HomeMy WebLinkAbout02-20-08 (3)
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15056051047
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
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
;z I 0 ~
File Number
063 r
Date of Birth
(JI03~"Og
O~OS/1Ar
Decedent's Last Name
Suffix
Decedent's First Name
MI
o W f.,J~
R.o
L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix First Name
MI
Owf..-J,)S E. I
E
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
c::>
2. Supplemental Return
c::>
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
c::>
4. Limited Estate
c::>
c::>
c::> 4a. Future Interest Compromise (date of
death after 12-12-82)
c::> 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c::> 10. Spousal Poverty Credit (date of death c::> 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
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
-
Firm Name (If Applicable)
First line of address
REGISTER onW.,LS USl:!bNL Y
,.".J .
r...)
C":J
Second line of address
,~'J
City or Post Office
State
ZIP Code
DATE FILED
Correspondent's e-mail address:
DATE",. ...q" C
c<:: - /tf -0 C7
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
- ~
Side 1
L
15056051047
15056051047
--.J
-1
15056052048
REV-1500 EX
Decedent's Social Security Number
Decedent's Name:
Q(o B>'i: fL./" L. 0 fA) f: ,J~
~...
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
3~ s-" :z
(j . 66
6. Jointly Owned Property (Schedule F) c:::> Separate Billing Requested .
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::> Separate Billing Requested. .
6.
7.
.
8. Total Gross Assets (total Lines 1-7).
8
.3 4; ~ ft;.. ,,)..
if To 1. 1 J
9. Funeral Expenses & Administrative Costs (Schedule H).
9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .
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)
. . 12.
'1 00 7...., I
u /SJ.(J1)
11. Total Deductions (total Lines 9 & 10).
. . . . . . . . . . . . . .. 11.
. 13.
.
14. Net Value Subject to Tax (Line 12 minus Line 13)
. 14.
o. 0 ()
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 .0_
16. Amount of Line 14 taxable
at lineal rate X.O
.
15. .
16. .
17. .
18. .
... . 19. .
.
17. Amount of Line 14 taxable
at sibling rate X .12 .
18. Amount of Line 14 taxable
at collateral rate X .15 .
19. TAX DUE. . . . . . . . . . .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
c:::>
Side 2
L
15056052048
15056052048
--.J
'REV-1500 EX Page 3
File Number
;(I-~'l-(j031
Decedent's Complete Address:
DECEDENT'S NAME
STREET ADDRESS
~bl;,fl2..' L. QtJJLiJ.5
)..-;-/ H ST.
CITY
(! ItlJ../ SL L
STATE P A
ZIP
17()lp
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
CJ . at) .
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C ) (2)
TotallnteresUPenalty ( 0 + 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)
5. 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.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(SA)
(5B)
0.0 ()
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 ~
b. retain the right to designate who shall use the property transferred or its income; .......................................... D ~
c. retain a reversionary interest; or......................................................................................................................... D ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... D ts1
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D !XI
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D I)(]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ D ~
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 PS. 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.150HX . (1.97}
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
R08t((rL, OV(,)s
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
;:u- of- tJtJ3'1
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. IfsA4 Ik,c i'. ::# 3g~O~3J 3;(3;{ .J :J. ~7. .A i
). Jf S-rL ~~IJ v{. + L1J1, I vc.. Ac.c:r.=4 I ~ /5 F= - 6 Y 17- ,?';.3 :39f. 3~
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
36S~. ~~
REV-1511 EX+ (10-06.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
R6~ t/(i L. OW t,J5
FILE NUMBER
.:2 I - () 15 - tJt) 31
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
t-WIIJ6r I3/Zls. FtJ,.)t-ItAl.. jJ,n-tL
FLo UJf 1/...5
FIJIJ "'D
39f~. ~,
/3.1 . S-o
600. at)
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
State _ Zip
Year(s) Commission Paid:
2. Attorney Fees
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
-gO.oll
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
4 f () 1. 7 I
REV.1509 El, 1,.97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
fZ;;e t /l..T L. () AJf. JJs
FILE NUMBER
:)1- o~- Of) 3'1
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. &t-~AJ.j)lt.J<.. t. OWt-l.JS
~S'I H 5,.
C. A R l.. I St f:, P /I
s p(),; > L
J70/~
s.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY 'Io0F DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. I q'it" riD If Sot. AN\) i..OT llr &l()L)/l,jb {tJ,-JANI1 B
AI Al)l Ii ~T'I (2Alhl!.Lfl III. fIJTI{l (71 t.!.
~. A, ;) A R If) j)( C. H-f.e.~ ,,..)1;- AceD;) /J T T(J,JA,J(''( ~1
f. ,J7/1- {'7/~5
3. A. MI~t. H 0 u :> ~ ,.,Jo L D G-CJ,1 j) 5 tH ~ fJ IJ U1.. ~7
f: JJnlL f... 7'1( j
{ ,4. 4" ItJ /Ill 0 /3 IL L I{y
Tt JJIfl.)('1
f.un R-(Tlts
TOTAL (Also enter on line 6, Recapitulation) $ ~ /.J1H-J(1 A'1 €AJ7,.'<. t
'/
1Ft
(If more space is needed, insert additional sheets of the same size)
LAST WI LL AND TESTAMENT
OF
ROBERT LA THA I RE OWE NS
I, ROBERT LATHAIRE OWENS, a legal resident of Cumberland
County, Commonwealth of Pennsylvania, being of sound and disposing
mind and memory, do hereby make, publish and declare this
instrument to be my LAST WILL AND TESTAMENT. I hereby revoke any
and all wills and codicils by me heretofore made.
I
IDENTIFICATIONS AND DEFINITIONS
A. I am married to GERALDINE ELIZABETH OWENS, hereinafter
referred to as llmy Spouse." We have one (1) child, TABITHA
OWENS-BANKS. I have three (3) children by a previous marriage,
JEFFREY LYNN KIRKLAND, ROBERT LATHAIRE THOMAS and ELIZABETH MARIE
WILLIAMS. References in this Will to "my children" include these
children and any other lawful children born to or adopted by me.
Except as otherwise provided in this my LAST WILL AND TESTN~ENT,
have intentionally omitted to provide herein for JEFFREY LYNN
KIRKLAND, ROBERT LATHAIRE THOMAS and ELIZABETH MARIE WILLIAMS and
for any relatives or for any other person, whether claiming to be
an heir of mine or not.
B. The following definitions obtain in any use of the terms
In this Will:
1. llDescendantsll means the immediate and remote lawful,
lineal descendants of the person referred to, and it
means those descendants in being at the time they
must be ascertained in order to give effect to the
reference to them, whether they are born before or
after my death or of any other person. The persons
who take under this Will as Descendants shall take
by right of representation, in accordance with the
rule of per stirpes distribution and not in
accordance with the rule of per capita distribution.
Persons legally adopted when under the age of
fourteen years shall not be differentiated from
blood descendants for any purpose.
2. "Survive me" is to be construed to mean that the
person referred to must survive me by thirty days.
If the person referred to dies within thirty days of
my death, the reference to him shall be construed as
if he had failed to survive me.
3. As used in this Will, the words llExecutor,ll llhe,ll
"him,ll llhis," and the like shall be taken as generic
and applicable to a natural person of either sex or
a corporate person of other legal entity.
Page 1 of 4 Pages
c. I have served in the Armed Forces of the United States.
Therefore, I direct my Executor to consult the legal assistance
office at the nearest military installation to ascertain if there
are any benefits to which my dependents are entitled by virtue of
my military affiliation at the time of my death. Regardless of my
military status at the time of my death, I direct my Executor to
consult with the nearest Veterans Administration and Social
Security Administration office to ascertain if there are any
benefits to which my dependents may be entitled.
I I
PAYMENT OF DEBTS AND TAXES
I direct my Executor to pay the following as soon after my death
as may be practicable:
1. All of my just debts and the expenses of my last
illness, funeral and of the administration of my
estate; but my Executor need not accelerate and pay
those unmatured obligations which, in his opinion,
it might be proper and more advantageous to retain
or renew and pay as they become due and payable.
2. All inheritance, transfer, estate and similar taxes
(including interest and penalties) assessed or
payable by reason of my death, on any property or
interest in my estate for the purpose of computing
taxes. My executor shall not require any benefic-
iary under this will to reimburse my estate for
taxes paid on property passing under the terms of
this Will.
I I I
RESIDUARY ESTATE
A. I define "my Residuary Estate" as all of my property
after the payment of debts and taxes under Article II, including
real and personal property, whenever acquired by me, property as
to which effective disposition is not otherwise made in this Will,
and property as to which I have an option to purchase or a
reversionary interest.
B. I give my Residuary Estate to my Spouse if she survives
me.
Page 2 of 4 Pages
C. If my Spouse does not survive me, I direct my Executor to
divide and distribute my Residuary Estate as follows:
1. thirty-five percent to my daughter TABITHA
OWENS-BANKS, if she survives me;
2. the rest, residue and remainder of my Residuary
Estate to inlcude any lapsed legacies under sub-
paragraph 1 above shall be divided into equal
s h are san d d i s t rib ute d a s f 0 I low s : /. :-;/_ /;; .<'w !~<,L ~....,
a. five, Jhar/es each to m~GrandC~ildrenrP'~;Lij~HA" l."-~
MARQUET.. t:KIRKLANb'~t~:::::. WUIS.~:NS.., ~NTO. I N~TTE _' . ".I"",.,;, ..?( ~ /)!...,"....!..-{/
ELIZAB_E H.W(/ILLIAfv1S an MORrtANEL ZABET BANK~)f < J '
the~ '-sur ,v me;\ " ~C, tJ"'"-"'~" ,.,,~r..,
'. ~ / \....... ' ~
,,) ~~~ec~~~e~ac~~:_mY r_emai~Ldren who
9> if any of my Grandchildre'h-'TaCI to survive me, \
then his or her share shall be distributed among )
his or her descendants who survi.ye me; ..' .'_'" ,/
"', ,,-" ," ..... ,. .....,--'_.,,--"-"'---'~~w.~~:~~~'--'
./__I~ "~> if any of my Grandchildren fai~ to survive m~
6~ \' and leave no descenda. nts who surVive me, then hiS
or her share shall b~ divided equally among such
;yf} --. of my Grandchildrenfi\.Vho survive me, or their
" 'I i descendants who survive me, as set forth in
v subparagraphs a, 'and ,& above.
IV
APPOINTMENT AND POWERS OF EXECUTOR
I nominate and appoint my Spouse, GERALDINE ELIZABETH OWENS,
as Executor of this my LAST WILL AND TESTAMENT. If my Spouse,
GERALDINE ELIZABETH OWENS, is unable or unwilling to serve in this
capacity, I appoint my daughter TABITHA OWENS-BANKS to serve
instead. I request that my executor be permitted to serve without
bond or surety thereon. I authorize my Executor to do any and all
things which in his opinion are necessary to complete the
administration and settlement of my estate, including full right,
power and authority, without the order of any court and upon such
terms and under such conditions as my Executor shall deem best for
the proper settlement of my estate; to bargain, sell at public or
private sale, convey, transfer, deed, mortgage, lease, exchange,
pledge, manage and deal with any and all property belonging to my
estate; to compromise, settle, adjust, release and discharge any
and all obligations or claims in favor of or against my estate;
Page 3 of 4 Pages
. .
and to borrow money for the payment of inheritance and estate
taxes or for any other purpose. Without in any way limiting the
scope of the powers enumerated herein of my executor, I hereby
specifically give to him full power to retain any and all
securities or property owned by me at the time of my decease
whenever, in his absolute and uncontrolled discretion, such a
course shall seem to him to be best, without liability for
depreciation or loss, and free from investment restrictions
incident to executorship, whether imposed by common law or
statute. In the execution of his duties and powers as Executor he
shall have the power to comply with all legal requirements as to
the execution and delivery of deeds and all other writings,
documents or formalities without the order of any court; and he
shall furnish a statement of receipts and disbursements at least
annually to each person then entitled to receive income or
property from my estate.
IN WITNESS WHEREOF, I have at Carlisle Barracks,
Pennsylvania, this j~ day of-cS~.j!nLJ-1.~d!.....1987, set my hand and
seal to this my LAST WILL AND TESTN~ENT consisting of four (4)
typewritten pages.
"~~ ttt2
i..'- : ~
~ .,~~~~:__<t~~SEAL)
ROBER L THAIRE OWENS
Testator
Signed, sealed, published and declared by the Testator,
ROBERT LATHAIRE OWENS, as and for his LAST WILL AND TESTAMENT, in
the presence of us, who at his request, in his' presence and in the
presence of each other, have hereunto subscribed our names as
witnesses.
NAME
=~(2~~ ~-~=-~---
'I. / /; ~
l' /"'1.'
j~,-f~0~<:.!j;-c_(~_______________
ADDRESS
-----
?A~_~ A'-_~-r-Ii
__p ,":\ /1 !) ') 1
pi 2 d~l7f~l1~hLj~l::.~~~-!.~7-~('
Page 4 of 4 Pages
. .
Acknowledgment
oa~~O~VEALTH OF PENNSYLVANIA) SS:
COU NTY OF CUMBE RLA ND )
I, ROBERT LATHAIRE OWENS, Testator, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and acknowledged before me, by ROBERT
LATHAIRE OWENS, the Testato~~a~ OI~~~~~~, 1987.
V~~~J~~iLa~~~___
-JROBERT LATHA~/R OWENS, Testator
/) 7
, c M (A, ,,/!..?~e..~
------------ ------ --- -----
No tar y pu b I i C
ROSP. f\ flf)D~!GUEZ, N(]T,~HY FUGUe
CAlli i'\\ f B~'hJqGi~ CUMr,\JL'I"-;U COUNTY
..h '- LV. .......::., ::~. ': 7. p. A........ ." Hlir.:)
~y CGM;~I.):)~'JN !',X~~,~lS Q',~i. ~_.U, l.~~ .
Momb..r. P~l\n''1h'~r.l:j A~!;<l~i~\;Qn "t N"I~f1~~
(SEAL)
A ff i da vi t
COMMONWEALTH OF PENNSYLVANIA) SS:
COU NTY OF CUlVlBERLA ND )
/YJ.... /J--- - / (
We, L~/L}g-'}::tPL_~_~f22t:r __ and j2L'I,!}:~::','S_ f:; ,~~~~~_________,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testator sign and execute the
instrument as his Last Will; that ROBERT LATHAIRE OWENS, signed
willingly and that he executed it as his free and voluntary act
for the purposes therein expressed; that each of us in the hearing
and sight of the the Testator signed the will as witnesses; 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 i nf 1 ue nce.
Sworn or affirmed to and subscribed to before me by
il113f'L~LA1~_ /C,-:LtJt?1-CQZ-l-------(1 a.A~ jL~hu:l'L~~S~{_C,[~____~_____,
witnesses, this J_~_ day of _~~~~ 1987.
~C?~~-------
WI T N~SS..
; ':;' ',-"
I I Ii ( "//'"
; ',~'l /'.\ ',' , ..
'-..-/:, /l, ,.,..{.... /l,t:..:;\ y ,. 'LAC?'
_~._--.:::-____:......~~~~__.::_::t:_______________
(S EAL)
WI7ESS7" /
~~PD~T~5-~~~, ----
!lO~i'.i', ~r!D!(!G!Irz. N'1TAiii' f'USUC
Cf\ffl.,; ~l::: l~:;.:;0~J(:;;1, CUklBrf..~L) :.:( j) CDUNTY
~y C~~~'':':\' :,:;~~tC'N rjU'iPts '::-';"_';:' r ~3:J
Mun;G.~{. t1el:il$/i\,'ania A~~af;ia't;'(j~ ~i'N~~;hr:~s