HomeMy WebLinkAbout06-17-15 (2) J Lsas61o1os
REV-1500 Ex�ma�)(FlI � OFFILIAL USE ONLY
Vi
PADepatlmentolRevenue Pennsytvanla �uunryCotle Year FleNumber
BureauoflnCiNtlualiaxes INHERITANCETAXRETURN
PO BOl(z8o6oi / I
H n b PA � B- 6 a RESIDENT DECEDENT ��I I'7 � � 7�
ENTER DECEUENT INFORMATION BELOW
Social Sacutlry Numoer Oa�e of DeaN MNDOYYYY Oat¢of Bi�h MMOpYYYY
10/08/2014 08/31/1940
OecedenYs Las�Nama Suffix Decedenfs Fi51 Name MI
Reilly Ann M
(If Appliceble)Enler Survlving Spouse's Informatlon Below
Spouse's Las�Name Sufpx Spouse s Fvst Name MI
Spousa's SwialSecutlty Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN AViROVRIAi E OVALS BELOW
O 1.Onginal ReWm � 2.Supplemental ReWrn O 3. Remaintler ReWm(Oala o�Dealh
Priar�0 12-13-82)
O d.LlmileC Es�a�e O aa. FUWre Interest Compmmise(date ot O 5. Fetleral Estale Tax ReWm Requiretl
tlea�h atler 12-02-82)
O 6,Oacetlen�DIeO Testate O ]. �ecatlent Malnlalnetl a Living Tmst _ B. Totai Numper of Sale Oeposl Boxes
(FttachCopyofWill) (AXacM1CopyolTmsl)
O 9.LWgalbn Proceetls ftecelvetl O ID.Spousal Poveity Credlt(Date ol pealh O fl. Eledion to Tax untler Sec.9113(N)
Between 43L91 and 1-b85) (AttacM1 SCM1edule O)
LORflESPON�ENT-TNIS SECTION MUST BE COMPLETE�.ALL COFRESPONDENCE AN�CONFIDENiIAL TA%MFORMATION SHOULD BE DIRECTEO T0:
Name OaN�me Telephone Number
Peter J. Russo (717) 591-fP55 ,s, � m
� o � o
REGISTHIOOF.591LLSUSE9NLY -, �-j
_ n
_
N
FUst Line of Atltlrass .. � -
5006 E.Trindle Road . � " � -n -:i
SewndLineofAtltlress ' -� �I
��
Suile 203 _ _- rv �- rn
0
Ciry or Post Office S[ale ZIP Cotle . onie Faeo � - -r�
Mechanicsburg PA 17050
CortespondenYa a-mall adtlress:pfU5S0(O-Jpjrl2W.com
Untler penal�ies of perjury.I Oeclam t�sl I�ave examineJlM1is reWm,Indutling accompanying sc�etlules an0 stelemenis,enE lo Ihe bas�ot my knowletlge antl bellel.
i�is We,mrtevi entl compl¢te.0ede21i n ol preparer olpe!�pan Ne pBRonal faplefenlalive is�asetl on all inblTaliOn o�wM1icM1 prepdrer M1as any knpwlpEg¢.
S TURE FS RE O 5� E FOR FlLING RETURN ORTE
;c_.,.,.,� � .� - o��,a
nooaEss
��J IL�I�U1'++e �r, �o�eb�er u`� /y�(�
ATU PREPFR THENTHANREPRESENTFfIVE �ATE
NO�RESS �/a 9 �
s�r,c, P'� ,� T,-...A4� 2.L s�,�, a �3 rn�.J�ah��.6,,.-. 1�Y� �->u �-r)
PLEASE USE ORIGINAL FORM ONLV
Side 1
L Lsas61a1os isas61o1os J
,,,
11 '
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J Lsos61a1os
REV-1500Ex�p$1t)(F'� � OFFICIALUSEONLY
PA�epartmento�Revenue PennryNania
Bureau otIntlividualTaxes ������ " Gounry Cotle Vear File Number
POBOXzeo6ai INHERITANCETAXRETURN
h'amsb�m.an i�ae-o6oa RESIDENT DECEOENT
ENTER OECEDENTINFORMATION BELOW
Social Secunty NUmb¢r Date Of Dedih A1MD�YVYY Da�e oi Birth MMO�VYYY
10/08/2014 08/31/1940
DecedenCs Las[Name Suffx Decedenfs First Name MI
Reilly Ann M
�1f Appllcable)Enter Surviving Speuse's Informallon Below
Spouse s Last Name Suffix Spouse's Firs�Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
O 1. Original ReWm � 2. Supplemental ReWm O 3. Remainder ReWm(Da�e oi Oea�h
PYior to 12-13827
O 4. limited Estate O 4a. FuWre Inleresl Compmmise(dale of O 6 Fetleral Eslate Tax ReWm Requiretl
aeam er�e�iz-iz�z)
O 6. Decedenl0ied Tes�ate O l. Decetlenl Maintained a Living Trust _ e. tolal Number ol5afe Deposit Boxes
(AUech Copy of Wlp (Altach Gopy of Trust)
O 9. Liligation Proceetls Receivetl O 10. Spousal Poverty Credit(�ate of�earo O 1L Election lo Tax under Sec.9113(A)
Be�ween 12�31�81 antl b496) (AneoM1 SCM1edule o)
CORRESPONDENT- THIS SELTION MIIST BE COMPLETED.RLL CORRESPON�ENGE AN�CONFIOENTIAL TA%MFORMATION SHOULD BE DIRECiEO T0:
Name Daytime Telephone Number
Peter J. Russo (717) 691-1755
REGISTER OF WILLS USE ONIY
Firs�Line of Atltlress
5006 E. Trindle Road
Second Line af Atldress
Suite 203
City o�Post Offme S�a�e ZIP Cotle OATE FILEO
Mechanicsburg PA 17050
Correspondenfs e-mall atltlress: pNSSO�pjf12W.COR1
Untler penalties ot perjory.I declare tM1at I M1ave examinetl IM1is reWm,inclutling accompanying sc�edules antl s�a�emenls,antl lo tM1e best ol my hnowletlge antl beliel,
It Is Irue,w rect antl complele.Declaration o!preparer oNer IM1an iM1e personal represenGtive Is basetl on all inkrmation of wM1icM1 preparer M1as eny knowleEge.
SIGNHTURE OF PERSON RESPONSIBLE FOR FlLING RETIIRN DHTE
A��RE55
ATII PREPAR THERTHNNREPRESENTATIVE �ATE
_ S�aS � I �
RODRE55
S(IC� G, Fo .�Ty-,�...� �e (1.�, S�n��a a Il3 `Mecl'�av���:.h..-. P� \">0 \ !)
PLEASE USE ORIGINAL FORM ONLV
Side 1
L 1505610105 15056101�5 J
J Lsos61o2os
REV4500 EX(FI) �ecetlenPs Social Securiry Number
oe�ae�r:Name: Ann McKay Reilly
RECAPITULP.TION
1. Real Estate(Schetlule A). .. . .. . . ... .. . .. . ... ... ... .... ... . .. . . .. ... . . 1.
2. Stocks antl Bantls(Schedule B) .. .. ... .. . ... ... . .. . ... ... . . .. . ... ... .. 2.
3. Closely Heltl Corporation.Partnership or Sole-Pmprietorship(Schedule C) . .. . . 3.
4. Motlgages antl Notes Receivable(Schedule D) ... . .. . . .. . . . . . .. . ... . .. . .. 4.
5. Cash,Bank Deposits antl Miscellaneous Personal Property(Schetlule E). .. . . . . 5. 1 g$,91$.$7
6. Joinlly Owned Property(Schedule F) O Separate Billing Requested . ... . . . 6.
]. Inter-Vivos Transiers 8 Mlswllaneous Non-Probate Property
(Schedule G) O Separate Billing Repues�etl.... . .. . ]. 0.00
e. 7mal Gmss assets Itotai �ines i mrough�).. . .. . . .. . .. . . .. . ._ ... . .. . .. e. 183,915.57
9. Wneral Expenses and AdminisUative Cosls(SCM1edule H).. . . .. . ... . ... .. . .. 9. 35.00
10. Debis of Decedent.Mortgage Liabilities and Liens(Schetlule I).. . ... . .. . . . . .. 10. 93.0�
11. Total Detluctions Qo�al Lines 9 antl 10). .. . .. . .. . .... .. . ... . ... ... . ... .. it. �28.00
12. Net Value o!Estate(Line e minus Line t1) . .. . .. . ... . ... . . . ... . ... . .. . .. 12. 183,787.57
13. Chantable antl Govemmemal Beques�s/Sec 9113 Tmsts br which
an election to tax has not been made(Schedule J) .... ... . .. . ... . .. . . .. . .. 13.
14. Net Value Subject to Tax(Line 12 minus Llne 13) ... ... . . .. . .. . ... . .. . ... 14. 183,802.57
TAX CALWLATION-SEE INSTRUCTIONS FOR APPUCABLE RATES
15. Amoun�of Line 14 taxable
at the spousal tax ra[e,or
transfers under Sec.9116
(a�(12)%.0_ 15.
16. Amounl of Line 141axable
auineairate x.o45 183,787.57 �6. 8,270.44
1]. Amounl of Line 14 taxable
et slbling rete X 12 1].
1B. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX�UE .. . ... . ... . .. ... .. . .. .. . .. . .. ... . ... . .. ... . ... . . .. . .. ... . 19. 8�270.44
20. FILL IN THE OVAL IF VOU ARE REpUESTING A REFUND OF AN OVERPAVMENT O
Side 2
L 1505610205 15056102�5 �
REV-t500 EX(FI� Page 3 Fil¢Number
DecedenYs Complete Address:
oECEOEN.sNnME
Ann McKay Reilly
-___ .. .. __..._ _ _ .
STREETADDRESS �
16 Sharon Road
—.– __. ___ .__._. _ . .
CITY � STATE . ZIP
Enola PA �. 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 79) (1) $27444
2 Credits/Paymems
A.Prior Paymen�5
B.Diswwt
Tolal Credlts(A�B) (2)
3 Interes�
(3)
4. If Line 2 is grea�er�han Llne 1 t Gne 3,anter Ihe dI%erance. Thls I5 Ihe OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a retuntl. (4)
5. If Llne 1 +Gne 3 is greater ihan Line 2,anla�ihe dlHerence-Thls is the TA%DUE. (6) 8,270.44
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did dewdent make a transfer antl: Yes Na
a. reWin the use or income of ihe property transferred _.._.... ................ ................ ............... ❑ �
b. retain ihe rigM to designate who shall use�he propetly transferred or i�s income ......................................._... ❑ �
c, re�ainareversionarym�erest ..._._.. ..._....._ ... ......_. ❑ �
............. ...........
d. receive�he pmmise Por life af either paymen�s,benef�s or rare'+ ........... ........, .._ ❑ �
2. Ii death occurred afler Dec. 12, iB82,tlltl decetlen��mnsfer pmperty withln one year of death � �
wi��oNreceivingadequa�econsidera�ion?. ................. .....__ ._._._ _._.._ ❑ �
3. Did deceaent own an"in imst fof'or payableupon�ealh bank eccount or securily et his or her dea�h7_............ ❑ �
4. Di0 decedenl own an individual retirement awoun�,annui�y or olher norvprobate property,which
conlainsabenefmiarydesgna�ion� _._._.. ......_.... _ ._.__ ._.._. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT A$PART OF THE RETURN.
For dates of death on or after July 1, 1994.antl before Jan. 1. 1995,ihe�ax rate imposed on the net value of iransfers to or for ihe use ot�he surviving spouse
Is 3 percent[72 PS.§9116(e)(1.1)(1��.
For da�es of death on or after Jan. 1, 1995, �he �ax ra�e imposed on ihe net value of Vansfers to or for the use ot ihe surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(il)�.The staWte does not exempt a transfer to a surviving spouse from tax,and Ihe statutory requiremenis for tlisGosure of asse�s and
filing a tax retum are still applicable even If ihe surviving spouse Is ihe only beneficiary.
For tlates of death on or aker July 7.2000:
. The tax rate imposetl on the net value of iransfers from a deceased child 21 years of age oi younger at death to or for the use of a naWral parent, an
adoptive parent or a stepparent of the child is 0 percent[72 PS.§9116�a)(1 2)].
• ThetaxrateimposedonthenatvalueoflransferstoorfortheuseofthedecedenCslinealbeneficlerie5154.5percenLaxceptasno�edin�72PS.§9116(e)(1)�.
• The tax rate imposed on ihe net value of irensfers to or for Ihe use of�he decedenfs siblinga Is 12 percent [72 P.S. §9116(a�(1_3)J-A sibling is dafined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
aev-.soe ex,�oaaz)
� pennsylvania SCFIEDULE E
��� oernnlmenroFaevervue CASH� BANK DEPOSITS & MISC.
iuHen�rnucernxnerun�v PERSONALPROPERTY
aesmervr oeceoexr
ESTATE OF: FiLE NUMBER:
Ann M. Reilly 2014-00976
IntluOe[he pmree0s of litigation an0 the date the proceees were receivee by the es[ate.
All pro0erry join[ly owneE with righ[o(survivorship mus[be AiscloseA on Schetlule F.
ITEM VALUE AT�ATE
NUMBER �ESCRIPTION OF DEATH
�. American Equity Investment Li(e Insurance 180,020.57
p. PersonalPropedy 3,895.00
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
707AL(Also enter on Line 5, Recapitulation) � 183,915.57
If more space is needed, use atlditional shee[s oF paper of the same size.
VEFIiV THF AIITNENTIqTY OF THIS OOWMENi ,� TMIS CH£CK IS YOIU WITHOUT A LOLOflED BACKOqOUN�.
R.__..... _.. ._.. _ ___
..�.___�_. _._.__�
.� AMERICAN EqUITY INVESTMENT LIFE INS. CO.
8000weatamceikxay '
� SUIte800
�.Weel f7es MoMas.IN 50286 . .
]E 33S
. . - WebtBenk � )39:: .. . . .. . . ...
���"4���.in sosec.00zo
PAY ONEHUNDRED EIGHTV THOUSAND TVJENTV AND 57/100 DOLkARS S""""^180,020:b7
�� TO7HEOR6EROF� . � �� vOiDAFrER��9oDAVS
ESTATE OF ANN M REILLY � � � � �
.C/O ROBER7 MC IVER EXECUTOR . . gy ��: �' +
. � ?40HILV+RNEYOR:�. . � .
. ROCHESTER NY�14516 � � �
B
ii• 560i563496�i' �:073903354�: i93404ii'
THFOP!CINGI. pM:11NFMu1SpNMmFRFc1[CT�/ewnecoueovMwco�rv uniTn+o�nvm�vnenervv...nv..n.m..n.�cn...........�........�..�.._.�
aev,-isiz ex+(iz-�z)
� pennsylvania SCHEDULE I
. .. oeanarwervroraevenue DEBTS OF DELEDENT�
1NMER1�ANCE`"'aE*�a" MORTGAGE LIABILITIES & LIENS
aesmervt oeceoerv.
ESTATE OF FILE NUMBER
Ann M. Reilly 2014-00976
Repor[debts incurretl by[he deceEen[priar ta Gea[h that remaineG unpaiG at the Eate af Geath,incluEing unreimburseE meEical ex0enses.
ITEM VALOE AT DATE
NUMBER DESCRIPTION OF DEATH
1� Search One Abstracting, Inc (Recording Deed) 93.00
2
3
4
5
6
7
8
9
io
ii
iz
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL(Also enter on Line S0, Recapitula6on) 5 93.00
If more space is nee0etl, insert atltlitional shee[s oF the same sire.
REV-I511 f%� (OB-13)
�'i�pennsylvania SCHEDULE H
� .� oEanarnErvroFaEVErvue FUNERAL EXPENSES AND
'""E"'T""�E'^""E"'"" ADMINISTRATIVE COSTS
aesmervr oeceoErvr
ESTATE OF FILE NUMBER
Ann M. Reilly 2014-00976
DecedenPs debts must be reported an ScheEule 1.
ITEM
NUNBER DESCRIPTION AMOUNT
u. FUNERALEXPENSES:
1.
2
3.
B, ADM[NISTRATNE COSTS',
1. Personal Represertative Commissions'.
Name(s)of eersonai Representative(s)
Street Adtlress
City . .. .... . . . . ..—_—_ State_ .ZIP . . .
Vear(s)Commisslon Paid�.
2, Attorney Fees�.
3, Famlly&emp[lon� (If OeceAenPs a00re55 is not the same as tlalman['s,attech explanaHan.)
Claimant
$[fPPIAEGfPSS
CiN . ._ ._ . _.____ _State.. ._ZIP
Relationship of Claimant[o�ecetlent
4. Probare Feer 35.00
5. Accountane Fees.
6. Taz REhrn Pr¢parer F¢es'.
].
707AL(Also en[er on Line 9, Recapitulation) S 35.00
If more svace is neetleQ use atldltlonal sheets ol oaper o1 the same size.