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HomeMy WebLinkAbout02-19-10 (2) FAMILY SETTLEMENT AND FINAL RELEASE ~~_t ESTATE OF HELEN M. DODGE `':: ~ 'rt KNOW ALL MEN BY THESE PRESENTS, that Helen M. D ' ~~) ~ ~ y ~ ' '~' o- ,late~f ~" Middlesex Township, Cumberland County, Pennsylvania, deceased, di ~.~ ~~~ sate-" ~ _~~ it ~n ~~=- Apr 14, 2009, having first made her Last Will and Testament, which was ~ ~'` ~ ~ ~ '~~' a~ly execuf~d ~ R ~ ,~:~~ on July 25, 1980 and probated in the Office of the Regis#er of Wills of Cumberl nd County, on April 16, 2009, at File No. 21-09-0359. WHEREAS, the said Helen M. Dodge, by the aforesaid Last Will and Testament, named David E. Dodge as Executor of said Last Will and Testament; WHEREAS, Letters Testamentary on the Estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, hereinafter called personal representative; WHEREAS, the personal representative has gathered the assets of the Estate of the said decedent and the assets consist of personal and real property with the total value of $67,151.24 as set forth in Exhibit "A", which is a copy of the Pennsylvania Inheritance Tax Return filed and approved by said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said Estate, which has now been paid, leave a balance for distribution of $44,837.27, also as set forth in the statement of said personal representative, which is attached hereto and marked Exhibit "B"; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit "B" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said Decedent; NOW, THEREFORE, David E. Dodge, being the sole heir under the Last Will and Testament of the said decedent, and being the person entitled to inherit under said Last Will and Testament, does hereby acknowledge that he has this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed to him by the said Last Will and Testament, the amount due him under said Last Will and Testament, which amount he has received this day or prior to this day; and he does hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, he agrees that no account is necessary and he does hereby agree and consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania. THEREFORE, he does hereby remise, release, quitclaim and forever discharge the said personal representative, David E. Dodge, his heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the Estate of the said decedent, and he does further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this Agreement, he does hereby covenant and agree with the aforesaid personal representative, that he will contribute his share of the Estate to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said Estate or the aforesaid personal representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, he has hereunto set his hand and seal the day and year noted below. ~/` Date -~~ i ess David E. Dodge ~' NOTICE OF INHERITANCE TAX pennsylvania ~ BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE '.TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE PO BOX 280601 REV-1547 EX AFP C12-09) HARRISBURG PA 17128-0601 DATE 12-28-2009 ESTATE OF DODGE HELEN M DATE OF DEATH 04-14-2009 FILE NUMBER 21 09-0359 GAKEB R WALTZ COUNTY CUMBERLAND TURD LAW OFCS ACN 101 2 8 S P ITT S T APPEAL DATE: 02-26-2010 (See reverse side under Objections ) CARLISLE PA 17013 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ ~-'---R_ETA_IN LOWER POR_TION FOR YOUR RECORDS E~ REV-1547 EX A C FP 12-~09~ NOTICE OF INHERITANCE DISALLOWANCE _ _ TAX APPRAISEMENT,-ALLOWANCE OR - OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: DODGE HELEN MFILE N0 .:21 09-0359 ACN: 101 DATE: 12-28-2009 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) C1) .0 0 NOTE: To ensure proper 3. Closely Held Stock/Partnership Interest (Schedule C) C2) •0 ~ credit to your account, C3) •~ ~ submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) of this form with your C4) 00 • tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 67,151 24 6. Jointly Owned Property (Schedule F) . 7. Transfers (Schedule G) c6) .00 c7) .00 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: c8) -- 67, 1 24 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 2 10. Debts/Mortgage Liabilities/Liens (Schedule I) cy) 0.~11_~7 clo) .00 11. Total Deductions 12. Net Value of Tax Return C11) 20,311.57 C12) 4 6,8 3 9.6 7 13. Charitable/Governmental Bequests; Non-elected 9113 Tr t 14. Net Value of Estate Subject~to T us s (Schedule J) C13) ,0 0 ax NOTE: If an assessment was issued previously, c14) 4.6,839.67 lines 14 15 reflect figures that include the total , and/or 16, 17, 18 and 19 will of ALL retur ASSESSMENT OF TAX: ns assessed to date. 15. Amount of Line 14 at Spousal rate 1 0 0 ~ 0 C15) 6. Amount of Line 14 taxable at Lineal/Class A rate X ' = .0 0 C16) 46 8 9 17. Amount of Line 14 at Sibling rate _ , 67 x 045 = 2,107.79 18. Amount of Line 14 taxable at Collateral/Class B ra C17) ~0 X 12 = .00 te C18) 00 15 19. Principal Tax Due • X = . 00 TAX CREDITS: C19)° 2,107.79 PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID 07-09-2 (-) AMOUNT PAID 009 CD011466 ,~~ ~., EXHIBIT ~ TOTAL TAX PAYMENT 2,107.79 ~ BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. --J REV-1500 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes county code Year File Number Po Box.2soso~ INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 9 0 0 3 5 9 ~.. ~ Ott uca.cucrv ~ rPIrVKMA I f1UN t3ELOW Social Security Number Date of Death 211226690 04142009 Decedent's Last Name DODGE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number Date of Birth 04211930• Suffix Decedent's First Name MI HELEN M Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa Future Interest Compromise 5. Federal Estate Tax Return R (date of death after 12-12-82) ^ eQuired ^ g. Decedent Died Testate ^ ~ Decedent Maintained a Living Trust (Attach Copy of IMill) (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p• Spousal Poverty Credit (date of death between 12-31-91 •and 1-1-95) 11 • Election t0 tax under Sec. 9113 A ^ ( ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame GALEN R WALTZ Daytime Telephone Num~r ,~,~ 717 2 9 6 8 8 ~, -~, ~_;.' ~ Firm Name (If Applicable) ~ ~ ~ ~--- ~ '- C? .,- ~ ~ T URO LAW OFFICES _ -~ - REGIST6R~~LS 17~E ONLY-; 1 3 ~ '1J ~~ i First line of address . .r ~,~ ~r ~ ~ _i:3 r~; ~, ~ ~_ ~~ ..1 28 SOUTH PITT STREET ~-~ ~~~~'- <~ f~ Second line of address ~ ~, ~... ~ -~ ~~ v `' t - N City or Post Office ~ DATE FILED State ZIP Code CARLISLE PA 17013 Correspondent's a-mail address: g w a l tz ~ t u r o l a w. c o m Under penalties of pery'ury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is correct and complete. DeG tion of preparer other than the persona-I representative is based on all information of which preparer has any knowledge. SIG RE OF FjER N PONSI OR FI NG RETURN DATE ~ David E. Dodge (© ADDRESS 1080 Starlight Terrace Wayyg~lesquite, Nv 89034-1023 SIGNA~J,J OF PREPARER QT~IER T1~1'N pRr=RFUiternic Galen R Waltz DATE 28 South Pitt Street, Carll Is e, PA 17013 Side 1 1505607120 1505607120 ___I 1505607220 REV-1500 EX Decedent's Social Security Number DecedenPs Name: D O D G E HELEN M. 2112 2 6 6 9 0 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. 6 7 , 15 1 . 2 4 6. Jointly 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) .......... ...................... ....................................... $. 67 , 151.24 9. Funeral Expenses & Administrative Costs (Schedule H)............ ............................. 9. 2 0 , 3 1 1 . 5 7 10. Debts of Decedent, Mortgage Liabilities, ~ Liens (Schedule I) ................... ............. 10. 11. Total Deductions (total Lines 9 8~ 10) .... ..................................................................11. 2 0, 3 1 1. 5 7 12. Net Value of Estate (Line 8 minus Line 11) ............. ................................................12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 46, 839.67 an election to tax has not been made (Schedule J) ....... .................... ...................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 4 6 , 8 3 9 . 6 7 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate x .045 4 6, 8 3 9. 6 7 16- 17. Amount of Line 14 taxable 2, 10 7. 7 9 at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18 19. Tax Due .................................................................................... ...............................19. 2 , 10 7 . 7 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 00359 Dodge, Helen M. CTGCCT A1'~1'1lnrnn Claremont Nursing and Rehab Center cITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 105.39 STATE Pa ZIP Total Credits (A + B + C) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) 2,107.79 (2> 105.39 (3) 0.00 (4) (5> 2,002.40 (5A) (5B) 2,002.40 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCK S 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.. 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 considerations ^ 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 roe x contains a beneficiary designation?. P P rty which ....... ... _ a IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUF 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)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. COMMONWEAL7}{OFPENNSYLVANIA PERSONAL PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dodge, Helen M. FILE NUMBER ----- ---- --- - 21 - 09 - 00359 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 PSECU Account No. 0211-22-6690 - - -- Share Account 5.07 1 Credit Union Place, Harrisburg, Pa. 17110-2990 2 PSECU Account No.. 0211-22-6690 Checking 8,223.58 1 Credit Union Place, Harrisburg, Pa. 17110-2990 3 PSECU Account No. 0211-22-6690 Money Market 45,587.68 1 Credit Union Place,Harrisburg, Pa. 17110-2990 4 PEBTF Health Insurance Refund Check 150 S. 43rd St. 1,107.34 Harisburg, Pa. 17111-5700 5 Burial Reserve: Account No. 105-113-5-60 First National Bank of Liverpool 7,530.46 104 N. Front Street Liverpool, Pa. 17045 6 Claremont Refund Claremont Nursing and Rehab Center 4,697.11 1000 Claremont Road Carlisle, Pa. 17013 TOTAL (Also enter on Line 5, Recapitulation) 67151.24 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dodge, Helen M. S(~-IEDI~E H FUI~~R~4~L wD~VSES & ~, N „~~ FILE NUMBER 21 - na _ nn~~4 veo~s or aecedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION A• 1 George P.Garman Funeral Home Inc. 606 North Front Street B- ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Turo Law Office, 28 S. Pitt St., Carlisle, Pa. 17013 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills -short certificates, probate Register of Wills -Inventory and inheritance tax Register of Wills - Additions! Probate 5. Accountant's Fees 6. I Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal -Estate Notice 32 S. Bedford St., Carlisle, Pa. 17013 AMOUNT 7,737.32 2, 950.00 132.00 30.00 45.00 75.00 TOTAL (Also enter on line 9, Recapitulation) 20,311.57 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN __ RESIDENT DECEDENT Schedule H ww~~^^~Fiax~al ~ & ESTATE OF Dodge, Helen M. 2 The Sentinel -Estate Notice PO Box 130, Carlisle, Pa. 1.7013 3 Claremont Nursing Home Carlisle, Pa. 4 Special Event Emergency Medical Services 5 Pharmerica 6 Walmart -Thank You cards 7 Postage 8 Executor travels to Harrisburg (gasoline) Exhibit A 9 Executor lodging in fulfillment of duties Exhibit B 10 Executor travel costs return to Nevada (gasoline and turnpike} Exhibit C 11 Executor lodging costs return to Nevada Exhibit D 12 Pastor of 29th St Methodist Church - (funeral service) 13 Brachendorf Memorial (stone engraving) 2131 Herr St., Hbg., Pa. 14 Executor travel while at Harrisburg (Register of Wills, Attorney, other fiduciary responsibilities related to banking and arrangements) FILE NUMBER 21 - 09 - 00359 208.78 7,650.00 122.53 122.72 37.12 35.56 55.33 372.37 168.29 256.75 100.00 195.00 17.80 Page 2 of Schedule H REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF - _ Dodge, Helen M. FILE NUMBER ------ 21 - 09 - 00359 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE RECEIVING PROPERTY DECEDENT (Words) (~$$) Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS[include outright spousal ~ - distributions, and transfers under Sec. 9116 (a) (1.2)] 1 David E. Dodge Son The entire estate 1080 Starlight Terrace Way Mesquite, Nevada 89034-1023 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T - --- ---- -- - - --- - 0.00 EXHIBIT "B" GROSS ESTATE NET OF TAX LIABILITIES A. George P. Garman Funeral Home, Inc. B. Turo Law Offices C. Register of Wills D. Cumberland Law Journal E. The Sentinel -Legal F. Claremont Nursing Home G. Special Event EMS H. Pharmerica 1. WalMart (Thank-You Notes) J. Postage K. 29th Street Methodist Church L. Brachendorf Memorials TOTAL LIABILITIES AMOUNT REMAINING TO BE DISTRIBUTED DISTRIBUTIONS: David E. Dodge $ 65,148.84 $ 7,737.32 2, 950.00 207.00 75.00 208.78 7,650.00 122.53 122.72 37.12 35.56 100.00 195.00 $ 20,311.57 $ 44, 837.27 $ 44,837.27