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Home My WebLink About11-15-10T . 1 , r r FANYILY SETTLEMENT AND RELEASE o o ~7 Ili 2 rn ~ ~ tom'- ~ ~ :~:~ C.^ ~~ ESTATE OF BRUCE A. WALTER, SR ' ~ ~ ~ (File No. 2009-007557 j ~ -v c::~ :~:~ _ ' _= KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Bruce A. Walter,+,~' , 'ate of tN~ `.~ Camp Hill, Cumberland County, Pennsylvania, deceased, died testate on July 4, 2009, having first made his Last will and Testament, which was duly executed on February 17, 1993, and is duly horded at the Register of Wills in Cumberland County, Pennsylvania. WHEREAS, the said Bruce A. Walter, Sr., by the aforesaid Last Will and Testanhe~t, named Carryl Walter, as Executrix of said Last Will and Testament; WHEREAS, letters testamentary on the estate of the said decedent were duly isslue~ by the Re ister of Wills of Cumberland County, Pennsylvania, to the said Executrix hereinafter called personal g representatives; '~ WHEREAS, the said personal representative has gathered the assets of the estate o~ Uhe said decedent and the assets consist of real and personal property; to a total value of $161,361.81, as set forth in the attached Inheritance Tax Return, which is attached hereto and made a part hereof,I ac~dmarked Exhibit "A". !~ WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate amount to $16,019.54, leaving a balance for distribution of $145,342.33. WHEREAS, the balance for distribution as shown in the said Inheritance Tax RGet~rl- marked as Exhibit "A" has been distributed as herein indicated in accordance with the terms of thel L~st Will and Testament of the said decedent; ', NOW, THEREFORE, KNOW YE, that I, Carryl Walter, the heir under the Lash V~ill and Testament of the said decedent, and being that person entitled to inherit under said Lash. W ill and Testament, do hereby acknowledge that I have this day had and received from the aforgsa'dlpersonal representative, in full satisfaction and payment of all sum or sums of money, legacies, $sts, and ~'' I_ I i_ _ _ __ -- -- r ~ ~' devises as are given, devised and bequeathed to me by the said Last Will and Testament, the aanount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved ih t~e filing of a ormal account and schedule of distribution, I agree that no account is necessary and I dolhe~by agree. f that I do consent to distribution being made without the filing of an account and schedule) of~ distribution, the same to be with the same force and effect as if they had been filed and confirmed by ~he CDrphan's Court Division of the Court of Common Pleas, Cumberland County. ' ~~, THEREFORE, I do hereby remise, release, quitclaim and forever discharge the ~aic~ personal re resentative, Carry) Walter, her heirs, executors, and administrators and assigns, or an~ from the said P estate and from all actions, suits, payments, accounts, reckonings, claims, and demands~}vh~tscever for c by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upo~y th~ Mate- of the said decedent, and I do further hereby covenant and agree that should any liability come ~'~,du~ to the estat of the said decedent after the signing of this agreement, I do hereby covenant and agree that 1 will contribute my share of the estate to satisfy any and all claims, demands, suits, or causespf tion which may be successfully prosecuted against the said estate or the aforesaid personal represe~tat vie after the signing, sealing and delivery of this family settlement and final release. _~ _ i._ i ~ _ I_ __ __ _- ~- ~- ~ , . ~.. 2010. .~~ Witness Carryl COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMB,EyR~~LAND : On this, the ~~r~'" `` day of ~ , 2010, before me, a notary undersigned officer, personally appeared Carryl Walter, (known to me or satisfa< to be the person whose name is subscribed to the within instrument, and acknow executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand ~i{i official seal Notary IN WITNESS WHEREOF, I have hereunto set my hand and seal this (~'r ly bf ~ve '~ ;, the proven) that she __ _ _ _ _ _, ~r i t .. devises as are given, devised and bequeathed to me by the said Last Will and Testament; the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved in .the filing of a formal account and schedule of distribution, I agree that no account is necessary and I d~ h~neby agree that I do consent to distribution being made without the filing of an account and schedule off distribution, the same to be with the same force and effect as if they had been filed and confirmed by I,th$ orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the ~ai~i personal representative, Carryl Walter, her heirs, executors, and administrators and assigns, or and fihom the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands ~dvhatscever for o~ i by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon) this state of the said decedent, and I do further hereby covenant and agree that should any liability come kiu~ to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that T will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes bf &ction which may be successfully prosecuted against the said estate or the aforesaid personal represenl~atiivc after the signing, sealing and delivery of this family settlement and final release. EX (01-10) REV-1500 PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 1 1505610140 INHERITANCE TAX RETURN RESIDENT DECEDENT Hamsb PA 17128- ENTER ~CEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth Yv1MDDYYYY ', i 2 1 1 2 2 6 5 1 3 0 7 0 4 2 0 0 9 0 3 0 9 1 9 3 3 i i Decedent's Last Name Suffix Decedent's First Name I ! MI Wal t er SR Br uce ICI A (If Applicable) Enter Surviving Spouse's Information Below ~, Spouse's Last Name Suffix Spouse's First Name ' MI Walter Carryl ~ ' Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICA Y1~ITH THE REGISTER OF WILLS ~, FILL IN APPROPRWTE OVALS BELOW ® 1. Original Return ~ 2. Supplemental Return ~ 3. Remain um (date of de th pmorto 1 -1 2) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal E to Tax Return R uirecl death after 12-12-82) 6. Decedent Died Testate [~ 7. Decedent Maintained a Living Trust 8. Total Nu be} of Safe Deposit xes (Attach Copy of Will) (Attach Copy of Tnrst) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Ebdion t under Sec. 911 (A) between 12-31-91 and 1-1-95) (Attach ) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND C'ONFIDENTtAL TAX UIFORMA S~IOIN.D ~ TC Name Daytime Teleph Number K a r I E. Ro mi n g e r 7 1 7 ~ 1 6 0 0 REGISTE OF WILLS USE ONL First line of address , 1 5 5 S o u t h Hanover S t r e e t ~~ Second line of address ~ City or Post Office State ZIP Code ~ FILED Car l i s t a PA 1 7 0 1 3 C:omspondenes e-mail adde+ess: i Under penaltlss of perjury. I dedane that 1 have examkted this realm. including accompanying sd~edubs and statements, and to the my knowledge beNef, it is true. correct and campleta. Dedaratrorr of prepanr other than the personal representative is based on au. information of which lhss arty k E OF PER N RESPONSIBLE FOR FILING RETURN DATE ALL ~ ~i~ ~ A~E eS ~~l v~ r.1 i ~ SIGNATURE OF PARER OTHER THAN REPRESENTATNE DATE ADDRESS 253 Ke West Boulevard Carlisle P PLEASE USE ORIGINAL FORM ONLY i Side 1 i 1 1505610140 ~ ~ ~~ 150561 1 10 ~ ;~/t.~ h,/ i~ ~/T ~~; 060 r ~• . REV-1500 EX Decedents Name: Bruce A. Walter, Sr. Decedent's Social Security Numbe 2 1 1 i 2', 2 6 5 1 3 RECAPITULATION 1 3 8 ~' 0 0 0. 0 0 1. . ........................ Real Estate (Schedule A) ... 1 1 2'' 4 0 2 0 2. Stocks and Bonds (Schedule B) ...... ..... ................. 2. , . 3. Closely Hek1 Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages and Notes Receivable (Schedule D) ................... .... .. 4. 5 h ll C B k D it d Mi P l P h l S 2 1 '' 2 2 1 6 7 . ro ) , an as s s an sce aneous ersona epo party ( c edu e E ..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. ', 7. Inter-Vivos Transfers 8 Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested ..... .. 7. ', 8. Total Gross Assets (total Lines 1 through 7) .................... ..... .. 8. 1 6 1 ' 3 6 1 • 8 7 9. Funeral Expenses and Administrative Costs (Schedule H) ........... ..... .. 9. 1 0 61 1 9 . 5 4 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ..... .. 10. 1 t. Total Deductions (total Lines 9 and 10) ......................... .... .. 11. 1 6 0 1 9. 5 4 12. Net Value of Estate (Line 8 minus Line 11) ...................... .... .. 12. 1 4 5 ~ 3 4 2. 3 3 13. Charitabb and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ .... .. 13. li 14. Net Valve Sutrjact to Tax (Line 12 minus Line 13) ................ .... .. 14. 1 4 5 ~' 3 4 2. 3 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~ 15. Amount of Una 14 taxable ' at the spousal tax rate, or transfers under Sec. 9116 (a)(t .2) x .o _ 0. 0 0 1 s. I 0. 0 0 18. Amount of Line 14 taxable at lineal rate x .o_ 1 0 0. 0 0 16. I i, 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. ~ 0. 0 0 18. Amount of Line 14 taxable ll 15 0 t l t x 0 t 0 0 0 0 era a co a ra e . . t 8. . 19. TAX DUE ................................................ .... .. 19. O • O O 20. FILL IN THE OVAL IF YOU ARE REDUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 i ill 1505610 4~ i , REV-1500 EX Page 3 Decedent's Complete Address: File Number 00 DECEDENTS NAME _ Bruce A. Walter, Sr. ___ _ STREET ADDRESS - - - - --- _ CITY 'STATE ZIP Tax Payments and Credits: t. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest o.oo Total Credits (A + B) (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FiN in oval 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. (3) (4) (5) 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: 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? ....................................................... 2. If death occurred after December 12,1962, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 3. Did decedent own an 'in trust for• orpayable-upon-death bank account or security at his or her death? ......... 4. Did decedentown an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. IF THE ANStNER TO ANY OF THE A80VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE For darts of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to 0 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 survivi [72 P.S. §9116 (a) (1.1) (ii)j. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requil fif~g a tax return are still alpplicable even if the surviving spouse is the only benefiaary. 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 tl adoptive parent or a stepparent of the child is 0 percent (72 P.S. §9116(a)(1.2)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent, r 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 decedents siblings is 12 percent [72 P.S. §91' Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. TE No ~~, ~'! A$ PART OF TF fort the use of the se is 0 for disc ~se of a natural xc~pt as noted in 6(~)(1.3)j. A sibling ~I riving spouse is t of assets and ant, an defined, under REV-1502 EX+ (01-10) . •pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: '~, Bruce A. Walter Sr. 0 0 All real property owned solely a as a tenant in common must be reported at Mir market value. Fair market value is defined a the price at which pr rty would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonabl kn~rnlWledge of the rel vast facts. Real propeRy that is jointly-0wned with right of aurvivorahip must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALU AT DATE NUMBER OF EATH DESCRIPTION 228 Cumberland Drive-Camp Hill, PA -Appraised 2008 i I I ~~ 138,000.00 TOTAL (Also enter on Line 1, Recapitulati .) 5 38 000.00 If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (6-98) . ~ ~ ~ ~ ~ ~ scHEOV~E s COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALU AT DATE NUMBER DESCRIPTION OF EATH 1. Sixteen Savings Bonds-Commerce Bank ~i I I I ~I I I I ~I I I 2,140.20 TOTAL (Also enter on line 2, Recapitulati n) I = 2 140.20 (If more space is needed, insert additional sheets of the same size) REV-1504 EX + (6-98) - SCHEDULE C ' CLOSELY•HELD CORPORATION, COHNNONWEALTH OF PENNSYLVANIA PARTNERSHIP OR IN RES DENT DE EDENTRN SOLE•PROPRIETORSHIP ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 I' Schedule C-t or C-2 (including all supporting information) must be attached for each closelyateld corporationlpartnership interest of th decedent, other than a sole-proprietorship. See instructions for the supporting information to be submit~d forsole-proprietorships. ITEM VALU AT DATE NUMBER DESCRIPTION OF EATH 1. I i ~I ail i VIII TOTAL Also enter on line 3, Recapitulati pr more space is needed, insert additional sheets of the same size) e REV-1505 EX +(6-98) SCNEDlJLE G 1 COMMONWEALTH OF PENNSYLVANIA CLOSELY-HELD CORPORATE IN RES DENT DECEDENT N STOCK INFORMATION REPORT '' ESTATE OF FILE NUMBER Bruce A. Walter Sr. p p ~~ 1 Name of Corporation State of Incorporati n Address Date of Incorporati n City State Zip Code Total Number of S ar~'holders 2. Federal Empbyer LD. Number ~ Business Reportin Year 3. Type of Business ProducUService 4. ~~ TYPE TOTAL NUMBER OF PAR VALUE NUMBER OF SHARES VALUE THE V V SHARES OUTSTANDtiYC OWNED BY THE DECEDENT DECEDENT STOCK Common Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? ....................................... ^ Yes ^ No If yes, Position Annual Salary $ Time Devoted to E 6. Was the Corporation indebted to the decedent? ....................................... ^ Yes ^ No If yes, provide amount of indebtedness $ 7. Was there I'rfe insurance payable to the corporation upon the death of the decedent? ............... ^ Yes ^ No If yes, Cash Surrender Value $ Net proceeds payable $ C+wner of the policy 8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years if the date of death was prior to 12-31-82? ^ Yes ^ No If yes, ^ Transfer ^ Sale Number of Shares Tr~sferee or Purchaser Consideration $ Attach a separate sheet for additional transfers andlor sales. 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ............ ^ Yes ^ No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? ................................................. ^ Yes ^ No ff yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? ....................... ^ Yes ^ No ff yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? ...................... ^ Yes ^ No If yes, report the necessary inforration on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detatied calculations used in the valuation of the decedent's stock, B. Complete copies of finanaal statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4~~ years C. If the corporation owned real estate, submit a list showing the complete addresses and estimated fair market valuels. If real e~tat~ ~praisals have been SerXlfed, attach COpleS. ! ~~ D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. Ust of officers, their salaries, bonuses and any other benefits received from the corporation. ~~, F. Statement of dividends paid each year. Ust those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. ', (If more space is needed, insert additional sheets of the same size) ii REV-1506 EX + (9-00) ~CHED~/LE C-2 COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP IN RES DENT DECEDENTRN INFORMATION REPORT ESTATE ~ FILE NUMBER Bruce A. Walter Sr. p p 1. Name of Partnership Date Business Co minced Address Business Reportin Yaar City State Zip Code 2. Federal Employer I.D. Number 3. Type of Business ProducUService 4. Decedent was a ^ General ^ Limited partner. If decedent was a limited partner, provide initial investment $ 5. PARTNER NAME PERCENT PERCENT E OF pF ~O~ pF pyy~Htp C AL ACCOUNT A. B. C. D. 6. Value of the decedents interest $ 7. Was the Partnership indebted to the decedent? ................................ ^ Yes ^ No If yes, provide amount of indebtedness $ '~i 8. Was there -ife insurance payable to the partnership upon the death of the decedent? ........ ^ Yes ^ No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years If the date of death waS pnorto 12-31-82? ^ Yes ^ No If yes, ^ Transfer ^ Sale Percentage transferredlsold Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers andlor sales. 10. Was tt~re a written partnership agreement in effect at the time of the decedent's death?........ ^ Yes ^ No I! ff yes, provide a Dopy of the agreement. 11. Was the decedents partnership interest sdd? .................................. ^ Yes ^ No If yes, provide a copy of the agreement of sate, etc. 12. Was the partnership dissdved or liquidated after the decedents death? ................. ^ Yes ^ No ff yes, provide a breakdown ~ distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? ................................ ^ Yes ^ Na ~~ If yes, explain 14. Did the partnership have ~ interest in other corporations or partnerships?....... .. ^ Yes ^ No ff yes, report the necessary inforrn~ion on a separate sheet, induding a Schedule C-1 or C-2 for each interest . A. Detailed ca~ulations used in the valuation of the decedents partner lip interest. ~I~ ', B. Complete copies of finanaal statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 pr edEng years. C. If the partnership owned real estate, submit a list showing the complete addressles and estimated fair market valuels. If real es ate (!,appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedents partnership interest. REV-1507 EX + (,6-98) scN~ov~E v CC~FAMONWEALTH OF PENNSYLVANIA MOR I ~+AGE~7 R ~O 1 ES INHERITANCE TAX RETURN RESIDENT DECEDENT RECEIVABLE ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 A8 property joiMlyowned with the right of survivorship must be discbsed on Schedub F. ITEM VALUE T DATE NUMBER DESCRIPTION OF TH 1. ~I III i TOTAL Also enter on line 4, Recapitulati n) ~ S (If more space is needed, insert additional sheets of the same size) _. _ ,.__. T... --i _ _. _ 1. I REV-1508 EX * (6-98) SCHED~/tLE E M~SC. CASH, BANK DEPOSITS, ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~ PERS~\I A L PR~PER 1 1 1' ~\/1 RESIDENT DECEDENT ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 Include the proceeds of li6gatbn and the date the proceeds were received by the estate. AU properly joiMly~ovmed vrith right of survivorship must be dhrcbeed on Schedule F. ITEM VALU AT DATE NUMBER DESCRIPTION OF EATH 1. M&T Bank Account 9834711930 1,221.67 State Farm Life Insurance-LF-0216-7442 I i III 20,000.00 TOTAL (Also enter on line 5, Rerapitulati n)'' S 21 221.67 (If more space is needed, insert addidonai sheets of the same size) ~i REV-t 509 EX+ (01-10) 'pennsylvania ~ ~CNEDULE F DEPARTMENT Of REVENUE JOINTLY•OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUINBER: Bruce A. Walter Sr. 0 0 ff an asset was made jointly owned within one year of the decedent's date of death, it must be reported n Schedule G. SURVIVING JOINT TENANT(S) NAME{S) ADDRESS RELATIONSHIP TO DECEDENT A. B. I C. it JOMITLY-0WNED hROPERTY: ITEM LETTER FOR JOINT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANGAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH 96 OF <~ECEDENT'S ATE OF DEATH VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DEC DENTS INTEREST 1. A. .TOTAL (Also enter on Line 6, Recapitulation) ~ If more space is needed, use additional sheets of paper of the same size. 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 OF FILE NUMBER Bruce A. Walter Sr. 0 0 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-15 0 is yes. DESCRIPTION OF PROPERTY STEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S ~XCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLIC.4BLE1 VALUE L TOTAL Also enter on Line 7, Recapitulation) S If more space is needed, use additional sheets of paper of the same size. __ __ ~ REV-1511 EX+ (10-09) 'penlnsylvania DEPARTMENT OF REVENUE WHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS Decedents debts must be reported on Schedule t. ITEM NUMBER DESCRIPTION A OUNT A. FUNERAL EXPENSES: ~. Malpezzi Funeral Home- 6,065.00 Advertising-The Evening Sentinel 187.54 Cumberland Law Journal 75.00 Internment Services-Rolling Green Cemetery 1,345.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Represerrtadve(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: Karl E. Rominger 3. Family Exemption: (If decedents address is not the same as daimanrs, attach explanation.) Clainwnt Street Address Cry State ZIP Relationship of Claimant to Decedent 4. Probate Fes; Cumberland County Register of Wills 5. Accountarrt Fees: 6. Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulati n) _ If more space is needed, use additional sheets of paper of the same size. 8,000.00 347.00 16.01 REV-1512 EXf (12-08) Pennsylvania ~ SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS RESIDENT DECEDENT , ESTATE OF FILE NUMBER ' i Bruce A. Walter Sr. 0 0 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimb rs~d medical expen ITEM ' VALUE T DATE NUMBER DESCRIPTION OF EATH 1. I i i i I i I' I ~i I i I I TOTAL (Also enter on Line 10, Recapitul ion S If more space is needed, insert additional sheets of the same size. REV-573 EX~ ;Ot-t 0 pennsylvani~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBi Bruce A. Walter Sr. 0 0 RELATIONSHIP TO DECED NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trusteets) ~ TAXABLE DISTRIBUTIONS (Include outr' ht spousal distributions and transfers under Sec. 91 f6 (a) (1.2).] 1. Carryl Walter Lineal ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 [I. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: OF STATE 100.00 MEET, AS APPR RIATE. TOTAL OF PART [I -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed, use additional sheets of paper of the same size. ', REV 15t4 EX+ c4.09, penn~yhl-ania SCHEDULE K DEPARTMENT OF REVENUE LIFE ESTATE, ANNUITY Bureau of Individual ?axes ~ TERM CERTAIN PO Box 280601 iiamsburq PA 17128.0601 (CHECK BOX 4 ON REV-1500 COVER SHEET) ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates f dleath prior to 5-1- 9, actuarial factors far single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5 1-8q to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. ^ Will ^ Intervivos Deed of Trust ^ tlheir NAME OF LSE TENANT DATE OF BIRTH NEARE8T AIiE AT OF YE/IRS DATE OF DEATH E ATE IS PAY ^ Life r (Term of Years ^ Life r Term of Years ^ Life r (~?erm of Years ^ Life r LJ Tenn of Years ^ Life r [Term of Years 1. Value of fund from which life estate is payable ......................................... $ 2. Actuarial factor per appropriate table ............................... ................ . Interest table rate - ^3.5°r6 ^ fi°~ ^ 10°k ^Variable Rate 3. Vatus of life estate (Line 1 muldplisd by Line 2} . . . . . . . ............................... $ MAME OF LIFE ANNUITANT DATE OF BRl'll DA~D~TAFIT M PA1fABLE ^ Life o [~ Term of Years ^ Life o Term of Years ^ Life o [] 'Tenn of Years ^ Life o ['] Term of Years 1. Value of fund from which annuity is payable ..........................................: 2. Check appropriate bkx* bek>Mr and enter corresponding number , , , , , , , , , , , , , , , , , , , , , , Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^Seml-annually (2) ^ Annualy (1) ^ Other ( ) i 3. Amount of payout per Period ......................................................i 4. Aggregate annual payment, Line 2 multiplied by Line 3 ,, , , , , , , , , , , , , , , , , , , , , , , , , ,, 5. Annuity Factor (see instructions) Interest table me - ^ 3.5% ^ fi°~ ^ 10% ^ Variable Rate °~ 6. Adjustment Factor (See instructions) ................................................ 7. Value of annuity - If using 3.5%, fi°~, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ...........................s If using variable rate and period payout is at beginning of period, calculation is (Line 4 x Line S x Line 6) + Line 3 ......... ........................ 5 NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Sc ~fles A through G f the tax retum. The resuttin life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 throw h 1 8 o the return. If more space is needed, use additional sheets of the same size. REV-1644 EX+ (01 ~t 0) penn'sy~vania ~ INHERITANCE TAX OEPARTMENTOFREVENUE SCHEDULE L INHERITANCE 7AX RETURN REMAINDER PREPAYMENT RESIDENT DECEDENT OR INVASION OF TRUST CORPUS I. ESTATE OF FILE NUM Walter, Bruce A., Sr. This schedule is appropriate only for estates of decedents dying on or before Dec This schedule is to be used for all remainder returns when an election to prepay has been filed Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of (i, REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of Wills on (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on date or Annuitant(s) of Election C. Assets: Complete Schedule L-1 1. Real Estate .............................. $ 2. Stocks and Bonds ......................... $ 3. Closely Held Stock/Partnership ............... S 4. Mortgages and Notes ....................... $ 5. Cash/Misc. Personal Property ... . .. . ......... $ 6. Total from Schedule L-1 ....................................................$ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities .......................... $ 2. Unpaid Bequests ..........................$ 3. Value of Non Includable Assets ............... $ 4. Total from Schedule L-2 ........................ , $ ........................... E. Total Value of Trust Assets (Line C-6 minus Line D-4) ............................... $ F. Remainder Factor .......................... ................................ G. Taxable Remainder Value (Multiply Line E by Line F) .............................. $ (Also enter on Line 7, Recapitulation) [[[. INVASION OF CORPUS: A. Invasion of Corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on Date or Annui~nt(s) Corpus Consumed C. Corpus Consumed ............................................ ...............g D. Remainder Factor ......................................................... .. E• Taxable Value of Corpus Consumed (Multiply Line C by Line D) ....................... s . (Also enter on Line 7, Recapitulation) 0 0 f 12, 1982. ~! the provisions of Years wity is P Te jof Years I or nry~uity is Pa __ REV-1645 EX+ (1 T-09)' INHERITANCE TAX penn~sylvania SCHEDULE L-1 DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REMAINDER PREPAYMENT ELECTION RESIDENT DECEDENT -ASSETS- L ESTATE OF FILE NU E'R Walter, Bruce A., Sr. ' 0 0 II. ITEM NO. DESCRIPTION A. Real Estate (Please describe.) Total Value of Real Estate (Include on Section II, Line C-1 on Schedule B. Stocks and Bonds (Please list.) Total Value of Stocks and Bonds (Include on Section II, Line C-2 on Schedule L.) C. Closely Held Stock/Partnership -Please list. (Attach Schedule C-1 and/or C-2.) Total Value of Closely HeIdlPartnership Include on Section II, Line C-3 on Schedule L.) D. Mortgages and Notes (Please IistJ Total Value of Mortgages and Notes $ Include on Section II, Line C-4 on Schedule L.) '' E. Cash and Miscellaneous Personal Property (Please list.) Total Value of Cash/Miscellaneous Personal Property $I! Include on Section II Line C-5 on Schedule L. [II. TOTAL (Also enter on Section II, Line C-6 on Schedule L.) $' If more space is needed, attach additional sheets of paper of the same size. REV-1646 ~Xf (11-09) ,pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT [. ESTATE OF Walter, Bruce A., Sr. [I. ITEM NO. INHERITANCE TAX SCHEDULE L-2 REMAINDER PREPAYMENT ELECTION -CREDITS- FILE DESCRIPTION A. Unpaid Liabilities Claimed against Original Estate and Payable from Assets Reported on Schedule L-1 (please list) Total Unpaid Liabilities $ include on Section II, Line D-1 on Schedule L B. Unpaid Bequests Payable from Assets Reported on Schedule L-1 (please list Total Unpaid Bequests ~ include on Section II, Line D-2 on Schedule L) C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are Not Included for Tax Purposes or that Do Not Form a Part of the Trust. Calculation as follows: Total Non Includable Assets include on Section II, Line D-3 on Schedule L) «<• TOTAL (Also enter on Section II, Line D-4 on Schedule L) If more space is needed, attach additional sheets of paper of the same size. 0 0 REV-194; EX (02-101 ~ penrisylvani~ ~ SCHEDULE M DEPARTMENT OF REVENUE FUTURE. INTEREST COMPROMISE INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4a on REV-1500) ', :STATE OF FILE NUMBER 3ruce A. Walter Sr. 0 0 This schedule is appropriate onty for estates of decedents who died after Dec. 12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future i terest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the to return. ^ III ^ Trust ^ Other [. Beneficiaries NAME OF BENEFICIARY I RELATIONSHIP I DATE OF BIRTH „_ _ _ AGE ~. 2. 3. 4. 5. [I. For decedents who died on or after July 1, 1994, if a surviving spouse exerdsed or intends to exerdse a right nine months of the decedent's death, check the appropriate block and attach a copy of the document in whid exerdses such withdrawal right. ^ Unlimited right of withdrawal ^ Limited right [[. Explanation of Compromise Offer: [V. Summary of Compromise Offer: 1. Amount of future interest ................................... . Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ...... $ 3. Value of Line 1 passing to spouse at appropriate tax rate (Also include as part of tots shown on lane 15 ofREV-1500.) 4. Value of Line 1 taxable at lineal rate (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) ...... $ 6. Value of Line 1 taxable at collateral rate (15%) (Also include as part of total shown on Line 18 of REV-1500.) .. , , , . $ 7. Total value of future interest (sum of Lines 2 thru 6 must equal Line 1) ............... . .....$ If more space is needed, use additional sheets of paper of the same size. ~r writhdrawal within the surviving spous REV-1648 EX <r02-~i9)' Pennsylvania OEPARTMF~NT OF REVENUE ,Bureau of Individ6al Takes PO Box 2806D1 SCHEDULE N SPOUSAL POVERTY CREDIT FOR DATES OF DEATH 01/01/92 TO 12/31/94 Iter. Sr. rya scneou~e must be completed and filed if you Checked the I 0 credit box on the cover 1. Taxable assets total from Line 8 (cover sheet) ................. .. 1 2. Insurance proceeds on Gfe of decedent .......................... _............................................ _ 2. 3. Retirement benefits ......................................... _ ..........................................._............. 3. 4. Joint assets with spouse ........................... _................. _......... _....... ................................... ....... 4. 5. PA Lottery winnings ................................ ............................................................................................ 5. 6a. Other nontaxable assets: List and attach schedule if necessary .. 6 a. 8. SUBTOTAL (Lines 6a, b, c, d) ................................................................................................. ............. 6• 7. Total gross assets (Add Lines 1 thru 6) ................................................................................................ 7. 8. Total actual liabilities ...................... ...................................................................................................... 8• 9. Net value of sshEe (Subtract Line 8 from Line 7 ... ate a~sfxewr .................. Man i20i0,000 -STOP. ............................................ 9. 71fe asEraErr r.r,r ' ° iv maim the Cre~G4t if not oen-in,.. s.. a..., income: 1. TAX YEAR: 19 2. TAX YEAR: 19 a. Spouse ............ 1a. 3. TAX ; ................. 2a. 3a b. Decedent .......... 1b. . ............... 2b. ~. c. Joint ..................... 1c. ............ 2c. 3c. d. Tart Income . 1d. ........ s. Other income not 2d. 3d, Nstsd above ..........:.......... 1e. 2 f. Total. ................................ 1 f. e. ~ 3e. 4• Average joint exemption income calculation 4a Ad ' 3f. . d joint exemption income from above: (1~ + (21) + (3~ -~ _ 4b. Average joint exemption income .......... _ nNne ~(bp is yM,n ................................. _ ... SIq,000 -ATOP. 7Aa suer is rat ................................... _ sAi~ib/e ib r~fairn Mie credit if not catlrua m Part 1!!. 1. Insert amount of taxabb transfers to spouse or 6100,000, whichever is less .............:.................... 2. Multiply by credit percentage (see instructions ~ ~ ~ ~ ~ ~ ~ ~ 1 3. This is the amount of the Resident Spousal Poverty Credit. InGude this figure 2 in the calculation of total credits on Line 18 of the cover sheet ...................... 4. For nonrosidents, enter the ratio of the decedent's gross estate in PA to the value of the 3 decedents gross estate .... . ..................................................................................................................... 5. Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident Spousal 4 Poverty Credit. Include this figure in the calculation of total credits on Line 18 of the cover sheet .......... 5. __._ __ 1 161.31 161,31.87 REV-1649 EX + ~_g(I ~ y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN OF ~CHED~JLE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(AOof the Inhr If the election applies to more than one trust or similar arrangement, a separate form must be filed for This election ies to the If a trust or similar arrangement meets the requirements of Section 9113(A), and: Trust marital residual A E a. The trust or similar arranyement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's persona! representative may specifically identify the trust (all or a fractional portion or percentage) to be included it filar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxab representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or si Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, w surviving spouse under a Section 9113 (A) trust or similar arrangement. Par4 a TnM1 ce 8 Estate Tax trust. on to haves ch trust orSim- on Schedule 0, the personal n is equal to he amount of pass to the (If more space is needed, insert ~ditional sheets of the same size) _ _ _ - - - __ ' 'REV-1500 Discount, Interest and Penalty VUorksheat Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: Discount: _ 0.00 Interest Table Year 'Days Delinquent ~ Balance Due Interest this time c~eriod this ..e~~ .~:_ _ _~ Before 1981 ----_ rte...... 1982 1983 1984 1985 1986 1987 1988.throu h 1891 i 1892 1993 throw h 1994 ~ 1895 thro h 1998 ~ i 1999 i 2000 2001 2002 2003 2004 , ~ ZOOS 2006 2007 2008 2009 2010 i TOTALS I ~ P~naity Calculation If the decedents date of death was on or before March 31, 1993, insert the applicable amount Total Balance Due on January 17, 1996: Penalty: