HomeMy WebLinkAbout09-27-10 (2)1505610143
REV-1500 Ex(°'_'°''
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code veer File Number
Bureau of Individual Taxes °~°~"*aE"*~"~'^"~
Po Box.2aoso~ .INHERITANCE TAX RETURN 21 10 0811
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
202 01 5108 08 05 2010 11 01 1918
Decedent's Last Name
MARQUART
Suffix Decedent's First Name
MILDRED
MI
R
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF-WILLS
FILL IN APPROPRIATE OVALS BELOW
. O 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Retum (date of death
oriorto 12-13-821
^ 4. Limited Estate ^ 4a. Future Irnerast Co q omise 5. Federal Eataie Tex Retum Required
(data of death artei 72.12.82> ^
X 8. Decedent Died Teetale
^ (Attach Copy of will) ^ ~ Dacetla Mair~ netl a Living Trust 1
(Attach copy of~ruat) s. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 10. bg°twue~er;Pt~~1~1 a~dtttlatge5~f death ^ 11.Election to fax under Sec. g113(A)
(Attach Sch. O)
CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
RICHARD L WEBBER JR ESQU 717 532~.,~388 ,,
y
C C
-+..
REGISTER I~LS US LY ? ~ ~?
..,
~
,
r~ r., "'~
~ ~ ,
First line of address ~ ~ ~ r~
126 EAST ICING STREET j~CY A. c?
Second line of address r
- .x7 = _ 3~
- , t
~ _.,t ...
.n ~ '-=
r-
~ i.7
City or Post Office DATE FILED h+ ,
State ZIP Code
SHIPPENSBURG PA 17257
Correspondent's e-mail address: rwebbBrt~WtBigleaS80C1ateS.COm
Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules antl statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
William R. Boldosser ~.,.T/ ~ ~ // ~
SIGNATURE OF PRE RER OTHER THAN REPRE ENTATIVE D9TE
/~ . ~ ~ Richard L .Webber, Jr. Esquire y ~a3 /~
126 East King Street, Shippensburg, PA 17257
Side 1
1505610143 1505610143
~~
_I 1505610243
REV-1500 EX
o.ceaern~aNeme: Marquart, Mildred R.
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
Decedent's Social Security Number
202 01 5108
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......:................................................ 4.
5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 158 , 012.68
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested............ 7, 163 , 140.92
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 321 , 153.60
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 34 , 930.54
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 3 , 0 97.03
11. Total Deductions (total Lines 9 & 10) ................................................................... 11, 38 , 02 7.57
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 283 , 12 6.03
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which'
an election to tax has not been made (Schedule J) ............................................... 13, 2 63 ,12 6.03
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14; 2 0 , 0 0 0.00
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X :00 15. 0 . 0 0
16. Amount of Line 14 taxable
at Ilneal rate X .045 O. O O 16. O. O O
17. Amount of Line 14 taxable
at sibling rate X .12 17. 0 , O 0
18. Amount of Line 14 taxable
at collateralrateX.15 20, 000.00 18. 3, 000.00
1 s. Tax Due .................................................................................................................. 19. 3, 0 0 0. 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243 J
Rsv-7608 EX+ (8.981
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Marquart, Mildred R. 21-10-0811
Include the proceeds of lifiganon and the date the proceeds were received by the estate.
All properly Jointly-owned with Uta dght of ourvtvorahip moat tw tlisclowd on whedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Ameriprise Financial Acct. #0000 2138 6198 2 021
5,282.40
2 Blue Cross/Blue Shield -refund
100.00
3 FB~M Trust #075-2975087 -Certificate of Deposit
33,067.98
4 F8<M Trust #015-2886213 -Certificate of Deposit
101,317.39
5 F8<M Trust #33-07077 -Checking Account
18,244.80
TOTAL (Also enter on Line 5, Recapitulation) I 158 012 68
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-7810 EX+(8.89)
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSriVANIR
INHERrrANCE TAX RETURN
REa1DENT DECEDENT
ESTATE OF FILE NUMBER
Marquart, Mildred R. 21-10-0811
This schedule must be completed antl filed ii the ensurer to any of questions t through 4 on the reverse side of the REV•1500 COVER SHEET is yes.
ITEM I DESCRIPTION PR Y DATE OF DEATH %OF DECD'S
NUMBER THE DATE OF TER~ANSFER SATfACIiTA COPY OF THE DEED ~OREREAL EST tTE. VALUE OF ASSET INTEREST
Ameriprise Financial Acct. #0930-0783-3343-0-004 -
Transferrees -Date of Transfer August 5, 2010
William R, and Dorothy Boldosser, Cousin and
Spouse $10,000.00
38 Mount Rock Road
Newvilie, PA 17241
First Church of God -Charity $78,570.46
475 Shippensburg Road
Nettwllle, PA 17241
Newville Historical Society -Charity $38,285.23
69 S. High Street
Newvllle, PA 17241
John Graham Public Library -Charity $38,285.23
9 Parsonage Street
Newvllle, PA 17241
TOTAL (Also enter on Line 7, Recapitulation)
183,140.92 X100.000°/.
TAXABLE
VALUE
183,140.92
163,140.92
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule G (Rev. 6-98)
ESTATE OF
REV-1181 EX* (10-08)
SCHEDULE H
COMM~I T ~F~D~,U„A ADM NISTRATIVE C S S
Mildred R.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
FILE NUMBER
21-10-0811
AMOUNT
8,063.57
12,634.61
12,534.61
City State Zip
Relationship of Claimant to Decedent
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
William R. Boldosser
street Address 36 Mount Rock Road
city Newville state PA zip 17241
Year(s) Commission paid 2011
2. Attorney's Fees Weigle Sr Associates, P.C.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4. Probate Fees
' 5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
419.50
1,178.25
34,930.54
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-D6)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Marquart, Mildred R. 21-10-0811
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative e~ c
1 Cumberland Law Journal -Legal Advertising 75.00
2 Howard's Accounting -Reserve for income tax return preparation 250.00
3 Register of Wills -Filing fee for inheritance tax return 15.00
4 Register of Wills -Filing fee for First and final Accounting and Schedule of Proposed 250.00
Dlstributfon
5 Valley TimesStar -Legal Advertising 88.25
6 William Boldosser -Transportation costs, long distance phone calla, copying charges, 500.00
postage and misc. expenses
H-B7 1,178.25
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7600 Schedule H (Rev. 6-98)
Rav1672 EX+(72AE(
SCHEDULE 1
DEBTS OF DECEDENT
,
MORTGAGE LIABILITIES, 8~ LIENS
COMMON W SALT H OF PENNSV LVANIA
INHERITANCE TAX RETURN
RESIDEM DECEDENT
ESTATE OF FILE NUMBER
Marquart, Mildred R. 21-10-0811
R~polt debb ineumd by the ascWant prbr to dsNh thtl nmeln~d unpNd at Iha drAte of daatl~, Including unnlDlbunW msdleN ~xpsmr.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 Camp Hill Emergency Physicians
23.19
2 Cumberland Goodwill- EMS 101.00
3 Millineum Pharmacy 104.08
4 Newvllle Ambulance Service 180.00
5 Presbyterian Homes, Inc.
1,981.26
6 Presbyterian Homes, Inc.
707.50
TOTAL (Also enter on Line 10, Recapitulation) I 3 097.03
(IF more space is needed, additional pages of the same size).
Copyright (c) 2009 form software only The Lackner Group, Inc. Form pA-1600 Schedule I (Rev. 12-OB)
REV-1673 EX+(~~-081
COMt~1. (){{W~OF~F~VANIA
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Marquart, Mildred R. 21-10-0811
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
no Not Llat Trustee s
I TAXABLE DISTRIBUTIONS (include outright spousal
1 I ~Iliam R. and Dorothy Boldosser
36 Mount Rock Road
Newville, PA 17241
Other I TEN THOUSAND
DOLLARS
20,000.00
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 15 0 cover sheet, as appropi
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9173 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Nevtnfille Historical Society
2 First Church of God
3 John Graham Public Library
20,000.00
65,781.51
131,563.01
85,781.51
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-150D COVFR sHFFT ~aa a ~a n~
Copyright (c) 2009 form software only The Lackner Group, Inca Form PA-1500 Schedule J (Rev. 11-OB)
.Z.AST Fi'~~ A.l~ll T~'STAt~LGNT
I, Mildred R. Marquart, presently residing at 210 Big Spring Road, Newville, West
Pennsboro Township, Cumberland County, Pennsylvania 17241, .being of sound mind, memory
and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby
revoking and making void all Wills by me at any time heretofore made.
FIRST. I order and direct the payment of all my legally enforceable debts as soon as
may be convenient after my decease. My funeral expenses have been prepaid.
SECOND. I hereby give and bequeath the the full sum of Ten Thousand ($10,000.00)
Dollars to William R Boldosser and Dorothy Boldosser, on a per. capita distribution basis, this
gift to be considered in my name as well as that of my deceased sister, Dorothy C. Marquart:
THIRD. I give, devise and bequeath all of the rest, residue, remainder of my estate,
real, personal and mixed, whatsoever and wheresoever situate, as follows, with said gifts being
considered in my name as well as that of my deceased sister, Dorothy C. Marquart:
A. Fifty (50%) percent to my church, Fast Church of God of Newville,
Pennsylvania;
`~ B. Twenty-five (25%) percent to the Newville Historical Society of Newville,
Pennsylvania; and
C. Twenty-five (25%) percent to the John Graham Public Library of
~ Newville, Pennsylvania
FOURTH. I nominate, constitute and appoint William R Boldosser. to be the
E~tecutor of this my Last Will and Testament. In the event that he be unable to fulfill the duties of
~ Executor, I then nominate, constitute and appoint Richard L. Webber, Jr., to be the Executor of
this my Last Will and Testament.
FIFTH. To the greatest extent permitted by law, .before actual payment to a
beneficiary or to his or her account, no interest in income or principal shall be assignable by a
beneficiary or available to anyone having a claim against a beneficiary.
SIXTH. I direct that my personal representative(s) shall not be required to give bond
for the faithful performance of their duties in any jurisdiction.
~, SEVENTH. I hereby direct that 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 in connection with such taxes,
WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
shall be considered a part of the expense of administration of my estate and that such be paid out
of the rest and residue of my estate.
IN WITNESS WHEREOF, I, Mildred R. Mazquart, have hereunto set my hand and ~eal to
this my Last Will and Testament, the first page signed for identification only, this (~
day of ~/~ u ~ ~ ~ , 2010.
~,:-,~~ ~
(SEAL)
MILDRED R. MARQUART
WEIGLE 6c ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHfPPEN56URG, PA 17257-1397
This instnunent was by the Testatrix, on the date hereof, signed, published and declared by her to
be her Last Will and Testament, in our presence, who at her request and in the presence of each
other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed
our names as witnesses.
~~ /~ - ~.~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, Mildred R Mazquazt,'the person whose name is signed to the foregoing instnument, having been
duly. qualified according to law, do hereby acknowledge that I signed and executed the instrument
as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
~~~'°
MILDRED R UAR
Sworn or affirmed to and acknowledged before
me by Mildred R. Mazquart, the Testatrix,
this f S~'`'day of ~.~ ~, „ , ZO10.
Notary
Naiarisi S6~
R. WaYad, Namryl Putt
Ig 6or~, GLRrL~zrland Colstiy
PJ{y ,iicg;^s+;"~=..`=r:_` .:-^n, Qn. 2Di3
WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17 267-13 9 7
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLANI3 .
We, ~ud ~ fh A. (~ ~b6 e ~ and /~--, C ~~~~ L.. L ,~.~~~ J ,~
the witnesses whose names aze signed to the foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw Mildred R Marquart, the Testatrix, sign
and execute the instrument as her Last Will; that she signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the
Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no
constraint or undue influence.
~1 ~ , fib/ E%l~~C~/
Sworn or affirmed to and subscribed before me
r^ r`/, ~
bY_ J!.(~i~ lI ~~6P~1
wi ss 1 s, this r~ I ~t ~of ~ C /J, 2010.
Public
r ~~
~q.~VY~oy/~~adC ca
-'x"114 W~~1 M M
WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-73 9 7
4' •-~
I
ltrastonline.com
~~~~
August 19, 2010
Weigle & Associates, P.C.
Attorney's-at-Law
126 East King St
Shippensburg, PA 17257-1397
To Whom It May Concern:
RE: Mildred R. Marouart
In reference to the above customer, our records show the enclosed information to be
accurate of today's date. If I may be of any further assistance, please contact me.
Sincerely,
Tricia Ganoe
Deposit Operations Manager
717-261-3624
717-264-6116 888-264-6116 P.0. Boz 6010 Chambersburg, PA 17201-6010
FINANCIAL SOLUTIONS... FROM PEOPLE YOU KNOW
0
m
3,
0
m
m
5
m
c
m
0
w
m p
N
+
O
h ~ N
G Y m
pO W m
O
O
W
NN
M
p
V V O
V
m~
~2
H M
O pO
S N
ppO M N
O ppO MM
O N
pOp M w N~ q n p~
~ 4/ O 6a • 4
O
S O O O O O '
O
N
O~~ S
y
y
V A
m O ~
S
O ~
~~D
~~.
,
Sa3n~'
a
'
z~zz
~
~~i~~
G C C C o
d m m m
3 3.7 .Z
n
o`
Q
a
a
s°
~g
~~
PZ
g~
D 3
ad 3
~~
N ~
O
m
O
C
m
The Personal Advisors of
Ameriprise
Financial
September 14, 2010
Richazd Webber, Jr., Esq
Weigel & Associates, P.C.
Attorneys at law
126 East King St
Shippensburg PA 17257
Sara R. NeaCley, CFP®, CRPC®,
CFS
Flnancial Advisor
CER'nFlGD FINANCwL PuNNQtTM
practitioner
Ameriprise Fnancial Services, Inc.
Suite 103
4 Lemoyne Drive
Lemoyne, PA 17043
Tel: 717.737.5455 Fact. 13
Fax: 717.737.4944
Sara. r.neagley@ampf.com
ameri priseadvisors.com
Dear Mr. Webber,
I am writing to provide you with the information you requested in your letter of
8/12/2010. Miss Mazquart was the owner of two accounts at Ameriprise:
Account # Ownership Opened Date of Death Value
930076334430004 Individual 11/29/2005 $163140.92
213861982021 Individual 10/08/2002 $5282.40.
As mentioned on our phone call, the distributions out of the annuity account #
930076334430004 have been completed. They were distributed as follows:
$1.0,000 to William R Boldosser
Of the remainder:
50% to First Church of God
25% to Newville Historical Society
25% to John Graham Public Library
There remains the smaller account # 213861982021 with $5282.54 in it, which will be
distributed to her estate. I have a call.. in to the case manager for this estate settlement to
make sure that check gets mailed out to her executor, Mr. Boldosser as soon as possible.
If there is more information needed, please do not hesitate to contact me.
Sincerely,
Saza R Neagley, CFP, CRPC, CFS
Financial Advisor
An Ameriprise Financial franchise. Ameriprise Fnancial Services, Inc. offers financial advisory services, investments, insurance and annuity products. ~t~O%`
RiverSource' products are offered by affiliates of Ameriprise Flnancial Services, Inc., Member FlNRA and SIPC. `I~•~