HomeMy WebLinkAbout07-01-15 (2) e� =pemnylvania 1505614105
J ���,,.� E.�0,_�4„Fl,
REV-1500 OFFICIAL USE ONLV
8ureauofln0ivitlualTaxes CounryCaUe Year FileNumOer
ao eox zeoeoi INHERITANCE TA7C RETURN n r q
nanisburg PA 1�128-0601 RESIDENT DECEDEN'�' LI I � O� / 2
ENTER DECEOENT INFORMATON BELOW
SoualSewnry Number Date of Death MMDDWYY Date of Birih MMOOYVYY
02282015 09297950
Decedenfs Last Name Suffix oecedenfs First Name MI
Irvin Marsha G
pf Applicable)EnterSurviving Spouse's Informatlon Below �
Spouse's Last Nama Suffiz Spouse's Firs�Name MI
� THIS REfURN MUST BE FILED IN UUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Onginal ReNm O ��SupplemenUl ReWrn O 3. Remaindat ReNm(Ca[e ol tleatM1
prior M 12-13A2)
p 4.AgriCUlWre Enemption Itlale of � 5.FNum In�erea�Gompmmise(tlate of p fi. Fede21 Es�ah Tax Rewm Required
tleaVi on or aRer]-1-2612) deaN afler 1242d2)
p ].�ecedent Oietl Tasiate O e.�ecetlant Main�inetl a LiNng Trust _ 9. Total Number o(Se(e Deposit Boxes
(AtlacM1 coOY o�'MII.) (Attach copy of imst�
0 10.LMgafion Pmceetls Recaivetl O 11.NonProEata Trenataree ReNm O ��� �efenallElec�ion of Spousal Tmsh
(SeM1edule F antl G Avsets OnlyJ
O 13.Buslness Ns6et5 � 14.Spouse is Sole Bene�ciary
�No Ws�involveE)
COPRESPONDEM—THIS SEL110X NUST BE COMPLEfEU.RLL CONRESVONUENCE ANU CONFIDENML TAl IXFORMRTON SNOULD BE�IRECTEO T0:
Name Daylime Telephone Number
Belinda Edsall (717)623-8141
First Line afAtltlress �
fi80 Colleen Drive
$amntl Line of Add�ess � �
City or Post O(fice � . State ZIP Cotla
Harrisburg PA »�O9
GomspontlenCs emall atltlress: SmaM1Ghiay@yahOO.COm
REGISTER�i WILLS USE OAL
C_ C'.
REGISTEROFWILLSOSEONd ' � -
1"-
OATE FlLEO AIMOOYYYY .
F�
-)
�
OATE FlLED STAMP
Ci , �l
� ("� ..�
S �
PLEASE U8E OR101NAL FORM ONLY
Side 1
L ��IM�I�I�'II�P 1����1��111�11������ y505614105 J �
J1505614205
REV-1500 EX(FI) pecetlenfs Social5ecunry Numbe�
o m�r:H,,,,a Marsha G. Irvin 18840-8fi76
RECAPITOLATION . . -
1. RealEstatel5chetlNeA). ... .. . .. ......... .... . ....... . .. . .... . . ..... L _ . . . �.DO
2. Slacks aM Bontls ISc�etlule 8) ...._.......... ........_._ 2 . �.00
3. Closety HeIC Gorpo26on, PaMership or SolaProprietorship(SCM1edule C) ..... 3. 0.00
A. Mortgages and Notas Receivable(Srliedula�)................ ..... 4. O.DO
5. Cash,Bank Oeposits and Miscellaneaus Personal PropeM l5chetlule EJ....... 5. . ����52�
6. Jdnily Owned Property(ScheGule F) O Separzte Billi�g Requestetl ....... 6. .. . 2,582.00
]. Inter-Vvos Transfers&Miscellaneous Noo-Pmbate Pmperty 4 9�2�6
(Schadule G� O Separete Billing Requested....... �.
8. Total Gmss Ansets(total Lines 1 through 1).... ......... . ........... B. 16,329.33
9. Funeral Expenses a�AGministrative Costs(Schetlule H�..........
......... g. 3.83271
t0- �ebts of Oecetlenl.Mortgage Liabiliti¢s antl Liens(Schetlule I) ... ..... 10. 5,689.47
t1. Tetal Deductions(toWl Linas 9 antl 10)....... ..................... 11. 9,522.18
12. Net Valua of EstaG(Line B minus Line 11) .............................. 12 . $,807.1$
13. CM1anfable arM Govemmental Bequesls/Sec 9113 Tmsh for which
an election ro tax M1as not been matle(Schetlule J) .............. .......... 13.
16. Net Value Su�)ect to Tax��ne 12 minus Line 13) ....... .............. �4 5,SU7.15
TAX CALCULATION-SEE INSTRUCTiON3 FOR APPLIGABLE RATES
15. Amount of Line 14[anable �
a[Ne spousai Wz ra�e,or . . -
transhrs under Sec.9116 �5
(a)(12)X.0_ . .. .
i6. AmountofLinel4taxable S,8O�.75 ts. Zg�.32
at lineal rate X 045 . . .
1]. AmountofLinel4taxable � ��
at sibling rate X.12 � �
18. AmountolLineidhdxable 1e
atmnateralrate x.t5 . . � �
261.32
19. TAX DUE ... .... .................................... 19. ...
.... ..........
20. FILL IN THE OVAI.IF YOU ARE REpUESTING A REFUNO OF AN OVERPAYMENT �
UnJer penallia of perjury.I tleclere I Mve evireneJ�h's re1um.IMudng armmpanyin9 sQietlules eM sdRmanls.aM lo Ne Omt M my k�oMedge anJ belief.
it is hue.oxrevt entl complNe,Oeda2tim repare�dM1e�Man Me peROn�es�sible fw fili�g Ne R�um Is E33 tl m d�l InkRnaM1m o�w�MA�pep9te�Fas
any kmn'led �
SIGN P ON RES 51 L G E
ADDRE55 � /
SIGNFTUFE OF PREPPAER OTHER THAN PERSON PONSIBLE FOR Fl G THE RENRN �A�
l�OFESS
In'IIIq��yry��pryq��y���AYI�iY'IN�� Side2 15�56142�5 �
L III ISIIIIW�150561 ��tl RN 81
REV-05GU EX �FI) Page 3 File Number
DecedenYs Complete Address:
oecEOEr+rs run�E
Mars�a G. Irvm _ .. . -
_. . _- .. . _—._. — _.____ _— .
STREEfA��RESS � �
16 South Enola Dme.Apt 204 .. .. . ..--
. ._._ . _ — _.g_ -. .—.� ZIP �
cnY -� — .. pq � 17025
Enola
Tax Payments and Credits:
1. Tax Due(Page 2,Line t9) (�) 267.32
2. CreOitslPayments
A.PnorPaYmenls . ._ .. --- ---
B.Dismunt _--. --- TMaICreCils(A+B) (2)
($eeinstmctlons.)
3. Interesl (3)
4. If Line 2 is g2a@r Man Lirre 1+Line 3,en�er�he tliflerence. This is Ihe OVERPAYMENT. (a)
Fill in oval on Page 1,Line 4010 request a relund.
5. If Line 1+Line 3 is greater than Line 2,enler Ne diRe2nce.T�is is Ne TAX DUE.� �`'�
261.32
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRSATE BLOCKS
1. Dk tlecedent make a transhr and: � ■
� trare�erted............ ._.__... _...._.. .._. . ❑ �
a. relain Ne ose or mmme of Ne propertY
........ ......
b. relain ihe rgM to designate who shall use Ne pmpeM hansferte ot i mcome ■
. ....... ..___. _ .__.. ❑ .
c. retain a re�reiswnary interest ........... . . .. .........._
tl. receive�he Ommise for lde of e�Ner DaYments benePos or rare'+ .
__...... ......_. ......... ❑
2. If tleath ocarted aXer Dec.12,1982,did dacedent transfer property within one year of death ❑ .
._...._.._ _....__ ■
vnihoutreceNiigadequateconsitlaration?. �����--- �-�
3. �iU tlecetlent avn an'in Wsl fof'or payable-uporvdeaih bank account or security a[hvs a��er tlea�M ...._. ❑
4. DiC decedenl own an iMividual 2ti2manl account,annuiry or oNer nomprobate properry,which ■ ❑
wntainsabeneficia74esi9w�ion? .._...... __......_..... .__.._
........._...._..........
IF THE ANSWER TO ANY OF THE ABOVE DUESTIONS IS YES,YOU MUST COMPLEf E SCHEDULE G AND FILE R AS PART OF THE RETURN.
Por dates N deaN un or aRer July 1,1994.and hefore Jan.1,1995,�he tax 2le imposed on the�t value of t2nsfers to or forlhe use of the surriving spouse
is 3 percenl[72 PS.§9116(a)(t.t)@l�
Fw dates d deaN'o a� aThe shalule dce 5rwl exemP����m a s rvrv ng spouse from ta�,a�d the slzNtory requ iemenis tor d sclwure of assels and
[IZPs.gs��s(a)( . )(lb �;smeon� be�sc;a
filing a tax reNm are sti�l applidhle even R the surmnng spai Y ry�
Fa dales ot death on a after July 1,2000:
. The tax rate impoud on me net value of hansfers from a deceasetl chiltl 21 Y�rs of age or youryer at death m a for the use of a naWrol parent,an
ydop6ve perent or a step-parem of tl�e chiltl is 0 percent[/2 P.S.§9116(a)(L2)].
. Thetax�e�elmposedaithe�e��alueoftransfersloorfartheuseoftliedecedemslineal6eriefida�esis4.5percen[exceptasfwtedin[/2P.S.§9116(a)(t)�.
. The lax 2te imposed on ihe net value of transfers to or fa the use of die decedenPs si6lings is 12 percent[/2 P.S.§9fl6(a)(1.3)].A siblirg Is defined,
under Sedion 9102,as an inOiNdual who has at least one parent in comrtan vnth Ne decetlent,whether by Mood a adoption.
rzevame�_;az-is7
� : pennsylvania
SCNEpULE E
oevaarner+rornevenue CASH, BANK DEPOSITS &MISC.
�n�euru+araa�w+ pERSONALPROPERTV
0.E90EMDE��fM
ESTATE OF: FILE NUMBER:
MARSHA G. IRVIN 20151)0392
[ndude the pm¢eEs o(IlFigatlon antl Me Ga[e Uie proceeEs were rxeiveE by�fie esta[e.
All property lantly avmed wkh right of wrvivorship murt be ABdosed on Schedule F.
REM VALUE AT DATE
fiUMBER OESCRiP110f! OF DFATH
i. PSECUCHECKINGACCOl1NT 4,485.89
2. CHECK FROM SLEEPY'S MNTTRE55:REFUND 42.38
3. CHECK FROM ADVARA DENTAL:REFUND FOR PAID SERVICES NOT RECENED 2247.00
4. CLOTHING DONATED TO SALVATION ARMY 500.00
5. HOUSEHOLD GOODS DONATED TO BETHESDA MISSION 1 G000 WILL 500.00
TOTAL(Also enter on Line 5,Rewpitulatlon) ; 7.77527
if more space is needed,use aGGitional sheeGs of paper oF the same size.
PEY-1509 E%�(@-15)
� � pennsylvania SCNEDULE F
oeanarnExroFnev�,u„e )OINTLY-0WNED PROPERTY
RES1�EMOE�OEHi R
ESTATE OF: FILE NUMBER:
MARSHA G. IRVIN 201500382
If an amt beceme joinHy ownetl wlMin ane year ot the GecetlenCs Uate af tleath,it mus[�e reportetl on XheEule G.
SURVNING)OINTTENAM(5)NAME(5) ADDRESS REIATIONSHIPTODECEDEM
A�BELINDA EDSALL 680 COLLEEN DRNE DAUGHTER
HARRI58URG,PA 17109
B.
C.
IOINTLY OWNED PROPE0.7Y:
��,q pph oESWTIorvoFGROCERtt no� om[aFofnTM
�ry pp]p�ry� MppE INO11M1UMEOfFlNRNML�N5RNI10NFIJDBWKi�I1MHLP1&'0.00.5MIWl 0>iEOFCEAM CfCE�FNI'S VNAIEOF
NUMYA IFIMM ]OIM IORRIfYdG NUMPE0.Pii�01 DEEO fOP WIXRY HE1D 0.EAL ES>lE. VKUE Of ASSE� INIEPEST �E�EM'S INlFAFS�
1� A' CHRYSLERCORPORATION-ACCT.k7756692 5,i6A.00 50 2,582.00
7012 FlAT POP 500 HATCHBACK
TOTAL(Alw enter on Line 6, RecapiNlatlon) ; 2•58Z_��
If more space is neeGeQ use adtliFonal slreets of Daper af Ne same size.
nw-ism ex� �oz-is7
�� pennsylvania SCHEDULE G
oeaaarner+rornever�ue INTER-VIVOS TRANSFERS AND
°'^�T�^« MISC. NON—PROBATE PROPERTY
0.ESIDHJT OE�OEM
ESTATE OF FILE NUMBER
Mareha G. Irvin 2015-00392
This schetlule mu4 be mmple[eA an0 filetl if the answer to any of quesGons t[hrough 0 on page Mree ot the 0.EV-1500 is yes.
DESCRIPIIONOFPROPERiY DATEOFDEATH %OFOECD5 EXCWSION TA%ABIF
REM ���wnerc�mueaff,mfnuunmwvroer�rmeno
NUMBEN �wrtvm�xsse�.�mm�mvraTrto�rcaui�es*�h VPWEOFASSEf INTERESt 1� VAWE
i. PSECU IRA paya6le to heneficiary BelinOa Etlsall q g�Z� q,g7p.p�
TOTAL(Alm enter on Line 7, 0.erapitulation) $ 4,9�Z.06
If more space is nee0e0,uze additional sheefs of paper of tM1e same sire.
REV-ISll E%i (02-li)
~� pennsylvania SCHEDULE H
oennainerrrorae�r�ue FUNERAL EXPENSES AND
mnearta��rn�curunn qDMINISTRATIVEC05T5
0.ESIDEM DECcDEN!
ESTATE OP FILE NUMBER
MARSHA G. IRVIN . 2015-00382
Decedent'z 0ebts must be reparted an Schedule I.
�M PM011NT
NIIMBER �ESCH[VIION
A. FUNERAL EXPENSES:
1' W.ORVILLEKIMMELFUNERALHOME 2,875.60
CREMATION 11RN �57�18
PASTOR'S EULOGV 100.00
PROGRAM/DVD MEMORIAL SERVICE 61.38
e. ADMINISTMTIVE COSTS:
i. Personal Represen[ative[ommissions: 200.00
Name(s)of Personal aepresen[atice(s) BELINDA EDSALL.
5treet nddress 680 COLLEEN DRNE .. _ _._ . .
�i�y HARRISBURG � � State _PA_Zla 1�109__
Vear(s)Commission Paitl: _ __ _.
50.00
2. Attomey Fees:
3. Famity Eremptiw: pf DeceGen['s atlOress is no[t�e same as tlaimanPs,attach exD�ana[lon.)
Claimant
Sh¢P[AtlOress
[m ... . SUte__ZIP_ _ .
Relatlonship of Claimant ro Decetlent
4. 4robate fees� 316.50
5. Acmuntant Fees:
6. Tax Remrn Preparer�ees: 37.09
�.
TOTAL(Alw en[er on Line 9, RewOiNlation) $ 3,832.71
If more space is neetletl,use aU016onal shee[s of Oaper of the ume tize.
REV-0SL2 E%+ (OD6)
i� pennsylvania SCHEDULE I
oeaanrmEnroFn�H� DEBTS OF DECEDENT�
xEsmEoroeceoa+r R
^' MORTGAGE LIABILITIES &LIENS
ESTATE OF FlLE NUMBER
MARSHA G. IRVIN 2015-00392
Report debts InwmeE by Me EecMent D��or ta Eeath tha[remaintd unpald at Me tlata of deaM,IncluOing unreimbursed mMinl expenses.
REM W W E AT�ATE
NUMBER DESCRIPTION OF OFATH
1� ENOLACOMMIXJS-RENTMARCH2O15 536.00
ENOLA COMMONS-RENT APRII 1-15,2015 268.00
NATIONWIDE AUTO INSURANCE �zz.26
CHRVSLER CAPI7AL CAR(HAIF OF BAIANCE DUE ON AUTO LOAN) 2.719.00
CAR PAYMENT DUE ON 0412912015 133.97
HOLY SPIRIT HOSPITAL 254.59
HOLY SPIRIT MEDICAL GROUP ����5
SPRINGSTONE PATIENT FINANCING 1,490.00
ASPEN DENTAL 88.50
TOTAL(Also enter on line 10,RecaDi[ulatlan) f 5,fi89.47
If more space is neetletl,insert atlGitional sheets of the same size.
REV-t5t3 E%t!OE-IS)
'¢ �' ' pennsylvania SCHEDULE ]
oevnarnwrocaEvenue gENEFICIARIES
M 0.ENRN
PESIDFM OE�OEM
ESTATE OF: FILE NUMBER:
Marsha G. Irvin 2015-00392
RElATIONSHIPT00ECE�EM AMOUNT00.5HARE
NUMBER NAME AND AD�RESS OF PERSON(5)RECEIVING VROPERTV Oo NM List Trvatee�s) OF ES�ATE
1 TA%ABLE DISf0.IBlflIONS[IntluOe outngh[spousal distributlons antl tansfers un0er
Sec 9ll6(al 11.11.1
i� BelirMa Edsall,PO Bon 6040,Harrishurg,PA 17112 Daughter 388.64
2. Michael Irvin, 10 East Glenwood Drive,Camp Hill,PA 17011 son 388.65
3. Davitl Irvin(LL-1526),SCI Pine Grove,197 Fyock Rd,Indiana,PA 15701 son 388.65
4. Benjamin Irvin,CC Pnson,1101 Claremont Road,Cadisle,PA 17015 son 388.65
ENTER DOLLAR AMOUNTS F00.D[SiRIB11ilON5 SHOWN A60VE ON lINES IS THROUGH IB OF REY4500 COVER SHEB,AS ACPROPWATE.
I1 NON-TA%ABLE 0[SiNBUTi0N5
A. SPoUSAL�ISTRI9UTIONS UNOE0.SEQION 9111 FOR WHICX AN ELERION TO TAH IS NOTTANEN:
1.
B. CHA0.ITABLE AND GOVERNMENrAL DI5IRIBIRIONS:
1.
TOTAL OF PART 11-ENTER TOTAL NON-TA%ABLE DISTRIBUTIONS Ofi LLNE 13 OP REV-1500 COVER SHEEf. j
IF more space is neetletl,use aadi[ional sheets of paper of the same size.