HomeMy WebLinkAbout07-09-07
~
15056051047
REV-1500 EX (06-05)
PA Department of Revenue .
Bureau of Individual Taxes .
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
c:::) 4a. Future Interest Compromise (date of
death after 12-12-82)
c:::) 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c:::) 10. Spousal Poverty Credit (date of death c:::) 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 Da ime Tele hone Number
Date of Birth
Decedent's Last Name Suffix
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return
c:::)
2. Supplemental Return
c:::)
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
c:::)
4. Limited Estate
c:::)
-
o
8. Total Number of Safe Deposit Boxes
c:::)
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
MI
8
MI
@I
-0
:J:
::0 P,J
--1
W
\.0
Correspondent's e-mail address: b e dine-reS l:) ep; 1(. nd
Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SPO SIBLE FOR FILING RETURN
IJII /7fJSS
ADDRESS C.HA-~t.G.s t;:; S/(IE~S :or
, (!.I"IISU" L,,4.<- Ae~~~IIUCS'],M;t:, 11/1- /7IJSS-
PLEA USE ORIGINAL FORM ONLY
Side 1
L
15056051047
15056051047
.-.J
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...J
REV-1500 EX
15056052048
Decedent's Name: ~ '* J<..e>A- tt l C H Pc(l \)
RECAPITULATION
1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) c:::::) Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::::) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10).. .. . ... .... .. .... .. .......... ... .. 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0lL
16. Amount of Line 14 taxable
at lineal rate X.O ~
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable,.
at collateral rate X .15
19. TAX DUE. ... .. ... .. . . . . .. .. . .. .. . . . . . .. .. .. .. .. .. .. ...... ...... .. 19.
~
Decedent's Social Security Number
15.
16.
17.
18.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052048
Side 2
c:::::)
15056052048
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R~V-1500 EX Page 3
O,cedent's Complete Address:
DECEDENT'S NAME
File Number
:2/-/)'- 03/7
IJ./CHAIUJ 1=. SAJl.SA
STREET ADDRESS
5S" tfJAk tv~ol> A- rE:
CITY
/hE {!JIA-A/I C .r S 1I Ie (j.
I STATE p~
I ZIP /7tJSS-
I
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
o
o
()
()
Total Credits ( A + B + C ) (2)
o
3. Interest/Penalty if applicable
D. Interest
E. Penalty
e>
~~--
o
o
p
()
()
o
----- 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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
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;.......................................................................................... D IXI
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 IKl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D [XI
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? ........................................................................................................................ J8 D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable 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.
:-'~~.~ '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
8AItSA-, ~/CHAJej) r=:
FILE NUMBER
~/--()1. - 3/ 7
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
~.
3.
DESCRIPTION
11 5 ha.rll.s CZIUl1D1J S fz>cJ< Df ~ lore
If'/. 51Z~ s~U'U sf J.uc.f!,,,t Tuhn. &lII.ntIJII
/2/ Shl/"U "I P,."eI~AP41 CoIMIHOII
( See. Ya/lta h~" J' 4#t' etJlcu/ah~H s/.ee-f t:tffached)
VALUE AT DATE
OF DEATH
"150, 7"
~ I ~ $"1 II
JI
tt, 170, s9
ITEM
NUMBER
1.
TOTAL(Alsoenteronline2,Recapitulation) $ 9, "I{~/,
(If more space is needed, insert additional sheets of the same size)
Title
Stock
Shares
Hiah
Low
Close
Richard F. Barba Agere 3/10106
11
13.89 13.37 13.55
$152.79 $147.07 $149.05
(;lilt. 13.10S'( II :'1 S"~.1"
Richard F. Barba Agere 3/13/06
11
13.91
$153.01
13.65
$150.15
13.75
$151.25
-_._-"....,......,..."._'---~--~._--_.".".,-_."-..........,..~"----<'""-'''''..."~,..,'.~~......-""----
Richard F. Barba Lucent 3/10106 44.5826 2.841 2.79 2.83
$126.66 $124.39 $126.17
o..v t. . ... . 822 'l.lI1/S& :"2.5. %/
Richard F. Barba Lucent 3/13/06 44.5826 2.85 2.83
$127.06 $126.17
-----~., ------..........""'..."".-"'"..--,-.-...--...---,~~,.-,'--...,^...~...-..,....--....."..04:_"___",..".olo"____.____.._'" -
--
Richard F. Barba Prudential 3/1 0106 121 76.46 75.30 76.04
$9,251.66 $9,111.30 $9,200.84
~lJe 7S.7' 'I /'2.1 r .tot ~ 110,5'1
Richard F. Barba Prudential 3/13/06 121 76.28 75.12 75.26
$9,229.88 $9,089.52 $9,106.46
~"., !>".~' . 'po- .. .... iII'''' "_A.
Richard F. Barba & MetUfe 3/10106 60 49.77 49.01 49.63
Alice C. Barba $2,986.20 $2,940.60 $2,977.80
~b\VT -N/A
Richard F. Barba & MetUfe 3/13/06 60 49.85 49.38 49.73
Alice C. Barba $2,991.00 $2,962.80 $2,983.80
Richard Barba Date of Death March 12, 2006
THE PURCHASE DATES, AMOUNTS AND
PRICES PROViDED ARE FROM SOURCES
CONSIDERED TO BE RELIABLE, BUT ARE
NOT GUARANTEED AS TO ACCURACY.
CHECK YOUR MONTHLY STAtEMENT
FOR VERIFICATION OF FIGURES
_m..~ .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF 6~ft811-, j?(~HIffl,/)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
F.
FILE NUMBER
~/#O()~-317
Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinUy-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
lYJeM13G1f5 !=II(S-r rEDEltAl. etlG/)/T UNIDN
A. I<~IIV S'..v,,,,~ .lkd: NI) . /1(, J S 'I - ~()
/#.. ClteeKi'Jj ,kd /lib. /1'6 3S9 - II
(dee rA/~4n'tJ" II-Iter fr.eJm /J/lIItben ';;.st 4/fAd.~")
~
33.07
~
I Dt!J./~
TOTAL (Also enter on line 5, Recapitulation) $ I 3 3. t2h
(If more space is needed, insert additional sheets of the same size)
tv 1st
MEMBERS 1st
FEDERAL CREDIT UNION
Primary Owner: RICHARD F. BARBA RICHARD F. BARBA
REGULAR SAVINGS ACCOUNT:
Account NumberlSuffix 30036 -00 105138 -00
Date Account Established 04/22/1982 11/10/1988
Principal Balance at Date of Death $29.11 $25.79
Accrued Interest to Date of Death $.00 $.00
Total Principal and Accrued Interest to Date of Death $29.11 $25.79
Name of Joint Owner Alice C. Barba Alice C. Barba
Date Joint Ownership Established 05/13/1999 11/10/1988
CHECKING ACCOUNT:
Account Number/Suffix 30036 -11 105138 -11
Date Account Established 10/23/1982 11/10/1988
Principal Balance at Date of Death $.00 $.00
Accrued Interest to Date of Death $.00 $.00
Total Principal and Accrued Interest to Date of Death $.00 $.00
Name of Joint Owner Alice C. Barba Alice C. Barba
Date Joint Ownership Established 05/13/1999 11/10/1988
INVESTMENT SAVINGS ACCOUNT:
Account NumberlSuffix 30036 -05 105138 -05
Date Account Established 10/07/1985 11/10/1988
Principal Balance at Date of Death $13,948.34 $24.85
Accrued Interest to Date of Death $7.20 $.00
Total Principal and Accrued Interest to Date of Death $13,955.54 $24.85
Name of Joint Owner Alice C. Barba Alice C. Barba
Date Joint Ownership Established 05/13/1999 11/10/1988
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 30036 -41
Date Account Established 05/09/2005*
Principal Balance at Date of Death $4,873.48
Accrued Interest to Date of Death $6.12
Total Principal and Accrued Interest to Date of Death $4,879.60
Name of Joint Owner Alice C. Barba
Date Joint Ownership Established 05/09/2005
}, VISA CREDIT CARD ACCOUNT:
Account Number 4121449998014018
Date Account Established 09/23/1987
Principal Balance at Date of Death $54.57
Name of Joint Cardholder None
Name of Authorized User Alice C. Barba
.Purchased with transfer of funds from redeemed certificate 30036-40 opened 12/09/00 listing Alice C. Barba
as joint owner
Page One
5000 Louise Drive · P.o. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org
Primary Owner:
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
Date Joint Ownership Established
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
Date Joint Ownership Established
HOLIDAY CLUB ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
Date Joint Ownership Established
Primary Owner:
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
Date Joint Ownership Established
Estate of: RICHARD F. BARBA
Date of Death: March 12,2006
Social Security Number: 283-30-7202
RICHARD F. BARBA ALICE C. BARBA
'.. 186359-00
08/03/1999
$33.07
$.00
$33.07
None
31461 -00
10/06/1982
$1,001.19
$.30
$1,001.49
Frank F. Barba
08/26/2005
y
186359 -11
10/13/1999
$100.19
$.00
$100.19
None
31461 -11
10/06/1982
$1,913.35
$.00
$1,913.35
Frank F. Barba
05/13/1999
31461 -02
11/06/1992
$601.12
$.19
$601.31
Frank F. Barba
05/13/1999
ANTONIO M. ALATORRE
270515 -00
08/26/2005
$2,449.96
$.73
$2,450.69
Frank F. Barba
08/26/2005
;(J;;;s 1~RAL CREDIT UNION
Denise A. ~f ~
Insurance Services Supervisor
May 8, 2006
.~....~ '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF $.IIJe8~ ~/(!HA/l.l>
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
J:::
FILE NUMBER
.2/-~' - 3/7
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1.
DESCRIPTION OF PROPERTY
INClUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER
ATTACH A COPY OF THE DEED FOR REAl ESTATE.
DATE OF DEATH
VALUE OF ASSET
Pf?U.DEIVr,AL ~/')/ O<J /lU/IJ ~A-~~~.'
A; '330J fJoS. 01
8.) "9, 3 S ~ - '1-0
f:l.39J "S7.'11
'/)ESI'AlA7F/) MlEFl(!/AltY-","~/~E e.
~~ SttJ!.Y/Y'N6 k)1J)~p,I
(SEE' rAtJlA-711# ~G7Te:7l ~AI J~EL C.
~SEIJI8LArr e>F moA(;MI sm-Al~er
A i'7JH!NEtJ )
~
~ 3~ 357.'11
,
%OF
DECO'S
INTEREST
/OO/D
EXCLUSION
(IF APPliCABLE \
-0-
TAXABLE VALUE
~
~~9, $ S7. 'II
TOTAL (Also enter on line 7, Recapitulation) $ d 39, .3 5 7. l/ I
(If more space is needed, insert additional sheets of the same size)
~
MorganStanley
4th And Walnut Streets
P.o. Box 12053
Harrisburg, PA 17101
toll-ftee 800 676 0673
tel 7172556666
fax 7172556651
April 21, 2006
Charles E. Shields III
6 Clouser Road
Mechanicsburg, P A 17055
Dear Attorney Shields;
We wanted to provide you with the information which you requested regarding the date
of death values for assets held by Richard F. Barba in his name and in joint names of
Richard F. Barba and Alice C. Barba.
His Prudential 40 1 (k) plan balances were rolled directly into an IRA which Morgan
Stanley set up for Alice C. Barba. There were two retirement plan balances rolled to
Alice:
$230,005.01
$9.352.40
$239,357.41
The titling and date of death values for Friday March 10 and Monday March 13 (since
Mr. Barba died on a weekend) are shown on the attached page.
Weare in the process of re-titling these stock certificates into the name of Alice C. Barba
and holding them in an account in her name at Morgan Stanley.
If you need any additional information, please call Amy Moyer, her card is enclosed.
Very truly yours,
~~/df
Joel G. Rosenblatt
Vice President
Investment Consultant
Retirement Planning Specialist
Cc: A. Barba
Title Stock Shares Hiah Low Close
Richard F. Barba Agere 3/10/06 11 13.89 13.37 13.55
$152.79 $147.07 $149.05
Richard F. Barba Agere 3/13/06 11 13.91 13.65 13.75
$153.01 $150.15 $151.25
Richard F. Barba Lucent 3/1 0/06 44.5826 2.841 2.79 2.83
$126.66 $124.39 $126.17
Richard F. Barba Lucent 3/13/06 44.5826 2.85 2.81 2.83
$127.06 $125.28 $126.17
Richard F. Barba Prudential 3/10/06 121 76.46 75.30 76.04
$9,251.66 $9,111.30 $9,200.84
Richard F. Barba Prudential 3/13/06 121 76.28 75.12 75.26
$9,229.88 $9,089.52 $9,106.46
Richard F. Barba & MetLife 3/10/06 60 49.77 49.01 49.63
Alice C. Barba $2,986.20 $2,940.60 $2,977.80
Richard F. Barba & MetLife 3/13/06 60 49.85 49.38 49.73
Alice C. Barba $2,991.00 $2,962.80 $2,983.80
Richard Barba Date of Death March 12, 2006
THE PURCHASE DATES, AMOUNTS AND
PRICES PROVIDED ARE FROM SOURCES
CONSIDERED TO BE RELIABLE, BUT ARE
NOT GUARANTEED AS TO ACCURACY.
CHECK YOUR MONTHLY STA:rEMENT
FOR VERIFICATION OF FIGURES
REV-l511 EX+ (12-99) .
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
tS/I-/UJA;
,i1t!#A12LJ F
FILE NUMBER
ZI-~~-317
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) ""'t.leG" e. 8;ht!1A
Social Security Number(s)/EIN Number of Personal Representative(s) .:J.LJ() - 30- 8 S 1'1
Street Address 5$ oAkltlfJ/J/) ;l/J'G:
City /H~aH"IYIC.s~III2.(;'
WAiveD
State~Zip 17D~
Year(s) Commission Paid:
2.
Attorney Fees CHIfIU./fiS E. SIIIFLOS 7iI
IJ.AI/)F1FIPM/~E'/)
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant A-LiC.E e. /JA-'l8A
Street Address SS P,l}tKIVHLJ A#'e.
City IH/FCNA-NICS ~"'Je(;.
Relationship of Claimant to Decedent SetN.IIIVIN6
~
3;~'~
State fllf Zip r7 OS-&"
~/D~W
4.
Probate Fees 4JAII f)/"!J",,,t issue PI $.,./ etu'f"~'c.:~
f
I D 5". 110
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Iftltl;h'f)"./ /I/'O#Je let
~/I/II' t:U t;" II~/sn,. pf III,'//.$~,. MileI'. 14,x /(eflln,
';6, ()O
IS: J)O
,.
TOTAL (Also enter on line 9, Recapitulation) $ 3, ,,1./ s. lJ"'D
(If more space is needed, insert additional sheets 01 the same size)
REV.1sn EX+ (12-03) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
8,f,e8A~ te/CHA~J> i=.,
FILE NUMBER
;{ l-06J- 317
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. VISA t!./lEtJIT ~ AU": Np. ~/2/ fI.'I" 9R~1 ~/8 'S"~ S7
($et: /klllllh"A /~Ikr !;v,1II /)f~h1~ J:;rst p/fztdtelll &
Sd1~d, E 41I1JI"t!.)
TOTAL (Also enter on line 10, Recapitulation) $ S ~ S7
(If mor~ space is needed, insert additional sheets of the same size)
.
REV-l~13 EX+ (9-00*,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF L7 LA A A~ /1
o ff1C,I!J n; FC-I aHA-I2tJ F:
FILE NUMBER 2/
- ~h - 3/7
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
1. A-t..leE (!. ~Aall f"t)IDfJW
5S" oAk ~P()J> ~YF.
/J/Gt!HIf-A'IC,58t11l6, /~ /70""
AMOUNT OR SHARE
OF ESTATE
100%
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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(II more space is needed, insert additional sheets 01 the same size)
-'.~.----ii-
LAST WILL AND TESTAMENT OF RICHARD F. BARBA
I, RICHARD F. BARBA aka R. F. BARBA, currently of Upper Allen Township,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do
make, publish and declare this' my Last Will and Testament, hereby revoking and making void any
and all prior Wills by me at any time heretofore made.
l.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my beloved wife ALICE C. BARBA, currently of
Upper Allen Township, Cumberland County, Pennsylvania.
3.
In the event that my beloved wife, ALICE C. BARBA predeceases me, then seventy-five
(75 %) per cent of all the rest, residue and remainder of my estate shall be divided into three (3)
equal shares, to be distributed as follows:
a. one-third (1/3) to my daughter, ANGELA M. ROSE
b. one-third (1/3) to my son, FRANK R. BARBA
c. one-third (1/3) to my daughter, PAULA R. SCHUL TZ
In the event any of the above-named children predeceases me then his or her share shall
go to his or her issue. In the event he or she is not survived by issue, then his or her share shall go
to the above-named children who survive me or to their issue as the case may be.
The remaining twenty-five (25) per cent is to be divided equally among my surviving
grand children, oer caoita, excepting from this class, however, a grandson through my son
FRANK R. BARBA, who is believed to be named BRANDON TYLER BARBA (his mother's
laslname 2eliev~ to be Ogden'" ~ j/ (34--
. '
CODICIL TO LAST WILL AND TEST AMENT
OF
RICHARD F. BARBA
I, RICHARD F. BARBA, also known as R. F. BARBA, currently of Upper Allen
Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this Codicil to my Last Will and Testament dated
November 13, 2002.
I hereby revoke Paragraph 3 of my said Last Will and Testament in its entirety and substitute
in its place the following:
In the event that my beloved wife, ALICE C. BARBA predeceases me, then seventy-five
(75%) percent of all the rest, residue and remainder of my estate shall be divided into (4) equal
shares, to be distributed as follows:
a. One quarter (1/4) to my daughter, ANGELA M. ROSE
b. One quarter (1/4) to my son, FRANK R. BARBA
c. One quarter (1/4) to my daughter, PAULA R. SCHULTZ
d. One quarter (1/4) to my son, SEAN M. BARBA
In the event any of the above-named children predeceases me then his or her share shall go
to his or her issue. In the event he or she is not survived by issue, then his or her share shall go to
the above-named children who survive me or to their issue as the case may be.
The remaining twenty-five (25%) is to be divided equally among my surviving grandchildren,
oer caoita, excepting from this class, however, a grandson through my son FRANK R. BARBA, who
is believed to be named BRANDON TYLER BARBA (his mother's last name was believed to be
Ogden).
~I WITNESS WHEREOF, I hereunto set my hand and seal this /4 day of
1=------__, A.D. 2005.
~ij~
~A.
(SEAL)
(SEAL)
Signed, sealed, published and declared by the above-named RICHARD F. BARBA a/k/a R. F.
BARBA, as and for a Codicil to his Last Will and Testament dated November 13, 2002, in the
'presence of us, who, at his request and in his presence, and in the presence of each other, have
hereunto subscribed our names as witnesses.
~~~
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