HomeMy WebLinkAbout03-30-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
IRWIN ROGER B
60 WEST POMFRET STREET
CARLISLE, PA 17013
_____n~ fold
ESTATE INFORMATION: SSN: 189-30-2842
FILE NUMBER: 2106-0284
DECEDENT NAME: STOCK PHYLLIS
DATE OF PAYMENT: 03/30/2006
POSTMARK DATE: 03/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 01/05/2002
NO. CD 006503
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,752.75
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TOTAL AMOUNT PAID:
$1,752.75
REMARKS: IRWIN ET AL
CHECK# 022866
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV-1737-A EX 19-DO}
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FILE THIS RETURN WITH:
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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REV-1737-A
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
STOCK PHYLLIS
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
01/05/2002 09/20/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[X] 1. Original Return
o 4. Limited Estate
[X] 6. Decedent Died Testate (Mach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (dale 01 death belween 12-31-91 and 1-1-95)
OFFICIAL USE ONLY
F~E N~M~E; '_ D ~ ~ 4
---->>------
COUNTY CODE YEAR NUMBER
SOCfAL SECURITY NUMBER
89- 3 0 - 2 8 4 2
SOCIAL SECURITY NUMBER
o 3. Remainder Return Idale of dealh prior 1012-13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 01
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
ROGER B_ IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM NAME (It Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE
REFER TO METHOD OF COMPUTATION IN THE NONRESIDENT DECEDENT INSTRUCTION BOOKLET (REV-1736)
Check One: 0 Flat Rate Proportionate (Complete Worksheet on Reverse Side)
METHOD
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(Schedule C)
4. Mortgages & Notes Receivable (Schedule 0) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. A.mount 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
0.00 X .0_ (15)
38,950.00 X .O~ (16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
19. Tax Due. Make check payable to Commonwealth of PA
20. 0
CHECI(HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
PA 17013
38.980.00
OFFICIAL USE ONLY
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REV-1737-1 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
This affidavit must be completed and sworn to by a person having personal knowledge of these
facts, preferably by a surviving spouse or member of the decedent's family.
Name of Decedent Date of Death
STOCK PHYLLIS 01/05/2002
Legal Address at Time of Death:
Street Address City/Borough State Zip Code
NONRESIDENT DECEDENT
AFFIDAVIT OF DOMICILE
1734 ORANGE BLOSSOM AVENUE
SEBRING
Fl
33870
The following information is submitted in support of the statement that the above individual was
not domiciled in the Commonwealth of Pennsylvania at the date of death.
1. Names and addresses of the decedent's surviving spouse and members of hislher immediate family:
Name and relationship to decedent
JAMES STOCK
Street Address
1617 RAINBOW AVENUE
Name and relationship to decedent
PHilLIP STOCK
Street Address
ROUTE 2. BOX 117A
Name and relationship to decedent
City/Borough
SEBRING
SON
State
Fl
Zip Code
33870
City/Borough
WilLIAMSBURG
SON
State
PA
Zip Code
16693
ROBERT STOCK
Street Address
209 NEIGHBORLY WAY
2. Did the decedent ever live in Pennsylvania?
If yes, during what periods?
City/Borough
MURPHY
IX Yes
SON
State
NC
No
Zip Code
28906
3. Did the decedent spend time in Pennsylvania during the five years preceding death?
If yes, during what periods and at what address?
99 Ridge Road. Newville, PA 17241
IX] Yes
o No
4. What was the nature of decedent's places of residence during the five years immediately preceding death?
Indicate whether decedent resided in a house or apartment and whether it was rented or owned by the decedent. and/or whether decedent resided in a hotel
or the heme of relatives or friends.
House - 99 Ridqe Road, Newville, PA - jointly owned with Lloyd E. Shoemaker, Sr. and
1734 Orange Blossom Avenue, Sebring, FL
5. Was the decedent employed during the five years preceding death? 0 Yes
If yes, list the name and address of employer(s).
IX! No
8. Did the decedent leave a will? [XJ Yes C No
If yes, state the court which admitted the will to probate, the date admitted, and attach a copy, including all codicils, and a certificate of issuance of
letters testamentary.
Hiqhlands Count,!, Florida - Petition For Summary Administration (Testate) - File No. PC02-425
7. If the decedent did not leave a will, has an administrator of his estate been appointed? 0 Yes 0 No
If yes, state the court which appointed the administrator, the date of appointment, and attach a certificate of the issuance of letters of administration.
8. At any time during the last five years did the decedent execute a will, a codicil, trust indentur~ deed, mortgage, lease or any other document in which
the decedent was described as a resident of Pennsylvania? lXJ Yes 0 No
If yes, describe such document.
General Warranty Deed
Continuation of REV-1737-A Inheritance Tax Return Nonresident Decedent
STOCK
PHYLLIS
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Page 1
1. Names and Addresses of Decedent's Immediate Family
Name and relationship to decedent
FREDA M. STOCK RILEY DAUGHTER
Street Address City/Borough State Zip Code
912 BLOOMFIELD STREET ROARING SPRING PA 16673
Name and relationship to decedent
DONNA LORD DAUGHTER
Street Address City/Borougn State Zip Code
13410 SO.75E AVENUE BIXBY OK 74008
Name and relationship to decedent
KAY WILLIS DAUGHTER
Street Address City/Borough State Zip Code
11033 STREAMSIDE DRIVE TAMPA FL 33624
REV-1737-2 EX -r (9-00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
SCHEDULE A, PART 1
REAL ESTATE
IN PENNSYLVANIA
ESTATE OF
FILE NUMBER
STOCK PHYLLIS 21 05 0
Part 1 must include all real property owned by the decedent individually or as a tenant in common with another party(ies), having its
situs in Pennsylvania. Property which is jointly-owned with right of survivorship should be disclosed on Schedule F. All real estate
must be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and
a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
ITEM
NUMBER DESCRIPTION VALUE AT DATE OF DEATH
1. 99 Ridge Road, North Newton Township, Newville, Cumberland County, Pennsylvania 38,980.00
1/2 interest with Lloyd E. Shoemaker, Sr.
I
PART 1 TOTAL
$ 38,980.00
PART 2 TOTAL
Proportionate Method Only from reverse side $
TOTAL (Also enter on line 1, Recapitulation) $ 38,980.00
(If more space is needed, insert additional sheets of the same size)
REV-1737-6 EX + (9-00*'.
REVERSE ~..
If. 'K
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Use Schedule H ONLY for proportionate
method of tax computation.
FILE NUMBER
STOCK
PHYLLIS
21 05 0
Debts of decedent must be reoorted on Schedule I.
DESCRIPTION
AMOUNT
ITEM NUMBER
A.
1.
FUNERAL EXPENSES:
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
Probate Fees
4.
Accountant's Fees
5.
Tax Return Preparer's Fees
6.
7.
Miscellaneous Expenses
Register of Wills - Filing Fee
30.00
TOTAL (Also enter on line 9, Recapitulation). $
(If more space is needed, insert additional sheets of the same size)
30.00
REV-1737-7 EX + (9-0r~. ..
REVERSE ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
STOCK
PHYLLIS 21 05 0
When flat rate method is elected, list the beneficiaries of the Pennsylvania property.
When proportionate method is elected, list all beneficiaries.
RELATiONSHIP TO
NAME AND ADDRESS OF PERSON IS) RECEIVING PROPERTY DECEDENT f\MOUNT OR SHARE
NUMBER Do Not List Trustee/s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2))
1. James Stock Lineal
1617 Rainbow Avenue 1/6th
Sebring, FL 33870
2. Phillip Stock Lineal
Route 2, Box 117A 1/6th
Williamsburg, PA 16693
3. Robert Stock Lineal
209 Neighborly Way 1/6th
Murphy, NC 28906
4. Freda M. Stock Riley Lineal
912 Bloomfield Street 1/6th
Roaring Spring, PA 16673 .
5. Donna Lord Lineal
13410 So. 75E Avenue 1/6th
Bixby, OK 74008
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON REV-1737 COVER SHEET OR THE PROPORTIONATE METHOD WORKSHEET ON THE REVERSE
SIDE OF REV-1737 COVER SHEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II
ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1737 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1737-A Inheritance Tax Return Nonresident Decedent
STOCK
PHYLLIS
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Page 2
Schedule J, I - Taxable Distributions
RELATIONSHIP TO
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT AMOUNT OR SHARE
NUMBER Do Not List Trusteelsl OF ESTA TE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)]
6. Kay Willis Lineal
11033 Streamside Drive 1/6th
Tampa, FL 33624
I