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AEV-1500 EX + (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONL Y
RLENUMBER _ I
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COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
83- 1 2 - 2 0 2 4
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date 01 death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
__ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Anach Sch 01
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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 (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
OFFICIAL USE ONLY
39,149.59
c.
39,149.59
0.00 X _(15) 0.00
0.00 X .045 (16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
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SHOEMAKER
DATE OF DEATH (MM-DD-Year)
LLOYD
E.
DATE OF BIRTH (MM-DD-Year)
7,141.50
57,677.78
(11)
(12)
(13)
64,819.28
-25,669.69
03/14/2005 01/11/1922
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
(14)
-25,669.69
[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 (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95)
20. [8]
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
>:> · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
1. Real Estate (Schedule A)
(1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole.Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
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)
(8)
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
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
Decedent's Complete Address:
STREET ADDRESS
99 RIDGE ROAD
CITY T STATE I ZIP
NEWVILLE PA 17324
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
7.63
Total Credits (A + B + C)
(2)
7.63
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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 Payable to: REGISTER OF WILLS, AGENT
7.63
0.00
0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN II X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... 0 [Xl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Xl
c. retain a reversionary interest; or ...................................................................................................... 0 [Xl
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Xl
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................... 0 [Xl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [Xl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................................................. .......... 0 [Xl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
~ ~., 0'
PA 17324
DATE
~ /..~/06
ADDRESS
PA 17013
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. !l9116 (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. !l9116 (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. !l9116(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. !l9116(1.2) [72 PS. !l9116(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. !l9116(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-1509 EX + (6-98)
'*
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHOEMAKER
FILE NUMBER
LLOYD
E.
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. PHYLLIS STOCK
1734 ORANGE BLOSSOM AVENUE
SEBRING, Fl 33870
DIED 1/5/02-
FRIEND
B LLOYD E. SHOEMAKER, JR.
91 RIDGE ROAD
NEWVillE, PA 17324
SON
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 DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 99 RIDGE ROAD, NORTH NEWTON TOWNSHIP 77,960.00 50. 38,980.00
NEWVillE, CUMBERLAND COUNTY, PENNSYLVANIA
2. B. FARMERS NATIONAL BANK 339.17 50. 169.59
CHECKING ACCOUNT #12-979-8
TOTAL (Also enter on line 6, Recapitulation) $ 39,149.59
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+(12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
ESTATE OF
SHOEMAKER
LLOYD
E.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Egger Funeral Home, Inc. 3,785.50
2. Silbaugh Memorials 265.00
B. ADMINISTRATIVE COSTS:
1. 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 IRWIN & McKNIGHT 1,950.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees 350.00
6. Tax Return Preparer's Fees
7. Register of Wills, Filing Fee 30.00
8. Notary Fees 10.00
9. Mary Jane Matheny, P.A., Attorney Fees 350.00
11. WSI, Trash Removal 401.00
TOTAL (Also enter on line g, Recapitulation) $ 7 141.50
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHOEMAKER
FILE NUMBER
LLOYD
E.
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
2,016.42
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Tammac Corporation - Mortgage Payments
Sprint - Telephone
266.35
PP&L - Electric
156.49
Philip Carey, M.D. - Medical
28.33
Andorra Radiology Assoc - Medical
18.50
West Shore EMS - Ambulance
77.52
North Shore Agency - Medical
33.91
Carlisle Cardiology - Medical
58.78
AmeriGas - Utility
670.01
Lehigh Anesthesia Assoc. - Medical
58.68
Wakefield Assoc. - Medical
86.48
Newville Ambulance
80.92
Graham Medical Center - Medical
106.19
Carlisle Regional Medical Center - Medical
108.24
MBNA - Credit Card
1,925.51
TOTAL (Also enter on line 10, Recapitulation) $
57677.78
(If more space is needed, insert additional sheets of the same size)
"'"'' "" I'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
_11__....
FILE NUMBER
'~':l
LLOYD
E.
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Lloyd E. Shoemaker, Jr.
91 Ridge Road
Newville, PA 17241
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
NUMBER
1.
Lineal
Remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
ll. 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-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
SHOEMAKER
Decedent's Name
LLOYD
E.
Page 1
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. Pinnacle Health Hospitals - Medical 912.00
17. Nationwide Insurance - Homeowner's Insurance 568.00
18. Darlene Pittman, Tax Collector - Taxes 984.76
19. Cumberland County Taxes 920.14
20. Tammac Credit Services - Mortage Loan 48,600.55
SUBTOTAL SCHEDULE I 51,985.45
GRAND TOTAL SCHEDULE I $ 57,677.78
..
~~~~~~~~~~~*~~~*~~~~~***~*~~~*~*~~v~~I~
I!I Last Will and Testament ~
~ *
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~ I, Lloyd Everett Shoemaker,Sr. of the City of Nevlville *
~ *
~ County of Cumberland , State of Pennsylvania *
~ being of sound mind, and not acting under duress, menace, fraud, or undue influence of *
~ any person do hereby make, publish and declare this instrument my last Will and *
~ Testament and do hereby revoke any and all other Wills and Codicils heretofore made *
~ by me. *
~ *
-ec FIRST: I order and direct that my just debts and funeral expenses, expenses for *
~ administration of my estate and any inheritance, State or Federal taxes upon said estate, *
: except those, if any, which are secured by mortgage or deed of trust, shall be paid as ~
-ec soon after my death as may be practical. *
: SECOND: I am a unmarried person. My spouse is N/A and ~
-ec Lloyd Everett Shoemaker, Jr. *'
-ec *'
-ec *'
-ec are all my children either natural or adopted. *"
-ec~ *"
-ec TI-llRD: I nominate my spouse as Guardian of my minor children. In the event that my *"
-ec spouse shall predecease me or fails to serve as such Guardian, then I nominate *"
-ec *"
-';x and appoint N / A Guardian of the person and property *"
-ec of my minor children. I further direct that no bond shall be required. *"
-ec *'
.e.t FOURTH: I hereby make the follovving specific bequests: *"
.e.t *"
.e.t I leave ALL my belongings to my son Lloyd Everett Shoemaker, JR *'
-';x and his family, except the 1118'/ Homette Mobile Home Model *'
.e.t :Ii: M!-JMATCA Serial # 18106bL which I leave to Marie V. Hancock. '.r-
~ *'
~ *"
~ *"
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~ FIFTH: I hereby give, devise and bequeath all of the rest and residue of my estate, all *'
~ *'
~ property over which I have power to dispose to Lloyd E. & Deborah <"A.. Shoemaker *'
~ Jr. *"
~ SIXTH: I nominate and appoint Lloyd E. Shoemaker, Jr. *"
~ as Executor of this "",rill. In the event that the Executor named above shall predecease me *"
~ or fails to serve as such Executor of this \\-rill, I nominate and appoint *"
~ *"
~ Deborah A. Shoemaker as Executor. I further direct that no appointee hereunder *"
r;. shall be required to give any bond for the faithful performance of their duties. z:.
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SEVENTH: I hereby authorize my Executor to exercise all power, rights, discretion and
duties deemed necessary for the proper administration and disposition of my estate.
I subscribe my name to this Will this
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Signature
On the day \vritten below,
Lloyd Everett Shoemaker,
Sr.
declared to us, the undersigned that this instrument, consisting of 2 pages, was
his Will and he requested us to act as witness to it. He thereupon sign~d
this Will in our presence, all of us being present at the same time. We now in hIS
presence and in the presence of each other subscribe our names as witnesses.
It is our belief that T.1 oyd--Fvprett '" 9)hoemaker, Sris of sound mind and under no
constraint or undue influence whatsoever.
We declare under penalty of perjury that the foregoing is true and correct and that
this declaration was executed on .c:'(7'-~1 ,;t , 19 /,)...
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F. CHARLES EGGER, Supervisor
EGGER FUNERAL HOME, INC.
15 Big Spring Avenue
NEWVILLE, PENNSYLVANIA 17241
717-776-3414
FRANK C. EGGER, Funeral Director
April 22, 2005
Funeral Bill for Lloyd Shoemaker
Date of Death March 14,2005
Professional Services
$3,275.00
Cemetery Opening
$300.00
5 Death Certificates $6.00 a piece
$30.00
Clergy Offering
$100.00
Obituary Charge
$80.50
Total
$3,785.50 /J ,
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP C06-05)
LLOYD E SHOEMAKER JR
91 RIDGE RD
NEWVILLE PA 17241
DATE 10-24-2005
ESTATE OF SHOEMAKER LLOYD E
DATE OF DEATH 03-14-2005
FILE NUMBER 21 05-0810
COUNTY CUMBERLAND
SSN/DC 183-12-2024
ACN 05139144
APPEAL DATE: 12-23-2005
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --to RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV=is4S-EX-AFP-COj=osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 10-24-2005
ESTATE OF SHOEMAKER
LLOYD
E DATE OF DEATH 03-14-2005
COUNTY
CUMBERLAND
FILE NO. 21 05-0810
TAX RETURN WAS:
S.S/D.C. NO. 183-12-2024
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05139144
FINANCIAL INSTITUTION: FARMERS NATIONAL BANK
ACCOUNT NO.
12-979-8
TYPE OF ACCOUNT:
DATE ESTABLISHED
()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
03-07-1985
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
339.17
0.500
169.59
.00
169.59
.45
7.63
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-10-2005 CD005792 .00 7.63
TOTAL TAX CREDIT 7.63
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
03/15/2006 12:08 FAX 1888 617 3800
T M~M~,C CORP
I4!001/003
TAMMAC HOLDINGS CORPORATION
100 COMMERCE BLVD.
SUITE 200
WILKES-BARRE, P A 18702
PHONE#888-226-8923
FAX#888-617 -3800
FAX.
TO: KAREN FAX#717-249-6354
FROM: :MEGAN KENNEDY DATE: 03/15/2006
RE: ACCT#Ol-06314 PAGES: 3 (INCLUDING COVER)
CC: SHOEMAKER PAY
HISTORY
03/15/2006 1210 FAX 1888 617 3800
TAMMAC CORP
i4J 003/003
Account. Number.... A 01 - 6314 Mn1:hly Pymt...
Nam...... LLOYD E SHOEMAKER
PAY#: *DUE* *TRAN* PRINCIPAL
41 04/01/05 03/28/05 52.27
42 OS/01/05 04/18/05 52.57
43 06/01/05 OS/24/05 52.88
44 07/01/05 06/27/05 53.19
45 08/01/05 07/25/05 53.50
46 09/01/05 08/30/05 53.81
47 10/01/05 09/21/05 54.12
48 11/01/05 10/24/05 54.44
49 12/01/05 11/28/05 54.76
50 01/01/06 12/28/05 55.08
Sl 02/01/06 01/23/06 55.40
S2 03/01/06 02/20/06 55.72
MFG HOUSING ---- ~AY.MENT HISTORY
336.07 L/e Due... 100.00
Pymt Due Date.. 04/01 2006
Lie MISC *PAID* BALANCE
.00 336.07 48600.55
.00 336.07 48547.99
.00 336.07 48495.10
.00 336.07 48441.91
.00 336.07 48398.41
.00 336.07 48334.60
.00 336.07 48280.48
.00 336.07 48226.04
.00 336.07 48171.29
.00 336.07 48116.20
.00 336.07 48060.80
.00 336.07 48005.08
INTEREST
283.80
283.50
293.19
282.88
282.57
292.26
281.95
281.63
281.31
280.99
280.67
280.35
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