HomeMy WebLinkAbout10-10-05 (2)
REV-1500 EX (6-00)
OFFICIAl USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
~L
COUNTY CODE
~!L 0 ~ q Q_
YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Shatto Doroth
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
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SOCIAL SECURITY NUMBER
198-22-9079
ntlS RETlJRH MUST BE FILED IN DUPLICATE WITH THE
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3/26/2005 8/4/1929
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INlTlAL)
Denton S. Shatto
[i] 1. Original Return
D 4. Limited Estate
[i] 6. Decedent Died Testate (Attach copy 01 Will)
D 9. Litigalion Proceeds Received
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
201-18-4557
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D 2. Supplemental Return D 3. Remainder Return (elate of elealh prior to 12.13-82)
D 4a. Future Interest Compromise (elate or eleath after 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Attach copyofTrusl) _ 8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (dale 01 dealh between 12.31-91 aro:ll-1-95J D 11. Election to tax under Sec. 9113(A)fAltachSchO)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
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James D. Hu hes, Es i.re
FIRM NAME (If Applicable)
SALZMANN HUGHES PC
TELEPHONE NUMBER
95 Alexander Spring Road Suite 3
Carlisle, PA 17013
717-249-6333
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1. Real Estate (Schedule A)
(1)
'~C"'-USEIii'o/
('"') ....-c
2. Stocks and Bonds (Schedule B)
(2)
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3. Closely Held Caporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule 0) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. JEj O'M1ed Property (Sdledule F) (6)
0
i= Separate B~ling Requested
::s 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7)
:;) (Schedule G or L)
l-
ii: 8. Total Gross Assets (tolalLines 1-7)
<C
(,)
W 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
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10. Debts of Decedent, Mortgage Liabilities, & liens (Sct\eclule I) (10)
11. Total Deductions (total lines 9 & 10)
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35,759
12. Net Value of Estate (line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts forwt1ich al election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus line 13)
SEe INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax 0
z rate, or transfers under Sec. 9116 (a)(1.2)
0
;:: 16. Amount of line 14 taxable at lineal rate 26,745
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:> 0
... 17. Amount of line 14 taxable at sibling rate
:IE
0 0
0 16. Amount of Line 14 taxable at collateral rate
)(
< Tax Due
I- 19.
..0 ~(15)
x .0 ~(16)
x .12 (17)
x .15 (16)
(19)
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE AND RECHECK MATH < <
3W46451.000
Decedent's Complete ress:
smffT ADlJRESS
1422 Bradlev Drive Apt. Clll
Cumberland
CI1Y I STATE If.J013-
Carlisle PA
Add
Tax Payments and Credits:
,. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Cred~
8. Prior Payments
C. Discount
(1)
1.204
o
o
o
Total Cred~ (A + 8 + C) (2)
o
3. Interest/Penalty if applicable
D. Interest
E. Penany
o
o
Total Interest/Penalty (0 + E) (3)
o
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 line 20 to request a refund
(4)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
1.204
A. Enter the interest on the tax due.
(SA)
o
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WIl..LS, AGENT
(58)
1. 204
^"
PLEASE ANSWER THE FOlLOWING QUESTIONS BY PLACING AN "X" IN lliE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
8. retain the use or income of the property transferred;. . . . . . . . . . . . . . . 0 []g
b. retain the right to designate who shall use the property transferred or its income; . D [lg
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . 0 ~
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 0 [j
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? , . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 [1g
3. Did decedent own an ~jn trust for" or payable upon death bank account or security at his or her death? 0 []g
4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . " Ii] D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I <1edare that I have 8>3fflined tma retlJm, indudirlQ ~aJ1J1ing schedules and statements, and to the basl of my knowle<:lge and belief, ills true. lXMTed. and complete
Declaralion of preparer other than the personal representative is based on all infonnation of which preparefha any knowledge.
~SON RESPONSIBLE FOR FILING RETURN
f2 .,& ~p.. 'V
AlXlRES
rive H 113
R THAN REPRESENTATIVE
~(dJ'
Car~isle PA
17013
Car~isle, PA 17013
'f&i.~};-#i'5'Tt~tj~~:#'2~;r;;;1;$??~::r,~~i@i~~~t;'~''&:12.~~1il1f}(ii'ft?:";~~:>4~j\4t[;~~";fr'ii;?"'ffi.0iT.it~i'fu~;~~~~:t~m~~~'+j'~
of death on or atter July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use cAtha surviving spouse is 3%
. S 9916 (0) (1.1) (I)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value cAtransfers to or for the use cAthe survi'o1ng spouse is 0% [72 P.S, ~ 9116 (a) (1.1) (ii)]
The statute does not exempt a transfer to a surviving spowse from tax. and the statutory requirements fordisdosure d assets and ming a tax return are still applicable even jf
the surviving spouse is the only beneficiary.
For dates of death on or after JulV 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years cI age or younger at death to or for the use cI a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(a}(1.2)).
The tax rate imposed on the net value of transfers 10 or for the use of the decedent's lineal beneficiaries is 4.5%, 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% (72 P.S. ~ 9116(1lI)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common \Mth the decedent, vdlether by blood or adoption.
3W46461.000
REV-1509 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITAf\CE TAX RETURN
RESIDENT DECEDENT
EST ATE OF
DorotQy L Shatto
SCHEDULE F
JOINTLY -OWNED PROPERTY
FILE NUMBER
2105
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(Sl NAME
AOORESS
RELATIONSHIP TO DECEDENT
A.
Shatto, Mary Jane
1416 Bradley Drive H113, Carlisle,
PA 17013
Daughter
B.
Thomas, Dora L
61 Meade Drive, Carlisle, PA
17013
Daughter
c.
JOINTL V-OWNED PROPERTY:
<EnE< DATE CESCRlPllON OF PROPERlY %QF DATE OF OEA lH
ITEM FORJOINT MADE INCLUDE """ME OF FINANCIAL II\5T1TUTIONAN:I BAlli< ACCOLNT DATE OF DEA lH DECD'S VAlUE OF
N..MBEROFl SIMILAR IDENTIFYING NJM8ER. ATTACH DEED FOR
NUMBER ,""'" JOINT ..oINflY-I-ELDREALESTATE VALLE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
1 BA 9/1/1975 M&T Bank, savings 11,174 33.0000 3,725
TOTAL (Also enter on line 6, Recaottulationl $ 3 725
3W46AE1.000
(If more space is needed, insert additional sheets of the same size)
REV.1510EX+(6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONlNEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
EST ATE OF
Dorothv L. Shatto
FILE NUMBER
2105
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV~1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM IN:U.a:: TI-E N'\ME OF ne TRANSFEREE, TfElR RELATIONSHIP TO DECEDENT AKl DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
"'MSE' Tl-EDATEOf'TRAN5FER. ATTACHACOPV OF Tt-E OEEO FOR REAL. ESTATE- VALUE OF ASSET INTEREST IF,4pp[JCl\BLfI VALUE
1. American National Insurance
Company, Annuity Policy
#14405618 ; paid to daughters,
Mary Jane Shatto & Dora L.
Thomas 32,034 100.0000 0 32,034
TOTAL (Also enter on line 7, Recapitulation) $ 32 034
(If more space is needed, insert additional sheets of the same size)
3W46AF 1.000
REV-1511 EX + (12-99)
COMMQN\IIJEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dorothv L. Shatto
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FilE NUMBER
21 05
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Carlisle Memorial Service Inc. 160
2 First Church of God 100
Total from continuation schedules 7,739
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative{s)
Social Security Number(s) I EIN Number of Personal Representative(s) - -
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 1,000
3. Family Exemption: (If decedent's address is not the same as daimant's, attach expfanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1 Register of Wi.lls 15
TOTAL (Also enter on line 9, Recapitulation) $ 9 014
3W46AG 1.000
(If more space is needed, insert additional sheets of the same size)
Estate of: Dorothy L. Shatto
198-22-9079
Schedule H Part 1 (Page 2)
Item
No. Description
Amount
3 Hoffman-Roth Funeral Home Inc.
7,723
4 Hoy's Greenhouse
16
Total (Carry forward to main schedule)
7,739
REV-,S12 EX+ (12-03)
COMMONv'vEALTH OF PENNSYLVANIA
INt-ERITANCE TAX REWRN
RESIDENT DECEDENT
ESTATE OF
Dorothy L. Shatto
SCHEDULEJ
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
2105
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NLlMBER
L
DESCRIPTION
VALUE AT DATE
OF DEATH
None
3W46AH 2_000
TOTAL (Also enter on line 10, Recaoitulation) $
(If more space is needed, insert additional sheets of the same size)
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REV.1513 EX+(9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Dorothv L. Shatto
NUMBER
I
1
2
3
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS {include outright spousal distributions, and transfers
under Sec. 9116 <a) (1.2)J
Denton S. Shatto
1416 Bradley Drive Clll
Carlisle, PA 17013
Mary Jane Shatto
1416 Bradley Drive Hl13
Carlisle, PA 17013
Dora L. Thomas
61 Meade Drive.
Carlisle, PA 17013
FILE NUMBER
2105
RELA TIQNSHIP TO DECEDENT
00 Not list Trustee(s)
Surviving Spouse
Daughter
Daughter
AMOUNT OR SHARE
OF ESTATE
-0-
$13,372.50
$13,372.50
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
3W46All.000
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets oHhe sameslZe)
$
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II' I, DOROTHY L. SHATTO, of North Middleton Township, Cumberland
i County, Pennsylvania, declare this instrument to be my Last Will
II And Testament, in manner and form following:
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I' fore made by me.
, 2. I hereby direct my Executor to pay all my just debts,
III funeral and administrative expenses out of my estate, as soon as
I practicable after my death.
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I period of thirty days following my death, Irlevise and bequeath
Ii the remainder of my estate to Denton S. Shatto.
II 4. Should my husband, Denton S. Shatto, predecease me or I
II die' on or before the thirtieth day following my death, I devi.se I
II and bequeath the remainder of my estate to my issue living on the I
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Ii thirty first day following my death, per stirpes. I
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II 5. Should my husband, Denton S. Shatto, predecease me or die
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lion or before the thirtieth day following my death, and should I I
I! have no issue then living, I devise and bequeath the remainder of I
Ii my estate to the First Church Of God Of North America, Carlisle, I
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il Pennsylvania.
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Ii 6. I nom~nate and appoint Farmers Trust Company, Carlisle,
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iiPennsylvania, guardian of any property which passes to a minor I
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Hand with respect to which I am authorized to appoint a guardian
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!: and have not otherwise specifically done so.
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Ii 7. I nominate and appoint my husband, Denton S. Shatto, as
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I: Executor of this my Last Will And Testament; and as substitute
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Ii Executors I nominate and appoint, in order of preference: First,
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iimy daughters, Mary Jane Shatto and Dora L. Shatto, providing they
II or either of them is twenty one years of age; and Secondly, my
II brother and sister-in-law, Richard H. Swartz and;Lucille Swartz.
II
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LAST WILL AND TESTAHENT OF DOROTHY L. SHATTO
1.
I hereby expressly revoke all Wills and Codicils hereto-
3. Should my husband, Denton S. Shatto, survive me for a
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lias well as their successors shall not be required to give bond for
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lIthe performance of their duties in any jurisdiction.
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I direct that my personal representatives and guardian,
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of April, 1966.
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Shatto
(SEA )
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II Signed, sealed, published and declared by the above named
IITestatrix, Dorothy L. Shatto, as and for her Last Will And Testa-
,
11'1' ment, in our presence, who, in her presence, at her request, and
, in the presence of each other, have hereunto subscribed our names
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II as attesting witnesseso
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r:! M&fBank
499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
July 12, 2005
Salzmann Hughes PC
Attorneys At Law
95 Alexander Spring Road - Suite 3
Carlisle, Pennsylvania 17013
Re: Estate of Dorothv L Shatto
Social Security: 198-22-9079
Date of Death: March 26, 2005
Dear Sir or Madam:
Per your inquiry dated July 06, 2005, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1.
Type of Account
Checking Account
Account Number
436356
Ownership (Names oj)
Denton S Shatto, Dorothy L Shatto .
Dora Thomas, Mary JShatto, POA
Opening Date
09/01/67
Balance on Date of Death
$9,693.48
Accrued Interest
$ 0.05
Total
$9,693.53
Interest Paid YTD
-$---i467A~~ru~-'n~t~~~si-;;Mti~~i-;'d~dj
2,
Type of Account
Savings Account
Account Number
021000000999980
Ownership (Names oj)
Dorothy L Shatto, Mary Jane Shatto, Dora L Thomas *
Dora Thomas, POA
Opening Date
09/01/75
Balance on Date of Death
$1I,173.99
Accrued Interest
$
5.32
Total
. _._.__.___,_"" n-..,_.
$1I,179.3I
Interest Posted YTD
$
.__, ..........____.......,_..__._ __.n...
0.00 (Accrued interest is not included)
Please be advised, there was no safe deposit box found for the above decedent. * For further account information,
regarding ownership, closures andlor reimhursement of funds, etc., please call the High Street Carlisle Ollice # 717-
240-4536.
Sincerely,
~4,:,:<,~aCl<<~'--
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Nancy Clagett
Records Management
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AMERICAN NATIONAL INSURANCE COMPANY
LIFE INSURANCE AND ANNUITY CLAIMS DIVISION
P. O. BOX 1840. GALVESTON. TX 77553-1840 BUS: 1-800-615-7372 FAX: 409-766-6994
July 29, 2005
JAMES D HUGHES
SALZMANN HUGHES PC
95 ALEXANDER SPRING RD STE 3
CARLISLE PA 17013
RE: Claim C618971 - Dorothy L Shatto - Policy 14405618
Dear Mr. Hughes:
Thank you for your letter dated July 21, 2005.
Our records indicate this annuity was issued September 15, 2003 with Dorothy L. Shatto as the
Annuitant and Owner. No changes in ownership occurred after the date of issue.
The beneficiaries of her annuity were her daughters, Mary Jane Shatto and Dora L. Thomas, in
equal shares. The death benefit as of the date of death was $32,033.96.
The annuitant had requested at issue to receive monthly interest withdrawals from her policy.
The interest payments the annuitant received in 2005 prior to her death on March 26, totalled
$245.14.
Our records also indicate that, prior to the Company's receiving notice of her death, a check was
issued to the annuitant on April 15, 2005 in the amount of$84.44. Since the Company paid the
value of the contract as of March 26, 2005 and the check was issued after that date, it has resulted
in an overpayment of$84.44. If the check has not been cashed it should be returned to our
office. If the check has been cashed, the beneficiaries may submit their personal checks totalling
$84.44.
Should you have any questions, please feel free to contact our office at 1-800-615-7372.
Sincerely,
~C\CV11h u G-liJUQu0<'--
Marsha Garwick
Associate Customer Service Representative
MG/tn