HomeMy WebLinkAbout08-14-15 a pennsylvania 1505618403
DEPARTMENT OF REVEN&(03-14)
REV-15010 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 21 15 0735
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
02 07 1999 12 14 1958
Decedent's Last Name Suffix Decedent's First Name MI
PICKREN PATRICIA A
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
MENTZER RICKEY J
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
❑X 1. Original Return 1:12. Supplemental Return 1:13. Remainder Return(date of death
prior to 12-13-82)
4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
❑ 7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
F13. Business Assets ❑ 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
CHRISTOPHER E RICE 717 243 3341
First Line of Address
10 EAST HIGH STREET
Second Line of Address
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's email address: criceCa�martsonlaw.com
REGISTER OF WILLS USE QDILY
REGISTER OF WILLS USE ONLY n �+'� rri
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DATE FILED MMDDYYYY
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DAT AILED ST
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CD
Side 1
I IIIIII IIIII IIIII IIIII II II IIIII IIIII IIIII ILII II II Ilii IIII
1505618403 1505618403
J1505618411
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Pickren, Patricia A.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 25,700 - 00
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.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 25,700 - 00
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. 25,700 - 00
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. 25 ,700 - 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.00 25 ,700 . 00 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .06 0 . 00 16. 0 . 00
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 11 - 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 011 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
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.
SI IRE PERSO RES ONSIBL OR FILING RETURN Rickey J. Mentzer T�
ADDRESS ?S I 1
39 Wet a ood Drive, Carlisle, PA 17015
SIGN U E PftEPA�€R O ER THAN REPRESENTATIVE Christopher E. Rice D T�
ADDRESS •1(•t �j
10 East High Street, Carlisle, PA 17013
L 111111111111111111111111111111111111111111111111111111111111 Side 2
1505618411 1505618411
REV-1500 EX Page 3 File Number 21-15-0735
Decedent's Complete Address:
DECEDENT'S NAME
Pickren, Patricia A.
STREET ADDRESS
419 Potato Road
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
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. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make Check Pa able 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;..................................
ncome:.................................. ❑
c. retain a reversionary interest;or............................................................................................................... ❑ ❑x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................. ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑ 0
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 January 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 21ears 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.
Rev-1502 EX+(12-12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Pickren, Patricia A. 21-15-0735
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate-Located in Upper Frankford Township, Cumberland County,Pennsylvania, 25,700.00
known as Parcel No.43-06-0029-014, being described in Deed dated April 15, 1994,and
recorded in Cumberland County, Pennsylvania,Deed book 104, Page 85,and being
conveyed to Patricia A. Pickren,decedent herein.See attached Assessment value and Deed
($25,700.00 x 1.00 common level ratio).
TOTAL(Also enter on Line 1, Recapitulation) 25,700.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Pickren, Patricia A. 21-15-0735
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT
0 Not List Trustee(s) (Words) ($$$)
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Rickey J. Mentzer Spouse 100% of residue 25,700.00
39 West Oakwood Drive
Carlisle, PA 17015
Total j 25,700.00
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
Property Mapper
Cumberland County, PA
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43-06.0029-014
Site Address:POTATO ROAD
Deedbook:00104-00085
Owner:PICKREN,PATRICIA A
Land use Code:121
Property Type:RS
Acreage:0.15
Square Feet:252
Taxable Status:T
Clean&Green Status:
Land Assessed Value$:25500
Building Assessed Value$:200
Total Assessed Value$:25700
Sale Price$:4500
Sale Date:Sun Apr 17 1994 08:00:00 PM
Year Built:1950
Municipality:UPPER FRANKFORD TWP
Height In Stories:1
Type of Dwelling:DETACH
Primary Exterior:Aluminum
BasementPercentage:
Air Conditioning:NO
Total Rooms:2
Bedrooms:
Full Bath:
Half Bath:
�! 93V
�atr't fs DEED
THIS DEED made this \SA�`day of April,1994,between
JANE STIMELING,Executrix of the Estate of Robert J.Moffitt,deceased,late of
the Borough of Coasts,Cumberland County.Pennsylvania,hereinafter called'GRANTOW,
AND PATRICIA A.PICKREN,of P.0.Box 61,Plainfield,Pennsylvania 17081,hereinafter
called*GRANTEE*:
WITNESSETH:
That in consideration of One and 00/100($1.00)Dollar,in hand paid.the receipt
whereof is hereby acknowledged,the Grantor does hereby grant and corrvey to the said Grantee,
her halts and assigns;
ALL that certain tract of land situate in Upper Fronkford Township, Cumberland
County.Pennsylvania,bounded and described as toOows:
BEGINNING at a point in the center One of Township Road No.T-439 at line of land
now or formerly of Melvin W.Fry,single and Margaret C.Fry.widow;thence by the same.North
63 degrees 40 minutes East 69 feet more or less to a point at the low water mark of the
Conodogulnet Creek;thence by the same,South 21 degrees East 81 feet more or less to a point
at One of land now or formerly of Leo F.Peters,at ux;thence by the same.South 65 3/4 degrees
West 35 feet to an Iron pin;thence atilt by the same,South 491/2 degrees West,48.7 feet more
or less to a point in the center One of sold road;thence by the same North 12 degrees 40 minutes
West 91.7 feet,more or less to a point,the Place of BEGINNING.
BEING the same property which Melvin W.Fry,single and Margaret C.Fry,widow,
by their Deed dated August 17, 1982 and recorded In the Office of the Recorder of Deeds In and
for Cumberland County,In Dead Book*13%Volume 20,Page 679, granted and conveyed unto
Robert J.Moffitt and Pearl 8,Moffitt,husband and wife. Pearl E.Moffitt died May 4,1987,thus
vesting full Crile in Robert J.Moffitt,as surviving tenant by the entirety. Robert J.Moffitt died on
December 4.199,and by his Last Wig and Testament duty probated in the Office of the Register
of Wills In and for Cumberland County appointed Jana Stimaling Executrix of his Estate,to wham
Letters Testamentary were duty issued.
SUBJECT TO a reserved easement of drainage In favor of the grantors,their halts end
assigns,with a right to enter to repair the same as such now exits on the land.
Boor. VPar 85
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THIS CONVEYANCE Is made pursuant to Section 3351 of the Probate,Estates and
Fiduciaries Code.
AND the Grantor hereby covenants and agrees that she warrants specialty the property
hereby conveyed.
IN WITNESS WHEREOF,said Grantor has hereunto set her hand and seat the day and
year first above written.
Sped,s.wd and acmes
M sa Prmms of
ftd Q1J���/ v£
,Ia4 Stlmeling,Executrix of t e
Estate of Robert J.Mott deceased
COMMONWEALTH OF PENNSYLVANIA )
as.
COUNTY OF CUMBERLAND )
On this,the\ day of April,1994,before me,the undersigned officer,personally
appeared Jane Stimeling,Executrix of the Estate of Robert J.Moffitt,deceased,known to me(or
satisfactorily proven)to be the person whose name is subscribed to the within Instrument, and
acknowledged that she executed same for the purposes therein contained.
IN WITNESS WHEREOF,I hereunto set my hand and official seal.
c 4ad�v NOTARIAL SEAL
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I do hereby c entfy that the precise residence and complete post office address of the
within named Grantees is P.C),(23 ft), g I
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COMMONWEALTH OF PENNSYLVANIA
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COUNTY OF CUMBERLAND )
RECORDED on this day CIA&I flog,In the
Recorder's Office of the said County,In Deed Book 10.E Page .
Given under my hand and seal of the said office,the dal
a e Inn w
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•sv.rn nePt•q RIVOIDER'S USF ONLY
REALTY TRANSFER TAX Is.sew '00
COMMONWGITrl er nraunVAN1A STATEMENT OF VALUEa-
•1rAerMSNTOrRevisal! r w
evetAU Of INMVWUA!TAXIS
NAulsw.no,rFAAIsol1l07»►oiw See Reverse for InstrucFlons - l
Complete ea&xabn and Me In dvplkae wld,Recorder of Deeds-ban(1)the full volwfcowld•ralen h moi Sol forth la the dead.(2)whoa Ib deed
IS,without mmlduoNon w by SIN,or S)o tax exnem
npllan Is clahned.A Slolenl of Vohs Is not tequlred if the transfer h wholly••smpl from lox
baud on:(1)famMy n�allonsfilp ar(i�publk slily eowmenl.If mon syone Is needed,clad,oddllionol deet):).
Telephone NO,
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R.Check Appcopdot•Eos E•law I.,fWamplle.Clalmsd
❑win ,Im"we Summon
❑ ttonder to fadmitlol De•elopmem Agency.
C)Troeder to c Ined.(Ahad eamplNe copy of kwl ognement id•ndfying all bmufidorler.)
❑Trundw beheoom pdndpol and open'.(Allach campl•le copy of ogencylstraw porty agre•o•nl.)
❑Transit"to At Comxromseohh,the Un"Id$two$and ImtrrmrentdNier by Sib,d•diwlion,condemnallon w In Rau al condemnoiaA.
(U condo 11"or In No of cods nnalon,aeach copy OF too"".)
❑Transfer from nwrtgagw to o holder of o noollogs,In default.Mongoge Book Number ,Page Number_
❑ Corrective w conflrmotory deed.(Attach complete copy of As prlw dead bel"aunecld or conlbrned.)
❑ Stauury cwpoMe".w0dallon,mwgw.w dMslen.(Atlodr copy of adid•c•)
i ❑Other(Pleocs enptoto ou mpNar dolmed,II other If—Ibud above.) ----
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10d,E le hw,cornea and complete.
fvi;q. en•r er7 Y Iw at.
FAILORE TO COMPLETE THIS FORM PROPERLY ORATTACH APPLICABLE DOCUMENTATION MAY RESULT IN THE RECORDER'S REFUSAL
TO RECORD THE DEED. h 104 ;{rE op8
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