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HomeMy WebLinkAbout04-15-10t 15056041169 J REW-1500 EX (06-05) OFFICU\L USE ONLY PA Department of Revenue Bureau oflndNidualTaxes County Code Year File Number PO Boxz3050t INHERITANCE TAX RETURN ~ / O ~ ~ ^n ( f Harrisburg,PAt7126.0501 RESIDENT DECEDENT ~] ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 168-26-5498 12192009 10311921 Decedent's Last Name Suffix Decedent's First Name MI MCCLAIR VIVIAN L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffut Spouse's First Name MI MCCLAIR JACK R Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 18 8 - 0 9 - 9 018 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW © 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-t2-82) a 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 e. Total Number of Sale Deposit Boxes (Attach Copy of WIII) (Attach Copy of Trust) 9. Litlgation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 91t3(A) between 12-31-97 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DDTECTED T0: Name Daytime Telephone Number MATTHEW M. HAAR 717-257-7524 Firm Name (If Applicable) REGISTER OF WILLS USE ONLV SAUL EWING LLP First line of address n o 2 NORTH SECOND ST. 7TH FLOOR r TO ° ~.~ ~ y. =~'-' r"n ~ "7 Second line of address ~~ ~ ~ -`~ ~ ~~ n-, GJ'1 .~Cn~ -~' - City or Post Office State ZIP Code LED y G i~ - r°c , HARRISBURG, PA 17101 ~~ ~ Ln D w Correspondent's a-mail address: MHAARCa?SAUL . COM Under penalties of perjury, 1 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. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O7'1~E~ ~ I~S~BLE F~ FJyry~'RETURN II (~, r (YYL ~0// DATE ~i~-~ - w 325 WESI3EY DR., APT. 3110, MECHANICSBURG, PA 17055 2 NORTH 2ND ST., HARRISBURG, PA 17101 PLEASE USE ORIGINAL FORM ONLY Side 1 15056D41169 15056041169 J 15056042160 RI=V-1500 EX Decedent's Social Security Number Decedent's Name: VIVIAN L MCCLAIR 168-26-5498 RECAPITUIJ'1TK)N 1. Real estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ........................................ 2. 3. Closely Held Corporatan, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedub D) ............................. 4. 0 0 0 0 10 , 0 74 .19 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 6. Jointy Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 0 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property 0 (Schedub G) ^ Separate BiNing Requested .... ... 7. 8. Total Gross Assets (total Lines 1 - 7) ................................ ... 8. 10 , 0 7 4.19 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 10. Debts of Decedent, Mortgage Liabilities, ~ Liens (Schedule 1) ............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................ .. 11. 0 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 10 , 0 7 4.19 13. Charrtabb and Gavemmental BequesLa/Sec 9113 Trusts for which 0 an ebdbn to tax has not been made (Schedub J) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus line 13) ...................... .. 14. 10 , 074.19 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Se}c: 9116 10 , 0 74.19 (a)(1.2) x .00 15. 0 . 0 0 16. Amount of Line 14' taxabb at Nneal rate x .0 16. 17. Amount of Line 74 taxable at sibNng rate x .12 17. 18. Amount of Line 14' taxable at collateral rate x .15 18. 19. TAX DUE ........................................................ 19. 20. FILL IN THE BOX' IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 Side 2 L 15056042160 15056042160 REV-1500 Ex Page 3 t7P_f_P_l')IP_fl+~S Cor11t]lete AC)7C171'f3SS: File Number DECEDENT'S tJAME Vivian L. McClair STREETADDRESS Bethan Villa e 325 Wesley Dr., A t. 3110 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 0 . 0 0 2. CreditslPayments A. Spousal PoveAy Credit 0 B. Prior Payments 0 C. Discount 0 Total Credits (A + B + C) (2) 0 .0 0 3. InteresUPena6y'rfepplicable D. Interest 0 E. Penaky 0 Toil InterestlPenafty (D + E) (3) 0 . 0 0 4. If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FlN in tax on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than tine 2, artier the rrilfsnence. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This 's the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTKMIS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use a klcome of the Properly transferred : .......................................... ^ b. retain the right to desk,Xrate who shah use the propeAy transferred a its income : .................... ^ r~ retain a reversionary interest; or ......................................................... ^ d. receive the promise for fife of either payments, benefits or cue? ................................ ^ 2. If death occurred after December 12,1962, did decedent transfer property witl-in one year of death without receiving adequate rxxtsidera6on? .................................................... ^ 3. Did decedent own ~ "intrust fa' ar payable upon deatll bank account or seasity at his or trey death? ..... ^ 4. Did decedent awn an Individual Retkement Account, annuity, or other non-probate property which aaltains a beneficiarydesignation? .......................................................... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YE3, YOU MUST COMPLETE SCHEDULE G ANO 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(aK1.1.)(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 (12 P.S. §9116(aK1.1 }(ii)]. The statute does rat exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applic2ible even 'rf the surviving spouse is the only benefiaary. For dates of death on or after J~ily 1, 2000: The tax rate. imposed on the net value of transfers from a deceased child twenty~ne years of age or younger at death th or (or the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent (72 P.S. §9116(aK1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is four and one-ha/ (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 decedents siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)). A sibFng 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) COMMONY~EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8r MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Vivian L. McClair 21-09-1204 Indude the Proceeds of Migation and the die the proceeds were received by the estak. MI property joirdlyowrred wHh right of survivoraMp must be dbcbssd on ScMduk F. (Nmore apse is needed, Ysrert addidorwl atreek otthe same size) REV-1513 EX+ (11-08) ~ Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Vivian L. McClair 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 [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Jack R. McClair Spouse 10,074.19 Bethany Village, 325 Wesley Dr. Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPRODRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN L B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ tr more space is needed, insert additional sheets of the same size. . +~! I, VIVIAN L. McCLAIR, of York County, Pennsylvania, declare this to be my Will and revoke all prior Wills. FIRST: Tangible Personal Property: I give all of my tangible personal property, including any automobiles, together with all insurance on such property, to my husband, JACK R. McCLAIR, if my husband survives me; otherwise I give such property to such of my children as survive me, to be divided as they shall agree. If there be no agreement or if any child is a minor, such property shall be divided as my Executor, in my Executor's sole discretion, deems appropriate. My Executor shall pay, as an expense of settling my estate, the costs of packing, storage, shipping and insurance incurred in connection with the distribution of the gifts of tangible personal property made above. SECOND: Residue: I give, devise and bequeath all of the residue of my estate, of whatever nature and wherever situated, to my husband, JACK R. McCLAIR, if my husband survives me; otherwise my Executor shall divide my residue into as many equal shares as there shall be children of mine living at my death, and make distribution accordingly. THIRD: Disability Provision: If a beneficiary shall, in the sole opinion of the Executor, become mentally or physically incapacitated, the Executor may apply the share to which such beneficiary is otherwise entitled hereunder for such beneficiary's support, health and welfare, directly, without the intervention of a guardian. FOURTH: Protective Provision: All principal and income shall, until actual distribution to the beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and shall not be liable to any levy, attachment, execution or sequestration while in the hands of my Executor. mss~.i snsros FIFTH: Tax Clause: All estate, inheritance, succession and other death taxes, imposed or payable by reason of my death, and any penalties thereon, with respect to all property owned by me at the time of my death and passing under this Will or under any Codicil hereto, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. Such taxes shall be paid at such time or times as my Executor may deem advisable. SIXTH: Powers of Executor: In addition to the powers given by law, my Executor, and any successors, without any order of court and in the sole discretion of the Executor, may: a. Retain any real or personal property, as long as deemed advisable. b. Invest in any real or personal property in accordance with the prudent investor rule. c. Subscribe for stocks, bonds or other investments; join in any plan of lease, mortgage, merger, consolidation, exchange, reorganization, foreclosure or voting trust and deposit securities thereunder; and generally exercise all the rights of security holders or employees of any corporation. d. Register securities in the name of a nominee or in such manner that title will pass by delivery. e. Vote securities in person or by proxy, and in such connection delegate discretionary powers. f. Repair, alter, improve or lease, for any period of time, any real or personal property, and give options for leases. g. Sell at public or private sale, for cash or credit, with or without security, exchange or partition any real or personal property, and give options for sales or exchanges. h. Borrow money from any person, including any fiduciary, and mortgage or pledge any real or personal property. i. Disclaim any interest or power granted to me under any instrument or by operation of law. 97d97.1 S/14/03 '2- j. Employ investment and legal counsel, accountants, brokers and other specialists, and, whenever there shall be no corporate fiduciary in office, a corporate custodian, and compensate them and reimburse their expenses out of income or principal or both (in addition to fiduciary commissions), and delegate to investment counsel (including an account executive at a securities firm) discretion with respect to the investment and reinvestment of any or all of the assets held hereunder. k. Pay administration expenses, including, without limitation, interest on death taxes ("administration expenses") from principal or income, including income otherwise payable to my surviving spouse or to charity; provided, however, that no allocation of administration expenses to income shall be made that would prevent any assets frgm otherwise qualifying for the federal estate tax marital deduction or the federal estate tax charitable deduction. 1. Use administration expenses as deductions for federal estate tax purposes or fiduciary income tax purposes or partly for each, without making adjustments between principal and income in consequence of the exercise of such discretionary power. m. File joint income tax returns with my husband and pay a portion of such tax, and consent to gifts made by my husband and pay a portion of any gift tax thereon. n. Compromise claims. o. Divide any trust hereunder, which division may be made on a non- pro rata basis, into two or more separate and independent trusts and make any principal distributions otherwise authorized hereunder from the trusts on a non-pro rata basis. p. Add to the principal of any trust created hereby any property received from any person by Deed, Will or in any other manner. q. At any time merge any trust hereunder with any other trust held by my Executor, whether created by me or by any other person by Will or Deed, if the terms of the trust are then substantially similar and held for the primary benefit of the same person or persons. r. Make distributions without the consent of any beneficiary, in cash or in specific property, real or personal, or an undivided interest therein, or partly in cash and partly in such property and do so, except as otherwise specifically provided elsewhere herein, without regard to the income tax basis of specific property allocated to any beneficiary (including any trust) and without making pro rata distribution of specific assets. 41497.1 5/14/07 -3- r, s. Allocate basis pursuant to Section 1022 of the Internal Revenue Code of 1986, as amended, or successor provisions (the "Code"); provided, however, that such allocation shall be made in a fair and equitable manner among the beneficiaries of my estate, as my Executor, in my Executor's sole discretion, shall determine. t. Exercise all power, authority and discretion given hereby, after the termination of any trust created herein until the same is fully distributed. My Executor may make, but shall not be required to make, any adjustment of the amount distributed to either beneficiary who would have received a greater or lesser amount if my Executor had made a different or contrary decision in reference to any of the above matters. T exonerate my Executor from any liability arising from any exercise or failure to exercise these!powers, provided the actions (or inactions) of my Executor are taken in good faith. SEVENTH: Appointment of Fiduciaries: I appoint my husband, JACK R. McCLAIR, Executor of this Will. Should my husband, for any reason, fail to qualify or cease to act as such during the administration of my estate, I appoint my son, BARON R. McCLAIR, Executor of this Will to serve with the same duties, powers and discretion as if originally appointed. No Executor named herein shall be required to give bond or furnish sureties in any jurisdiction. /// ~H- IN WITNESS WHEREOF I have hereunto set my hand and seal this / ~0 day of May, 2003. i ~ j ''' ~~ '~VIVIAN L. McCLAIR ~am.i vuro3 -4- ~~ SIGNED, SEALED, PUBLISHED and DECLARED by the above named VNIAN L. McCLAIR as and for her last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. WITNESS WITNESS ~em.i siuroa -5- ADDRESS ADDRESS ~''~-© COMMONWEALTH OF PENNSYLVANIA COUNTY OF (,(,tfYf ~Q.i?~ ss We, VIVIAN L. McCLAIR, the testator, and ~(X,(.C~, C• Sef2.GG and ~ ~/~ ~ 9~~~ ,the witnesses, whose names aze signed to the foregoing ins~"trum~ ent, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as her last Will and that she signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and tk-at each of the witnesses, in the presence and heazing of the testator, signed the Will as a witness and that to the best of the witnesses' knowledge the testator was at that time over eighteen years of age, of sound mind and under no constraint or undue influence. ` ,~~~ ~- ~ ~if%G~~ ' ~~ ~-~~ ~ VIVIAN L. McCLA - Q~ Witness Witness Subscribed, sworn to and acknowledged before me by VIVIAN L. McCLAIR, the testator, and subscribed and sworn to before me by ~~-~ and ,the witnesses, this /(0 day of May, 2003. C~ N tazy Publi name sed Rebecca J. Odes, nbmry RibYc terrwyne Born, Q~rnbeAand Courxy My Commission Expires nbv.12, 2006 Member. Perxisylvar~ Assocfdfon Of Nolarles mem.i s~iaro3 -6- M8 ACCOUNT N0. ACCOUNT TYPE 9843136962 M8T CLASSIC CHECKING N/INTEREST 00 0 06117M NM I17 8536 VIVIAN L MCCLAIR 1520 ROUNDTOP RD LEWISBERRY PA 17339-9110 INTEREST EARNED FOR STATEMENT PERIOD 0.41 INTEREST PAID YEAR TO DATE 4.87 A f`1"f111MT CIIMMADV STATEMENT PERIOD PAGE OCT.30-NOV. 27,2009 1 OF 2 MECHANICSBURG B7tLANCE bTHER JIDOrTIOMS CHECKS PAID «O S1IBTRACT~ONS CURRENT INTEREST PD 'ENDING BALANCE - N0. AMOUNT N0. AMOUNT N0. ANOINIT 10,162.24 2 1, 22.35 2 1,200. 5 9.87 0.42 10,074.19 A f`f'f111MT Af TTVTTV ,> ., ESC IPT tUl `,:. ,. R.: S:: ONE RI S TRAC OHS' ' DAILY BALANCE 10-30-0 BEGINNING BALANCE ~ 510,162.24 11-02-0 US TREASURY 303 RR RET 1,034.85 11-02-0 RETIREMENT PENSION / 87.50 11,284.59 11-10-0 DELUXE CHECK CHECK/ACC. 9.8J 11,274.72 11-13-0 CHECK NUMBER 0190 / 1,137.64 10,137.08 11-17-0 CHECK NUI~ER 0191 X63.31 10,073.77 11-27-0 INTEREST PAYMENT 0.42 10,074.19 ENDING BALANCE 510,074.19 ~HE#:K3>Pl1T~..SUMMARY 190 11-13-04 1,137.64 191 11-17-09 63.31 ANNUAL PERCENTAGE YIELD EARNED 0.04 Y. SAVE BIG THIS HOLIDAY SEASON NITH YOUR NLT CHECK CARD. ENJOY EXCLUSIVE SAVIIICS FROM OVER 50 NATIONAL RETAILERS MHEN YOU USE YOUR CARD IN STORES, ON THE MEB AND OVER THE PHONE. JUST BE SURE TO SELECT (OR ASK TO USE YOUR CARD ASl °CREDIT". PICK UP A COUPON BOOK AT YOUR LOCAL MiT BRANCH BEGINNING MID-NOVEMBER. TO START SAVING NOM, VISIT MNM.NTB.COM/StXIPPING.