HomeMy WebLinkAbout02-03-09 5056041125
REV-1500 Ex (06-05)
C
OFFI
IAL USE ONLY
PA Department of Revenue
County Cade Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 2 1 0 8 0 6 6 2
Hanisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Sociat Security Number Date of Death Date of Birth
2 0 4 0 3 9 3 9 1 0 5 2 9 2 0 0 8 1 0 2 3 1 9 1 6
Decedent's Last Name Suffix Decedent's First Name MI
M C D E R M O N D CAR L S
(If Applicable) Enter Surviving Spause'a Information t3elow
Spouse's Last Name Suffer Spouse's First Name MI
M C D E R M O N D H E L E N F
Spouse's Social Security Number
THIS RETURN MUST BE FILEp IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Retum ^ 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 Retum Required
death after 12-12-82)
to
^X 6. Dew en~p ~ ~i I ^ 7'. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
) (Attach Copy of Trust)
^ 9. Litigation Proceeds Received [] 10. Spousal Poverky Credit (date of death ^ 11. Election to tax under Sec. g113(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 t0:
Name Daytime Telephone Number
W I L L I A M A D U N CAN 7 1 7 2 4 9 7 7 8 0
Firm Name (If Applicable) REGISTER OF WILLS USE ONLY
D U N C A N & H A R T M A N, P C
~'
First line of address
O "'
1 I R V I N E R 0 W ~ ~~ r~T-t - r
Second line of address ~ ~ ~ ~ , } ";
City or Post Office State 21P Code ~~D --'R' - * ' f
- ~ _
--i N
'"~
. `~,
C A R L I S L E P A 1 7 0 1 3 y ~ __
ttv
Correspondent'5 e-mail address: bilidUncan@pa.tlet
Under penalties of perjury, f dedare that i have examined this rNurn, irxAtding acoompar-yk,g schedules and statements, and to the best of my knawrledge and belief,
it is true, coned and complete. Dedaration of preparer ocher than the personal represenfativve rs based on aA in(onnation of which preparer has any knowledge.
SIGNATUR F PERSON j~~NSI~FOR FIG R~'fURN ~`' // DATE
1~ - - :~af~fJ s f /_ ~ 1'l~. ~ 1~,- ,n ~ !'° ~a/_1Z~ ~ - ~"' ~
W BREECHES RD CARLISLE PA 17015
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIE3INAL FORM ONLY
15056041125
Side 1
15056041125
J ~
15056042126
REV-1500 EX Decedent's Social Security Number
Decedents Name: CARL S. MC DERMOND 2 0 4 0 3 9 3 9 1
RECAPITULATION
1. Real estate (Schedule A) ........................................ 1.
2. Stocks and Bonds (Schedule B) .................................. 2.
3. Closely Hekl 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. 6 1 6 6 • 0 1
6. Jointty Owned Property {Schedule F) ^ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) ........................... 8. ~ 1 6 6 • 0 1
9. Funeral Expenses & Administrative Costs (Schedule H) .. ..... .
g
1 9 0
7.
1
4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... .... ... 10.
11. Total Deductions (total Lines 9 8 10) ............. ....... .... ... 11. 1 9 0 7• 1 4
12. Net Value of Estate (Line 8 minus Line 11) ........... ....... .... ... 12. 4 2 5 8 • 8 7
13. Charitable and Govemmentai Bequests/Sec 9113 Trusts for wh ich
an election to tax has not been made (Schedule J) .... ....... .... ... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .... ....... .... ... 14. 4 2 5 8 • 8 7
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.o _ 4 2 5 8. 8 7 15. 0. 0 0
16. Amount of Line 14 taxable
0
0
0
0
0
0
at lineal rate X .0 _ . 16 .
17. Amount of Line 14 taxable
0
0
0
0
0
0
at sibling rate X .12 . 17. .
18. Amount of Line 14 taxable
0
0
0
0
0
0
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
0. 0 0
J
REN-1500 EX ?age 3
Decedent's Complete Address:
File Number
21 08 0662
DECEDENTS NAME
CARL S. MC DERMOND
STREET ADDRESS
2189 NEWVILLE ROAD
CITY
CARLISLE STATE
PA ZIP
17015
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2, CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
3. InterestlPenatty 'rf applicable
D. Interest
E. Penalty
4.
ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval an Page 2, Line 20 to request a refund.
5. If lane 1 + Line 3 is greater than Line 2, enter the difference. Thls Is the TAX t1UE.
A. Enter the interest on the tax due.
0.00
(4) 0.00
(5A}
0.00
B. Enter the total of Une 5 + 5A. This is the BALANCE t)UE. (5B) 0.00
Make Check Payable fo: REG/STEFt OF WILLS, A~ENt
PLEASE ANSWER THE FOLLOWING QUESTION$ 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 ................................................................................................ ^ 0
d. receive the promise for life of either payments, benefits or care? ....................................................... ^ X^
2. ff death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate corrsideration? ....................................................................................... ^
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 Accamt, annuity, or Sher non-probate property which
contains a beneficary designation? .................................................................................................. ^ 0
IF THE ANSWER TO ANY OF THB ABOVE QUESTIONS tS YES, YOU MUSt COMPUTE 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 or for the use of the surviving spouse is zero (0) percent
(72 P.S. §9116 (a) (1.1) (fi)], The statute ~cempt a transfer to a surviving spouse from tax, and the statutory requirem~-ts for disclosure of assets and
filing a ta~c return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2004:
The tax rate imposed on the net value of transfers from a deceased childtwenty-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 dtlkl is zero (0) percent [72 P.S. §9116(aX1.2)].
The tax rate Imposed on the net value of transfers to or for the use of the decedent's lineal benefkiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) (12 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use ~ the decedent's siblings is twelve (12) percent (72 P.S. §9116(a}(1.3)]. A sit>oing is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
(1) 0.00
Total Credits (A + 13 + C) (2) 0.00
Totat Interest/Penalty (D + E) (3)
(5)
REV-1508 EX + (6-98)
scHE®v~E E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
CARL S. MC DERMOND 21 08 0662
Indude the proceeds of 66gation and the date the were received by the estate.
All p-oP~Y lo~Y vrlth right of survivorshs be dlscbsed on ScheduMa F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATN
1. M8T BANK ACCOUNT # 31003917740902 6,166.01
(SEE ATTACHED DOD LETTER]
TOTAL (Also enter on line 5, Recapitulation) I ; 6 166 01
(if more space is needed, insert additSonal sheets of the same size)
REV-1511 EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CARL S. MC DERMOND 21 08 0662
Dells of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME -ADDITIONAL COSTS 816.14
2. HOFMAN-ROTH -DEATH CERTIFICATES 72.00
3. ORGANIST 50.00
4. SOLOIST 50.00
5. MINISTER 100.00
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representative (s)
Soaal Security Number(sUEIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2, AttomeyFees DUNCAN 8~ HARTMAN, PC 700.00
3. Family Exemption: (If decedents address is not the same as claimanCs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS -FILING FEE 104.00
5 Accountants Fees
6. Tax Retum Preparer's Fees
7. REGISTER OF WILLS -FILING FEE 15.00
TOTAL (Also enter on line 9, Recapitulation) I S 1,907.14
(if more space is needed, insert additional sheets Of the same size)
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CARL S. MC DERMOND ~~ no necn
~~~~
RELATIONSHIP TO DECEDENT
AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY fb Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (include ht spousal disUilwtions, and transfers under
S
9116
ec.
(a (1. )2 j
1. HELEN F. MC DERMOND Collateral
2189 NEWVILLE ROAD 100%
CARLISLE, PA 17015
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 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
1.
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET z
(It more space Is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
I, HELEN F. McDERMOND, of West Pennsboro Township, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
1. I direct my executor to pay all of my debts, funeral and administrative expenses as
soon as maybe done conveniently after my decease.
2. I authorize and empower my executor to sell any realty owned by me at my death,
and not specifically devised herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do if living.
3. I devise and bequeath all of my estate of every nature and wherever situate to my
husband, CARL S. McDERMOND, providing he shall survive me by sixty days.
4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my
estate of every nature and wherever situate as follows:
(a) I give certain items of personal property according to a list left with
my substitute executrix.
(b) 50% of the residue is to be divided equally between LYNNETTE C.
LEWIS, LAURI ANN SHERIFF and JAMIE L. KELLY, share and share
alike. If LYNETTE predeceases me, her share shall go to LAURI ANN
and JAMIE. If either LAURI ANN or JAMIE predecease me, their share
shall go to their children, share and share alike.
(c) 25% of the residue is to be divided equally between CARLEE
HAHN and CORY HAHN, share and share alike, but to beheld in Trust
by MANUFACTURERS AND TRADERS TRUST COMPANY, of
Carlisle, Pennsylvania.
(d) 25% of the residue is to be divided equally between SHAUNA
KELLY, BRADY KELLY, SIDNEY ERIN KELLY and KYLIE KELLY,
share and share alike, but to be held in Trust by MANUFACTURERS
AND TRADERS TRUST COMPANY of Carlisle, Pennsylvania, until
they reach the age of eighteen (18) years and then the funds are to be
used for their education, and any remainder is to be distributed to them
upon completion of their education.
5. I nominate and appoint CARL S. McDERMOND to be the executor of this my Last
Will and Testament; he is to serve as such without bond. Should he die before my death,
renounce or refuse to serve for an reason, or die leaving any of my estate unadministered, I
2
nominate and appoint LYNETTE C. LEWIS as substitute executrix, also to serve as such
without bond, with the same powers as are given herein to my executor.
6. I hereby suggest that my personal representative retain the services of Irwin, McKnight
& Hughes as attorneys in the settlement of my estate
IN WITNESS WHEREOF, I have hereunto set my hand and seal this r 3.w day of
August, 2002.
HELEN F. McDERMOND
Signed, sealed, published and declared by HELEN F. McDERMOND, the testatrix
above-named, as and for her Last Will and Testament, in the presence of us, who, at her request,
in her presence and in the presence of each other have subscribed our names as witnesses hereto.
3
ACKNOWLEDGEMENT AND AFFIDAVIT
WE, HELEN F. McDERMOND, MARTHA L. NOEL and JACQUELINE L.
DRAWBAUGH, the testatrix and witnesses respectively, whose names are signed to the
foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that
the testatrix signed and executed the instrument as her last will and that she had signed willingly,
and that she executed it as her free and voluntary act for the purpose herein expressed, and that
each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and
that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of
sound mind and under no constraint or undue influence.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
. SS:
Subscribed, sworn to and acknowledged before me by HELEN F. McDERMOND, the
testatrix, and subscribed and sworn to before me by MARTHA L. NOEL and JACQUELINE
L. DRAWBAUGH, witnesses, this r 3 `' day of August, 2002.
~_ cr~~.
Public
'~'Notariai Seal
Roger B. Irwin, Notary Public
Carlisle Soro, Cumberland County
My Commission Expires Oct. 3, 2004
Ntertd~er,PennsYNaniaAssociationof Notaries
Tp1 HELEN F. McDERM(~ND
1-C~~~ l~'~iLl~' 4111::. ~--~.:.
1~ Q~~6. k 1 / f A
JESSICA R~:E~E - lie: prod -- Date of L~e~tl~ Request
From: DA'I'S ~F I~EAT~-t T.tE~iTTE~TS
'1<'0: REF.S~, JFSSI~C'A
Date: ~!3/~~0~ 3.1 ~3 ~M
Subject: Re: I~rod - L7ate ~}f Ueath Ie.eyuest
Tc~: Jessica ~)3l()~i
Please print a copy for your files.
Flc;asc- find belot~r tIYC date of death balance fc~r:
Carl 5 McDermcmd, social security ~~ ?U4-(}3-a31?1
l .Account # 3100391774t1~42, Balance `~~>OE2.fi3 + accrued interest ~ l(13.1 ~ = $ fi,16Ci.t)1 total
REC<~rils Management /DOD Unii
I~1&.T f3aIlk- "t ~Iid~CSt;aIlCilYlg E~/~1Rt'S important.,'
-==r <JLREESE(~z?intb.c;ot~n> ~12~r'2U()~ 9:~"? p,Nl 1:•=~
Accc~uut Infoni~atiorl
I~atc; of death: Q~i'Z~,r20t)~
Account Number: 31003917?40902
Pr~~duct Typc: Deposit Accc~ttnt
Additional Inturmation SS'~T 2t14039391
Retluest Details
Deli~rer to: P~eiluesfinr
Delivery Qptitrn:;; E-mail
Delivery Detail;;: ~I~I~I°aJ31~.
file:'I~;:~l.locuments and Settui~silE~I'~I~113f~\Local Settirags`~.Temp'~~c-pwis~~48f~Er~1A~A... ~)1 {-~'~~ti;