HomeMy WebLinkAbout03-07-07
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15056041147
REY-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
OFFICIAL USE ONLY
.
County Code Year
INHERITANCE TAX RETURN 2 1 0 7
RESIDENT DECEDENT
File Number
00057
Date of Birth
089223781
01012007
01221929
Decedent's Last Name
Suffix
Decedent's First Name
MAXINE
MI
D
CARSON
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
CARSON
Suffix
Spouse's First Name
DONALD
MI
K
Spouse's Social Security Number
506162014
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
D 1. Original Return D 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future intarest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[K] 6. Decedent Died Testate D 7. Decadent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal Poverty Credit (date of death D 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 Daytime Telephone Number
EDMUND G. MYERS 7177614540
Firm Name (If Applicable)
JOHNSON DUFFIE
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REGISTER ~LS USE ~L Y
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First line of address
301 MARKET STREET
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Second line of address
_'1, "J
-a
''0
City or Post Office
LEMOYNE
DATE FILED
State
PA
ZIP Code
17043
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is tr ,correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN TUR OF PERSON RESPONSIBLE FOR FILING RETURN DATE
Donald K Carson D"3
17055
EDMUND G. MYERS
DATE
<?({I.)
301 MARKET STREET, LEMOYNE, PA 17043
Side 1
L
15056041147
15056041147
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15056042148
REV-1500 EX
Decedent's Name: Maxine D CARSON
Decedent's Social Security Number
089223781
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.
5,402.95
6. Jointly Owned Property (Schedule F) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
5,402.95
585.90
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.
585.90
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.
4,817.05
14. Net Value Subject to 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, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
4,817.05
4,817.05
o . 0 0
o . 0 0
15.
0.00
16.
0.00
17.
o .00
18.
o . 0 0
19.
o . 0 0
19. Tax Due......... ..................... ......... ............. ......................... ...................... ..................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
D
Side 2
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15056042148
15056042148
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07 -00057
DECEDENT'S NAME
Maxine 0 CARSON
STREET ADDRESS
301 Messiah Circle
CITY I STATE IZIP
Mechanicsburg PA 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
Total Credits (A + B + C)
(2)
0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (D + E)
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
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
o
o
o
o
o
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0
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.
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 without
receiving adequate consideration?............. .............. ...... ........ ..................... ............................. .......... ........ .........
No
[!]
[!]
[!]
[!]
[!]
[!]
, 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 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 exemDt a transfer to a surviving spouse from tax, and the statutory 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 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. 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 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 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-1608 EX+ (6.98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARSON, Maxine 0
FILE NUMBER
21-07 -00057
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolnlly-owned with the right of survlvonlhlp must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 PNC Bank Checking Account No. 5140075971
VALUE AT DATE
OF DEATH
5,402.95
TOTAL (Also enter on Line 5, Recapitulation)
5.402.95
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1161 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARSON, Maxine D
FILE NUMBER
21-07 -00057
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2.
Attorney's Fees
Johnson Duffie
250.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Donald K Carson
Street Address 301 Messiah Circle
City Mechanicsburg State PA Zip 17055
Relationship of Claimant to Decedent Spouse
4.
Probate Fees
68.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
267.90
TOTAL (Also enter on line 9, Recapitulation)
585.90
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
ReY-1602 EX+ (6-98)
.
SCHEDULE H.B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARSON, Maxine 0
FILE NUMBER
21-07 -00057
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills - Filing Fees for Inheritance Tax Return and
Inventory
30.00
2
Cumberland County Register of Wills - Additional Probate Fees
15.00
3
The Cumberland Law Journal. Notice of Estate Administration
75.00,
4
The Patriot News - Notice of Estate Administration
147.90
Subtotal
267.90
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
REV.1613 EX+ (9-00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
CARSON, Maxine D
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trusteefsl
FILE NUMBER
21-07 -00057
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Donald K CARSON
301 Messiah Circle
Mechanicsburg, PA 17055
Spouse
Entire Estate
Total
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
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
ESTATE OF MAXINE D. CARSON
SCHEDULE OF EXHIBITS
EXHIBIT A Last Will & Testament of Maxine D. Carson
dated June 16th, 2006.
:292958
Last Will and Testament
OF
MAXINE D. CARSON
I, MAXINE D. CARSON, of Upper Allen Township, 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 and making void any and all
Wills or Codicils at a..'1y time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done.
ARTICLE II
TANGIBLE PERSONAL PROPERTY
I give and bequeath my motor vehicles(s), household and personal effects and other
tangible personalty of like nature (not including cash or securities), together with any existing
insurance thereon, unto my husband, DONALD K. CARSON, provided she survives me by
thirty (30) days. In the event that my husband, DONALD K. CARSON, is not living on the
thirty-first (31 st) day following my death, I give and bequeath the same unto those of my children
who are then living, to be divided between them in as nearly equal shares as practical. If there be
disagreement as to the disposition of any item or items described in the Article, I direct that it
shall be disposed of in accordance with Article III hereof.
,<
ARTICLE III
REST~ RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever
nature and wherever situate, unto my husband, DONALD K. CARSON, provided she survives me
by thirty (30) days. Should my husband, DONALD K. CARSON, not be living on the thirty-first
(31 st) day following my death, I give, devise and bequeath the same in equal shares unto my
daughters, DONNA M. SHAFFER and JEANNE C. KOSANOVIC, provided that should either
daughter not be living on the thirty-first (31 st) day following my death, I give, devise and bequeath
such deceased daughter's share unto her then-living issue, per stirpes.
ARTICLE IV
UNIFORM TRANSFER TO MINORS
In the event any beneficiary of my Will has not reached the age of twenty-five (25) years
at the time for distribution of his or her share, distribution of said share may be made in the
discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian for such beneficiary until age twenty-five (25)
under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301 et seq., or the
applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of
residence of such beneficiary as the case may be. My Personal Representative may designate as
such Custodian any institution or person, including my Personal Representative, qualified to act
as a Custodian for such beneficiary under such Act in effect at the time such distribution is made.
A receipt for any payment or distribution so made shall be a full discharge therefor to my
Personal Representative, who shall not be responsible to see to, or be liable for, the application of
such proceeds thereafter.
2
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ARTICLE V
POWERS OF PERSONAL REPRESENTATIVE
My Personal Representative(s) (Executrix or Successor) shall have the following powers
in addition to those vested in them by law and by other provisions of my Will applicable to all
property, whether principal or income, including property held for minors, exercisable without
court approval and effective until actual distribution of all property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in
such manner as they may determine.
R To retain any or all of the assets of my estate, real or personal, without restriction
to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to
any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification
or risk.
D. To sell at public or private sale, to exchange, or to lease for any period of time any
real or personal property and to give options for sales, exchanges or leases, for such prices and
upon such terms or conditions as they deem proper.
E. To allocate receipts and expenses to principal or income or partly to each as they
from time to time think proper.
F. To compromise any claim or controversy.
G. To make such elections, decisions, concessions and settlements in connection
with all income, estate, inheritance, gift, generation skipping or other tax refunds and the
payment of such taxes as my Personal Representative shall deem appropriate, without obligation
to adjust the distributive share of any person thereby affected.
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ARTICLE VI
PERSONAL REPRESENTATIVE
I name, constitute and appoint my husband, DONALD K. CARSON, Executrix of this
my Last Will and Testament. Should my husband, DONALD K. CARSON, fail to qualify or
cease to so act, I name, constitute and appoint my daughters, DONNA M. SHAFFER and
JEANNE C. KOSANOVIC, alternate Co-Executrices to complete the administration of my
Estate. Should either fail to qualify or cease to so act, I direct that the other complete the
administration of my estate. I direct that no fiduciary appointed herein shall be required to post
bond for the faithful administration of the duties required in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testamen~ this lr)!1dayof ~. 200:
(SEAL)
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
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AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
We, MAXINE D. CARSON, ~L"L't..befk Sn.O\ler and
f ~ rn u.. rui. G. l1A ~ e ('- .s , the Testatrix and the witnesses, respectively,
whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and that she had signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
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Witness
Subscribed, sworn to and acknowledged before me by MAXINE D. CARSON, Testatrix,
and subscribed and sworn to before me by f. \ \ ~etk. . S ~ 0 V-e v and
CC J..~u. ~ G, vU.'1 E-r? , witnesses, this lfl.!! day of 0lUn...L.
2006.
)jcu-~.~_
Notary Public
5
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
GAil J. MAHONEY, Notary Public
lemoyne Boro., Cumberland County
My Commission Expires Feb. 19, 2010
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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
Donald K Carson
} ss
}
File Number
21-07 -00057
Personal Representative(s) of the Estate of
Maxine D CARSON
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deceased, depose(s) and say(s} that the items appearing in the following inventory include all of the personal asset$ wherever situate
and all of the real estate in ttie Commonwealth of Pennsylvania of said Decedent, that the valuation placed oppos~ each item of said - -:
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estata' ou15ide otffle
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. '::. c:::3
I verify that the statements made in this Inven- } -O~..~ \{ ~_ 0 3,~ -'c> (3
tory are true and correct. I understand that false state- \ ,
ments herein are made subject to the penalties of Donald K Carson
18 Pa.C.S. ~ 4904 relating to unsworn falsification to }
authorities.
.-~
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Attorney - (Name)
(Firm)
(Address)
(Telephone)
EDMUND G. MYERS
Johnson Duffie
301 MARKET STREET
(717) 761-4540
(Supreme Court 1.0. No.)
20558
DATE OF DEATH
01/01/2007
LAST RESIDENCE 301 Messiah Circle
Mechanicsburg, PA 17055
FIGURES MUST BE TOTALED
DECEDENT'S SOC. SEC. NO.
089-22-3781
Personal Property
Cash.............................................................................................. .
Personal Pro perty .........................................................................
Stocks/Listed................................................................................ .
Stocks/C losely Held......................................................................
Bonds............................................................................................ .
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
All Other Property......... .............. ........................................... .......
5,402.95
Total Personal Property................ .................. .......
5,402.95
Total Real Property .............................. ........ ..........
Total Personal and Real Property.........................
5,402.95 I
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each
item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ~ 3301 (b))
Form RW-09 Rev. 10-13-2006
INVENTORY
,.- ,.....
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21-07 -00057
DATE OF DEATH
01/01/2007
LAST RESIDENCE 301 Messiah Circle
Mechanicsburg, PA 17055
DECEDENT'S SOC. SEC. NO.
089-22-3781
Cash
PNC Bank Checking Account No. 5140075971
5.402.95
Total Cash
5.402.95
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
5.402.9~