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Home My WebLink About10-11-06 ---I 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICtAL USE ONLY County~ode Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21 os 0475 Date of Birth 177-16-1054 05/14/2005 01/06/1920 Decedent's Last Name Suffix Decedent's First Name BYERS MARY MI J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ca:> 2. Supplemental Retum c::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::) c::::> 4a. Future Interest Compromise (date of death after 12-12-82) c:.::;) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c::::;) 10. Spousal Poverty Credit (date of death c:::;) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Cl~ytimeIf3If3phone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c.-::::> 4. Limited Estate c::.;, (717) 737-34Q5 () THOMAS E. FLOWER Firm Name (If Applicable) C), SAlOIS, FLOWER & L1NDSA REGISTER OF Wu,L-8 USE ONlY :-.-.:.:-! ........P..{ First line of address or Post Office State ZIP Code 'J 2109 MARKET STREET Second line of address (...) DATE FILED Correspondent's e-mail address:tfJower@sfl-law.com Under penalties of pe~ury, 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE 10/04/06 SIG ATV AODr&S SAlOIS, FLOWER & LINDSAY, 2109 MAR ET STREET, CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY DATE 10/04/06 L 15056051058 Side 1 15056051058 --I --.J 15056052059 REV-1500 EX Decedent's Name: MARY J BYERS 177-16-1054 RECAPITULATION 1. Real estate (Schedule A). ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c::J Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::J Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. Decedent's Social Security Number 1 ,403,93 1,403.93 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). . . .. . ... . . . ... . . . .. . .... .. ... . . . .. 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 1 ,403.93 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 1,403.93 15. 16. 63.18 17. 18. 63.18 c:::> c<~o 50 V( () fJv1/ I ;1/ 11 P D {V"- I Ov.....""'_ . e ---- REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME MARY J BYERS STREET ADDRESS 23 HENDEL LOOP File N\lml:!er i~--~] ~ ("'">OWO''' "n',>,",'''''''' I 21 I 01 110475 ;,,> "," 1...-.._ ....J L, ,m,", '''"'wo,,''''''''''>'' DECEDENTS SOCIAL SECURITY NUMBER 177-16-1054 '- ---- _O~__ CITY CARLISLE I STATE PA --- I ZIP : 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 63.18 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Totallnterest/Penalty ( 0 + E ) (3) 4. If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) 63.18 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. 63.18 Make Check Payable to: REGISTER OF WILLS, AGENT 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;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or.......................................................................................................................... 0 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [i] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. ~9116 (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 zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot 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 zero (0) percent [72 P.S. ~9116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [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-1508 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF MARY JO BYERS FILE NUMBER 21-05-0475 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. FEDERAL INCOME TAX REFUND FOR YEAR ENDING 12/2004 2. LATELY ARRIVED CHECK FROM STERLING FINANCIAL TRUST COMPANY, IDENTIFIED AS PA INCOME TAX REFUND FOR THE DECEDENT, TAX YEAR NOT IDENTIFIED 1,224.00 179.93 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,403.93 .c' _ in.!:.~' +.~.' ~ .. lIr....mnm15-S1 UUIUlll A"1l1.InI \W.DUIUI.! 000 . A 451,620,007 Check No. Ii,:,:, I -. I '" 0\ '" M v:; '" 08 18 06 73 AUSTIN, TEXAS 2307 65121692 20092800 130 OBYER 1...111...111..11'1111..11.1.. n ...1..1.1..11.1.1..1.1.1.11..1 MARY JO BYERS THOMAS E FLOWERS EXEC 2109 MARKET ST CAMP HILL PA 17011-4723 2307 65121692 PHILA TAX REFUND 12/04 92 $***1224*00 III 2 3 0 'i' B III 1:000000 5 .81: b 5 . 2 . b ~ 2 ~1I1 01..080 b 1 -'>',> \.)::,:":'~~:- ~<::::::::~:,:,):?; .-, :<;. :.(:~'<X{:. ;,,::';::- :.'."',' :':\,~ ,:C,:, ,.:.} ;:~'><:.:\ - ;,:","-,-;-.:/,,"'- ::::,:.i.,:/-,: :::'.:.'; "'~:.)'-.'" -':"-,'> ....-'..-.".::-.....:.: -,:: :'.,'~.'.'--":' .:.: :.' "" ":','" ",,'--, - - .-..".'" "'.,'".' ..... --, ''-'" -'.., ','-'.-" ..... DRAWER:STERL1NG~NANCI~ TRUST COMPANY ./l, ~~em'~v =-----c:>--__--=O=-O~-""O"-~-~;:::>Q.O~--~-~--==-:::::x::>---------~ THIS lJ()CUMENT HAS AN ARllflC1i\L W';I'E~t( I'R1NTEDONTHEIlACK. THE. FRONT Of. THEDOCI;IIo1ENT HAS II MlCRo-.PRINT SlGNATUIlEUNE. ABSENCE Of THESE FEATURES WILL INDICATE A COf>Y. STERLING FINANCIAL TRUST COMPANY CREATING MANAGING PRESERVING WEALTH... 0313 ISSUED BY: TRAVEL"'RSEXPRESS COMPANY. INC. . .... . P.O..BOX9476,MINNEAPOUS.MN5548(l POfloX~ ..... ................ .......... ....;< DRAWEE: BOSTON SAfE DEPOSIT.&TRUST CO. . EastPelersburg,PA J7520-o03& BOSTON. MASSACHUSETTs 1097 . Commercial Ave, OFFICIAl. CHECK ',,, Estate of Ma.!"1d 2109 MarketSr . c/o Atty Thomas' Camp Hill .&931100 ..':; " " -> -: <,i:.' ,'::::',,":::::->~~-'_:'.'< One Bundretl~' ....... :),'.<,-", -,~' " , " AUTHORIZED SIGNATURE , ,-: ',: ;,:;; ":::":;::~:~'/':';'(i~;(.:~,Y:::'::~,:~:~5 1/1 2 I.. ~ b 3 Sill 1:0 ~ ~oo 70 ~ 21:0 ~ bOO .0 b I.. 20B ~1I1 STERLING FINANCIAL TRUST COMPANY 1097 Commercial Ave. PO Box 38 East Petersburg. PA 17520 249635 99000500 Mise Cash Gen Led Principal Distribution for Beneficiary . State tax refund for Mary Jo Byers alc #001622 Amount: 09/29/06 **179.93* Transaction # 15799950 Estate of Mary Jo Byers 2109 Market St c/o Atrj Thomas Flower, Exec Camp Hill PA 17011 Administrator Name: Kimberly A Kutzer (717) 735-5847