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HomeMy WebLinkAbout08-21-08r 15056041125 -' REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 28oso1 INHERITANCE TAX RETURN 2 1 0 7 0 9 5 5 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 7 3 0 3 8 1 4 0 9 0 4 2 0 0 7 1 2 1 6 1 9 3 7 Decedent's Last Name Suffix Decedent's First Name MI T H O M P S O N J A M E S L (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 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13.-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 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 S C O T D G I L L E S Q U I R E 8 1 4 6 4 3 2 4 6 0 Firm Name (If Applicable) REGISTER OF WILLS US€,ONLY G I L L M C M A N A M O N ~>( f=. • \ J C- ' First line of address - , ., . 2 0 0 P E N N S T R E E T Second line of address P O B O X 3 8 3 City or Post Office H U N T I N G D O N Correspondent's a-mail address: State ZIP Code P A 1 6 6 5 2 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, come and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN U RS ESPONSIBLE FOR FILING RETURN 7 ~y _ D8'1 ~~"~©g 505 25TH STREET HUNTINGDON PA 16652 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS P. 0. BOX 383 HUNTINGDON PA 16652 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 15056041125 J 15056042126 REV-1500 EX Decedent's Social Security Number JAMES L. THOMPSON 1 7 7 3 0 3 8 1 4 Decedent's Name. 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) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... 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) ...................... a. ... 5. ... 6. ... 7. ... 8. 1 1 6 6 3 3 9 9 9 9 5 0 0 6 8 6 ~ 8 9 9. Funeral Expenses & Administrative Costs (Schedule H) ........ ... 9. 1 8 0 2 8 0 2 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) 10. 2 4 8 9 5 9 1 11. Total Deductions (total Lines 9& 10) ................... .... 11. ........ 12. Net Value of Estate (Line 8 minus Line 11) ..... ....12. - 8 4 9 6 4 1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 13. - 8 ~ 9 6 4 1 ............. 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, or transfers under Sec. 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 18. 19. Tax Due 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 15056042126 REV-'1500 EX Page 3 Decedent's Comalete Address: File Number 0955 DECEDENT'S NAME JAMES L. THOMPSON STREET ADDRESS 1107 APPLE DRIVE CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit - B. Prior Payments _ C. Discount Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (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 1, 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. (5A} B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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; ......................... ...... X 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? ................................................................................. " " ...... ^ ^ 0 0 or payable upon death bank account or security at his or her death? ... in trust for 3. Did decedent own an ...... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................ ...... ^ 0 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 fax rate imposed on the net value of transfers to or for the use of tfie 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 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. §9116(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) j72 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)]. Asibling 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 +~ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JAMES L. THOMPSON ITEM NUMBER SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 0955 Include the proceeds of litigation and the date the proceeds were received by the estate. AN property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION ~, Sovereign Bank Account no. 1681713268 $135.46 + $.07 accrued interest 2 Commerce Bank Checking Account No. 536884497 $2559.02 + accrued interest $.22 3. Credit One Bank Account No. 4731 9004 5112 4746 Refund due 4 Raymond James Financial Services Account No. 74916094 5 Central Penn (AAA) Travel Insurance Refund 6. Refund for PSU Athletic Tickets 7 Delta Dental, premium Refund 8. FTC, Payment on Lawsuit -Claim # FTCAAC-1192658-9 9. Wyndham Vacation Resorts -Time Share Account No. 000238813398 10. FTC v. Assail/Advantage Capital -Payment on Claim 11. Pa. Income Tax Refund 12. AARP Medical Premium Refund 13. Federal Tax Refund - 2007 Taxes 14. Economic Stimulus Payment TOTAL (Also enter on fine 5, Recapitulation) b $ VALUE AT DATE OF DEATH 135.46 2,835.14 435.04 7,464.05 724.50 384.00 123.66 20.50 0.00 41.15 110.00 309.00 3,217.00 600.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+'(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS ATE OF FILE NUMBER JAMES L. THOMPSON 0955 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Brown's Funeral Home, Funeral Expenses 4,304.50 B. ADMINISTRATIVE COSTS: ~ Personal Representative's Commissions Name of Personal Representative (s) Philip G ThompSOn . Sociat Security Number(s)/E1N Number of Personal Representative(s) 189-36-0404 , Street Address 505 25th Street Cary Huntingdon State PA Zip 16652 . Year(s) Commission Paid: 2008 2. 3. Attorney Fees Scot Q. Gill, Esquire Family Exemption: (If decedent's address is not the same as claimants, attach explanation) Claimant Street Address rltu Relationship of Claimant to Decedent State Zip 4. ~ Probate Fees Glenda Farner Strasbaugh, Register of Wills of Cumberland County 5 I Accountant's Fees 6. ~ Tax Retum Preparers Fees 850.00 850.00 144.00 7. Cumberland County Law Journal, Estate Notice 75.00 8. The Sentinel, Estate Notice 150.64 9. Bank Service Charge 5.50 10. Underpayment of Federal 2006 Taxes 103.00 11. Register of Wills of Cumberland County, Short Certificates 8.00 12. Certified Mailing of 2006 Taxes 11.71 13. Underpayment of Pa 2006 Taxes 17.00 14. United States Treasury, 2006 late interest charge 8.54 15. Register of Wills of Cumberland County- Exemplified copy of recod 40.00 16 Allowance for closing costs 300.00 TOTAL (Also enter on line 9, Recapitulation) S 6.867.89 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8 LIENS ESTATE OF FILE NUMBER JAMES L. THOMPSON 0955 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Estate Information Services, LLX 412.56 Capital One -Mastercard Matter No. 1808244 2. Applied Card -Account No. 4227093712706559 672.42 c/o Weltman, Weinberg & Reis 3 Capital One Bank (Visa Platinum) 226.70 Account No. 4862 3524 7995 1249 Matter No. 1808273 4 Capital One Bank (Mastercard Platinum 84.15 Account No. 5291- 1573-4331-4949 Matter No. 1807964 5. Ford Motor Company, Payment due on repossessed vehicle 14,049.95 6. Aspire, Account No. 416037010055 8446 158.00 7. Phillips & Cohen Associates, Ltd. 320.24 HSB Card Services - Metris - AccountNo.5458001643047362 8. Quantum Imaging & Therapeutic Associates, medical services within 6 months of death 2,104.00 TOTAL (Also enter on line 10, Recapitulation) I S 18 028. (If more space is needed, insert additional sheets of the same size) REV-{513 EX ~a (g!00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JAMES L. THOMPSON na~~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2}j 1. Judith M. Simpson 1107 Apple Drive Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET ll. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I I -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ tlr more space is neetletl, Insert atltlltlonal sheets of the same size) Last Will and Testament I, -- i~ iYl t <~ ~# 1~ c ~~1 p S c ti~r of the City of ~ e_ c ~-c~#~' < < y ~~ u •Z~; County of ~- ~ ~n ~3c~ x.14 ~.~ .~ ,State of ~~ ,,~ ,~, s ,#~l ~~ ,- . , ~ 2 , being of sound mind, and not acting under duress, menace, fraud, or undue influence of any person do hereby make, publish and declare this instrument my last Will and Testament and do hereby revoke any and all other Wills and Codicils heretofore made by me. FIRST: I order and direct that my just debts and funeral expenses, expenses for administration of my estate and any inheritance, State or Federal taxes upon said estate, except those, if any, which are secured by mortgage or deed of trust, shall be paid as soon after my death as may be practical. SECOND: I am a L' '~ '~~' R ~' E~ person. My spouse is ~ ~ ~#6 and area 1 my children either natural or adopted..t ~~ ~~ THIRD: I nominate my spouse as Guardian of my minor children. In the event that my spouse shall predecease me or fails to serve as such Guardian, then I nominate and appoint #8 N I ~~ Guardian of the person and property of my minor children. I further direct that iio bond shall be required. FOURTH: I hereby make the following specific bequests: ~` ~ ~ Cam. _ ~•- ~ a ~• ~. ~ ~ J ~: S v 2c:. ~ G t. C~ I ~ c.. ~`. S' - YV~ ,,` ~ u ~ ~ S + ~'~ ~;'~- S , 11~ Z. ;~ ~' •", R, ~~ S ~ ' c.. y n~ R ..; J ~L tv. ,~ s r1n~~ ~" 1 # 9 F ~ w d s -1- o - T~ d ~- (~ Yy~ti • S ~ w, ~ s ~ w' ~ S ~ ~~ ~ v.~~ Vt1 ~ S p ~,~'~- v ~ P'~v c.t ~-d S -}-V, ~ C.CZ.~ +5 0 ~'~+o~-a~ '~ f~ L Il ,, `' rGLt~L ~,;`~ ~ ~'- VG- rl/, f~~ ~ y~ {~ ~C~ t ~Q.. ~ i rL ~ V trJY r ~. (~4 V J t ~C~t ~/\C~C,~ ~ d FIF~'H: I hereby give, devise and bequeath all of the rest and residue of my estate, ~~ all property ~` over which I have power to dispose to SIXTH: I nominate and appoint ?~~ ` i' i G mil'" f~l 1 V~ ~ ~~~~-L'~~ K as Executor of this ~ti~ill. In the e~~ent that the Executor named abo~ e sh~~il predecease me or fails to ser~~e as such Executor of This titiill, 1. nominate an:i appoint ,. -~ n 1? as Executor. I further direct tE~~at no arpolntee hereunci~r r shall be required to gi~~e an}- bond for the faithful performance of their duties. ='- SEVENTH: I hereby authorize my Executor to exercise all power, rights, discretion and duties deemed necessary for the proper administration and disposition of my estate. >Nt~ tc~~ ~vo ~ I subscribe my name to this Will this #13 day of #14 #15 at ~h1~c~~~ti~c.sb~~~~ P i ~l~ti ~ n, City ~ State #18 Signature On the day written below, ~~ ~+~1 ~ ~ ~' # 19 ~ 'O7 declared to us, the undersigned that this instrument, consisting of 2 pages, was #20 Will and #21 requested us to act as witnesses to it. #22 triere- upon signed this Will in our presence, all of us being present at the same time. We now in #23 presence and in the presence of each other subscribe our names as witnesses. It is our belief that #24 is of sound mind and under no constraint or undue influence whatsoever. We declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed on # at '~ ~ , y Witne ,~ .,.,/~,µ~~(~j/I/ ~~ / Witness #26 , #28 ,- ~,J ~, Addre'~ss ~~ Address -, .- ~ ._ may Witness Address ~ ~' . INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA Z COUNTY OF HUNTINGDON j SS COUNTY, PENNSYLVANIA File Number 2 1 Personal Representative(s) of the Estate of JAMES L. THOMPSON deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end this inventory. 1 verify that the statements made in this Inven- tory are true and correct. f understand that false state- l G ~,~---' ©~- ~~_ Cog ments herein are made subject to the penalties of HILIe~~' . THOMPSON 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) SCOT D . GILL , ESQUIRE (Supreme Court 1. D. No.) 16322 (Address) 200 PENN STREET HUNTINGDON PA 16652 (Telephone) 814 6 4 3 2 4 6 0 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 1107 APPLE DRIVE 9/4/2007 MECHANICSBURG PA 17055 17'7303814 FIGURES MUST BE TOTALED Sovereign Bank Account no. 1681713268 $135.46 + $.07 accrued interest Commerce Bank Checking Account No. 536884497 $2559.02 + accrued interest $.22 Credit One Bank Account No. 4731 9004 5112 4746 Refund due Raymond James Financial Services Account No. 74916094 Central Penn (AAA) Travel Insurance Refund Refund for PSU Athletic Tickets Delta Dental, premium Refund (Attach additional sheets as needed) 135.46 2,835.14 435.04 7,464.05 724.50 384.00 123.66 TOTAL: 16.399.50 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election ofthe.personal representative include the value of each item, but such tigures should not be extended into the total of the Inventory. (See 20 Pq. C.S. § .330t (bJJ ~ -i~ 07 0955 Form RW-09 rev. 10.13.06 ~ ~ - . Continuation of Inventory JAMES L. THOMPSON 21 0 7 0 9 5 5 Decedent Name File Number Page 1 Description of Inventory FTC, Payment on Lawsuit -Claim # FTCAAC-1192658-9 Wyndham Vacation Resorts -Time Share Account No. 000238813398 FTC v. Assail/Advantage Capital -Payment on Claim Pa. Income Tax Refund AARP Medical Premium Refund Federal Tax Refund - 2007 Taxes Economic Stimulus Payment 20.50 0.00 41.15 110.00 309.00 3,217.00 600.00 Subtotal S 4,297.65 Grand Total S 16,399.50 LAW OFFICES GILL Hv MCMANAMON 200 PENN STREET P. O. BOX 383 HUNTINGDON, PA 16652 SCOT D. GILL TELEPHONE scotgillupenn.com 814-643-2460 PETER M. MCMANAMON FAX pmcmanamon~t?penn.com 814-643-3229 August 18, 2008 r -_ , -.~. Glenda F. Strasbaugh, Register c- of Wills of Cumberland County ~'~ One Courthouse Square ~~ Carlisle, PA 17013-3387 ~ ~ ~ __. _,~~ -. RE: ESTATE OF JAMES L. THOMPSON ~-~ Dear Ms. Strasbaugh: Enclosed are two copies of the Pennsylvania Inheritance Tax Return and one copy of the Inventory in the Estate of Jarnes L. Thompson which I would request that you file. Also, I have enclosed a check in the amount of $30.00 which is required to file these documents. If you should require anything further, please let me know. Thank you very much. Very truly ours, ;~ GILL & McM~NAM ~~ BY r,, ~ .C ~~ / Scot D. Gill SDG/sa Enc. ',.3 ~. ~,~'i ~~ m~ ... M 1l ! r„ ~ s .. h iR ~~ '~ ~ ~ r-! ~~ .Y Y.~ ~r..n ... A ~~ ,.,~~ ,. ~; x~a -; r~^~ a~ '~ ~ Q) ~r'~ •~ f f U N r C1 ~ ~ f~ = t ~ ~ ~ ~rN ~~ ~ ~ '~ C~MQ X ~ ~ ~cn~ ~~ LL n , C O a1 U a~ (.~ ~ m ~ k u.{ ~ d 0.. ~ p p„ ~ ~ ~ fi+ r-+ ~ ~ N3 = b ` U ~ C" .~ C G c6 U _. [i. U O t-- - _ t ` ,. ^^ ~~ .: Lam. ~~ _' '` -... _ ''":