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Home My WebLink About03-31-15 (2) f 15056051058 REV-1500 EX(06-05) OFFICIAL USE ONLY PA Department of Revenue = Bureau of Individual Taxes County Code Year File Number BOX 280601 INHERITANCE TAX RETURN Ha .... 1 ( Harrisburg,PA 17128-0601 � RESIDENT DECEDENT 05 ENTER DECEDENT INFORMATION BELOW 12/28/2004 03/15/1909 Decedent's Last Name Suffix Decedent's First Name MI Weaver Edith , M . (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 CO x 2.Supplemental Return C'_' 3. Remainder Return(date of death prior to 12-13-82) 4.Limited Estate 4a. Future Interest Compromise(date of 7D 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate C 7,Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ®: 9. Litigation Proceeds Received ' 10.Spousal Poverty Credit(date of death _.. 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT– THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Terence J. Barna, Esq. . (717) 852-7020 Firm Name(If Applicable) — REGIBER OF WILLSgJE ONLY Benn Law Firm C a C" MCI I 'T First line of address _ 103 E. Market Street Second line of address P.O. Box 5185 City or Post Office State ZIP Code _-_____ ".DA1-L FILM York PA 17405-5185 I o Correspondent's e-mail address: tbarna@bennlawfirm.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, 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE z2e v ADDRESS Doris Anne Young, Executrix, 9445 Carlisle Road, Dillsburg, PA 17019 SIGNATURE O ER OTHER THAN REPRESENTATIVE DATE ADDRESS " ! l Benn Law Firm, 103 East Market Street, P.O. Box 5185, York, PA 17405-5185 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 , 15056052059 REV-1500 EX �! RECAPITULATION __. 1. Real estate(Schedule A). ... . . .. . .... .... .. . . .... . . . ...... . . . . ... .. . . 1. 0.00 2. Stocks and Bonds(Schedule B) 2. i 0.00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . .. 3. ; 0.00 4. Mortgages&Notes Receivable Schedule D 4. 0.00 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E) .... . . . . 5. 3,700.00 6. Jointly Owned Property(Schedule F) = Separate Billing Requested ... . . .. 6. I 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property i (Schedule G) C Separate Billing Requested.... . . .. 7. 0.00 8. Total Gross Assets(total Lines 1-7)..... ..... . ...... ..... ..... . . . ...... 8. !3 3,700.00 9. Funeral Expenses&Administrative Costs(Schedule H). . . . . .... . . .... ... .. . 9. 1,535.52 i 10. Debts of Decedent, Mortgage Liabilities, &Liens(Schedule 1). . .... . . . ....... 10. 3 0.00 I 11. Total Deductions(total Lines 9&10).. . .. . . ... . . . . .. . . . . . ..... . . . . .... . 11. ! 1,535.52 j 12. Net Value of Estate(Line 8 minus Line 11) . . . . .. . ..... .. . ... .. ... ..... .. 12. , 2,164.48 13. Charitable 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. 2,164.48 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.0_ 15. I I 16. Amount of Line 14 taxable at lineal rate X.0 45 2,164.48 16. 97.40 17. Amount of Line 14 taxable at sibling rate X.12 17. j 18. Amount of Line 14 taxable I at collateral rate X.15 18. i 19. TAX DUE ..... . . . .. . . . .. .... ..... .... . .. .... .. . .... . . .. .. ...... . . . 19. 97.40 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 . ° msV-1mmcxPage u File Number _ Decedent's Complete Address' IDECEDENT'S NAME STREETADDRESS Messiah Village, 100 Mt. Allen Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2Line 19) (1) 97,40 2. Credits/Payments A.Spousal Poverty Credit 8,Prior Payments C.Discount Total Credits<A+B+C) (2) 0.00 3, Interest/Penalty if applicable D,Interest E,Penalty Total Interest/Penalty(D+E) pV 0,00 4. If Line 2 is greater than Line I +Line 3,enter the difference, This is the OVERPAYMENT. Fill iooval vnPage%.Line 2Otorequest orefund. (4) 5. |fLine 1 +Line 3iogreater than Line 2.enter the difference.This iethe TAX DUE. (5) 97.40 A.Enter the interest onthe tax due, (5A) 0.00 8.Enter the total u(Line 5+5&This isthe BALANCE DUE. (50 87.40 Make Check Pnm6lo to: REGISTER OF WI / S, AGENT ~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make utransfer and: Yes No u. retain the use urincome of the property transferred;............................................................. ........................ 11 R b. retain the right to designate who shall use the property transferred o,its income;........................................... F] R o. retain ureversionary interest;ur.....................................-- ......-...............---- .........._ ... ... ...... Q 2 Fl [� d. receive the promise for life of either payments,benefits or care?......................................................... ........... 2 Kdeath occurred after December 12,1V82.did decedent transfer property within one year ofdeath [� wNm��uo�inOu�quamoonu�emUnn?------------------------------------' �� =[� 3. Did decedent own an"in trust for"mpayable upon death bank account msecurity athismhmdeoN?----' 7 Fxl 4. Did decedent own anIndividual Retimmont Account,annuity,urother non-probate property which Fl [� containaehonefidurydomiQnahun? ---------------------------------------- |FTHE ANSWER TOANY OFTHE ABOVE QUESTIONS|SYES.YOU MUST COMPLETE SCHEDULE GAND FILE|TASPART OFTHE RETURN. - - - , - For dates of death on or '~ after July 1. 1994 and before January 1. 1895,the tax rate imposed on the net value of transfers tomfor the use of the surviving spouse is three CBpercent[72PS.§9116(a)(11)(i)], For dates ofdeath onmafter January 1. 1995, the tax rate imposed onthe net value of transfers tomfor the use of the surviving spouse is zero (0) percent [72P&§9116(a)(1.1)(ii)]. The statute does not exempt a transfera surviving spousefrom tax, and the statutory requirements for disclosure ofammtsand filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates ufdeath onmafter July 1.2OOO: The tax rate imposed unthe net value oftransfers from adeceased child twenty-one yeamofmgon,yoonguratdaath0oorforihouomo[amatura| pomnt. on adoptive parent,orestepparent ofthe child iozero(0)percent[72 RS.§9116(u)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half(4.5)percent, except as noted in 72 RS.§8116(12)[72PS.§0118(u)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve(12)percent[72P3.§0118(a)(1.3)].Asibling bdefined,under Section 9102.as an individual who has at least one parent in common with the decedent,whether byblood or adoption. ` REV-1508 EX+(6_98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 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 �–�—�. On or about March 10,2015 the Estate received litigation proceeds from Integrity Insurance Company in 3,700.00 J � w t 1 Liquidation in connection with York County State Court litigation initiated prior to the decedent's death, i 'i:}Y.i C '-.Y•.T. e.svaRs�-.�-- w wr-n - tw Ti _. - ., -w n..w -.- � �....,.-�._....�.�..�....-u ' Weaver v. Donald K.English,et al.,No.87-SU-03093-01,said proceeds in the amount of$3,700.00 t t- ; TOTAL(Also enter on line 5, Recapitulation) $ 3,700.00 ;t (If more space is needed,insert additional sheets of the same size) 1 ' REV-1511 EX+(12-99) & SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 Debts of decedent must be'reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: . B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) i Social Security Number(S)fEIN Number of Personal Representative(s) Street Address City _ A _r State=Zip Year(s)Commission Paid: 2. Attorney Fees 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent _ 4. Probate Fees 5. Accountant's Fees 1 �� =ss- 6. Tax Return Preparer's Fees f __ s 1 7. Benn Law Firm--contingency fee paid on litigation proceeds T 480.00 FA Cumberland County Register of Wills filing fees 30.00 L�J Benn Law Firm--cost reimbursement! 25.52 TOTAL(Also enter on line 91 Recapitulation) $! � 1,535.52 (If more space is needed,insert additional sheets of the same size) REV-1513 EEX+(11.-08) �,pennsylvania SCHEDULE 1t�7 DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Edith M. Weaver 21-05-0028 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. Doris Anne Young,9445 Carlisle Road,Dillsburg,PA 17019 daughter 50% residue 2. Donald E.Weaver,4307 Lemonwood Circle,Bradenton,FL 34208 son 50% residue 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,insert additional sheets of the same size.