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HomeMy WebLinkAbout10-18-06 :f\Lt5llO EX (&all COMMONWEAlTH OF PENNSYLVANIA DEPARTJ.ENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (lAST, ARST. AND MIDDlE INITIAl.) UHL,JOinl R. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-OO-YEAR) 05 - 09 - 2005 0' -O~ -1~2 (IF APPLICABlE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDlE INITW..) UHL., ELYNORE A. [XI 1. OrigInal Return D 4. Umited Estate [XI 6. Decedent Died Testate (AlIac:h copy 01 WI) D 9. UIIgalion Proceeds Received I- Z W C W (.) W C ~ lI::S~ uO:u wa.o xi.... Ua.llI a. <( D 2. Supplemental Retum D 48. FuIln Interest Compromise 1- of.... .,2-'2-12) D 7. Decedent Malntained a Living Trust (MIcIt capy of TIIIII) o 10. Spousal Powrty Cnlditl_oIdeIIII........,2-31-81...1-1.e5) OFFICIAL USE ONLY FILE NUMBER ~ .1.. - ..Q... 2. .Q. JL L .L .2.... COIIf1Y CXlllE ltM NIIIIER SOCIAl. SEClIRrtY.NtitBER 197 - 1 6 - 8350 THIS RE1URN.. BE FILED IN -..:ATE WITH THE REGISTER OF WILLS SOCIAl. SECURITY NUMBER o 3. RemaindBr ReIum /dIItof....prlGrlD 12-1U2) D 5. Federal Estate Tax RelumRequired 8. Total Number d Sale Depoeit Boxes o 11. Election ~ tax lIlder See. 9113(A) l/oIIIdt Sell 0) NAME I- Z W Q ~ a. m ~ (J JOHN J. OHL FIRM NAME l1IApp1cab1e) TELEPHONE NUMBER 717- 867- 6 z o 5 ::) l- ii: c( (.) w a:: COMPlETE MAILING ADDRESS P.O. BOX 66 ANNVILLE PA tlbo3 (1) (2) (3) (4) (5) 217,Q72_::iR 356,219.67 1. Reel Estate (Schedule A) 2. SIDCks and Bonds (Schedule B) 3. Closely Held Corporation, PartneIShip or SoIe-ProprleIorip 4. Mortgages & Noles Receivable (Schedule 0) 5. Cash, Bank Deposils & Miscellaneous Personal Properly (Schedule E) 6. JoinUy Owned Properly (Schedule F) D Separate BIIing Requested 1. Inter-VIY06 Transfers & MisceRaneous Non-Probale Property (Sc:I1eWIe G or L) 8. ToIal Grou AIseIs (total Lines 1-7) 9. Funeral Expenses & AdminIstrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabifilies, & liens (Schedule I) 11. Total DeducIIons (total Unes 9 & 10) 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitable and GoverMlental BequeslsISec 9113 TrusIs for which an eIecIion to tax has not been made (Schedule J) (6) (1) (9) (10) 7,574.52 3,986.85 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCnONS ON REVERSE SIDE FOR APPlIcABLE RATES 15. Amcu1I d Line 14 taxable at Ihe spousal tax rate, or transfers under See. 9116 (a)(1.2) z o ~ ..... ::) "- ::E o (.) ~ 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Une 14 taxable at ooIIateraI rate 19. To Due OFFICIAL USE ON(Y- o Sg -n -...-0 .-----.,-- iTl :::J /':~ r--.> c::::J = C1"'\ o n --I OJ ~:) CJ )C--':)"il '. )c= ..~ :::0 .'J~ ):> > ::x o w (8) 574,192.05 (11) (12) (13) 11,561.37 562,630.68 (14) 562.630.68 x.O_ (15) x .0 4.5.:. (16) 21,520.62 x .12 (17) x .15 (18) 1?f\!:\Q_1Q (19) 34,179. R 1 478,236.08 84,394.60 20.0 CtiFCK .~t Rf 'F you .\f~E eEI:'JESr!~jG A "EFUND 'IF .\N OV"RPAyrN:NT Decedent's Complete Address: STREET ADDRESS Cumberland Count ) 8 Louis I;iane CITY STATE PA ZfI 11025 NA Tax Paymel)~and Credits: 1. T!I/C Que (PQ tline 19) 2.~,., A.. Spousal PoWIrty Cid . B. Prior Payments C. Discount (1) 344:1 '79..81 ' 3. InterestlPenalty if applicable D.lnterest E. Penalty Total CredlIs (A + B + C ) (2) o TotaIlnteresI/PenaIly ( D + E ) (3) 4. If line 2 is greater lhan line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on "1 Une 20 to requ8st a refund (4) 5. If line 1 + line 3 is greater lhan line 2, enter the dilfererm. This is the TAX DUE. (5) 34.179.81 3,417.98 A. Enter the interest on the tax due. (SA) B. Enter the total of line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT ~'1'v;ri:W0}'MWJ.tW~_\.~~ii~~~'~'~j'IR~v,;j')1'~!}~~'~It~~IL,...".."_!"'~.~~c.\~~,""",I~!U'i\II!;,..,,,,,:,.,..;~ 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 lransferred;.......................................................................................... 0 KJ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 LI c. retain a reversionary interest; 01'.......................................................................................................................... 0 :KJ d. receive the promise for life of either payments, benefits 01' care? ...................................................................... 0 :KJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 iJ 3. Did decedent own an "in trust for" or payable upon death bank account 01' security at his 01' her death? .............. 0 LI 4. Did decedent own an Individual Retirement Account, annuity; 01' other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 KJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. l.IndIIr penaIlies of perjury, r d8clanllhall haw exami1ed lhis 18lIm. incIudng llCCOl'lp....tittll sc:IIecUes 8IIlI slaIem8nIs. 8IIlI1o Ihe blIsl of my IlIXMIBdge 8IIlI bIII8f. it is Irue. aJII8d 8IIlI CIDlIIIlIlJIt. 0ec:IlIlIli0n of Jll8PIIIIr oilier tIa1lhe peISOlllII repl8S8Illative is based 011 aI irionnelion of wIich JII8IlIIW has any knowledge. =~PER&W~U1 P.O~ BOX 66 ANNVILLE PA 17003 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~7,C\q7_7q DATE 10-07-06 DATE 10-07-06 ADDRESS' 149 ALMOND DRIVE HERSHEY PA 17033 ~~~~~fr rITi>ll1:..~.}~~Et~3(:;!,^ "'0 . 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. SlJ116 (8) (1.1) (ij). 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 stniving spouse is 0% [12 P.S. 59116 (a) (1.1) (i) The statute does not ~ a transfer to a surviving spouse from tax, and the sIatutoIy requirements for discIoslI'e of asseIs and fiIilg a tax relum are slI applicable Ml'l the SUfViving 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 yoooger at death to or for the use of 8 naluraI parent, an adoptive .... or a stepparent of the child is 0% [12 P.S. 59116(a)(1.2)). The tax rate imposed on the net value of transfers to 01' for the use of the decedent's lineal benellciaries Is 4.5%, exalpt as noted in n P.S. 59116(1.2) [12 P.S. 59116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's sibIngs is 12% [12 P.S. 59116(a)(1.3)~ A sIbIng is defined, IIlder SecIIon 9102, as a indMduaI Vt'ho has at least one parent in common with the clecedlri, whether by blood or adoption. ._a._ *' CCMDIItQLTHaF PaNM.VANIA NEffrAfiICE TAX AEnRt SCHEDULE B STOCKS & BONDS ESTATE OF "0:<' '.::..cl '."\.":"".=,[ -- John R. Ubl AI pnlpIItJ joInIIyocMned wIh rIgIIt 01 stnilrorIIlIp lIIlIIt lie dllc;1DMd on ..... F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 22,461.68 T.Rowe Price Blue Chip Growth 2. T. Rowe Price Equity Income 3. AT&T Common (SBC) 838.481 shares @ 23.58 30,907.35 19,771.38 4. Bell South 513.432 shares @ 26.20 13,451.92 5. Verizon 442.585 shares @ 34.54 15,286.89 6. Excelon 2,394.167 shares @ 48.49 116,093.16 TOrAL (Also enter on line 2, Recapitulation) $ 21 7 , 972 . 38 (If more space Is needed, Insert adrJtionaI sheeIs d the sane size) _a._ . COIIMOIMEALlHOF PBIIM.VNM IIHIITNICE TAX .REnJIt i. '_I.=J .~.......~::J. '::.J SCHEDULE E CASH, BANK DEP08ff'S, & MISC. PERSONAL PROPERTY ESTATEOF 3'ohh R. Uhl Indude.. pIOClllIdI<<....... and .. d8lt ..1lftlllIlldI_1ICIllIId ..,........ AI......, JllfIIJ .111111 If ....."......-....... lie .1 . r ....... .......F. ITEM VAl.l.EATD\1E NUMBER DESCRIPOON OF DEATH 1. Commerce Bank 99,697.17 2. 3. 4. 5. 6. Belco 20,551.91 40,000.00 30,217.60 PA State Banki (Cn) u.s. Treasury (EE Bonds) M & T Bank (IRA) 15,143.57 Allianz Annuity 22,262.70 7. Hartford Saver 6 Annuity 18,861.07 8. Nationwide Annuity Platinum 70,010.55 9. Midland Life Insurance Annuity 26,172.10 10. 2002 VW Cabrio GLS (Bluebook) 10,875.00 11. Personal property 2,428.00 TOTAL (Also entBr mine 5, RscapIdaIIon) $ 356 , 21 9 . 67 . REV-1511 EX+ (12-99) . ~~t.. ~ COMMONWEALTH OF PENHSVlVANA INHERfTANCE TAX RETURN RESIDENT DECEDENT HNIDULI H FUNERAl. EXPENSES & ADMNS1RA1IVE COSlS ESTATE OF John R. UbI ALE -..sEA 21 - 05 00719 DellIs of ........d IIIU8t be ......... .. Sc:bIduIe L ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1. Richardson Funeral Home 3,975.00 2. Miscellaneous Expenses 1,359.02 B. ADMINISTRATIVE COSTS: 1. Personal Represen/alive's CommissioIIS Name of Personal RepresenIalive(s) Social Seaaity Number(s)IEIN Number of PersonaIRepresentaIive(s) Street Address City Stale _~ Year{s) Commission Paid: 2. AUomey Fees 472.50 3. Family Exemplion: (H decedent's address is not the same as claimant's, aIIach explanation) CIaimanl Street Address City Relationship of Claimant to Decedent Slate _ Zip 4. Probate Fees 150.00 1,250.00 5. Accountanl's Fees 6. Tax RetOOl Preparer's Fees 7. Register of Wills 368.00 TOTAL (Also enter on line 9, Recapitulation) $ 7 , 574 . 50 III _ "'Nlr.A ifll1AAttAtl inllflft IIr1lfllinnRIRhMl'l of fhfI same slzel _~D."~ . COMMONWfALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RE ~NT DECEDENT SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FilE NUMBER John R. Ubl Include unreimbursed medical expenses. ITEM NUMBER 1. Comcast Cable DESCRIPTION AMOUNT 39.39 2. Fleible Financial Corp. American Homecare Supplies 28.40 566.06 3353.00 3. 4. Visa Balance Federal and Pennsylvania Income Tax TOTAL (Also enter on line 10, Recapitulation) $ 3986 . 85 (If more space is needed. insert additional sheets of the same size) REV-1513 EX+ IW COMMQNWEALlH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHIDULI , BENEFICIARIES ESTATE OF FI.E NUMIER John R. Uhl NUMBER I RELA1'J()MSHIp 10 DECEDENT NAME AM) ADDRESS OF PERSON(S) RECEIVING PROPERTY Do NCIt lilt....... TAXABLE DISTRI8UTIONS (Include OlIIrW1IlIflOUll8I dIsIribulIons, and IranIIIer8 under See. 9116 (8) (1.2)] 1. John J. Uhl P.O. Box 66 Annville, PA 17003 Son 2 Timothy A. Klein 14628 S. 35th Place Phoenix,AZ 85044 None AMOUNT ORSHAfE OF ESTATE 85% 15% 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 BaNG MADE 1. B. CHARITABlE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV.1500 COVER SHEET $ (If more soace is needed. Insert addillonal sheets of the same size) No. 2005- 00719 Esta te Of: JOHN R UHL (FIm. MIddle. U6tJ PA No. 21-05-0719 Late Of: EAST PENNSBORO TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 197-16-8350 WHEREAS, on the 12th day of August 2005 an instrument dated June 10th 1998 was admitted to probate as the last will of JOHN R UHL (FIm. MIddle. LatJ la te of EAST PENNSBORO TOWNSHIP, CUMBERLAND County, who died on the 9th day of May 2005 and, WHEREAS, a true copy of the' .will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: JOHN J UHL who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 12th day of August 2005. * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) I --~- . .. . . - ~ . - v ~ ~ ~ JUctst lltIill ttnb @~,gtttttt~nt OF JOHN R. UHL I, John R. Ohl, of 8 Louis Lane, Enola, Cumberland County, Pennsylvania, declare this to be my Last will and Testament, hereby revoking all prior Wills and Codicils. XTEM X. I direct that the expenses of my last illness and funeral shall be paid from the funds of my estate. XTEM XI. I direct that, if possible and reasonable, arrangements for my viewing and burial be handled by the Myers- Harner Funeral Home, Inc. I further direct that where feasible and possible any memorial service take place at the West Shore Baptist Church and that I be buried at an appropriate place in the cemetery at Fort Indiantown Gap, Annville, Pennsylvania. XTEM XXI. I direct that all the rest, residue, and remainder (~ of my estate be divided as follows: A. Fifteen percent (15%) to Timothy Klein, now. or ~ formerly at 1010 Fox Chase Drive, Apartment 317, San Jose, California, 95123, provided he survives me by thirty (30) days. B. All the rest, residue, and remainder to my son, John J. UbI, now or formerly of Annville, Lebanon County, Pennsylvania, provided he survives me by thirty (30) days. Should John J. UbI fail to survive me by thirty (30) days, I ~ ~ {Y :~ ~ {..... , ~ direct that all the rest, residue, and remainder of my estate be distributed as follows: 1. Ten percent (10%) of my estate to LuAnn UbI, provided that she survived me by thirty (30) days and provided that she was married to my son, John J. UbI, at the time of his passing; 2. The' balance in equal shares to any surviving children of John J. UbI. XTBK xv. No interest of any beneficiary under this Will or any Codicil hereto shall be subject to anticipation or voluntary or involuntary alienation. XTBK V. No provision in this Will is intended to exercise any power of appointment. XTBK VZ. In addition to powers vested in them by law, my Executrix and her successors shall have the following powers, applicable to all property held by them, including all property held for minors, effective without the order of any Court and until actual distribution of all such property: A. To retain any property received by them including the stock of any corporate fiduciary acting hereunder. B. To sell real estate for any purpose, publicly or privately, for such prices and on such terms as they deem proper, without liability on the purchasers to see to application of the purchase monies. c. To compromise controversies. D. To distribute in cash or kind or partly in each at valuations fixed by them. E. To hold investments in the name of nominee. ITEM VII. All taxes and interest and any penalties thereon payable by reason of my death with respect to property comprising my gross taxable estate, whether or not passing under this Will, .~ shall be paid from the principal of my residuary estate. ITEM VItI. I hereby nominate, constitute and appoint John J. Uhl Executor of this my Last Will and Testament. If John J. Uhl predeceases me, or if for any reason does not act or continue to act as such, I appoint LuAnn Uhl as Executrix in his place. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have set my hand and seal this /1) day .- of ...J l'( n~ , .1998, to this my Last Will and Testament, which consists of three (3) tyPewritten pages to each of which I have affixed my signature. '/ . ~ COMKOBWEALTHOF PENNSYLVANIA ) COUN'l'Y OF D~ ""1 (\ : SS: ) We, John R. UbI,. t,estator, -e.- , ~~\ r~eU. t\"'r\~ . f.Sri...lLand the Testator -and the witnesses, res ecti vely, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his free voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Last Will and Testament as witness and that to the best of their knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. . i ,-,,/ Testator residing at ? k;U;r..!wlff ~M fa (Ja. 17P).5' / . at .JIll? j)/ ;;L:1/'-- /+///(.I#/d /7 /7//0 J ~ Witness .' /" // /." . ..... ._-I,-:f /........ 0' ..- /.,/? ". ,.? / / ",. .' /.." I c;170 -.(.11 /',., /l./It"residing ,/ . at 7CXJ 71. 7rtr:r 4A /- ./I. At.rl! frvufJJ(trN-('l i'J.?1 . /' 17~- residing at J/d.- '~...e.;:.t- 1/!..~~ tJ/;.a {/ ,LIp /7/ J d- p Subscribed, sworn to and acknowledged before me by John R. UbI, Testator, and subsc~ibed and sworn ~o befor~ me by . \(pV'\"e-\ h A.. ,All Sr"" ,. ~~\r\e!r.4. 8nne ~s1:i1J ., and (-,)(1-\-,^-,0.... \.o..'W:;liS , the witnesses, this ,0 day of :S-IA V\e.., 1998. Witness fu., ',I.(7.pu_, k residing witness ~<(%J,{J{.J us) PUblj.c NoIIIIII C8ndIIhy.... ~ NlIc c MyC:==~2001 . c:\wp5lc1ocmri1\u1v"\wil