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Home My WebLink About08-19-15 (4) � 1505614134 EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 5 0 6 7 8 Harrisburq PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death nnMDDYm' Date of Birth MMDDYYYY 0 6 0 8 2 0 1 5 0 6 2 0 1 9 2 3 DecedenYs Last Name Suffix Decedent's First Name MI B 0 B B J 0 H N R (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N / A THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1.Original Return � 2.Supplemental Return � 3. Remainder Return(date of death Prior to 12-13-82) � 4.Agriculture Exemption � 5. Future Interest Compromise(date of � 6. Federal Estate Tax Return Required (date of death on or after 7-1-2012) death after 12-12-82) Q 7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust � 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) ❑ 13. 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 T0: Name Daytime Telephone Number J 0 H N C • Z E P P I I I 7 1 7 5 2 8 8 9 0 � First Line of Address P • 0 • B 0 X 2 0 4 Second Line of Address 8 4 3 8 C A R L I S L E P I K E City or Post Office State ZIP Code Y 0 R K S P R I N G S P A 1 7 3 7 2 ,,a c� � CorrespondenYs e-mail address: n � "� ►T� C � c� REG&TE�3.tOF WILL�_: E O Q LJ 't7 G� �.:,n %z7 REGISTER OF WILLS USE ONLY CTl __ C'� .._;. C7 _.7 .�,. i i--� . � T�l DATE FILED MMDDYYYY - ` � CD : ��-� __ _..., .. -, r.:� _�� _, _�� +� � .� ' � __...� C 7 _.. Crl DATE FILED ST�tlZP F�_A V � � PLEASE USE ORIGINAL FORM ONLY Side 1 (IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII �� 1505614134 1505614134 J � �� 1505614234 � REV-1500 EX(FI) DecedenYs Social Security Number DecedenYS rvame: J 0 H N R • B 0 B B 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(Sehedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. • 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 8 6 5 3 . 7 6 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 2 � 9 4 . 3 0 7. Inter-Vivos Transfers&Miscellaneous N -Probate Property (Schedule G) � Separate Billing Requested . . . . . . . 7. . 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 1 4 4 8 , � 6 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 4 3 1 8 . 4 7 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 4 3 5 2 . � 2 11. Totai Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 8 6 7 0 . 4 9 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 2 � 7 � . 5 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. 2 7 7 7 . 5 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 15. � . � � 16. Amount of Line 14 taxable at lineal rate X.045 2 7 7 7 . 5 7 �g. 1 2 4 . 9 9 17. Amount of Line 14 taxabie at sibling rate X.12 � . � � 17. � . 0 � 18. Amount of Line 14 taxable at collateral rate X.15 � • 0 � �g, � . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1, 2 4 . 9 9 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,inciuding accompanying schedules and statements,and to the best of my knowledge and beiief, 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. SIGNATUR OF PE ON RESPONSIBLE F R FILING RET� DATE a / ADDRES P • 0 . 76 YORK SPRINGS PA 17372 SIGN UR OF PREP ER T R THAN PERS SP NS BLE FOR FILING THE RETURN QDATE b ADDRESS P . 0 • BOX 204 YORK SPRINGS PA 17372 I I'II'I IIIII IIIII III'I IIIII IIIII II'll II�I'IIIII IIIII IIII IIII Side 2 � 1505614234 1505614234 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 2� 15 0678 DECEDENT'S NAME JOHN R. BOBB STREET ADDRESS 770 South Hanover Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: �• Tax Due(Page 2,Line 19) (1) 124.99 2, CretlitslPayments A.Prior Payments B.Discount 6.24 (See instructions.) Total Credits(A+g) (2) 6.24 3. I nterest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the tlifference.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) 118.75 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 ...................................................................... ❑ ❑X b. retain the right to designate who shall use the property transferred or its income ............................... ❑ X c. retain a reversionary interest ..................................................................................................... ❑ ❑X 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 consitleration? ....................................................................................... ❑ � 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?.................................................................................................. ❑ ❑X 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 decetlent'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 EK+(OS-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: JOHN R. BOBB 21 15 0678 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. 2009 Hyundai Sonata (sold) 8,000.00 2. Prepaid burial over payment 358.82 3. car insurance refund 294.94 TOTAL(Also enter on Line 5,Recapitulation) $ 8 653.76 If more space is needed, use additional sheets of paper of the same size. REV-1509 E�+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE �OINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JOHN R. BOBB 21 15 0678 If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT a. Linda J. Green P.O. Box 76 Daughter York Springs, PA 17372 B. c. JOINTLY•OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 1/2001 PNC Bank Checking and Savings 5,588.60 50. 2,794.30 #51-4000-5228#51-38-5853 TOTAL(Also enter on Line 6,Recapitulation) $ 2 7g4.30 If more space is needed,use additional sheets of paper of the same size. REV-1511 F�X+(08-13) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN R. BOBB 21 15 0678 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Linda J. Green and Debra A. Stine 1,500.00 StreetAddress PO BOX 76 ciry York Sprinqs State PA ziP 17372 Year(s)Commission Paid: 2. Attomey Fees: John C. Zepp III 2,000.00 3, Family Exemption:(�f decedenYs address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. ProbateFees: Cumberland County Register of Wills 150.50 5 Accountant Fees 6. Tax Return Preparer Fees: 7, The Sentinel 243.64 8. Cumberland Law Journal 75.00 9. Ad to try to sell the car $.25 10. Car Insurance for June and July$124.05 each month 248.10 11. Returned funds for over payment from Public School Retirement 92.98 TOTAL(Also enter on Line 9,Recapitulation) $ 4 318.47 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN R. BOBB 21 15 0678 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. Millenium Pharmacy 40.76 2 Chapel Pointe Nursing Home 2,019.37 3. Estate Recovery Program 2,29�.89 TOTAL(Also enter on Line 10,Recapitulation) $ 4 352.02 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JOHN R. BOBB 21 15 0678 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 [Inciude outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Linda J. Green Lineal 11.11 PO Box 76 York Springs, PA 17372 2. Debra A. Stine Lineal 11.11 1180 Old Mountain Rd. Dillsburg, PA 17019 3. Terry R. Bobb Lineal 11.11 366 S. Middlesex Rd. Carlisle, PA 17013 4. Larry Bobb Lineal 11.11 2261 Coon Rd. Aspers, PA 17304 5. Stanley C. Bobb Lineal 11.11 3921 Trail Ridge Road Middleburg, FL 32068 6. Michael L. Bobb Lineal 11.11 216A Capital Hill Td Dillsburg, PA 17019 7. Patricia K. Wooten Lineal 11.11 956 Cedars Rd Lewisberry, PA 17339 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. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is neetletl,use additional sheets of paper of the same size. � Continuation of REV-1500 Inheritance Tax Return Resident Decedent JOHN R. BOBB 21 15 0678 DecedenYs Name Page 1 File Number Schedule J -Beneficiaries - 1 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).] 8. Randy J. Bobb Lineal 11.11 131 Schofield Drive East Berlin, PA 17316 9. Steven R. Bobb Lineal 11.11 222 Lion Park Lane Shermans Dale, PA 17090