HomeMy WebLinkAbout04-30-07 (2)
REV-1500 EX (6-00)
OFFIOAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21
20~ -973L __
YEAR NUMBER
COUNTY CODE
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
!z Pugh, Gladis E.
W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
C
~ 08/01/20~ 4/25/1908
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
C
SOCIAL SECURITY NUMBER
162-50-2457
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
w
~
::&::Scn
(.)D::::&::
wll.(.)
J:OO
(.)D::..J
ll.al
%:
[Xl 1. Original Retum
D 4. Limited Estate
[X] 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum D 3. Remainder Return (date of dealh prior 10 12-1H2)
D 4a. Future Interest Compromise (date of dealh after 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Attach copy of Trusl) _ B. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (dale 01 death between 12.31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A)(Attach Sch 0)
~
z
W
Q
Z
o
a.
III
l:i
II::
o
(,J
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Elyse E. Rogers, Esquire
FIRM NAME (If Applicable}
Keefer Wood Allen << Rahal, LLP
TELEPHONE NUMBER
635 North 12th Street, Suite 400
Lemoyne, PA 17043
717-612-5801
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly Owned Property (Schedule F) (6)
0 D Separate Billing Requested
i=
:5 7. I nter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
:;:) (Schedule G or L)
I-
0: B. Total Gross Assets (total Lines 1-l)
<(
(.)
W 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
a::
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
c.)
o
0.00
493,549.40
0.00
0.00
C~::;l'
OfFICIAL USE O!!t
C) ....
=U "
Ld
3,710.13
12,352.77
0)
0.00
(B)
12,101. 24
509,612.30
28,109.46
(13)
40,210.70
469,401. 60
0.00
(11)
12. Net Value of Estate (Line B minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an eleetion to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
469,401. 60
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
~
::::l
~ 17. Amount of Line 14 taxable at sibling rate
o
(.) 1B. Amount of Line 14 taxable at collateral rate
X
~ 19. Tax Due
20. 0
0.00
469,401. 60
0.00
X.OO_ (15)
0.00
x .12 (17)
21,123.07
0.00
x .04~ (16)
0.00
x .15 (1B)
0.00
(19)
21,123.07
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
2W4645 1.000
Ci
Decedent's Complete Address:
SlREET ADDRESS
824 Lisburn Road
CITY I STATE I ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
21,123.07
0.00
19,750.00
1,039.44
Total Credits (A + B + C) (2)
20,789.44
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
TotallnteresUPenalty (D + 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 )
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
333.63
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 Payable to: REGISTER OF WILLS, AGENT
(5B)
333.63
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D
b. retain the right to designate who shall use the property transferred or its income; . D
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " D !ZJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes
No
[R]
[R]
[R]
[R]
[Xl
[Xl
Declaration of preparer other than the personal representative is based on all information of which preparar has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
DATE
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 surviving 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 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 0% [72 P.S. 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. S 9116(1.2) [72 P.S. S 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. 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.
1W4646 1.000
Decedent's Complete Address:
SlREET ADDRESS
824 Lisburn Road
CITY I STATE ,ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
21,123.07
0.00
19,750.00
1,039.44
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
20 , 789 .44
0.00
0.00
TotallnteresUPenalty (0 + E) (3)
o .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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
333.63
A. Enter the interest on the tax due.
(5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(58)
333.63
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Ves
D
D
D
D
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
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 0 [Z]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
No
[X]
[X]
[X]
[X]
[XJ
[XJ
DATE
6~'Z6.()
SIGNA TV
DATE
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 surviving 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 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 0% [72 P.S. 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. S 9116( 1.2) [72 P.S S 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. 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.
4646 1.000
Decedent's Complete Address:
SlREET ADDRESS
824 Lisburn Road
CITY , STATE 1 ~P
Came Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
21,123.07
0.00
19,750.00
1,039.44
3. Interest/Penalty jf applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
20,789.44
0.00
0.00
Total Interest/Penalty (D + 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
333.63
A. Enter the interest on the tax due.
(5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BAlANCE DUE.
Make Check Pa able to: REGISTER OF WILLS, AGENT
(58)
333.63
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " D [Z]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
No
[Xl
[Xl
[Xl
[Xl
IKl
IKl
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
JlIDRESS 1200 WO~~!tdP(+ crU7At
York, PA 17403
REPARER 0
DATE
V. :,)0' Or
DATE
fA;,~~i~il#il~ai'S~\i;:lliftl:{
TJ~:{~;:;~.~~n~?1iJ,~FJ;:~r~'~:~.;
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. 8 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 surviving SpOuSe is 0% [72 P.S. 8 9116 (a) (1.1) (ii)]
The statute does not exempt a transfer to a surviving Spouse from tax, and the statutory nequirements 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 steppanent of the child is 0% [72 P.S. 8 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. 8 9116(1.2) [72 P.S. 89116(a)(1 )J.
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. 8 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.
4646 1.000
Estate of: Gladis E. Pugh
U2 -50-2457
Executor
Elizabeth P Grout
980 Wind Song Road
West Chester, PA 19382
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Pugh, Gladis E.
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-2006-0735
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
1. 1500 shares of North Pittsburgh Systems Inc
2 300 shares of Alltel Corp
3 2299.5 shares of D&E Communications Inc
4 200 shares of Verizon Communications
5 7462 shares of Wachovia Corp
6 310 shares of Windstre~ Corp
VALUE AT DATE
OF DEATH
37,395.00
16,383.00
27,226.08
6,644.00
402,089.87
3,811.45
TOTAL (Also enter on line 2, Recapitulation) $
493,549.40
2W46963.000
(If more space is needed, insert additional sheets of the same size)
Date of Death: 08/01/2006
Valuation Date: 08/01/2006
Processing Date: 08/17/2006
Shares
or Par
Security
Description
1)
300 ALLTEL CORP (020039103)
COM
New York Stock Exchange
08/01/2006
2)
2299.5 D & E COMMUNICATIONS INC (232860106)
COM
NASDAQ - Industrial
08/01/2006
3)
7462 WACHOVIA CORP 2ND NEW (929903102)
COM
New York Stock Exchange
08/01/2006
4)
1500 NORTH PITTSBURGH SYS INC (661562108)
COM
NASDAQ - Industrial
08/01/2006
5)
200 VERIZON COMMUNICATIONS (92343VI04)
COM
New York Stock Exchange
08/01/2006
6)
310 WINDSTREAM CORP (97381WI04)
COM
New York Stock Exchange
08/01/2006
Total Value:
Total Accrual:
Total: $493,549.40
rq..$q~ .1! '" ~y ..U..pn::tZT f..I~;~
-'
.. 5'~~ /~If1.I::'
Estate Valuation
High/Ask
55.31000
12.03000
54.33000
25.75000
33.84000
12.50000
Low/Bid
53.91000 H/L
11.65000 H/L
53.44000 H/L
24.11000 H/L
32.60000 H/L
12.09000 H/L
Estate of: Estate of Gladis E. Pugh
Account: Wachovia Securities
Report Type: Date of Death
Number of Securities: 6
File ID: Pugh, Gladis E. Estate
Mean and/or Div and Int
Adjustments Accruals
54.610000
11.840000
53.885000
24.930000
33.220000
12.295000
Security
Value
16,383.00
27,226.08
402,089.87
37,395.00
6,644.00
3,811.45
$493,549.40
$0.00
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Pugh, Gladis E.
FILE NUMBER
21-2006-0735
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
NUMBER
DESCRIPTION
1. Wachovia Securities Money Market Account 6775-0246
VALUE AT DATE
OF DEATH
9,399.73
2 The Woods at Cedar Run Refund
341. 60
3 Patriot News Refund
23.00
4 Comcast Refund
25.99
5 Traveler's Homeowner's Insurance Refund
162.00
6 PA Employees Benefit Trust Fund Refund
481. 09
7 Pugh Family Credit Trust Accrued/Undistributed Income
1,919.36
2W46AD 2.000
TOTAL (Also enter on line 5, Recaoitulation) $
(If more space is needed, insert add~ional sheets ofthe same size)
12,352.77
REV-1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Pugh, Gladis E.
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-2006-0735
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELA 1l0NSHIP TO DECEDENT
Son
A. Pugh, Wade W.
1200 Woodland Road
York, PA 17403
B.
c.
JOINTLY-OWNED PROPERlY:
lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FORJOINT MADE Include name of financial institution and bank account number or DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT similar identifYing number. Attach deed for jointlv-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A 01/02/1950 Wachovia Bank Checking 7,420.25 50.00 3,710.13
Account number
1000613103474 joint with
decedent's son, Wade W.
Pugh
TOTAL (Also enter on line 6, Recaoitulation\ $ 3,710.13
2W46AE 2.000
(If more space is needed, insert add~ional sheets of same size)
.- . -- ... ...... r'l'1UL:..
~/003
Fax Server
:-O'-~-
--..:-' --
c..-.-..... __
~onA.
Reference [1): 17.15liOO
Wnchovio. BlUlk N.A.
Bll.Iaoce CoD1imuuion Ser\,jce~
POBox 40028
Roonoke. VA 24022-7313
AUgIl'tt 28, 2006
KEEFER WOOD ALLEN & RAHAL
415 FALLOVv'FIELD ROAD SUITE 301
CAMP HILL, FA 17011-4906
SUBJECT: Verification i ConfiTlTllltion of Account and Balance Tnfonnlltion provided for:
Customer: GLADIS E PUGH (SSN# 162-50-2451)
Date or Death: AnguKt 1, 2006
A..-coUDt
Type
CAP CHEC.'KING ACCOUNT
Deposit Account Jnfonnation
&couat
Numh;:r
Dab: ofDe:db
BalmIcc
Avmuge
I:lalancc"
Date
Opcn::d
Mwrlty Interest !\c:rued YTD Dab:
J..)lIU; Rate lnu:rcs1 lnlcrest J'aid Closed
9071>715251
DRK - Y OIlr r~ has heen fnlWarded to the brnker li&ed below and will follow ""Parate1y,
DEFLURl& EBBERLY@717-975.812-1
CHECKING
1000613]03474
$7,419.75
112/1950
$0.50
$4.50
LEGAL 1TIU:.: GLADYS E PUGH
CHAlU.Es E PUGH
W AIlE W PUGH
. Due to S)'stt:rn limiIalions, We can aoly provide a melve DlClIlIh B\7erIBe baJan::e on depository accoUlll$.
Account
Type
Revolvint!' Credit Information
Accoum
]\ umber
Date ofDeaxh
Balance
Credit
Limit
Date
Opened
Date
Closed
Times Legal Title
Late
Vl~A
426429~3~172556
MBNA - Revolving credit accounts SIe no lo~er _"iced by Wachovill. Bank. Please con1act MB~!\ a1 Il00-'177-9131.
VISA
42642983gg8~1654
MBNA . Revolving cnodill\<'COUIIll: are no l<>l1!!llI" servil:etl by Wachovi. Bllllk.. Please l"1I1l,,~i MB:.-!A .1 800-477-9131.
A.>count
Tyl'''
Other Account Information
Accoum
1\ \Unhcr
Oatc oLl3aJan:x:
1)1I1c
Opcn::d
Date
Clll.crl
Lcd,,<>cr
ColLca.cd
BROKERAGE
67750246
~'~V'~VVD ~;18 PM PAGE
3/00Q
Fax Server
:'~K -
::>~ ~--:-
WAaronA
Reference Tn 17.15('() I)
BRK - Your~lIStbas beenfonvardcdl0 the brolw-lisUdbeJow:md will follow 8eplU"31ely.
DEFLURI &EBBERLY @ 717.975.8424
No SII1C Deposit Box tOund ior cllitoma.
· Date of death balanee doe~ not include acerued interest.
· If date of death cecum on a weekend or u. holiday, date of dellth balance does not include lmy tr.msacUons that were
made during lbal Ume period
~~~:.~
Amy Graybill
Servioenter Associate
Phone: (540)5n:1.7::;2~
""l';"B
REV-1511 EX + (1-97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Pugh, Gladis E.
FILE NUMBER
2J.-2006-0735
Debts of decedent must be recorted on Schedule I.
ITEM
NUMBER
A.
B.
J.O
J.J.
2W46AG 2.000
DESCRIPTION
1.
FUNERAL EXPENSES:
West Shore Country Club, funeral luncheon
2
Davis M. Myers Funeral Home, cremation
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
2.
Year(s) Commission Paid:
Attorney Fees Name: Keefer Wood Allen & Rahal, LLP
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.
Verizon
8
Wachovia Securities charge/commission and other fees
re: sale of shares of Wachovia Corp
9
Wachovia Securities, charge/commission and other fees
re: sale of shares of Wachovia Corp
The Sentinel, legal advertising
Cumberland Law Journal, legal advertising
Total from contl.nuatl.on pages....
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of same size)
$
AMOUNT
2,0J.3.66
J.,832.84
0.00
7,000.00
0.00
498.00
0.00
0.00
J.6.32
J.99.6J.
J.7J..52
144.29
75.00
150.00
12,101. 24
Estate of: Pugh, Gladis E.
Schedule H, Part B -- Administrative Costs
Item
No.
Description
12
Keefer Wood Allen & Rahal, LLP, reserve for
miscellaneous additional expenses
TOTAL. (Carry forward to main schedule)
Page 2
21-2006 -0735
Amount
150.00
150.00
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Pugh, Gladis E.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-2006-0735
Include unreimbursed medical eXDenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
28,000.00
1. Loan from Pugh Family Credit Trust
2 Verizon
27.75
3 West Shore EMS
5L91
4 Bonnie K. Miller, Tax Collector
9.80
5 Bronstein Jefferies, doctor
20.00
2W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
28,109.46
ACCOUNT INQUIRY
Pugh Family Credit Trust
all dates
Account
Loan from Trust to Gladis Pugh
Date Description of Transaction
02/17/2004 Transaction number 290
Loan from Trust to Gladis Pugh
12/22/2004 Transaction number 350
Loan from Trust to Gladis Pugh
12/20/2005 Transaction number 424
Loan from Trust to Gladis Pugh
09/13/2006 Transaction number 529
Opening
Balance
$0.00
Page 1
Closing
Balance
$0.00
Amount
($6,000.00)
($11,000.00)
($11,000.00)
$28,000.00
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
Pucrh
GladJ.s E.
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Pugh, Wade W.
1200 Woodland Road
York, PA 17403
1.
2
Grout, Elizabeth P
980 Wind Song Road
West Chester, PA 19382
FILE NUMBER
21-2006-0735
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
AMOUNT OR SHARE
OF ESTATE
234,700.80
234,700.80
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
2W 46AI 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
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0801
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
PUGH WADE W
1200 WOODLAND ROAD
YORK, PA 17403
_____n_ fold
ESTATE INFORMATION: SSN: 162-50-2457
FILE NUMBER: 2106-0735
DECEDENT NAME: PUGH GLADIS E
DATE OF PAYMENT: 10/31/2006
POSTMARK DATE: 10/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/01/2006
NO. CD 007375
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $19,750.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$19/750.00
REMARKS:
CHECK# 114
SEAL
INITIALS: WZ
RECEIVED BY:
T AXPA YER
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
IVI!:..I I t:., I:. v 1-\1'\(::>> a: WUUUSIDE
ATTORNEYS AT I...Aw
HARRISBURG. PE'NN~Y[ VANIA 171 ] 0.0950
Last Willi and T <estc81Jt1l.1l.<ent
OF
GLADIS E. PUGH
I, GLADIS E. PUGH, of Lower Allen Township, Cumberland County,
Pennsylvania, do make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me at any time made.
ITEM I: I direct that all inheritance and estate
taxes becoming due by reason of my death, whether payable by my estate or by
any recipient of any property, shall be paid by the Executor out of the residue of
my estate, as an expense and cost of administration of my estate. The Executor
shall have no duty or obligation to obtain reimbursement for any such tax so paid,
even though on proceeds of insurance or other property not passing under this
Will.
ITEM II: I direct the Executor to pay the expenses
of my last illness and funeral expenses from the residue of my estate as an
expense and cost of administration of my estate.
ITEM III: I specifically decline to exercise the
Power of Appointment contained in the Last Will and Testament of my husband,
CHARLES E. PUGH.
ITEM IV: If I die before my husband, CHARLES E.
PUGH, I give to him all of my household furniture and furnishings, books,
pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of
Page 1
~..;. f. !?
household or personal use or adornment and all policies of insurance thereon. If I
do not die before my husband, I may leave a '-'>TI.tten list in my safe deposit box or
elsewhere disposing of certain items of my tangible personal property. The
Executor shall dispose of items of my personal property as specified in the written
list. If no written list is found in my safe deposit box or elsewhere and properly
identified by the Executor within thirty (30) days after the probate of my Will, it
shall be presumed that there is no other statement or list. Any subsequent
discovered list shall be ignored. I give to my children living at the time of my
death any tangible personal property not set forth in a written list, to be divided
between them as they shall agree.
ITEM V: I give the residue of my estate, not
disposed of in the preceding portions of this Will, as follows:
(a) To my husband, CHARLES E. PUGH, and my son,
WADE W. PUGH, as Trustees (collectively "Trustee"), IN TRUST, to
be administered and distributed as provided in ITEM VI, a fraction of
my residuary estate. The numerator shall be a sum equal to the
largest amount that can pass free of Federal estate tax under my Will
by reason of the unified credit and the state death tax credit
(provided that the use of this credit does not require an increase in
state death taxes) allowable to my estate but no other credit and after
taking account of dispositions under other items of this Will and
property passing outside of this Will which do not qualify for the
marital or charitable deduction and after taking account of charges to
principal that are not allowed as deductions in computing my Federal
estate tax. The denominator shall be the value of my residuary
estate. For purposes of establishing this fraction, the values finally
fixed in the Federal estate tax proceeding relating to my estate shall
Page 2
F
be used. I recognize that the numerator of such fraction may be zero
(0), in which case no property shall pass to this Trust. I also
recognize that the numerator may be affected by the action of the
Executor in exercising certain tax elections.
(b) The balance of my residuary estate shall be paid to my
husband, CHARLES E. PUGH, if he survives me. Ifhe does not
survive me, this portion of my estate shall be added to the Trust
funded pursuant to subsection (a) and shall be administered and
distributed as provided in ITEM VI.
ITEM VI:
the Trust established by Item V (a):
The following provisions shall apply to
(a)
Trust.
This Trust shall be known as The Pugh Family Credit
(b) The Trustee shall pay to or for the benefit of my
husband, CHARLES E. PUGH, all of the net income of this Trust in
convenient installments, but not less frequently than annually. The
Trustee shall also pay to my husband, so much of the principal of this
Trust as may be necessary in the discretion of the Trustee for the
proper support, maintenance and medical care of my husband.
(c) Upon the death of my husband, the Trustee shall pay
over all of the remaining assets, to one or all, or less than all of my
issue, in the amounts, and in the estates, in trust or otherwise, as my
husband may direct, making specific reference to this Power of
Page 3
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Appointment, either by written instrument filed with the Trustee
during his lifetime or by his Will.
In no event may this Power of Appointment be exercised
in favor of my husband, his estate or creditors of either.
Cd) If this Power of Appointment is not exercised by my
husband, in whole or in part during his lifetime, or in his Will, then
upon the death of my husband, the Trustee shall divide the
unappointed principal into as many equal parts as there are then
living children of mine and then deceased children of mine
represented by then living issue. The Trustee shall distribute one
share to each living child, and shall pay one share to the then living
issue, per stirpes, of each my deceased child.
ITEM VII: The Executor and the Trustee shall each
possess the following powers, each of which may be exercised without court
approval and in a fiduciary capacity only:
(a) To retain any investments I have at my death, including
specifically those consisting of stock of any bank even if I have named
that bank as the Executor or Trustee.
Cb) To vary investments, and to invest in bonds, stocks,
notes, real estate mortgages or other securities or in other property,
real or personal, without being restricted to so-called "legal
investments", and without being limited by any statute or rule of law
regarding investments by fiduciaries.
Page 4
fU
(c) In order to divide the principal of a Trust or for any
other purpose, including final distributions, the Executor and Trustee
are authorized to divide and distribute personal property and real
property, partly or wholly in kind, and to allocate specific assets
among beneficiaries and Trusts so long as the total market value of
each share is not affected by the division, distribution or allocation in
kind. The Executor and Trustee are each authorized to make, join in
and consummate partitions of lands, voluntarily or involuntarily,
including giving of mutual deeds, or other obligations, with as wide
powers as an individual owner in fee simple.
Cd) To sell either at public or private sale real and personal
property severally or in conjunction with other persons, and to
consummate saleCs) by deedCs) or other instrumentCs) to the
purchaser(s), conveying a fee simple title. No purchaser shall be
obligated to see to the application of the purchase money or to make
inquiry into the validity of any saleCs). The Executor and Trustee are
authorized to execute, acknowledge and deliver deeds, assignments,
options or other writings as necessary or convenient to any of the
power conferred upon the Executor and Trustee.
Ce) To mortgage real estate, and to make leases of real
estate.
CD To borrow money from any person, including the
Executor or Trustee, to pay indebtedness of mine or of my estate,
expenses of administration or inheritance, legacy, estate and other
taxes, and to assign and pledge assets of my estate or any Trust
established by this Will.
Page 5
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(g) To pay all costs, taxes, expenses and charges in
connection with the administration of my estate or any Trust
established under this Will.
(h) To make distributions of income and of principal to the
proper beneficiaries, during the administration of my estate, with or
without court order, in such manner and in such amounts as the
Executor deems prudent and appropriate.
(i) To vote shares of stock which form a part of my estate or
any Trust established under this Will, and to exercise all the powers
incident to the ownership of stock.
(j) To unite with other owners of property similar to
property in my estate to carry out plans for the reorganization of any
company whose securities form a part of my estate.
(k) To disclaim any interest in property which would devolve
to me or my estate by whatever means, including but not limited to
the following means: as beneficiary under a will, as an appointee
under the exercise of a power of appointment, as a person entitled to
take by intestacy, as a donee of an inter vivos transfer, and as a
donee under a third-party beneficiary contract.
(1) To prepare, execute and file tax returns of any type
required by applicable law, and to make all tax elections authorized
by law.
Page 6
p
(m) To employ custodians of property, investment or business
advisors, accountants and attorneys as the Executor or Trustee deems
appropriate, and to compensate these persons from assets of my
Bstate or trust, without affecting the compensation to which the
Executor and Trustee are entitled.
(n) To divide any Trust created in this Will into two or more
separate Trusts so that inclusion ratio for purposes of the generation-
skipping transfer tax shall be either zero or one, in order that an
election under Section 2652(a)(3) of the Intemal Revenue Code may
be made with respect to one of the separate Trusts, or for any other
reason.
(0) To allocate administrative expenses to income or to
principal, as the Executor or Trustee deems appropriate. However,
no allocation to income shall be made if the effect of the allocation is
to cause a reduction in the amount of any estate tax marital
deduction or estate tax charitable deduction.
(p) To do all other acts in their judgment necessary or
desirable for the proper and advantageous management, investment
and distribution of the estate and Trusts established under this Will.
ITEM VIII: The Trustee is authorized to distribute
principal and/or income in anyone or more of the following ways if the Trustee, in
the sole discretion of the Trustee, considers the beneficiary unable to apply
distributions to the beneficiary's own best interests, or if the beneficiary is under a
legal disability:
Page 7
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(a) Directly to the beneficiary;
(b) To the legal guardian or conservator of such beneficiary;
(c) To the Trustee, or to another person selected by the
Trustee, as custodian under the Pennsylvania Uniform Transfers to
Minors Act as to a beneficiary under the age of twenty-one (21) years;
(d) To a relative of the beneficiary, to be expended by that
relative for the benefit of the beneficiary; or
(e) By directly applying distributions for the benefit of the
beneficiary.
ITEM IX: Any person who has died within thirty
(30) days of my death, or under such circumstances that the order of our deaths
cannot be established by proof, shall be deemed to have predeceased me. Any
person (other than myself) who has died at the same time as any beneficiary
under this Will, or in a common disaster with that beneficiary, or under such
circumstances that the order of deaths cannot be established by proof, shall be
deemed to have predeceased that beneficiary.
ITEM X: I hereby nominate, constitute and
appoint my children, WADE W. PUGH and ELIZABETH PUGH GROUT, to be the
Executors, collectively referred to as "Executor". The Executor and Trustee are
specifically relieved from the obligation of filing bond or entering security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last Will and Testament, consisting of this and the preceding seven (7) pages, at
Page 8
fEA-
the end of each page of which I have als~set my initials for greater security and
better identification this I & day of & ~ ' 199 >
/iM -d ,;) [ ;J,~
G IS E. PUGH /
(SEAL)
We, the undersigned, hereby certify that the foregoing Will was
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 and in her
presence and in the presence of each other, have hereunto set our hands and seals
the day and year first above written, and we certify that at the time of the
execution thereof, the said Testatrix was of sound and disposing mind and
memory.
~ ~(SEAL) Residing at 1</1 fJ,qk'lE). R.(
~ ~)/d), VJ(/;,ZPI/
(SEAL) Residing at
I
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~~
)
) SS:
)
I, GLADIS E. PUGH, 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 and
Testament; that I signed it willingly; and that I signed it as my free and voluntary
act for the purposes therein expressed.
~r d < ~,~ ,sf 5~' (SEAL)
G ~IS E. PUGH
Swom to and subscribed before
~. me, this 10 daycof
\p-p~ ,19/7
~~2~)
Notary Pu lie
My Commission Expires:
(SEAL)
Notarial Seal
Elyse E. Rogers, Notary Public
Susquehanna Twp.. Dauphin County
My Commission Expires April 5. 2001
M~mbf!r Pf!nnS\lI"~ni? Association of Nolan?!'
---~...... ...-r
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AFFIDAV1T
. -._.'-T~.--"
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF D w.y ~
)
) SS:
)
we,LJi/ttf-A/v/
, ~A1V' c:-T 1J1. lIoP./tiL and
, 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, GLADIS E. PUGH, sign and
execute the instrument as her Last Will and Testament; that Testatrix signed
willingly and that she executed said Will 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 that time eighteen (18) or more years of age, of sound mind and
under no constraint or undue influence.
~1I1:v:Ja?L
WItness
~~
Witness
Swam to and subscribed before
me this I ~ day of
~~ ,19').
~~tfp~'
My Commission Expires:
(SEAL)
Notarial Seal P bl'
R Notary u Ie
Elyse E. ogers. u hin County
Susquehanna Twp.. Da AP '\ 5 2001
My Commission Expires Pr!. - .. .
P I .~'I' Asso~i~llnn "j !\il1laneS
Member. ~nnsv "'."'" ,
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