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Home My WebLink About10-06-10 (3) N n C~ ® ~ j ~"7 C:O"Q ~ - --~ n'1 1 i }_ i FAMILY SETTLEMENT AND FINAL RELEASE ~~ ~ -,~,- °` ` ` ~ ' ~ _3 r- J n ~ .. ==i h~ ; ri ESTATE OF BARBARA S• BOURDETTE, DECEASE ~~~, ~~ u ~~ cn - ,a rW KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, BARBARA S• ETTE, late of 15 Cedarhurst Lane, Camp Hill, Cumberland County, Pennsylvania, BOURD ed died testate on July 25, 2010, having made and executed her Last Will and Testament deceas , on October 14, 2009; WHEREAS, letters testamentary for the estate of the said decedent were duly issued on 010 b the Register of Wills of Cumberland County, Pennsylvania, to LISA B. Bock, August 2, 2 Y Executrix, hereinafter called personal representative, for the Estate of BARBA~ S• BOURDETTE, Number 21-10-0777; WHEREAS, the said personal representative has gathered the assets of the estate of the cedent and the assets consist of both real property and personal property, to a total value said de 319 739.32, as set forth in Exhibit A, which is the inheritance tax return of the said estate, of $ and which is attached hereto and made a part hereof, and marked Exhibit A; WHEREAS, the debts, including the payment of inheritance tax in the said estate, have been paid; It is hereby stipulated that Lisa B. Bock and Leslie J. Sansone agree to modify the 'bution as set in Exhibit A, at Schedule J, in that Lisa B. Bock will take the real property at di stri Cedarhurst Lane, Camp Hill, Pennsylvania, free and clear, and in return for allowing her to 15 L roe and forsaking her interest therein Leslie J. Sansone shall receive a lump take said real p p rtY 0.00 and Leslie J. Sansone shall receive an additional $28,500.00 if and/or when sum of $50,00 ma decide, choose or otherwise opt to sell, and thereafter complete, consummate, Lisa B. Bock y e u on the sale, of said real property. Otherwise, the distribution shall remain as or otherwise clos p outlined in Exhibit A at Schedule J; THEREFORE KNOW YE, that we, LISA B. Bock and LESLIE J. SANSONE, NOW, 1 of the children of the said decedent and heirs under the WILL, and being those persons being al rit under said testate provisions, do hereby, each of us, acknowledge that we have entitled to mhe nd received from the aforesaid personal representatives, in full satisfaction and this day had a m or sums of money due us under said WILL, which amounts we have received payment of all su amounts are in the amount set opposite our respective names in the table and this day, and which ution in said statement attached hereto and marked Exhibit A, unless modified schedule of distrib herein; ND each of us does hereby stipulate that in order to avoid the expense and time A , in the filing of a formal account and schedule of distribution, we each agree that no involved ecess and we do hereby agree that we do consent to distribution being made account is n ~' ilin of an account and schedule of distribution, the same to be with the same force without the f g e had been filed and confirmed by the Orphans Court Division of the Court of and effect as if th y Common Pleas, Cumberland County Branch. THEREFORE ~'~'e and each of us do hereby remise, release, quitclaim and forever aid ersonal representatives, their heirs, executors, and administrators and assigns, discharge the s p the said estate and from all actions, suits, payments, accounts, reckonings, claims, of and from 2 ~~ ~ for and othef > ~' ~~ of thing ar~d demands ~ ~ `~ ~ fl the ~ of the said ~ cash o~tu ~ ~ ~~~ ~uvhatsoevcr tot~h~ Who after ~ ~.il+Ef ' 1i~bilty come to the .estate of the said decedent co-~enant ~~ aatt e~th each ~r si g of this agreement, we and each of us dv hY ~~ ~ rata o~ sip oftlr~ estate tc~ the aforesaid Personal r+:~ar~s~ve that we 'will trilrttt~ ~ clai~xs, demo sins, yr canse~ of ~~an v~lZich tnay he s~u:c~ssftill satisfy ~ the said ~ or the a£ar~d P~$°~ F°~ the signi~s prosecut,Ed against ~d fuxal release. Ming and delivery of this family s~~~ ve hereto set out haFids and seats this ~~- }~ WITNESS V/a~H~~~~ `~``e ha ~~h~,1 y LVkLf. Qf ~~/ J /~) WITNESS: 3 .. ~.. .. :. Ty' ... .. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND ~_ da of ~"~ ~~ , 2000 ,before me, a Notary On this, the Y Public, the undersigned officer, personally appearedrumlent andOacknowledged that he executed person whose name is subscribed to the within In the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. ~j ~ ~S `' IAL SEAL `~ " NOTAR CAROLE A ROSE Notary Public Notary Public LOWER ALLEN TWP, CUMBeRLAND COUNTY My Commission Expires: ~;(., • ~ ~ ~ My Commiss-on Expires Dec b, 2011 ~- . SS: COUNTY OF . ~_ da of ~~______-~ 20Q~ before me, a Notary On this, the Y Public, the undersigned officer, personally appeared LESLIE J. SANSONE, known to me to be the person whose name is subscribed to the withinidnstrument, and acknowledged that she executed the same for the purpose therein conta IN WITNESS WHEREOF, I have hereunto set my hand and official seal. NOTARIAL SEAL CAROLE A ROSE Notary Publlc LOWER ALLEN TWP, CUM9ERLAND COUNTY My Commission Expires Dec b, 2011 ICJ X ~' otary Public My Commission Expires: ~ - ~ ,~~ 4 1505610101 OFFICIAL USE ONLY '-"~ REV-1500 Ex (~~-~~~ PA Department of Revenue ~ Mme County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOx 280601 RESIDENT DECEDENT Harrisbu PA i 128-o6oi ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 192-30-0903 07/25/2010 08/07/1939 Suffix Decedent's First Name _ _ MI Decedent's Last Name _ Barbara S Bourdette __ _ _. __ _ ___ . _ ...................... . (H Applicable) Enter Surviving Spouse's Information Below MI Spouse's Last Name ___ Suffix Spouse's First Name __ __ _ _ __ __ ..... _ ............. . _. Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS _. FILL IN APPROPRIATE OVALS BELOW 3, Remainder Return (date of death (~ 1. Original Return O 2. Supplemental Return O prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of WiII) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 1Q' betweenl2-3 91Cand 1a1tg5)f death O 11. EAttach SchaO) nder Sec. 9113(A) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX DaytRme Te ephone NumbeECTED T0: Name (717) 731-1600 James W. Kollas REGISTER OF WILLS USE ONLY First line of address _ _ _ _ _ __ __ _ _ __ Kollas and Kennedy .._ .................. ......................... . ........................ Second line of address 1104 Femwood Avenue City or Post Office _ _ _ . Camp Hitl State PA ZIP Cod DATE FILED e .17011 Correspondent's a-mail address: 'ames kollasandkenned .com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, cor and complete. Declaration of preparer other than the personal representative is based on all information of which prepareDATE any knowledge. ,..,..,.r, ~ c ocRCnuRESPONSIBLE FOR FILING RETURN j,~ ~ ~ ~.~ ~,~~ / ~~ ~ 7 THAN t5~ PLEASE U8E 1505610101 Side 1 DATE /,~ ~~ ~ ~~ i Y 1505610101 O REV-1500 EX Decedent's Name: RECAPITULATION 1. Real Estate (Schedule A) ........................................... ............... .. 1. 157,200.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. ' 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 143,908.35 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 18,630.97 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 0.00 8. Total Grass Assets (total lines 1 through 7) ........................... .. 8. 319,739.32 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9.: 7,686.65 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) ........... ... 10. 825.72 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 8,512.37 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 311,226.95 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which - an election to tax has not been made (Schedule J) ...................... .. 13. 500.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 310,726.95 TAX CALCULATION -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 .0- 15. 0.00 16. Amount of Line 14 taxable at -ineal rate X .0 45 310,726.95. 16. 13,982.72 17. Amount of Line 14 taxable _ _ _. at sibling rate X .12 17. 0.00 18. Amount of Line 14 taxable . at collateral rate X .15 ._ ...... ....... . .. _........... t8. 0.00 19. TAX DUE ....................................................... .. 19. _ ._ 13,982.72 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505610105 Decedent's Social Security Number 192-30-0903 O Side 2 L 1505610105 1505610105 J REV-1500 EX Page 3 Flle Number Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 13,982.72 2. CreditslPayments A. Prior Payments 0.00 B. Discount 699.14_ Total Credits (A + g) (2) 699.14 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 13,283.58 Make check payable 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 : .......................................... .. ^ c. retain a reversionary interest; or ........................................................................................................................ .. ^ d. receive the promise for life of either payments, benefits or care? .................................................................... .. ^ Z. If death occurred after Dec. 12, 1982. did decedent transfer property within one year of death without receiving adequate consideration? .............................................. .............................................................. ^ .. 0 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ............ .. ^ Q 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 of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1,1) (i)]. For dates of death on or after Jan. 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)]. Asibling 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-1502 EX+ (11-08) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Barbara S. Bourdette 21-10-0777 All real property owned solely or as a tenant in common must be roported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Indude a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' 15 Cedarhurst Lane, Camp Hill PA 17011 157,200.00 TOTAL (Also enter on Line 1, Recapitulation.) ~ ~ 157,200.00 If more space is needed, insert additional sheets of the same size. REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHED~/LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Barbara S. Bourdette FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by thn wcfnfn 21'10-077 All eromrh. t.,~..~~..,....--~ ---...- .-.. - REV-1509 EX+ (Oi-10) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCE16ptILE F JOINTLY-OWNED PROPERTY C~TATE pF: Barbara S. Bourdette FILE NUMBER: 21-10-0777 It an asset became jointly owned within one year of the decedent's date of death it must lye re ~ ported on 5chedula G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS A• Lisa B. Bock B. C. 70INTLY OWNED PROPERTY: RELATIONSHIP TO DECEDENT 15 Cedarhurst Lane, Camp Hill, PA 17011 Daughter ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INS7ITUTTON AND BANK ACCOUNT NUMBER OR SIMILAR °~0 OF DATE OF DEATH IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE DATE OF DEATH DECEDENT'S VALUE OF 1. A. . PNC Bank Account #xxxxxx5648 VALUE OFASSE7 INTEREST DECEDENT'S INTEREST 13,215.78 50 6,607.89 2 A PNC Bank Account #xxxxJOC2713 24,046.15 50 12,023.08 TOTAL (Also enter on Line 6, Recapitulation) I; 18 630 97 If more space is needed, use adddional sheets of paper of the same slze. REV-1510 EX+ (08-09) Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE AC Barbara S. Bourdette FILE NUMBER This schedule must be comn~arod ~.,,~ fi~ea ;f.~._ ___...__._ 21-10-0777 REV-1511 EX+ (10-09) -~ Pennsylvania DEPARTMENT OFREVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS rr.n.r. yr Barbara S. Bourdette Decedent's debts must be reported on Schedule I. A• I FUNERAL EXPENSES: 1' Musselman Funeral Home, funeral services FILE NUMBER 21-10-0777 2,485.00 B. ADMINISTRATIVE COSTS: I• Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: Z• ~ Attorney Fees: 0.00 1,000.00 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 3,500.00 Claimant Lisa B. Bock street address 15 Cedarhurst Lane city Camp Hill State PA ZIp 17011 Relationship of Claimant to Decedent Daughter 4• Probate Fees: 701.65 5• Accountant Fees: 0.00 6• Tax Return Preparer Fees: 0.00 ~. State ZIP --__ TOTAL (Also enter on Line 9, Recapitulation) I $ 7 686 65 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) ~ ~ Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES $e LIENS RESIDENT DECEDENT ESTATE OF Barbara S. Bourdette FILE NUMBER Report debts incurred by the decedent n~~~ -,. a.~.~..~~ ___,_ _. .. 21-10-0777 REV-1513 EX+ (O1-10) ~ Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: Barbara S. Bourdette NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Do Not List Tri Sec. 9116 (a) (1.2),] 1• Lisa B. Boric, 15 Cedarhurst Lane, Camp Hill, PA 17011 Daughter 2• Leslie J. Sansone, 3310 W. Bright Terrace, Tucson, Arizona 85741 Daughter FILE NUMBER: 21-10.077 AMO~ NT OR S OF ESTATE 50% 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. Christian Life Assembly, 2645 Lisburn Road, Camp Hill, PA 17011 500.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. # 500.00