HomeMy WebLinkAbout07-30-15 1505610140
REV-1500 EX (01-10'
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO Box 280601 INHERITANCE TAX RETURN 2 1 1 2 0 9 5 5
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 8 3 1 2 0 1 2 ' 0 9 1 8 1 9 5 8
Decedent's Last Name Suffix Decedent's First Name MI
W A R D V I O L E T M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
n 1.Original Return Q 2.Supplemental Return n 3.Remainder Return(date of death
prior to 12-13-82)
4.Limited Estate n 4a.Future Interest Compromise(date of n 5.Federal Estate Tax Return Required
death after 12-12-82)
® 6.Decedent Died Testate n 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
® 9.Litigation Proceeds Received n 10.Spousal.Poverty Credit(date of death 11.Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
G E R A L D J S H E K L E T S K I E S Q 7 1 7 7 7 4 7 4 3 5
REGISTER OF WILLS USE ONLY
First line of address
4 1 4 B R I D G E S T
C� :;0
Second line of addresso M
P - 0 B 0 X E
City or Post Office State ZIP Code 'DATE FILO r—
rTt rn
N E W C U M B E R L A N D P A 1 7 0 7 0 o
C--)
-) Z n
CorrespondenCse-mail address: GSHEKLETSKI@STONELAW.NET + ��'', r M
Under penalties of
p perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of mi-knowledge and�,eli@f, (/) O
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has"any knowledge.cn 71.
SIGN TURE OF ERSON RESY0 SIBLE FOR FILING RETURN D T
•
ADDRESS
GARY D• WOLFE, 1491 SIMPSON FERRY RD NEW CUMBERLAND PA 17070
SIGNA �PR�ER�R�T &RST�4TIVEADDRES
GERALD J • SHEKLETSKI, ESQ • 414 BRIDGEST•NEW CUMBERLAND PA 17070
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140
J �
1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: V 10 L E T M • WARD
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. 1 6 7 1 8 4 . 9 7
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .. . . ... 6.
7. Inter-Vivos Transfers 8 Miscellaneous N�Probate Property
(Schedule G) Separate Billing Requested .. . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) . . .. . .. . . . . . . . . . . . .. .. . . .. . 8. 1 6 7 1 8 4 . 9 7
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. 1 6 7 1 8 4 . 9 7
13. Charitable and Governmental Bequests/Sec 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. 1 6 7 1 8 4 . 9 7
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 - 0 . 0 0 15. ❑ . 0 0
16. Amount of Line 14 taxable
at lineal rate X.0_ 0 . 0 0 16. 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate x.15 1 6 7 .1 8 4 . 9 7 18. 2 5 0 7 7 . 7 5
19. TAX DUE . . .. . . . . . . . .. . . . .. . . . . . . . . .. . . .. .. . . . . .. . . . .. . . .. . . . . . 19. 2 5 0 7 7 • 7 5
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
L 1505610240 1505610240
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 12 0955
DECEDENTS NAME
VIOLET M - WARD
STREET ADDRESS
1491 SIMPSON FERRY ROAD
CITY STATE ZIP
NEW CUMBERLAND I PA 117070
Tax Payments and Credits:
11. Tax Due(Page 2,Line 19) (1) 251077 .75
2. Credits/Payments
A.Prior Payments
B.Discount '
Total Credits(A+B) (2) 0 . 00
3. Interest
(3)
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) 25,077-75
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; ........................................................... .......... ❑
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ 191
c. retain a reversionary interest;or ................................................................................................ ❑
191
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑
191
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... El ❑X
3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. ❑
IF 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 stepparent 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(1.2)[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,unde
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1508 EX+(11-10)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE
INHERITANCE TAX CASH, BANK DEPOSITS, & MISC.
RESIDENT DECEDE DECEDENT
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
VIOLET M. WARD 21 12 0955
Include the proceeds of litigation and the-date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. LITIGATION PROCEEDS RECEIVED FROM SURVIVAL ACTION • 1671184 . 97
COPY OF CHECK ATTACHED. PLEASE WAIVE INTEREST AS THIS
RETURN IS FILED WITHIN 30 DAYS OF RECEIPT OF CHECK-
TOTAL(Also enter on Line 5,Recapitulation) $ 1671l84 -97
If more space is needed,insert additional sheets of paper of the same size
REV-1513EX+(01-10)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
VIOLET M. WARD 21 12 0955
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include ought spousal distributions and transfers under
Sec.91 6(a)(1.2).]
1. GARY D. WOLFE Collateral 167i184 -97
1491 SIMPSON FERRY RD
NEW CUMBERLAND, PA 17070
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B,CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET.
ENTER CrK I U I AL NON-TAXABLE
If more space is $
STONE, LAF"ER & STONE
ATTORNEYS AT LAW
414 BRIDGE STREET 0
NEW CUMBERLAND,PA 17070 C13:17
-n
LAST WILL AND TESTAMENT
' OF
VIOLET M. WARD
I, VIOLET M. WARD, of the Borough of New Cumberland, Cumberland
County, Pennsylvania, declare this to be my last will and revoke any
will previously made by me.
ITEM I: I devise and bequeath all of my estate, of every nature
and wheresoever situate, to GARY D. WOLFE, if he survives me.
ITEM II: Should GARY D. WOLFE fail to survive me, I devise and
bequeath all of my estate, of every nature and wherever situate, to my
brother, DALE C. WARD. Should my brother, DALE C. WARD, fail to
survive me, I devise and bequeath all of my estate, of every nature
and wherever situate, to the FIRST CHURCH OF GOD, Fourth and Strawber-
ry Streets, Harrisburg, Dauphin County, Pennsylvania.
ITEM III: I appoint GARY D. WOLFE Executor of this my last will.
Should GARY D. WOLFE fail to qualify or cease to act as Executor, I
appoint my brother, DALE C. WARD, Executor of this my last will.
Should my brother, DALE C. WARD, fail to qualify or cease to act as
Executor, I appoint my Pastor, PAUL ANDERSON, Executor of this my last
will.
ITEM IV: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of his duties in
any jurisdiction.
Page 1 of 3
RHOADS&SI NON LLP e U J G 4-j
IOLTA ESCROW ACCOUNT ESTATE OF,VIOLET M. WARD
DATE INVOICE NUMBER MEMO BALANCE.
07/17/2015 07/17/2015' 13299-000-• 1 167,184.97
RECOVERY WRONGFUL DEATH-/ SURVIVAL
T«
CHECK.. CHECK
DATE, 'NUMBER
.167
07/17/20 23 TOTAL
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