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Home My WebLink About11-29-07 ---I 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 2 1 0 7 File Number 417 Date of Birth 182228483 o 4 1 4 2 0 0 7 10271928 Paxton Charles MI E Decedent's Last Name Suffix Decedent's First Name (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 00 1. Original Return o 4. Limited Estate o o 2. Supplemental Return o o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 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 0 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 r--.:> Way n e F S had e, E s qui r e 7 1 7 ~ 4 3 ~2 2-An~ '::~ 0 -,r fl~\ i_-) Firm Name (If Applicable) REGIST~~'~S U~NL Y F1 '~ . ::::-~ r~ N r:j,,:.r!\ ,:~ ::0 \.D ~, I CJ . c";:;;:,;;, 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes 5 3 W est Pomfret Street :P" _.~~ -" First line of address Second line of address U1 N City or Post Office State ZIP Code DATE FILED Car 1 i s 1 e P A 17013 Correspondent's e-mail address: 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 co lete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF S RESP SIBLE URN IrT~7-CJ Carlisle PA 17015 OTHER THAN REPRESENTATIVE Pomfret Street Carlisle PLEASE USE ORIGINAL FORM ONLY PA 17013 Side 1 L 15056041125 15056041125 --F-b --.J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Charles E. Paxton RECAPITULATION 182228483 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) 0 Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . . .. 7. 255242.36 8. Total Gross Assets (total Lines 1-7) 8. 2 5 5 2 4 2 . 3 6 .......................... . 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 2 3 9 0 2. 1 5 ............... . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 7 3 0 3 . 8 9 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 1 2 0 6. 0 4 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 2 2 4 0 3 6. 3 2 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. 2 2 4 0 3 6. 3 2 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 _ 16. Amount of Line 14 taxable at lineal rate X .0 _ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 o . 0 0 15. O. 0 0 O. 0 0 2 6 8 8 4.3 6 O. 0 0 26884.36 o . 0 0 16. 224036.32 17. o . 0 0 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o <\~ ~~ ~. c;"I ~ ~()() Side 2 15056042126 15056042126 .-.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Charles E. Paxton STREET ADDRESS 770 Poplar Church Road File Number 21 07 417 CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 26,884.36 24,000.00 Total Credits (A + B + C) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty 24,000.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 0.00 2,884.36 TotallnterestJPenalty ( 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 requesta refund. (4) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. 2,884.36 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. ~9116 (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. ~9116 (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. ~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-1fi08 EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Paxton FILE NUMBER 21 07 417 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 Fulton FmancIal AdVIsors, Account #21-F021-01-4 2. West Shore Health & Rehab Center, balance of patient account 3. Department of Revenue, unclaimed property VALUE AT DATE OF DEATH 254,665.01 68.17 509.18 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 255,242.36 ~ FULTON FINANCIAL ADVISORS. P.O. BOX 3215 LANCASTER, P A 17604 NEW ADDRESS OR NAME ESTATE OF CHARLES E. PAXTON RICKY L. PAXTON, PERSONAL REP. C/O ATTORNEY WAYNE F. SHADE 53 W. POMFRET ST. CARLISLE PA 17013 ACCOUNT NUMBER: 99-F025-01-1 ~ i ' PLEASE INDICATE ADDRESS OR NAME CHANGES AND RETURN ~ FULTON FINANCIAL ADVISORS. 1089166 $0.00 $821. 72 $821.72 DATE 07/05/07 07070398917 ESTATE OF CHARLES E. PAXTON PAYMENTS TO BENEFICIARIES DIVIDENDS ON ACCT. #21F021014 CHECK NUMBER: 1089166 99-F025-01-1 MISCELLANEOUS DEP INC: PRIN: TOTAL: FUNDS - FULTON ~ FULTON FINANCIAL ADVISORS~ P.O. BOX 3215 LANCASTER, PA 17604 NEW ADDRESS OR NAME ESTATE OF CHARLES E. PAXTON RICKY L. PAXTON, PERSONAL REP. C/O ATTORNEY WAYNE F. SHADE 53 W. POMFRET ST. CARLISLE PA 17013 ACCOUNT NUMBER: 21-F021-01-4 I,' PLEASE INDICATE ADDRESS OR NAME CHANGES AND RETURN ~ FULTON FINANCIAL ADVISORS~ 1088879 21-F021-01-4 CHARLES E PAXTON GDN TCS INC: PRIN: TOTAL: $18,178.70 $235,664.59 $253,843.29 DATE 06/26/07 07062693579 ESTATE OF CHARLES E. PAXTON PAYMENTS TO BENEFICIARIES DISTRIBUTION TO ESTATE PER RECEIPT AND RELEASE AGREEMENT CHECK NUMBER: 1088879 REV-1511 EX + (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Paxton FILE NUMBER 21 07 417 ITEM NUMBER A. 1. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Ronan Funeral Home, funeral expense 7,825.53 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Ricky L. Paxton Social Security Number(s)/EIN Number of Personal Representative(s) 168-48-4587 Street Address 401 Heiser's Lane City Carlisle State P A Zip 17015 Yea<<s) Commission Paid: 2008 Attomey Fees Wayne F. Shade Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant 7,500.00 7,500.00 Street Address City Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills of Cumberland County 353.00 Accountant's Fees Tax Return Preparer's Fees Shirley W. Ahlers, oath of subscribing witness fee Cumberland Law Journal, advertise Letters of Administration The Sentinel, advertise Letters of Administration Cumberland Law Journal, additional advertising fee Register of Wills, filing inheritance tax return Register of Wills, reserve for filing Account, etc. 25.00 60.00 158.62 15.00 15.00 450.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 23,902.15 REV-1512 EX + (12-03) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Paxton FILE NUMBER 21 07 41 7 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including un reimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Good Samaratin Hospital, medical services VALUE AT DATE OF DEATH 6,783.00 2. PharMerica, pharmaceuticals 520.89 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,303.89 ",V.""" >'* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Paxton SCHEDULE J BENEFICIARIES FILE NUMBER 21 07 417 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. Dallas J. Paxton Sibling 112,018.16 700 Walnut Bottom Road Carlisle, P A 17013 2. Robert L. Paxton Sibling 112,018.16 916 Colver Street Muscatine, IA 52761 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 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) ---. .:- I, CHARLES E. PAXTON, of the Eorough of Carlisle, Cumberlan County, Pennsylvania, declare this to be my last will and testament and revoke all wills which I have previously made. I I give, devise and bequeath my entire estate, real and personal, to my mother, Ruth P. Paxton, if :.iving, otherwise in equalsnareir" to-my two brothers, Dallas J. Paxt<iri and Robert L. Paxton, if living; and if either shall be deceased to hi.s surviving issue per stirpes. II I appoint my brother, Dallas J. Paxton, as executor of this will. If for any reason he shall fail 1:0 qualify or cease to act as such during the adminis tra tion of my es tc.te, I appoint Farmers Trust Company of Carlisle, Pennsylvania, as sub~"tituted executor. I direct that no bond shall be required of any ficuciary named in this will. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7th day of December, 1982. ~........____.__._. .".... .__. ._...._.w. ~~~~ (SEA ) Signed, sealed, published and declared by Charles E. Paxton, testator above named, as and for his last will and testament, written on one sheet of paper, in our presence, who, in his presence, at his request, and in the presence of each other have hereunto subscribed our names as attesting witnesses: _A/;A~ .2t/.{,-'~ rx~' ( I