HomeMy WebLinkAbout09-10-09 (2)1,505607121
. REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
Po sox 2sosol 2 1 0 9 0 1 5 2
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 0 9 0 1 7 9 1 2 0 1 1 9 2 0 0 9 0 6 2 7 1 9 2 0
Decedent's Last Name Suffix Decedent's First Name MI
R I C H A R D S O N T H E L M A p
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
N O T A P P L I C A B L E
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
4. Limited Estate ~ prior to 12-13-82)
4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum 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 T0:
Name Daytime Telephone Number
D O N A L D F D A V I S E S Q? 1 7 9 0 9 2 ~3 9
Firm Name (If Applicable) C'7 -'
REGISTER , _QEs~QIDLS USE ~
v ~
First line of address _Y' > m ~
P O B O X 2 0 5 ~~r~~ o
Second line of address _~~_ _
` ~ ....
..
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City or Post Office State ZIP Code DATE FILED
N E W K I N G S T O W N P A 1 7 0 7 2
Correspondent's a-mail address:
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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.
SIG RE OF PERSON RES~IB~ ILING ETURN DATE q 9
ADDRESS /~r7 ~ - D
322 VALLEY ROAD, ETTERS, PA 17319
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505607121
1505607121
J~
1505607221
REV-1500 EX
Decedent's Social Security Number
~ecedent'slvame: THELMA P• RICHARDSON 0 0 9 0 1 7 9 1 2
RECAPITULATION
1. Real estate (Schedule A) .................................
2. Stocks and Bonds (Schedule B) ................ . ................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. ~Aertgages ~ Notes Receivable (Schedule D) ........................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 1 3 0 8 6 5 . 0 2
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property
(Schedule G) a Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 3 0 8 6 5, 0 2
9. Funeral Expenses 8~ Administrative Costs (Schedule H) ........ ...... .. 9. 2 9 6 9 . 4 7
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ..... .. 10.
11. Total Deductions (total lines 9 & 10) .................... ..... .. 11. 2 9 6 9 , 4 7
12. Net Value of Estate (Line 8 minus Line 11)
..................
..... , 12.
. 1 2 7 8 9 5 . 5 5
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. 1 2 7 8 9 5 . 5 5
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 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 1 2 7 8 9 5. 5 5 1 s. 5 7 5 5. 3 0
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18 0. 0 0
19. Tax Due .................:.............................. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505607221
5 7 5 5. 3 0
1505607221 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 09 0152
DECEDENTS NAME
THELMA P. RICHARDSON
STREET ADDRESS
1700 MARKET STREET
CITY STATE Zlp
CAMP HILL PA 17011
Tax Payments and Credits:
~~ Tax Due (Page 2 Line 19) (1) 5,755.30
2. Credits/Payments -
A. Spousal Poverty Credit
B. Prior Payments ~ 5,271.21
C. Discount 263.56
Total Credits (A + g + C) (2) 5, 534.77
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5j 220.53
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 220.53
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 : ......................................................... ^ Q
.............
b. retain the right to designate who shall use the property transferred or its income; ........
..................... . ^ 0
c. retain a reversionary interest; or .............................................................................
...................
d. receive the promise for life of either payments, benefits or care? .......................................................
^
^
^X
^X
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? ......... ^
^ O
X^
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 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) (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)J.
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)]. 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)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
- IN REST DENT DECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
THELMA P. RICHARDSON 21 09 0152
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Manning & Napier Fund, Inc. (see attached facsimile dated February 20, 2009, marked 48,218.72
Exhibit "1"and incorporated herein by reference).
2. ABWE Foundation, Inc. WGA #1319 (see attached letter dated January 19, 2009 78,319.05
marked Exhibit "2" and incorporated herein by reference).
3. Integrity Bank checking account#203006659 (see attached letter, marked Exhibit"3" and 1,482.25
incorporated herein by reference.
4. Refund from Manor Care 2,717.00
5. (Refund from Pennsylvania Income Tax I 128.00
6. (Assorted clothing - no value
TOTAL (Also enter on line 5, Recapitulation) I $ 130 865 02
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
SCHEDULE
H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES St
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THELMA P. RICHARDSON 21 09 0152
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Pathemore Funeral Home & Cremation Services, Inc. 408.17
2. Anair Memorials (grave marker) 1,166.00
3. I Lyndon Center, Lydonville, Vermont (internment) 300.00
B. .ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City State Zip
Year(s) Commission Paid:
2, Attorney Fees Donald F. Davis, Esq.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
COY State Zip
Relationship of Claimant to Decedent
4• Probate Fees Cumberland County Register of Wills
5 Accountant's Fees
6. Tax Return Preparer's Fees
7. Cumberland Law Journal
8. The Sentinel
9. Pamela Purrington (reimbursement for flowers for internment)
10. Pamela Purrington (reimburesementfnr pastor and pianist at funeral)
11. Benjamin Barrett - (preparation of DVD of funeral service)
500.00
54.00
75.00
166.30
50.00
200.00
50.00
TOTAL (Also enter on line 9, Recapitulation) I ~
(If more space is needed, insert additional sheets of the same size)
.47
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THELMA P. RICHARDSON 21 09 0152
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Pamela R. Purrington Lineal 40,786.93
322 Valley Road
Etters, PA 17319
2 Gregory N. Richardson Lineal 40,786.93
5641 Bidwell Pkwy #102
Sarasota, FL 34233
3 Jeffrey L. Richardson Lineal 40,786.93
66757 Reilly Road
Gregory MI 48137
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. 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 II -ENTER TOTAL NON-TAXABLE bISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(It more space is needed, insert additional sheets of the same size)
Feb 20 2005 3:33PM HP LRSERJET FRk
PO BOX 162454 • COLUMBUS, OH 43218
p. (800) 466-3853 f. (614) 428-3390
I_i'_ -.~
p. 1
Mann ing & Napier inc. ~~
Fund
,
To: Pam Farrington Frortx Krmberly M. Wood
Fax: 717-774-1919 Pa9~ 1
pF,~ Dah: 02120/09
Ra: Account Vakre Verification ~~
^ lNgent ^ For Review D PMsre Commas! O Please Rap4r ^ Pllease Raey~eN
Ms. Farrington,
Please let this fax serve as cor>finnation of Thelma Rlchardson's TOD account vale as of her date of
death on '1/19/09. The acxo~mt value as of 1119109 was $48,218.72. The price per share was $10.04.
Please let me know iE you have any questions or need anythiig else. Thank you.
Best Regards,
Kimberly M. Wood
Fund Services Assoaate
Distributed by Harming 8~ Napter Invesbr Services, inc.
iM
ASSOCIATION OF BAPTISTS FOR WORLD EVANGELISM
January 19, 2009
To Whom It May Concern:
This letter is to confirm that on this day of January 19, 2009, the date of death of Thelma P.
Richardson, there was an account balance of $78,319.05 with the ABWE Foundation, Inc.
Sinc ly,
h
v~ n
Larry D. Inskeep
Director of Accounting
ABWE Foundation, Inc.
P.O. Box 8585
Harrisburg, PA 17105-8585
Phone: 717-909-2335
MAIL P.O.Box 8585, Harrisburg, PA 17105-8585 PHONE 717-774-7000 FAX 717-774-1919 WEB www.abwe.org
DELIVERIES 522 Lewisberry Road, New Cumberland, PA 17070
CANADA OFFICE 980 Adelaide Street South, Suite 34, London, Ontario, CANADA N6E 1 R3 PHONE 519-690-1009
03/11.!2009 1.4:3 7179015aE~1 _ INTEGRITY BANK
Lt~tegt,~ty
B A N K
PAGE 02/02
On the day of January 19~' 2009, Thelma Richardson's checking account
number 203006659, had an account balance of $1482.25. This balance
reflects any and all transactions and interest payments up to that daft.
Sincerely,
~ ~
Joseph hatter
Customer Sezvice Rep.
Integrity Banl~
... ~...
334>' Marbr Sr.cr4 Goryrp H,II, A4 /71%11 - ~P~rw: 717-9Z0-4900.87T- l• fIAYE17' • Aix: 717-J~D-~XN • wwr. o+te~nir~mk~ulbeerone
ORiGiNAL AT LAIN OFFICE OF
LEAHY & DEhlAtiLT, LLP
178 BRQAQ ST., p.0. BOX $29
CLAREI~4NT, l~lii 03743-f1829
(6O3) 543-3185
~.~~t #~~ a~~ ~e~tan~er~t
of
~C~jeCma ~. ~ticfjarb~on
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I, Thelma P. Richardson, of Clazemont, in the County of Sullivan and State of New
Hampshire, do make this my last will, hereby revoking all earlier ones,. and I dispose of my estate
in the following manner:
1. I direct the payment of all my just debts, funeral expenses and expenses of
administration of my estate.
2. I direct that any legacy and succession tax, inheritance, estate, transfer, or similar tax,
~ whether state or federal or foreign, which shall be imposed on my taxable estate, whether or not
f ,:
` ` passing under this will, or upon any beneficiary or other recipient thereof as a result of my death,
shall be paid out of the residue of my estate as an expense of administration without proration.
3. Mindful of any children and issue of deceased children of mine who may survive me
who are not named or referred to in this will, I make no specific provision for any one of them other
than as herein provided.
4. I may leave a memorandum stating my wishes with respect to the disposition of certain
articles of my tangible personal property, but such memorandum will be simply an expression of my
1
LEAHY 6t DENAUL'i; LLP • ATTORNEYS AT LAW ~ i78 BRQAD STREET • P.O. 80X B29 • CLAREMCNT. NH 03743.0829 • (603) 543.3185
wishes and shall not create any trust or obligation, nor shall it be offered for probate as a part of this
will.
S. All the rest, residue and remainder of my estate, whether real or personal and
wherever situate, I give, devise and bequeath to my husband, C. Ross Richardson.
In the event that my said husband should predecease me, or in the event that our deaths
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should occur simultaneously, or approximately so, or in the same common accident or calamity, or
under any circumstances causing doubt as to which of us survived the other, then I give, devise and
bequeath all the rest, residue and remainder of my estate, whether real or personal and wherever
situate, to my children, Jeffrey Richardson, Pamela Farrington, and Gregory Richardson, all in
equal shares share and share alike. If any of my said children shall have predeceased me said
deceased child's share shall pass to his or her issue, per stapes, and far lack of such issue to my
children then living:
6. An adopted-child in any generation and his issue, including adopted issue, shall have
the same rights under this instrument as if born to the adopting parent and of the same blood.
7. I nominate and appoint my daughter, Pamela Parington, as Executrix of this my last
will. and testament. If she shall not be living at the time of my decease, or if, for any reason, she
shall be unable or unwilling to accept this trust and act as Executrix of this my last will and testament,
I nominate and appoint my son, Gregory Richardson, as the Executor hereof. Except as otherwise
specifically herein limited, my Executrix and her successors shall have all of the powers conferred
on trustees by New Hampshire RSA S64-A, the Uniform Trustees Powers Act, as it exists at the date
of this execution of this ViTiII, which Statute is hereby incorporated by reference.
2
IN WITNESS WHEREOF I have hereunto set my hand and seal this 27`h day of May 2005.
/~ ~'
Thelma P.
Signed, sealed, published and declared by the above-named Thelma P. Richardson as her
last will and testament in our presence who at her request in her presence and in the presence of each
other have hereunto set our names as witnesses the year and date above written.
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3
STATE OF NEW HAMPS~IIRE
COUNTY OF SULLTVAN
We, Thelma P. Richardson, Denise B. Saucier, and Debra Johnson-Melcher, the testatrix
and.the witnesses, respectively, whose names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned. authority that the testatrix signed and
executed the instrument as her Iast will and that she had signed willingly or directed another to sign
for her, and that she executed it as her free and voluntary act for the purposes therein expressed; and
that each of the witnesses, at the request of the testatrix, in her presence, and in the presence of each
other, signed the will as witness and that to the best of their Imowledge, the testatrix was at that time
18 or more years of age, of sound mind and under no constraint or undue influence.
y
Thelma P. Richardson
Testatrix
~~
- ~`
Wit e s `
Witness
Subscribed, sworn to and acknowledged before me by Thelma P. Richardson, the testatrix
and subscribed and sworn to before me by Denise B. Saucier and Debra Johnson-Melcher, the
witnesses, this 27`" day of May 2005.
EXPlRE3 -
DEC:. •?,;_ ?."_~~ _-
f~.~
Notary Public /
DONALD F. DAMS, ESQ.
Attorney and Counselor at Law
P.O. Box 205
New Kingstown, PA 17072
Phone: (717) 909-2339
Fax: (717) 774-1919
September 8, 2009
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013-3387
Re: Estate of Thelma P. Richardson
File No. 21-09-0152
Dear Sir:
Enclosed find an original and two copies of Inheritance Tax Return for the above referred to
estate. Also, enclosed find a check in the amount of $220.53 for the balance due of the
inheritance taxes. Please return a receipt to my office in the enclosed self-addressed, stamped
envelope.
Thank you for your assistance in this matter.
Sinc y
onal .Davis, Esq.
Enclosures
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