HomeMy WebLinkAbout08-20-15 (2) J pennsytvania 1505614105
DEMNF MOFREVENUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN , , --I
Harrisburg, PA 17128-0601 RESIDENT DECEDENT �`�
ENTER DECEDENT INFORMATION BELOW
Social Security Number _ Date of Death MMDDYYYY Date of Birth MMDDYYYY
` — — 03082015 _ I 07271929
Decedent's Last NameSuffix Decedent's First Name _ MI
(Weaver --�_—..--— —.---I ;�—� Elmer � � H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name _ Suffix Spouse's First Name MI
Weaver ; Anna I M
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CgD 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 O 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)
OD 7. Decedent Died Testate O B. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received O 11. Non-Probate Transferee Return O 12. DeferraUElection 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
(Thomas P Gleason, Esquire (717) 532-3270
First Line of Address
49 West Orange Street
Second Line of Address
L— a
City or Post Office — -- State ZIP Code _ _—� v, -;j m
� rrl
Shippensburg [TA] 17 5 I,, ? o
Correspondent's email address: tomgleason@tomgleasonlaw.com "= MN -;l M
- CD
REGISTER OF WILLS USE OW (D
REGISTER OF WILLS USE ONLY ..
r
DATE FILED MMDDYYYY :j CO
DATE FILED STAMP
PLEASE USE ORIGINAL FORM ONLY -
Side 1
111111111111111111(ill IN
1505614105 1505614105 J
1505614205
REV-1500 EX(FI)
Decedent's_Social Security Number
Decedent's Name: Elmer H. Weaver 0911
RECAPITULATION
1. Real Estate(Schedule A). ...... .............. .... .. .......... ........ 1. 0.00
t
2. Stocks and Bonds(Schedule B) .... . ...... ....... ..................... 2. 1 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00
4. Mortgages and Notes Receivable(Schedule D) ... ...... .. ................ 4. 1
0.00 j
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 53,778.33
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... .... 6. 1 0
7. Inter- ivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
I
8. Total Gross Assets(total Lines 1 through 7).... ...... ... ................ 8. 53,778.33
9. Funeral Expenses and Administrative Costs(Schedule H).. . .... ............ 9. 21,043.89
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). .............. 10. 3,706.70
+
11. Total Deductions(total Lines 9 and 10). ....... ...... ...... ............. 11. 24,748.14 i
12. Net Value of Estate(Line 8 minus Line 11) ..... ...... .. . . . ......... ..... 12. 29,029.74 i
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which
an election to tax has not been made(Schedule J) ....... .. .......... ..... 13. 13,063.38
r-
14. Net Value Subject to Tax(Line 12 minus Line 13) ..... . . ..... ............ 14. 1 15,966.36
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 8,708.92
(a)(1.2)X.0 00 i15. 1 0.00
16. Amount of Line 14 taxable I
at lineal rate X.0 45 I 7,257.44 i 16. 326.59
17. Amount of Line 14 taxable I T `
at sibling rate X.12 t 0.00 i 17.i 0.00
18. Amount of Line 14 taxable
at collateral rate X.15 0.00 18.1 0.00
19. TAX DUE .............. ..... .... . . .... .. . ..... .. . ..... .... .... .... 19.
326.59 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
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.
SIONATURE OF PERSON RESPONSIBLE FOR FILING RETU DATE `
`
DDRESS
999 Ridge Road, Shippensburg, PA 17257
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADDRESS
11111 IIIII 1111 Jill Side 2
1505614205 1505614205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Elmer H. Weaver
STREETADDRESS
999 Ridge Road
CITY STATE 717257
Shippensburg PA
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 326.59
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) 326.59
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 .......................................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0
c. retain a reversionary interest .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑
2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑
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 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
172 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.
REV-1508 EX=(02-15)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Elmer H.Weaver
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
• Orrstown Financial Investment account with Pershing (Account No.4N2-975817-1) 53,778.33
TOTAL(Also enter on Line 5, Recapitulation) $
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(02-15)
pennsytvania SCHEDULE H
w-Ol DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT
DE EDENTAX TURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Elmer H. Weaver
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Fogelsanger-Bricker Funeral Home 11 648.50
2. Country Pantry for Memorial Luncheon 375.14
3. Newville First Church of God use of building for funeral&luncheon 225.00
4. Pastor Allen Martin for honorarium 75.00
5. Kenny Wadel for honorarium 75.00
6. Jonathan Wadel for honorarium 25.00
7. Rowe Mennonite Church 25.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 2,400.00
Name(s)of Personal Representative(s) Jerome Weaver&Anna Weaver
Street Address 18 Jumper Road and 999 Ridge Road
city Shippensburg _ State PA ZIP 17257
Year(s)Commission Paid: 2015
2. Attorney Fees: 2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00
Claimant Anna Mary Weaver
Street Address 999 Ridge Road
city Shippensburg State PA zip.17257
Relationship of Claimant to Decedent Wife
4. Probate Fees: 315.50
5. Accountant Fees: 200.00
6. Tax Return Preparer Fees:
7• Cumberland Law Journal to publish estate notice 75.00
8. The News Chronicle to publish estate notice 104.75
TOTAL(Also enter on Line 9, Recapitulation) $ 21,043.89
If more space is,needed,use additional sheets of paper of the same size.
REV-1512 EX+(02-15)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Elmer H. Weaver
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Franklin County Medical Associates 109.05
2. Menno Haven Physician Services 117.66
3. Chambersburg ALS Transport 994.33
4. Chambersburg Imaging Associates 3.64
5. Summit Physician Services 236.44
6. Menno Village at Menno Haven 2,042.00
7. Borough of Chambersburg Ambulance 72.96
8. Fayetteville Volunteer Fire Company 128.17
TOTAL(Also enter on Line 10,Recapitulation) $ 3,704.25
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(02-15)
pennsytvania SCH EDU LE
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Elmer H.Weaver
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. Stephen K.Weaver Lineal-Son 6.25% of residual
2. Herbert G.Weaver Lineal-Son 6.25%of residual
3. Emmy B.Gerber Lineal-Daughter 6.25%of residual
4. Jerome D.Weaver Lineal-Son 6.25%of residual
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:
1 Anna M.Weaver 30%of residual
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
Rowe Mennonite Church 15%of residual
2. Christian Light Publications 15%of residual
3. Christian Aid Ministries 15% of residual
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.
Oew t Wiff and ToWment of
(?u-bnar 0� CWemer
I.ELMER H.WEAVER.of Hopewell Township.Cumberland County.Pennsylvania,
beingof sound mind and memory declare this to be my Last Will and Testament and revoke any
will or codicil previously made by me.
ITEM 1: 1 direct that all my just debts and funeral expenses.including my gravernarker
and all expenses of my last illness,shall be paid from my residuary estate as soon as practicable
after my decease as a part of the administration of my estate.
ITEM H: I direct.that all shares of stocks,of which I am a sole owner.be liquidated as
part of the administration of my estate. I give.devise,and bequeath the net value received for
said stock liquidation to the following organizations: Fifteen(15%)Percent to Rowe
Mennonite Church; Fifteen(15%)Percent to Christian Light Publications,Fifteen(15%)
Percent to Christian Aid Ministries;Twenty-five(25%)Percent to Stephen K.Weaver,
Emmy B.Gerber,Jerome D.Weaver.and Herbert G.Weaver,their heirs and assigns living on the
thirty-fist day following my death in shares of equal value and Thirty(30%)Percent to Anna M.
Weaver.
ITEM III: I give.devise,and bequeath the farm tractor. skidloader,and any other farm
equipment of-which I die seized to my issue per stirpes.. share and share alike.
ITEM IV: I give. devise.and bequeath all of the rest residence,and remainder of my
estate of every nature and whosoever situate including any car and pick-up truck which I may
own at my death.to my wife.ANNA M.WEAVER.providing she shall survive my by thirty
j30)days.
ITEM V: I direct that all taxes that my be assessed in consequence of my death.of
whatever nature and by whatever jurisdiction imposed. shall be paid from my residuary estate as
part of the expenses of the administration of my estate.
ITEM VI: I appoint JEROME D.WEAVER and ANNA M.WEAVER,co-executors
of this,my Last Will and Testament.
IN WITNESS WHEREOF.I hereunto set my hand and seal to this my Last Will and
Testament written on Two(02) sheets of paper.dated this (07h day of ��e� `�. .2001.
(SEAL)
ELMER H.WEAVER
The preceding instrument,consisting of this and One(0 1)other typewritten page,each
identified by the signature of the testator.ELMER H.WEAVER,was on the day and date
thereof signed.published and declared by ELMER H.WEAVER,the testator herein named.as.
and for his Last Will, in the presence of us.who.at his request in his presence,and in the
presence of each other.have subscribed our names as witnesses hereto.
JW`rte` residing at /v r iq
ORA residing at T /
2