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Home My WebLink About04-08-15 J 1505614134 ts(oa-iatlF�l REV-1500 OFFICINL USE ONLY CwntyCode Year fkNumber Bureauo(IndivitlualTaxes INHERITANCETAXRETURN aosoxzaosoi RESIDENTDECEDENT 2 1 1 5 0 0 7 1 Marrisbur ,PA i]728-0601 ENTERDECEOENTINFORMATIONBELOW Social5ecurity Number Date of Death MmDDYYVY Date of Birth MMDOYYYY 0 1 1 5 2 0 1 5 � 5 0 3 1 9 4 2 Decetlenl's Las[Name SuKx Decetlenl's Firs�Name M� H E L L E R E V E L Y N I (If Applicable)Enter Survivinq Spouse's Infortnalion Below MI Spouse's last Name Suffx Spouse's Flrst Name THIS RETURN MUST BE FILED iN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS OELOW Q i.O�iginal ReNm � 2 Supplemental ReWm � 3.RemainCe�ReNm(tlate of dealh P�iorto 12-1J-82) � 4.Agriculcure Exemptio^ 5.PoNre In�erest Compmmise(tlale of � 6. Federal Eslate Tax ReNm ReQuiretl (tlaROldeallonora%er]-0d012� � deathaker124&02) � ]. Decetlen�Dietl Tes�ate ❑ 8.Oecedent Maintained a Living Trust _ 9.Tolal Numbet of Safe Deposit Boxes (AttacAmpYotwill.) (AllachwPYo(Wst) � 14 Litiga[ion Proceeds Receivetl ❑ ��'�Sche ru eaF antl G Asselsonly) � �Z.DeferraVEleIXion of Spousal Trusts ❑ 13. Bvsiness Assels ❑ 14.Spouse is Sole BeneFciary (No Wst involved) CORRESPONDENT�THIS SECTION MIIST BE COMPLETEO.ALL CORRESPONUENCE NND CONFIDENTIFL TAX INFORMATION SHOIILO BE DIRECTEO T0: Name Daytime Telephone Number M U R R E L W A L T E R S , I I I E S Q 7 1 7 6 9 7 4 6 5 0 Firsl Line of Nddress 5 4 E • M A I N S T R E E T Secontl Line of AtlCress CRyorPostOKce 5[ate ZiPCoae o M E C H A N I C S B U R G P A 1 7 � 5 5 3 �'01 � � � UJ Z1 � — O CorrespondenPse-mailatltlress: muf�el(4lWalt¢�sa311owaycortl � � � <�� n REGISIER F_'��SU�NL a O .l O REGISTEROFWILLSOSEONLY i --� � -TJ 'q �1 DATE FlLEO MMODYVYY ��> -� 3 - '� < � , i--� r m ti r n� (n � . W �ATE iIlEO STAMP PLEASE USE ORIGINAL FORM ONIV Side 1 ! L IIIIIIIIIIilllllllllllilllllllllllllllllllllllllllllllllllll 1505614134 1505614134 � � 1505614234 REV4500 FX(Fl) DecetlenCs Sociai Securily Number oeceae�rsName: EVELYN I• HELLER � 4 5 5 2 RECAPITULATION , Ls � 311 . oa 1. Real Esta�e(Schetlule A) ... .. ...... ... ... ..... ..... . ...... ...... .. . Z s339o . s6 2 S�ocks and Bonds(5chedule BI . .. ..... .. . ..... .... .. .. .. .. ...... .. .. 3. Closety Held Coiporation, PaMership or Sole-0ropnetorship(Stlietlule C) .. .. . 3. � 6. MOM1gages antl Notes Receivable(Schedule�) .. .... ...... .. ... . .... .. .. 4. � 2 0 6 8 7 6 . 4 9 5. Cash,Bank Deposits antl Miswllaneous Personal Pmperty(Schetlule E�.. .. ... 5. 6. Jointly Owned PmpeM1y(Schetlule F) ❑ Separa�e Billing Requestetl ... . ... 6. ' Z Inter-Vivos Transfers 8 Miscelianeous Non-0mbafe Pmperty L 0 7 9 8 5 , 1 2 (Schetlule G) � Sepa�ate Billing Requesletl .. ._. . . l. B. ToGI Gross Assets(tolal Lines i ihrough]) .... .. .. ..... ... .......... . e. 5 2 5 5 6 3 . 1 7 9. Poneral Expenses ane Administrative Costs(Schedule H) .... . . .. .. 2 8 1 4 0 . 6 5 . .. . .. .. 9. 10. De�ts of Decetlent,Mohgage Liabili[es.antl Liens(Schedule I) .. .. ... 10. 5 7 8 9 . 8 0 ��, Total DeEuctiore potal Lines 9 and 10) .. _ . .. ._ _._ ...�.. . . ..- 11. 3 3 9 3 0 . 4 5 12. Nel Value of ESG[e(Line 8 minus Line 11) . ... . . .. .. . . 12. 4 9 L 6 3 2 . 7 2 . .. .. .. . ... .. .. . 1J. Charitable antl Governmental Beques�s/Sec 9113 Tmsls forwhich " an eleclion lo�az has not been matle(Scheeule J) .... .... . . ..... .. ..... 16. Net Value Subjec[lo Taz(Line 12 minus Line 13) . .. .. .. .... .. .... .. . 14. 4 9 1 6 3 2 . 7 2 TAX CALGULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amom�of Line 14laxable al the spousal tax rate,or hansfers unEer Sen 9116 (a)(1 2)X.0 _ � . � � 15. � . � � tfi. AmounlofLinetbtaaable y 9 1 6 3 2 . 7 2 ts. 2 2 1 2 3 . 4 7 al lineal re�e X-�45 iZ AmountofLinel4taxable � . a � 1]. Q • � 0 at sibling rale X.12 18. qmount of Line 14laxable ❑ , � Q 18. � • � � at collateral rate x.15 19. TAX DUE . . 19. 2 2 1 2 3 . 4 7 .. . ........... ....... ..... ... .......... ...... .. ..... 20. FILL IN THE OVAL If YOII ARE REpUESTING A REFUNO OF AN OVERPAVMENT ❑ USVueencortect ntlm plee0aedard�ionolprepreNONeruNanNeperson�resmponsl�ble%fln9tne�rewm�ibaseUontla111in�fwmafionofwtiicM1prepaerM1aslief. anY��9e. SIGNATU F PER PONSIBLE FOR FILING RENRN DATE ��- a7- �CJ/S qODRESS TODD D- L R � 2 S • BROAD ST- MECHANICSBURG PA�1E�55 SIGNATUREOF P E HANPERSONftESPONSIBLEFORFlLINGTHERETURN � �G/� ADORE55 MURREL R • WALTE , III, 54 E- MAIN ST MECHANICSBUftG PA 17055 IIIIIIIIIIIIIIIIIIIIII'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Side 2 L 1505614234 1505614234 � REV-1500EX (Fp Page3 FileNumber DecedenYs Complete Address: z� �5 007� pECEDENPSNAME EVELYNI. HELLER STREETAODRESS 224 S. YORK STREET CIN STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: t. Tae Due(Page 2,Line 19) (1) 22.123.47 2. CreditslPayments A.PnorPayments _ 21,000.00 B.Discaunt '1,050.00 (SeeinsWctions.) TolalCredils(A+B� (2) 22050.00 3. In�erest (g) 4. If Line 2 is greaterthan Line 1 +Line 3,enler Ihe tliRuence.This is Ihe OVERPAYMENT. Fill in oval on Page 2,Line 20 to�equest a refund. (4) 0.00 5. IfLinel .Line3isgrealer�hanLine2,enlerNediRerence.ThisislheTAXDUE. �5) 73.47 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS 1. Did decedenl make a transfer and: Yes No a. retain the use or income o�Ne PmPe�Y trans(ertetl _....._...........................__......_................... X b. relain�he n9ht�o designa�e who shall use Ne pmperty Vansferted or ils income ................._............ ❑❑ O c. retainareversiona7inleresl ....._............_........_........._................_........_..................._._...... � � d. receive�hepmmiSefoNi�eofeiUerpayments,benefLsorcare? ........._......._._......_......_............... 2. If dealh occurted afler Dec.12,1982,did tlecedenl lransfer pmpetly wilhin one year of tlealh ❑ ❑ wiNONreceivingadeQualemnsiderafion? ....._... --- X ......................_............_................................ 3. Did decedent own an'in Wsl�ol'or payable�upondealh bank accoun�or security al his or her dealh? .._..... ❑K ❑ 4. Did tlece0enl own dn intlividudl retirement daouni,annuity or olher nompmbate pmperly,which conlainsabenefuarydesignation?...........__......_........_........._._................._........................_.._.. ❑ ❑X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,VOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Por tlates o�tleath on or atter July 1,1994,and hetore Jan. 1,1995,ihe taz ra[e impose0 on ihe net vaWe ot trans(ers tu or for ihe use ot IDe surviving spouse is 3 percent�72 P.S.§9116(a)(1.1)(i)�. Por dales of death on or after Jan. 1, 1995,Ihe tau ra�e imposed on Ihe nel value of Iransfers lo or for Ne use of�he surviving spouse is 0 percent [!2 P.S.§9776(a)(7.1)(ii)�.The sWtute does no�exempt a transfer m a surviving spouse imm tar,antl IDe staWtory requiremenis tor disclosure o�asseLs and filing a lax return are siill applicable even if Ihe surviving spouse is Ne only beneficiary. For dales of deafh on or afler July 1,2000: • The ta�c rate imposed on the net value of Uansfers hom a deceased child 21 years of age or younger at dealh Io or for Ne use of a naWral parenl an adoptive parent or a slep-parent of the child is 0 percenl[/2 P.S.§9116(a)(12)�. • The tax rate imposetl on Ne net value of Vansfers lo or for Me use ot me tlecedenCs lineal bene�icianes is 45 percent,except as noled in[72 P.S.§9116(a�(1��. • The tax rele imposed on ihe ne(value of iransfers to or for ihe use of Ne decetlenfs siblings is 12 percenl�72 P.S.§9116(a)(1.3)�.A sibling is defined, under Section 9102,as an individual who has at least one parenl in common with ihe decedenL whe�her 6y blood or adop�ion. REV-15W EX�(4-12) pennsylvania SCHEDULE A oEPu:rmer+rovaEvexue REALESTATE INHEWiPNCEtAYPENRN RESIDEMOEWDENi ESTATE OF: FILE NUMBER: EVELYN 1. HELLER 2'I 15 007'I NI real properry ovmed solely or as a lenant in common must 6e reported al fair market value.Fair maAee�value is defned as the pnce atwhich pmpetly wa10 be exchange0 helween a willing buyer aiM a willing seller,neither being campelled�o buy or sell,hoth having reasonahle knowledge of the relevant fads. fteal property�ha�is jointlynwned with right of survivorship must 6e disclose0 on Schedule F. Atlach a coDY of�he settlemenl shee�if Ihe pmpetly has been sd0. VAW E AT DATE ITEM IncluDeacoDYofNedeedshowingdeceaenfsin�eresli(ownedaslenantincommon. pFDEATH NUMBER DESCRIPTION 1 224 S.YORK STREET 157,31'I.00 MECHANICSBURG, PA'17055 ASSESSEDVALUE-158,900.00 X COMMONLEVELRATIO -.99 TOTAL(Alw enler on Line i,Recapitulalim.) b �57 3'I 1.00 aEv-isoa ex�(e-iz� pennsylvania SCHEDULE B �EPARThIENTOPREVENUE STOCKS 8� BONDS INNEWiANCEiPXPEIURN RESIpENiDECE�EM FILE NUMBER ESTATEOF EVELYN I. HELLER 2'I 15 0071 All property join[ly owned wilh righl of survivorship must be tlisclosetl on Schedule F. VALUE AT DATE ITEM OF DFATH NUMBER DESCRIPTION t. THEALLSTATECORPORATION 34,640.68 %WELLSFARGO 2. MORGAN STANLEY '10,323.40 %COMPUTERSHARE 284 SHARES 8,426.28 3. DISCOVERFINANCIALSERVICES %COMPUTERSHARE 142SHARES TOTAL(Aiso ente on Line 2,RecapiNlation) S 53 390.56 aev-isae ew�ae��z) pennsylvania SCHEDULE E oEvuerxen*oraever+ue CASH, BANK DEPOSITS 8 MISC. iHxEairuacEraraEruw+ pERSONAL PROPERTY aEsioEN*oECEOEr+r ESTATE OF: FILE NUMBER: EVELYN I. HELLER 21 15 0071 InGude�he pmceetls o(Iiiigation antl Ihe tlate the proceeds were received by the estate. All p�operty joinfly owned wi[h right of survivorship mus[be disclosed on Schetlule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS'ISTFEDERALCREDITUNION 1,6'I5.5'i CHECKING 2. MEMBERS'IST FEDERAL CREDIT UNION 99�9�2'sa SAVINGS 3. MEMBERS'ISTFEDERALCREDITUNION 96,767.7'i MONEYMARKET 4. AUTOMOBILE 4,726.00 2006 CHEVROLET MALIeU KELLEY BLUE BOOK VALUE 5. INTERNAL REVENUE SERVICE 293.00 2014FEDERALINCOMETAXREfUND g, PENNSYLVANIADEPARTMENTOFREVENUE 250.00 2014 RENT REBATE 7. NATIONWIDE 112.25 CARINSURANCEREFUND 8. HOLY SPIRIT HOSPITAL 35.00 REFUND g. HIGHMARK HEALTH INSURANCE 656.00 REFUND '10. VERIZON B.4Z REFUND 11. HOUSEHOLD CONTENTS 2,500.00 TOTAL(Also rnleron Line 5,RecapiWla6on� E 206 876.49 If more soare is neetletl.use atltlitinnal sM1eets nf oaoerof ihe same cize.. eev-�sm ex+(aa os� pennsylvania SCHEDULE G oeoaa�e�+rorae�r+�E INTER-VIVOSTRANSFERSAND iHnewrnxcErnxr+�ruw+ MISC. NON•PROBATE PROPERTY REsmErvroECEOExr ESTATE OF FILE NUMBER EVELYN 1. HELLER 2'I 15 0071 This sclietlule musl be ampleleE and fileE i�Ne answer to any o(QuesUms 1 Nrough 4 on page Nree olNe REV-0500 is yes. DESCRIPTIONOFPROPERTV OATEOFOEATH °/OFDECD'S EXCWSION TAXAB�E REM ixrx�oemew�aeorMErwivsfea¢m�iaaannoxsrvi>rao[ceoeuru+o w NUMBER txEosrtoriwwsr�+.n*r+cx�caProrm[o�n�onR�esrnr�. VALUEOFASSET IMEREST nrwNrwan 1. MEMBERS'ISTFEDERALCREDITUNION 72,233.'16100.00 72,233.�6 IRA P.O.O.TO SONS,TODD, CRAIG,CHRIS&MARK HELLER 2. MEMBERS�ST FEDERAL CREDIT UNION 17,675.98 100.00 '17,875.98 CD P.O.D.TO GRANDCHILDREN,CASEY L HELLER&CIDNEY L HELLER 3. MEMBERS'IST FEDERAL CREDIT UNION 17,675.96 100.00 ��8�5�9g CD P.O.D.TO GRANDCHILDREN,ZACHARYR.HELLER BLAURENIHELLER TOTAL(Also enler on Line 7,RecapiWla�ion) E 107 985.12 11 m�m.ceure is n>Men use aAnilnnal cneats nl�rer nf Iha samn sioe aev-�sn ex.(oe-ia) pennsylvania SCHEDULE H oEaaatmenroFaevEH�e FUNEf�.LEXPENSESAND iHxewraxeer�eaE�uw+ ADMINISTRATIVE COSTS RESIOENTDECEDENT ESTATE OF FILE NUMBER EVELYN I. HELLER 21 '15 007� Oecedenfs Eebis must be reporteE on Schetlule I. ITEM qMOUNT NUMBER DESCRIPTION p. FUNERALE%PENSES: 6,573.53 1. MALPEZZI FUNERAL HOME, MECHANICSBUftG 2. HOSS'S-FAMILY DINNER 234.94 3. GINGRICHMEMORIALS -TOMBSTONE 380.00 g, ADMINISTRATNE WSTS'. �. PersonalRepresentativeCommissions'. Name(s�o�PersonalRepasen�a6+e(s� TODDD. HELLER 4,000.00 sbeetnearess Z07 S. BROAD STREET C;ry MECHANISBURG S�a�e PA nP 17055 YeaQs�Commission PaiG: p AnomeyFeu: MURREL R.WALTERS, III 15,700.00 3. FamiyExemptim:�1ltltzdenCsa�tlreuisnolNesameasGaimanCs,allachexplana6on.) ClaimaN 51ree�AJeress Ciry Sm�e LP ReWtionship olGlaimant lo Oecedenl 4. ProbateFees�. CUMBERLAND COUNN REGISTER OF WILLS 470.50 5 AaounlantFeS: 6. TUReWmPreparerFeas: FLOYDFAHNESTOCK-20'14FEDERAL&STATETAXES 40.00 7. PENNLIVE-ESTATENOTICE ��'02 8, CUMBERLAND LAW JOURNAL-ESTATE NOTICE 75.00 9, COMPUTERSHARE-STOCK SALE FEE 489.66 TOTAL(AlsoenteronLine9,Recapitulalion) S Zg �q0.65 If more space is neetled,use adtlitional shee6 of pape�oi 1he same s've. REv-isix En.(iaiz� pennsylvania SCHEDULE I oevnarMeN.oraEVExue DEBTS OF DECEDENT, iHxewrnNce.aYaEruaH MORTGAGE LIABILITIES & LIENS RESI�ENTDECEDENt ESTATE OF FILE NUMBER EVELYNI. HELLER 2'I 15 0071 RepoA tlebis incuned by the d¢cedent prior to dealh Nat remained unpaid at the dale ot dealh,including unrelmbursed mediwl expenses. ITEM VALUE AT DATE Nl1MBER DESCRIPTION OF DEATH �. COMCAST 2fi4.86 TELEVISION �. 2. KOHL'S 97.�3 CREDIT CARD 3. MEMBERS'IST 428'9� CREDIT CARD 4. VERIZON 28.41 PHONE 5. HOLY SPIRIT EMS 100.00 ' AMBULANCE 6. BOROUGH OF MECHANICSBURG 13'1.00 SEWER&TRASH 7. UNITED WATER 60.76 �� WATER 274.54 8. PPL ELECTRIC g. CAPITAI CITY OIL 351.00 FUEL OIL '10. KUHN BROTHERS OIL SERVICE 359.85 �� FUEL OIL �'� '11. DONEGAL INSUftANCE GROUP 335.00 HOMEOWNERSINSURANCE �2. HIGHMARKINSURANCE 656.00 MEDICAL 13. HOLY SPIRIT HOSPITAL 535.00 MEDICAL 14. CHRIS HELLER 459.70 CARPET FOR HOUSE �5. BOROUGH OF MECHANICSBURG 825.00 SIDEWALK REPLACEMENT TOTAL(Also enler on Line 10,RecapiWlation� S 5 789.80 I!more space is neetletl,inseR atltliiional shee�s of the same sae. Continuation of REV-1500 InheriWnce Taz Return Resident Decedent � EVELYNI. HELLER 21 75 0071 Decetlenfs Name Page 1 File Number Schedule 1-Debts of Decedent, Mortgage Liabilities, & Liens ITEM AMOUNT NUMBER DESCRIPTION 16. BARRY L. HECKARD, SR.,TAX COLLECTOR 882.64 2015 COUNTY(fOWNSHIP TAXES SUBTOTAL SCHEDIILE I 88Z.64 GRANDTOTALSCHEDULEI (Alwen�eronLinelO,Recaqlulation) E 5,789.80 REV ISll E%�101-ID) pennsyivania SCHEDULE J oevuem+eNr oF aeveuue BENEFICIARIES INHERIiANCEiRXfVETURN IiE510ENi pECEDENi ESTATE OF: FILE NUMBEft: EVELYN I. HELLER 2'I 15 0071 RELATIONSHIPTODECEDENT AMOUNTORSHARE NUMBER NAMEANOADDRESSOFPERSON(S)RECEIVINGPROPERN DallotLislTrustee�s) OFESTATE ' TA%ABLEOISTRIBUTIONSP^GSc.9L11g6(e�P(1.2jlJtlisNbWonsandlranskrsuntler 1. TODD D. HELLER Lineal 207 5. BROAD STREET MECHANICSBURG, PA 17055 2. CRAIG A. HELLER Lineal 224 5.YORK STREET MECHANICSBURG, PA'17055 3. CHRIS A. HELLER Lineal 469 WOLF BRIDGE ROAD CARLISLE, PA 17013 4. MARK L. HELLER Lineal 224 5.YORK STREET MECHANICSBURG, PA 17055 5. ZACHARY HELLER Lineal 207 S. BROAD STREET MECHANICSBURG, PA 17055 6. LAUREN HELLER Lineal 207 S. BROAD STREET MECHANICSBURG, PA 17055 7. CASEY HELLER Lineal 469 WOLF BRIDGE ROAD CARLISLE, PA'17013 EMER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LMES 15 THROUGH 18 OF REV4500 COVER SHEET,PS APPROPRIATE. �I. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL�ISTRIBUTIONS 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-TA%ABLE DISTRIBUTIONS ON LME 73 OF REV-1500 COVER SHEET. E If more space is needed,use addilional sheets of paper of ihe same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent EVELVNI. HELLER 21 15 0077 Decetlent's Name Page 2 File Number Schedule J -Beneficiaries -1 RELATIONSHIPTODECEDEN7 AMOl1NTORSHARE NUMBER NAMEANDAOORESSOFPERSON(S�RECEIVINGPROPERTY OONolListTmslee�s) OFESTATE � TAXABLEDISTRIBUTIONS pndueeouvqhtspousaltlisNbutionsandtransfersunGer Sec.91161a1112�.� 8. CIDNEY HELLER Lineal 469 WOLF BRIDGE ROAD CARLISLE, PA 170'13 �� Qi�°��°�+� ��a`�'� �