date of death.
As per your request,the decedent did not have a safe deposit box with our institution. For all other
inquiries,please call 1-877-579-2667.
WdSincere
ger
Decedent Account Processing
REF#: 633510
C i iz ns ank-
M e B
Account Number 6100786765
Account Title Jacqueline A Stumpf
Date Opened 5/3/1983
Account Type Checking
Principal Balance as of DOD $8821.09
Interest from Last Posting to DOD $ .04
Account Balance as of DOD $8821.13
YTD Interest to DOD $ .69
AJ-
Co
itizens Bank
I WC
Account Number 6100701352
Account Title Thomas A Stumpf USMC /Jacqueline A Stumpf
Date Opened 4/5/1972
Account Type Checking
Principal Balance as of DOD $22476.55
Interest from Last Posting to DOD $ .23
Account Balance as of DOD $22476.78
YTD Interest to DOD $4:72
Catozens Bank.701
Account Number 6140860474
Account Title Jacqueline A Stumpf
Date Opened 4/2/2002
Account Type Time Deposits (IRA)
Principal Balance as of DOD $1724.32
Interest from Last Posting to DOD $ .17
Account Balance as of DOD $1724.49
YTD Interest to DOD $2.16
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
�'ac�ke.1►>1e A-. Sh,�n�pC all- l3 - /.263
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEMDESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. 1218+17ew 13amk -S" , Trme 'Depos;f
.prinaipat $11'1d4. 32, ,!7 7o+al 1,7�q. `f9 '0I,721V.5f4 /vOgo !� 721f V9
pa too(e t; spa►Se, Ti•d0146 A %gu.n��'
Cse6 v4l6wAo,n �fheGf k>*cAa)
TOTAL(Also enter on Line 7, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCA/HEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
I
ESTATE OF ct FILE NUMBER
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: .
I. &4[perr; Atnrra,j f-('ome eF /Yteehan'�sbu .� , balance.
3, S/g. So
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: R�7 L
Name(s)of Personal Representative(s) •7 &AS A Sfuo►je/' &t4l Ved
Street Address 9 13rm rn p o r D
Mr.
city I e eA#w t CSb(4Fj State PA ZIP 17-OSS'
Year(s)Commission Paid:
�+LL W�CIe�tr m i
2. Attorney Fees: a a r'GS �., c7/1•ei�dS
f led
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) (,IJP J yEJ)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees pT Ctl"fl� GS ¢�3�• 5�
Civ)w ort q i naa i�s►ne s{� Sl, >�
5. Accountant Fees: OC pA; rn aye C S 6 url u n
S �¢1 ulh��rnb, c�2�'erm►1tec�
6. Tax Return Preparer Fees:"
O. DO
7. �duli�i'ona/ /0 f O k AA
8 �Qe/n►6kr�seMenTs ' 1; 4—
nCh 4-6rm:ned
' pJ,,o!•oeop�eS, Pte• (•t�fi.,,
TOTAL(Also enter on Line 9, Recapitulation) $ 3 .95
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+ (01-10)
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
,7'ac kerne 4. 5fumpF 21-I3 -/26�
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 outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
1. Aoly Al c5AaMW .Seo use /D ole
,�roaa�n�ea r 17r.
/Y1ec�art,;e-5 t4 j. 1-7P-55
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.
LAST WILL AND TESTAMENT OF JACQUELINE A.STUMPF
I,JACQUELINE A.STUMPF,currently of 8 Broadmoor Drive,Mechanicsburg,
Cumberland County,Pennsylvania, 17055 being of sound and disposing mind,memory and
understanding,do make,publish and declare this my Last Will and Testament,hereby revoking
and making void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniently be done.
2
I give,devise and bequeath all the rest,residue and remainder of my estate,real,
personal,and mixed,whatsoever and wheresoever situate,to my beloved husband,THOMAS
A.STUMPF,absolutely and in fee simple.
3.
In the event that my said husband,THOMAS A.STUMPF,has predeceased me or
has died at about the same time as I do as the result of a common disaster or accident,then I
give,devise and bequeath all the rest,residue and remainder of my estate,real,personal,and
mixed,whatsoever,and wheresoever situate,to be divided and distributed as follows:
ALL TANGIBLE PERSONAL PROPERTY that is part of my Estate,including any
automobiles and the insurance thereon,shall be made available to my two(2)sons,to wit:
ERIC A.STUMPF,currently of Fontana,California and DOUGLAS D.STUMPF,
currently ofAledo,Texas. They may,after valuation and appraisement,attempt to make as
nearly an equal division of the items they choose to select therefrom as may reasonably be. In
the event they do not wish to select all items,those not selected shall be sold as per the normal
course of Estate administration and closeout. Those which are selected shall have their
respective values credited against each son's respective share in order to make their respective
shares herein as equal as may reasonably be. In the event my said sons cannot agree upon a
selection,then they shall flip a coin or use some similar method so as to determine which son
may take each such item as part of his share. In the event either of my sons predeceases me,
his right of selection shall descend to issue,per stupes.
FOR CLARIFICATION PURPOSES,the use of the term tangible personal property is
meant to be limited to household furnishings,articles of personal adornment and the like. It is
not to be considered to refer to cash,coins,stocks,bonds,C.D.s,securities or other similar items
or forms of property-. \
�r�S —� 1QYG Page i `
All the rest,residue and remainder of the Estate assets shall be divided and distributed as
follows:
A. Fifty percent(501%)to my son,ERIC A.STUMPF,per stupes.
B. Fifty percent(50%)to my son,DOUGLAS D.STUMPF, ep r stupes.
However,the value of an aircraft,which we fix at$25,000.00,to wit:a 1977 Varga
Kachin 2150,Registration:N5085V,which we gave more than one(1)year previous hereto to
our said son,DOUGLAS,shall be deducted as an advancement against his share so as to
better result in equal shares of inheritance.
4.
I nominate,constitute and appoint my said husband,THOMAS A.STUMPF,as
Executor of this,my Last Will and Testament. In the event he is unable or unwilling to act
as Executor,then I appoint ORRSTOWN BANK,as Executor in his place and stead. They
shall not be required to post bond or enter security in any jurisdiction.
IN WITNESS WHEREOF,I have hereunto set my hand and seal this /44 day
of A.D.2012.
-(SEAL)
JACQ LINE A.STUMPF V
Signed,sealed,published and declared by the above-named JACQUELINE A.
STUMPF,as and for her Last Will and Testament,in the presence of us,who at her request and
in her presence,and in the presence of each other,have hereunto subscribed our names as
witnesses.
X&Z Z'�
Page 2
D FEES IP
1 US ppSTAGE AN Ma�ledfromZlP 17055
MAR 13 2Q15�lie 't
6ozR� '
4
4 -
p71M0062574
endicia.com
Imac
ST-CLAA$
USPS FIR` 0coo'
GHAR�ES SRIE`4S
6 CLO
USER RDURG p 17055-9751
M�CNAi.I1CSg
WIIut4" CoUR-TNOUSE
SWIP'[O: RESISTER�p Cp
cI ljt R HOUSE so RM 'a2
1 G�URT 3322
17013"
CpR1.iS1-EPA ►a,,�,llll�hll►�t
CHARLES E. SHIELDS,III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG,PA 17055
GEORGE M.HOUCK TELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
March 13, 2015
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Jacqueline A.Stumpf
No.21-13-1263
Dear Register of Wills:
Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Jacqueline
{
A. Stumpf Estate as well as Check No. 4037 in the amount of$15.00 for the filing fee.
. Thank you for your kind attention to this matter.
Very truly yours
Charles E. Shields, III
Attorney-At-Law
CES/mj j
Enclosures
73
_;. •, ,
'.Kj
I ' ► 4 f7P
7„
—14 -'
rl
C.J