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HomeMy WebLinkAbout01-15-10 (2)J 1505607121 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 Box 26oso1 2 1 0 8 0 5 3 6 Harrisburta, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 5 0 9 2 0 0 8 0 9 2 9 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI M C C A R T H Y M A R L E N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW 1. Original Return Q 2. Supplemental Return ~ 3. Remainder Re#um (date of death prior to 12-13-ffi2) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ^X 5. Federal Estate Tax Return Required death after 12-12-82) 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. a) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J A N L B R O W N ? 1 7 5 4 1 5 5 5 0 Fi N If I' bl THIS RETURN MUST BE FILED IN DUPLICATE WItH THE REGISTER OF WILLS nn ame ( App rca e) J A N L B R O W N 8 A S S O C First line of address 8 4 5 S I R T H O M A S C T S T E 1 2 Second line of address City or Post Office H A R R I S B U R G State P A ZIP Code REGISTER O~'~IILLS USE O ~~~ ~ ~~r? C"! ~ ~ i Ta ` :~ r:~~ ~ ILED •• ~.' 1 7 1 0 8 Correspondents e-mail address: BRENDAJLBCcDVERIZON.NET C...) Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knjowledge and belief, it is tru correct and complete. Declaration of preparer other than the personal representatve is based on all information of which preparer has arty knowledge. SI N RE OF PERSO E SIBLE FOR FILIN E URN DATE ],/14/2010 DRESS 73 NAILOR ROAD DILLSBURG PA 17D19 SIGNATURE F ~AEPHE~~ N REPRESENTATIVE PATE 1/14/2010 845 S7F~ THOMAS CT STE 12 HARRISBURG PA 17109 PLEASE USE ORIGINAL FORM ONLY -.~.- _~ _~ _. fi~ ;7 -:-, 1 .3 E~ Side 1 1505607121 1505607121 15015607221 REV-1500 EX DecedenPs Social Security Number ~ecedenrsName: M 'ARLENE MCCARTHY 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) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 2 6 7 7 0 . 5 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6• 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property uested arate Billin Re l ~ Se S h d G 7 ....... p g q ( c e u e ) . 8. Total Gross Assets (total Lines 1-7) ........................... 8. 2 6 7 7 0. 5 4 9. Funeral Ex enses & Administrative Costs Schedule H P ( ) ................ 9. 8 7 0 0 . 0 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 2 D 3 0 . 0 0 11. Total Deductions (total Lines 9 & 10) ........................... 11. 1 0 7 3 0 . 0 6 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 1 6 0 4 0 . 4 8 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 6 0 4 0 . 4 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0 0 0 . (a)(1.2) x.o _ . . 16. Amount of Line 14 taxable 1 6 0 4 0 4 8 7 2 1. 8 2 . at lineal rate X •045 16. 17. Amount of Line 14 taxable 0 ~ 0 17 ~• 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 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 7 2 1. 8 2 Side 2 1505607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 0536 DECEDENTS NAME M ARLENE MCCARTHY STREET ADDRESS 60 Glendale Drive Silver Spring Township CITY STATE ZIP Mechanicsbur PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty ff applicable D. Interest E. Penalty (1) 721.82 Total Credits (A + B + C) (2) 0.00 Total Interest/Penaity (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. (5) 721.82 A. Enter the interest on the tax due. (5A) _ 33.25 B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 755.07 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 : ...................................................................... ^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 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? ......... ^ 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 ff 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) (!2 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 p2 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 + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN R SI DENT DECEDEN RN PERSONAL PROPERTY ESTATE OF FILE NUMBER M ARLENE MCCARTHY 21 08 0536 Indude the proceeds of Iitigatan 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. Coins 54.50 2 PA Department of Revenue; 2008 PA-40 refund 336.00 3 U S Treasury; 2008 1040 refund 6,079.00 4 Verizon health refund 23.46 5 Verizon telephone service refund 9.58 6 1977 Shasta Trailer; VIN A22P006402 -200.00 Valued and reported on original Inher Tax Return at $1,000; subsequently sold for $800; difference of ($200). 7 1984 Honda Motorcycle Spree; VIN JH2AF0603ES005772 -50.00 Valued and reported in error on original Inher Tax Return at $350; should have been $300; difference of ($50). 8 1986 Komfort Trailer; VIN 1 K73KFR27G1002833 3,000.00 Valued and reported on original Inher Tax Return at $2,000; subsequently sold for $5,000; difference of $3,000. 9 Household goods and furnishings 17,518.00 Valued and reported on original Inher Tax Return at $20,205; subsequently sold for $37,723; difference of $17,518. TOTAL (Also enter on line 5, Recapitulation) ~ ; 26.770.54 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER M ARLENE MCCARTHY 21 08 0536 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. 2. 3. 4. 5. 6. ADMINISTRATIVE GOSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commissan Paid: State Zip Attorney Fees Jan L Brown & Associates (actual fee lower than originally reported on ITR) Fatuity Exemption: (If decedents address is not the same as daimant's, attach explanation) Claimant Street Address City State Zip Relatbnship of Claimant to Decedent pr~teFees Register of Wills, Cumberland County; additional fees Accountants Fees Parks & Company; additional fees Tax Return Preparers Fees -725.00 50.00 500.00 7. U S Postal Service; certified mail Form 706 & priority mail Rev-1500 14.45 8 Administrator's ofFce supplies/expenses 1,274.28 Adm expenses incurred in order to preserve assets of estate, as follows: 9 Debra Baseshore Wiest, Tax Collector; real estate tax 2,226.19 10 Erie Insurance; farm liability insurance 213.00 11 Landscape maintenance 625.96 12 Maintenance 525.00 13 Heating oil 1,170.29 14 PPL Electric Utilities 448.86 15 On-site auction held 6/27/09; costs related thereto 2,377.03 TOTAL (Also enter on line 9, Recapitulation) S 8,700.06 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, ~ LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER M ARLENE MCCARTHY 21 08 0536 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursied medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Pa Department of Revenue; PA-40 estimated tax payments -400.00 Reported on original Inher Tax Return at $1,200; actual $800; difference ($400) 2 Estate of Calvin D McCarthy Jr; adjustment; Cessna 150 Plane 7,000.00 See Supplemental Inheritance Tax Return filed 10/26/09; File No. 2107-1044 3 Verizon sickness death benefit; federal tax w/h -4,570.00 Reported on original Inher Tax Return at $4,570; subsequent refund from US Treasury TOTAL (Also enter on line 10, Recapitulation) 15 2 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF M ARLEN E MCCARTHY 21 08 0536 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 [indude outri~ ~ spousal distributions, and transfers under Sec. 9116 a) 1.2 1. Kenneth L McCarthy, son Lineal P.O. Box 564, Enola, PA 17025 25% residue 2 Carolyn L Bishop, daughter Lineal 659 Sawmill Road, Mechanicsburg, PA 17055 25% residue 3 Diane L Cline, daughter Lineal 73 Nailor Road, Dillsburg, PA 17019 25% residue 4 Marilyn LMcCarthy-Wadlinger, daughter Lineal 67 Millers Gap Road, Enola, PA 17025 ~5% residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON EV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS 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 S (If more space is needed, insert additional sheets of the same size) ATTACHMENT TO SUPPLEMENTAL REV-1500 ESTATE OF M ARLENE MCCARTHY FILE NUIWIBER 21 08 0536 We are supplementing the Inheritance Tax Return due to additional information that was discovered when the estate was being reconciled. SUPPLEMENTAL INFORMATION 7~6 F United States Estate (and Generation-Skipping orm Transfer) Tax Return OMB No. 1545-0015 (Rev. August Zoos) Department of the Treasury Estate of a citizen or resident of the United States (see separate instructionsy. Internal Revenue Service To be filed for decedents dying after December 31, 2007, and before January 1, 2009. 1a Decedent's first name and middle initial (and maiden name, if any) 1 b Decedent's last name 2 Decedent's SSN MARY ARLENE ARNOLD MCCARTHY 202-20-3868 0 3 3a County, state, and ZIP code, or foreign country, of legal 3b Year domicile established 4 Date of birth 5 Date of death x residence (domicile) at time of death 19 6 3 9 2 9 19 2 6 5 0 9 0 8 W a CUMBERLAND , PA 17 0 5 0 6b Executor's address (number and street inGUding apartment or suite no.; city, town, ~ '«° 8a Name of executor (see page 4 of the instructions) or post office; state; and ZIP code) and phone no. DIANE L CLINE 73 NAILOR ROAD m ~ 6c Executor's social security number (see page 5 of the instructions) DILLSBURG PA 17 019 ~ 206-38-9776 Phaneno.717-432-4622 i 7d Name and location of court where will was probated or estate administered 7b Case number ~ CUMBERLAND COUNTY REGISTER OF WILLS a ONE COURTHOUSE S ,CARLISLE, PA 17013 2008-00536 8 If decedent died testate check here - and attach a certified co of the will. 9 if ou extended the time to ftle is Form 106 check here - 10 If Schedule R-1 is attached check here - 1 Total gross estate less exclusion (from Part 5-Recapitulation, page 3, item 12) 1 2 , 9 0 8 , 2 2 8 2 Tentative total allowable deductions (from Part 5-Recapitulation, page 3, item 22) 2 18 5 , 5 8 6 3a Tentative taxable estate (before state death tax deduction) (subtract line 2 from line 1) 3a 2 , 7 2 2 , 6 4 2 b State death tax deduction 3b 12 5 , 4 5 4 ................................................................................ c Taxable estate (subtract line 3b from line 3a) 3c 2 , 5 9 7 , 1 8 8 .,. ... ....................................... 4 Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after December 31, 1976, other than gifts that are includible in decedent's gross estate (section 2001(b))) 4 , ... .. 5 Add lines 3c and 4 5 2, 5 9 7, 18 8 ....................................................................................... 6 Tentative tax on the amount on line 5 from Table A on page 4 of the instructions 6 1, 0 4 9 , 5 3 5 ~ 7 Total gift tax paid or payable with respect to gifts made by the decedent after December 31, 1976. Include Ift taxes b the decedent's s Ouse for such s Ouse's share of s lit Ifts section 2513 onl if 9 Y P P P 9~ ( ) Y a the decedent was the donor of these gifts and they are includible in the decedent's gross estate (see c instructions) 7 o' ......................................................................................... 8 Gross estate tax (subtract line 7 from line 6) .................................................. ........... 8 1 049 535 ~ X ~ 9 Maximum unified credit (applicable credit amount) against estate tax 9 7 8 0 , 8 0 0 ~ ` ' N 10 Adjustment to unified credit (applicable credit amount). (This adjustment ~ may not exceed $6,000. See page 6 of the instructions.) .. .. .. ... .. .. 10 0 ` ~' a .. . ...... ... ....... . .. .. 11 Allowable unified credit (applicable credit amount) (subtract line 10 from line 9) .. 11 7 8 0 8 0 0 . . 12 Subtract line 11 from line 8 (but do not enter less than zero) ................................................. 12 2 6 8 , 7 3 5 13 Credit for foreign death taxes (from Schedule(s) P). (Attach Form(s) 706-CE.) ................................................... ............... 13 `, .:: 14 Credit for tax on prior transfers (from Schedule Q) ... ........... . ... . . . . . . . . . 14 '' 15 Total credits (add lines 13 and 14) 15 ..................................... 16 Net estate tax (subtract line 15 from line 12) 16 2 6 8 , 7 3 5 _ 17 Generation-skipping transfer (GST) taxes payable (from Schedule R, Part 2, line 10) 17 18 Total transfer taxes (add lines 16 and 17) 18 2 6 8 , 7 3 5 19 Prior payments. Explain in an attached statement SEE STMT 1 19 263 , 946 .......................................................... 20 Balance due or ove a ment subtract line 19 from line 18 ................................................ 20 4 7 8 9 Under penalties of perjury, I deGare mat I have examined this return, inGutling accomparrymg echetlules antl statements, antl to the best or my knowledge and belief, it is We, correct, and complete. Declaration of prepares other than the executor is based on all information of which preparer Sign ~ - ~~~~~ Here DIANE L CLINE ~~ ~ .C~~.ivr~C , C~_ l,_ _ Signature of executor , Date Signature of executor ' Date Preparer's Date Preparers SSN or PTIN Paid signature DARYL R WSBBER , CPA ~ - " .?cEf /~ ~mpbyed IF ^ P 0 0 0 0 7 9 9 4 Preparer's pARKS & COMPANY EIN - 3 0- 0 5 0 3 0 9 3 Use Only Firm's name (or yours if self-employed),' 815 E ARCH ST .Phone no. address, and ZIP code pALMYRA, PA 17 0 7 8 717 - 8 3 8 - 2 3 87 For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the separate instructions for this form. Form 706 (Rev. a-2oo8) DAA Decedent's Social Security Number Estate of: ~Ry ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 Pert ~Fler_tinnc by the FYpr_utnr Please check the "Yes" or "No" box for each question (see instructions beginning on page 6). Note. Some of these elections ma re uire the stin of bonds or liens. Yes No 1 Do ou elect alternate valuation? .......................................................................................... 1 X 2 Do you elect special-use valuation? X If "Yes " ou must corn lete and attach Schedule A-1. 2 ........... .......... 3 Do you elect to pay the taxes in installments as described in section 61667 ................................................... X If "Yes," you must attach the additional information described on pages 10 and 11 of the instructions. Note. By electing section 6166, you may be required to provide security for estate tax deferred under section 6166 and interest in the form of a sure bond or a section 6324A lien. 3 4 Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described in section 6163? ............................................................................................................ 4 X Paft 4-Gettefal (flfofRlatlOn (Note. Please attach the necessary supplemental documents. You must attach the death certificate.) (see instructions on page 12) Authorization to receive confidential tax information under Regs. sec. 60t.5114(b)(2)(i); to aet as the estate's representative before the IRS; and to make written or oral resentations on behalf of the estate if return re ared b an attom ,accountant, or enrolled a nt for the executor. Name of representative (print or type) State Address (number, street, and room or suite no., city, state, and ZIP code) 815 E ARCH STREET DARYL R WEBBER, CPA PA PALMYRA PA 17078 I deGare that I am the attorney/ X certified public accountant/ enrolled agent {you must check the applicable box) for the executor and prepared this return for the executor. I am not under suspension or disbarment from practice before the Internal Revenue Service and am qualified to practices in the state shown above. Signature ~ ~ nA / CAF number Date Telephone number V'"'' 2605-46635R 'S ~ a o/° 717-838-2387 1 Death certi number and issuing authority (attach a copy of the death certificate to this return). P145 06 COMMONWEALTH OF PENNSYLVANIA 2 Decedent business or occupation. If retired, check here - ~X~ and state decedent's former business or occupation HOMEMAKER 3 Marital status of the decedent at time of death: 8 Married X Widow or widower-Name, SSN, and date of death of deceased spouse -... 9 / 2 5 /.0 T CALVIN D MCCARTHY 162-22-0400 ........................................................................................................................................ Single Legally separated 4a Surviving spouse's name 4b Social security number ~ 4c Amount received (see page t2 of the instructions) S i.,n~„u„dam /nNur Min Nu e,,.vn.inn e.w ~m1 M ieM iv nfhnr nefnx uihn roroivn honafite frnm tha xfatw IM nn1 inrlu/ta rfiaritahln MruRrriariae chrrun in Ghnrlulw (11 recta ineh 1 Name of individual trust or estate receivin $5 000 or more tdenti in number Relationshi to decedent Amount see instructions DIANE L CLINE KENNETH L MCCARTHY CAROLYN L BISHOP MARILYN L MCCARTHY-WADLINGER 206-38-9776 206-38-9774 206-38-9775 206-38-9777 DAUGHTER SON DAUGHTER DAUGHTER 582,113 582,113 582,113 582,113 All unascertainable beneficiaries and those who receive less than $5 000 ... ......................... ..................... - Total ............................................................................................................... .. 2 3 2 8, 4 5 2 Please check the "Yes" or "No" box for each uestion. Yes No 6 Dces the gross estate contain any section 2044 property (qualified terminable interest property (QTIP) from a prior gift or estate) see a e 12 of the instructions ? ................................................................................................ X Ta Have federal giR tax returns ever been filed? X If "Yes," lease attach co ies of the returns, if available and furnish the followin information: 7b Period s covered 7G Intem~ Revenue office s where filed 8a Was there an insurance on the decedent's life that is not inGuded on the return as art of the ross estate? ....... . . .. . ....... . ....... X b Did the decedent own an insurance on the life of another that is not included in the ross estate? ................. X (continued on next page) Page 2 DAA Form 706 (Rev. 8-2008) MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6$ Part 4-General Information (continued) If ou answer "Yes" to an of uestions 9-16, ou must attach additional information as described in the instructions. Yes No 9 Did the decedent at the time of death own any property as a joint tenant with right of survivorship in which (a) one or more of the other joint tenants was someone other than the decedent's spouse, and (b) less than the full value of the property is inGuded on the return as art of the ross estate? If "Yes " ou must corn lete and attach Schedule E ........ . .............. ................. X 10a Did the decedent, at the time of death, awn any interest in a partnership (for example, a family limited partnership), an unincorporated business or a limited liabili corn an ~ or own an stock in an inactive or close) held co ration? .............................. ................. X b If "Yes," was the value of any interest owned (from above) discounted on this estate tax return? If "Yes "see the instructions for Schedule F on a e 20 for re ortin the total accumulated or effective discounts taken on Schedule F or G ..........:................. X 11 Did the decedent make any transfer described in section 2035, 2036, 2037, or 2038 (see the instructions for Schedule G beginning on a e 15 of the se arate instructions ? If "Yes " ou must corn lete and attach Schedule G ........................................ X 12a Were there in existence at the time of the decedent's death an trusts created b the decedent Burin his or her lifetim ? ............... X b Were there in existence at the time of the decedent's death any trusts not created by the decedent under which the decedent ossessed an over beneficial interest ortrusteeshi ? .......................................................................... X c Was the decedent receiving income from a trust created after October 22, 1986 by a parent or grandparent? X If "Yes "was there a GST taxable termination under section 2612 u on the death of the decedent? .................................. X d If there was a GST taxable termination (under section 2612), attach a statement to explain. Provide a copy of the trust or will creatin the trust and ive the name address and hone number of the current trustees . e Did the decedent at any time during his or her lifetime transfer or sell an interest in a partnership, limited liability compamy, or . . . . . . . ... . . . ... . ........ closely held corporation to a trust described in question 12a or 12b? X ......... ... ... . .. ... . .. . . . ... . . . If "Yes " rovide the EIN number to this transfercedlsold item. - ......... ........... .......... .......... 13 Did the decedent ever ssess exerase or release an eneral of a 'ntment? If'Yes " ou must lete and attach Schedule M . .............. X 14 Did the decedent have an interest in or a signature or other authority over a financial account in a foreign country, such as a bank account securities account or other financial account? ..................................................... ................ X 15 Was the decedent, immediately before death, receiving an annuity described in the "General" paragraph of the instructions for Schedule I or a rivate annul ? tf "Yes " ou must corn lete and attach Schedule I ................................. . ................ X 16 Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of apre-deceased spause under section 2056(b~(7) and which is not re orted on this return? If "Yes "attach an ex lanation .................... ................ X Part 5-Recapitulation Item no. Gross estate Alternate value Value at date of death 1 Schedule A-Real Estate 1 0 0 2 Schedule B-Stocks and Bonds 2 1, 2 0 0 , ~ 0 0 1, 411, 4 21 3 .................................................... Schedule C-Mortgages, Notes, and Cash 3 0 0 4 ... Schedule D-Insurance on the Decedent's Life (attach Form(s) 712) 4 0 0 5 Schedule E-Jointly Owned Property (attach Form(s) 712 for life insurance) 5 0 0 6 Schedule F-Other Miscellaneous Property (attach Form(s) 712 for life insurance) 6 13 3 217 13 3 , 217 7 Schedule G-Transfers During Decedent's Life (att. Form(s) 712 for life insurance) 7 1, 4 3 4, 4 8 6 1, 4 3 4, 4 8 6 8 Schedule H-Powers of Appointment 8 0 0 9 ............................................... Schedule 1-Annuities ............................................................. 9 13 9 6 2 5 13 9, 6 2 5 10 Total ross estate add items 1 throw h 9 ........................................... 10 2 9 0 8, 2 8 3, 1 1 8 7 4 9 11 Schedule U-Qualified Conservation Easement Exclusion 11 0 0 12 ............................ Total gross estate less exclusion (subtract item 11 from item 10). Enter here and on line 1 of Part 2-Tax Com utation ........................................... 12 2 , 9 0 8 2J 2 8 3 , 118 , 7 4 9 Item no. Deductions Amount 13 Schedule J-Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims 13 172 , 137 14 Schedule K-Debts of the Decedent 14 13 , 4 4 9 15 .................................................. Schedule K-Mortgages and Liens .......... ............ 15 16 ................................................... Total of items 13 through 15 .......... ............ 16 1 8 5 , 5 8 6 17 .................................................. Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recap itulation) _ 17 18 5 , 5 8 6 18 Schedule L-Net Losses During Administration .. ............ 18 19 Schedule L-Expenses Incurred in Administering Property Not Subject to Claims _ 19 20 Schedule M-Bequests, etc., to Surviving Spouse 20 21 Schedule O-Charitable Public and Similar Gifts and Be nests .. ...................... .. . .. .......... . .. . ....... .......... 21 22 Tentative total allowable deductions add items 17 throw h 21 . Enter here and on line 2 of the Tax Com utation .. 22 18 5 5 8 6 Page 3 DAA Form 706 (Rev. 8-2008) Decedent's Social Security Number Estate ,of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 SCHEDULE 6-Stocks and Bonds (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.) Item Descdption, including face amount of hoods or number of shares ~ par value for identification. Give CUSIP number. If trust, CUSIP number or EIN, Unit value Alternate ARemate value Value at date of number h' , a cbsel heW anti ive EfN where applicable valuation date death 1 746 SS - ALCATEL-LIICENT (ALII 013904-305 6.990 5,215 cot4MON - soLD 9-4-08 5.362 9/04/08 4,000 2 10,000 SH - A T at T (T) 00206R-102 38.580 385,800 COMMON - SOLD 9-04-08 31.820 9/04/08 318,228 3 13,895.73 SIi - A T ~ T (T) 00206R-102 38.580 536,099 COMMON - SOLD 9-08-08 31.704 9/08/08 440,530 4 3, 034 Sti - COMCAST CORP (CMCSA) 20030N-101 21. 81.0 66, 172 COMMON - SOLD 9-04-08 21.180 9/04/08 64,260 5 150 SH - PAZRPOINT COMM (FRP) 30556010 9.000 1,350 COMMON - SOLD 9-26-08 8.552 9/26/08 1,324 6 428 SH - IDEARC INC (IAR) 451663-108 4.930 2,110 COMMON - SOLD 9-04-08 1.622 9/04/08 694 7 239 S& - LSI CORD (LSI) 502161-102 6.660 1,592 COMMON - SOLD 09-04-OB 6.192 9/04/08 1,480 8 368 SH - NCR CORP (NCR) 62886E-108 24.800 9,126 cornKON - soLD 9-04-08 24.954 9/04/08 9,1s3 9 1,044 SIi - QwEST COMM (Q) 749121-109 4.810 5,022 coMMON - soLD 9-04-08 3.952 9/04/08 4,126 DIVIDEND PAID 5-9-08 5/09/08 B4 84 10 36a S8 - TERADATA CORP (TDC) 88076W-103 23.540 e, 663 coMMON - soLD 9-04-08 23.052 9/04/08 e,4s3 11 922 SH - vERIZON COMM (vz) 92343V-104 37.850 34,898 cot4rtoN - soLD 9-04-08 34.552 9/04/08 31,as7 12 8,000.42 sx - vsxxzoN coMM (vz) 92343V-104 37.850 3o2,els coMMON - soLD 9-08-08 34.637 9/08/08 277,1oa 13 1,666.926 SH - VODAFONE GR(voD) 92857W-209 31.480 52,475 COMMON - SOLD 9-08-08 23.722 9/08/8 39,543 Total from continuation schedules (or additional sheets) attached to this schedule . TOTAL. (Also enter on Part 5--Recapitulation, page 3, at item 2.) ... ... ................................. lr 200, 900 1, 411.421 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule B are in the separate instructions.) Schedule B-Page 12 oAA THERE ARE NO CONTINUATION SCHEDULES ATTACHED Decedent's Social Security Number Estate.of: MARY ARLENE MCCARTHY 2 0~- 2 0- 3 8 6 8 SCHEDULE F-Other Miscellaneous Property Not Reportable Under An!y Other Schedule (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E_) (If you elect section 2032A valuation, you must complete_Schedule Fand Schedule A-1.) 1 Did the decedent at the time of death own any works of art or items with collectible value in excess of $3,000 or Yes No any collections whose artistic or collectible value combined at date of death exceeded $10,000? ........................................ X If "Yes "submit full details on this schedule and attach a raisals. 2 Has the decedent's estate, spouse, or any other person, received (or will receive) any bonus or award as a result of .......... ...:..::: the decedent's employment or death? X If "Yes "submit full details on this schedule. 3 Did the decedent at the time of death have, or have access to, a safe deposit box? X If "Yes," state location, and if held in joint names of decedent and another, state name and relationship of joint depositor. If any of the contents of the safe deposit box are omitted from the schedules in this return, explain fully why omitted. Item Description. For securities, give CUSIP number. If trust, partnership, or Altemate number cosely held entity, give EIN valuation date Altemate value Value at date of death CUSIP number or EIN, where applicable 1 2007 IRS REFUND 5/23/08 5, 036 5, 036 2 STIMULUS REBATE CHECK 7/ 0 3/ 0 8 1, 2 0 0 1, 2 0 0 3 VERIZON 6/1 PENSION PAYMENT 6/01/08 1, 043 1, 043 4 VERIZON PENSION BENEFIT 9/01/08 45, 700 45, 700 5 ALLI S- CHALMERS TRACTOR - SOLD 11 j 0 9/ 0 8 3, 0 0 3, 4 0 0 6 1953 cADILLAC coNV couPE 11/01/08 20, p00 20, 000 VIN 536294872 - SALE PROC88DS 7 1975 YAMAHA MOTORCYCLE 11/09/08 340 300 VIN 437114639 8 1977 SHASTA TRAILER 11/09/08 1, 000 1, 000 VIN A22P006402 9 19 8 2 CHEVROLET CHEVETTE 11 / 0 9/ 0 8 1, 0 0 0 1, 0 0 0 VIN 1G1AB68D6CY104614 - SOLD 10 1983 MERCEDES 30oDT 11/01/08 4, 000 4, 000 VIN WDBAB33A6D8020413 - SOLD 11 19 8 4 HONDA MOTORCYCLE 11 / 0 9/ 0$ X 5 0 3 5 0 VIN JH2AF0603ES005772 - SOLD 12 19 8 5 PLYMOUTH HORIZON 7/ 0 8/ 0 8 4 9 0 4 9 0 VIN 1P3BM18C7FD166731 - SOLD 13 1986 KOMFORT TRAILER 7/08/08 4,750 4,750 VIN 1K73KFR27G1002833 14 HOUSEHOLD GOODS - SOLD 10 / 0 1 / 0 8 2 2, 7 2 3 2 2, 7 2 3 15 HOUSEHOLD GOODS & FURNISHING 11 / 0 9 / 0 8 15 , Q 0 0 15 , 0 0 0 16 CAROYLN MCCARTHY 5/ 0 9/ 0 8 6i 2 0 6 2 0 17 COMCAST - DIVIDEND 5/09/08 39 39 18 COMCAST - DIVIDEND 5 / 0 9 / 0 8 151 151 19 2008 IRS REFUND 11/09/08 6, 079 6, 079 20 2008 PA DEPT REVENUE - REFUND 11/09/08 3'36 336 Tota l from continuation schedules or additional sheets attach ed to this schedule . ............. . TOTAL. Also enter on Part 5-Reca itulation a e 3 at item 6 . .............................. 13 3 217 13 3 , 217 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) DAA THERE ARE NO CONTINUATION SCHEDULES ATTACHED Schedule F-Page 19 Decedent's Social Security Number Estate.of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 SCHEDULE G-Transfers During Decedent's Life (If you elect section 2032A valuation, you must complete Schedufe G and Schedule A-1.) Item number Description. For securities, give CUSIP number. If trust, partnership, or Gosely held entity, give EIN Alternate valuation date Alternate value Value at date of death A. Gift tax paid or payable by the decedent or the estate for all gifts made by the decedent or his or her spouse within 3 years before the decedent's death (section 2035(b)) X X X X X .. .. , B. Transfers includible under section 2035(a), 2036, 2037, or 2038: THE M ARLENE MCCARTHY LIVING TRUST CREATED MARCH 20, 2008 1 PERSONAL RESIDENCE & FARM LAND 11/09/08 1,150,000 1,150,000 91.45 ACRES - 60 GLENDALE DRIVE SILVER SPRING TOWNSHIP CUMBERLAND COUNTY, PA 2 BELCO - MONEY MARKET ACCT 93,314 ACCT # 0197?0 11/09/08 93,314 3 BELCO - SAVINGS ACCT 95,773 ACCT # 019780 11/09/08 95,773 4 M & T BANK - CHECKING ACCT 91,900 ACCT # 11/09/08 91,900 5 M& T BANK - C D 3,331 ACCT # 031003915257066 11/09/08 3,331 ACCRUED INTEREST 5 09 08 168 168 THERE ARE NO CONTINUATION SCHEDULES ATTACHED Tota l from continuation schedules (or additional sheets) attached to this schedule . ............. . TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 7.) .............................. ~ 1, 4 3 4 , 4 8 6 ~ 1, 4 3 4 , 4 $ 6 SCHEDULE H-Powers of Appointment (Include "5 and 5 lapsing" powers (section 2041(b)(2)) held by the decedent.) (If you elect section 2032A valuation. you must complete Schedule H and Schedule A-1.) Item I Descri lion I Alternate I Alternate value I Value at date of death number p valuation date THERE ARE NO CONTINUATION SCHEDULES ATTACHED m continuation schedules /or additional sheets) attached to this schedule .............. . TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 8.) .............................. ~ 0~ 0 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) {The instructions to Schedules G and H are in the separate instructions.) Schedules G and H-Page 21 DAA Decedent's Social Security Number Estate. of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 SCHEDULE I-Annuities Note. General) , no exclusion is allowed for the estates of decedents d in after December 31 1984 see a e 17 of the instructions . A Are you excluding from the decedent's gross estate the value of a lump-sum distribution described in section Yes No . . . 2039(f)(2} (as in effect before its repeal by the Deficit Reduction Act of 1984)? X . . . .. . . . .. . ... .. .. If "Yes " ou must attach the information re uired b the instructions. Item number Description. Show the entire value of the annuity before any exGusions Alternate valuation date Includible alternate value Incudible value at date of death 1 GREAT AMERICAN LIFE INSURANCE CO 29,356 QUALIFIED ANNUITY POLICY 11/09/08 29,356 POLICY 80508960 2 GREAT AMERICAN LIFE INSURANCE CO 54,433 NON-QUALIFIED ANNUITY 11/09/08 54,433 POLICY 06541248 3 SHENANDOAH LIFE INSURANCE CO 55,836 NON-QUALIFIED ANNUITY 11/09/08 55,836 POLICY 001058871 Tota l from continuation schedules or additional sheets attached to this schedule . ............. . TOTAL. Also enter on Part 5-Reca itulation a e 3 at item 9 . .............................. 13 9 6 5 13 9 , 6 2 5 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) Schedule I-Page 22 (The instructions to Schedule 1 are in the separate instructions.) DAA THERE ARE NO CONTINUATION SCHEDULES ATTACHED I Decedent's Social Security Number Estate,of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 SCHEDULE J-Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims Note. Do not list on this schedule expenses of administering property not subject to claims. For those expenses, see the instructions for Schedule L. If executors' commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in computing the taxable income of the estate for federal income tax purposes. They are allowable as an income tax deduction on Form 1041 if a waiver is filed to waive the deduction on Form 706 (see the Form 1041 instructions}. Itnom ~ Description I Expense amount f Total amount A. Funeral expenses: MYERS FUNERAL HOME 8,'120 GINGRICH MEMORIALS 3,'.300 ROYERS FLOWERS 320 Total funeral expenses - ~ 11, 7 4 0 ............................................. B. Administration expenses: 1 Executors' commissions- PAID (Strike out the words that do not apply.) .... 5 8, 0 0 0 2 Attorney fees- PAID (Strike out the words that do not apply.) 71, 2 7 5 ....................... 3 Accountant fees- AGREED UPON (Strike out the words that do not apply.) 2 , 3 5 0 4 Miscellaneous expenses: Expense amount REGISTER OF WILLS 1, 67 CUMBERLAND LAW JOURNAL - LEGAL ADVE 75 PATRIOT NEWS - LEGAL ADVERTISING 304 DON SHEATER REAL ESTATE APPRAISAL 2,500 SMITH BARNEY - COMMISSIONS 7,272 ANIMAL CARE 428 DEBRA WEIST - REAL ESTATE TARE 3,959 ERIE INSURANCE 426 STAPLES - OFFICE SUPPLIES 1,23 LAWN CARE & LANDSCAPE 5,36 HOME DEPOT 1,060 PPL - ELECTRIC X61 KEVIN M WICKARD AUCTIONEERING 2,477 HEATING OIL COSTS 1,170 US POST OFFICE - MAILING FEES 14 Total miscellaneous expenses from continuation schedules (or additional sheets) Total miscepaneous ex enses ................................................................................ - 2 8 , 7 7 2 TOTAL. (Also enter on Part S--Recapitulation. oaae 3. at item 13.1 '- 17 2.137 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule J-Page 23 DnA THERE ARE NO CONTINUATION SCHEDULES ATTACHED Decedent's Social Security Number Estate.of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 SCHEDULE K-Debts of the Decedent, and Mortgages and Liens Item number Debts of the Decedent-Creditor and nature of claim, and allowable death fazes gmount un aid to date P Amount in contest Ama dedUaction as 1 CHECK 3269 - WRITTEN PREDEATH 126 2 CHECK 3270 - WRITTEN PREDEATH 28 3 CHECK 3265 - WRITTEN PREDEATH 5,304 4 COMFORCARE - MEDICAL 55 5 HOLY SPIRIT HOSPITAL 55 6 PA DEPT OF REVENUE 800 7 PINNACLE HEALTH SERVICES 23 8 PPL - ELECTRIC 58 9 ESTATE OF CALVIN MCCARTHY, CESSNA 7,000 ADJUSTMENT PER PA ITR THERE ARE NO CONTIN UATION SCHEDU LES ATTACHED Tot al from continuation schedules or additional sheets attached to this sc hedule ................. ................... .. . TOTAL. Also enter on Part S--Reca itulation a e 3 at item 14 . ...................................................... 13 44 9 Item number Mortgages and Liens-Description Amount THERE ARE NO CONTINUATION SCHEDULES ATTACHED nation schedules (or additional sheets) attached to this schedule TOTAL. (Also enter on Part 5-Recapitulation, pace 3, at item 15.) ...................................................... ~ 0 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule K are in the separate instructions.) Schedule K-Page 25 DAA I 202-20-3868 Federal Statements ~ Statement 1 -Form 706. Part 2. Line 19 - Payment Explanation Description PAID WITH ORIGINAL FORM 706 SUPPLEMENTAL INFORMATION FORM 706 MARY ARLENE MCCARTHY SSN 202-20-3868 We are amending the original Form 706, due additional information that was discovered when the attorney was reconciling the estate. An amended Inheritance Tax Return has been filed the Pennsylvania Department of Revenue. The following changes were made: Schedule B - no changes Schedule F -adding $26,683 in value # 13 - 1986 Komfort Trailer -added $2,750 -adjusted to correct sale pride # 14 -Household Goods -added $17,518 -adjusted to correct sale price # 19 - 2008 IRS Refund -Added $6,079 - 1040 filed after original 706 was filed #20 - 2008 PA Refund -Added $336 - PA-40 filed after original 706 wa$ filed Schedule G - no changes Schedule I - no changes Schedule J -adding $8,698 in expenses Attorney Fees -lowered by $725 -actual expenses less than projected Accounting Fees -added $500 -additional fees needed Register of Wills -added $50 -additional filing fees Debra Weist -added $2,226 -missed real estate taxes paid by estate Erie Insurance -added $213 -missed insurance paid by estate Staples -added $1,274 -missed expenses paid by estate Lawn Care -added $626 -missed expenses paid by estate Home Depot -added $525 -missed expenses paid by estate PPL -added $448 -missed expenses paid by estate Kevin Wickard -added $2,377 -cost paid to auctioneer missed Heat Oiling -added $1,170 -missed expenses paid by estate US Post Office -added $14 -missed expenses paid by estate Schedule K -added $6,600 in expenses #6 - Pa Dept of Revenue -reduced by $400 corrected estimated payments made to PA #9 -Estate of Calvin -added $7,000 -missed item owed by decedent and paid by estate Form 706 -Line 3b -added $743 -additional amount paid to PA Department of Revenue ~. /~ Form 7~6 United States Estate (and Generation-Skipping Transfer) Tax Return MB N sas-oo,s (Rev. August zoos) Department of the Treasury O Estate of a citizen or resident of the United States (see separate instruct s . Internal Revenue Service To be filed for decedents dying after December 31, 2007, and before Janua , 20 9. 1a Decedent's first name and middle initial (and maiden name, if any) 1b Decedents last name 2 DecedeM's SSN ` MARY ARLENE ARNOLD MCCARTHY 202-20-3868 o ~ 3a County, state, and ZIP code, or foreign country, of legal 3b Year domicile established 4 Date of birth 5 Oate of death x residence (domicile) at time of death 19 6 3 9 2 9 19 2 6 5 0 9 0 8 w ~ CUMBERLAND , PA 17 0 5 0 6b Executor's address (number and street inGrlding apartment or suite no.; city, town, ~ :°. 6a Name of executor (see page 4 of the instructions} or post office; state; and ZIP code) and phone no. ,`, DIANE L CLINE 73 NAILOR ROAD ~ 8e Executor's social security number (see page 5 of the instructions) DILLSBURG PA 17 019 c 206-38-9776 Phaneno.717-432-4622 i 7a Name and location of court where will was probated or estate administered 7b Case number r, CUMBERLAND COUNTY REGISTER OF WILLS a ONE COURTHOUSE S ,CARLISLE, PA 17013 2008-00536 8 If decedent died testate check here - and attach a certified co of the will. 9 If ou extended the time to file his Form 706 check here - 10 If Schedule R-1 is attached check here - ', 1 Total gross estate less exclusion (from Part 5-Recapitulation, page 3, item 12) 1 2 , 8 81 , 54 5 . _ 2 Tentative total allowable deductions (from Part 5-Recapitulation, page 3, item 22) ~, 2 17 0 , 2 8 8 ~ 3a Tentative taxable estate (before state death tax deduction) (subtract line 2 from line 1) 3a 2 , 711 , 2 5 7 .. b State death tax deduction 3b 12 4 , 711 ... , . .. ................................................................... c Taxable estate (subtract line 3b from line 3a) 3c 2 , 5 8 6 , 5 4 6 .. ......................... . .. . ....... . . ..... 4 Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after December 31, 1976, other than gifts that are includible in decedent's gross estate (section 2001(b)}) 4 . 5 Add lines 3c and 4 5 2, 5 8 6, 54 6 ....................................................................................... 6 Tentative tax on the amount on line 5 from Table A on page 4 of the instructions 8 1 , 0 4 4 , 7 4 6 ~ 7 Total gift tax paid or payable with respect to gifts made by the decedent after December 31, 1976. Include gift taxes by the decedent's spouse for such spouse's share of split gifts (section 2513) only ff a the decedent was the donor of these gifts and they are includible in the decedent's gross estate (see c instructions) 7 v .... ............................................................... .......................... 8 Gross estate tax (subtract line 7from line 6) ............................................................. 8 1, 0 4 4, 7 4 6 x ~ 9 Maximum unified credit (applicable credit amount) against estate tax 9 7 8 0 , 8 0 0 .. ~ 10 Adjustment to unified credit (applicable credit amount). (This adjustment ~ may not exceed $6,000. See page 6 of the instructions.) .. . . .. . ...... . .. . .. 10 0 a . 11 Allowable unified credit (applicable credit amount) (subtract line 10 from line 9) 11 7 8 0 8 0 0 ...... , ... _ , 12 Subtract line 11 from line 8 (but do not enter less than zero) ................................................. 12 2 6 3 , 9 4 6 13 Credit for foreign death taxes (from Schedule(s) P). (Attach Form(s) 706-CE.) .................................................................. 13 14 Credit for tax on prior transfers (from Schedule Q) .. ...... . ..... . ...... 14 i :.. 15 Total credits (add lines 13 and 14) 15 ..................................... ..... _..... .. .. _ 16 Net estate tax (subtract line 15 from line 12) 16 2 6 3 , 9 4 6 , , . . _ .. , .... ...... . , , _ . .. 17 Generation-skipping transfer (GST) taxes payable (from Schedule R, Part 2, line 10) 17 18 Total transfer taxes (add lines 16 and 17) 18 2 6 3 , 9 4 6 19 Prior payments. Explain in an attached statement 19 . _ . .... _ .. _ .. 20 Balance due or over a ment subtract line 19 from line 18 20 2 6 3 , 94 6 Under penalties of perjury, I declare that I have examined this return, inGuding 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 executor is based on all information of which preparer has anv knowledge. Sign tiers ~ DIANE L CLINE Signature of executor Date Signature of executor , Date Preparer's Date ~~'rf Preparer's SSN or PTIN Paid signature ' DARYL R WRBBSR, CPA self-employed Ir ^ P 0 0 0 0 7 9 9 4 Preparers pARKS & COMPANY EIN - 3 0- 0 5 0 3 0 9 3 Use Only Firm's name (or yours if self-empbyed), , $15 E ARCH ST Phone no. address, and ZIP code p~rgy~ ~ pA 17 0 7 8 ' 717 - 8 3 8 - 2 3 8 7 For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the separate instructions for this form. ' Form 706 (Rev. s-2008) DAA Decedent's Social Security Number Estate of: MARY ARLENE MCCARTHY 2 0 2- 2 0- 3 8 6 8 Part 3-.-Elections b the Executor Please check the "Yes" or "No" box for each question (see instructions beginning on page 6). Note. Some of these elections ma re uire the stin of bonds or liens. Yes No 1 Do ou elect alternate valuation? ....................................................................................... 1 X 2 Do you elect special-use valuation? X If "Yes " ou must corn lete and attach Schedule A-1. 2 3 Do you elect to pay the taxes in installments as described in section 6166? .......... .... ..... ... ' ........... X {f "Yes," you must attach the additional information described on pages 10 and 11 of the instruction Note. By electing section 6166, you may be required to provide security for estate tax deferred section 6166 and interest in the form of a sure bond or a section 6324A lien. 3 4 Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described in section 6163? ............................................................................................................ 4 X Part 4-General InfornlatlOn (Note. Please attach the necessary supplemental documents. You must attach the death certificate.) (see instructions on paoe 12) Authorization to receive confidential tax iMormation under Regs. sec. 601.504(b)(2)(i); to act as the estate's representative before the IRS; and to tlnake written or oral presentations on behalf of the estate if return prepared by an attomev. accountant. or enrolled anent for the executor: Name of representative (print or type) State Address (number, street, and room or suite no., city, state, and ZIP code) 815 E ARCH STREET DARYL R WEBBER. CPA PA PALMYRA PA 17078 I declare that l am the Uattorney/ U certified public atxountantl U enrolled agent (you must check the applicable box) for the executor and prepared this return for the executor. I am not under suspension or disbarment from practice before the Internal Revenue Service and am qualified to practice in the Si nature CAF number Date Tele Mone number 9 P 2605-46635R 717:-838-2387 1 Death certificate number and issuing authority (attach a copy of the death certificate to this return). P14583106 COMMONWEALTH OF PENNSYLVANIA 2 Decedent's business or occupation. If retired, check here - and state decedent's former business or occupation. HOM~~AER 3 Marital status of the decedent at time of death: 8 Married X Widow or widower-Name, SSN, and date of death of deceased spouse -... 9 / 2 5 / 0 7 CALVIN D MCCARTHY 162-22-0400 ........................................................................................................................................ Single legally separated Divorced-Date divorce decree became final - 4a Surviving spouse's name 4b Social security number ~ 4c Amount received (see page 12 of the instnictions) 5 Individuals !other than the surviving spousal. vests. a other estates who receive benefits from the estate (do not inGude charitable t>enefidaries shown in Schedule 0) (see insUJ Name of individual trust or estate receivin $5 000 or more (dent in number Relationshi to de ant Amount see instructions DIANE L CLINE KENNETH L MCCARTHY CAROLYN L BISHOP MARILYN L MCCARTHY-WADLINGER 206-38-9776 206-38-9774 206-38-9775 206-38-9777 DAUGHTER SON DAUGHTER DAUGHTER 580,650 580,650 580,650 580,650 All unascertainable beneficiaries and those who receive less than $5 000 ... ......................... ...................... - Total .................................................................................................................. 2, 3 2 2 6 0 0 Please check the "Yes" or "No" box for each uestion. Yes No 6 Does the gross estate contain any section 2044 property (qualified terminable interest property (QTIP) from a prior gift or estate) see a e 12 of the instructions ? ................................................................................................ X 7a Have federal gift tax returns ever been filed? X If "Yes " lease attach ro ies of the returns if available and furnish the followin information: .......... .......... 7b Periods covered TC Internal Revenue office s where filed 8a Was there an insurance on the decedent's life that is not included on the return as art of the ross estate? ........................... X b Did the decedent own an insurance on the life of another that is not included in the ross estate? .................................... X (continued on next page) Page 2 DAA 02- Part 4-General Information (continued) f~ ~1~ If ou answer "Yes" to an of uestions 9-16, ou must attach additional information as described in the tnstructio Yes No 9 Did the decedent at the time of death own any property as a joint tenant with right of survivorship in which (a) one or of the other joint tenants was someone other than the decedent's spouse, and (b) less than the full value of the property is included on the return as art of the ross estate? If "Yes " ou must corn lete and attach Schedule E ......................................... X 10a Did the decedent, at the time of death, own any interest in a parfiership (for example, a family limited partnership), an unincorporated business or a limited lialsili corn n ~ or own an stock in an inactive or closes held co ration? ................................................ X b If "Yes," was the value of any interest owned {from above) discounted on this estate tax return? If "Yes "see the instructions for Schedule F on a e 20 for re ortin the total accumulated or effective discounts taken on Schedule F or G ............................ X 11 Did the decedent make any transfer described in section 2035, 2036, 2037, or 2038 (see the instructions for Schedule G beginning on a e 15 of the se crate instructions ? If "Yes " ou must corn lete and attach Schedule G ....................... ................ X 12a Were there in existence at the time of the decedent's death an trusts created b the decedent Burin his or her lifetime? . .............. X b Were there in existence at the time of the decedent's death any trusts not created by the decedent under which the decedent ossessed an over beneficial interest ortrusteeshi ? ......................................................... ................ X c Was the decedent receiving income from a trust created after October 22, 1986 by a parent or grandparent? X .. ... . ........ . .... ............... ................ If "Yes "was there a GST taxable termination under section 2612 u on the death of the decedent? .. X d If there was a GST taxable termination (under section 2612), attach a statement to explain. Provide a copy of the trust or will creatin the trust and ive the name address and hone number of the current trustees . e Did the decedent at any time during his or her lifetime transfer or sell an interest in a partnership, limited liability company, or . . closely held corporation to a trust described in question 12a or 12b? X . . .. . ...... . ............ . ... . . ...... . ... . . .... . . .. . . . . If "Yes " rovide the EIN number to this transferred/sold item. - ......... .......... 13 Did the decedent ever secs exercise or release an eneral rota intment? If 'Yes ' ou must corn lete and attach Schedule ............... X 14 Did the decedent have an interest in or a signature or other authority over a financial account in a foreign country, such ~s a bank account securities account or other financial account? ...................................................................... X 15 Was the decedent, immediately before death, receiving an annuity described in the "General" paragraph of the instructions for Schedule I or a rivate ennui ? If "Yes " ou must corn lete and attach Schedule I .................................................. X 16 Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of apre-deceased spouse under section 2056jb)~7} and. which is not re orted on this return? If "Yes "attach an ex lanation ..................................... X Part S--Recapitulation Item no. Gross estate Alternate value Value at date of death 1 Schedule A-Real Estate 1 0 0 2 .......................................................... Schedule B-Stocks and Bonds 2 1 2 0 0 ,910 0 1, 411, 4 21 3 .................................................... Schedule C--Mortgages, Notes, and Cash 3 0 0 4 , .... .. _ , .... .... ... Schedule D-Insurance on the Decedent's Life (attach Forms} 712) 4 0 0 5 Schedule E-Jointly Owned Property (attach Form(s) 712 for life insurance) 5 0 0 6 Schedule F-Other Miscellaneous Property (attach Form(s) 712 for life insurance) 6 10 6 , ~ 3 4 10 6 , 5 3 4 7 Schedule G-Transfers During Decedent's Life (att. Form(s) 712 for life insurance) 7 1, 4 3 4 , 4' 8 6 1, 4 3 4 , 4 8 6 8 Schedule H-Powers of Appointment 8 0 0 9 , .. .............. Schedule l-Annuities ............................................................. 9 13 9, 6 2 5 13 9 6 2 5 10 Total ross estate add items ltfirou h 9 ........................................... 10 2 8 8 1, 5'4 5 3, 0 9 2, 0 6 6 11 Schedule U-(2ualified Conservation Easement Exclusion 11 0 0 12 ............................ Total gross estate less exclusion (subtract item 11 from item 10). Enter here and on line 1 of Part 2-Tax Com utation ........................................... 12 2 , 8 81, 54 5 3 , 0 9 2 , 0 6 6 Item no. Deductions Amount 13 Schedule J--Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims 13 16 3 , 4 3 9 14 ScheduleK-Debts of the Decedent 14 .^ 6,849 15 ................ ... .._. _. ., ., ,. _.. Schedule K-Mortgages and Liens __.._„__. .._....._.,. 15 16 ................................................... Total of items l3 through l5 .......... ............ !16 170,288 17 ................... .. ... .... ._ .. ......,_ ._ Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recap _... ... . itulation} _ ......_ .. 17 17 0 , 2 8 8 18 Schedule L-Net losses During Administration 18 19 ........................................ Schedule L-Expenses Incurred in Administering Property Not Subject to Claims .......... ............ 19 20 Schedule M-Bequests, etc., to Surviving Spouse 20 21 Schedule O-Charitable Public and Similar Gifts and B nests , . ...................... _ .......... .. _ . .......... 1 22 Tentative total allowable deductions add items 17 throw h 21 . Enter here and on line 2 of the Tax Com utation .. 22 17 0 , 2 8 8 Page 3 DAA N O d o r r Op~ Q~ NM N p ~ ~~ ~ 7 S ,. P Y~~ ~ y4, M M Y r H 'c' a. (> Q ,,, ~, o 0 oa +~~- "~ p.. C~C.~t3 ~ cn s p Q U ~'- ~ o ~ ~ o ~~~ ~ ~. ~~~ ~~ ~, _ .