HomeMy WebLinkAbout09-01-10 (3).e.- _ _ _
1505610143
Ritr ~ - ^ vwv ... OFFICIAL I~1 3E ONLY
PA Department Of Revenue psnnsyivenia courny code Year FNe Number
Bureau of Individual Taxes e®°""~1TOf1~°e^
Po Box.2sosol INHERITANCE TAX RETURN 21 ~ 10 0598
Harrisburg, PA 17128-0801 RESIDENT DECEDENT ~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
~
204 O1 2699 05 23 2010 10 25 1915
~~~
Decedent's Last Name Suffix Decedent's First Name MI
GOUDY MARIE H
(If Applicable) Enter Surviving Spouse's Infomtation Below I', ~
I
Spouse's Last Name Suffix Spouse's First Name ~ MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPL
CA-TE WITH THE
REGISTER OF WIL S~
FILL IN APPROPRIATE OVALS BELOW
emai
O 1. Original Retum ^ 2. Suppbmental Retum ^ 3' p (date of death
d
~
„ 2
13-82)
^ 4. Limited Estate ^ 4a. Fie 1A1efit ~~fO1"~e ^ 5. F
(date of deWh after 2-12-92) 1 Effitate Tax Retum Required
® g Dswdent Died Teelale ~ ~• ~ olTrwl) LWinp Tnut 0 8. Total
(Adech Copy of VNII) m ~ ~~ urrVDer of Safe Deposit-Boxes
^ 9. l.itlgation Proceeds Received ^ 10. ~1~~) death ^ 11.~A~ tq O~ nder Sec• 9113(A)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INF TION SHOULD BE DIRECTED TO:
Name Daytime T ~hons Number
WM D SCHRACK III 717 4 3~ 9733
RE(313T WILLS US~NLY
O o _a_~
Ffrst line of addross r1 ~ r'*7
C;
~~m ~ `
124 W I3ARRISBURG STREET `
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Second Ilne of address C7 U r .)
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~ FILED w
City or Post Office State ZIP Code ;
~
,
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DILLSBURG PA 17019 'i
Schracklaw(~comcast.net
Correspondents a-mall address: ~,
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h It~derP a~ndi~leU~r~ab' on~a~p t marl Ute persona"I n~fa>ivb b ~~on al iMorn'of~d
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31 OF PERSON RE F R FILINt3 RETU N ` DATE
`' Richard E. Goud ~d
Ao
~
i
504 Falcon Drive Cslrlisle PA 17013-8777
SIGNATURE OF PRE O REP NTATNE DATE
Wm. D. Schrack ~ ~. d-
ADDRESS
124 W. H~rrisbu Street, DiNsbu PA 17019
Side 1
1505610143 15056 ~Id143 J
REV-1500 EX
~'•-+~^~~ Goudy, Marie H.
eoeden 's Social Seaulty Number
204 01 2699
RECAPRULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Glossy Hak1 Corporation, Partnership or Soie-Proprietorship (Sctredule C)......... 3.
4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4.
5. Cash, Bank Deposits & Miscellaneous Pensonal Property (Schedule E) ............... 5.
6. Jointer Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8~ Miscellaneoua I~q Probate Property
(Schedule G) LJ Separate 8ilfing Requested............ 7.
6, Total Gross Assets (total Lines 1-7) ..................................................................... 8.
63,182.09
234,611.69
297,793.78
16 , 160.80
9. Funeral Expenses & Administrative Coats (Schedule H) ....................................... 9.
147.72
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule q .............................. 10.
16,328.52
11. Total Dsductfons (total Lines 9 ~ 10) ................................................................... 11.
12. Net value of Estate (Line 8 minus Line 11) .......................................................... 12. 2 81, 4 65.2 6
13. Charitable and Governmental Bequesta/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13. ~,
2 81 , 4 6 5 . 2 6
14. Net Yaiw SubJect to Tax (Line 12 minus Line 13) ............................. 14, I
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 0 0
0 15
(a>(1.2) x .oo . .
16. Amount of Line 14 taxable 2 81 , 4 65.2 6 1 s.
at lineal rate X .045
17. Amount of Line 14 taxable
0
0 0
17
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0 0
0
18
at collateral rate X .15 . .
19. Tax Due ................................................. ................................................................. 19.
20. FILL IN THE OVAL IF YOU ARE RECUESTING A REFUND OF AN OVERPAYMENT.
0.00
12,665.94
0.00
0.00
12,665.94
Side 2
L, 1505610243 150561043
1505610243
J
REV-1500 EX Page 3 File Number 21-10-0598
Decedent's Complete Address:
DECEDENTS NAME
Goody, Marie H. I!i
STREET ADDRESS
801 N. Hanover Street
'~
CITY
Carlisle STATE I
PA ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) ,
2. Credits/PaymeMs
A. Prior Payments 12,000.00
B. Discount 631.58
3. Interest
4, If Line 2 is greater than Line 1 + Line 3, enter the ditferonoe. Thin is the OVERPAYMENT.
Check box on Page 2 Lfne 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the differonce. This is the TAX DUE.
Make Check Payable to:
Total Credits (A +
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE
(1) 12,665.94
(2) 12,631.58
(3)
(4)
(5) 34.36
TE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the properly trensferred :..............................................................................
b. retain the right to designate who shall use the property trona(emed or its income :.................................
c. retain a roversanary interest; or ...............................................................................................................
d. receive the promise for life of either payments, benefits or care? ........................................................... x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of deaf without ^
receiving adequate consideration? .......................................................................................................
3. Did decedent own an "in trust for" or payabb upon death bank account or security at his or her des ?....... ^ ^x
4. Did decedent own an Individual Retiroment Account, annuity, or other non-probate property which
corrtains a beneficiary designation? ................................................................................................................. 0 ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YE3, YOU MUST COMPLETE 8CHEDULE a AND Flt. I~' AS PART OF THE RETURN.
For dates of death on or after Juy 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers t or for the use of the surviving
spouse is 3 perc~t [72 P.S. §9116 (a) (1.1) (i)J.
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 th surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a trensfer to a surviving spouse from tax, and the statutory ulrements for disclosure of
assets and fifing a tax return aro still applicable even ff the surviving spouse is the only beneficiary.
For debt of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21ye ars of age or younger at death to or r tie use of a natural parent, an
adopWe parent, or a stepparent of the chikf 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 decxdent's lineal beneficiaries is 4.5 pe t, except as noted in
72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)J.
. The tax rate knposed 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 least one parent in common with the decedent, w ether by blo or adoption.
R~„_15Rt EYa /W1
-- -- - . SCNEDVLE E
+~ CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
corMONwEKTN of rENNSVw~
MlERRANCE TA7f RETURN
REa4ENT OECEOEWT '..
ESTATE OF FIL NUMBER
Go Mans H. 2 -10-0598
k,cwd. n,s procews a and n» d.u s» procMd~ vwrs ncsN.d by the ~..
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ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Pukon Bank checking account#3621-20228 ~ 61,040.06
2 Church of God Hom®-refund ~~ 1,770.10
3 Church of God Home -refund
~I
~I
I, 371.93
TOTAL (Also enter on Line S, Rscapitulatb ) ' 63,182.09
(If more space is needed, additlonal pages of the same size)
Copyright (c) 2002 form software ony The Lackner Group, Ina
Form A-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+ (6.81)
SCHEDULE 6 - -
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
t;OMAONVYEAI.TN of PErwsvLVANIA '~..
ar1ERITANCE TAX RETURN
RESIDENT DECEDENT '
ESTATE OF FILE NWMBER
Gou Marie H. 21 10i-0598
This schedule moat be oompbted end fibdrf the answer to any of questions 1 throiph 4 on the reverse aide of the REV-1500 COVER SHEE in yes.
ITEM
NUMBER ut~c,Klr - tcnv ~r rK~rtK I Y
TF E DAOETE OF ETRANF SFAET ~EIi A COPYEOF T~IiE QED FOR REAL Esi~~. DATE OF DEATH
VALUE OF ASSET 9i OF DECD'S
INTEREST
~l c ~~
pp~~gg~E) TAXABLE
VALUE
1 ING Contract #0007439-GG 26,718.28 26,718.28
2 ING Contract~C019089-GG 131,109.82 131,109.82
3 Lincoln National Contract #959976796 76,783.59 ~~~ 76,783.59
TOTAL (Also enter on Line 7, Recapitulation) 234,611.69
(tf more apace is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form P -1500 Schedule G (Rev. 6-98)
REV-1151 EX+(19-061 ~ _
scN~~u~~ H
co ,u,a FUNERAL EXPENSES ~
ADMINISTRATIVE COSTS
ESTATE OF FILE UMBER
Goud ,Marie H. 21- 0-0598
Debts of decedent must be reported on Schedule L
ITEM DESCRIPTION ~ AMOUNT
i
q, FUNERAL EXPENSES:
See continuation schedule(s) attached
3,873.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Richard E. Goudy
Street Address 504 Falcon Drive ~
City Carlisle state PA Zio 17013-8777
~i
Year(s) Commission paid 2010 5,496.00
p, Attomev's Fees Wm. D. Schrack III 6,238.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio ~I
Relationship of Claimant to Decedent ~
4. I
Probate Fees
186.50
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs ~ ~, 389.30
See continuation schedule(s) attached
TOTAL (Aiao enter on line 9, Recapitulation) 16,180.80
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form PA-15Q0 Schedule H (Rev. 10-06)
scHEau~E H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Goudv. Marie H. 21 0+0598
I
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral. Exg~nses Iii,
1 Gingrich Memorials -engrave marker ~, 140.00
~i
2 Stone & Murray Funeral Home 3,733.00
H-A ~'~ 3,873.00
Qther Administrative Costs
3 Carlisle Sentinel -estate advertisement
4 Clerk of Orphans' Court -Fiduciary Release filing fee
5 Cumberland Law Journal -estate advertisement
6 Miscellaneous expense during administration (phone, copies, postage, etc.)
7 Register of Wills -additional Short Certificates
8 Richard E. Goudy -reimbursement for out-of-pocket costs
Copyright (c) 2002 form software only The Lackner Group, Inc.
166.30
I
20.00
75.00
20.00
~I 8.00
~I~ 100.00
H-B7 i! 389.30
Form P,4-1500 Schedule H (Rev. 6-98)
i
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
casrorAAeA~n+ of PEwisnvAwlA
INHERRANCE TAX RETIMN
RESIDENT DECEDEr(T
ESTATE OF FILE NWMBER
Goud Made H. 21 1 0lA598
Report debts Incurrod by The decedent prior to death thst romNned unpaid et the date of dsalh, Ineludiny unrotmburosd cN iexpsnsss.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Continuing Care RX -last illness 147.72
TOTAL (Also enter on Line 10, Recapitulatlo ) 147.72
(If more space is needed, additional pages of the same size)
Copyright {c) 2009 form software only The Lackner Group, Inc. Form PA 15p0 Schedule 1 (Rev. 12-08)
SCHEDULE J
COA"'~~~~~'""'" BENEFICIARIES
I
ESTATE OF
FI
E
WUMBER
Goud , Maris H. 21 1 0.0588
NAME AND ADDRESS OF RELATIONSHIP TO
DECEDENT SHARE OF ES ATE MOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY (Words) (3b3)
I TAXABLE DISTRIBUTIONS [include outright spousal
'
• distributions, and transfers i
under Sec. 9116 a 1.2
Donald R. Goudy Son
112 E. 143rd Avenue ~
Tampa, FL 33613
Richard E. Goudy Son
504 Falcon Drive
l
Carlisle, PA 17013 i,
Lisa Goudy Peirano Granddaughter
~
156331ndian Queen Drive I
Odessa, FL 33556 '
Pamela Goudy Roman Granddaughter
312121st Avenue East
Tampa, FL 33612
~I
Total ~'
Enter dollar amounts for diaMbutions shown above on lines 15 thro h 18 on Rev 15 00 cover sheet a a ' ' te.
NON-TAXABLE DtSTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NO TAIKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
i
I
TOTAL OF PART I! -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF RfV-1500 COVER H
Copyright (c) 2009 form soiMrare only The Lackner Group, Inc. Form PA~1iSb0 Schedule J (Rev. 11-08)
~"~ ~# r.rX ~x `~.~~~~~~
~~
®~
MAINE I-i. (~4~lli.:~:1-: ii l~
BE IT REMEMBERED, that I, MARIE II. GC~N1m~Y, presently of 8~4 Lisburn Road,
Apartment 610, Camp Hill, Cumberland County, Pennsylvania, bein of sound mind,
memory and understanding, do make, publish and declare this as and fog my Last Will
and Testament, hereby revoking and making null and void any a d all Wills and
Testaments and writings in the nature thereof by me at any time heret fore made.
ITEM 1: I direct that my hereinafter mined Executor pay all y just debts, my
funeral expenses, and the expenses of the administration of my estate. With this
direction, I authorize and empower my Executor to expend for my fune al expenses and
interment such amounts as he may consider necessary and proper, with~ut regard to any
limit that may be prescribed by a court of law.
ITEM 2: I direct my Executor to pay all inheritance, estate, succession, and
legacy taxes of whatsoever nature and kind, to which my estate, or th transfer of any
property passing hereunder or otherwise passing by reason of my demise may be subject,
and to charge such taxes against my residuary estate. It is my intention thaat none of the
aforesaid taxes, either federal or state, on any property required to be inicluded in my
gross estate, under the provisions of any state or federal law now in fo c~ or hereafter
enacted, shall be prorated among the persons interested in my estate to whom such
property is or may be transferred or to whom any benefit accrues.
ITEM. S: I give and bequeath the contents of my apartme t unto my son,
RICHARD E. GOUDY, absolutely.
w,
!'
~' ;
~:
'd...
ITEM 4: All the rest, residue and remainder of my estate, of w atsoever nature
and wheresoever situate, whether it be real, personal or mixed, includi g property over
which I have a power of appointment, I give, devise and bequeat unto the heirs
hereinafter named, in the amounts designated:
A. Fifty Per Cent (50%) thereof to my son, RICHARD E. G UDY;
B. Thirty-Five Per Cent [35%) thereof to my son, DONALD GOUDY;
C. Seven and One-Half Per Cent (71/Z~o) thereof to my granddaughter,
PAMELA GOUDY ROMAN; and 'I
D. Seven and One-Half Per Cent (71/x%) thereof to my granc~d~ughter, LISA
GOUDY PEIRANO.
ITEM 5: I nominate, constitute and appoint my son, RIC E. GOUDY,
to serve as Executor of this my Last Will and Testament, directing that h not be required
to give bond for the faithful performance of her duties in this or any j isdiction.
h '~~.
IN WITNESS WHEREOF, I have hereunto set my hand and seal is~day
of , 2005.
,~,r ,
E H. GOUDY
The preceding instrument, consisting of this and one (1) other t p~written page,
was on the day and date thereof signed, sealed, published, and declared by the Testatrix
herein named, as and for her Last Will and Testament, in the presence o us, who, at her
request, in her presence and in the presence of each other, have subsc ibed our names
as witnesses h ret
~ ~~/,~
OF ~-~C~/~-----
~_
~ilt~
LISTENING IS JUST THE BEGINNING.`"
July 16, 2010
William D. Schrack, III
124 West Harrisburg St.
Dillsburg, PA 17019-0310
Dear Mr. Schrack:
0
RE: Marie H. Goudy, deceased 5/23/2010
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following account was open at the date ~,f death:
Checking #3621-20228, open 7/24/2001, date of death balance
$61,040.06, titled in her name alone with Richard E. Goudy as
Power of Attorney.
If you should have any further questions, please do not hesitate to contact me ~t X17-291-
2589.
Very truly yours,
~ (I -
~~~L -ti~~
Christine Smith
Credit Confirmation Processor
`. . L...~ .. ,
1.800.FULTON.4 fultonbank.com
Fulton Bank, N.A. Member FDIC. Member of the Futon Financial Family.
/~/,y r /~ L ~~
Wells Fargo Advisors, LLC
Three Lemoyne Drive
Lemoyne, PA 17043
July 20, 2010
Law Office of Wm. D. Schrack III
124 West Harrisburg Street
Dillsburg PA 17019-0310
Re: Estate of Mane H. Goudy
Dear Mr. Schrack:
.--~.
~.
In response to your request received in our office on July 14, 2010 we have provide.
details on each of the three annuities that were in effect at the time of Mrs. Goudy's
Lincoln National
Contract # Issue Date
959976796 01/14/2005
ING
Contract # Issue Date
C019069-GG 12/13/2001
0007439-GG 03/26/2001
DOD Value Beneficiaries
$76,783.59 Richard Goudy & Donald Goudy
DOD Value Beneficiaries
$131,109.82 Richard Goudy & Donald Goudy
$ 26,718.28 Richard Goudy & Donald Goudy
If we can be of any more assistance please do not hesitate to call.
Sincerely,
Marshall A. Ney
Vice President -Investments
Te1717-761-7344
Fax 717-975-8426
800-468-8685 ~ ~ •
~Y ~lA" ~~
Ju lth A. Walker
Associate Vice P:
1 the date of death
death.
- lrlvestments
MemberRNRA/SIPC •- a(. ~/ ~/ J I J~
J1 V