HomeMy WebLinkAbout04-02-08 (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
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 8
County Code Year
File Number
0051
Date of Birth
10 25 2007
12 18 1920
Decedent's Last Name
Suffix
Decedent's First Name
WILLIS
LYDIA
MI
T
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
, X 1 Original Return
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
4. Limited Estate
4a. Future Interest Compromise
(date of death after 12-12-82)
!X
6. Decedent Died TestatE!
(Attach Copy of Will)
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
1 0 ~~t~::~ ~3~:l'r!sf~en~t 1(?1a~5)f death
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
DAVID J. LENOX 717 432 9666
Firm Name (If Applicable)
THE WILEY GROUP PC
PA
ZIP Code
17019
'"
REGISTER~ WILLS USfB'NL Y
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First line of address
130 W.
CHURCH STREET
Second line of address
City or Post Office
DILLSBURG
State
r.-
en
. I'~;l
Correspondent's e-mail address:
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of llY knowledge and belief.
it is true, correct and complete. Declaration of preparer other than the personal representative IS based on all information of which preparer ~Ias any knowledge
SIGNATURE PEf'SON-RES~IBLE FOR FILING RETURN DATE
i,' \. I .17 r.-e€ Lydia F. Mogel .~\ -J.. Lf'-of?
17019
David J. Lenox
I?P,TE / _
-~ ..:.:; 4_C: '6-
130 W. Church Street, DiIIsburg, PA 17019
L
Side 1
15056041147
1505604114'7
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-1
15056042148
REV-1500 EX
Decedent's Name L y d i aT. Will is
RECAPITULATION
1. Real Estate (Schedule A)
................................ ...........................
2. Stocks and Bonds (Schedule B).. 2.
3 Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)..
4. Mortgages & Notes Receivable (Schedule D).. 4.
6. Jointly Owned Property (Schedule F) Separate Billing Requested.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested
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/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ......................
14. Net Value Subject to Tax (Line 12 minus Line 13)
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
16, Amount of Line 14 taxable
at lineal rate X 045
17. Amount of Line 14 taxable
at sibling rate X 12
18. Amount of Line 14 taxable
at collateral rate X .15
0 00 15.
0 00 16.
0 00 17.
84 145 83 18.
. . . . . . . . . . . . . . . . . 19.
19. Tax Due.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
L
Side 2
15056042148
5.
6.
7.
8.
9
10.
11.
12.
13.
14.
Decedent'
1.
22.080,44
6 5 200 3 9
87 280 83
3 135 00
3
135
00
8 4 145 8 3
84. 145 , 8 3
o 00
o 00
o 00
12 621 87
1 2
621
87
o
15056042148
-1
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Lydia T. Willis
STREET ADDRESS
404 Silver Springs Road
File Number 21-08-0051
CITY
Mechanicsburg
STATE
ZIP
PA
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
12,621.87
11,000.00
578.95
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
11,578.95
Total Interest/Penalty (0 + 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 Lme 5 + 5A. This is the BALANCE DUE.
(2i)
(4)
(5)
(5A)
(5El)
1,042.92
1,042.92
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:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income; ....................
c. retain a reversionary interest; or ................ ............... .............................. ............................
d. receive the promise for life of either payments, benefits or care? .................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................... ..................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?. x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.. x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes No
x
x
x
Xi
i
Xi
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. 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 survivin9 spouse is zero
(0) percent [72 P.S. 99116 (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 PS 99116 1.2) [72 PS. 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.
LAST v\] U \'\0 TESTA\JFNT
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S}':CO:-~D: i direct that all [(lXI'S tlt:il 111:1Y be assessed in cOIlscqLleILc (If mv death.
,il \,\!r;i[C\C] n:liUie :ii1d by \vhatcver J lilisdicilOll imposed, shad be paid rrom lIlY re<.;ldu,lry
l'slate ]S :1 pdll Ollhc expense 0(' adrni flIS[ratio!l or my estate.
PERSON:\L PROPERTY
'1'111 RD: 1 hequeath those items of IllY household furnIshings, personal effects,
~1I1Li pcrsol1all'rupcrty as I may set forth in a separate signed memorandum [l) I he persons
1I:11l1ed ill iil:ll Illl~morandllrn,
DISTRIBLTH))\J OF RES} DUE
I'UUH,TIL [1\ I' the efiliie I(",i'll" ui 111\ CSidlt iu L'i DiA F. lvl0(;] I pr()VIulng
"il" ,,11:i1ISLlI\ I',,: fm' IUI':l period or illJ[fV ilO) clays, 11 Sill' shaJl not so SUnl\, rtl,', I !)I\('
Ifli' l'fJtlre rlc;iull' (d 1m estate to TUUI) i\1()(iLL.
PROTECTH);,\ (H' BENEFICIARIES
(Spendthrift Provision)
FIFTll: '\]'l Jlllnesl in inl()llll' ur prJrlcipal shall he assignable by a lLliClaryor
,\,IILtllc to ,IIi llll h:!\illg a ClalIll ;J,'-':U1l',1 ~l benefiCIary belore actual p~lvmellll,llhe
11('111,'1 I\. 1:11'\
!RiSTEF OF ESTATE (H
\I1 N( )RS A"\ D i '\'( '\ P\( TL\TFD BEN "TICL\. 1<1 F"i
SiXTI i: if ~l!lY i!1l'()IllL' Ilr r'rlrlL'l!)~lI \jl~111 hr' 1';t.V~lhlc tp :IIl\ jlc'[\Ull \\II)<;tI~tlllll' J
;!Ii 'I"', 'l1Y l'Xl'Cllt()L a\ Inlstel' c;h~llll}(lld "lllh illCOIlW :IIlJ !,rinlip:1i durin:! llilllt \Ill)' :11l1I
i ,i': ill' d:!lil,'d III :Ipph' c;llL'll Ilkl'!i!,' :lil\j prrllClp:il il' lhl' 1ll',:lth, [f1~iillk)LiI]CI', SIi)lpO;i
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i" I) I I I: I h' ,IJ'P lJ l' ,: 11 , .' II I) \ r):: \ Ii! l' fill'; I! I U Ii l1l' ; I f III fill r Ie' Jj ) ; Ii j(, : I1\.' J \ I r \'Ill ())
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!\I ,I J Idli.sl.,'j\ Iu \llllUl'-, Ad, j Ill\[l'~' flLty, In dJ\char~'l' l)f :111 the I rllstec's duties,
[i,I\ :111\ ItllfJ sll:ln~ del'1l1ed impl:lLlIl'~11 oj :ldlllinis!ICltJOn tu the p:lIl'n! Ill' urhcr persOll
III Ilil!l'C 01 Ill!,' I1llll0r u[ to IllS or IhT )'II;lrdi;lfl (if II) :1 ('II\tndi:fl! r'nr tl!I.: TI1II10r under the
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:I~'l' ilj 18, \1) '1Illstee klillla\'l' the S;lI1ll' P()WLT\ CIS my eXl'cutDl' and sh:lli SlTVC without
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per'I'Ii sr;:ll! k' entitled S11~11) be distributcd Ii) stich PLT";Uii ujI()i] such pn,,()fj li\ILIJing tile
: 11:;''l:11 Ticllbil']" In [\itnol"; Ad, ,\n) 1r.'lllallling illL'ollle alII.! I'llflClpal to \\]Iich such
II' any income or princip:d shall he payable to any person who shajJ be
lI!\.:lpaCltated lor any reason, my executor, as [rustee shall hold such incume and principal
chi ring inc::lj)aclty and sh;lll be entitiec! to apply sllch income and principal to the health,
111:lllJlen:lIlCe,\lIpport alld educatjon of such person clUJing inu'pacity without the
:ljJpoinlment of ~li1Y commillec or any authority of courL My Trustee shall havc thc same
PO\'vl rs a~-; n executor and shall serve \vithout bOIllL
POWERS OF EXECUTOR
j\._'~j j or
SEVEI\Tl:: I confn UPOlJ my executor the rigId to ,~di Ul ulfJCI\\isc (nllVen any
ll1:11 DIOI)(Tlv ;11 nuhlie ()II1II\:Ill',;;lIe ;J1 ';111'f! rilll(' (ll rimes !I) c:!wh 1)):1nnc:[
l;, i. 1, . "
dIld !Ul such pill'!.' U! prices, alld lI['(,n such [Clll1S ane! C{lnclllions (IS my exccutO! shal]
,ili, IIII!lil', Mid il I l'\l'Cllle ,md Llciih:! ~'u()d ami suilicicIll cOI1\eyances, ~LS,;jgnmCnlS and
i:;111'k Ihel,'cll, \<'llI101If li;Jhillty oj :,m l,ureh:lscr lor !k~ :lppiicdtlOll of an
,1l[i'ld 'r:lliOf), to hll!n)\\ moncy :lI1d t(\";('l'Iilr.' its P(lYI1L~nt tl)' murtg:lge of 11,':11 or person::!
)()i11,TlY, pkdg,,: Ii! ill\c';trncnh or ()lk~r\\ISC, \\J{houll1:1hIlJIy 011 the pan 01 the Il'Ill1crs [0
\l',' !Il I aprlll':llio!l tlll'lCOt; [0 rCl:ii!l ;Ill\ ItlVl'stnlents :.tllhsl'lctio!l; to tl1h'S[ : 'ill]
lr.'l!l\l'\[::t UlSlTCl::\fL \vitholll n:slril'll(\llt() s(lealJed "k~':d ill\'cstments;" lO fll,ikc
dhlIlhuli()!l ill c:lsil ur 111 kinJ; ilnd [() do all uIJ1L'l acts :lIld thIngs nccessary I)r :t]1prupnmc
If I lhl' ffUrl rIll:nl, adI11111istr,lliOrl :iIlU di-;trihlltlOll or IllY cstate,
APPOI!\T\JFNT ()Ii EXE( '{ :TOR
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U11\\; I! 111.' 'i' , L [ j lhcll IlppCliJl! TODD \JO( iiI, 11\ ,'\Celltll[ Ill'n'o/ I dirl'Ct Ill:!! Ill\'
\ 'Ii! Ii,: '! I Ill: h' l'c'l!',11 fl'd II) I lltfli,,1t \l'ClI[i I \ i!1 1111\ iurisdICt]()I1.
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i [',I 11'(' [Wi)'l': 111,1\ /,,, i:'~ld ID IllCllldc Ihe rn;isl'lillli,' Ilnd k'lllir11J1C'
HEADINCS
TF\TII: The I1clldifl;~'> used on the varlOIlS paragraphs or thi\ \Vill arc inc!/i(j('ii
lor (()r\:'rl1 'liCe: only Ilnd sh;dJ have 110 legal significance,
Ii \l' sigril'd this Will this 24th day of ;\llgllSL 20()(L
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:i!ict i U \tA. LJ, (~Iue r , Ih,' witnesses to tlie 1:1'~1 Will, the :ltf:il il"'!
1'[ !'." ""1 ':!ht!l!InC!ll \\[l(~ h:1VC sl,L:fJed Ii", li:,tru;ncl1l. lu\ilip hL'CiJ ,luly Lju:iiiiil,j
dll"11 d Ii i,) :,IW do CkPUSl' dfld S;iy:
:1 : 1::1 L ll!l' testalr! lr. do hereby :lckn(lwJcuge that I signed dnd l!XeClltL:d tll,
liiSrrlllIh'nt ;IS my !:tSl will, that I Siglll'd it willingly and as lilY Irce aIld
'."1llntary aC110r till' purposes therell! expressed; and
ih) r!i::f Wl:, the witnesses, \vere present and saw the testatrix/or ,sign and eXlTUL'
,t", ;l's''''t'''e~' 'c,' Ll'" L1S' 'viII '~1'" ,.\." ':""C'"I ;, "Vl'lll' fir> 1\' "11'\ "ul'''''',,,l ;, "\ i.",
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i 'IT and voluntary dCt for the rurpo(,:c~ therein expressed: that each of U~ in ih:'
k:llillf' and sight of the testatrix/or Sit'llCd the will as a witness and that to till'
l uf uur knov/ledge the testatrix/or was at that time 1 S or more yedrs oj d~'l,
ul '-lIlIlltl minu anu under no constraint or undue influence,
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Rev-150~ EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX. RETURN
RESIDENT DECEDENT
ESTATE OF
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.
lFILE NUMBER
21-08-0051
Willis, Lydia T.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 PNC Bank - Account 5140069328 2,392.90
2 PNC Bank - Accrued Interest Account 5140069328 0.20
3 PNC Bank - Account 5004890007 19.477.26
4 PNC Bank - Accrued Interest Account 5004890007 25.21
5 PNC Bank - Account 5060021252 184.87
TOTAL (Also enter on Line 5, Recapitulation)
22,080.44
(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)
.
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o PNCBAN<.
The Thinking Behind The Money
January 17, 2008
David J Lenox
Attorney at Law
130 W Church St Suite 100
Dillsburg, PA 17019
RE: Lydia T Willis (Deceased)
SSN:
DOD: 10-25-2007
Dear :Mr. Lenox:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Cbecking Account
Account # 5140069328
Established 10-01- J 968
LYDIA T WILLIS
DOD balance: $2,392.90 + 0.20 accrued interest
Savings Account
Account # 5004890007
Established 08-28-2006
LYDIA rWULIS
DOD balance: $19,477.26 + 25.21 accrued interest
Account # 5060021252
Established 05-25-1993
LYDIA r WILLIS
DOD baiance: $184.87 + 0,00 accrued interest
Please note t.l:iat this office only provides date of deatll bala.'1ces for deposit accounts
(rRAs, CDs, Checking and Savings accounts). We do not process any financial
...-..................,J"Lh......_... ....- __......~:;r..... ...+.!'+,.._....._4-.. T~..,....." .....o.c;...-t ........."".:....4-^...^^ ..,r:+-h ...~..., ....,,++~8{'O.('I. .;+~~
u AJ.1~a~u.vu~ UI I'J VY lU~ ~t.a'~JUCl.l~ li) VY ll\"'~U lJ...:>~1:)La.l.l\"1I;:. ...,. JUJ. all! UJ. U1\;,U\';< .ul.,.l.uJ~)
please call 1-888-PNe-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincer~y, fi n . ~cJ/I...
Colle~
1-800-762-1775
P7-PFSC-04-F
500 First Ave
Pittsburgh, PA 15219
Member FDIC
Page 1 of 1
Rev-1510,EX+ (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX. RETURN
RESIDENT DECEDENT
ESTATE OF
Willis, Lydia T.
IFILE NUMBER
21-08-0051
This schedule must be completed and flied jf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET IS yes
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DE CD'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLlCP.BLE) VALUE
THE DATE OF TRANSFER ATTACH A COpy OF THE DEED FOR REAL ESTATE
1 Mass Mutual Annuity - Contract No. SPA 8513282 65,200.39 65.200.39
TOTAL (Also enter on Line 7, Recapitulation) 65.200.39
(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)
. 81;16-~C08 15:48
FROM-M/\$ S~1UTUAL
+14137443321
T-807 P eOl/OOI F-77E
M;:;;sachu;,crr.s M\!wal LIto Insurance C0mpallY and aftlhUles
SpnoSfield ylA 01111-0001
_ ~~~~~~t~~,.
January 16,2008
b-M356"n
DAVID LENOX
VIA FAX (717) 432-0426
Dear Anomey Lenox:
RE: Annuity Contract No(s),: SPA8513282
Deceased Annuitant: Lydia T Willis
Please be advised the contract value as of the date of death, October 25, 2007, was $65,200.39.
IfyoLl have any questions, you can contact me directly at (800) 272-2216 ex!. 21436.
Sincerely,
'Z'emd4 1'~
Dennis Desmarais
Claim Examiner
Life and Annuity Benefits
cc: Manhew A Kell (037)
.' REV-1151 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Willis, Lydia T.
I FILE NUMBER
21-08-0051
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION I AMOUNT
NUMBER
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) f EIN Number of Personal Representative(s)
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees The Wiley Group, PC 3,000.00
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 135.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL (Also enter on line 9, Recapitulation) 3,135.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev 6-98)
..
.'
REV 1513 EX. (9 00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Willis, Lydia T.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-08-0051
I.
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
Lydia T Mogel
310 W. Siddonsburg Road
Dillsburg, PA 17019
Niece
100% Residual
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 SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc
Form PA-1500 Schedule J (Rev 6-98)