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Home My WebLink About10-26-10 (2)1505610143 REV-1300 E,t (a,_,o, OFFICIAL USE ONLY PA Department Of Revenue pennsylvenfa County cods Y~ File Number Bureau of Individual Taxes "~^-~*~ PO Box.260601 INHERITANCE TAX RETURN 21 10 0745 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 190 34 7075 07 O1 2010 09 07 1921 Decedent's last Name Suffix Decedent's First Name MI ROSS CHARLOTTE B (If A~licable) Enter Survh-in® Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 4. Limited Estate 8. Decedent Died Testate (Attaeh copy orwu) ^ 9. Lfigation Proceeds Received ~I THIS RETURN MUST BE FILED IN DUPLICATE'~NITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 3. Remainder Retu (date of death txiorto 12-13-8 ^ 4a, Futuro krteresl Comppromise 5. Federal Estate ax Return R Ired (date of de.n, after 12-12-02) ^ ~ ^ 7. ~Mai~in ~)a Livirp Tent ~ 8. Tots! Number o~ Safe t>epoait Boxes ^ 10. ?~~~~~~ d-th ^ 11. Election to tax tlrtaer Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORM Name Daytime TeN RICHARD L TilfEBBER JR ESQUI 717 53 REGISTER First Iine of address 126 EAST RING STREET Second line of address City or Post Office SHIPPENSBURG CorrespondertYs e-mail address: State ZIP Code PA COn1 SHOULD BE DIRECTED TO: r Number a 388 "' _, , ~, ;-; ,=, ~NLY~. -_ fV r-r t1-. tT~ - _ -' ~ -_ 3a _ ~ '~ ~~ - rT} N ~~ c~ -+, C' _ DATE RILEI rt Is~COfreCt aarWPerjury, I declare that I have examined this rotum, indudirq accompanying schedules and statements, and tD the bee complete. Detiaraiion of preparer other than the personal representative 18 based On aH information of which Preps ADDRESs Charlotte Ruth Ross Cullen 6356 Pfafflin Lake_Blvd., Newbureh. IN 47630 knowledge and belief, any knowledge. _ ,~ SIGNATURE OF PREPARER OTHER TWIN REPRESENTATNE DA ~ / ~( ~-, ~ Richard L. Webber, Jr. Esquire (a~y~l y ss 126 East King Street, 3hippensburg, PA Side 1 1505610143 150561D143 J I ~~ ~~ J 15D561D243 REV-1500 EX Decedent's Social Security Number ova®^e8 Nom: Ross, Charlotte B. 190 3 4 7 0 7 5 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. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. i 70,091.59 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) :.............. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vroos Transfers & Miscellaneous -Probate Property arate Billin ~ Se Re uested h G 14 , 072.37 g ............ p q (Sc edule ) 7. 8. Total Gross Assets (total Lines 1-7) .............:.................:..................................... g, 84 ,163.96 ~ 16 , 584.00 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 1, 373.66 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. ~ 9 , 95 7. 6 6 12• Net Value of Estate (Line 8 minus Line 11) .......................... ................................ 12. II 74 , 206.30 13. Charitable and Govemmentat Bequests/Sec 9113 Trusts for which ~, an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Sut~ject to Tax (Line 12 minus Line 13) ............................................... 14, I~ 7 4 , 2 0 6 . 3 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(L2) X .00 15. 16. Amount of line 14 taxable 7 4 2 0 6. 3 0 1 s at lineal rate X .045 , . 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ................................................. .. ........................................................... . ... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15D561D243 Side 2 7~5D561D24~ 0.00 3,339.28 0.00 0.00 3,339.28 a REV-1500 FCC Page 3 1>tpr_erlpnt's Cemnlete Address: Fite Number 21-10-0745 --------- - - - - - DECEDENTS NAME Ross, Charlotte B. STREET ADDRESS 210 Big Spring Road, CITY Newville STATE PA iZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) P1) 2. Credits/Payments A. Prior Payments 3,050.00 B. Discount 160.53 Total Credits (A + B) ~2) 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, errter the difference. This is the TAX DUE. Q5) Make Check Payable to: REGISTER OF WILLS,_AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE 1. Did decedent make a transfer and: j 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 :...............................f.. c. retain a reversionary interest; or ............................................................................................................L., d. receive the promise for life of either payments, benefits or care? .........................................................' .. 2. H death occurred after December 12, 1982, did decedent transfer property within one year of death with~u receiving adequate consideration? ....................................................................................................:............1.. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefiaary designation? ............................................................................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS tS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT i For dates of death en or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or 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 su [72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from taz, and the statutory requi 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: 3,339.28 3,210.53 128.75. BLOCKS Yes No x x x ^ 0 ^ a PART OF THE RETURN. the use of the surviving spouse is 0 percent s for disclosure of 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 tex 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 Ka) (1.3)). A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether y blood or adoption. Rav-1508 taC+ {8-98) col~toNw~Tr of I~ENNSVS_v~NN wrlERmwcE TAX tZETURTi RESIDENT DECEDENT SCHEDULE E CASH, BANK REPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF Charlotte B. Include the proceeds of liti tan and the datepr `o ~ed~ ~e received by the estate. All propeAy tlJoM gowned dro rlpM of s dbdwsd on schadlAa F. Rev-1610 D(~ (6-88) SCHEDULE G INTER VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY C.OMAAONINEALTN oFPENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FlLE N M!$ER Ross, Charlotte B. 21-10 745 This acheduk must fx completed and filed'rf the answerto any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is y~s. ITEM NUMBER DESCRIPTION OF PROPERTY TMELanTETR wSF~ER AT'fACEN A COPY OFTTHE DEED FOOREREAL E37n~. DATE OF DEATH VALUE OF ASSET %oF OECD~s INTEREST ~ ~ ~tF nr~p Slo~t~ tcnH~E- TAXABLE VALUE 1 FbM Trust Company #025-2986118 -individual 14,072.37 100.000'1. 0.00 14,072.37 Retirement Account Transferees: Date of Transfer 7H/2010 David Vincent Ross - ;7036.19 6538 Sugar Ridge Road Roanoke, VA 24018 Charlotte Ruth Ross Cullen ;7036.18 ~, 6366 Pfafflin lake Blvd. Newburgh, IN 57630 ~, '~ ~. ~~ I TOTAL (Also enter on Line 7, Recapitufa13on1 14,072.37 {B more space is needed, addffional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. ForTn PA-1500 Schedule G (Rev. 6-98j Rte.„s,~.t,u.osi SCHEDULE H k;o-a~~~-v In D~i~r`F""vnN-n FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUhABER Rass, Charlotte B. 21-10-b745 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N A. FUNERAL EXPENSES: See continuation schedule(s) attached 'i ~ 4,718.50 S. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio YeaKs) Commission paid 2. Attomev's Fees Weigle ~ Associates, P.C. 3,250.00 3. Fatuity Exemption: (If decedent's address is not the same as claimant's., attach explanation) Claimant Street Address City State Zia Relafionshio of Claimant to Decedent 4. Probate Fees 269.50 5. Accountant's Fees 6. Tax Return Preparer's Fees i, 7. Other Administrative Costs 346.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 8,584.00 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Ross. Charlotte B. 21-1 ITEM DESCRIPTION AMOUNT NUMBER I'~ 1 Eby Granite Works -Grave monument ', 2,234.00. 2 Egger Funeral Home I 2,200.00 3 First United Presbyterian Church -Service 75.00 4 Flowers -Funeral Expenses ~•~ 5 Funeral Mininster ' 75.00 6 Funeral Organist ' 50.00 Other Admini:trative Costs 7 Cumberland County Register of Wills -Filing fee for inheritance tax return 8 Cumberland Law Journal -Advertising 9 FBdN Tnist -Estate Check Book Fee 10 Howard's Accourrting -Reserve for income tax return prepanriion 11 Valley Times tar -Advertising Copyright (c) 2002 form software only The Lackner Group, Inc. H A ~' 4,718.50 15.00 75.00 '~ 30.50 150.00 75.50 H-B7 346.00 Form PA-1 Schedule H (Rev. 6-98) Rw-1512 EIC+ (12-06) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS coMUONwEAUH oFrENNSr~vANw He#RrTANCE TAX RETURN RESIDFM DECEDENT ESTATE OF FILE NU~IAEER Ross, Charlotte B. 21-10 745 Report dabls Inemnd ty uia dswdent prior to death r~ -eeWned tripald ar the dab or death, inww6rg Yrtre~mb~ased nrdlal ITEM VALUE AT DATE NUMBER DESCRIPTION I OF DEATH 1 Carlisle Regional Medical Center 220.02 2 Carlisle Regional Medical Center -Emergency Room Physicians ~i 6.98 3 Darryl Guistwita, D.O. '' 12.25 4 Darryl Gustwite, D.O. 29.38 5 Green Ridge Village ~ 751.33 8 Green Ridge Village 190.00 7 Milennium Pharmacy Systems I i, 66.22 8 Mof'fltt Heart and Vascular 9.87 9 Newville Community Ambulance ~ 19.95 10 Physicians' Hospital Care ~i 15.14 11 Spring Rosd Family Practice 6.22 12 Walt Shore EMS Carlisle i ~I 48,52 TOTAL (Also enter on Line 10, Rtacapitulation) 1,373.66 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Forth PA-7500 chedule I (Rev. 12-08) REV•1513 EX+ (11-0BI SCHEDULE J COMINH,~p~~~'-~YA""~ BENEFICIARIES ESTATE OF FILE NUMBER Ross, Charlotte B. 21-10+07 45 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE MOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 Charlotte Ruth Ross CuNen Daughter Fifty Percent 37,103.15 6566 Pfafflin Lake Blvd Newburgh, IN 47630 David V. Ross Son Fifty Percent 37,103.15 6538 Sugar Ridge Road Roanoke, VA 24018 i '~, i I Total 74,206.30 Enter dollar amounts for distributions shown above on lines 15 throw h 18 ~on Rav 15 00 cover sheet, as a riate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAK~N B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 S edule J (Rev. 11-08) _,; ,.\ , ~`=~- Last Viand ~!estamerit O!` caARZO~ a. Ross I, CHARLOTTE B. ROSS, a resident of Cumberland County, State of Pennsylvania, being of full age, of sound and disposing mind, memory and understanding, and under no restraint or improper influence, do make, publish and declare this to be my LAST WII~L AND TESTAMENT, hereby revoking all previous wills and codicils made by me. FIRST: I direct that my Personal Representative, hereinafter named, pay all my legal debts, the expenses of the administration of my estate, and my fimeral expenses, said funeral expenses to include the cost of a burial lot, perpetual care thereof, and a suitable marker or tombstone, if not otherwise provided for during my lifetime, and the total cost of said funeral expenses shall be within the sole discretion of my Personal Representative. SECOND: I give, devise, and bequeath the rest, residue and *r*~~tnder ofmy estate, consisting of real, personal, and mixed property, of every kind and description whatsoever, and wheresoever situated which I may now own, hereafl~er acquire, or have the right to dispose of at the time of my death, to my two children, in equal shares, for purposes of Definition and identification, my children are: Name ~ Date of Birth Charlotte Ruth Ross Cullen August 24th 1943 David Vincent Ross May 24th, 1947 THIRD: Beneficiary Provisions. The following temps and conditions apply to the beneficiary clauses of this will. A. 45-Day Survivorship Period. As used in this will, the phrase "survive me" means to be alive or in existence as an organization on the 45th day after my death. Any beneficiary, except any alternate residuary beneficiary, must survive me to take property under this will. B. Shared Gifts. If I leave property to be shared by two or more beneficiaries, it shall be shared equally by them unless this will provides otherwise. If any beneficiary of a shared specific gift left in a single paragraph of the Specific Gifts clause, above, does not survive me, the gift shall be given to the surviving beneficiaries in equal. shares. If any beneficiary of a shared residuary gift does not survive me, the residue shall be given to the surviving residuary beneficiaries. in equal shares. C. Encumbrances. All property that I leave by this will shall pass subject to any encumbrances or liens on the property. FOURTH: Ezecutor. I name Charlotte Ruth Ross Cullen as executor, to serve without bond If she does not qualify or ceases to serve, I name David Vincent Ross as executor, also to serve without bond I direct that my executor take all actions legally permissible to probate this will, including filing a petition in the appropriate court for the independent administration of my estate I grant to my executor the following powers, to be exercised as the executor deems to be in the best interests of my estate: A. To retain property, without liability for loss or depreciation resulting from such retention. B. To sell, lease, or exchange property and to receive oradminister the proceeds as a part of my estate. C. To vote stock; convert bonds, notes, stocks, or other securities belonging to my estate into other securities;. and to exercise all other rights and privileges of a person owning similar property. D. To deal with and settle claims in favor of or against my estate. ~,. E. To continue, maintain, operate, or participate in any business which is a part of my estate and to incorporate, dissolve, or otherwise change the form of organization of the business. F. To pay all debts and taxes that maybe assessed against my estate, as provided under state law' G. To do all other acts that in the executor's judgment may be necessary or appropriate for the proper and advantageous management, investment, and distribution of my estate: These powers, authority, and discretion are in addition to the powers, authority, and discretion vested in an executor by operation of law and may be exercised as often as deemed necessary, without approval by any court in any jurisdiction. ,~ i,• Signature t I subscribe my name to this will this ~n~"h day of ~~~o~e.~ a Cx?~ Cumberland County in the Sate of Pennsylvania. I declare that it is my will, t I sign it willingly, that I execute it as my free and voluntary act for the purposes expressed, and that I am of the age of majority or otherwise le 1 empow _djopi ce nlunde~ r~ constraint or undue influence. Signature: J~~ ~ } h Witnesses On this ~~ `-^ day of ~, _~g the testator, Charlotte B. Ross declared to us, the undersigned, drat this instrument was her will and requested us to act as witnesses to it. The testator signed this will in our presence, all of us being present at the same time. VJe now, at the testator's. request, in the testator's presence and in the presence of each other, subscn'be our names as witnesses and each declare that we are of sound mind and of proper age to witness a will. We further declare that we understand this to be the testator's will and that to the best of our knowledge the testator is of the age of majority, or is otherwise legally empowered to make a will, and appears to be of sound mind and under no constraint or undue influence. We declare under penalty of 'ury that the foregoing is true and correct, this bk,^ day of ~~, at Cumberland County, State of Pennsylvania ~ ~~Q witness 1 / ~~~ signature: L.~ Typed or printed name: L1t'yf2A L tfaWGtL Residing at: !1~f04 /k~17!`VKff t:FT,,~ City, state, zip: ~-LF~ ~/i}- 2-Zt~ 30 Witness Signature ~t.~.~ ~ sa ~ . as_A~ Typed or printed name: ~r a. ~ ~ e R C~ S' nQ, ~ Residing at: z f~,~-L P: , .~~. City, state, zipG~L~i ~es~ (~.~ .~?N~ / Witness 3 Signature: ~, o'» Typed or printed e: E/~6e r ' lQ„rll/'y~ Residing at: ! / !'eeh 1 ~~ ~ aM~ City, state, zip: ~(,~,*a-c` i J ~ i 7Z ~/ August 12, 2010 Weigle & Associates, P.C. Attorney's-at-Law 126 East King St Shippensburg, PA 17257-1397 To Whom It May Concern: RE: Charlotte B Rossi In reference to the above customer, our records show the enclosed inforlmation 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 888-2646116 P.O. Box 6010 Chambersburg, PA 1201-6010 FINANCIAL SO.LUtIONS... FROM PEOPLE YOU KNOW ' ~ .: O ' i___