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Home My WebLink About07-31-15 _ �pennsytvania 1505614105 DEPAPTM'cNTOF PEVF.NUF EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number INHERITANCE TAX RETURN Ha BOX 280601 ............ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ................_......_..............._..._........._............__..............................._.............._..................... ......_......................_........._..._..__..........._..........._.._................ ..._.... ` 08222014 06091956 e..._..............................._...._......................._.......... ...........................__.............._..........__..f f.............................__.................................................. ....................................__i u.................._......._............................................................................................ Decedent's Last Name Suffix Decedent's First Name MI JShu,ghart Cheryl L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ..................... ......... ............................................_.............................. .... Shughart i ? Alan ((€ ..................................................................................................................................................................................................................................1 ...............................................i THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW CED 1.Original Return O 2. Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Agriculture Exemption(date of C=) 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) C@D 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) O 10, Litigation Proceeds Received p 11. Non-Probate Transferee Return p 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 14.Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Ronald E. Johnson, Esq (717) 243-0123 3 First Line of Address 78 West Pomfret Street Second Line of Address . ............................................................................................................................................................................................................................................................................................................. r ............ .............................................................................................................................. ..! City or Post Office State ZIP Code Carlisle PA 17013 0 Correspondent's email address: rejOhnSOn@pa.net M o r T1 n REGISTER OF WtL SE ONLF—_ -- REGISTER OF WILLS USE ONLY ::0 ;;.. r-'- W r� DATrTI E FILED MMDDYYW CD "L7 ry r— rTl DATE FILED STJ%MP r— 0 PLEASE USE ORIGINAL FORM ONLY Side 1 1505614105 1505614105 1505614205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Cheryl L. Shughart RECAPITULATION 1. Real Estate(Schedule A). . ..... . .... .. .. .. .... .. ........ .. ...... .... . 1. 0.00 2. Stocks and Bonds(Schedule B) .. . .. ........ ..... ... ................ .. 2. 1 50,278.65 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 i 4. Mortgages and Notes Receivable Schedule D 4. 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 0.00 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . ...... 6. 1 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 0.00 8. Total Gross Assets total Lines 1 through 7 8. 50,278.65 i 9. Funeral Expenses and Administrative Costs(Schedule H).... .... .. .. . ..... . 9. 25,447.20 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). ..... ... .. .... 10. 0.00 11. Total Deductions(total Lines 9 and 10). .... .. .. .... ... . .. ........ ... . .. 11. 25,447.20 ' 12. Net Value of Estate(Line 8 minus Line 11) ...... .. ...... ....... ....... .. 12. € 24,831.45 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) ... ...... . ...... ........ 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) .. ..... ..... ... ......... 14. 0.00 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 1 24,831.45 15 ` 0.00 16. Amount of Line 14 taxable i I at lineal rate X.0_ 16. 17. Amount of Line 14 taxable at sibling rate X.12 17. ` i� 18. Amount of Line 14 taxable at collateral rate X.15 18. 1 19. TAX DUE .. ... ......... .. ..... .. ..... .... ...... . .. .. .... .. .. .. . .. . 19. 0. 10 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Under penalties of perjury,I declare 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. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has any knowledge. SIG;WF PE RESP NSIBLE POR FILING RETURN D ADDRESS OF REP OTH H PERSON RESPONSIBLE FOR FILING THE RETURN DATE / /Ii AD RESP]�2 Ar"A 0 ` A ! (I L Side 2 15 5614205 1505614205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Cheryl Lynn Shughart STREETADDRESS 55 Kelly Road CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 (See instructions.) Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 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) 0.00 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.......................................................................................... ❑ N b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ c. retain a reversionary interest .............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ N 3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death?.............. ❑ E 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 step-parent 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(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, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. LAST WILL AND TESTAMENT OF CHERYL LYNN SHUGHART 1, CHERYL LYNN SHUGHART, of Penn Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my Husband, ALAN E. SHUGHART, providing he shall survive me by thirty(30) days. Should my Husband, ALAN E. SHUGHART,predecease me or die on or before the thirtieth day following my death, I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my children, equally, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death, shall be distributed to his or her issue, per stirpes, living on the thirty-first day following my death, and in default of such then living issue, such share shall be added to the share or shares for my other children. THIRD: I direct that all taxes that may be assessed in consequence of,my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. FOURTH: I nominate, constitute and appoint my husband, ALAN E. SHUGHART Executor of this my Last Will and Testament. FIFTH: I direct my Executor and his successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of one (1) typewritten pages, each identified by my signature, this g?j day of August 2014. A L ,1472-4A A )r)U A,11& W��Am ) Cheryl L)ON 8hu_gh2!�V Signed, sealed, published and declared by the above-named Testatrix, Cheryl Lynn Shughart as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, CHERYL LYNN SHUGHART Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Cheryl Lynn Shughart the Testatrix, this z day of August 2014. �U-�(SEAL) Ch L Shughart T atrix No COMMONWEALTH OF PENNSYLVANIA Notarial Seal Ronald E Johnson, Notary Public Carlisle Borough, Cumberland County My Commission Expires March 11,2016 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF UMBERLAND WeI� �Zpf 9 and � �/� �, �f�j' �lij , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that Cheryl Lynn Shughart signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or armed to and subscribed to before me by S' ffiN and witnesses, this day of August 2014. (SEAL) ntess 44�� !Lsla� (SEAL) L. Witness ' A29&oz-!4— otary Public COMMONWEAL ByL,4ANIA Notarial seal Ronald E Johnson, Notary Public Carlisle Borough,Cumberland County My Commission Expires March 11,2016 REV-1503 EX+(02-15) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Cheryl Lynn Shughart 21-14-1004 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 _ 649 shares_.._ hareses FNB CoPratoin $12.35/share(8/22/14) 8,015.15; jr 2; `412 shares Exxon Mobil Corporation @$98.50/share(8/22/14) 40,582.00 3 $3,000 Bond-The Industrial Development Authority of the County of Stone,Missouri- �.. III ndustnal Revenue Bond,Series 1981 (see attached) H � 'E 1,681.50 1 fl I t i ; 1 E t is , t I l. .._.........................._.......,....,_............... � It l_ _ . . - .... �. _ i , t TOTAL(Also enter on Line 2, Recapitulation) $ 50,278.65 jj If more space is needed,insert additional sheets of the same size Johnson From: landon.luther@usbank.com Sent: Tuesday, October 28, 2014 11:10 PM To: Johnson Cc: 'Shelly' Subject: Re: Industrial Revenue Bond-Stone Co. Missouri Mr. Johnson, The value of Ms. Shugharts Stone Co. Revenue Bond at the time of her death was and still is$1,681.50. If you'd like to transfer ownership of Ms. Shugharts bond, the requirements are below and they can be sent to my attention at our address below. I suggest you consult a bond broker to make arrangements in selling this bond as this is a service that U.S. Bank Corporate Trust doesn't offer. Feel free to reply or give me a call if you have further questions. Regards. Transfer Requirements: -Original bond R_1119 registered to Sheryl Lynn Shughart - Form of Assignment on back of bond completed by representative of Sheryl Lynn Shughart. Individual assigning ownership must sign their name and provide capacity to sign (ie. personal representative, executor, etc, etc.) Assignment must be affixed with a valid, undated, Medallion Signature Guarantee stamp. -Clear letter of instruction that details the transfer of ownership. Letter should include new holder information, address, tax id, payment information (check or wire) and address to mail newly registered and printed bond. -W9 tax form for new holder -$15 Transfer fee check made payable to U.S. Bank National Association. Landon L. Luther Operations Manager U.S. Bank Global Corporate Trust Services 111 Fillmore Ave E. St. Paul, MN 55107 Phone: 651-466-5101 For security reasons, U.S. Bank Corporate Trust Services requests that if customer confidential information is included in your email, please utilize the Cisco Registered Envelope Services (CRES) Secure Mail system if sending customer confidential information to U.S. Bank. IMPORTANT NOTICE: This email is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and/or exempt from disclosure under applicable law. If you are not the intended recipient of the information or an employee or agent responsible for delivering it to the intended recipient, please be advised that any dissemination, distribution or copying of this communication is strictly prohibited. From: "Johnson"<reiohnson Wya.net> To: <Landon.LutherAusbank.com>, Cc: "'Shelly"'<aJ(cDPa.net> 1 REV-1511 EX+(02-15) Iffpennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Cheryl Lynn Shughart 21-14-1004 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Ronan Funeral Home-funeral service _ 9,976.70!j »-r._.�...rr.�.-....i,_......_ � -..... . yam 2] [Osiris Osiris Holding of Pennsylvania, Inc.-Cumberland Valley Memorial Gardens-grave opening ':{� _ 1,926 00 F31Cumberland Valley Memorial Gardens-grave marker _7,L39.00 11 L ElS iE, 1 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: {' -y Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: T 2,000.00�+ 2. Attorney Fees: --=�- � -- 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Alan E. Shughart Street Address 55 Kelly Road city Shippensburg state PA zip 17257 Relationship of Claimant to Decedent Husband '. 4. Probate Fees: 190.50 rf- 5. Accountant Fees: 6. Tax Return Preparer Fees: �• L - )�Sollenbergers-notary fees �- �15.00 Reserve for closing and accounting }1,_� 500.00 TOTAL(Also enter on Line 9, Recapitulation) $3� 25,447.20 If more space is needed,use additional sheets of paper of the same size. 1 REV-1513 EX+(02-15) i` pennsylvania. SCHEDULE DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT - ESTATE OF: FILE NUMBER: Cheryl Lynn Shughart 21-14-1004 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. 'Alan E Shughart,55 Kelly Road Shippensburg,PA 17257 husband J 1F 100%I' ......._.....__..._.., ...w .._.............. ._._. 7 ....._.4 .. ............. ......_..........._._.._._..,............._......................_....___'- ....... _... .....-.._.....,.........._..,..•..............,................$ I t _.._.__. a L.... - j, ywR.� I - - • I , I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: ��--�•-�-,-mow:;-�•��r_-:-W .� ._--:;- .�•:_u:�w.�<<µ:::::•�.w:��,--��.-�•-��M—;-� ---- - LJr ppCC � B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 -- -...._.__..................._..........-........................_............_.._..................-........._............._.__. . F � I x LJ F t t 1 • �I TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed,use additional sheets of paper of the same size.