Loading...
HomeMy WebLinkAbout08-09-07 .... . , --.l 15056051058 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 195-42-8558 Decedent's Last Name CARTER OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 07 0466 04/21/2007 Date of Birth 10/22/1953 Decedent's First Name MI JACQUES D Spouse's First Name MI KIMBERLY S Suffix (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix 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 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 CARTER Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW :e:> 1. Original Return 4. Limited Estate c.' 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THOMAS E FLOWER Firm Name (If Applicable) SAIDIS, FLOWER & L1NDSA First line of address 2109 MARKET ST Second line of address City or Post Office CAMP HILL THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes (717) 737-3405 REGISTER ~61.S USE -il ~ C': G) I I..!J -i.. ~,::2 ~ co ) 1 State ZIP Code DATE,~ILED PA 17011 Correspondent's e-mail address:tflower@sfl-Iaw.com Under penalties of perjury, I declare that I have examined this return, 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 pre parer has any knowledge. ::::~;1:1tS~ESr~nFI~NG:~T_URN . ____ ______ t l'7jQ~7-~E_ 187~ Qouglas Drive, Carlisle, PA 17013 SIGNA~/~~/;f~:E:A:R~~~~~~~N:AT~'-~- lTE : ~V---t ----r~"'~-un-"_ l' /I'~' 7- ADDRESS Saidis, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17013 PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 ~ ~ " .-.J 15056052059 REV-1500 EX Decedent's Name: JACQUES o CARTER RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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) Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 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/Sec 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 .O~ 3,353.17 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 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L 195-42-8558 Decedent's Social Security Number 2. 15056052059 646.62 6,667.35 7,313.97 3,960.80 3,960.80 3,353.17 3,353.17 0.00 0.00 --.J ,. REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME JACQUES D CARTER STREET ADDRESS 1878 Douglas Drive File Number 0466 DECEDENT'S SOCIAL SECURITY NUMBER 195-42-8558 CITY Carlisle STATE PA 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) 0.00 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty --- . -- 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) 0.00 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. 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... D [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ D [i] c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [iJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [i] [J 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. 39116 (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 PS. ~9116 (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. ~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 four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.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 twelve (12) percent [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JACQUES D. CARTER FILE NUMBER 21-07-0466 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH MEMBERS 1ST FCU SAVINGS ACCOUNT 91.64 2 WACHOVIA CHECKING ACCOUNT 554.98 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 646.62 REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF JACQUES D. CARTER FILE NUMBER 21-07-0466 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. DESCRIPTION OF PROPERTY % OF DECD'S ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. TIAA-CREF PENSION BALANCE 6,667.35 100 6,667.35 TOTAL (Also enter on line 7 Recapitulation) $ 6,667.35 (If more space is needed, insert additional sheets of the same size) .- . REV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF JACQUES D. CARTER FILE NUMBER 21-07-0466 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: HOFFMAN-ROTH FUNERAL HOME 3,525.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 350.00 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 70.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TAX RETURN FILING FEE 15.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,960.80 ~. REV-1513 EX. (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JACQUES D. CARTER FILE NUMBER 21-07-0466 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 KIMBERLY S. CARTER SURVIVING SPOUSE 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) LAST WILL AND TESTAMENT OF JACQUES D. ,CARTER I, JACQUES D. CARTER, of the Township of West Pennsboro, County of Cumberland and State of 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 all former Wills by me at any time heretofore made. 1. 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, of whatsoever natune and wheresoever situate, I give, devise and bequeath to my wife, KIMa~Y S;, CARTER, absolutely and in fee simple, c 3, --j In the. event my wife should predecease me b~ die ,:.:-, ,~ within thirty (30) days of my death, then I give, devise and bequeath my entire estate to my daughters, KELLI SUE CARTER andJIIMIE LEE CARTER, share and share alike. 4, Notwithstanding the above, should my daughters be less than the age of twenty-five (25) years at the time of distribution hereunder, I direct that their shares be paid in trus.t to my Trustee, my sister-in-law and her husband, STACY and BRAD STRINE, to be dealt with according to the following; -1- I,.. ~~ I'; I !- \' \ . -. I ~: "~ J ~ '~ " .~ ' .""; (;\:;~t p. ~!:, 1:1 \.' ~ '~"~:i\~'" iI.t ~.'1v~' .~~')'.~ t:L,)-~. ..0., '4" ,,'I .'11 ~ "'1~J' ~",~l\.,':" fJi~tf~jl{~ '1",;4"jf" b: ,Aj'!!..-: ',,;I"I'r. ""~""'I""."~1 .~. ! ^"" ~:.' .,/;,.', i" ';"'- "'(';1(>> '(1'1,'1 '; (I !. ""I i't!' <~ t ,ti,l' I;' >...,..,,~ 1t ,l(,"!,~,'. ! ~j'\t \I_~'I'."~H~ ''''..tjlf,t'' , ~"'}'~H' /I'.i'" (11" I'll 'lr '!h l~ ~.) ;l'~#~'l','.:~d~t~:t1I' i!!1':;;~*~ '1!';~,)~ '.If:'li~ 'l<~!" " l1",'"L~;;~- .~ l~it"ltt ~ 1 :;1 ~\f- ~" I '.' ~ i:~ "1~~,J. 'Il/u'>..: ~'~:;-~;'~~~!~';'$' :.;~t~~1 ,~~~tj:~'!:5ttfl"t~~ ~~J;' .!~". f j ~, .\ ~;1 1, I "~" rtl, to, i,lL tL~~~ ,'I'~}JII",~ '>;i-I";'I{l~:"'4 .i'tt 14 ",;t~""~f~"'4~!/' , 1 :t,~~{i.JiI.kr11k~<~,t'~'''k . ' " (, I . , ~ I ( ':f' I ,,,,~,,, -, 1'<'~. (A) My Trustees shall invest the principal and pay the income thereof to my daughters, or to their Guardian should they be less than twenty-five (25) years of age. (B) My Trus.tees may pay such amounts of principal as in their sole discretion is advisable for the educa~ tion, maintenance, and support of said children, (C) Upon my daughters reaching the age of-twenty- five (25) years, then all principal and accumulated in- terest shall be distributed to them, at which time this trust shall end. (D) In the event either daughter should predecease me or dies prior to reaching the age of twenty-five (25) years, then the share of said deceas.ed child shall pass to the surviving daughter. (E) I authorize my Trustees to make payments ac~ cording to the terms hereof without petitioning the Court for permission to do so, and I further direct my Trustees shall serve without bond. 5, I nominate, constitute and appoint my sister-in-law and her husband, STACY and BRAD STRINE, to be the guardians of the persons and estates of my daughters if they have not reached the age of majority at the time of my death. 6, LASTLY, I nominate, constitute and appoint my wife, KIMBERLY S, CARTER, to he the Executrix of tbis, my Last Will and Testament, and in the. event she should be unwilling or unable for any reason to act as. such, I nominate, cons.titute -2- "' and appoint my mother, JEAN ~, CARTER, to be the Execut~~ of this, my Last Will and Tel;ltament, in her place and stead. seal this IN WITNESS WHEREOF, r have hereunto set my hand and 'l ZeLday of d"~ L_D~ cracquesD. arter , A.. D. 1987. Cl)EA,L } Signed, sealed, published and declared by the above.. named JACQUES D. CARTER, as and for his Last Will and Testament, in the presence of us, who, at his. request and in his presence, and in the presence of each othex, havehereunte subscribed O\lX names as witnesses. C~l~~W1&~ '~x .43!/,;"w, -3- st Send InqUires to 5000 Louise Drive PO Box 40 Mechanicsburg, PA 17055 www.members1sl.org Statement of Accounts ~ i ,tiEMBERS 1st FEDERAL CREDIT UNION 6215 1 AV 0.312 6215-6215 1",111'11111"1",11,,11.,1..1,11....1,1,,11,111,11111,1,,1,I JACQUES 0 CARTER CIO KIMBERLY CARTER 1878 DOUGLAS DR CARLISLE PA 17013 Mar 25, 2007 thru Jun 24, 2007 @ Main Switchboard: (717) 697 -1161 or (800) 283-2328 EZ Call: (717) 697-4372 or (800) 283-4372 TOO: (717) 697-5312 or (800) 283-2328 ex! 5312 TeleBranch: (717) 795-6049 or (800) 237-7288 Account Number: 40313 =- - Account Balances at a Checking: Savings: Certificates: Loans: Money Management: Glance: 0.00 0.00 0.00 0.00 0.00 - Page: 1 of 1 --- Are you looking for a way to invest your hard earned money? Consider a certificate from Members 1 st. Ask an associate about our monthly specials or visit www.members1st.org for more information. SAVINGS ACCOUNTS 00 - REGULAR SAVINGS Date Mar 25 Transaction Description Balance Forward Joint Owner : KIMBERLY S CARTER Deposit Deposit Withdrawal by Check REGULAR SA VINGS Closed """This is the final statement presenting information on .this product""" """ Please retain this final statement for tax reporting purposes Additions Subtractions Balance 27.19 39.03 66.22 25 .42 91,64 91.64- 0.00 May 11 May 11 May 11 YTD SUMMARIES TOTAL DIVIDENDS PAID 00 REGULAR SAVINGS 0..00 Total Year To Date Intere~t P,aid NOTE: Total includes closed' loans Don't forget about our new Member Loyalty Rewards Program. The more products you have with us, the more 'benefits you'll receive. Ask an associate for details or visit our website at www.members1st.org for details. 0.00 . t- OFFICIAL CHECK III ~,." WACHOVIA )ay To The )rder Of Remitter Issued by Integrated Payment Systems Inc., Englewood, Colorado JPMorgan Chase Bank, N.A., Denver, Colorado 373154291425099562 REV110/05 i ~)mm 8510007542 23-97 1020 ,.. ~, .joI<>o.c. $ 5~q 3! Dollars NON NEGOTIABLE Retain this copy. Serial No. required for any further inquiry. CUSTOMER COpy I + I \ \ I \ ! >-1 8\ 0:' 1\ \ J .~ FINANCIAL SERVICES FOR THE GREATER GOOD"' 730 Third Avenue New York, NY 10017-3206 212490-9000 Y!&7!o7 do d dol::;> IDldl~/s3,. /15'-VOJ - "(55"6 \ . (S""> \':i~A t,.".',.,,',>,. CREF fi. i' ,-,~, Payment For: KIMBERLY S. CARTER Deceased Name: JACQUES D CARTER Effective Date: 06/04/07 Check Date: 06/15/07 TlAA Controct IH41076-4 Traditional Payment Interest Deductions Net Payment $41 .65 $1,333.47 $5,375.53 1,333.47(F) $41 _ 65 $1,333.47 $5,375.53 $41 .65 $1,333.47 $5,375.53 $6,667.35 - ;;;;;;;;;;;;;;; - TIAA Iota 1 $6,667.35 - Grand Tata 1 $6 ,667.35 - - - - ;;;;;;;;;;;;;;; TIAA-CREF reports all taxable payments to the government for the year in which they are made. If you have any questions, please call our Telephone Counseling Center toll free at 1 800 842-2776. F = Federal Tax Withheld '''ClYIIlCIIL Please Keep This Statement for Your Records Per your request, we have sent the payment to the address below: CORNERSTONE FCU CR: KIMBERLY S. CARTER PO BOX 1181, 5 EASTGATE DR. CARLISLE PA 17013 CR KIMBERLY S CARTER AIC 0621142108 AUIUUII L "'5, 315 _ 53 KIMBERLY S. CARTER 1878 DOUGLAS DR. CARLISLE PA 17013-4623 /,11 Funeral Home & Crematory, Inc. 219 North Hanover Street Carlisle, PAl 7013 (717)243-4511 . .re 1015 / funeral Service for Jacques Douglas Carter 15025-94 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. FACILITY, STAFF, EQUIPMENT Visitation/Viewing (Conducted at Funeral Home) . . . . . . . . . . . . . . USE OF STAFF & EQUIPMENT Transfer of Remams to Funeral Home . . . . . . . . . . . . . . . . . $250.00 $442.50 OTHER SERVICES Receiving of Remains from Another Funeral Home. Direct Cremation (As Selected). . . . . . . FUNERAL HOME SERVICE CHARGES $835.00 $1490.00 $3017.50 SELECTED MERCHANDISE: Norfolk Casket(Cremation) . Keepsake Bronze Urn. Visitor Register . . Memorial Folders. . Gold Cross Necklace. THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THATYOUHAVESELECTED . . . . . . . . . . . . . $925.00 $55.00 $25.00 $25.00 $520.00 $4567.50 Cash Advances Newspaper Obituary Notice - Sentinel. Certified Copies of Death Certificate . Flowers. . . . . . . . . . Coroner Authorization Cremation Fee. $69.30 $180.00 $159.00 $50.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES. $458.30 Total Total Cost . . . . . . . . . . . . . . . . . . . . . . . . . $5025.80 History 06/07/2007 Kimberly S. Carter. . . . . . 06/19/2007 Payment - Check: Kimberly S. Carter $-1500.00 $-3525.80 Jacques Douglas Carter