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15056041147
REY-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX.280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
*'
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 6
1055
Date of Birth
184244888
11202006
08121929
Decedent's Last Name
Suffix
Decedent's First Name
MI
LOCKWOOD
KARL
L
(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
[!] 1. Original Return
4. Limited Estate
D
D
D
D
4a. Future interest Compromise
(date of death after 12-12-82)
2. Supplemental Retum
D
D
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
D
[R]
D
6. Decedent Died Testate
(Attach Copy of Will)
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
10 Spousal Poverty Credit (date of death
. between 12-31-91 and H-95)
D
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
CHARLES A. RITCHIE JR. 7178671200
Firm Name (If Applicable)
FEATHER AND FEATHER, P.C.
REGISTER Ot~ILLS USE ~L Y
....- .,-,j
First line of address
22 WEST MAIN STREET
'e.,-)
+ ;,.,
Second line of address
r-.)
ANNVILLE
State
PA
ZIP Code
17003
DATEFI4:D
i -".)
City or Post Office
["'
co:.
Correspondent's e-mail address: C a r@feath e r I a w . com
Diana Lockwood
Charles A. Ritchie Jr.
DATE
f?- )-0
22 West Main Street, Annville, PA 17003
L
Side 1
15056041147
15056041147
---I Off,
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15(]56(]42148
REV-1500 EX
Decedent's Name: KARL L. LOCKWOOD
Decedent's Social Security Number
184244888
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)................
6. Jointly Owned Property (Schedule F) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
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, of
transfers under Sec. 9116
(a)(1.2) X .00
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
o . 00
15.
o . 00
16.
o . 00
17.
o . 00
18.
19. Tax Due........................ ..... .......... ....................................... ....................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15(]56(]42148
5.
9,881.05
9,881.05
3,518.76
9,120.03
12,638.79
-2,757.74
-2,757.74
o . 00
o . 0 0
o .00
o . 0 0
o . 0 0
D
15(]56(]42148
---I
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-06-1055
DECEDENT'S NAME
KARL L. LOCKWOOD
STREET ADDRESS
Sarah A. Todd Memorial Home
1000 West South Street
CITY I STATE IllP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
0.00
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(58) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
o 0
o 0
o 0
o 0
o 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?..................................................................................................................... 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;..................................................................................
b. retain the right to designate who shall use the property transferred or its income;....................................
c. retain a reversionary interest; or............... ............... ................................................................. ...................
d. receive the promise for life of either payments, benefits or care?..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.......................................................... ........................................................ .....
Yes
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.1~8 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REnJRN
RESIDENT DECEDENT
LOCKWOOD, KARL L.
FILE NUMBER
21-06-1055
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Sovereign Bank - checking account #2551709067
VALUE AT DATE
OF DEATH
9,814.26
2 United American Insurance Company - premium refund
66.79
TOTAL (Also enter on Line 5, Recapitulation)
9.881.05
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1'P51 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOCKWOOD, KARL L.
FILE NUMBER
21-06-1055
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 908.76
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid 1,000.00
2. Attorney's Fees Feather and Feather, P.C. 1,000.00
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 95.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 315.00
7. Other Administrative Costs 200.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 3,518.76
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev. 6-98)
Rev-15W2 EX+ (6-96)
SCHEDULE H.A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANLlI
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOCKWOOD, KARL L.
FILE NUMBER
21-06-1055
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Kreamer Funeral Home - funeral services
908.76
Subtotal
908.76
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev.15i'2 EX+ (6-98)
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOCKWOOD, KARL L.
FILE NUMBER
21-06-1055
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills - filing fee for Inheritance Tax Return
15.00
2
Cumberland County Register of Wills - filing fee and advertising of First and Final
Account
130.00
3
Feather and Feather, P.C. - reimbursement for five death certificates
45.00
4
Peggy S. Clements - notary fees
10.00
Subtotal
200.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H.B7 (Rev. 6-98)
Rev.153!2 EX+ (6.98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOCKWOOD, KARL L.
FILE NUMBER
21-06-1055
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Cumberland - Goodwill Fire Rescue - medical transport
VALUE AT DATE
OF DEATH
108.36
2 Cumberland - Goodwill Fire Rescue - medical transport
63.61
3 PA Department of Public Welfare - Class 3 Medical Assistance Claim
8.775.28
4 United Church of Christ Homes - final nursing home expenses
172.78
TOTAL (Also enter on Line 10, Recapitulation)
9,120.03
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule J (Rev. 6-98)
REV-1.913 EX+ (9-O0)
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
LOCKWOOD, KARL L.
NAME AND ADDRESS OF
PERSON(S) RECEiVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions. and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-06-1055
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not list Trust99{S
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
1
Evelyn Kay Greene
135 Madison Avenue
Redwood City, CA 94061
Daughter
1/2 of residue
2
Diana Lockwood
5107 Goodson Road
West Jefferson, OH 43162
Daughter
1/2 of residue
Total
Enter dollar amounts for distributions shown above on lines 15 through 18. as appropriate. on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule J (Rev. 6-98)
.'
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ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Sovereign Bank
Karl L. Lockwood
184-24-4888
November 20,2006
Account #: 2551709067 Type:
In the name of: Karl L Lockwood
Date of Death Balance:
Int.(YTD) from 1/1/2006 to
Accrued interest to date of death:
Other Info:
Checking
Open date: 9/16/1963
$9,814.17
11/13/2006
$0.09
$7.51
Page 1 of 1
Schedule "E"
.
.
COpy
1ffnst 11'ill nn~ 'QJtstamtnt
KARL L. LOCKWOOD
I, KARL L. LOCKWOOD, of Lebanon County, Pennsylvania, do
hereby make, publish and declare the following as and for my Last
Will and Testament, hereby revoking and making null and void any
and all former wills and codicils heretofore made by me.
ITEM 1: I hereby nominate and appoint my daughter, DIANA
LOCKWOOD, of West Jefferson, Ohio, as Executrix (herein referred
to as "Executor") of this, my Last Will and Testament. In the
event DIANA LOCKWOOD is unable or unwilling to serve, then I
appoint my daughter, EVELYN K. OGATA, of Honolulu, Hawaii, as
Contingent Executrix.
ITEM 2: I hereby direct that my Executor shall not be
required to give any bond in any jurisdiction and that if,
notwithstanding this direction, any bond is required by any law,
statute, or rule of court, no sureties shall be required thereon.
ITEM 3: I direct that all of my funeral expenses, including
my grave marker, shall be paid from my residuary estate as soon
as practicable after my decease as a part of the expense of the
administration of my estate.
ITEM 4: I direct that all taxes that may be assessed in
consequence of my death, of whatever nature and by whatever
jurisdiction imposed, shall be paid from my residuary estate as
part of the expense of the administration of my estate.
Page 1 of 2 Pages
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~
. .
..
ITEM 5: All the rest, residue and remainder of my estate I
give, devise and bequeath unto my beloved daughters, DIANA
LOCKWOOD and EVELYN K. OGATA.
ITEM 6: In the event any of my children predecease me, then
AV $'t/lfnwN (;. .
the share of said predeceased child shall go to ~ lB~~)~d
C!lltP,{'EA/. ~~
preacccas8j rAild.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last Will and Testament, consisting of this and one (1)
other page, this I~~day of ~ ' 1997.
~~oXM~EAL)
~ . LOCKWOOD
SIGNED, SEALED, PUBLISHED AND DECLARED by the Testator above
named, as and for his Last will and Testament, in our presence,
who in his presence, and at his request, and in the presence of
each other, have hereunto subscribed our names as attesting
witnesses.
.~
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Address ~
Address ~ /4
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Page 2 of 2 Pages
FEATHER AND FEATHER. P. C.
ATTORNEYS AT LAW
22 WEST MAIN STREET
JOHN E FEATHER, JR.
CHARLES A RITCHIE, JR.
ANNVILLE, PENNSYLVANIA 17003
KEVIN M. DUGAN
(717) 867-1200
FAX (7\7) 867-5074
feather@featherlaw.com
PHILIP H. FEATHER
SPECIAL COUNSEL
August 1, 2007
Cumberland County Register of Wills
1 Courthouse Square
Carlisle, P A 17013
r~~.,)
RE: Estate of Karl L. Lockwood
Estate File No. 21-06-1055
c.-)
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Dear Sir or Madam:
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Enclosed please find three counterparts of the Pennsylvania Inheritance Tax Return to be filed
with your office and the Pennsylvania Department of Revenue, together with a check in the amount of
$15.00 for the filing fee. Please return the time-stamped copy to our office in the enclosed envelope.
If you have any questions or need additional information, please contact me.
Very truly yours,
FEATHER AND FEATHER, P.C.
By:
CH
CARlpsc
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