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Home My WebLink About06-30-06 . OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 FILE NUMBER DEPARTMENT OF REVENUE DEPT. INHERITANCE TAX RETURN 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2006 0274 COUNTY COOE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- Tays, Bennv E 425-58-0983 z UJ DATE OF DEATH (MM-DD-YV) DATE OF BIRTH (MM-DD-YV) THIS MUST BE FILED IN DUPLICATE Q UJ 3/15/2006 11/22/1934 WITH THE REGISTER OF WILLS 0 W (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER Q I w x:J 1. Original Return o 2. Supplemental Return o 3. Remainder Return ><t :s::t:CI.l :J 4. Limited Estate 0 D 5. Fed. Est. Tax Return Req'd oo:::s:: 4a. Future interest Compromise wa..o :x:OO Xl 6. Decedent Died Testate o 7. Decedent had Living Trust 0_ oO::..J 8. Total number of SOB's a..1D a.. "I 9. Lit'g'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax w/ Sec. 9113(A) ><t I- ~j$.~t.f&d~l..ti~@nll:fit~jt~~$i.~ff~J!.~jJ;J.Qj$.jt~$.t~it~lfjl~1J&'.Q@Ql\1~@j@IliMM@~ z NAME: COMPLETE MAILING ADDRESS: w 0 z Ronald E. Johnson, Esquire 0 Ronald E. Johnson, Esq. a. FIRM NAME: CI.l w Andrews & Johnson Andrews & Johnson 0:: 0:: TELEPHONE NUMBER 78 W. Pomfret St. 0 0 717 243-0123 Carlisle, PA 17013 1. Real Estate (Schedule A) (1 ) $0.00 OFFICIAl, USE ONLY t:.'-- 2. Stocks and Bonds (Schedule B) (2) $880.87 --. ~"::.~ ; '.::./~ 3.Closely Held Corporation, Partnership or Sole-Prop. (3) (::: 4. Mortgages & Notes Receivable (Schedule D) (4) $0.00 . -2' z 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) (5) $21,485.11 . . 0 $0.00 '-::0 i= 6. Jointly Owned Property (Schedule F) (6) ~ o Separate Billing Requested - -Ti - ::J 7. Inter-VIVos Transfers & Misc. Non-Propate Prop. (7) -~ .... -~. c: $22,365.98 '. 8. Total Gross Assets (total lines 1-7) (8) c-.> <( 9. Funeral Expenses & Administration Costs (Sch H) (9) $4,463.30 - 0 W 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $129.00 0:: 11. Total Deductions (total lines 9&10) (11 ) $4,592.30 12. Net Value of Estate (Line 8 minus Line 11) (12) $17,773.68 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $17,773.68 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z 15. Amnt of Une 14 taxable at the spousal rate, 0 i= or transfers under Sec.9116(a)(1.2) x.O_ (15) $0.00 ~ ::l 16. Amount of Line 14 taxable at lineal rate $0 x.045 (16) $0.00 a. $17,473.68 :E 17. Amount of Line 14 taxable at sibling rate x.12 (17) $2,096.84 0 () 18. Amount of Line 14 taxable at collateral rate $300 x.15 (18) $45.00 >< ~ 19. Tax Due (19) $2,141.84 20 n CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ............:..0:..........._........:.,:...............:...:...;.......:.:.:.......:...:.................:..........N..................:.;.....................:..........................:............ ...v...........:...................................... .....................................................:......................................................................................................:...:...........................:....... Kl~:::~~:W~~W!:flt~:KiiMti!::~Witi:~l$:~~:~r..q:~IIlW$.'h~tt:gm~li~t$.N:i~g~:e~l$.l~~~i~IIUUWm~KiMar.fi~$.~titmi:i:mtit:ii%:f!:~~iJHt~;t:)i .,67 AJ, Cg ,.--) :~rl (':'.:;..? r'-rj lP/V . Decedent's Complete Address: STREET ADDRESS 940 Walnut Bottom Road CITY STATE ZIP Carlisle PA 17013 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 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT Tax Payments and Credits: 1. Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discounts Total Credits (A+B+C) 3. Interest/Penalty if applicable D. Interest E. Penalty 4. TotallnterestlPentalty (D+E) 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. (1 ) (2) (3) (4) (5) (SA) (5B) $2,141.84 $0.00 $0.00 $2,141.84 $2,141.84 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: b. retain the right to designate who shall use the property transerred or its income: c. retain a reversionary interest: or d. retain the promise for life of either payments or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust fo~' 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 disignation7 D D D D D D D EI EI EI EI EI EI EI 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 pe~ury, r declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. ADDR DATE (;;, ~ Z 7 - Q(P DATE 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% [72P.S. Sec. 9116(a)(1.1 )(1)]. For dates of death on or after JanualY 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sUMving spouse is 0% [72 P.S. Sec. 9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a suMlling spouse from tax, and the staMolY requirements for disclosure of assets and filing a tax retum 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 deseased 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. Sec. 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1). The tax rate imposed on the net value of transfers to or for the use of the decedenfs Siblings is 12% [72 P.S. Sec.9116(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. t~ ~ .<;) ~\r-. ~ ~ r f ~ LAST WILL AND TESTAMENT OF BENNY E. T A YS I, BENNY E. T A YES, of Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that an thy just debts andfuneral expenses, including my grave marker, shall be paid from th~ assets of my estate as soon as practicable after my decease. SECOND: I give and bequeath any vehicle which I may own at the time of my death to my friend, EDWARD EGE. TIDRD: I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my Brother, HERBERT E. T A YS, JR., provided that should he predecease me his shall be distributed to his children equally living at the time of my death. FOURTH: 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. FIFfH: I nominate, constitute and appoint, EDWARD EGE, Executor of this my Last Will and Testament. Should EDWARD EGE. fail to qualify or ~ase to act as Executor, I appoint DEBORAH EGE, Executrix of this my Last Will and Testament. SIXTH: I direct my Executor and his successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of one (1) typewritten pages, each identified by my signature, this 16 TII day of July 2004. <-8.A- m/ll1 Benny E. Tays ~~J 7 (SEAL) Signed, sealed, published and declared by the above-named Testator, BENNY E. T A YS, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have scrio our ames as witnes COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, BENNY E. T A YS, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volUrl~arj act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Benny E. Tays, the Testator, this 16th day of July 2004. NOTARIAL SeAL SHELLY SEXTON, Notary Public Carlisle Boro, Cumberland C<lunty My Commission Expires April 26, 2007 (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, RONALD E. JOHNSON and TA YLORP. ANDREWS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that Benny E. Tays, signed willingly and that he executed it as his free and voluntary act for ,the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON and TAYLOR P. ANDREWS, witnesses, this 16th day of July 2004. NOTARIAL SEAL SHELLY SEXTON, Notary Public Carlisle Boro, Cumberland County SCHEDULE B STOCKS AND BONDS ESTATE OF FILE NUMBER Benny E. Tays All property jointly-owned with Right of Survivorship must be disclosed on Schedule F ITEM DESCRIPTION NUMBER 21~06-0274 VALUE AT DATE OF DEATH 1 US Savings Bonds - see attached $880.87 2 TOTAL (also online 2, Recapitulation) $880.87 Savings Bond Calculator Page 1 of 1 193/2006 - - Value As Of Bond Info Series ~Bonds __ Denomination Serial Number Issue Date i ----' '--_J ., $1100 i1 Results # Bonds Total Price Total Interest Total Value YTD Inten 10 $487.50 $393.37 $880.87 $8.89 Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturity N C566915863EE 05/1996 EE $100 $50.00 $22.16 $72.16 3.41% OS/2006 OS/2026 C553157294EE 02/1996 EE 100 50.00 23.88 73.88 3.41% 08/2006 02/2026 C551749228EE 01/1996 EE 100 50.00 23.88 73.88 3.41% 07/2006 01/2026 C560973871EE 04/1996 EE 100 50.00 22.72 72.72 3.23% 04/2006 04/2026 C537958112EE 10/1995 EE 100 50.00 24.64 74.64 3.23% 04/2006 10/2025 C545653062EE 12/1995 EE 100 50.00 23.88 73.88 3.41% 06/2006 12/2025 C532166721EE 07/1995 EE 100 50.00 25.84 75.84 3.41% 07/2006 07/2025 C517270286EE 05/1995 EE 100 50.00 25.84 75.84 3.41% OS/2006 OS/2025 C535611890EE 08/1995 EE 100 50.00 25.84 75.84 3.41% 08/2006 08/2025 K5372770EE 02/1980 EE 75 37.50 174.69 212.19 4.00% 08/2006 02/2010 le(end Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty MA Matured and Not Earning Interest Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator o o o o - http://wwws. publicdebt. treas.gov IBC/SBCPrice 4/6/2006 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Benny E. Tays 21-06-0274 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 ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 Checking account no: 482617 - M&T Bank (see letter attached) $20,695.57 2 US Treasury-income tax refund $250.54 3 White Circle benevolent fund $239.00 4 1982 Chevrolet S-lO pickup truck - poor condition $300.00 TOTAL (also on line 5, Recapitulation) $21,485.11 rmM&rBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 April 5,2006 Andrews & Johnson Attorneys At Law 78 West Pomfret Street Carlisle, Pennsylvania 17013 Re: Estate of: Bennv E Tavs Social Security: 425-58-0983 Date of Death: March 15, 2006 Dear Sir or Madam: Per your inquiry dated March 31, 2006, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type of Account Checking Account Account Number 482617 Ownership (Names of) Benny E Tays * Edward LEge, POA * Opening Date 02/01/72 Closed 04/05/06 Balance on Date of Death $20,695.57 Accrued Interest $ 0.00 Total $20,695.57 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the High Street Carlisle Office # 717-240-4536. Sincerely, ~qa-;7V"'YW~.fi- Nancy Clagett Records Management SCHEDULE H FUNERAL EXPENSES, ADMINlSTRATlVE COSTS AND :MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Benny E. Tays 21-06-0274 A. ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses: 1 2 Administrative Costs: 1 Personal Representive Commissions Name of Personal Representative(s) Edward Ege $1,118.30 Social Security Number of Personal Representative: Street Address: 14 Kutz Road City: Carlisle State: PA Zip: 17013 Year(s) commissions paid: 2006 2 Attorney fees to Andrews & Johnson $1,500.00 3 Family Exemption Claimant Street: City: State & Zip Relationship of Claimant to Decedent: 4 Probate Fees to Register of Wills $102.00 5 Accountant Fees to Patricia Rosendale, CPA 6 Tax Return Preparer's Fees 7 HCR Manor Care Health Services - nursing home - final bill $1,428.00 8 Register of Wills - Inheritance Tax Filing fee $15.00 9 Reserve for closing and accounting $300.00 10 II 12 13 14 15 16 17 18 19 TOTAL (also on line 9, Recapitulation) $4,463.30 Debts of decedent must be reported on Schedule L B. SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER Benny E. Tays 21-06-0274 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expense.. ITEM DESCRIPTION NUMBER VALUE AT DATE OF DEATH 1 Belvedere Medical Center - medical bill $109.45 2 Borough of Carlisle - occupation tax $5.00 3 Lancaster lIMA - medical bill $14.55 TOTAL (also online 10, Recapitulation) $129.00 ,. SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER enny avs - - ITEM NA1\1E AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER Do Not List Trnstee(s) OF ESTATE I TAXABLE DmTRlBUTlONS [include oulrilltt spoun! dislributions. ond tnnsfcrs under Sec. 9116(.XI.1)] 1 Herbert J. Tays residue less 2401 College Street, Boonesville, MS 38829 Brother $300 2 Edward Ege 14 Kutz Road, Carlisle, P A 17013 Friend $300 II NON.TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTlON 9113 FOR WHICH AN ElECTlON TO TAX IS NOT BEING MADE B. Charitable and Govcnunenlal Bequests: B ET 21 06 0274 TOTAL CHARITABLE AND GOVERNMENT AI.. BEQUESTS (also enter on line 13, Recapitulation) $0 --- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EGE EDWARD 14 KUTZ RD CARLISLE, PA 17013 ____un fold ESTATE INFORMATION: SSN: 425-58-0983 FILE NUMBER: 2106-0274 DECEDENT NAME: TAYS BENNY E DA TE OF PAYMENT: 06/30/2006 POSTMARK DATE: 06/30/2006 COUNTY: CUMBERLAND DATE OF DEATH: 03/15/2006 NO. CD 006910 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,141.84 I I I I I I I I TOTAL AMOUNT PAID: $2,141.84 REMARKS: EDWARD EGE CHECK# 305 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS