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Home My WebLink About04-08-15 V.fY pennsytvania 15051214105 EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Box 1 INHERITANCE TAX RETURN Ha T13_ I I Harrisburgrg,, PAPA ENT 17128-0601 RESIDENT DECED ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 02162013 y 11071922 Decedent's Last Name Suffix Decedent's First Name MI RUDY BETTY Ll (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 m 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Agriculture Exemption(date of 5. Future Interest Compromise(date of 0 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) O 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 O 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 GRETCHEN L. BEARD. (717) 319-6014 First Line of Address 23 HILLCREST ROAD n Second Line of Address G C�j ::U n <D,-t� City or Post Office State ZIP Codej p ENOLA PA 17025 Correspondent's email address: REGISTER OF WILLS-ftE ONLY REGISTER OF WILLS USE ONLY _, _ �.� DATE FILED MMDDYYYY DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 i 111111 11111 11111 11111 150 6 41� �iiiii ilii 11111 11111 ilii ilii J 5 1505614105 1505614205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: BETTY L. RUDY RECAPITULATION 1. Real Estate(Schedule A). ............................................ 1. 2. Stocks and Bonds(Schedule B) ...........................:........... 2. 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)....... 5. 2,846.52 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ..... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets total Lines 1 through 7 8. 2,846.52 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 11. Total Deductions(total Lines 9 and 10)................................. 11. 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 2,846.52 13. Charitable and Governmental Bequests/Seca 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. 2,846.52 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. 16. Amount of Line 14 taxable at lineal rate X.0 45 16. 2,846.52 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ......................................................... 19. .128.09 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O 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. SIG ATURE OF PERSON RESPONSIBLE OR FILING RETURN DATE -4,_ o/ 0 3 ADDRESS 03 14,'l(g_f es� me).,, Z no/,z 76 2_s Z1, !7 SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS 1111111111111111 11 111[11�JJJJ�JPJJJJJJJ 1111111111111 Side 2 5 4 1505614205 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME BETTY L. RUDY STREET ADDRESS GOLDEN LIVING & REHABILITATION CENTER, 705 POPLAR CHURCH ROAD CITY STATE ZIP CAMP HILL PA 17011 . Tax Payments and Credits: 1. Tax Due(Page 2;Line 19) (1) 128.09 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (2) 0.00 3. Interest (3) 5.19 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 133.28 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.......................................................................................... ❑ N b, retain the right to designate who shall use the property transferred or its income ............................................ ❑ N c. retain a reversionary interest .............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ N 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 0 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ N 4. Did decedent own an individual retirement account,annuity or other non-probate property,which containsa beneficiary designation? ......................................................................................................................... ❑ ■ 1F 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 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. I a i�otal Control Account' June 2012 Account No. 4042882030 Statement Period From 4/01/12 To 6/30/12 Page I of I SH-37419-TCAlPGI0 BETTY L RUDY Your Representative: WALK GERALD L 205 ENOLA RD ENOLA PA 17025-2414 Branch servicing PENNWOOD FIN GROUP your account: 4905 TILGHMAN ST STE 200 ALLENTOWN PA 18104 Telephone: (610) 398-0100 Customer Service: (800) 638-7283 We want to remind you that you will receive a statement at the end of each quarter, itemizing the recent -=i%ty-coff yo—u r Tat-di Co fit-ro I-Wd-co-u n-T-. Y-oiFr sta-t-e-m--e-n-fi-n-61U-des details-o--n-We-deafts-that--cle-d-rea-yo—ur"° C� "— since the previous statement, the amount of interest paid, and other important information. You will receive a monthly statement for any month in which you have activity on your TCA, and your quarterly statements also include transactions that already may have appeared on monthly statements during the quarter. TCA SETTLEMENT OPTION EFFECTIVE ANNUAL YIELD 3.00% AS OF 06130112 Account Summary ------------- A --------------------- NIB N* ------ $2,765.93 Interest $20.19 $2,786.12 -e $40.21 $0.00 ..........------- ----------- Transaction Details 4/30 Interest" $6.66 5/31 Interest $6.82 6/30 Interest $6.77 G 1 i 2 0 3 0 0 N COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(l 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020425 BEARD GRETCHEN L 23 HILLCREST RD ENOLA, PA 17025 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------— f.ld 101 1 $133.28 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-0516 DECEDENT NAME: RUDY BETTY L DATE OF PAYMENT: 03/30/2015 POSTMARK DATE: 03/27/2015 COUNTY: CUMBERLAND DATE OF DEATH: 02/16/2013 TOTAL AMOUNT PAID: $133.28 REMARKS: CHECK# 5720 INITIALS: DB1 SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAYER