HomeMy WebLinkAbout06-01-07 (2)
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15056041125
REV -1500 EX (06-05)
PA Department of Revenue.
Bureau of Individual Taxes . INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
2 1 0 7
018 5
Date of Birth
090 - 0 7 - 0 3
o 2 122 0 0 7
o 4 0 1 1 9 1 6
Decedent's Last Name
Suffix
Decedent's First Name
G RAY
LILLIAN
MI
E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[ZJ 1. Original Return
D 4. Limited Estate
[ZJ
D
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 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
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
D
D
D
D
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
D
D
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
W ILL I A M A ADD A M S E S QUI R E
717 243 763 8
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY
First line of address
4 3 W SOU T H S T
Second line of address
.... .'1
i
i
+
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City or Post Office
State
ZIP Code
DATE FJI2ED
CAR LIS L E P A
17013
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"f
-,
Correspondent's e-mail address:waddams@earthlink.net...
Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the bestbfmy knowledge-ElflEl belief,
it is true, correct and compl te eclaJlltion of preparer other than the personal representative is based on all information of which preparer has any knowlOOge.
SIGN}\TURE,. ONSI F RETURN . / .DATE
V ' V v-~O
ADDRESS
110 Briarwood Lane,
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Carlisle
PA 17015
DATE
ADDRESS
57 W. Pomfret St.,
Carlisle
PLEASE USE ORIGINAL FORM ONLY
PA 17013
Side 1
L
15056041125
15056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: L ill i a n
RECAPITULATION
E. Gray
090 - 0 7 - 0 3
1. Real estate (Schedule A)
. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
16490000
2. Stocks and Bonds (Schedule B)
.................................. ~
o 0 0
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.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested. . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
37080064
8. Total Gross Assets (total Lines 1-7) 8. 5 3 5 7 0 0 6 4
.......................... .
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 3 8 5 8 3 5 9
. . . . . . . . . . . . . . . .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 8 5 8 3 5 9
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 9 7 1 1 7 0 5
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 4 9 7 1 1 7 0 5
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _ 0 0 0 15. 0 0 0
16. Amount of Line 14 taxable 4 9 7 1 1 7 0 5 3
at lineal rate X .O~ 16. 2 2 7 0 2 7
17. Amount of Line 14 taxable 0 0 0 0 0 0
at sibling rate X .12 17.
18. Amount of Line 14 taxable 0 0 0 0 0 0
at collateral rate X .15 18.
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 2 2 3 7 0 2 7
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L
15056042126
15056042126
---I
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Lillian E. ~
STREET ADDRESS
13 Strawberry Dr.
File Number
0185
~ ~~--~~~ -~-~~-
I STATE
I PA
CITY
Carlisle
ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
22,370.27
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
0.00
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
22,370.27
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
22,370.27
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; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 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-1502 EX + (6-98)
'*
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lillian E. Gray 0185
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is iointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
13 Strawberry Dr., Carlisle, PA 17013, selling price
VALUE AT DATE
OF DEATH
164,900.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
164900.00
REV-1508 EX + (6-98)
'*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lillian E. Gray
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
0185
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M& T Bank checking 43,451.15
2. Sovereign Bank checking 28,463.65
3. Gibb Financial 274,845.72
4. U.S. Savings Bonds, Series E 14,528.48
5. Internal Revenue Svc, tax refund, 2006 1040 8,930.00
6. Tax proration received on 13 Strawberry Dr., Carlisle 381.64
7. Personal property 200.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
370 800.64
REV-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lillian E. Gray
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
0185
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman Roth Funeral Home 2,783.48
2. Allenberry, funeral reception 2,302.08
3. Car Service - Transportation for care giver to her home 300.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Numbe~s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Yea~s) Commission Paid:
2. Attorney Fees William A. Addams 18,100.00
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 330.00
5. Accountanfs Fees preparation of 1041 fiduciary return - Klingler & Assoc. 600.00
6. Tax Return Preparer's Fees
7. Sentinel, advertising estate ad - approximate 130.00
8. Cumberland Law Journal 75.00
9. Klingler & Assoc. prepare 2006 1040 225.00
10. PA. Dept. of Revenue, 2006 PA 40, tax due 112.00
11. Realty Transfer tax 1,649.00
12. Ebener & Associates, real estate commission 9,894.00
13. Register of Wills, filing fees 100.00
14. Sovereign Bank, return of last retirement pay 1,239.77
15. IRS, 1st quarter estimated tax for 2007 125.00
16. PP&L 250.10
17. Embarq 62.78
18. Waste Management 44.88
TOTAL (Also enter on line 9, Recapitulation) $ 38,583.59
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Lillian E. Gray
Decedent's Name
Page 1
21 07 0185
File Number
Schedule H - Funeral Expenses & Administrative Costs - 87.
ITEM
NUMBER
DESCRIPTION
AMOUNT
19.
20.
21.
PMT Condo Assoc.
Final Water
Final Sewer bill
125.00
60.50
75.00
SUBTOTAL SCHEDULE H-B7
260.50
R~""".i'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FilE NUMBER
lillian E. Grav 0185
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)] 1/2 of residue
1. Samuel Gray Lineal
110 Briarwood Lane
Carlisle, PA 17015 1/2 of residue
2. Eileen F. Weeks Lineal
232 Heather View Dr. #d
Jonesboro, TN 37659
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.
TOTAL OF PART n - 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)
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For official use only:
Customer Name
Customer No.
PD F 1522 E
Department of the Treasury
Bureau of the Public Debt
(Revised February 2006)
SPECIAL FORM OF REQUEST FOR PAYMENT OF
UNITED STATES SAVINGS AND RETIREMENT
SECURITIES WHERE USE OF A DETACHED
REQUEST IS AUTHORIZED
OMB No. 1535-0004
FOR OFFICIAL USE ONLY
TRANSFER MONTH & YEAR _,_
FISCAL AGENT CODE
1. DESCRIPTION OF BONDS
I am the owner or perron entitle~ to payment of the securities described below, which bear the name(s) of
L-t l \ d. (\ E G; R.~ dl S- ~ ue-( 0 (<-?LL(
ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER
t-L.> A -+-J- /') ~ j) / I ......,.-
/
2. REQUEST FOR PAYMENT
(If you need more space, use the continuation sheet on page 3.)
{ ~ check.
I request that the descriped bonds be redeemed and payment be made in the form of 0 Direct Deposit.
o To the extent of:
(Complete this line only if ~arlial redemption and reissue of the remainder is desired or if the signer is only entitled to a
portion of the bonds listed. See Item 2 in the Instructions.)
(Social SeCurity Number of Payee)
OR
3.5"' ~ '71 ~ (,p 17
(Employer Identification Number of Payee)
3. DELIVERY INSTRUCTIPNS (Read Item 3 in the Instructions before completing this section and complete only Item 3A or 3 B.)
A. MAIL REDEMPTION CHECK To:
S.tlVA.u e...-\ C, fZtt \...f [. Y-E'CuTOf
\ (Name)
I l 0 13 ~(Ct (' VD-0--Z5--Vt LtJL.v--<-
(Number and Street or Rural Route)
~Il)[ ~_
(City)
I-Ir-
(State)
- ..--
ICO l ~
(ZIP Code)
B. DIRECT DEPOSIT FUNDS As AUTHORIZED BELOW:
(Depositor's Account No.)
(Name/Names on the Account)
Type of Account: 0 Checking 0 Savings
Bank Routing No.
(Financial Institution's Name)
(Phone No.)
4. SIGNATURE
You must wait until you are in the presence of a certifying officer to sign this form.
Sign Here: ./' 'S; & /J. U <2.-1 G M Lf
(Signature) (Print Name) -t--
Home Address
ilo ?3^-ICv'tlu~ ~
(Number and Street or Rural Route)
CO-r{l) le- tY4
~City) (State)
(E-Mail Address)
. ~
liDto
(ZIP Code)
--
"7 I 7 - 2.lf 1- '1 7 ~ :3
(Daytime Telephone Number)
Certifying Officer- The injdividual must sign in your presence. Complete the certification and affix your stamp or seal.
Stt RAV*L I Cc,K~~
, whose identity is known or was
I CERTIFY that
proven to me, personally appeared before me this
at ~l~~le- P A-
(City) (State)
day of
~tL>\ ~
(Month)
200 "7
(Year)
, and signed this form.
(Signature of Certifying Officer)
(OFFICIAL $T AMP
OR SEAiL)
(Title of Certifying Officer)
(Number and Street or Rural Route)
o
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i
I
i
i RESERVED FOR IDENTIFICATION NOTATIONS
Customer Account Number I
and Date Established: I 0 Document(s} _ Description:
I
Identified by (Signature andIAddress):
(City)
(State)
(ZIP Code)
INSTRUCTIONS TO CERTIFYING OFFICER
Each person appearing before y u must establish identification by positive and reliable evidence before this form is signed, unless he
or she is personally known to yo . Place an adequate notation above or on a separate record, showing exactly how identification was
established. A notation is adeq ate if it is sufficiently detailed to permit, at a later date, a determination of the exact identification
actually used. You and the orga ization will be held fully responsible for the adequacy of the identification.
The signatures to the request m st be executed in your presence. Fully complete and sign the certification form provided for your use
for each signature you witness.
If you are an employee (rather t an an officer) authorized to certify signatures, insert the words "Authorized Signature" in the space
provided for the title. Insert the p ace and date, as required on the form, and impress the seal of your organization.
. PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE
We're asking for the information on th s form to assist us in processing your securities transaction requests. Our authority comes from 31 U.S.C. Ch. 31
which authorizes the Treasury Depa ent to borrow money to pay the public debt of the United States. Also, 26 U.S.C. 6109 requires us to use your
SSN on certain forms when we report axable income to IRS. It's voluntary that you provide the requested information, but without it, we may not be able
to process your transaction request. Information concerning your securities holdings and transactions is considered confidential under Treasury
regulations (31 CFR Part 323) and t e Privacy Act. However, the following routine uses of this information may include disclosure to the following
persons or entities: agents and con ractors who help us manage the public debt; others entitled to the securities or payment; agencies (including
disclosure through approved computer matches) determining eligibility for benefits, finding persons we've lost contact with, or helping us collect debts;
agencies for investigations or prosec tions; courts, counsel, and others for litigation and other proceedings; a Congressional office asking on your
behalf; and as otherwise authorized b law.
We estimate it will take you about 15 minutes to complete this form. However, you are not required to provide information requested unless a valid
OMB control number is displayed on t e form. Any comments or suggestions regarding this form should be sent to the Bureau of the Public Debt, Forms
Management Officer, Parkersburg, . 26106-1328. DO NOT SEND completed form to the above address; send to correct address shown in
"WHERE TO SEND" in the instructidns.
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form HUO~ 1 (Jl86) ref Handbook 4305.
A. Settlement Statement
R
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4 OVA
C.Note:
2. OFmHA 3. OConv. Unins. .16. Fi! Number
~ 0..., In. GRC 88J05-07
~~:o,:::;~)!O~r::= ::=::;-:hs::~~s:e~~~~~ =~ea~~~~~~~~~~:~nshth~lals.
WARNING: " i~ a aime to knowingfy make false statemen to.~'::,~~ ~~ates on this ~ any other simila~ form. Penalties upon
U.S. Department of Housing and Urban Development
nOAR . nnrnv~' 'n "~M_
I J. Loan NUll1ber I 8. Mortgage Insurance Case Number
I TiUeExpress Settlement Systerr
D. NAME OF BORROWER: Judith L. Gross
Arm.,,,...
E. NAME OF SELLER: The Estate of Lillian E Gray
mn.,,,...
F. NAME OF LENDER: Nt A
Anmu:",,,,.
G. PROPERTY ADDRESS: I3 Strawberry Drive, (arlisle, PA 17015
H.SElTLEMENT AGENT: Salzmarm Hughes, P.C., Telephone: 717-249-6333 Fax: 717-249-7334
m 95 Alexander 8orin!!: Rbad Carlisle P A 170 I3
I <~~ 05n5n007
J SUMMARY OF BORROWER'S Tf; ANSACTION:
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164 900.00
K. SUMMARY OF SELLER'S TRANSAr.TION:
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SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contaIn herein Is Important tax information an,d is being furnished to the Internal Revenue SVrvice. If you are requ!",d to file a return,
:,;:.rc:~:~C::~:t:~:~ G~~;:'':~cr~~dt:'~~i::iS Item is fl! uired to be reported and the IRS determines that 11 has not ~en reported. The Contract Sales Price deSa1~ on
You are required by law to provide the selOement agent (Fed. Tax 10 No: 1 with your rorrect taxpayer identification number. If you do not provide your correct taxpayer identification
number, you may be subject to civil or criminal penalties imposed by law. Urn: er penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number.
TIN:_-_-_'_-_---+ SELlER(S)SIGNATURE(S):
SELLER(S) NEW MAILING ADDRESS: I
SELLER(S) PHONE NUMBERS:
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U.S. DEPARTMENT OF HO SING AND URBAN DEVELOPMENT
SETILEMENT STAT MENT
File Number: GROSSJ05-07
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Hun CERTIFICATION OF BUYER AND SELLER
I have ear.fully ~ 1M HUO-' Sel~_el IInl S.ta1erntnt and to lhtt beat of my knowledge and belief. it is a true and ac:r::urlle ,telement ollall receipts and disbursements m.dII on my account or-by me
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KI~ngler & Associates, P.c.
, 236 S Hanover St
1arlisle, P A 17013-3906
717-243-7743
5GRA YLEO
March 9, 2007
CONFIDENTIAL
Lillian E. Gray
13 Strawberry Drive
Carlisle, P A 170] 3-4438
Dear Mr. Gray:
We have prepared the enclosed retrrns from information provided by you without verification or
audit. We suggest that you exami~e these returns carefully to fully acquaint yourself with all
items contained therein to ensure that there are no omissions or misstatements.
I
Federal Filing Instructions I
i
Your 2006 Form 1040 shows a tot41 overpayment of$8,930, which is to be refunded to you in its
entirety. !
I
I
Sign and date the return on Page 2.1 Initial and date the copy, and retain it for your records.
!
Mail the Form 1040 return by April 17,2007 to:
I
Internal Revenue ~ervice
Philadelphia, PAl p255-0002
Pennsylvania Filing Instructions I
,
,
Your 2006 Form P A-40 shows an a~ount due of $112. A check in the amount of $112 should be
made payable to the Pennsylvania !f>epartment of Revenue. Write "S.S.N. 090-07-0343, 2006
Form PA-40" on the check. I
Sign and date the return on Page 2 *nd mail it by April 17,2007 to:
I
I
PA Dept ofReven~e/Payment Enclosed
I Revenue Place I
Harrisburg, PA 17~29-0001
!
Pennsylvania Estimate Filing Ins.ructions
I
Your required estimated tax payme~ts are shown below. Each payment is to be accompanied by
a completed preprinted coupon. ~ake each check payable to Pennsylvania Department of
Revenue, and write your social sefurity number and "2007 Form PA-40ES" on the check.
Reminders for estimated tax installments will not be sent to you. You should establish your own
reminder system for making timely deposits.
Due Dates:
4/] 7/07
6/1 5/07
9/17/07
1/15/08
Remittances: $125
$0
$0
$0
I
P A Department of Revenue
Dept 280403 .
Harrisburg, PAl V] 28-0403
Also enclosed is any material you ~urnished for use in preparing the returns. If the returns are
examined, requests may be made fur supporting documentation. Therefore, we recommend that
you retain all pertinent records fori at least seven years.
I
Mail To:
In order that we may properly advlse you of tax considerations, please keep us informed of any
significant changes in your financi~l affairs or of any correspondence received from taxing
authorities. .
If you have any questions, or if we! can be of assistance in any way, please do not hesitate to call.
Sincerely, :
i~ }- A~ ~_c:...
Klingler & Associates, P.c. .
THE LAST WILL AND TESTAMENT
OF
LILLIAN E. GF:AY
Being of lawful !age and sound and disposing mind and memory and not acting
under any duress, f~aud, undue influence or inducement of any person, I,
LILLIAN E. GRAY, a ~omiciliary of Mount Holly Springs, Pennsylvania:
ITEM 1
Hereby make, pu~lish, and declare this my last Will and Testament, revoking
and rendering null ~nd void other Wills and codicils heretofore made by me.
ITEM 2
I direct my Exedutor to pay the following as soon after my death as may be
practicable:
a. All of my just debts and the expenses of my last illness, funeral
and of the administr~tion of my estate; but my Executor need not accelerate and
pay those unmatured pbligations which, in his opinion, it might be proper and
more advantageous to retain or renew and pay as they become due and payable.
b. All inheritance, transfer, estate and similar taxes (including
interest and penalties) assessed or payable by reason of my death, on any
property or interest in my estate for purpose of computing ta:{es. My e:<ecutor
shall not require any beneficiary under this ~."ill to reimburse m\1 estate .for'.
ta:{es pai d on property passi ng under the terms of thi s vii 11. . _-~ ~ ~
ITEM 3
)
TESTATOR - The term !'Testator"
Will, whether male o~ female.
as used in this Will refers to the mak~~pf t~is
-/
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EXECUTOF: - The term 1'E:-:ecutor" as used in this t,.Jill refers to the person I
appoint to execute t~is Will, whether male or female. ~_
SURVIVAL - Whenever ~ provision of this Will conditions a beneficiary's taking
by that beneficiary .urviving the Testator, such condition of survival shall be
construed as a condi~ion precedent to the validity of the gift, devise or
bequeath; and such c$ndition shall be satisfied only upon survival by the
beneficiary for a pe1iod of thirty days after the date of death of the Testator
or until this Will i* probated, whichever shall be the first to o~~tir, unl~s
E:;pressly statedothttnlise in a provision of this Will. ::-~~3 ~
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PAGE ONE OF SIX PAGES
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CHILDF:EN - The term "children" as used in this ~'Jill shall include any children
hereafter born to on adopted by me, and any minor stepchildren living with me
at the time of my d~ath, as well as the children I now have, EILEEN WEEKS and
SAI'1UEL GF:AY, IV, unlless e:.:pressl y stated otherwi se in some provi si on of thi s
~lJill.
t1INOR - The tet-m "Mihot-II as used In this ~Jill means a person under years of
age.
DESCENDANTS - The tehn "Descendants" as used in this L1Jill means the immediate
and remote lawful li~eal descendants or offspring by blood or adoption of the
person referred to who are in being at the time they must be ascertained in
ot-der to gi ve effect: to the rEference to them.
F'EF: STIFWES - The te~m "Per Stirpes" as used in this Will means that i-Jhene\ter
distribution is to b~ made per stirpes, the estate or portion of the estate, to
be so distributed, srall be divided into as many shares as there are surVivIng
heirs in the nearest! degree of kinship to the decedent and deceased persons in
the same degree of k~nship who left issue who survive the decedent. This
degree of kinship sh~ll be termed the root generation. Each surviving heir in
the root generation ~hall take one full share. Those remaining heirs, i.e. the
surviving issue of the deceased persons in the root generation, shall take the
share of their decea~ed ancestor in the root generation, such share being
divided in the follo~ing manner: each surviving issue shall take the
fractional share that his or her immediate ancestor would have taken had he or
she survived; and wh~n there are two or more such surviving issue in the same
degree of kinship th~y shall divide such fractional share equally among them.
F'ER CAPITA - The ter~ "Per Capita" as used in this ('Jill means that whenever
distribution is to b$ made per capita, the estate or portion of the estate, to
be so distributed, s~all be divided into as many equal shares as there are
surviving iSSUE, sta~ding in the same degree of kinship to the decedent.
Distribution shall b$ made without reference to right of representation of the
surviving issue.
ISSUE - The term "Is~ue" as used in this Will means all persons i'lho are
descended from the p$rson referred to, either by legitimate birth to or
adoption by that per$on or any of that descendant's legitimately born or
legally adopted desc$ndants.
INTENTIONAL OMISSION
or other person, not
Testament, whether
provided for in this
- I haVE intentionally omitted to provide for any relative
named as a beneficiary, under this my Last Will and
aiming to be an heir of mine or not, unless otherwise
my Last Will and Testament.
PAGE TWO OF SIX PAGES
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ITE!'l 4
I hereby give, d~vise and bequeath all the rest, residue and remainder of
my said estate and property of which I may die seized and possessed, and to
which I may be entitled at the time of my death, of whatsoever kind and nature,
and wheresoever it m~y be situated, be it real, personal or mixed includinq any
i _ .
power of appointment, that I may have, absolutely and in fee simple forever to
my children, who shall survive me, in equal shares, and to the issue, living at
my death, of such children who shall predecease me, per stirpes and not per
capita.
ITEM 5
In the event that the above beneficiaries shall not survive me, I hereby
give, devise and beq~eath all the rest, residue and remainder of my said estate
and property, of whi~h I may die seized, and possessed, and to which I may be
entitled at the time!of my death, of whatsoever kind and nature, and
wheresoever it may b$ situated, be it real personal, or mixed, including any
power of appointment!that I may have, absolutely and in fee simple forever to:
SAINT PATRICKS CATHO~IC CHURCH in CarliSle, Pennsylvania.
ITEM 6
I hereby appoint my son, SAMUEL GRAY IV as Executor of my Will. If my
Executor fails to sertve, or for any reason fails to continue to serve, I then
appoint my daughter, EILEEN WEEKS to serve as Executor.
ITEM 7
I designate my Executor to be an Independent Executor to the fullest extent
permissible under the laws of the State of Pennsylvania. I direct that no bond
or other security be ,required. I further direct that no action be had in any
court relative to the administration of my estate other than to prove and
record thi s vJi 11 and to return an inventory, 2.pprai sal and 1 i st of cl ai ms of my
estate.
ITEM 8
My E:-:ecutor shall have the foil owi ng pOv-lers, v-lhi ch are to be construed in
the broadest manner consistent with the validity of this Will and with their
duties as fiduciarieS. The powers stated herein are not intended to be
exclusive, but shall be in addition to those granted by law and shall also
pertain to any admini!strators or trustees who Succeed the fiduciaries I have
appointed. These powers are:
a. to take possession of property, to keep it safely, and to
segregate it from oth,er property ol^med or hel d by the fi duci ary;
PAGE THREE OF SIX PAGES
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b. to ret~in and to invest in property, or an undivided interest in
property, including residential real estate, for any per-iod, ~'Jhether- or not the
property be of the character permissible for investment by fiduciaries;
c. to sell, transfer, exchange, lease, rent, mortgage, pledge, give
options upon, partition and otherwise dispose of real Or personal property, at
private or public s~le, for cash or upon whatever terms the fiduciary deems
advisable, without notice or order of court;
d. to render liquid my estate, in whole or in part, and to hold cash
or readily marketable securities of little or no yield for such period as my
fiduciary deems advisable;
e. to borrow in the name of my estate or of the trust, upon whatever
terms and conditions and for whatever periods my fiduciary deems advisable for
the purpose of preserving, protecting or imprOVing property held by him;
f. to pay, compromise, adjust, settle, compound, renew or abandon
claims held by my fiduciary and claims asserted against my fiduciary, on
whatever terms he de~ms advisable, without prior court authority;
g. to distribute in cash or in kind, or partly in cash and partly in
kind, in divided or undivided interests, notwithstanding the fact that
distributive shares may as a result be composed differently;
h. to insure the property he holds as fiduciary against the risks,
and in the amounts he, in his discretion, deems expedient, and to obtain and
pay for life, health, liability and other forms of insurance for the
beneficiaries of the trust, in his discretion;
i. to employ attorneys, accountants, investment advisors and other
professional assistants including depositaries, proxies, agents, and
appraisers;
j. to enter into transactions with other fiduciaries including
e>:ecutors or trustee$ of estates and trusts in which my beneficiaries have an
interest, and including him as fiduciary for other estates and trusts;
k.
of corporate
pOvJer:
to engage in the powers necessary to the effective administration
securities, including, without limiting the generality of this
1. po~er to vote in person or by proxy upon all securities held
by the fiduciary;
2. power to engage in a voting trust or voting agreement with
respect to securities;
PAGE FOUR OF SIX PAGES
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~. power to consent or become a party to, or participate in;
mergers, consolidation, sales of assets, recapitalization, reorganizations,
dissolutions or othe'r alterations of corporate structure, including adjustments
in capital structure affecting securities held by the fiduciary, whether or not
these adjustments involve payments by or to the fiduciary; and
of a nominee;
4. power to hold securities in unregistered form or in the name
1. to pay himself reasonable compensation for his services.
ITEM 8
If any part of this Will, or any trust hereby created, shall be invalid,
illegal, or inoperative, for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Executor may seek and obtain court instructions for the purpose
of carrying out as nearly as may be possible the intention of this Will shown
by the terms hereof, including the term held invalid, illegal or inoperative.
ITEM 9
Either I or my spouse have served in the Armed Forces of the United
States. Therefore, I direct my Executor to consult the Legal Assistance
Officer at the nearest military installation to ascertain if there are any
benefits to which my estate or my descendants are entitled by virtue of such
service. Regardless of my military status at the time of my death, I direct my
Executor to consult with the nearest Veteran's Administration Office to
ascertain if there are any benefits to which my survivors may be entitled.
ITEM 10
I have made, or may from time to time make, a written memorandum expressing
my desire to give certain items of personal property to specific persons. I
urge my Executor and beneficiaries to respect these wishes. Such a memorandum,
if made, shall be stored in conjunction with this Will.
PAGE FIVE OF SIX PAGES
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IN WITNESS WHEREOF I have hereunto set my hand and seal in the presence of
the witnesses whose names appear hereafter, published this ~7 day
of "--'[;1 h.U.AUJJ.h/ 19 q D .
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(SEAL)
ATTESTATION
On thisc(f1~ day of ;;~~~~< 19~, LILLIAN E. GRAY, the Testator,
personally Published and Declared the foregoing Last Will and Testament, in the
presence of each of us and all of us together, who, at the Testator's request,
personally witnessed the Testator Sign and Seal the same. We then, at the
Testator's request, and in the presence of the Testator and of each other, also
signed each page of the said document as witnesses. We further state that each
of us believes that at the time the Testator executed the foregoing instrument
said Testator was of sound mind and memory, of lawful age, and did so execute
it as a free act and deed and not under the unlawful influence of any person.
NAME: ~/~!
NAME: ,&JJ.-i.:LU' )7v ' 0~t..IJ--,
.3 82 tf Can-ict.jl~ Jh:e..,5e- JJi-.
ADDRESS: CacuP /Iill, II}- /7011
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ADDRESS: Jg-:J.r/~/.:L1'''''-/.&.., ~fj,jku..r(jJ;f
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NAME: :A~~):~L.
ADDRESS: (0 2.. cr A J. do"""- ~ R ,g C""- --r (~.s 'e
PAGE SIX OF SIX PAGES
Commonwealth of Pennsylvania Self-Proving Clause
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, LILLIAN' E. GRAY, Testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
~i ~ ~ A5!1.(!
LILLIAN E. GF:AY
Sworn or affirmed to and
E. GRAY, the Testator, this
Notary
Notarial SA...aI
Wanda K Hurt.er, Notary Public
Carrltile Boro, Cumberlari:I Countv
My Commission Expires Oct. 18, 1993
Affidavit
Membef, P$nn"Ylvania Associa:ion of N~"r:es
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
l1Je, EUC;ENF ~ Z:!EdTEL ,.f)t:JU12.ES /Y). Be(}TEt..- ,
and ..Th.c ""o...~ Gr, \<.a V\~ , the wi tnesses whose names are si gned to
the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw
the Testator sign and execute this Will as her Last Will; that
LILLIAN E. GRAY signed willingly and that LILLIAN E. GRAY executed
it as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the
Testator signed the Will as witnesses; and that to best of our
knowledge the Testator was at that time eighteen (18) or more
years of age, of sound mind and under no constraint or undue
influence.
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vJ I TNESS
:;:~ r.. D P- K O--.-l
WITNESS
by
and
Sworn or affirmed to and subscribed to before me
EU6E/V~ vv: BEU/EL- , DOLO/f.E5 IV/ _ /..~EtJTeL.- ~,. .
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NctariafSea/ ~~__ ____
Wanda K Hunter, Notary Public Not a r y
Carlisle Bora, Cumbeifanj County
My CommissioO Exjlres 0::1.18,1993
/P? y;' c:7 .
Member, PennSylvania A~ of Nota;ies