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REV-1500
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 05
COUN.T'( CQP!= YE:i\R
SOC~LSECURITYNUMBER
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OEPT. 280601
HARRISBURG, PA 17~28-0601
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lebo, Ruth N
DATE OF DEATH (MM-DD-YEAR) '-1 DATE OF BIRTH (MM-DD-YEAR)
06/18/2005 02/21/2023
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
REGISTER OF
SOC~L SECURITY NUMBER
182-16-9967
0593
NUMBER
THIS RETURN MUST BE FILED IN DU LICATE WITH THE
1. Original Return
3. Remainder Return (date of death
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o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of death
after 12-12-82)
o 7. Decedent Maintained a living Trust (Attach
copy of Trust)
o 10. Spousal Poverty Credit (date of death between
12-31-91 and 1-1-95
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAnON SHOUI..D BE DIRECTED TO:
AME COMPLETE MAILING ADDRESS
Michael R Smith
6. Decedent Died Testate (Attach copy
of Will)
9. Litigation Proceeds Received
o 5. Federal Estate Tax Return Re uired
o
8. Total Number of Safe Deposit Boxes
o 11.EJection to tax under Sec. 911 (A) (Attach Sch 0)
o 4. limited Estate
~
o
IRM NAME (If applicable)
Turo Law Offices
28 8. Pitt 8t.
Carlisle, P A 17013
LEPHONE NUMBER
7i7/245-9688
None
'JFFICIL.1. IYS or JL l
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
None
None
3. Closely Held Corporation, Partnership or Sole-Proprietorship
None
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None
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
9,244.05
2,288.37
-0-
1,881.50
(8)
(9)
(10)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
% .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
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lL 17. Amount of Line 14 taxable at sibling rate x .12 (17)
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x 18. Amount of Line 14 taxable at collateral rate
0( x .15 (18)
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19. Tax Due (19)
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2000 form software only The Lackner Group, Inc.
>> BE SURE TO ANSWER ALL QUES110NS ON RfM!RSI!! SIDE AND.RECMECK MATH<<
Form REV-1500 X (Rev. 6-00)
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Decedent's Complete Address:
STREET ADDRESS
335 Wesley Drive
Apt. 21 7
CITY
STATE PA
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
ZIP 17055
(1)
(2)
0.00
(3) 0.00
(4)
(5) 0.00
(5A)
(5B) 0.00
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;..................................................................................... D
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d. receive the promise for life of either payments, benefits or care?.................................................................. D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................................................................................................. ............ D
D
D
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?...................................................................................................................... .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
Oecl~ionof prepare'olhEl,_than the """,,,"al repre<;~lfJli~isba~ed--""all inf<>rmatiOllofwhich P",pa~ has anyknow!e<!9"c_
SIGNATURE OF PERSON RESONSIBLE FOR FILING RETURN ADDRESS
~ri.D D. W. De - 212 Green Lane Drive
Camp_liill, P A 17011
E SON RESPONS-II:lLE FOR FlUNG TURN ADDRESS
--ADDRESS-
28 S. Pitt Street
Carlisle, P A 17013
.lit
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of t e
surviving spouse is 3% [72 P.S. S9116 (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 us'
[72 P .5. S9116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the sta
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 twenty-one years of age or younger a
parent, an adoptive parent, or a stepparent of the child is 0% [72 P ,5. S9116 (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.!
1.2) [72 P.S. S9116 (a) (1 )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. ~
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
flAP])
J 1111-57
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lebo, Ruth N
FILE NUMBER
21 - 05 - 00593
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on Line 5, Recapitulation)
ALUE AT DATE
OF DEATH
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEAL lH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lebo, Ruth N
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(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A Brian D. Wayne
212 Green Lane Drive
Camp Hill, PA 17011
Son
JOINTLY OWNED PROPERTY:
I
ITEM I LETTER
NUMBER IFOR JOINT
TENANT
A
DATE .1 ..OESCRTpTIONOF PROPERTY i- .-r % OF I DATE OF DEATH
05:~1~996~~~7~:?~=-~~r~~r~~IS~~J~:~~ol,~E~t D CED~~~ ~::~~:;
Acet. # 1000926188034
TOTAL (Also enter on line 6, Recapitulation)
1,881.50
. '
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SCHEDULE H
FUNERAL EXPENSES &
ADMNISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANiA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lebo, Ruth N
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
Parthemore Funeral Home and Cremation Services, Inc.
2
Cemetary Fees
3
Richard H. Rhoads, Jr. Memorials
4
Flowers
5
Christian Life Assembly Church
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
1.
Social Security Number(s) I EIN Number of Personal Representative(s):
2.
Street Address
City State
Year(s) Commission paid
Attorney's Fees Turo Law Offices -- Michael R. Smith
Zip
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees Register of Wills
The Sentinel
Cumberland Law Journal
5. Accountant's Fees
State
Zip
4.
6. Tax Return Preparer's Fees
7. Other Administrative Costs
I
FILE NUMBER
21 - 05 - 00593
AMOUN
TOTAL (Also enter on line 9, Recapitulation)
7,252.00
825.00
235.00
231.50
100.00
300.00
74.00
151.55
75.00
9,244.05
I . I
.
. SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA I LIABILITIES, & LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.. - -------- . mm
m__....... I FILE NUMBER .
ESTATE OF Lebo, Ruth N
21 - 05 - 00593
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
"------.--
I Pinnacle Health Hospitals 2,288.37
TOTAL (Also enter on Line 10, Recapitulation) 2,288.37
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LAST WILL AND TESTAMENT
OF
RUTH N. LEBO
I, RUTH N. LEBO, of the Township of Cumru,
u.
nty,
all
Pennsylvania, make this my Last Will and Testament. I revo
prior wills and codicils made by me.
1. Debts. I direct the payment of all my legal ebts
and funeral expenses as soon as possible after my death.
2.
Taxes.
I direct the payment of all es ate,
inheritance, succession, transfer or like taxes, whether ral,
State or otherwise, which may be payable by reason of my d ath,
together with any interest or penalties, out of the principal f my
residuary estate as if such taxes were administration expens s.
However, no residuary beneficiary, as a resu t of
the direction in the preceding sentence, shall be denied the
f. .\_
benefit of any deduction, credit, favorable rate of tax or
benefit to which such beneficiary is entitled by law.
3.
Residuarv Estate.
I give all the rest, re
and remainder of my estate, real and personal, in cash or in
(including any property over which I may have a powe
of
appointment at the time of my death) to my three sons,
L.
WAYNE, BRIAN D. WAYNE, and SCOTT CHARLES WAYNE, or their issue, per
stirpes.
76 67.1
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4. Appointment of Personal Representatives. I a point
my son, BRIAN D. WAYNE, presently of 212 Green Lane Drive Camp
Hill, PA 17011, as my personal representative to carry 0
terms of this will.
In the event my son is unable to se ve, I
appoint my sons, Dennis L. Wayne and Scott C. Wayne.
my
personal representative to engage the services of
k T.
Barrett, Esquire and Bingaman, Hess, Coblentz & Bell,
Reading, Pennsylvania, who are familiar with my wishes, to
in its proper administration.
5.
Personal Representatives Riqhts and Powers.
My
personal representatives shall have the following right and
powers, without limitation by reason of specification a d in
addition to all powers vested in them by law, which powers th y may
exercise in their sole discretion without obtaining any Court
approval:
(a) To retain any property in the form rece'ved.
(b) To invest and reinvest all property inc uding
accumulated income in any kind of property, real or per
including stocks, bonds and other securities without being
to invest for trust funds by any governing laws, and w hout
diversification as to kind or amount.
(c) To sell or otherwise dispose of rea and
personal property at public or private sale, wholly or part y on
credit, or to lease, exchange or grant options in such re I or
personal property.
(d) To vote, in person or by proxy, or consen for
any purpose, in respect of any securities constituting assets f my
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estate or any Trust created in this Will, as the case may b .
(f) To allocate receipts and expenses b
(e) To exercise or sell any rights of subscr' tion
or other rights in respect of any securities constituting ass
my estate or any Trust created in this Will, as the case ma be.
principal and income.
(g) To hold property in the name of a nomin
(h) To take any action they deem prudent with
regard to any reorganization, merger, consolidation, bankrup cy or
other proceeding affecting any stock, bond, note or other sec
(i)
borrow
To
from
the
money
pe
representatives, as the case may be, or others.
(j) To pledge or mortgage any property fo
any
purpose.
(k) To compromise or settle claims.
(1) To distribute in cash or in kind.
6.
Anticipation of Interest.
While any prese
future interest in my estate, whether in income or prin
passing under this Will to any person is in the hands
f my
personal representatives, and before such interest is actuall paid
or delivered to the person entitled to such interest, such in erest
shall not be subject to voluntary or involuntary anticip tion,
encumbrance, alienation or assignment, either in whole or in part,
nor shall such interest be subject to any jUdicial process to levy
upon or attach the same for or on behalf of such person's cre itors
or claimants.
3
6967.1
7 .
Bond.
My personal representatives shallot be
required to enter any bond or other security for the fa thful
performance of their duties in any jU:risdiction.
Dated:
.' . '. ~ '---- .~. .,'
/~.. ,,-..------.. ......?1..- ___-~7--.?
/ -..... . - -- ,., ....
/ >6 / ./ .?>---cJ
Ruth N. Lebo \-.-/'./
Ruth N. Lebo, testatrix, signed, published and de lared
the above instrument (consisting of this and the preceding three
(3) typewritten pages) to be her Last will and Testament, n our
presence. We, at her request and in her presence and . n the
presence of each other, have signed our names as witnesses his
Icl+~ day of n:..U('u..DS'1Y ' 1996.
Address
4
7 967.1
~
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF BERKS
I, Ruth N. Lebo, testatrix, whose name is signed t
attached instrument, having been duly qualified according to
acknowledge that I signed and executed the instrument as my
Willi that I signed it willinglYi and that I signed it as my
and voluntary act for the purposes t~ereln expressed.
~",/' .
the
law,
last
free
Sworn to and subscrib
testatrix this I~ day of
N. Leb , the
Notaiial Seal
Usa M. Bechtel,No1ary
ReOOlng, Ber1~ Co
COMMONWEALTH OF PENNSYLVANIA: MyCcrnmlsSionExpiresMay 0,1997
: ss. etnOOr, nsyfvahiaAssoci' ofNotfbleS
COUNTY OF ::~s, : ~ rfbk ~
the witnesses C:~~~ed to the att~nstr ment;
being duly qua~~~~Ihn:~cording to law, do depose and say t at we
were present and saw the testatrix sign and execute the inst ument
as her last Willi that she signed willingly and that she ex cuted
it as her free and voluntary act for the purposes t erein
expressed; that each of us in the hearing and sight f the
testatrix signed the will as witnesses; and that to the best four
knowledge the testatrix was at the time 18 or more years of e, of
sound mind and under no constraint or undue influence.
[" .- _' .Not..liaJ Seal
.. fd~~ .~ ~tef, Notary Public
. ....~. :~:~'~, Bef!<s County
-~!::~::. '~'f.~xp:resMay 10, 1997
M€~Hr",;, 1"..: ~\'Wiia~ cf ~!otf:j
above
5
76967.1