HomeMy WebLinkAbout04-20-15 J L pennsylvania 15056141�5
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REV-1500 OFFICIA�USE ONLY
BureauoilntlividualTaxes CounryCode Vear FileNumber
po eox zao6oi INHERITANCE TAX RETURN `'
Marrisburg, PA t�128-0601 RESIDENT DECEDENT 2� I� � I�N
ENTER DECEDENT INFORMATION BELOW
Social Secmity Number Date of Oea1M1 MMODYVYY Oate o(Blrth MMO�YVYV
03152012 04062015
Decetlenfs Last Name Sutfix Decetlenfs Flrst Name MI
Dodsan Shirley J
(If ApplicaEle)Enter Surviving Spouse's Informalion 8elow
Spouse's Lasl Name SuHlx Spouse's Firs�Name MI
TNIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original ReWm O �� Supplemen�al FeWrn O 3. Remaintler ReNm(Ca�e of Oeat�
pdor l0 12-1b82)
p 4.AgnculW�e ExempOon(date of � i FUNre Inlares�Gompmmise(aele of � B- Fetleral Estete Tax Relum Raquiretl
aealh on or aner]-0-2012) tlealn aner 1242-a2)
m ]. Derztlent Oied Tes�a�e p 8.Der,e�en�Main�ainetl a Living Tmst _ 9. To�al Number of Safe�eposi�Boxes
(AVacM1 coPY of will.) (AVac�coDY of ImsL)
� 10.Litigalion Proceetls Received O 11.Non-Pmbale Transferee ReWm p 12. DeferzaVEledion o(Spousal Tmsls
(Schetlule F antl G Assais Only)
O 13. Business Assels O i4.Spouse is Sole Beneficiary
(No Vus[Involvetl�
CORRESPONDENT- THIS SECiION MUST BE COMFLEiED.ALL CORRESPONDENCE RN�CONFIDENTIAL TA%INFORMATION SHOIILD BE OIRECTEO T0:
Name Daytime Telephone Number
Lintla Barrs p17)421-6298
First Gne ot Atldress
4 Scarsdale Dnve
Secontl Line otAtltlress
City or Posl Off¢e Slale ZIP Code
Camp Hill PA 17011
corresponaent's email aaaress: bizsmom@aoLcom _ _
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PLEASE USE ORIGINAL FORM ONLV
Side 1
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505614 15056141�5 �
� � 1505614205
REv-1500 EX(FI) DecetlenCs Social Securily Number
oP�eeems Name� Shirley Dodson 210-26-9854
RECAPITULATION
1. Real Estafe(Schetlule A). . ... . ... . .. .... .. . . . . ... .... . .. . ... .. . ... ... 1.
2. Stocks and Bontls(Schedule B) .. . . . . ... .. . ... . .. . ... ... . .... . . ... . .. . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(SchedWe C) . .... 3.
4. Mortqages an0 Noles Receivable(Schedule D). .... ... . . . . .... ... ... . .. . . 4.
5. Cash,Bank�eposils antl Miscellaneous Personal Property(Schetlule E). . ... . . 5. s�4Z4.�
6. Join�ly Owned Propetly(Schetlule F) O Separate Billing Requestee . .... .. 6.
1. In[er-Viws Transfer 8 Miswllaneous NomProbate Pmperty
(Schedule G) O Separate 8illing Requested.... . ... ].
8. TOWI Gross Assets(total Lines 1 ihmugh]). .. . ... . .. .... . .. . . . . ... . .. . . 8. 6,424.44
9. Funeral Expenses and Adminishative Cos�s(ScheJule H). ... ... . .. .... . ... . 9. 5,976.68
10. �ebts of�ecetlent Mortgage LiaDilities antl Liens(Schedule I).. . ... ... . ... . . 10. 1.435.90
11. TOWI Detluctions(to�al Lines 9 and 10). . ... . .. . . .. . ... ... . . .. . .. . .. . .. . 11. 7�412.58
12. Net Value oi Estate (Line 8 minus Line 11) .. ... . ... ... . ... ... . . . . . . . .. . . 12. 0.�0
13. Chan�a�le and Govemmental BequesislSec 9113 Trusls�or which
an election ro[ax has not been matle(Schedule J) .. ... . ... . .. . ... ... . .. .. 13. �.��
14. Net Value Subject to Tax(Line 12 minus Gne 13) . . ... . .. . ... ... ... . . .. .. 14. �.�0
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 Uxa�le
alihe spousaltaxra[e,or
transfers untler Sec 9116
(a1�12)%.0- 15_
16. Amount of Line 141axable
at lineal rate X.0 __ �6-
iZ Amount of Line 14 taxable
etsiblingrete % .12 »�
18. Amount of Line 14 taxable
el wlla�eral rete X.15 �8�
14. TAX DUE .. . . .. . .. .. . ... . . .. . ... . ... . .. . . . . ... ... . 19.
20. FILL IN THE OVAL IF VOU ARE REOUESTING A REFUND OF AN OVERPAYMENT O
Unaer penallies al per�ury.I deciare I M1ev netl(M1is relurn,IncWding a mpanyiqg scM1edules entl s�alemen�s,and to IM1e bes�ot my knowlatl9e end belief.
��is ime, c rootan0 mmpie�e_Oeola�alion olpreyarerotM1ertM1an iM1e persoo responsiWe brfiling I�a ralum Is Oasetl on alllnforma�ion ofwM1icO preparer bas
any knowle0ge.
�I qTUR OFV SONft�5PON51BLEFOftFlLINGRETURN DATE
�j�ti�fw � ' _r,;�. 04I08/2015
aooaEss
4 Scarsdale Drive, Camp Hill, PA 17011
SIGNATURE OF PREPAR[R OTHER THAN PEftSON RESPON516LE FOR FlLING THE RETl1NN DNTC
ADDRE55
���'I�II���I�I�II�IIIIIIIII II�III'II�I�l�lll�l'���I�I�II'�� Side2
L 1505�142�5 1505614205 J
,Hev-isooex �Fp vaqea FilaNumbe�
DecedenPs Complete Address:
oECEOENr�sr�nME �
Shidey Dodson ._ _.. .--
STREETADDRE55 �
108-A South Ront Street __ _.
CITV� .— . . .—.. . STATE � ZIP
Wormleysburg � PA . 17043
Tax Payments and Credits:
L Tax Due(Page 2,Llne 19) (1) OAO
2. CredilslPaymenis
A.Prior Payments _ _ . _ . 0.00
B. Dismum 0.00
(Seeinsimcfions.) To�alCredlts(A+B) (2) 0.00
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 +Llne 3,enter�he diflerence. Thls ls Ihe OVERPAYMENT.
Fill in oval on Page Y,Line 2010 requesl a refund. (a) 0.00
5. H line 1 t Line 3 is grea�er ihan Line 2,enler che difference.This is ihe TAX DUE. (5)_ 0.00
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Dld decedent make a transfer and�. Yes No
a. retain�ne use or income o(ihe pmperty Iransferretl _....._ ............. .............. _.......... ❑ �
b. retain Ihe ng�t to designa�e who shall use�he pmpeny transferred or i�s income .........._.__._...................... ❑ �
c. relainareversionarymterest _.......... ......_..... ....._...._ .........._ ................ ❑ �
d. receive ihe Fromise for life of either payments,bene6ts or care� ........_. ............_... _.......... ❑ �
2. If death ocwned aBer Oec.12. 1982,tlitl decedent trans�er pmperly within one year o�tleafh
withou�receiving adequate consideration? ........._... ......_........ .........._._ ........._.... ❑ �
3. Did deceden�o�vn an"in Imst fof'or payable-upon-dea�h bank accoun�o�searity at his or her tleath?_.,.......... ❑ �
4. Did decetlen�own an intlividual retiremen�account.anrnity or oNer non-probate properry,which
cantainsabenefciarydesignahon7 ..._..... ............ ._....._._ ..........._.. _............ � �
IF THE ANSWER TO ANY OF THE ABOVE�UESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Por dates af death on or after July 1 1994,and before Jan. 1,1995,ihe tax rate imposed on the net value of transfers to or for Ihe use of Ihe surviving spouse
Is 3 percent�72 P�B.@8116(a)(1_1)(i]].
For dates of deat� on or after Jan. 1, 1995, ihe tax rate imposed on the net value of Vansfers to or for the use of the surviving spouse is � percem
[72 PS.§911fi(a)(1.1)(ii�].The staWle dces not exempt a transfer to a surviving spouse from tax,and�he s�aWtory requiremen�s for disdosure of assets and
fling a tax reWm are still applicable even it Ihe surviving spouse is the only beneficiary.
For dates of tleath on or afler July 1,2000�.
. The tax rete imposed on the ne�value o(transfers from a deceased child 21 years of age or younger af death to or for the use of a nalural paren�; an
adop�ive parent or a step-parent of the chlld Is 0 percent[/2 P.S.§9116(a)(12)�.
• The tax rdte imposed on ihe ne�value of iransfers to or for the use of the decedenPs lineal beneficiaoes is 4.5 percen�,excepl as no�ed in�72 P.S.§9116(a��i)].
. The tax rate Imposed on ihe ne�value of Vansfers to or for tha use of the decedenfs sihlings is 12 percent�72 P.S. §9116�a�(1.3)J.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 a0option.
Although I did not legally live with my mother, for the last year or so of my mother's life, I
practically lived with my mother during the day, spending signiTicant amounts of time
taking care of her and running errands for her after she fell and broke her wrist and was
unable to care for herself without assistance. I had also decided that, since my mother
was unable to care for herself without a signficant amount of assistance, my mother
would come and live with me once she had significantly recuperated and recovered
through her stay in the hospital and the rehab hospital; however, she lost her will to live
and passed away before she could move in wdh me.
' REV;�SOBEX.(o&�z)
i pennsylvania SCMEDULE E
� oeanarnrnrarnevexuc Cq$H� BANK DEPOSITS & MISC.
�v��Ea�*A^�E*^*a�a" pER50NALPROPERTY
aes:oeni uecEocrvr
ESTATE OF: FILE NUMBER:
Shidey Dodson
Indude the pmceeds of li[iga[ion ana Me date the pmceeds were receivee by tM1e estate.
All properry lointly owned with right of survivorship must be Oistlasetl an Schedule F.
"' ��M VAWEATONTE
NUMBER DESCRIPTION Of DEATH
� M&T Bank—Checking Account#9852437442 6 qpq qq
TOTAL(Also enter on Line 5, RecapiNlation) $ 6,424.44
If more space is neede�, use additional sheels of Oaper of IM1e same slre.
I... . .SLIF. - .IPI':I �
i pennsylvania SCHEDULE H ,
� oevnxrmenroFnevenu� FUNERAL EXPENSES AND �'
���Ea�T^��E*^*a�a� ADMINISTRATIVE COSTS
aEsmrn�oecroEnr
ESTATE OF FILE NUMBER
Shidey Dodson __,
DecedenPs Eebts must be reporteE on ScheEule 1.
ITEM
NUMBER DESCRIPTION AMDUNT
A FUNERALEXPENSES:
1� Musselman Funeral Home 1.680.00
z. Royers Flowers 300.00
3. Food and Supplies for reception after funeral service 215.18
a. Photo collage 150.00
5. Ministers honoranum 150.00
B, ADMINISTRATNE COSTS:
L Personal Representa[ive Commissions'.
Name(s)of Penonal Representa[ive(s) . . _. . - .
SheetAdtlress
City Sta[e ZIP
Year(sJ Commisson Paid:
2. q[romcy Fees
3. Famlry Exemption'. (If OeceOenPs aeeress ls not Ihe same as daiman['s,attach explanation.) 3,500.00
aa�man[ Linda Barcs
snee�nddress 4 Scarstlale Drive
. ._ _ .. . ..____
ciry Camp Hill . State PA Zla 17011
Helationsnip of claimavt ro oeceaent Daughter .
4. Pmba[e fees: 81.50
5. ncmun[ant rees:
6. iax Retum Prepamr Fees. 50.00
Z
tOTAI(Also enter on Line 9, RecaOiNlation) S 6,126.68
It more space is needeG,ose a0016onal sheets of paper of[he same size.
i pennsyLvania SCHEDULE I
� oEanmmE�vroFnevtrvue DEBTS OF DECEDENT�
�nrraiumcernxae.�,a�+ MORTGAGE LIABILITIES & LIENS
aesioErvr oeceoeNr
ESTATE OF FILE NUMBER
Shidey Dodson
Report Eeb6 incurreE by[he dmedent pnor m Eeath that remained unpaiE a[[he Eate of death,induEing unreimbursed mediral expenses.
ITEM VAW E AT OATE
NUMBEk �FSCRIMION OFOEATH
1� PhoneBill 2�.52
2. Elechic Bill 67.88
3. Rent 1,100.00
a. Newspaper 48.5�
5. Insurance 192.00
TOTAL(Also enter on Line ID,Recapitulatian) ; 1,435.90
if more space is neetled,insert adai6onal sheets of Ne same size.
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
r
'�,_ r(`�.,i
�
No. 2012- 00474 PA No. 21- 72- 0414
Estate Of: SHIRLEVJ�OOSON
rF;,,c mmm..ia,,,
Late Of: WORMLEYSBURG BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No: 270-26-9854 �
WHERE.4S, on rhe Sth day of April 2012 an instrument dated
October 18th 1995 was admitted to probate as the last will of
SHIRLEY J DODSON
rFosc Mwer�i..0
late of WORMLEYSBURG BOROUGH, CUMBERLAND Counry,
who died on the 15th day of March 2012 and,
WHEREAS, a true ropy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CCIMBERLANll County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARYto:
LINDA J WOODRING-BARRS
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARUSLE, PENNSYLVANIA.
ZN :EST1'MONY WHEI2EOF', _T have ..ereunto set my nan� ar.d aifixe] rne �ea:
of my office en the 5th dayofAp�il2012.
.� , . ......._....��, . . l:. . .
. :� 9B�S(E/O( AS . �
OPVury
**NOTE** ALL NAMES ABOVE APPEAR (FIkST, MIDDLE;, LAST)
WILL -
z•.
OF
SHZRLEY J. DODSON �=" -' -
-==r,
s, �..
�� I , SHIRLEY J. DODSON, of the Borough of Wormleysburg, C�rnli�rland �
�I�I�County, Penns�lcania , declare this to �e my last will an� revoke aii� w,i�3� �,
����previously made by me. �.�
f
ITEM L I direct that all my just debts and funeral exnenses , li
II!including my gravemarker and all expenses of my last illness , and any and ��
�lall taxes and assessments imposed bp anp governmental bodp as a result of ��I
imy death , whether on property passing under this will or otherwise, shall i
'ibe paid from my residuary estate as soon as practicable after my decease I
i
jas a part of the ezpense of the administration of my estate. �
ITEM II. I give and bequeath all of my household goods , ��'
i
r:,lllautomobiles, jewelry, and all other articles of household and personal �
��ijuse, equipment and ornament, together with all insuranre thereon and .�
'���,I,relating thereto, to such of my issue , per stirpes , as survive my death '�,
Jlllbp thirty {30) days . I
ITEM III. I give, devise, and bequeath all the rest, residue, and I
`�I�remainder of my possessions and estate of every nature and wherever '��
�I
�iisituate to those of m issue, �� ' ��
y p�r stirp_� , as surv.ve mv death bp thirty .
�:_JI�G30) days . �ii
�-. �1 ' ITEM IV. I appoint my dauyhter, LINDA J. WOODRING, elecutr:.x of '�,.
�:���this mv last wi11. ���.
� �i ITEM V. In addition to the other powers and authorities granted to
Ii
��,Imy personal representatives by Pennsylvania law and by the otYier terms �
;land provislons of this will, Z hereby give to my p?rsonal representatives �
'�Ithe following powers and authorities effective without court approval and
1
uni_i.! a^ruai �liscx�ibu�ion of a11 proc,ertc: to comprcmis� any claim or
�controversy; to mak:e distribati.on in r.a�h or in kind, or oartly in cash
',and oartly in kind, and in such m�nner a=_ ai, personal rep:esentativ2s m3p
� ��determine and at valuations finally to be fixed by them; to invest in all ��.
'� forms of property, including any stock or other securities in any I
r.orporate fiduciary or its successor without restriction to investments ��
'llauthorized for Peni:syivania fiduciaries , as my pei�sonal represeritatives �
�
lideem proper, without regard to any principle of risk or diversification; �
to retain any or all assets of nry estate, real or personal, withont '
regard to any principle of risk or diversification; to sell at public or i
private sale, to exchange, or to lease for any period of time, any real '
Ior personal property and to give options for sales, exchanges, or leases,
Ifor such prices and upon such ter.ms or conditions as my personal I
sepresentatives deem proper; and to allocate receipts and expenses to �..
� i
�Iprincipal or income or partly to each as my perso�al representatives deem 'I
Iproper in their sole discretion. ,
ITEM VI. I direct that my personal representatives and fiduciaries '
�shall not be required to 9ive bond for the faithful performance of their ,
�duties in any jurisdiction. '�.
IIN WITNE33 WHER60P, I have hereunto set my hand this /4' day �I
I��lof :i-t.X� . 1995. ii
I
.�,� . ,`. . � i?�p�ri.l<-_.'
�II SHIRLEY,*J,� DODSON
i
'I I
II,�� ���.'��.
i 2
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�. The precediny instrument, consisting of this and bdo other
I.,t;pe�:�ritten pages , eac:; ider,tified by the siqnature oc ine testaLrix wa, I
��i�lon the date thereof signed, published, and declered by SHIRLEY J. DODSON,
! I
!'iihe testatrix therein named, as and for her last will , in the presence of ���
li
Ilus , who at her request , in her presence, and in the presence of each -
��other, have subscri�ed our names as �.�itnesses hereto . '�
n���� �.'�`r� . .'..:,:` {,r-�p"��'ee ._..*d i
,a4J' ��
! Samuel L. Andes �i
* I
yl
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�� i-�/� �-J�.� -- ;
il ��.' B rt DeLone �i
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!;p•IPli;�4;��,\r.?:-! G:' FE�NSY'L6a5i\
( ;5 . :
COG'riTY OF CL'P13ERL.a�D )
The undercigned, being the testatrix whose name is signed to the
� attached or foregoing instram2r,t, haviny been duly qualified according to
��, law, does hereby acknowledge that I signed and executed the foregoing �
� instrument as my last will , ihat I signed it willinyly; and that I signed
� it as my free and voluntary act for the purposes therein expressed. �
� i n � �
� ' S ,cl�:�>c�;,,��
SHIRLEY Jy� DODSON '
�� Sworn or affirmed to and acknowledged '.
. before me by the tes atrix named aLove �,
, this ��t�"1 day oE ���jr��� , 1995. �
�
- �„E.l �� �� ������ h��� tau�ww�,m�arvueuc � .
Notary Publi� ��•aMe�ww+ow P�. .
M'(�,pp��551pNIXP1RE5�IL 1.1958 '
COMMONWEALTH OF PENNSYLVANIA ) �
( SS . :
��I���� COUNTY OF CUMBERLAND 1 '
li
WE, SAMUEL L. ANDES and J. BART DeLONE, the witnesses whose names �
are signed to the attached or foregoing i�strument, being duly qualified ,.
according to law, do depose and say that we were present and saw the '��
�i! testatrix siyn and execute the instrument as her last will; that she
I�i signed it willingly and that she executed it as her free and voluntary .
act for the purposes therein expressed; that each of us in the hearing '�
�i�' and sight of the testatrix signed the will as witnesses; and that to the '�,
I� best of our knowledge, the testatrix was at that time 18 or more years of;
'�i age, of sound mind, aud un�er no constraint or undue i.nfluence.
�� � q, ,
i '.'�.�,. jC � ��:� .:,;��-) .
SaniUel L. Andes I
��.�h`�' �� _
Sworn or affirnied to and � J . Bart DeLone
acknowledged be�ore me this �
�.., t`R°.F'1 daY of (,� �' � ���.)✓1 • 1995 . � �.
� I' '�` I�IYi �
. Notary Publi-c ���-J �i��
� IEM7�ME�9ENRLANO CO.,&P'A
'. MYfOMMI5310N FMPIRES�PRIL].1998