HomeMy WebLinkAbout11-14-05 (2)
REV-1500 EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Weaver Paul L.
DATE OF DEATH (MM-DD-Year)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 0 6 7 9
COUN'TY"'C'Q5"E -----vEA~ - - NUMBER--
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
2 09- 1 2 - 8 508
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
07/07/2005 04/26/1921
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
Weaver Miriam L.
[Xl 1. Original Return
D 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy of Will)
D 9, Litigation Proceeds Reoeived
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NAME
Joel R. Zullin er
FIRM NAME (If Applicable)
Zullin er Davis P.C.
TELEPHONE NUMBER
717 264-6029
SOCIAL SECURITY NUMBER
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Retum (date of death prior to 12-13-82)
D 5. Federal Estate Tax Retum Required
~ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
COMPLETE MAILING ADDRESS
14 North Main Street, Suite 200
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Misoellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
Chambersbur
PA 17201
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
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79,541.27 ;
(6)
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(7)
10,961.09 I
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(8)
90,502.36
(9)
(10)
17,930.78
5,337.46
(11)
(12)
(13)
23,268.24
67,234.12
0.00
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
(14)
67 ,234.12
29,718.76 X (15) 0.00
37,515.36 X .045 (16) 1,688.19
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 1,688.19
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
9 East Main Street
CITY I STATE I ZIP
Walnut Bottom PA 17266
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty ( D + E) (3)
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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check to: REGISTER OF WILLS, AGENT
1,688.19
0.00
0.00
1,688.19
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
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; or ...................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ............................................................. 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................... ..... ....... ................................... ......... ....... 0
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
. b f" d' t' ? 1)(1
contains a ene IClary eSlgna Ion. ............................... ................. ................. .................. .................... ~
1,688.19
No
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IKl
IKl
IKl
IKl
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
PA 17201
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 the surviving spouse is 3%
[72 P.S. 99116 (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% [72 P.S. 99116 (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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S, 99116(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%, except as noted in 72 P,S. 99116(1.2) [72 P.S. 99116(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. 99116(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-15GB EX... (6-98)
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COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Weaver Paul L.
FILE NUMBER
21 05
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.
0679
ITEM
NUMBER
1.
DESCRIPTION
Checking Account #67348408, M& T Bank, including interest
accrued to date of death
VALUE AT DATE
OF DEATH
35,451.69
2.
Certificate of Deposit #4000004996, Orrstown Bank,
including interest accrued to date of death
12,841.64
3.
Certificate of Deposit #6140846242, Citizens Bank,
including interest accrued to date of death
25,598.33
4.
Checking Account #6204010895, Citizens Bank
5.00
5.
Share Savings Account #949830, Corning Federal
Credit Union
3,109.41
6.
Proceeds from sale of decedent's automobile
2,500.00
7.
Refund, The Patriot News
35.20
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
79.541.27
REV-1510 EX t (6-98)
*
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Weaver. Paul L.
FILE NUMBER
21 05
0679
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.
DESCR:PTION OF PROPERTY
ITEM INCLUOE THE NA.ME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DA TE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE
(IF APPLICABLE}
1. Non-Qualified Annuity with F&G Life Insurance Company, 10,961.09 100. 10,961.09
beneficiary of account is Miriam L. Weaver, decedent's
surviving spouse
TOTAL (Also enter on line 7 Recapitulation) $ 10961.09
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (1~-99)
, '.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Weaver, Paul L.
ITEM
NUMBER
A.
1.
2.
3.
4.
5.
B.
1.
2.
3.
4.
5.
6.
7.
8.
FILE NUMBER
21
05
0679
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Fogelsanger-Bricker Funeral Home, funeral expenses
Cumberland Valley Memorial Gardens, grave opening and closing
Food for meal after funeral
Cleaning suit for funeral
Gravemarker
6,455.20
1,045.00
69.58
8.25
514.00
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Miriam L. Weaver
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 9 East Main Street
City Walnut Bottom State PA Zip 17266
Year(s) Commission Paid: 2006
Attorney Fees Joel R. Zullinger
Family Exemption: (If decedent's address is not the same as c1aimanfs, attach explanation)
Claimant Miriam L. Weaver
Street Address 9 East Main Street
City Walnut Bottom State PA
2,000.00
3,900.00
3,500.00
Zip 17266
Relationship of Claimant to Decedent spouse
Probate Fees Register of Wills - JCP fee 10.00; short certificates 16.00; will 15.00;
automation fee 5.00; letters 210.00; filing return 15.00
271.00
Accountanfs Fees
0.00
Tax Return Prepare~s Fees
0.00
Cumberland Law Journal, advertise letters
News-Chronicle, advertise letters
75.00
92.75
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
17930.78
REV-1512 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
Weaver. Paul L.
FILE NUMBER
21
05
0679
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Shippensburg Health Care, medical services due at death
VALUE AT DATE
OF DEATH
4,605.00
2. Diamond Pharmacy Services, prescriptions
260.28
3. Chambersburg Hospital, medical services due at death
175.32
4. Urology Associates of Chambersburg, medical services due at death
251.34
5. Cumberland Valley Medical Services, medical services due at death
37.51
6. CP02 Billing Center, medical services due at death
8.01
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
5 337.46
",V."",""_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Weaver Paul L
SCHEDULE J
BENEFICIARIES
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. David Eugene Weaver, 1/3 of residue Lineal 18,757.68
9 Canal Street 1/3 of residue
Big Flats, N.Y. 14814
2. Laurie J. Weaver, 1/3 of residue Lineal 18,757.68
P.O. Box 215 1/3 of residue
Chemung, N.Y. 14825
3. Miriam L. Weaver, 1/3 of residue and Item 1 on Schedule G Spousal 29,718.76
9 E. Main Street 1/3 of residue and Item
Walnut Bottom, PA 17266 1 on Schedule G
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
1. 0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. 0.00
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
..
FILE NUMBER
21 05
0679
(If more space IS needed, Insert additional sheets of the same size)
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5.1
2004
Septewbe:::
f~':ea'/'er . 1
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LAST WILL AND TESTAMENT
I, Paul L. Weaver, of Nine East Main Street, Walnut Bottom,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby declare this to be my will, hereby
revoking any and all former wills and codicils thereto by me
heretofore made.
I.
I direct that all my just debts and funeral expenses,
including all expenses of my last illness, shall be paid from my
estate as soon as practicable after my decease as a part of the
expense of the administration of my estate.
II.
I give, devise and bequeath the residue of my estate of every
nature and wherever situate in equal shares, as follows:
A.One-third to my son, David Eugene Weaver;
B.One-third to my daughter, Laurie J. Weaver;
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C.One-third to my wife, Miriam L. Weaver.
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III.
Should my son, my daughter, or my wife predecease me or die
on or before the thirtieth day following my death, their share of
my estate shall be distributed to said beneficiary I s issue I per
stirpes, living on the thirty-first day following my death.
IV.
Any fiduciary under this will shall have the following powers
in addition to those vested in them by law and by other provisions
of my will applicable to all property whether principal or income,
including property held for minors, exercisable without Court
approval, and effective until actual distribution of all property:
A.To retain any and all of the assets of my estate, real or
personal,
without
regard
principle
of
to
any
diversification of risk.
B.To invest in all forms of property including stock, common
trust funds and mortgage investment funds without
restriction to investments authorized for pennsylvania
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fiduciaries as they deem proper, without regard to any
principle of diversification of risk.
C.To sell at public or private sale, to exchange or to lease
for any period of time any real or personal property
and to give options for sales, exchanges or leases, for
Page 2
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such prices and upon such terms or conditions as they
deem proper.
D.To allocate receipts and expenses to principal or lncome or
partly to each as they from time to time think proper.
E.To compromise any claim or controversy.
F.To distribute In cash or in kind or partly in each.
G.To hold property in their names without designation of any
fiduciary capacity or in the name of a nominee or
unregistered.
V.
I direct that all taxes that may be assessed in consequence
of my death of whatever nature and by whatever jurisdiction
imposed, shall be paid from my residuary estate as a part of the
expense of the administration of my estate.
VI.
I appoint my wife, Miriam L. Weaver, as executrix of this my
will.
Should my wife predecease me, fail to qualify or cease to
act, I appoint my stepson, Kenneth Byers, as executor of this my
will.
Page 3
VII.
No bond shall be re~~ired of any fiduciary hereunder In any
jurisdiction.
IN WITNESS WrlEREOF, I hereunto set my hand and seal to this
my last will and testament, consisting of five typewritten pages,
the first three of which bear my signature in the margin for the
/'1i&-
of
identification
this
day
of
purpose
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(SEAL)
Signed, sealed, published and declared by the above-named
testator as and for his last will and testament in our presence,
who in his presence, at his request and in the presence of each
other have hereunto set our hands as attesting witnesses.
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Weaver, ~ ~. ~L.Jli"D~
Paul
L.
and
;A
, the testator and the witnesses respectively,
instrument,
being first duly sworn, do hereby declare to the undersigned
Page 4:
authority that the testator signed and executed the lnstrument as
his last will and testament and that he executed it as his free
and voluntary act for the purposes therein expressed and that each
of the witnesses, in the presence and hearing of the said testator
signed the will as witnesses and to the best of their knowledge
said signer was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
Subscribed, sworn to and acknowledged
before me by the above-named signer and
subscribed and sworn to bef/~ me by the
~named witnesses this ~ day of
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Notar Public)
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COMMONWEALTH OF PENNSYLVANIA
Notarial Seal .
Teresa J. Burkholder. Notary Public
Shippensbur~ Boro, Cumberland County
My Conumssion Expires Aug. 6, 200g
Member. Pennsylvania Association of Notaries
Page 5
~ M&rBank
499 :YlitchC!1 Road, \llllsboro, DE 19966 \lail Code DE-\lB-12
Phone (888) 502-4349
Fa\; (302) 934-2955
September 9,2005
Law Offices
Zullinger - Davis
14 North Main Street, Suite 200
Chambersburg, PA 17201
Dear Sir or Madam:
Per your inquiry dated September 01, 2005, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
Re: Estate or Paul L Weaver
Social SecuritY',' 209-12-8508
Date of Death: JulY' 07. 2005
L
Type of Account
Checking Account
Account Number
67348408
Ownership (Names of)
Paul L Weaver *
Opening Date
OS/28/84 Closed 08/19/05
Balance on Date of Death
$35,451.52
Accn/ed Interest
$
0.17
Total
$35,45/.69
Interest Paid YTD
-- "-. -- --,.. --- _.--~-
$ 4,31 (Accnted interest is not included)
2.
Type of Account
IRA
Account Number
035004201773345
Ownership (Names of)
Paul L Weaver *
Miriam L Weaver, Beneficiary *
Opening Date
OS/29/84 Closed 07/22/05
Ba/ance on Date of Death
$23,079,79
Accrued Interest
$ 306.49
Total
. . ....-.-. .... -.., -. ..'. -~.
$23,386.28
Interest Paid YTD
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Please be advised, there was no safe deposit box found for the above decedent *For further account information,
regarding ownership and any changes, closures and/or reimbursement of funds, etc., please call the King Street
Office # 717-532-4132.
Sincerely,
Nancy Clagett
OQr"A....rl... l\If<'Jo~ra......ornont
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ORRSTOWN
BANK
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September 9, 2005
TO Law Offices
Zullinger Davis
20 East Burd Street
Shippensburg PA 17257
FROM Timothea Moose
Cust. Service Specialist
P,O BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Paul L Weaver
DATE OF DEATH: July 7, 2005
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKING ACCOUNTS
ACCOUNT NO, TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
SAVINGS ACCOUNTS
ACCOUNT NO TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
CERTIFICATES OF DEPOSIT
ACCOUNT NO, TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
4000004996 Paul L Weaver 11/22/04 12,828,88 12,76
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~~ Citizens Bank
525 William Penn Place
Suite 153-2510
Pittsburgh. PA 15219
September 27,2005
ZULLINGER - DAVIS
14 NORTH MAIN STREET
CHAMBERSBURG PA 17201
Estate of PAUL L WEAVER
Date of Death: Jul 07. 2005
SSN: 209-12-8508
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of his/her date of death.
For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please
call 412-867-2205
Sincere.IY' ~ C1fit;. '..
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Daniel Peters
Operations Services
~~ Citizens Bank
Account Number 6140846242
Account Title PAUL L WEAVER
Date Opened 11/19/2001
I Account Type Time Deposits
Principal Balance as of DaD $25558.95
Interest from Last Posting to DaD $39.38
Account Balance as of DaD $25598.33
YTD Interest to DaD $374.01
~~ Citizens Bank
Account Number 6204010895
Account Title PAULL WEAVER
Date Opened 3/19/2003
Account Type Checking
Principal Balance as of DOD $5.00
Interest from Last Posting to DOD $.00
f.------ -
Account Balance as of DOD $5.00
YTD Interest to DOD $.00
Se? 07 as ~1:a3p
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Cc~nin~ Credit Union
7175974336
Law Offices
Zullinger-Davis
Professional Corporation
14 North Main Street
Suite 200
Chambersburg P A 17201
Dear Sir,
Here is the information that your office requested concerning the Estate of Paul L.
Weaver. Mr. Weaver had a share savings account, member number 949830, account
number one. The account was opened in June 1960. The account is only under Mr.
Weaver's name. The balance was 53109.41 at the time of death. The account earns
1.00% interest that is paid quarterly,
Sincerely,
r ' '._1,1, .<2 _ ~ ~ (lIJ-[)" r-
", __ '''-., '/ l{ir.l<.-O)"'<.)w ~ "J
Corning Credit Union
Corning Federal Credit Union, 677 S. Antrim Way, I. Greencostle, PA 17220
717-597-4400: 800-677-8506 except Corning-Elmira. N,Y. coUing area: http://wlN'\Vcorningcuorg
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,~s per our ~i"cussion,.l ha:vl' obtaine? the date of d~ath vahw fM Palll L \vC'avt'l
NOll- Q}lahfied Annully wIlh F&G Life lnsuran("~ Company. Tht" value for PA ~
Inhcrilallc(" Tax pUrpoSES as ofJuly 7, 2005 was $10,961.09. Named benef i-:f
ciary is Miriam L. Weaver, spouse of Paul L. Weaver. i
rf you have any other (luestions or conct'ms, please call me at (717) 530-3S25. j
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Septemlx:r 12, 2005
VIA FACSI:VULE
Thank,,!
Chrissy Ward Cfl>>J
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