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Home My WebLink About11-28-06 REV-1500 EX (6-bl) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER ~L COUNTY CODE ~L 0915 ___ YEAR NUMBER I- Z W C W o w c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Glass, Jr. Orville DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 3/25/2006 9/25/1930 OF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Yvonne H. Glass [X] 1. Original Return D 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy of \Mil) D 9. Litigation Proceeds Received W SOC~SECURnvNUMBER 206-26-8833 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURllY NUMBER W I- ~$n o a::~ wlll.O :E:~ o Ill.af Ill. c( D 2. Supplemental Return D 3. Remainder Retum (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a LMng TNst (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0 11. Election to tax under See. 9113{A)(AttachSchO) 44 West Main Street THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DiReCTED TO: NAME COMPLETE MAILING ADDRESS ... Z W o Z o a. en w a:: a:: o Co) Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER 717-697-8528 Mechanicsburg, PA 17055 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1 ) (2) 0.00 3,382.72 0.00 0.00 0.00 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) z o t= :3 ::;) l- ii: c( o w a:: 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly O\M"led Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8,620.67 8. Total Gro88 Assets (total Lines 1-7) (8) 14,146.20 55.63 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1 O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (1 0) 11. Total Deductions (total Lines 9 & 10) (11 ) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 TNst8 for which an election to tax has not been made (Schedule J) (12) (13) ~ICIAL USE ONL@ C'O c::J"\ ~:o Z ;,'-! v 0 .'~ :::r: ("') -< ...~ ;:;;; Fn N ~:o Q) :x:: C)O --,-) :. ;,_ 11 C) c:: - ::0 .:-0 -I .1> 12,003.39 14,201.83 (2,198.44) 0.00 :r:a :z: V? W \0 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 15. Amount of Line 14 taxable at the spousal tax z rate, or transfers under See. 9116 (a){1.2) o ~ 16. Amount of Line 14 taxable at lineal rate I- :J ~ 17. Amount of Line 14 taxable at sibling rate o o 18. Amount of Line 14 taxable at collateral rate )( ~ 19. Tax Due 20. ~ 0.00 x.O L (15) 0.00 x .0 45 (16) 0.00 x .12 (17) 0.00 x .15 (18) (19) (2,198.44) 0.00 0.00 0.00 0.00 0.00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 ~.) Decedent's Com lete Address: SlREETADDRESS 415 Kent Drive U er ~len T Cumberland Count CllY Hechanicsbur STAle PA ZIP 17055- 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 0.00 0.00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 0.00 0.00 TotallnterestlPenalty (0 + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Pa able to: REGISTER OF WillS, AGENT (5B) 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes D D D D without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Ii] D 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 perjury, I declare that I have elCllmined this retum, induding accompanying schedules and statements, and to the best of my knowledge and belief, n is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SlGNAl\.RE OF PERSON RESPONSIBLE FOR FILING RETURN 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death No ~ OQ ~ Cia ~ ~ 415 Kent Drive, Richard C. Snelbaker, Esquire 44 West Main Street, Mechanicsburg, PA 17055 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. S 9916 (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 sunliving spouse is 0% [72 P.S. S 9116 (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 ellen 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 adoptille parent, or a stepparent of the child is 0% [72 P.S. 99116(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. 99116(1.2) [72 P.S. 99116(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. 9 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. 3W4646 1.000 R,EV-1503 EX ~ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Orville W. Glass. Jr. 21 06 0915 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER IESCRlPTlON VALUE AT DATE OF DEATH 3,382.72 1.Tyco International Ltd 124 shares common stock valued at $27.28 per share 3W46961.0oo TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,382.72 REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INl-ERlTANCETAX RElURN RESIDENT DECEDENT ESTATE OF Orville W. Glass. Jr. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 06 0915 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERlY ITEM I/IO..lIE Tt€ _ OF TH: TRANSFEREE. nElR RELATIONSHP TO DECEDENT />NJ DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBEI' TH:DATEOF~. ATTIlCH A COPY OF TH: DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF I>PPUCABLEl VALUE 1. Vanguard Group 8,620.67 100.0000 0.00 8,620.67 IRA account number 0033/09900655035 TOTAL (AlSO enter on line 7, Recapitulation) $ 8.620.67 (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 REV-1511 EX + (12-99) ITEM NUMBER A. B. FUNERAL EXPENSES: 1. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. DESCRIPTION Clergy, organist and vocalist for funeral services Total from continuation schedules 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Claimant Street Address City Relationship of Claimant to Decedent 5. Accountant's Fees Probate Fees Street Address City Year(s) Commission Paid: State Zip Snelbaker & Brenneman, P.C. 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 4. 6. TaxReturn Preparer's Fees 7. 1 3W46AG 1.000 Malpezzi Funeral Home death certificates State PA Zip Total from continuation schedules FILE NUMBER 21 06 0915 TOTAL (Als'o enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 200.00 12,372.20 875.00 102.00 97.00 500.00 14,146.20 Estate of: Orville W. Glass, Jr. Item No. 2 3 4 5 6 7 206-26-8833 Schedule H Part 1 (Page 2) Description Amount Diocese of Harrisburg, Gate of Heaven Cemetery cemetery lots 800.00 Gate of Heaven opening of grave 1,575.00 Malpezzi Funeral Home funeral services 6,853.44 Office of Catholic Cemeteries grave marker 2,650.00 Rothermel's Florist flowers for funeral 159.00 Trinity Lutheran Church funeral luncheon 334.76 Total (Carry forward to main schedule) 12,372.20 Estate of: Orville W. Glass, Jr. 206-26-8833 Schedule H Part 7 (Page 2) 2 Reserve for filing fees, accounting fees and other costs associated with the administration of Decedent's estate 500.00 Total (Carry forward to main schedule) 500.00 REV-1512 EX + (12-03) COMMOI'M'EAL TH OF PENNSYLVANIA INl-ERlTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Orville W. Glass. Jr. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 06 0915 Report debts incurred by the deced~nt prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NLfJIBER 1. DESCRIPTION VALUE AT DATE OF DEATH West Shore EMS ambulance service 55.63 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 55.63 REV-1513 8<+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INl-ERlTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Orville W Glass. Jr FILE NUMBER 21 06 0915 1 NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Yvonne H. Glass 412 Kent Drive Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE NUMBER I Spouse 0.00 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 BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3W46AI 1.000 TOTAL OF PART 11- 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) $ 0.00 " ~ ~~ J LAW OFFICES ~NELBAKER & ELICKER ~ LAST WILL AND TESTAMENT I, ORVILLE W. GLASS, JR., of the Township of Upper Allen, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, unto my wife, YVONNE H. GLASS, absolutely and in fee simple, if she survives me by as many as sixty (60) days. THIRD. If my wife, YVONNE H. GLASS, does not survive me by as many as sixty (60) days, then and in that event, I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my children, namely, KIM M. HANNIGAN, JOY M. PEREZ-DAPLE, COLLEEN M. REILLY, KEVIN M. GLASS and JILL M. TAMOSAITIS, share and share alike, absolutely and in fee simple. If any of my said children should predecease me, I order and direct that the foregoing share of my residuary estate otherwise attributable to such deceased child shall be distributed unto her or his lawful issue per stirpes by 1 representation and not per capita, subject, however, to the protective trust provisions as set forth in item Fourth hereinbelow. FOURTH. I order and direct that the distributive share of my Estate attributable to any beneficiary under the age of twenty-five (25) years shall be paid over and delivered unto DAUPHIN DEPOSIT BANK AND TRUST COMPANY, of Harrisburg, pennsylvania, (or its successor by merger, consolidation or other corporate reorganization) as my testamentary Trustee, IN ~ TRUST, NEVERTHELESS, to hold, manage, invest, accumulate income and reinvest until said beneficiary attains the age of twenty-five (25) years, at which time said trust shall be - ~ ~ ~ terminated and the then remaining net assets shall be distributed unto the beneficiary absolutely. During the existence of such trust, I authorize and empower said Trustee in the exercise of its sole discretion to use, consume, expend and apply from time to time such amounts of income and principal as the Trustee shall determine to be necessary and proper for the beneficiary's education. The term "education" shall be interpreted and construed to mean college, post-graduate school or other post-highschool training which is intended to improve the beneficiary's productivity as an adult or to enhance the quality of his or her life. LASTLY. I nominate, constitute and appoint my wife, YVONNE H. GLASS, to be the Executrix of this, my Last Will and Testament, but if for any reason she should fail to qualify as such Executrix or cease so to serve, then and in that event, I .W OFFICES KER eo ELICKER nominate, constitute and appoint my son, KEVIN M. GLASS, to be the Executor hereof. If both of the above named persons should -2- u_ fail to qualify as my personal representative hereunder or cease -, , . so to serve, then and in that ultimate event, I nominate, constitute and appoint my daughter, namely, KIM M. HANNIGAN, to be the Executrix of this, my Last Will and Testament. I order and direct that none of the above named persons shall be required to post bond or other security as a condition of qualification as my Executrix or Executor, as the case may be. IN WITNESS WHEREOF, I, ORVILLE W. GLASS, JR., have hereunto set my hand and seal to this, my Last Will and Testament which consists of three (3) typewritten pages to each of which I have affixed my signature this ~ Lj l.!! day of )1 A.D., One Thousand Nine Hundred Ninety-one (1991). ~Ilj. '~f' (SEAL) The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by ORVILLE W. GLASS, JR., the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our na/,,?es.. .witnesses hereto. . ~.I4\ r ')e{. ;7~ LAW OFFICES .BAKER a ELICKER COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SSe M. FORRY, the Testator and the witnesses, respectively, whose We, ORVILLE W. GLASS, JR., RICHARD C. SNELBAKER and JANET 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 therein expressed, and that each of the witnesses, in the executed it as his free and vOluntary act for the purposes witness and that to the best of his or her knowledge the presence and hearing of the Testator, signed the Will as a Testator was at that time eighteen years of age or older, of sOund mind and under no constraint or undue influence. ( V/!J "'~ r7tf1- 1 ~'t Wltness Subscribed, sworn to and acknowledged before me by ORVILLE W. GLASS, JR., the Testator, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET M. FORRY, witnesses, this .? 1'?'<fl day of j2~ ' 1991. a a; ~?? :::z7; 6U7, '.: 0 ~~'--1 Notary Pu llC LAw OFFICES -BAKER 8: ELICKER -