HomeMy WebLinkAbout05-21-10 (2)'~ REV-1500 Ex (~)
PR Deparhneltt of Revenue
Btr~tr of Ntdividuat Taxes
Po cox 2ti0~t
Fm_ PA 171280801
15056051047
OFFICIAL USE ONLY
County Code Year Fde Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ENTER DECEDENT INFORMATN~1 BELOW
Social Securi Number Date d Death
aaase ,tare ma+a~m~gswm«,!.~+. ~.~smr;~w n.,
l 3 5 4 2 8 . °~ ~~~ 9f ~ ~ ~ '9
Decedent's Last Name Suffix
e )!FT0.1~Nh^IAh!rF9 .M.R~F.NUWM~!Pbtlto ,N~vu.>F~rSyYUY ">~M:". '/S.nNY1 h c.r a5'. yr ~.1::,
(If Appgcabie) Enter Survhring Spouse's Information Below
Spouse's Last Name Suffix
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~ 3 m ,~ ,• r~ A4 e x
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Spouse's Social Security Number
Date d Birth
~i `7 ~° `d 1 g~ ~ 1 r~.
Decedent's First Nome MI
,.. ~ ~ ~~ ~ ~ s. ~ -„~
D O Ry O T
S~pouse~s Frst Na~ me ,.: ~ «.w r .~ ~~
,~.,_r ~R .v ~, W~ .
^'°`~"°'`"~""""~"' ^~ 'a°"~""""~°"~~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~,..:.>~..,~,>~. ~,- ,~~~.,.,..~ „~. REGISTER OF WILLS
FILL IN A,PPROP'RIATE OVALS BELOW
O 1. Original Retum ~~ 2. Supplemental Retum
O 4. Limited Estate
i~ 8. Decedent Died Testate
(Attach COPY d ~)
O 9. Litigation Proceeds Received
O 4a. Future Interest Compromise (date of
death after 12-12-82)
O 7. Det~dent Maintained a Living Trust
(Attach Copy d Trust)
O 10. Spousal Poverty Credit {date of death
between 121-91 and 1-1-95)
O 3. Remainder Retum (date of death
prior to 12-13.02)
O 5. Federal Estate Tax Ratum Required
0
8. Total Number of Safe Deposit Boxes
CORRESPONDENT -'PHIS SECTION MUST tiE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTL4L TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daydme Telepiwne Number
,~ ,a t ~ ~. s. ,r .. ,~. ~~t ~.,. r. ~ ,_ ..
~ "_ ~ ~ ~~ .A L E_B ~ ~ 7 1 7 ~ 9 1 7 7 7°0
!~ A~ R L I g N I~ M c i(~~ $ y
~M- vaR .r . # <'.M ~. <+ ..-. n T ~: x r 1 _ _. . . r. npM2v.W„l+bFh'.]u YSrrMkHxIXSN'R.BV J~n.t .r
O 11. Election b tax under Sec. 9113(A)
(Attach Sch. O)
ME~C'H AUNT ~Cr5~ ?iJ G :P+A,1;7'0,',55; •t ._
Correspondent's a-rra»i aedresa:
Under panal8ea d perjury. I dedere tlrat 1 have eorertiirted 8tie return, irxiudirg accompanying seriedules and stelamen~, and b ale hest d my knowledge and belief,
it is true. coned and complete. Dedara8on d preparer direr Man the personal representative is based on al Infonrretiar d which preperer has any knoyedge.
Co-Executors
AU CJJ -«•«• «• ••••-•••• a~.ajuav'.w ..• aa..a...vr ~a•
601 South Frederick Street. Mechanicsbura. PA 17055
... ~ ...~
ADDRESS Marlin R. McCaleb
219 East Main Street. P.O. Box 230. Mochan+cab~ryr vA i~n55
PLEASE USE ORIOINittL FORM ONLY
Side 1
_15056051047 15056051047 J
REV 1500 FJ(
oeoeasncs Herne: Dorothy M. White
14. Net Value Sub~ct to Tax {tine 12 minus Lute 13) ................... ..... 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under See. 9116
{ax12) X .0~ 15.
18. Amount of Line 14 taxale
at lineal rate X .0 45 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Lme 14 taxable
at coNateral rate X .15 18.
19. TAX DUE .........................................................19.
Decedent's Social Security Number
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2 "'
15056052048
15056052048 15056052048
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21-09-00420
Dorothy _M. White
I STREETADlhtESS
~ 25 West Maplewood Avenue
_ ----
_ -
CiTY Mechanicsburg
-_ _ _ _
ZIP
PA 17055
STATE
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19) (1)
2. CreditstPaymants
A. Spousal Poverty Credit _ __ - --_-_----_. - --
B. Prior Payments
_.. _
C. Discount
___ -- TotalCredits(A+B+C) (2)
3. InterestlPenalty N applicable 2.62
D. Interest
__. --
E. Penalty ------ Twat InterestlPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Une 3, enter the differerxxi. This is the OVERPAYMEWT.
RII in oval on Page 2, Une 20 to request a refund. (4)
5. ff Une 1 + Une 3 is greater tllarl Une 2, solar the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(5A)
198.86
0.00
2.62
201.58
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 201.58
Make Check Payable fo: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a Uansfar and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^
b. retain the right fp designate who shah use the properly transferred ~ its 'vxxxrte : ............................................ ^
c. retain a ~ interest; or .......................................................................................................................... ^
d. receive the promise for Nfe of eilfl~ payments, txrrle8ts or care? ...................................................................... ^
2. ff d~th occurred after Decen>ber 12,1982, did decedent transfer properly w~lin one year of death
without receivirg adequate oorlsideraliorr? .............................................................................................................. ^
3. Did decedent own an 'xi trust for" or payable upon death bank account or security at his or her death?. ~......... ^
4. Did decedent own an Individual Retirement Accarnt, amuily, ar ottler rion-probate properly which
contains a t>enefiaary designation? ............................................................... ................................................ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spousE
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)J.
Fa 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} percerr
[72 P.S. §9116 (a) (1.1) (u)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets anc
filing a tax return are sb'N applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rath imposed on the net value of transfers from a deceased child 1waMy-one years of age a 1rot-nger at death to or for the use of a natural parent, ar
adoptive parent, or a stepparent of the ct-iki Ls zero (0} percent (72 P.S. §9116(a)(1.2)j.
The tax rate imposed on the net value of transfers to or far the use of the decedents lineal beneficiaries is four and oqe-half (4.5) percent, except as noted it
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)j. Asibling is defined, under
Section 9102, as an individual who has at least one parent in corrurron with the decedent, whether by blood or adoption.
REV-1508 IX ~ (t -97)
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
Dorothy M. White SS~~ 173-54-2258 04/21/2009 21-09-00420
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorahtp must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 U. S. Treasury, - 2009 federal income tax refund. 4,434.00
We were not aware of this asset when we filed the Inheritance
Tax Return in January. We only learned of it when we prepared
and filed the Decedent's final income tax return in April and
we were not certain of the amount until we received the refund
check last week.
TOTAL (Also enter on line 5, Recapitulatlon) ~S 4 , 434.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-i50B EX (Rev. 1-97)
REV-151,Ex.(1-97) ~ SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8
INHERITANCE TAx RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dorothy M. White SS~p 173-54-2258 04/21/2009 21-09-00420
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. ~ FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Zip
2. I Attorney's Fees
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. I Probate Fees
5. I Accountant's Fees
6. ~ Tax Return Praparer's Fees
7. Other Administrative Costs
1 Register of Wills, - filing Supplemental Inheritance Tax Return. 15.00
TOTAL (Also enter on line 9, Recapitulation) ~S 15 .00
(If more space is needed, insert addRional sheets of the same size)
Copyright (e) 1996 form software only CPSystams, Inc. Form REV-1517 EX (Rev. 1-97)
REV- 7513 EX * (9-00)
PENNSYLVANIA
SCHEDULE)
BENEFICIARIES
ESTATE OF FILE NUMBER
Dorothy M. White SSdk 173-54-2258 04/21/2009 ~1_ne_nn~~n
ELA IONSHIP O D C DEN UNT 0 SHA E
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [Includeoutrlghtspouseldlstdbutlons,and
transfers under See. 9116(8)(1.2)]
1 John E. White Son 1,767.60
601 S. Frederick Street
Mechanicsburg, PA 17055
2 Raymond W. White, Jr. Son 1,767.60
19 Lenox Court
Mechanicsburg, PA 17050
3 Douglas White Grandson 84.84
7 Jeffery Drive
Mechanicsburg, PA 17050
4 Lisa White Granddaughter 111.36
18 Kingswood Drive
Mechanicsburg, PA 17055
5 Rachel Milbrand Granddaughter 111.36
6028 Wallingford Way
Mechanicsburg, PA 17050
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE ON R EV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software onty The Laekner Group, Ine.
Form REV-1513 EX (Rev. s-oo)
ESTATE OF DOROTHY M. WHITE
No. 21-09-00420
SCHEDULE J, Part I - TAXABLE DISTRIBUTIONS (continued)
6 Kevin White
19 Lenox Court
Mechanicsburg, PA 17050
7 Rebecca White
3 W. Willow Lane
Carlisle, PA 17015
Grandson 111.36
Granddaughter 111.36
8 Sarah Josephine Sharp
3 W. Willow Lane
Carlisle, PA 17015
9 Samantha Rae Milbrand
6028 Wallingford Way
Mechanicsburg, PA 17050
10 Alexandra Nicole Milbrand
6028 Wallingford Way
Mechanicsburg, PA 17050
11 Joseph M. Sharp, Jr.
3 W. Willow Lane
Carlisle, PA 17015
12 Molly White
14 S. Market Street
Mechanicsburg, PA 17055
13 Dalton S. Keener
18 Kingswood Drive
Mechanicsburg, PA 17055
Great-Granddaughter 58.92
Great-Granddaughter 58.92
Great-Granddaughter 58.92
Great-Grandson 58.92
Great-Granddaughter 58.92
Great-Grandson 58.92
LAST WILL AND TESTAMENT
~I
I, DOROTHY M. WHITE, of the Borough of Mechanicsburg, County of
Cumberland and Commonwealth of Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this as and for my
Last WII and Testament, hereby revoking and making void all former wills and
codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be
paid by my Executor, hereinafter named, as soon as conveniently may be done
after my decease.
SECOND. I give and bequeath my automobiles, personal effects and
household goods, contents, furniture and furnishings (not including cash or
securities), together with any existing insurance thereon, unto my sons, RAYMOND
W. WHITE, JR., and JOHN E. WHITE, or unto the survivor of them if either is not
then living, the same to be divided between them by my Executors, hereinafter
named, with due regard for their personal preferences in as nearly equal shares as
possible.
THIRD. I give, devise and bequeath all the rest, residue and remainder of
my estate, real, personal and mixed, whatsoever and wheresoever situate, as
follows:
A. I give and bequeath my Kimball spinet piano unto my great-
granddaughter, ALEXANDRA NICOLE MILBRAND, absolutely, if she survives
LAW OFFICES
~RLIN R. McCALEB me, the same to be held and cared for her during her minority by her parents.
B. I give and bequeath the sum of Twenty-One Thousand and
a
F
No/100 ($21,000.00) Dollars unto my great-granddaughter, SAMANTHA RAE
MILBRAND, absolutely, if she survives me.
C. I give and bequeath the sum of Twenty-One Thousand and
No/100 ($21,000.00) Dollars unto my great-granddaughter, SARA
JOSEPHINE SHARP, absolutely, if she survives me.
D. I give and bequeath a share of said residue of my Estate, in an
amount equal to twelve (12%) per centum of said residue after deduction of
the specific bequests set forth in Paragraphs A, B and C, above, unto my
grandchildren, to be distributed as follows:
1. I give and bequeath an amount equal to sixteen (16%) per
centum of this share unto my grandson, DOUGLAS WHITE, absolutely;
2. I give and bequeath an amount equal to twenty-one (21 %)
per centum of this share unto my granddaughter, LISA WHITE,
absolutely;
3. I give and bequeath an amount equal to twenty-one (21 %)
per centum of this share unto my granddaughter, RACHEL
MILBRAND, absolutely;
4. I give and bequeath an amount equal to twenty-one (21%)
per centum of this share unto my grandson, KEVIN WHITE, absolutely;
5. I give and bequeath an amount equal to twenty-one (21 %)
LAW OFFICES
MARLIN R. McCALE6
-2-
per centum of this share unto my granddaughter, REBECCA WHITE,
absolutely;
6. If any of my said grandchildren shall predecease me
leaving lawful issue to survive me, then I order and direct that the
share provided herein for such grandchild had he or she survived me
shall be paid over and distributed unto his or her said lawful issue per
stirpes, said issue to take the ancestor's share by representation and
not per capita, and in default of said issue, the same shall be paid over
and distributed among the other shares of this Paragraph D pro rata.
E. I give and bequeath a share of said residue of my Estate, in an
lAW OFFICES
MARLIN R. McCALE6
amount equal to eight (8%) per centum of said residue of my Estate after
deduction of the specific bequests set forth in Paragraphs A, B and C, above,
in equal shares unto my great-grandchildren who survive me, share and
share alike, absolutely and in fee simple; provided, however, that if any great-
grandchild shall predecease me leaving lawful issue to survive me, then I
order and direct that the share provided herein for such great-grandchild had
he or she survived me shall be paid over and distributed unto his or her said
lawful issue per stirpes, said issue to take the ancestor's share by
representation and not per capita; and in default of said issue, said share
shall be paid over and distributed in equal shares among the other shares of
this Paragraph E, share and share alike.
-3-
F. I give, devise and bequeath all the rest, residue and remainder
of my Estate, real, personal and mixed, whatsoever and wheresoever situate,
in equal shares unto my sons, JOHN E. WHITE and RAYMOND W. WHITE,
JR., share and share alike, absolutely and in fee simple. Provided, however,
that if either of my sons shall predecease me leaving lawful issue to survive
me, then and in that event I order and direct that the share which such
deceased son would have received had he survived me shall be paid over
and distributed unto his said lawful issue per stirpes, said issue to take the
ancestor's share by representation and not per capita.
FOURTH. During my lifetime, I have loaned various sums of money to my
grandchildren and I may hereafter lend money to one or more of my great-
grandchildren. To the extent that any such loans shall remain unpaid at my
death, then I direct that the amount thereof shall be taken and considered by my
Executor and my Trustee, hereinafter named, as part of the share provided
above for the grandchild or great-grandchild owing the same and shall be
accounted for accordingly. The determination of my Executor as to the amount
of any loan remaining unpaid at my death shall be final, conclusive and binding
upon all parties.
FIFTH. All federal, state and other death taxes payable because of my
death, with respect to the property forming my gross Estate for tax purposes,
whether or not passing under this Will, including any interest or penalty imposed
LAW OFFICES II
MARLIN R. McCALE6
-4-
in connection with such tax, together with any debts and administration expenses
that are not deductible for federal estate tax purposes, shall be considered a part
of the expense of the administration of my Estate and the same shall be paid out
of the residue of my Estate, all without apportionment or right of reimbursement.
LASTLY. I nominate, constitute and appoint my sons, JOHN E. WHITE
and RAYMOND W. WHITE, JR., Co-Executors of this, my Last Will and
Testament, .but if for any reason either of them shall fail to qualify as such Co-
Executor or cease so to serve, then it shall not be necessary to appoint a
substitute Co-Executor ir- his place, but in such event the remaining or surviving
Co-Executor shall serve as my sole Executor under this Will. If for any reason
both of them shall fail to qualify as such Co-Executors or cease so to serve, then
I nominate, constitute and appoint COMMERCE BANK/HARRISBURG, N.A., to
serve in their place and stead, all to serve without bond in this or any other
jurisdiction.
IN WITNESS WHEREOF, I, DOROTHY M. WHITE, have hereunto set my
hand and seal to this, my Last Will and Testament, which consists of six (6)
typewritten pages, to each of which I have affixed my signature this day
of _a~t~_~ , A.D., Two Thousand Five (2005).
~~~h-~ ~ (SEAL)
The preceding instrument, consisting of this and five (5) other typewritten
LAW OFFICES II
MARLIN R. McCALE6
-5-
~i
3
LAW OFFICES
MARLIN R. McCALE6
pages, each identified by the signature of the Testatrix, was on the date thereof
signed, sealed,. published and declared by DOROTHY M. WHITE, the Testatrix
therein named, as and for her Last Witl and Testament, in the presence of us,
who, at her request, in her presence, and in the presence of each other, have
subscribed our names as witnesses hereto.
1 ~~
a-
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