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REV-1500 �x `°�,,,`�°
OFFICIFLl15E ONLY
PA�epaRmen[of Revenue Counry Goie Year File Number
aureau ot Intlivitlual Taxes INHERITANCE TAX RETURN
POBOX280601 RESIDENTDECEDENT 21 14 0765
Harrisbur . PA 1]12&0601
ENTER DECEDENT INFORMATION BELOW
Social Securiry Numbe�
Date Of�¢a�h MM�OYVYV �2te of Birth MMD�YYYY
1 0 9 0 3 2 0 � 6 � 4 1 6 1 9 2 6
Suffix Decetlent's First Name MI
DecedenPs Last Name T
B I X L E R C A L A N T H A
Qf Applicable)Enter Surviving Spouse's Information Below Suffx Spouse's Firs�Name ��'
Spouse's Lasf Name
Spouse's Social5earity Number
THIS RETURN MUST BE FILED IN �UPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW 3. Remainder Retum(Date of Death
O L Oriqlnal Raturn � 2. Supplemen[al ReNrn � prior to 12-13-827
� 4. Limitetl Estate � 4a. FUNre Inferesf Compmmise(tlate oi � 6. Federal Esta:a Tax ReNm ReqWretl
death afterl2-12-82)
� 6. Dec�tlent Dietl Testate ❑ �� Decetlenl Maintainetl a Living Tmst _ 8.Total Number oi Safe Oxposi�Boxes
(Attach Gopy of WIII) (Allach Copy ofTmst)
� 9. Litlgebon Pmceatls Receivetl � 10. Spousal Povetly Credlt(Date'f Dea[h � ��'EA��ecM1 Schedule O)r Sec.9�13(A)
BeN+een 1231-91 antl 1-1-95 (
CORRESPONDENT-THISSECTIONMUSTBECOMPLETEO.FLLCORRESPON�ENCEAN�CONFI�ENTIA�L��eTelephTooeNu00bDBE�IREGTE0T0:
Name
7 1 7 2 4 9 7 7 8 �
S U S A N J • H A R T M A N _
REGISTER OF WILLS US�ONL`[A
c o m
_ A Z1 f,J �
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FiStLineofAdd�ess '. �' N �
1 I R V I N E R 0 W � " . s �'�' '
Sacond Lice of Adtlress I ' � '_ �
.. � ��::�. � 1a'
� DAjEFlLED�. �— �
Gty or Post ORice State ZIP Cotle , N � o
C A R L I S L E P A 1 7 0 1 3 '- � -9
corresPonaenrs e-me�i aaaress: susanno duncanhartmanlaw com _
Untler penalties ot periury,I tleGare tM1at I have examinetl Ihls reW m,Intluaing acwmpanyin9 scheaules antl statements,antl�o��vreparer my k�y��leage ane�ellei,
itlstme,mrredantlwmpleb.Declara- nofprepareroIDerNanlM1epersonalrepreun�ativelsbasetlonalllniormalionofwM1icn �hATEnxnowlea
SIGN P O R50 0 BL ORFlLINGRETURN
noo ss CARLISLE PA 17015
6 LINDSAY LANE DA7E
SIGN TLREOFPREPHRE HERTHAN REPRESENTATNE �
A �RE55 �/
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15�561014� 1505610140 � ��.
✓
J Lsos61o240
REV4500 E%(Fl) Decedenfs Social5earity Number
1 6 2 2 2 3 8 6 2
oeceaeor:r+ame: CALANTHA T • BIXLER
RECAPITULATION
1. RealEs�a�e(Schetlule A7 . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .
1.
2. StocksandBonds(ScheduleB) . . . . . . .. . . .. . . . � � � " '- '- � " - "" ' - � " '
2
3. Glosely Heltl Corporation.PaM1nership or Sole-0mprie�orship(Schedule C) - � . �
3 �
. . . . . . . 4. �
4. Mortgages antl Notes Recervable(Schedule - � � � � � � � �� �� � - 2 $ O O . 0 O
5. Cash,eank Depasits and Miscellaneous Personal PropeM1y(Sc�eCule E). . _ . . . 5.
6. �
6. Joinlly Ovmed Pmperty(Schedule F) ❑ Separale Billing Requestea . . . . - � - O . O Q
Z Inler-Vivos Transters 8 Miscellaneous Ny�-PSepa a erBileng Requestetl . . . . . . . l.
�Sche0o1e�> � a s a o . a o
.. .. . . . . . . . . . 8.
B. ToUI Gmss Assats Qotal Lines 1 ihrough]) . .. . . .. � � � - � 4 7 O . $ O
9. Funeral Expenses and Administra[ive Costs(Schetlule H) . . -. � - � � �
. . . . . . . . . 9.
antl Liens(Scheaule q . - � � � -� � � ��-
10. Debls of DecedenL Morigage Liabilities, " ' -
��. Total OeducGons(ta�al Lines 9 antl 10) . . . .. .. . . .. .. . . . .. . . . . . . .. . . .
,, v 7 0 . s o
12. Ne[ValueofEstate�LineBminusLinell) . . . .. .. . . . . . . . .. .. � - � � � � � � � �
12 2 � 2 9 . S �
13. Cha�itable antl Govemmenlal BequeslslSec 9113 Tmsts br which 13 ,
an eleclion�o taz has not been made(Sc�etlule J) . . . . . . . .. . . . �
. �q 2 � 2 9 . 5 �
14. Net Value Subjec[to Tax(Line 12 minus Line 13) . . . . . . . .
TA%CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amowt of Line 14 taxable
at ihe spousal tax rate,ot 0 . O O
�rawfers untler Sec.9116 Q , 0 � �5,
(a)(L2)X.0 _
is. nmountoruneia�zxame 2 0 2 9 . 5 0 �5. 9 1 . 3 3
at lineal rote x .�5
1]. Amount of Line 14 taxable � � � �7 � • 0 �
at sibiing rete X A2
18. Amount of Line 14 taxable � . � � 18. � � � �
a[collateral rate %.15
. . . . . . . . . . . . . .
19 9 1 • 3 3
19. TA%DUE . . . . . .. . . .. . . . .. . . . .. . . . . . . . . . . . . . . . . .. .
20. FILL IN THE OVAL IF VOU ARE REOUESTING A REFIINO OF AN OVERPAYMENT �
Side 2
L 1505610240 1505610240 J
File Numbe�
aev�isoaex�Fq aage3 2� �q 0765
DecedenYs Complete Address:
DECEDENT'SNAME
CALANTHAT. BIXLER — -
sraeer aooaess ._
29 FAIRFIELD STREET
STATE ZIP
arv pq 17013
CARLISLE
Tax Payments and Credits: ��� st.33
�. Tax Due(Page 2,Line 19)
p. CreditslPayments
A.Prior Payments
B.DlscouN Tolal Credits(A+B) (2) 0.00
3. Interesf (3)
4. If Line 2 is grea�erthan Line 1 t Line 3,en�enhe diNerence.This is Ihe OVERPAYMENL �4) 0.00
Fill in oval on Page Y,Line YOIo requesta refund.
(5) 91.33
5. If Line 1+�ine 3 is 9reater Ihan Line 2,enler Ihe diHerence,This is�he TA%DUE.
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Ves No
1. Ditldecedentmakeatransferand'. X
a. re�ain�heuseorincomeof�hepropertyUansferted .......... . ............._ ���-��� �-- x
b. re�aintherighttodesigna�ewhoshalluse�hepmpertytransferredoritsincome
0 0
c. relain a reversionary interesl . .........._.. ................. ....._. X
d. receivethepmmise�orlifeo�eitherDaymenis benefitsorcare� ._...._ �������� -�-
p. If death ocarrad aflar December 12,1982,eid decedenlVansfer pmDedy wlihln one year of dea�h ❑
...._ ...._............_...... ❑ O
withoutreceivinqadequateconsieeralion? .. ..._.......... ����� x
3. Oiddecedemownan'in�ms�toforpayable-upondealhbankaccountorsewriryat�isorherdeath? ......_. ❑
4. Did tlece0ant own an individual re�irement account,annuity or o�her nonpmbate pmpetly,which ❑ ❑
containsahenefmiarydesignation? ......... ........._...... . ....._........
._._._.... _....... X
IF THE ANSWER TO ANY OF THE ABOVE Ql1ESTI0N51S YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Far dates of death on or after July 1, 1994,and before Jan.i, 1995,�he lax re�e imposetl on lhe net value of iransfers to or far fhe use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or afler Jan. 1, 1995,the�ax ra�e imposed on the ne�value of transfers to or for Ihe use of the surviving spouse is 0 percen�
[/2 P.S.§9116(a)(1.1)(li)�.The staWte does not exemp�a iransfer�o a survlving spouse from tax,and lhe staWtory requirements for dlsdosure of assets and
fling a�ax reWm are still applicable even if ihe surviving spouse is lhe only beneficiary.
For dates of tleath on or after July 1,2000�,
• The tax rate imposed on ihe net value of trensfers 6om a deceased child 21 years of age or younger at death lo or for ihe use of a naNral parent an
adoptive parent or a sfepparent of the child is 0 percent[72 P.S.§9116(a)(12)�.
• The�ax rate imposed on the net value of transfers to or for the use of the decetleN's lineal beneficiaries is 4,5 percen�,excep�as notad in��2 P.S.§5n61e1f�)I.
• The tax rate Imposed on ihe net value of transfers to or for the use of Ue decedenfs 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 parenl in common with the decedenl,whether by blood or adoption.
aev-+soe ex.(oe-+2)
pennsylvania SCHEDULE E
oePnarMer+roF ReveNue CASH� BANK DEPOSITS 8 MISC.
iNHERirnrvcErnxaEruar� pERSONAL PROPERTY
aEsioENr oECEOEN* FILE NUMBER:
ESTATEOF. 21 i4 0765
CALANTHAT. BIXLER
Inclutle�he pmceeds ot litigation antl tM1e tlate tM1e proceeds were received by lhe estate.
All property)ointly ownetl with righl oi survivorship musl be tlisclosetl on Schetlule F VAWE Ai DATE
ITEM OF DEATH
NUMBER DESCRIPTION p,500.00
�. DOWCORNINGTRUST
[DATE RECEIVED 11I20/2014]
Tp7AL(Also enteron Line 5,RecapiWlation) $ 2500.00
If more space is neetled use atltlitional sheets of paper af the same size.
aev-�eio ex�(ae-ae)
pennsylvania SCHEDULE G
oEpaarMEH.oFaeve�+ue ry�STC. NON PROBATE PROPERTDY
INHERITANCE iA%RRIIRN
aEsioErvr oECEOErvr FILE NIIMBER
ESTATEOF � pt 14 0765
CALANTHAT. BIXLER
This schetlule must be wmpleted and filed it Ne answer to any oi QuesOons 1lhmugA 4 on Dage Nree ol lhe REV-0500 is yes.
DESCRIPTIONOFPROPERTV DATEOF�EATH %OFDECD'S EXCLUSION TAXABLE
VALUEOFASSET INTEREST �e�ei VAWE
ITEM IrvC�7XEOPiEOFiPPNSFfRpAII2LHAECOMOfiEroEEOFOPBFALESiAENo Q.00
NUMBEft
i
TOTAL (Also en�eron Line 7,RecapiWlation) $
�.��
If more soace is neetled,use atlditional shee�s of paper of Ne same size.
vev-�si�ew�m-�o�
pennsylvania SCHEDULE J
oeaaarmEur oF aevEHue BENEFICIARIES
INYCRItANCE iAX REiURN
reEsioEr�r oECEOEN* FILE NUMBER:
ESTATEOF: p� 14 0765
CALANTHA T. BIXLER REU+TIONSHIP TO DECEOENT AMOUNT oR SHARE
NUMBER NAMEANDAODRESSOFPERSON(S)RECEIVINGPROPERTV �allotLiatTrvstee(s�
OF ESTATE
I TAYJ�BLEDISTRIBUTIONS PncWSec.9116(aj�jp�Itlistn�utionsanE�anstersuntler
t. SUSAN E. COWLEY Lineal
1/3 SHARE
216 PINTAIL LAKE DRIVE
GILBERT, SC 29054 Lineal
2. SALLY BOBB 1/3 SHARE
275 HIGH MOUNTAIN ROAD
SHIPPENSBURG, PA 17257 Lineal
3. WILLIAM H. BIXLER, JR. 1/3 SHARE
60 LINDSAY LANE
CARLISLE, PA 17015
ENTER�OLUR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LWES 15 THROUGH 18 OF REV4500 COVER SHEET,AS APPROPRIATE.
��, NON-TAXABLEDISTRIBUTIONS',
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9173 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 LWE 13 OF REV4500 COVER SHEET. 5
I�more space is needed,use additional sheets o�paper of Ihe same size.