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HomeMy WebLinkAbout06-19-0815056051058 REV-1500 EX (as-05) OFFlCUIL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box z80601 21 07 0694 Harrisburg, PA 1712&0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal Security Number Date of Death Date of Birth __ 198-30-1622 07/12/2007 04/25/1919 Decedent's Last Name Suffix Decedent's First Name MI WICKARD ETHEL ~ (H Applicable) Enter Surviving Spouse's Irtformatlon Below Spouse's Last Name Suffix Spouse's First Name Mi __ _ _ N/A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~~~ 1. Original Retum C:_? 2. Supplemental Retum cw::) 3. Remainder Retum (date of death prior to 12-13-82) .._~_ 4. Limked Estate ; ~_~ 4a. Future Interest Compromise (date of __ 5. Federal Estate Tax Relum Required death after 12-12-82) Cit: 6. Decedent Died Testate ~ 7. Decedent Mainta(ned a living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Wily (Attach Copy of Trust) ~:~1 9. Lkigatlon Proceeds Received ~ ~+ 10. Spousal Poverty Credk (date of death ..,~_, 11. Elediorl to tax under Sea 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT R. BLACK, ESQ. (717) 243-3727 Firm Name (If Applicable) _ _ . - - - __ REGISTER Q~WiLLS USE t>~!' LANDIS & BLACK ` l r-- C :~ c ; ~_; . First line of address ' , ~~ ~ _ 36 South Hanover Street -. , c_ ~ _ ~ ;- ~ econd line of address _ , _ r ,: ; ::~ - . -, ~1 -1 ~ . City or Post Office State ZIP Code _ . DATE`~jrLED -- Carlisle PA 17013 ~; Correspondent's e-mail address: Under penakiea of perjury, i dedare that I have examined this return, induding accompanying schedules and statements, and to the beat of my knowledge and belief. k B 1ryp, coned and complete. Dedaretbn of preparer other than the personal represer>tatlve !s 4eapd on all informatlon of which preparer has any knowledge P`ywrn vRC yr rcr~/ryRSFJ-'S/~1JIt3Lt ~VK ILI RETURN 1 ! / nwT T~ 117 , ~ 1 ADDRES9T^ 36 South Hanover Street, Carlisle, PA 17Q ~ ~ PLEwaKS use vrsrvrNar. FORM ONLY 1 505605 1 058 Side 1 15056051058 J 15056052059 REV 1500 EX Decedents Social Security Number ETHEL L WICKARD 198-30-1622 oaceaerK~s Name: RECAPITULATION 1. Real estate (Schedule A) .... . ...... . . .. . . . . ........ . ................. 1. 00 _ . ~ .. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits $ Miscellaneous Personal Properly (Schedule E) ........ 5. 88,212,05 8. Jointly Owned Property (Schedule F) ~:..a Separate Billing Requested ....... 6. 7,740.86 7, inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~==.~ Separate Billing Requested........ 7. 8. Thal (cross Assets (total Lines 1-7) .............. . ..................... 8. 95,952.91 9. Funeral Expenses 8 AdminisVative Costs (Schedule H) ..................... 9. 6,481.44 10. Debts of Decedent, Mortgage Liabilities, ai Ltens (Schedule 1) ................ 10. 166,565.23 11. Total Deductions (total Lines 9 & 10) ................................... 11. 173,046.67 12. Nst Value ot( Estate (Line 8 minus Line 11) .............................. 12. 0.00 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 __ _ _. 14. Net Value SubJe~t to Tax (Line 12 minus line 13) ........................ 14. 0.00 .._.,...._._....,...~.___. ___.~.. _..___._.._ ,.,_u...._ _ ......._.. _v, __..__.. .......__ ., _.._... _ _ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES _.._..:~.._ _ _. _._._.._ ......_.._ . _.._..__._...,... 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sea 9116 _ (a)(1.2) X .0~ 15. 16. Amount of Line 14 taxable __ _ at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable __. .. at collateral rate X .15 1 B. 19. TAX DUE ......................................................... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ,_:_. 15056052059 Side 2 15056052059 REV 1500 FJ( Page 3 fls~r_arlant'~e Cemnlete Address: flle Numbx_ . _ . _ _ _ 21 " 07 0694 ~~~~~.~___- ----'r---- - - - - _._......_.._ _..__. .. ___... DECEDENTS NAME DECEDENTS SOCIAL SECUR{TY NUMBER ETHEL L WICKARD 198-30-1622 STREET A~RESS Sarah Todd Nursing Home 1000 W. South Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit _ _ B. Prior Payments _ C. Qisoount Total Credits (A + B + C) (2) 3. InterestlPenalty if applicable D.lnterest _,_._ E. Penalty Total InterestlPenalty (D + E) (3) 4. If Lure 2 is greater than Line 1 + Line 3, enter the difference. This 1s the OVERPAYMENT. Fill in oval on Page Z, Line ZO to requeal a refund. (4) 5. K Line 1 + Lure 3 is greater than Line 2, enter the diAerence. This is the TAX DUE. (5) A. Enter the interest on the fax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT '~."'.~i -.~~. .fl xsce ~t cz .sx+nrm,. ssr~R t~S~$Ace-~ .. c~./~„~. ,..•rf~d'Fh42.n~, ~„ r.~.s':,~~~. ,r",~,,' _~fi F_~.''nL .. _ 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 :.......................................................................................... ^ b. retain the right to designate who shall use the properly transferred or its insane : ............................................ ^ c. retain a reversionary interest; a .......................................................................................................................... ^ d. receive the promise far fife of either payments, benefits a care? ...................................................................... ^ 2. ff death occurred attar December 12,1982, did decedent transfer property within are year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an 'in trust for' w payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, a other non-probate properly which contains a benefidary designation? ........................................................................................................................ ^ 0 IF THE ANSVYER 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 w for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) {if)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disdosure of assets and filing a tax return are stiff applicable even ff the surviving spouse is the only beneficiary. Fw dates of death on w otter July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age w younger at death to or for the use of a natural parent, an adoptive parent, w a stepparent of the child is zero (0) percent [72 P.S. §9116(a){1.2)]. The tax rate imposed on the net value of transfers to or fw the use of the decedent's Pineal 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 w 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-1508 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER WICKARD, ETHEL L. 21-07-0694 Include the proceeds of IitigaGon end the dale the proceeds wen: received by the estate. All property Jointly-ovmsd with right of aurvlvorshlp must be diaciosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. United Church of Christ -Rebate -Nursing Home Care 4,462.1 S 2. Public Employees' Retirement System -Pro-ration of benefds 245.02 3. M 8 T Investment Group -Money Market Acct. AZD4436887. See attached letter. 35.478.0 4. Distribution from the Estate of George B. Wickard. See attached Schedule and Order of Court. 48.028.84 TOTAL (Also enter on line 5, RecapRulation) s I 88.212.G•:; (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDt~LE F 101NT1.Y-OWNED PROPERTY ESTATE OF FILE NUMBER WICKARD, ETHEL L. 21-07-0694 If an asset waa 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• Larry W. Widcard 117 Flintstone Drive, Newville, PA 17241 Son B. C. JOINTLY-AWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAIESTATE. DATE OF DEATH VALUE OF ASSET is aF DECD'S INTEREST DATE OF DEAL, VALUE GF DECEDENT'S INTEREST ~' A' 08!05/82 Checking Account - Wachovia Bank, N.A. See attached letter. 15,481.72 o 50 /0 F 7.740.8,. TOTAL (Also enter on line 6 Recapitulation) I = 7 740 86 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-89) SCHEpVLE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES Se INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FlLE NUMBER VVICKARD, ETHEL L. 21-07-0694 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT a FUNERAL EXPENSES: t' Eby Granite Works -Lettering stone 106.00 z. Hoffman-Roth Funeral Home -Funeral bill 222.80 3• St. Peters Lutheran Church -Funeral Luncheon 400.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2,500.00 Name otPersonal Representative(s) George Wickard /Donna Hill /Larry Wickard Sodal Security Number(s)/EIN Number of Personal Representative(s) See SCh. J street Address 36 South Hanover Street Cary Carlisle .state PA Zip 17013 Year(s) Commission Paid: 2008 2. AttomeyFees 2,500.00 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant NONE Street Address Ctt1' State ,Zip Relationship of Claimant to Decedent 4. Probate Fees 432.64 5. Accountant's Fees 6. Tax Return Preparer's Fees 20.00 ~. File Account, Releases ~ Closing 300.00 TOTAL (Also enter on line 9, Recapitulation) I ; 6,4B 1, 44 (If more space is needed, insert additional sheets of the same size) REW1512 EX+ (12-03) CAMMDNWEALTI+ of t'ENNSnvANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCNEpt~LE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER WICKARD, ETHEL L. 21-07-0694 Report debts incurred by the decedent prig to death which remained unpaid as of the date of death, including unrsimbursed medical expenses. ~~~ ~~~~~ arm ~a ~~~, nieen aaamonai sneers m the same size) REV-?~13 EXr (9-OOi J SCHEDULE COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER WICKARD, ETHEL L. 21-07-0694 RElAT10NSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [nclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 • George P. Wickard, 551 Bloserville Road, Newville, PA 17241 Son One-Third S.S. No. 188-32-2580 2• Donna L. Hill, 515 Mohawk Road, Newuille, PA 17241 Daughter One-Third S.S. No. 206-32-1954 3• Larry W. Wickard,117 Flintstone Drive, Newville, PA 17241 Son One-Third S.S. No. 207-34-6723 ENTER DOLIAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THRO UGH 1 B, AS APPROPRIATE, ON RE V-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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET I f 0.00 (If mare space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF ETHEL L. WLCKARD I, ETHEL L. WICKARD, of Upper Frankford Township, R. D. 3, Newville, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM I: I direct that all my just debts and funeral expenses including my grave marker shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my husband, George B. Wickard, providing he shall survive me by sixty (60) days. ITEM III: Should my husband, George B. Wickard, predecease me or die on or before the sixtieth day following my death, I devise and bequeath residue of my estate, of every nature sad wherever situate, to my issue lip on the sixty-first day following my death, per stirpes. 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. ITEM V: I appoint my husband, George B. Wickard, Executor of this n Last Will. Should my husband, George B. Wickard, fail to qualify or cease to act as Executor, then I appoint my three children, George P. Wickard, Donna Lee Wickard and Larry W. Wickard, Executors of this my Last Will. ITEM VI: I direct that my personal representative shall not be requixed to give bond for faithful performance of their duties in any jurisdiction. LN WITNESS WHEREOF, I have hereunto set my hand this ~p day of December, 1968. J"`_ SEAL) The preceding instrument, consisting of one ttypewritten page, was on the day and date thereof signed, published and declared by Ethel L. Wickard, the Testatrix herein named, as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have sub- scribed our names as witnesses thereto. S .'4 ~~:: y ~ /, JINDIS, McIHTOSH C , ~- !i BLACK ., +ws,c. eaMmv~Nu ©M8T Investment Group M!<T Securldes, Inc. 2875 Union Road, Suite 30-33, Cheektowaga, NY 14227 Date of death valuation For the account of: Ethel L. Wickard Estate of Ethel L. Wickard Attn: Robert R. Black 36 S. Hanover Street Carlisle, PA 17013 Account # AZD443687 Date. of death_:_-7/_12/2007 - Description of Security Quantity Date of Valuation Price per sh on valuation date MTB Mone Market CI A2 35,478.01 7/12/2007 1.00 We have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share on valuation date is the closing price on that date. Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #1. Thank you. Sincerely, ~~~~ Shawna Donovan - M&T Securities, Inc. Investments: • Are Not FDIC-Insured • Have No Bank Guarantee • May Lose Value ~ ~: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF GEORGE B. Vv'ICKARD, . ORPHANS' COURT DIVISION DECEASED NO. 2006-01 1 1 3 SCHEDULE OF PROPOSED DISTRIBUTION TO: Combined Balance for Distribution Remaining as per First and Final Account 144,080.54 Estate of Ethel L. Wickard as per Election to Take Against Will -One third share 48,026.84 Larry W. Wickard as per Paragraph Third of Last Will and Testament 32,017.90 George P. Wickard as per Pazagraph Third of Last Will and Testament 32,017.90 Donna L. Hill as per Paragraph Third of Last Vdill and Testament 32,017.90 TOTAL BALANCE FOR DISTRIBUTION 144,080.54 GEORGE P. WICKARD, DONNA L. HILL and LARRY. W. WICKARD, Executors under the Last Will and Testament of GEORGE B. WICKARD, deceased, hereby declares under penalties of perjury that they have fully and faithfully discharged the duties of their office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that the first complete advertisement of the grant of letters was more than four months from the date the account was filed; that, to their kiiotivledge, there are no claims now outstanding against the Estate; and that all taxes presently due from the estate have been paid. They understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. 4904 relating to unsworn falsification to authorities. -~Geo~ge P. ickard, Executor ,~ onna T.,. Hill, Fxecut ix ,~ Larry ickard, Executor 4 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNYSLVANIA ORPHANS' COURT DIVISION Docket No: 21-2006-1113 IN RE: FIRST AND FINAL ACCOUNT OF GEORGE P. WICKARD, DONNA L. HILL AND LARRY W. WICKARD, EXECUTORS FOR THE ESTATE OF GEORGE B. WICKARD, LATE OF WEST PENNSBORO TOWNSHIP, CUMIERLAND COUNTY, PENNSYLVANIA, DECEASED. AND PETITION FOR ADJUDICATION/STATEMENT OF PROPOSED DISTRIBUTION ORDER OF COURT AN NOW, this 4th day of March, 2008, the herein account is confirmed absolutely and distribution is decreed in accordance with the proposed schedule of distribution herewith. t _.:~. ~^ .._ ~. . -~ r ;:L 7 ~ ;_•. ~'_;. ~Y_ . ~ T r.,' ~.. .... ~ ; - "1" .~ av ~rvc ~nTro•r Fax Transmission 8/14/2007 Wachavia Bank N.A. Balance Confirmation Services P U Box 40028 Reanolce, VA 24022-7313 August 14, 2007 LANDIS & BLACK 36 SOUTH HANOVER STREET C.~1RI,ISLE, PA 17013 Reference ID: 2142440 SUBJfiCT: Verification / Confim>lation o~ Account and Balance Information provided for: Customer ETHEL L WICHARD (SSN# 198-30-1622) Date of Death: July 12, 200 j Acconat Account Type Nutnbet 1;43 PM PAGE 1/042 Fax Server CHECKING 1000324157418 515,481.72 8~S11982 LEGAL TITLE: ETIiEL L WICKARD LARR1' W 1VICKARD • Due to ayatem limitations, we can onl~ provide a twelve month average balance on depository accounts. Revdlvin¢ Credit Information Account Account Date of Death Creiit Date Date Times Legal Title T}pe Nnmbes Balance ~ Limit Opened Closed Lau VISA 42b429880980829t MBNA -Revolving credit accoaata are no longer serviced by Wactrovie B>ittk Please cauact MBNA at 800-477-9131. 1 Datc of Deatlt 1 Average Date Maturity Interest Accrued YTD Date Balance I Balance" Opened Date Rate Interest InutestPaid Closed COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DiViSION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 1~1t>~r8486 August 10, 2007 LANDIS & BLACK ROBERT R BLACK ESQUIRE 36 SOUTH HANOVER ST CARLISLE PA 17013 Dear Attorney Black: Re: ETh'EL WICKARD CIS #: 860160338 SSN: 198-30-1622 Date of Death: 07J12J2007 Please be advised that the Department of Public Welfare maintains a claim in the amount of $159,241.44 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $6,452.55, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $152,788.89, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of thi Commonwealth's claim is admitted and H estate accounting is complete, please real estate, please provide copies of and a current appraisal, if available. s letter and advise whether the hen payment may be expected. If the provide a copy. If the estate contains the deed, the latest tax assessment, Sincerely, • ..r•- t~ ,. ' :~ Snober V. Ketty Claims Investigation Agent 717-772-6608 717-772-6553 FAX Enclosure