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HomeMy WebLinkAbout08-21-07 REV-1500 EX + (6-00) REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W (J W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl) Burrell, Carl R. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 08/17/2006 04/08/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W t- ~ ~(/) o a::~ wo..o :r: 00 O a::-J o..m a.. < [Z] 1. Original Return D 4. Limited Estate [Z] 6. DecedentDied Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrus!) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER ~L-1LL J2.a.l.L_ COUNTY COOE YEAR NUMBER SOCIAL SECURITY NUMBER 1 80- 0 1 - 2 044 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required .:!... 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Allach Sch 0) f"iHJslSEGMlaNi'Mlllli[.MaIIlED~~.EIJ!OQtlESRaNDENlerA:Nfji(1PNFjDENmtlllllx;:INEaRMA"laNISIQUIDIBe'lr)tRE.EDlila!l~l[i';i' NAME COMPLETE MAILING ADDRESS Lawrence J. Nea I Es uire 108-112 Walnut Street FIRM NAME (If Applicable) t- Z W C Z o a.. (/) w a:: a:: o o TELEPHONE NUMBER 717 238-4798 Harrisburg, PA 17101-1609 z o I- < -I ~ l- ii: < (J w 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (1 ) (2) (3) (4) (5) (6) (7) (8) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= < I- ~ a. :e o (J >< < I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X _ (15) 21,052.49 X .045 (16) 52,419.13 X .12 (17) 0.00 X .15 (18) (19) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT OFFICIAL USE ONLY 13,779.70 C) (c~; C) ~.":JJ =~~ ~) .~... j T 1 :: ~:;~ )~ 2jCi~ L, ::0 ::~ --1 1'-..) C'_-:::J ~:'j ~--' :~ c- G3 f',) v -,.,., ~ 52,419.13 N W .&:- 9,030.52 75,229.35 1,627.00 130.73 (11 ) (12) (13) 1,757.73 73,471.62 (14) 73,471.62 0.00 947.36 6,290.30 0.00 7,237.66 Add Decedent's Com pi ete ress: . STREET ADDRESS 4905 E. Trindle Road CITY . b I STATE PA I ZIP 17055 Mechanics urg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 7,237.66 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 4. T otallnterest/Penalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 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 0.00 7,237.66 5. 7,237.66 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; ........................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 c. retain a reversionary interest; or ...................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?................................ ........ .......................... ............................ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 4. ~~~t~::~e;~~;~i:~I~:~~~;li:~i~~~~~.t. ~~~~~~~'. ~~.~~i.t~,. ~~ .~~~~.r. ~~.~~~~~~~~~ .~~~~.~~:. ~~i.~~........................ bY No B'~ G 0" ~ B' ~ o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 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 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spollse 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 0% [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 4.5%, 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 12% [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. "I REV-1508 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell Carl R FILE NUMBER 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 1. DESCRIPTION M&T Bank - checking account no. 950563173 (statement attached) VALUE AT DATE OF DEATH 9,266.61 2. Metlife - shares - 82 shares @ $54.15 per share 4,440.30 3. Metlife Dividend 48.38 4. Mutual of Omaha - premium refund 24.41 o TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 13,779.70 REV-1509 EX + (6-98) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Burrell Carl R FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Irene E. King 160 Village Drive Marysville, PA 17053 Sister B c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 6/28/96 M& T Bank 87,665.07 50. 43,832.54 CD #031003914523343 2. A. 6/29/96 M& T Bank 17,173.18 50. 8,586.59 CD #031003914523351 TOTAL (Also enter on line 6, Recapitulation) $ 52,419.13 (If more space is needed, insert additional sheets of the same size) . '; REV.1510 EX + (6-98) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell Carl R SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 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 ITEM INClUDE THE NAME OF THE TRANSFEREE. THEIR RElATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION ""..... TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. M&T Bank -IRA account no. 035004201738167 9,030.52 100. 9,030.52 (statement attached) ...... .. . ... --..... TOTAL (Also enter on line 7 Recapitulation) $ 9,030.52 (If more space is needed, insert additional sheets of the same size) . REV-1S11' EX + (12-99) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell Carl R SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 0 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 - Lawrence J. Neary 1,500.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees -Cumberland County Register of Wills 127.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 1,627.00 (If more space IS needed. insert additional sheets of the same size) REV-1512 EX + (6-98) * SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell. Carl R FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRfPTION 1. Mobile X-ray imaging VALUE AT DATE OF DEATH 14.32 2. Lehigh Valley P.T. 1.57 3. West Shore EMS 114.84 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 130.73 ." REV-'513EX+IW COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER RlJm~1I Carl R " ~....... RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY Do Not List Trustee(s} OF ESTATE I. TAXABLE DISTRI BUTIONS pnclude outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. Benjamin C. Burrell Lineal 322 N. 2nd Street, Apt 905N 100% Harrisburg, PA 17101 ~ -~... ... 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 $ (If more space is needed, insert additional sheets of the same size) ,. --....." .#,-.... . lAST Will AND TESTAMENT ill CARL R. BURREll I, CARL R. BURRELL, now of 5022 Ohio Avenue, Harrisburg, Dauphin County, Pennsylvania, 17109, declare this to be my last Will and revoke an~yWill or Codicil previously made by me. ITEM I: I direct that all expenses of my last illness and funeral, including my gravemarker and perpetual care, 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 II: My executor shall distribute to my son, BENJAMIN C. BURRELL, such personal property items as my Executor, in. its~ole discretion, shall determine he may_ reasonably use for his personal continuing use at that time. It is my intention that my son, BENJAMIN C. BURRELL, be given the use of such items as all books, stereo equipment, a television, or items of furniture which my son, BENJAMIN C. BURRELL, may desire for his personal use. It is not my desire that items of personal property be distributed to my son, BENJAMIN C. BURRELL, which he would not use personally but \1vhich would be sold by him. ITEM III: I devise and bequeath all of the rest, residue and remainder of my estate, of every nature and wherever situate to my TRUSTEE, herein after named, in Trust, to be administered as follows: (a) The net income therefrom shall be distributed as frequently as my Trustee determines feasible, but in no event less frequently than annually, for the use of my son, BENJAMIN C. BURRELL, for and during his lifetime; (b) As much of the principal of this Trust, as the TRUSTEE, in its sole discretion, may from time to time think necessary for the reasonable support of my son, BENJAMIN C. BURRELL, or for his medical needs shall be distributed for the use of my son, BENJAMIN C. BURRELL, or paid directly on his behalf. My primary concern is for the continuing income needs which my son, BENJAMIN C. BURRELL, may have during his life, nonetheless my TRUSTEE, in its sole reasonable discretion, may from time to time make distributions of principal as are necessary for the purposes of support of my ~o~, BENJAMIN C. BURRELL; (c) Upon the death of my son, BENJAMIN C. BURRELL, my TRUSTEE shal! then distribute the then remaining principal to the Memorial Evangelical Lutheran Church where it sits now 17th and State Street, City of Harrisburg, Dauphin County, Pennsylvania, or its successor. ITEM IV: 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 a part of the expense of the administration of my estate, without apportionment. ITEM V: I hereby authorize and empower my Executor, or its successor, hereinafter named, to sell any of the real or personal property which I may own at the time of my death, as she shall, in her sole discretion, deems appropriate for the best interests of my estate and my beneficiaries, upon whatever terms and conditions she deems to be appropriate, and to execute, acknowledge, and deliver all proper writings, deeds of conveyance and transfers thereof. ITEM VI: My corporate fiduciary shall be entitled to compensation based on its regular schedule of fees for such services in effect at the time of the service rendered. ITEM VII: Should the principal of any trusLherein provided for, be or become too small in the Trustee's discretion so as to make establishment or continuance of the trust inadvisable, my Trustee or my personal representative may make immediate distribution of the then remaining principal and any accumulated or undistributed income. Upon such termination, the rights of all persons who might otherwise have an interest as succeeding income beneficiaries or in remainder shall cease. ITEM VIII: The principal and income of any trusts created hereunder shall be free from anticipation, assignment, pledge or obi igation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary alienation. ITEM IX: I appoint Dauphin Deposit Bank & Trust Company; or its successor, Executor of this, my Last Will. ITEM X: I appoint Dauphin Deposit Bank & Trust Company, or its successor, Trustee of any trusts created in this, my Last Wi II. ITEM XI: I direct that my Executrix, and/or Trustee, or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM XII: It is my desire that my Executrix shall retain the law firm of Nicholas & Foreman now of Harrisburg, Pennsylvania, to aid her in the administration of my estate. IN WITNESS WHEREOF, I have hereunto setmy hand this 1st day of March, 1996. ~n~.eR, !it, ~~()(L(L CARL R. BURRELL The preceding instrument, consisting of this and six (6) other typewritten pages, identified by the signature of the Testator, CARL R: B ORRELL, was on the day and date thereof signed, published and declared by CARL R. BURRELL, the Testator wherein named, as and for his Last Will, in the presence of each other, have subscribed our names as witnesses hereto. ,8f-Q!)LV r;~CLA- of I Jzu-<-~ hL^J . /t i fr,n ():P.fa~'Df>.-- UJJ<LJ4~~~ 12 U I Ii c ,-..::;, , ~-.J of Lt~- t 3 c-- L '()~l,:.-\","" Av(. \\ \.GC:- ~'Ctl-': (. S \J..~'J \? f\ (/C~3(S- c~~) C ~/". of . ^"-" (" '-U-(j ,-. . Yl-L<Jc>-- t\.... ~:,,,LKy-(.( ;:.. -"",". '- -"~- ..- ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF DAUPHIN 55. I, CARL R. BURRELL, the Testator .whose name is signed to the attached or foregoing instrument, having been duly qualified according to law,. qo hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. 5worn to or affirmed and acknowledged before me by CARL R. BURRELL, Testator, this 1st day of March, 1996 (0 G.'Le. R: fJ, ( "J) P. rZZ CARL R. BURRELL ~r;t/.' ~ , Notary Public NOTARIAL SEAL STEVE C: NICHOLAS, Notary Public City of Harrisburg. Dauphin County My Commission Expires Sept. 25, 1999 " COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN S5. We, 6(' \X ~ -1\ -+; fVi/o'lC,- i'~ , l' (' CL.1 eY-. I (. Ii and L'L~ A. FCt---<.....L\ Kru"/r , witnesses ""hose names are signecrto 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 the instrument as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Will as a witness; and that to the best of our knowledge, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed before me by the undersigned witnesses, this 1 st day of March, 1996. /:v 09-{' JJ .~/~L~ Witness SSf/ r _- _ .. -"'C Jo.A.Ui ) Witness c- f; c">_ 0 " ~ 'U _ ~~~ O.:\. . ~~_>_~___9-{L~~. } Witness W)N(((I/V-- .~ Notary Public NOTARIAL SEAL STEVE C:NICHOLAS. Notary Public City of Harrisburg, Dauphin County My Commission Expires Sepl25. 1999 ~' rl:1 M&fBank 499 Mitchell Road, MiIIsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302) 934-2955 April 3, 2007 Lawrence J Neary Attorney At Law 108-112 Walnut Street Harrisburg, Pennsylvania 17101-1609 Re: Estate of Carl R Burrell Social Security: 180-01-2044 Date of Death: Au~ust 17. 2006 Dear Sir or Madam: Per your inquiry dated March 26, 2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 950563173 Ownership (Names of) Carl R Burrell * Opening Date 10131/00 Closed 03130107 Balance on Date of Death $9,266.61 Accnted Interest $ 0.75 Total $9,267.36 2. Type of Account Certificate of Deposit Account Number 031003914523343 Ownership (Names of) Carl R Burrell * Irene EKing * Opening Date 06128196 Closed 08121106 Balance on Date of Death $87,665.07 Total $ 205.19 --$ 8-f8iii26------ um__u___ u ------oo - - ----- --.- - - u u -- _m___ - - -- -. -. -- Accnted Interest . . 3. Type of Account Certificate of Deposit Account Number 031003914523351 Ownership (Names oj) Carl R BUlfell * Irene EKing * Opening Date 06/28/96 Closed 08/21/06 Balance on Date of Death $17,173.18 Accroed Interest $ 69.79 Total $17,242.97 4. Type of Account IRA Account Number 035004201738167 Ownership (Names oj) Carl R Burrell * Shirley Burrell. Beneficiary * Opening Date 11/19/82 Balance on Date of Death $9,030.52 Accroed Interest $ 21.94 Total $9,052.46 5. Type of Account Certificate of Deposit Account Number 031003914560022 Ownership (Names oj) Carl R Burrell * Irene EKing * Opening Date 04/07/97 Closed 05/16/06 Balance on Date of Death $ 0.00 * Closed prior to the date of death Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, please contact our Colonial Park Branch at 4950 Jonestown Road, Harrisburg, PA 17109, or # 717- 255-2233. Sincerely, , ;I ~:~~~d- Nancy Clagett Records Management