HomeMy WebLinkAbout11-30-07 (2)
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15056041147
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 2 1 0 7
00629
Date of Birth
172019468
06202007
10191911
Decedent's Last Name
MCLAUGHLIN
EMMA
MI
S
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
[] 1. Original Return
[] 4. Limited Estate
[!]
D
6. Decedent Died Testate
(Attach Copy of Will)
0 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
10 Spousal Poverty Credit ~date of death D 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
9. Litigation Proceeds Received
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
EDMUND G. MYERS 7177614540
Firm Name (If Applicable)
JOHNSON DUFFIE
301 MARKET STREET
REGISTEF(DF WILLS UiiONL Y ~:!J
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First line of address
Second line of address
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City or Post Office
LEMOYNE
State
PA
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DAjE"FILED
ZIP Code
17043
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Correspondent's e-mail address:
,
Heather M Sigler
17057
DATE
EDMUND G. MYERS
301 MARKET STREET, LEMOYNE, PA 17043
Side 1
L
15056041147
15056041147
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15056042148
REV-1500 EX
Decedent's Name: Emma Seiders McLaughlin
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) 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 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 12 , 6 5 7 . 1 0
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 00
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0
15.
16.
17.
18.
19. Tax Due.................................................................. ............................................ ..... ~.9.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
Decedent's Social Security Number
172019468
385.36
2,892.32
9,764.78
13,042.46
11,854.27
1,580.70
13,434.97
-392.51
-392.51
0.00
569.57
0.00
0.00
569.57
D
15056042148
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,REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07 -00629
DECEDENT'S NAME
Emma Seiders Mclaughlin
STREET ADDRESS
1304 Carlisle Road
CITY I STATE IZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
569.57
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty (D + 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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
569.57
569.57
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 [!]
b. retain the right to designate who shall use the property transferred or its income;.................................... D [!]
c. retain a reversionary interest; or...............................................................................................................0 [!]
d. receive the promise for life of either payments, benefits or care?.............................................................D [!]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....................................................................................................................O [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... Q [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which _
contains a beneficiary designation?..................................................................................................................[!] [--.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 P.S. 39116 (a) (1.1) (ii)]. The statute does not exemoB 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. 39116 (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. 39116 1.2) [72 P.S. 39116 (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. 39116 (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-15G8 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONMAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
McLaughlin, Emma Seiders
FILE NUMBER
21-07 -00629
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estete.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Highmark Bluecross/Blueshield Reimbursement
VALUE AT DATE
OF DEATH
319.32
2 VISA Card - Credit Refund
66.04
TOTAL (Also enter on Line 5, Recapitulation)
385.36
(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-1509 ~+ (6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
McLaughlin, Emma Seiders
FILE NUMBER
21-07 -00629
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
A. Heather McLaughlin Sigler
ADDRESS
270 Keystone Drive
Middletown, PA 17057
RELATIONSHIP TO DECEDENT
Daughter
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE.
1 A M& T Bank Relationship with Interest 5.784.63 0.500% 2.892.32
Checking Account No. 59137673
TOTAL (Also enter on Line 6, Recapitulation) 2.892.32
(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 F (Rev. 6-98)
Rev-1510 EX+ (6-98)
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SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONVllEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
McLaughlin, Emma Seiders
FILE NUMBER
21-07-00629
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 DESCRIt-' IluN UI"" ,~. _. IY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Lincoln Financial Group Annuity - Beneficiaries: 9,764.78 9,764.78
Heather M. Sigler, Daughter and Kenneth L.
Sigler, Son
TOTAL (Also enter on Line 7, Recapitulation) 9,764.78
(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 G (Rev. 6-98)
REV-1151 EX+ (12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMON\lVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
McLaughlin, Emma Seiders
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -00629
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 10,624.65
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Johnson Duffie 900.00
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 58.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 271.62
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 11,854.27
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
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SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONVloEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
McLaughlin, Emma Seiders
FILE NUMBER
21-07 -00629
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Parthemore Funeral Home & Cremation Services, Inc.
9.198.65
2
Rolling Green Cemetery
1.320.00
3
Royers Flowers
106.00
Subtotal
10.624.65
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
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SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
McLaughlin, Emma Seiders
FILE NUMBER
21-07 -00629
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills Office - Filing Fees for Inheritance Tax Return
($15.00) and Inventory ($15.00)
30.00
2
The Cumberland Law Journal - Publication of Notice of Estate Administration
75.00
3
The Patriot News - Publication of Notice of Estate Administration
154.62
4
Vital Records
12.00
Subtotal
271.62
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-96)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
McLaughlin, Emma Seiders
FILE NUMBER
21-07 -00629
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1 AT & T
29.10
2 Bon Ton Credit Card Account
3 Household Expenses
4 M&T Bank Home Equity Loan Payment
5 Ohio Casualty - Homeowners Insurance
6 Orkon Pest Account
7 Pa American Water Co.
8 Pa American Water Co.
9 PP&L Electric
10 PP&L Electric
11 Sears Credit Card - Final Payment
12 UGI Utilities
13 Verizon
14 Verizon
15 VISA Card - Revolving credit charges
62.01
675.67
126.83
126.50
95.24
27.81
26.62
34.91
27.03
32.67
128.50
21.78
21.35
144.68
TOTAL (Also enter on Line 10, Recapitulation)
1,580.70
(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 I (Rev. 6-98)
REV-1513 EX+ (9-00)
*'
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
1
McLaughlin, Emma Seiders
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
Kenneth L. McLaughlin
1304 Carlisle Road
Camp Hill, PA 17011
RELATIONSHIP TO
DECEDENT
Do Not List Trustee/s)
FILE NUMBER
21-07 -00629
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
NUMBER
I.
Son
1/2 of Estate
2
Heather McLaughlin Sigler
270 Keystone Drive
Middletown, PA 17057
Daughter
1/2 of Estate
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 SHEE
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
EXHIBIT A
:317203
ESTATE OF EMMA SIGLER McLAUGHLIN
SCHEDULE OF EXHIBITS
Last Will and Testament of Emma S. McLaughlin signed and dated April
29th, 2005.
i,,_.
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J
\..:;,
1Last Will anb \!testament
OF
EMMA s. McLAUGHLIN
I, EMMA s. McLAUGHLIN, of Lower Allen Township, Cumberland County,
PelU1sylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking and making void
any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done.
ARTICLE II
TANGIBLE PERSONAL PROPERTY
I give and bequeath my automobi'e, household goods, personal effects and other tangible
property of like nature (not including. cash or securities), together with any existing insurance
thereon, unto my children, HEATHER McLAUGHLIN SIGLER and KENNETH L.
McLAUGHLIN, to be divided between them by my Executrix or successor with due regard for
their personal preferences in as nearly equal shares as may be practical. In the event that either of
my children predeceases me, I give and bequeath the items described in this Article II Unto the
survivor of them.
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever
nature and wheresoever situate, llilto my children, KENNETH L. McLAUGHLIN and
HEATHER McLAUGHLIN SIGLER., or the then-living issue, per stirpes, of either child who
predeceases me.
ARTICLE IV
PERSONAL REPRESENTATIVE
I name, constitute and appoint my daughter, HEATHER McLAUGHLIN SIGLER.,
Executlix of this my Last Will and Testament. Should my daughter, HEATHER McLAUGHLIN
SIGLER., fail to qualify or cease to so act, I name, constitute and appoint my son, KENNETH L.
McLAUGHLIN, alternate Executor to complete the administration of my Estate. I direct that no
fiduciary appointed herein shall be required to post bond for the faithful administration of the duties
required in any jurisdiction.
IN WIT~J~, ~EREOF, I haV(j':unto set my hand and seal to this, my Last Will and
Testament, tl1is~yof ~/ ,2005.
~ ~~~AL)
E~S.McLAU IN
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
each other, have herellilto subsclibed our nanles as witnesses.
:39534v2
-2-
.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, EMMA S. McLAUGHLIN, }J..WSS"J}
thUl1.){D f;. ~ Ye1-S
1Jgn ~
and
, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first dilly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will
and that she had signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
iJL
Witness
Subscribed, sworn to and acknowledged before me by EMMA S. McLAUGHLIN,
Testatrix, and~<;A'P~ e,~_ and t;OMu.)J!> G. M.-'tUJ"
witnesses, this~ay of (lp;uJ? , 2005.
NSIi&~ ""~ .~>
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r-""'"---~.-._---_.---"
t NOTARIAL SEAL
j DIANNE LENIG, Notary Public
! Lemoyne Borough Cumberland Co.
r. f\~r Commission Expires Dec. 21, 2005 .