HomeMy WebLinkAbout05-04-05
REV_lSOOEXI6-OO)
REV-1500
. COMMONWEALTH OF
PENNSYLVANIA
. . 'illll... DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 05
0165
COUNTY CODE YEAR
NUMBER
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DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
REYNOLDS, HELEN P.
SOCIAL SECURITY NUMBER
177-24-5146
DATE OF BIRTH (MM.DD.YEAR)
08/12/1912
DATE OF DEATH (MM.DD.YEAR)
01/31/2005
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
~1.0riginaIReturn
D 4. limited Estate
o 6. Decedent Died Testate (Attach copy 01 Will)
D 9. litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a living Trust (Attach copy 01 Trust)
D 10. Spousal Poverty Credit (dale ofdealh ttetwee~ 12-31-91 and 1-1-95)
D 3. Remainder Return (date 01 death prior to 12.13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A} {AlIach Sch 0)
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THIS SECTION MUST BE COMPLETEO. ALL CORRESPONDENCE ANo'(follllii ~1I;.TAX!JNFORMATIONSHOULD B
NAME COMPLETE MAILING ADDRESS
JOSEPH J. ELWOOD, EA 21 STATE AVE, SUITE 102
FIRM NAME '''A"'',~b1'1 CARLISLE, PA 17013
WAGGONER, FRUTIGER & DAUB
TELEPHONE NUMBER
(717) 241-6262
ECTED TO:.'
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
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3 Closely Held Corporation, Partnership or Sole-Proprietorship
4 Mortgages & Notes Receivable (Schedule D)
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5 Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
154,584.00
(6)
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8. Total Gross Assets (total Lines 1-7)
(8)
460.00
0.00
154,584.00
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line B minus Line 11)
(11)
(12)
(13)
460.00
154,124.00
0.00
13. Charitable and Governmental BequestsfSec 9113 Trusts for which an election to tax has not been
made (ScheduleJ)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
154,124.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a}{1.2)
x 0 (15)
. . J 5j,J.24.00 x 0 45 (16)
6,935.58
16. Amount of Line 14 taxable at lineal rate
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)
6,935.58
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE ToJ"'1'l$~R:~tL'QUE$TIQNS ON REVERSE'SIEi'A:IilP'IlEefl
Decedent's Complete Address:
STREET ADDRESS
430 HOGESTOWN ROAD
CITY MECHANICSBURG, I STATEpA I ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
6,935.58
Total Credits (A + B + C ) (2)
0.00
3, Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
6,935.58
A. Enter the interest on the lax due.
(SA)
(5B)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
6,935.58
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; .,......................... .................... ........................................ 0 [iJ
b. retain the right to designate who shall use the property transferred or its income: ................"..........."............ D [iJ
c. retain a reversionary interest: or... . . .... . .......... ..... .. .... . ..... ........ .. ....... D [iJ
d. receive the promise for life of either payments, benefits or care? ... .......................... ........... .... ............ ...... D [iJ
2. If death occurred after December 12, 1982, did decedenltransfer property within one year of death
without receiving adequate consideration? ...................... ....... ..... .... . ... .... ............. ....."......................... D [iJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .............,............,.............,............,.......,..................,......................................, D [i]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under pena~ies of pe~ury, 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
Declaralion of preparer other than Ihe personal representative is bas ed on all informalion of which preparer has any knowledge.
51 NATURE OF P: SON RESPONSI LE FOR ~ILlNG R?':~JiJt#.l1b ~~ h... ~ _________ .;..~_E~=q ~.~__~ ___~._
ADDRESS 7~---
4 BENTZEL DRIVE, MECHANICSBURG, PA 17050
SIGNATUR OF REPARER OC)ER ~TEA
ADDRESS '--fl. /
21 STATE SUITE 1 PA 17013
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For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS ~9116 (a) (1.1) (I)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% {72 P,S. S9116 (a) (1.1) (ii)],
The statute does not exemot 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent.
or a stepparent of the child is 0% (72 P.S. ~9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 P,S. S9116(1,2) [72 P,S, s9116{a){1)],
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S. 39116(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.
REV~1509 EX+ (6~98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
REYNOLDS, HELEN P.
FILE NUMBER
21 ~05~0165
If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. ROBERT E. REYNOLDS
827 FAIRFIELD ST
MECHANICSBURG, PA 17055
SON
B. ROBERT E. REYNOLDS
827 FAIRFIELD ST
MECHANICSBURG, PA 17055
SON
C.
DORIS L. BERGER
128 TUCKAHOE RD
DILLSBURG, PA 17019
DAUGHTER
JOINTLY~OWNEO PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUOE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD"S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. OS/22/01 PNC INVESTMENTS 8ROKERAGE ACCT #70487496 216,241.00 50 108,120.00
2 B 10/05/90 WAYPOINT BANK CD #1000198283 24,048.00 50 12,024.00
3 C 06/28/01 PNC BANK CD #31500211943 11,467.00 50 5,73300
4 D 12/22/96 COMMERCE BANK SAVINGS ACCT #21206 5,001.00 50 2,501.00
5 E 11/10/95 PNC BANK CD #21001028807 10,995.00 50 5,497.00
6 F 10/27/90 CITIZEN'S BANK OF PA CD #6140873606 10,722.00 50 5,361.00
7 A OS/22/01 PNC SAVINGS ACCT #5003607417 5,168.00 50 2,584.00
8 C&G 01/01/60 PNC CHECKING ACCT #5070115172 38,293.00 33 12,764.00
TOTAL (Also enter on line 6, Recapitulation) $ 154,584.00
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (5-".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
REYNOLDS, HELEN P.
FILE NUMBER
21-05-0165
If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. DORIS L. BERGER
126 TUCKAHOE RD
DILLSBURG, PA 17019
DAUGHTER
B. SHIRLEY A. FAKE
4 BENTZEL DR
MECHANICSBURG, PA 17050
DAUGHTER
C.
WILLIAM I. REYNOLDS
430 HOGESTOWN RD
MECHANICSBURG, PA 17050
SON
JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUOE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VAlUEQF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY.HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT"SINTEREST
,. A.
TOTAL (Also enter on line 6, Recepitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV.1509 EX+ 16.98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
REYNOLDS, HELEN P.
FILE NUMBER
21-05-0165
If an asset was made Joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. MILDRED E. SCEARCE
126 JAMES RD
DANVILLE, VA 24541
DAUGHTER
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FQRJOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
TOTAL (Also enter on line 6, Recapitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX. 112.991.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
REYNOLDS, HELEN P.
FILE NUMBER
21-05-0165
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
,.
0.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
0.00
Name of Personal Represenlative(s)
Social Security Number(s)fEIN Number of Personal Representative(s)
SlreelAddress
City
. State
lip
Year(s) Commission Paid:
2.
Attorney Fees
0.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
0.00
Claimanl
StreelAddress
City
Stale
.Zip
Relationship of Claiman! 10 Decedent
4.
Probate Fees
0.00
5.
Accountant's Fees
0.00
6.
Tax Return Pre parer's Fees
460.00
7.
TOTAL (Also enter on line 9, Recepitulation) $
(If more space is needed, insert additional sheets of the same size)
460.00
REV-1513 EX+ (9-00)
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
REYNOLDS, HELEN P.
FILE NUMBER
21-05-0165
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
J TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (,J (1.211
1 ROBERT E. REYNOLDS SON' 30,824.00
2 DORIS L. BERGER DAUGHTER 30,825.00
3 SHIRLEY A. FAKE DAUGHTER 30,825.00
4 WILLIAM I. REYNOLDS SON 30,825.00
5 MILDRED E. SCEARCE DAUGHTER 30,825.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET
" NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
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LAST WILL AND TESTAMENT
I, HELEN P. REYNOLDS, of Silver Spring Township, County of
Cumberland and State of Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this
as and for my Last Will and Testament, hereby rev~{ing and making
void all former wills and codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral
expenses be paid by my Executor or Executors, as the case may be,
hereinafter named, as soon as conveniently may be done after my
decease.
SECOND. I give, devise and bequeath all the rest, residue
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and remainder of my Estate, real, personal and mi~ed, ~~ftsoe~~
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and wheresoever situated, unto my husband, MERVIN S. REnwo~S,ccl
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absolutely and in fee simple, if he survives me.
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not;.o~ survi v2 me,
THIRD. If my husband, MERVIN S. REYNOLDS, does
then and in that event, I give, devise and bequeath my entire said
Estate in equal shares unto my five (5) children, namely, ROBERT E.
REYNOLDS, MILDRED E. SCEARCE, DORIS L. HYSER, SHIRLEY ANN FAKE, and
WILLIAM I. REYNOLDS. share and share alike.
Should any of my said children predecease me, I order and direct
that the share of my said Estate which would have been distributed
to such deceased child had he or she survived me, be distributed to
his or her issue per stirpes, said issue being substituted for
their deceased parent by representation and being entitled to only
that portion of my Estate to which their deceased parent would have
been entitled had he or she survived me.
LASTLY. I nominate, constitute and appoint my husband,
MERVIN S. REYNOLDS, to be the Executor of this, my Last Will and
Testament, but if for any reason he should fail to qualify as such
Executor or cease so to serve, then I nominate, constitute and
appoint my son, ROBERT E. REYNOLDS, and my son-in-law, WALTER H.
FAKE, JR., or the survivor of them, to be the Executors hereof, all
to serve without bond.
IN WITNESS WHEREOF, I. HELEN l? REYNOLDS, have hereunto set
my hand and seal to this, my Last Will and Testament which consists
of two, (2) typewritten pages to each of which I have affixed my
signature this tille, day of tfJ;;!/I/PtJh- A. D., One Thousand Nine
Hundred Sixty-seven (1967).
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(SEAL)
The preceding instrument, consisting of this and one (1) other
typewritten page, each identified by the signature of the Testatrix,
was on the date thereof signed, sealed, published and declared by
HELEN P. REYNOLDS, the Testatrix therein named, as and for her Last
will and Testament, in the presence of us, who, at her request, in
her presence, and in the presence of each other, have subscribed
our names as witnesses hereto.
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STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
es ta te of HELEN P REYNOLDS
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 18th day of February, Two Thousand and Five
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
, la te of SIL VER SPRING TOWNSHIP
(First,Middle,Last)
in said county, deceased, to ROBERTEREYNOLDS
and
(First, Middle, Last)
WAL TER H FAKE
(First, Middfe. L8srJ
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 18th day of February
Two Thousand and Five.
File No.
PA File No.
Date of Death
S.S. #
2005.00165
21.05.0165
1/31/2005
177.24.5146
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NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL