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Home My WebLink About10-26-06 ---1 15056051047 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL llSE ONLY County Cod,~ Year File Number ~\ tJ~ \) q ::;d. Date of Birth 1 ~ > l z... 3 4- i j- 6Lll'Z.oob Decedent's Last Name Suffix b3 (\l't\4. Decedent's First Name MI T 1\ L( L 0 (J... GLt:ANO~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FilED IN DUPlICA.TE WITH THE REGISTER OF WILLS Fill IN APPROPRIATE OVALS BELOW __ 1 . Original Return c:::l 2. Supplemental Return c:::l c:::J 4. Limited Estate c:::J 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) c:::J 3. RElmainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required .. 6. Decedent Died Testate c:::l (Attach Copy of Will) c:::l 9. Litigation Proceeds Received c:::l 8. Total Number of Safe Deposit Boxes c:::l 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number r1AN~ s fA 1(1... \ c..K. 't J q 4-b 1- S 3 $"' 4- Firm Name (If Applicable) REGISTER OF WILl.S USE ONl.Y i' "_ ~ First line of address l () 7 71~Bii"~ I/IE'w cA-tVE Second line of address City or Post Office State ZIP Code DATE FILED CA~Y N'c.. 'l.),;} / 667 ~ ,".-.1 .....0'-'" Correspondent's e-mail address: u ,~ \t\ .)'\ et- Under penalbes of perjury, I declare that I have examined this return, including accompany, edules 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 ail information of which preparer has any knowledge. SIGNATU ,. OF PERS9~ I)liSP~LE FOR "lUNG RETURN DAyE a.nu)U fa.., / t) / /-3 / tJ tP , , V!-. o?1S// DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ...J 1f!;J .-J 15056052048 REV-1500 EX Decedent's Name: RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . .. 1, 2. Stocks and Bonds (Schedule B) . , . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Recervable (Schedule D). 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) , . . . . . 6. Jointly Owned Property (Schedule F) c:::> Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::> Separate Billing Requested. . . . . 8. Total Gross Assets (total Lines 1-7). . . 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I). . 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) 14. Net Value Subject to Tax (line 12 minus Line 13) . 10. . 11. . . . . 12. . , . , 13, , , ' 14. Dececlent's Social Security Number t ~b.3 I 'L. 3 1-3 S- o 2, \ 3l7.b7 3, o. 4 o. s-9Bg.'( ( 5, 6, o. 7, o. 8, 7 3D b. ~g 1'413.t!J() 9. o . (,4-?3.~o ~ ~ :s "$ . S~ s ~ "$ 3.5"" B TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec, 9116 (a)(12) XO_ 16, Amount of Line 14 taxable at lineal rate X ,0 17, Amount of Line 14 taxable at sibling rate X ,12 18, Amount of Line 14 taxable at collateral rate X .15 . S' tf; 3. 3. . ~- ~ 19, TAX DUE, . ' , , 15, 16, 17, 18. , , ' . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 . . ~7 5. 00 '2>7S:o{) C) 1!i056052048 -.J Kt:V.10UU I::}<. page j File Numoer Decedent's Complete Address: DECEDENTS NAME STREET ADDRESS <= ~~ O.(S... I.A.'-fc...-a.@-... 1 2....0 F t L rs ~t2..1 S-r: M. ~c; tV lc.S~U~~ ! STATE ; f~ I : ZIP l7{) s-S- CITY Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ~7 $". tJO Total Credits (A + B + C ) (2) o 3. InteresUPenalty If applicable D. Interest E. Penalty ----. TotallnteresUPenalty ( 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) o B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) &/~IOD '0 ~ 7 s. (;) 0 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. (SA) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Old decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... 0 ~ b. retain the right to designate who shall use the properly transferred or its income; ............................................ 0 M c. retain a reversionary interest; or.......................................................................................................................... 0 IiQ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 2. If death occurred after December 12. 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. 0 IX 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation? ......................................................................................................................... 0 ~ 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. 99116 (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 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 zero (0) percent [72 P.S. s9116(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. 99116(a)(1)]. The tax rate imposed on the net value oftransfers to odor the use ofthe decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, undel Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 8Jc--As1If iJ (L FILE NUMBER Tkl.(~o(L All property jointly-owned with right of survivorship must be disclosed on Schedule F. iTEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH II 5bfA.~ 5 <'r Co ,vi t41..o ;f/ SiD 0 t-. f (J.. \J () (s-vv1i AL HtU ,ttU-11t<- ( ) /1.1 (! :f77,sl /S~ f "5 II , b 1 ( TOTAL (Also enter on line 2, Recapitulation) $ I -g/? b7 / (If more space IS needed. insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF <ELJc1':\/VlJ {L 77/-'(u ~ FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. AU property jointly-owned with right of survivorship must be disclosed on Schedulie F. ITEM NUMBER 1- DESCRIPTION c \\~'f...\~ b tr.... cc 0 U NT - M. ~ T \31\ N $~ ~cc..()lJ tvT -::#: ~ s-t I \ ~ ~ 8 VALUE AT DATE OF OEA TH S-14 Bf3 ,'1l TOTAL (Also enter on line 5, Recapitulation) $ S, q C6 e , cr { / (If more space IS needed, insert additional sheets of the same Size) REV~1511 EX+ (12~gg) l'l * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMEIER ~\:::"l\ r$ 0 .;-. 7A '(Lo fL.. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: G Mil €: (\'\ t\ t2..~ Ii- (l..o L L \ tv ri:1 ~ t2-k-etV C G t11 ~ 7e-;tl 'f I ~ tIC w:\- ~ISL~ (4t+~ cA:Af 14l VL I f -4 . I 70 Il I/IO~..oO B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) -1 AN e- 5, fA(J[2..) C)<-... ,q"Z.~ 30' l'lS-Z 7711t~b"tl- WCU/ ~ State /l/ C!. Zip t 7.:~-1 ( ~.5,o 0 Social Security Number(sYEIN Number of Personal Representative(s) Street Address , 0 7. Clt: aLl Year(s) Commission Paid: 'Z-O 0 6 City 2. Attorney Fees 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 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ } ~ 7> ,f) {) (If more spaoe IS needed, Insert additional sheets of the same Size) { .. ~ , ..;--~~ .<,\ ./ '.J '" , '1 ~ :\ J ,~ 'j'\JI R. Scott Cramer, Esquire CRAMER & MCPHERSON P.O. Box 159 Duneannon, PA 17020 LAST WILL I, ELEANOR M. TAYLOR, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my Last Will, hereby revoking all prior Wills and Codicils. FIRST: I direct that the expenses of my last illness and funeral be paid out of my estate as soon after my death as is convenient and expeditious in the judgment of my Co-Executors, hereinafter named. SECOND: I give and bequeath Lenora Miller's se'wing machine to Ella Steward. THIRD: I give and bequeath the sum of One Thousand ($1,000.00) Dollars to each of my grandnieces and grandnephews, Jaime Patrick, Jill Patrick, Sean Patrick, Kevin Patrick and my nephew, John E. Miller, Jr. FOURTH: I give, devise and bequeath all the rest, residue and remainder of my estate, to my niece, Jane Shetter Patrick. FIFTH: All estate, inheritance and other death taxes, together with any interest and penalties payable with respect to property or interests therein subject to taxation by reason of my death and whether passing under my will or any codicil thereto, or otherwise, including jointly held and other non-testamentary property shall be paid out of the principal of my residuary estate without apportionment. SIXTH: I hereby nominate, constitute and appoint, my niece, Jane Shetter Patrick, Executrix of this my Last Will. Should my niece, Jane Shetter Patrick, be unable to so serve, then and in that event, I nominate, constitute and appoint, Richard Patrick, Executor of this my Last Will. I further direct that they shall not be required to post any bond to secure the faithful performance of their duties in the Commonwealth of Pennsylvania or in any other jurisdiction. R. Scott Cramer, Esquire CRAMER & MCPHERSON P.O. Box 159 Duncannon, PA 17020 IN WITNESS wliEREOF, I have hereunto set my hand and seal to this my Last Will, which consists of two (2) sheets of paper, dated this .1] r'l day of September, 1988. ~ ~ '2 (/ ,_ ~ /~........ / ,;1-) \--. ~ U-. j SEAL) Eleanor M. Taylor ! The writing contained on this and the one preceding page was signed and sealed by Eleanor H. Taylor and by her published ar,d declared as her Last Will, in the presence of us, who have hereunto subscribed our names as witnesses at her request, in her presence, and in the presence of eac?~~(} xL n , -L-1.A;2..J./1 {j j / '/.r !/ l!lu")A./lA-.J SC01l Cramer, Esquire ~AMER & MCPHERSON P.O. Box ]59 "ncannon, PA ] 7020 COMMONWEALTH OF PENNSYLVANIA ) )SS COUNTY OF PERRY ) T, Eleanor M. Taylor. testatrix. 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~~ /? C") ~r~?2~~~ ~ J:Ci./L.;'",~ f SWORN or affirmed to and acknowledged before me by, Eleanor M. Taylor, testatrix, this ~J.Jday of September, 1988. \ ., "f .<> . /-i '_...,:>r'.....~.,._~~._._;. RUTH E:i:,,>ij:< G::RLfV\, Notary Public )unC2:''')iiC)f1, PeL 1-./\'1' Corn,7l;s:;ijon Expire.) /\1a);' !,?,:.~;) COM}10NWEALTH OF PENNSYLVANIA) )SS COUNTY OF PERRY ) C)' ',\ () L .., r, . \! We, :l, <..,) (--CJt {, l!l!"tl e~ and ~ )US (J. n L {)U f'1 tr] 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 testatrix sign and execute the instrument as her Last Will; that Eleanor M. Taylor signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ,~ /(' / - f /) .~....t~/ / '/ ------ r; ~ .to--ll/vL/ .f) {/ ] jy:~-<-..,. t-v(~ SWORN or affirmed to and subscribed to befo.re me by /', :See 11 Lf.-an1. er and ~C.J SG n l>. j)(///ii/, witnesses, this ,1J7"day of September, 1988. / ~~~~~...- "---f'~>':"-t...,;~:> _~~T'"'- -- ._<_/<_-'5!""; :"';'''~';:~-:'''_>~~::..,..._., '1 h..b;;c Scott Cramer, Esquire AMER & MCPHERSON P.O. Box 159 Jne.nnon, PA 17020 ~ I -- - ~ 3 1~::. 1a .tg l/') P-'?r- ~!~ ~,s z. ~ '; ~ '0 e. u \~ ~ ~ ~ ~Vl W ~ ~~ \L r- ~ ~ - ~~-----~ ~~~~ ~ 5=:>. ~ -.... ~~ ~ -- ~ ~ ~ \L ~ ~<:)XV\ ~ ~ ~ ~ ~_ ! ~ X: ::>~~ ~C2 -- ~ ~ ~ \ ~ ~ - :;-:. 'It:,' .' ,~ '" \' ~ 'I. \"