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HomeMy WebLinkAbout09-22-101505610143 REV-1500 ~``°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania county code Year File Number Bureau of Individual Taxes De°~rtnYetrtoFRevewuE Po Box.28oso~ INHERITANCE TAX RETURN 21 10 0 65 6 Harrisburg, PA 17128-os0~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number -Date of Death Date of Birth 213 52 8992 02 18 2010 06 Ol 1947 Decedent's Last Name Suffix Decedent's First Name MI WILCOX ADELE K (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI KIRK JOHN A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) s Decedent Died Testate (Attach Copy of Will) ~ ~, pAne~erlt PY iof Tnest a Living Trust (( GG of ) 9. Litigation Proceeds Received ~ 10. bBNveen 1~v3e1 ~Jt ~t jdatse5~f death 3. Remainder Return (date of death pnor to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number WM D SCHRACK III 717 432 9733 First line of address 124 W HARRISBURG STREET Second line of address City or Post Office DILLSBU'RG REGISTER OF WILLS USE ONLY C~ C .~ Q '~'' ~' ~,y~ ^.. ....- ,4,, f 4 DI~DE~ D sa. 'r ,ti _ ~ State ZIP Code ~ ~ _ ` -,~` PA 17 019 ~ ~,, :: •- ~-~; , _.. . -: Correspondent's a-mail address: Schracklaw~comcast.net Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the persona-I representative Is based on all information of which preparer has any knowledge. John Alan Kirk `~'~a-?~ 3`1'515th Street Cumberland PA 17070 SIGNATURE OF P AR R RE NTATNE DATE Wm. D. Schrack III-,~'~ ~ ~ /L 124 W. Harrisburg Street, Dillsburg, PA 17019 Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: WIiCOX, Adele Keigler 213 52 8 992 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. 35,000.00 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous emu; Probate Property uested rate Billin Re S 7 ............ g q epa (Schedule G) u . 3 5, 0 0 0. 0 0 8. ( ) ............................................................ Total Gross Assets total Lines 1-7 ,,,,,,,., g. 14 , 7 95.50 9. ( ) ....................................... Funeral Expenses 8~ Administrative Costs Schedule H 9. 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10. 14 , 7 95.5 0 11. ............................... Total Deductions (total Lines 9 & 10) .................................... 11. 2 0 , 2 0 4 . 5 0 12. ( ) .......................................................... Net Value of Estate Line 8 minus Line 11 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 2 0 , 2 0 4 . 5 0 14. Net Value Subject to Tax (Line 12 minus Line 13)..... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 2 0, 2 0 4. 5 0 15. 0. 0 0 (a)(1.2) X .00 16. Amount of Line 14 taxable 0 • 0 0 16. 0.00 at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0. 0 0 ' at collateral rate X .15 . 19. Tax Due .................................................................................................................. 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0656 DECEDENTS NAME Wilcox, Adele Keigler STREET ADDRESS 315 15th Street CITY New Cumberland STATE PA ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 0.~~ Make Check Pa able 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 .................................. ^ ^x c. retain a reversionary interest; or ....................... ...................................................................................... x .. d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 0 3. Did decedent own an "in trust forr or payable upon death bank account or security at his or her death?....... ^ ^x 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use o the surviving spouse is 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 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 21 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 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 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 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at feast one parent in common with the decedent, whether by blood or adoption. Rev-1507 EX+ (8-88) SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - I FfLE NUMBER Wilcox, Adele Keigler 21-10-0656 All property jointly-owned with right of survivorship must bedisclosed on Schedule F. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule D (Rev. 6-98) (If more space is needed, additional pages of the same size) REV-1151 EX+ (10-06) COM IN RES~~II~ I~~ECED~RNVANIA SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Wilcox, Adele Keigler 21-10-0656 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A, FUNERAL EXPENSES: B. 1 2 3 4 5 6 7 See continuation schedule(s) attached ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) ~ Street Address City State Zio Yearls) Commission paid Attorney's Fees Wm. D. Schrock III Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant John Alan Kirk Street Address 315 15th Street city New Cumberland state PA zio 17070 Relationship of Claimant to Decedent Spouse Probate Fees Accountant's Fees Tax Retum Preparer's Fees Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 8,211.00 2,500.00 3,500.00 141.50 443.00 14,795.50 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF ~ FILE NUMBER Wilcox, Adele Keigler 21-10-0656 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex eR Haas 1 Auer Cremation Services of Pennsylvania 1,556.00 2 Cory Niofoutr -organist for Memorial Service 150.00 3 Dawn Taylor, Ruth Woodkin, Sharon Vandigritt -honorariums for clergy 800.00 4 Floral spray for casket 200.00 5 Gratuities paid for various deliveries and to cemetery workers 250.00 6 Janell Foreman -Church Choir for Memorial Service 125.00 7 Mary Ridyard -funeral luncheon 625.00 8 Printing of leaflets for Memorial Service 145.00 9 Valley Forge Memorials -grave marker and engraving 2,260.00 10 Washington Memorial Chapel, Valley Forge Church Yard -purchase lot, open and close 2,100.00 grave H-A 8,211.00 Other Administrative Costs 11 Postage for acknowledgments and announcements 128.00 12 Register of Wills of Cumberland County -Inheritance Tax Return filing fee 15.00 13 Travel expense, including tolls, from Harrisburg to Phoenixville for three trips to finalize 300.00 arrangements Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF I FILE NUMBER Wilcox, Adele Keigler 21-10-0656 ITEM NUMBER DESCRIPTION AMOUNT H-B7 443.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-08) SCHEDULE J COMMN~~NT~ECE[)I~NT "ANIA BENEFICIARIES ESTATE OF FILE NUMBER Wilcox, Adele Kei ler 21-10-06 56 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (V1lords) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 John Alan Kirk Spouse 315 15th Street New Cumberland, PA 17070 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAMENT DUVALL, REUTER 'RUYNE & ONDREY ATTORNEYS•AT-LAW TOWANDA, PA DUSHORE, PA LERAYSVILLE, PA I, ADELE KEIGLER WILCOX, Po O. Box K, Dushore, Pa., 18614, declare this to be my Last Will and Testament, re- voking and making void hereby all former Wills and Codicils thereof by me at anytime heretofore made. FIRST; I order and direct the payment of all claims which may be legally asserted against my Estate as soon as may be conveniently possible following my death. SECOND; I leave the rest, residue and remainder of my Estate of whatsoever kind and wheresoever situate to my husband, JOHN ALAN KIRK, if he is alive at the beginning of the thirty-first (31) day following the date of my death. THIRD: If my husband is not alive at the beginning of the thirty-first ( .~l 3 da_y following the date <~f my death. I direct that such items of my tangible personal property as shall be specifically listed on a separate writing to be prepared and signed by me shall be distributed in accordance with my wishes as expressed at such writing. To the extent that there are items of tangible personal property which are not listed in that writing, I direct that such items shall be distributed to my sons, DOUGLAS GREGORY SMITH and BENJAMIN VINCENT SMITH and to my husband's sons, JOHN ALAN KIRK, JR. and JEFFREY G. KIRK, or to their issue per stirpes. /. ~ 9 i FOURTH: If my husband, JOHN ALAN KIRK, is not alive at such time, I give the rest, residue and remainder o.f my estate of whatsoever kind and wheresoever situate to DOUGLAS GREGORY SMITH, BENJAMIN VINCENT SMITH, JOHN ALAN KIRK, JR. and JEFFREY G. KIRK or to their issue per stirpes. FIFTH: I hereby nominate, constitute and appoint my husband, JOHN ALAN KIRK, to serve as Executor under this, my Last Will and Testament. In the event of his death, inability, or refusal to serve, I hereby nominate, constitute and appoint DOUGLAS GREGORY SMITH, of Philadelphia, PA to serve in his place and stead. SIXTH: My Executor, in addition to the powers granted to him by law or other provisions herein contained, may exercise the following powers, which shall continue after the termination of my Estate provided for herein until actual distribution of the assets: A. To sell at public or private sale, to mortgage, C~ ~ ~ C;` ~_~ ~ rr ~y} ~ r"; . t ~'~ ~. e a S ~ f G r a.?"k y ~'ie ~~ ~ rJ ~. ~~ f ~ i i~lc _ c1.-rl1 real or personal property which at any tine norms a part of my Estate and to give options for sale, ex- changes or leases. . B. To retain whatever investments, securities, stocks and bonds I may own at the time of my death in the form in which they may be and in making new investments, my personal representative shall not be restricted to those investments known as "legal investments" as de- fined by the Fiduciaries Investment Act of 1949 as amended. DUVALL, REUTER PRUYNE & ONDREY ATTOR NEYS-AT-LAW TOWAN~A, PA DUSHORE, PA LERAYSVILLE, PA C. To have the right to borrow money, mortgage real estate, pledge personal property as collateral for loans and compromise claims after my death. D. To invest in all forms of property, including com- mon and preferred stock, common trust funds,~a~d ,~ ,. mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representative deems proper without regard to any principle of diversification or risk. E. To execute and deliver any and all instruments in writing which my personal representative may deem ad- visable to carry out any of the foregoing powers. No party to any such instrument in writing signed by my personal representative shall be bound to see to the application by my personal representative of any money or other property paid or delivered pursuant to the terms of any such instrument. F. And to retain appropriate financial, accounting and legal advisers from time to time to pay their normal and reasonable charges for such services. DUVALL, REIJTER ~RUYNE 8 ONDREY ATTORNEYS-AT-LAW TOWANDA, PA DUSHORE. PA LERAYSVILLE, PA I direct that no fiduciary serving under the provisions hereof shall be required to give bond or enter security in any jurisdiction in order to qualify or to continue as such, ~::~- .,-??ie ~,r la.:ti ~~_~ the cor~trar~r nc?~~a.ii~hs~ta.nJ.? iii IN WITNESS WHEREOF I, ADELE KEIGLER WILCOX, the~~~~-~- Testa-prix, hereunto set my hand and seal this ;-~~ ~'- ~ a y of . ;- -yr ~ 1994. __ -, ~ ADELE KEIGLER ILCOX The foregoing instrument, consisting of 2 pages, was on the date hereof signed, sealed, published, and declared by ADELE KEIGLER WILCOX, Testatrix, herein, as and for her Last Will and Testament, in our presence, who in her presence and at her request and the presence of each other, - 3 - TD 5177 (Nowenb~r 200 Legacy Treasury Direct www.treasurydirect.gov ~-eoara2-mss 1-304-480.864 (Outside the U.S.) JOHN A KIRK SR 315 15TH ST NEW CUMBERLAND PA 17070 _ _ -- 717) 636-1005 - _ ~ - - - - - - - 332-32-00?.~-- ~ - z No withholdin Mai~ng Number. 021005fl11 TREASURY RETAII, SECL'~P~I'I'IES SITE P.O. BOX 567 PITTSBURGH PA 15230-0567 PHONE: (800) 722 2678 Payments made by direct deposit to: INTEGRITY BANK - Routing Number. 031318787 on Account= 70I~TA _ ---- G Account Number. 0203004211 ACCOUNT HOLDINGS TRANSACTION HISTORY For 06/03/2010 to 06/0412010 IF YOU HAVE DUESTIONS CONCERNING THOS STATEMENT, PLEASE CONTACT YOUR TREASURY RETAIL w© °~' w 0 0 ~••, N ~ ~ ~- W r ~ ~' U ! l11 a ~ ~ N ~~~ ~ ~~ ~~ ~w ~ N _„y ~SQ~1t1+~C"- p o '~ r =w~+i ^