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Home My WebLink About04-09-07 REV. 111I ex . .-4ID. . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT :?3(P NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28OllO1 HARRISBURG. PA 17128-0601 ,. z I!: w Ii! Q I DECEDENrS NAME (LAST. FIRST, AND MIDDLE INITIAL) r Williamson, Dorine C I DATE OF DEATH (MM'DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) I 107/27/2006 08/23/1927 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) i Williamson, Frank C. 1. Original Return 2. Supplemental Return OFF!C!~\L USE ONL y FILE NUMBER 21 07 COUNTY CODE YEAR SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPUCA TE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 168-12-8966 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Altach Sch 0) (1 ) None C) C;O ,~" =U . i-"_T:~] j o 4. Limited Estate 0 4a. Future Inte..51 Compromise (date of daath after 12-12-82) o 6. Decedent Died Testate (Altach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy oITrust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between ,/.... ........ ..... ............... .... .... 1~-31.~1 ~1'1:!lti .., .....,........ ..... ~l$i~liiI.IiI.<i8~~I.lE'I'S1l;MJL:iPOR~OENCE:.ANQiPONfflPEf<l~J~i....~lijQ8i$~QiBeDIREClEOto: AME I COMPLETE MAILING ADDRESS Susan E. Lederer FIRM NAME (If applicable) i 4811 Jonestown Rd. I Law Offices of Susan E. Lederer I Suite 226 jrELEPHONENUMBER --- Harrisburg, PA 17109 I 717/652-7323 III 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) I 3. Closely Held Corporation, Partnership or Sole-Proprietorship i I 4. ,Mortgages & Notes Receivable (Schedule 0) w ,. lIl:~~ li!A-8 zi... !.lA-II A- C .,. lI)z wI!: ~z 8~ z o 1= :5 ::::I ,. ~ lil Ill: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 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) (2) None (8) (11 ) (12) (13) (14) 15. Amount of Line 14 taxable at the spousal tax rate, 9,198.25 x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x 1= i! f 17.Amount of Line 14 taxable at sibling rate x .12 (17) a 0 u S 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 12. Net Value of Estate (Line 8 minus Line 11) (3) (4) (5) (6) (7) None None 12,839.60 None 12,028.25 (9) (10) 13,977.60 1,692.00 or:FlCIAL kt:lf; ONLY = -.... ,.~ ~-o ;::J I \.0 -0 13. Charitable and Govemmental Bequests/Sec 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES i 20. 0 CHf CK HEf\E If yOU ARE REQUESTiNG A REFUND OF AN OVERPAYMENT N o 0\ 24,867.85 15,669.60 9,198.25 9,198.25 0.00 0.00 . >>'isE6URETO ANsWER.ALL auesnONSONREVERSE6/DE Mb'RECHECK.....TH cic: Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ~ Decedent's Complete Address: STREET ADDRESS 2 Lantern Lane --~- CITY i STATE PA i I ZIP 17011 I - -- Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEDVERPAYMENT. 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 theT AX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is theBALANCE DUE (3) (4) (5) (SA) (58) 0.00 0.00 0.00 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;...,.....................................:................................... ~ .~. :: ::::~ ~h;e~;~i:~:~s~~~~s~~~. ~~~~~. .~.~~. ~.~~,:.~~~~ .~~~~.~~~~.~~~. .~~ .i~:. ~~.~.~~;.'.'.'.'.'.'.'.'.'.'.'.'.'.'~~::::::::::: .'~.'.'. 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?... .................... ........... ......... ............. ......... ................. ......... ..................... 0 181 3. Did d:~dent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 181 4. Did decedent own an Individual Retirement Account, annuity, or other non"probate property which contains a beneficiary designation?................................................................................................................ 181 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. Under penatties of perju . I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, ~ is true, correct and complete. Oeclaration preparer other than rsonal representative is based on all information of which preparer has any kn~~d~______________________________ SIGNATURE OF fl ON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Frank. lamson r. 357 Old Sta~e Road _~______~___ _.___L~\!is.t>.~~I}'!.._~1?~~_______ ___________ __~~~~?--- ONSIBLE FOR FILING RETURN ADDRESS DATE ADDRESS Lf hk~- 4811 Jonestown Rd. Suite 226 Harrisburg, PA 17109 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. ~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 0% [72 P .5. ~9116 (a) (1.1) (ii)). :The statutedoesnot exemDta transfer,.to a surviving, spouse from tax, and the statutory requirements for disclosure of assets and fil~ng a tax return are still applicable~~en.if.the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: ",. The tax rate imposed on thellet 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 ado,Jltive.parent, or a steppareIJtofthe child is 0% [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 4.5%, except as noted in 72 P.S. ~9116 1.2) [72 P .5. ~9116 (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. ~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. ':,'~;' _;,..."..',~,,1.....__ *' SCHEDULE I: CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Williamson, Dorine C FILE NUMBER 21 - 06 - Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Hospice of Central Pennsylvania (refund of services) 1,200.00 2 Social Security check 431.00 3 Capital BlueCross (refund of premium) 693.60 4 Musselman Funeral Home, Inc. (prepaid funeral) 10.515.00 TOTAL (Also enter on Line 5, Recapitulation) 12,839.60 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 06 - , ESTATE OF Williamson, Dorine C ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE NUMBER Include the name cK the transferee, their reletionship to decedent VALUE OF ASSET DECO'S (IF APPLICABLE) and the date of transfer. Attach a copy of the deed for real estate. INTEREST 1 1159.908 shares of RVS Strategic Allocation Fund 12.028.25 100% 12,028.25 Class A, CUSIP No. 76931Q106, held in an IRA Account at Ameriprise Financial, Dorine C. Williamson, owner, Frank E. Williamson, beneficiary ($10.370/sh) ! I I This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. TOTAL (Also enter on line 7, Recapitulation) 12,028.25 . SCI-EDlI.E H FlN:RAI..EXPENSES& ~TlVECOSTS COMMONWEAl. TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Williamson, Dorine C Debts of decedent must be reported on Schedule I. FILE NUMBER 21 - 06 - ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Musselman's Funeral Home 9,495.60 2 Weis Market (food for funeral luncheon) 167.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attomey's Fees Law Offices of Susan E. Lederer 800.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Frank E. Williamson 3,500.00 Street Address 2 Lantern Lane City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent Spouse 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 1 Register of Wills filing fee for PA Inheritance Tax Return 15.00 , TOTAL (Also enter on line 9, Recapitulation) 13,977.60 *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Williamson, Dorine C FILE NUMBER 21 - 06 - I Include unreimbursed medical expenses. ITEM DESCRIPTION NUMBER AMOUNT 1 South Central EMS Ambulance 75.00 2 Social Security (overpayment) 431.00 3 Quantum Imaging 300.00 4 Capital BlueCross (automatic withdrawal of premium 8/21/2006 - 12/18/2006) 578.00 5 Susan E. Lederer (Estate Planning) 300.00 6 Pennsylvania Department of Revenue 8.00 TOTAL (Also enter on Line 10, Recapitulation) 1,692.00 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF. . Williamson, Donne C I FILE NUMBER I 21 - 06 - RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE Do Not list TMltee(s) I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Frank E. Williamson Spouse 100% of Estate and 2 Lantern Lane IRA Camp Hill, PA 17011 I , Enter dollar amounts for distributions shown above on lines 15 through 18, as appropri te, on Rev 1500 cover shell t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE , I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE, Sc l~dlJ~. C;. )~~ v~ HOSPICE OF CENTRAL PENNSYLVANIA Dorine or Frank E. Williamson Check Number: Check Date: 34: 34159 Aug 31, 2006 Item to be Paid - Description Refund Check Amount: $1, 200.00 Discount Taken Amount Paid 1 , 200 . 00 c.. -X hs. Cl i.' L~ 6j 1- -f-k' h") ~ Social Security Adnlinistration Retirement, Survivors and Disability Insurance Important Information Mid-Atlantic Program Service Center 300 Sprin..g Garden Street Philadelpliia~ Pennsylvania 19123-2992 Date: August 1O~ 2006 Claim Number: 168-12-8966A 0803 T2R M04,PC2,I.PH.TD64.DRE,IOS FRANK E WILLIAMSON 2 LANTERN LN CAMP HILL P A 17011-8456 00001816301 SP o.3!lO 11JI1I1...1I1""III1'lIl11l1lu 1111.1.111111111111111.111.1.1 \y Ylo/P 1-v, "I\~ \\'V1 We are sorry to learn of your recent loss. Please accept our sincere sympathy. What We Will Pay And When · You will receive $1 ~32 7 .00 for August 2006 around September 1, 2006. · After that you will receive $1,327.00 on or about the third of each month. Overpayment Information We paid $431.00 more in benefits than we should have. We deposited DORINE WILLIAMSON's benefits for July 2006 into a bank account which you also owned. We can't pay benefits for the month of death~ July 2006~ or later. Because you are a joint owner of the bank account, you are overpaid $431.00. Enclosure(s): SSA-3105 Refund Envelope ])c.f'()~ ~ ~r=-;-- '81~\o1 Ke..~lj)~ ~bilo7 c See Next Page From: Frank Williamson [mailto:frank_williamson@lower-allen.pa.us] Sent: Monday, March 26, 20072:56 PM To: Amy@LedererLaw.com Subject: Mom's funeral expenses Amy, 'Sc\. \' . . "-l \J-- \) ~ ~.J 'J:-4.k n, \..1 I found the document from the initial talks we had after mom's death, that stated $10,515 in the pre-arrangement account. Frank Frank E. Williamson, Jr. Director of Public Safety Lower Allen Township 1993 Hummel Ave Camp Hill, P A 17011 717-975-7575 ext 1601 717-975-2285 fax :Sc}\t\:LIl.t._ c;:.) --:t~+<( ~ ./l ~ueline Mindeck From: Sent: To: Subject: Amy M. Maya [Amy@LedererLaw.com] Tuesday, August 29, 2006 10:19 AM Jacky@LedererLaw.com FW: Estate Settlement for Dorine Williamson 11653495 9 001 Check and make sure that we do have the information for the IRA -----Original Message----- From: Susan E. Lederer [mailto:Susan@LedererLaw.comJ Sent: Wednesday, August 23, 2006 2:23 PM To: Amy@LedererLaw.com Subject: FW: Estate Settlement for Dorine Williamson 11653495 9 001 FYI Susan E. Lederer Law Offices of Susan E. Lederer 4811 Jonestown Road, Suite 226 Harrisburg, PA 17109 717-652-7323 717-652-7340 (fax) Susan@LedererLaw.com "Pursuant to recently-enacted U.S. Treasury Department Regulations, we are now required to advise you that, unless otherwise expressly indicated, any federal tax advice contained in this communication, including attachments and enclosures, is not intended or written to be used, and may not be used, for the purpose of (i) avoiding tax-related penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any tax-related matters addressed herein" -----Original Message----- From: Michael G Papson [mailto:michael.g.papson@ampf.comJ Sent: Wednesday, August 23, 2006 1:25 PM To: susan@ledererlaw.com Subject: RE: Estate Settlement for Dorine Williamson 11653495 9 001 Susan Here are date of death values for all of the accts Thanks Michael Michael G. Papson, CFP@, CRPC, CFS Senior Financial Advisor CERTIFIED FINANCIAL PLANNERTM practitioner Papson, Grove & Associates A financial advisory practice of Arneriprise Financial Services 4661 Trindle Road, Suite 400 Camp Hill, PA 17011 Office: 717.761.3600 I Fax: 717.761.1994 Michael.G.Papson@ampf.com ameriprise.com Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member NASD and SIPC. 1 Rive:cSource 8M insurance and annuities issued by IDS Life Insurance Company, and in New York only by IDS Life Insurance Company of New York, Albany, NY, both Ameriprise Financial companies. Forwarded by Michael G Papson/Field/WH/AEFA on 08/23/2006 01:27 PM Kathleen E Doherty Papson/Field/WH/AEFA@AMEX To: Michael G cc: 08/23/2006 12:26 Settlement for Dorine Williamson PM Subject: RE: Estate 11653495 9 001 August 23, 2006 MICHAEL GEORGE PAPSON AMERIPRISE FINANCIAL SERVICES 4661 TRINDLE RD CAMP HILL, PA 17011-5603 Dear MICHAEL GEORGE PAPSON: Thank you for your recent inquiry regarding DORINE C WILLIAMSON's accounts. These are the values of the accounts as of 07/27/2006. Mutual Funds Account Number Value Per Share 01012408823 7 002 03263440524 8 002 Total Value # of shares Asset $19891. 59 $12028.25 3711.117 1159.908 5.360 10.370 i I Annuities - Pre-1985 Account Number 93001539815 7 004 Total Value $89684.93 The date of death values provided are for estate tax purposes and are not a ! value to be paid. governed by each product. Please note that the values indicated for any Life Insurance product(s) reflect the gross death benefit at date of death, not the cash value. Values for any dividends as applicable. Values manually calculated, and should be used as estimates only. The prices used to Accounts may be subject to market fluctuation as proprietary mutual funds include accrued provided for brokerage products are ' 2 p~ovide values are estimates obtained from outside sources believed to be reliable. Ameriprise Financial does not guarantee the values. if We appreciate the opportunity to be of service to you. Please contact us you have any questions. Sincerely, Kate Doherty Death Settlements Processing Team 70100 Ameriprise Financial Center Minneapolis, MN 55474 1-800-862-7919, Option 5,1 ----------------------------------------- ******************************************************************* *********** "This message and any attachments are solely for the intended recipient and may contain confidential or privileged information. If you are net the intended recipient, any disclosure, copying, use, or distribution of the information included in this message and any attachments is prohibited. If you have received this communication in error, please notify us by reply e-mail and immediately and permanently delete this message and any attachments. Thank you." ******************************************************************* *********** 3 ,"~~:O~:"'~:~,'!i.:f" "g II fCI . W o - .... Cl ~~ ..., IT S. O' ::l III ::OJ!: o III =0. ~ (I) ~Q "'", gg aJaJ .., io't 00 88 :::J :::J lD .... IS; r- n trl t:/'.) >- ""0 ......... ~ ::l n o ::i ...... '""i -. r 0 r ~ -. 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It 3 1lI ::I .... n C ... ... ID ::l .... < II E' lD ..-v-, )0 VI "CJ ..... 2: ~ N 0 _al S o N ::l 8 ..... al 0 ...., ~ 'TJ -< S' N ~ _ell ::l C"l N _. 8 ~ G) > C"l C"l o c::: ::l ..... en C') ... o C "CI Z ~ ~ II ... o W .,. .,. 5: '" .,. N Cl N It! o o - 0 ;:0 0 )> ;:0 ..,- -% g: m n ~ p , iO 3: <II o % cr" ~ ...... -. o ::i v:> o 0 ~o~o o::eo::e ozoz "'m"'m t.)::IIW::II a>fII<>>fII .,...,.. <>>_a>_ .,.".,." <11-11\:)-1 00......0 .~~~~ , , z o 2:ZZZ- g!.g!1I III II III II :g~:g~= ====n n n n n II ~3-~3-2: 1Di'1Di'11I z o zZzz- S!.2!DI III II III II """"- -g '! -g '! fir nnnnll ~1~12: (J) . (J) . 111 z Ul (}) 0 (J)Z(I)Z- (J) 0 (I) 0 II 0.;0.; s~ ~:g = -.'i.-'-n -n-nll al II al I) ICr 'fil~'fil~ii' o ~ 30 ~~g (J)!: 0_. .,:s &,0 n '0.. ~~:I':' ~. ~.< CIl lCg.O n lO-IC o .... 3 .~ ~n ;0 :IC 41::1 :; .. < n 41 iiiiiiiiii - - - - .... April 5, 2007 Susan!:. LpllPl'I'I' LAW OFFICES Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 RE: Dorine C. Williamson Social Security Number: 195-20-9502 To Whom It May Concern: Enclosed for filing with your office is one (1) completed Form REV-1500 with date of death valuations (in duplicate) together with a check for filing fees ($15.00). One (1) additional photocopy of the front-page of the completed REV- 1500 form has been provided. Please time/date stamp these copies as received and return them to me in the envelope provided. If there are any questions or further requirements regarding this return, please do not hesitate to contact me. Sincerely, ,~~ Susan E. Lederer, Esquire Enclosures C) 1--' I~:; i"-.,.) c;:::; c:;::::) --' ~ -0 ;;:;;;J I \D -u --- N <::) c..n 4811 Jonestown Road. Suite 226 . Harrisburg, PA 17109 . Phone 717.652.7323 . Fax 717.652.7340 . susan@ledererlaw.com www.ledererlaw.com , i~ge '0 00 ~""... ii;g~ rli-:i \~ ~~~ (h.__ <"0< ~......' 0 0 :lI . l-i.J V. EEu... 0(: C) C'- '-_:. ~-~~~ ~: q \.0 o N %: 0- 0'\ I 0::: CL <l: r-- ~ ~ <[ O. 1-- . 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