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Home My WebLink About10-24-08LAW OFFICES OF ZULLINGER -DAVIS PROFESSIONAL CORPORATION JOEL R ZULLINGER HAMILTON C. DAVIS 14 North Main Street Dale F. Shughart, Jr. 20 East Burd Street, Suite 6 Suite 200 of counsel P.O. Box 40 Chambersburg, PA 17201 717-264-6029 Fax:717-264-1884 zuing lx awnearthlink.net Register of Wills Cumberland Courthouse One Courthouse Square Carlisle, PA 17013 October 17, 2008 RE: Estate of Timothy C. Madeiros, Jr. Est. No. 21-07-1048 Dear Sir or Madam: ~-; '~ _:~~._ -_~_, ~v `~ :=- o coo Enclosed herewith please find an inheritance tax return, filed in duplicate. By way of explanation, the decedent was age 15 when he was killed in a motor vehicle accident on October 19, 2007. He, of course, had no will and his intestate heirs are his surviving parents. The net survival action litigation proceeds allocated to the estate by court order are reported on Schedule E. The net distributable estate, passing to the parents of the minor decedent, are at a zero rate, under Section §9116(1.2) of the Inheritance Tax Act, and thus there is not actual inheritance tax liability. I believe this should explain the basis for this return. A check for filing fee in the amount of $15.00 is also enclosed If there are any questions or concerns, please contact me at the Shippensburg office. Thank you. Sincerely yours, J 'Y ` ` Hamilton C. Davis for Zullinger -Davis Professional Corporation Reply to: Hamilton C. Davis P.O. Box 40 Shippensburg, PA 17257 Shippensburg, PA 17257 717-532-5713 Fax:717-530-5222 hamiltondavislawnae,comcast.net ~:~ ~_- p ~ _ , , - ~ o ~~ ~ ~7 c--: ~ _ = n --1 `s ~ f~'i (U ~' _ .s- f 15056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2aosol 21 0 7 10 4 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 185 74 2645 10 19 2007 Decedent's Last Name MADEIROS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Date of Birth 04 28 1992 Suffix Decedent's First Name MI JR. TIMOTHY C 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 Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death pnorto 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date or death aner 12-1z-82) g, Decedent Died Teatete (Attach Copy o} VJilq ~ ~ Decedent Maintained a Llving Trust (Attach Copy of Trust) Q 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and i-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 HAMILTON C. DAVIS 717 532 5713 ~~ Flrm Name (If Applicable) ZULLINGER-DAVIS, PC First line of address P.O. BOX 40 Second line of address City or Post Office SHIPPENSBURG State ZIP Cod REGISTERLLS US~NLY.- -~ ~~ z ~ r-~ --+ -'. t j fV ' -!r " ~ ~~ _..J`~t It9 DA'f~ FILED ~ e PA 17257-0040 Correspondent'se-mail address: hamiltondavislaw~comcast.net Under penalties of perjury, I deGare that I have examined this return, inGuding atxpmpanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeGaration of re arer other than the personal representative Is based on all information of which preparer has any knowledge. SI URE F PERSON ISLE FOR FILING RET DATE TIMOTHY C. MADEIROS /~//7~c1~ 97 QUIG EY ROAD, Newbur , PA 17240 SIGNAT RE PREPARER O HER THAN REPRESENTATIVE ~ DATE Hamilton C. Davis !G~/~ /~ P.O. BOX 40, Shippensburg, PA 17257-0040 Side 1 15056041147 15056041147 J PA Inheritance Tax Return Signature of Additional Fiduciaries I MADEIROS, TIMOTHY CRAIG JR. I FiIL~~NU~ 8BER I 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip KATHLEEN A. MADEIROS 97 QUIGLEY ROAD Newburg, PA 17240 Date ! i' ~ ~ `I ~0~ 15056042148 REV-1500 EX Decedent's Social Security Number DecedenYaName: TIMOTHY CRAIG MADEIROS JR. 185 74 2645 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits & Miscellaneous Personal Pro a p p rty (Schedule E) ................ 5. 2 4 7 7 0 0. 0 0 ~ 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Properly (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 4 7, 7 0 0. 0 0 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 5, 4 2 6. 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11, 5 , 4 2 6 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 4 2 , 2 7 4 . 0 0 13. Charitable and Governmental Bequests/Sec 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. 2 4 2 , 2 7 4 . 0 0 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 .o0 2 4 2, 2 7 4. 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 0 . 0 0 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due .................................................... ................................................................ . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15056042148 15056042148 0.00 0.00 0.00 0.00 0.00 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-1048 DECEDENT'S NAME TIMOTHY CRAIG MADEIROS JR. STREET ADDRESS 97 QUIGLEY ROAD CITY Newburg STATE PA ZIP 17240 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 3. Total Credits (A + B + C) Interest/Penalty if applicable (2) 0.00 D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 0.00 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 :.................................................................................. ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ ^x c. retain a reversionary interest; or .................................................................................................................. ^ ^x 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? ....................................................................................................................... ^ ^x 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. 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 p2 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 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. §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) [72 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)]. 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. Rsv7f0a ex+ (8.98) SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSriVANIA INHERRANCE TA% RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER MADEIROS, TIMOTHY CRAIG JR. 21-07-1048 Indude the proceeds of litigation end the date the proceeds were received by the estate. All propsRy Jolydlyownsd wlfh the Aght of suMvorship must bs dlselosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH WRONGFUL DEATH CLAIM -PROCEEDS OF SURVIVAL ACTION PURSUANT TO COURT ORDER DATED MAY 2008 -SURVIVAL ACTION IS NOT SUBJECT TO INHERITANCE TAX ON A TRANSFER FROM A CHILD 21 YEARS OF AGE OR YOUNGER TO A PARENT HAS A ZERO TAX RATE. DECEDENT WAS 15 YEARS OLD AT TIME OF DEATH. WRONGFUL DEATH PROCEEDS NOT SUBJECT TO INHERITANCE TAXES. 247,700.00 TOTAL (Also enter on Line 5, Recapitulation) I 247,700.00 THE DISTRIBUTIONS PURSUANT TO COURT ORDER ABOVE WERE DISTRIBUTED AS FOLLOW: TIMOTHY C. MADEIROS - $125,000.00 (WRONGFUL DEATH ACTION) KATHLEEN A. MADEIROS - $125,000.00 (WRONGFUL DEATH ACTION) ESTATE OF TIMOTHY C. MADEIROS, JR. - $247,700.00 HAMILTON C. DAVIS, ESQUIRE - $2,300.00 -LITIGATION FEES SEE ATTACHED COPY OF COURT ORDER (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-1161 EX+ (14.88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT. SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MADEIROS, TIMOTHY CRAIG JR. 21-07-1048 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. 1 ADMINISTRATIVE COSTS: 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 5 000.00 See continuation schedule(s) attached 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 a. Probate Fees 250.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 176.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 5,426.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rw•7602 EX+ (8.98) SCHEDULE H-B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MADEIROS, TIMOTHY CRAIG JR. 21-07-1048 ITEM NUMBER DESCRIPTION AMOUNT 1 ATTORNEY FEE -WILLIAM A. ADDAMS, ESQUIRE FOR LITIGATION EXPENSES - 0.00 SHOWN ON COURT ORDER $2,335.00 - NO BALANCE DUE 2 I ATTORNEY FEE -HAMILTON C. DAVIS, ESQUIRE FOR ESTATE ADMINISTRATION I 5.000.00 FEES Subtotal ~ 5,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) Rw•1602 EX+ (8.88) SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MADEIROS, TIMOTHY CRAIG JR. 21-07-1048 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rw•7602 EX+ (6.88) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSriVANIA INHERRANCE TAX RETURN continue RESIDENT DECEDENT ESTATE OF FILE NUMBER MADEIROS, TIMOTHY CRAIG JR. 21-07-1048 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV-1613 EX+ (8-00) SCHEDULE J COMMNHERITANCE TAX RETURN ANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER MADEIR05, TIMOTHY CRAIG JR. 21-07-1 048 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY (Words) ($$$) Do Not ust Tnut s I • TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. ~116(a)(1.2)] 1 KATHLEEN A. MADEIROS Mother of Minor 121,137.00 97 QUIGLEY ROAD Decedent Newburg, PA 17240 2 TIMOTHY C. MADEIROS Father of Minor 121,137.00 97 QUIGLEY ROAD Decedent Newburg, PA 17240 Total 242,274.00 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r 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 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) ~~ , ~~IN ~ RE~~ESTATE ~OF ~TIIv1OTI-IY ~C MADEIROS, JR. ORPHANS COURT DIVISION No. 21-07-1048 - In the Court of Common Pleas Cumberland County Pennsylvania ORDER OF COURT AND NOW, this :•.; i ~ day of May, 2008, in consideration of the attached Petition, the proposed settlement of $250,000 for the Wrongful Death Action and $250,000 or the Survival Action is approved, and the following distribution is directed: Timothy C. Madeiros $125,000.00 Kathleen A. Madeiros $125,000.00 Estate of Timothy C. Madeiros, Jr. $247,700.00 Hamilton C. Davis, Esquire $ 2,300.00 Total $500,000.00 A TRUE COPY FROM ~ ~ 9 ~ :'~ , J RECORt• In Testimony wherof, ! hereuntc set my hand and the seal of said Court at Carlisle, PA j~day of 2048 C rk Orphans CouT- ru erland Cot~r~~ idi10~ 5,ivb•Hdb~ ~0 ;dd~l~ 8~1 ~ 1 ~d g I ~.~L~ ~~+~i It is further ordered that Timothy C. Madeiros and Kathleen A. Madeiros, Administrators of the Estate of Timothy C. Madeiros, Jr., are authorized to execute general releases in favor of the parties and the insurance carriers involved. _. :_ ... _..v .J ... .. I. __ ` 3 ~M Y 1 9 2008 William A. Addams Attorney at Law 43 W. South St. P.O. BOX 261 Carlisle, Pennsylvania 17013-0261 (717} 243-7638 Fax: (717} 243-8955 waddams@earthlink.net May 16, 2008 Mr. and Mrs. Timothy C. Madeiros 97 Quigley Road Newburg, PA 17240 Re: Madeiros v. Larson Date of Accident: 10/19/07 Our File No. 7344 Dear Tim and Kathy: I am enclosing a copy of the Order of Court of May 16, 2008, approving the settlement of all claims. I have submitted the necessary documents to the insurance companies, and we are awaiting receipt of the checks. Sincerely, William A. Addams WAA:a Enclosure cc. Hamilton C. Davis, Esquire Zullinger-Davis 20 E. Burd St., Suite 6 P.o. Box 40 Shippensburg, PA 17257 Dale F. Shughart, Jr., Esquire 10 West High St. Carlisle, PA 17013