HomeMy WebLinkAbout03-02-11 (2)1505610143
REV-1500 EX (01-10) i ;.
~ OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code
Bureau of Individual Taxes DEPARTMENrOFREVENUE
PO 60X.280601 INHERITANCE TAX RETURN 21
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
Year File Number
10 1213
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
178 16 5883 05 27 2003
Decedent's Last Name
LAUGHLIN
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
LAUGHLIN
Spouse's Social Security Number
Date of Birth
11 15 1921
Suffix Decedent's First Name MI
HUGHIE D
Suffix Spouse's First Name MI
DOROTHY M
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ~ 2. Supplemental Return
4. Limited Estate ~ 4a. Future Interest Compromise
(date of death after 12-12-82)
g Decedent Died Testate
(Attach Copy of Will) ~ 7• (Attach Co a of Trust a Living Trust
PY
)
9. Litigation Proceeds Received ~ YY
10. behveeril2 31 ~9~andt~datges~f death
3, Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11.Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JERRY A WEIGLE ESQUIRE 717 532 738 ~~__~
First line of address
126 EAST KING STREET
Second line of address
City or Post Office
SHIPPENSBURG
Correspondent's a-mail address:
State ZIP Code
PA
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REGISTER OF WIlFf~~:~r~ONLY
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DATE FILED to
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Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
Doroth M. Laughlin ~,. - 2~""-~
ADDRESS
37 Turn ike Road Newbur P 1724
SIGNATUR O PREPARER OTH R THAN EP E TA VE DATE
r Jerry A. Weigle Esquire Z. ~"` Z,..~
~ ~ ~ ~~ i
ADDRESS ~ ~ ~
126 East Kin Street, Shi ensbur PA
Side 1
1505610143 1505610143 J
..~.
REV-1500 EX
Decedent's Name: LaUghlln, Hughie D.
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
1,742.64
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages 8~ Notes Receivable (Schedule D) ........................................................ 4.
5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous ty.Qn; Probate Property
(Schedule G) ^ Separate Billing Requested............ 7.
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 1 , 742.64
7,208.60
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9.
10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10.
11.
Total Deductions (total Lines 9 8~ 10) ...................................................................
11. 7,208.60
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12.
-5,465.96
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14.
-5,465.96
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
00
0
15
0
00
.
(a)(1.2) x .o0 . .
16. Amount of Line 14 taxable
0
0 0
16
0. 0 0
.
at lineal rate X .045 .
17. Amount of Line 14 taxable
0 0
0
17
0
0 0
.
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0
0 0
18
0
0 0
.
at collateral rate X .15 . .
19. Tax Due .................................................................................................................. 19. 0 . 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
1505610243
Decedent's Social Security Number
178 16 5883
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10-1213
DECEDENT'S NAME
Laughlin, Hughie D.
STREET ADDRESS
37 Turnpike Road
CITY
Newburg STATE
PA ZIP
17240
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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.
Make
heck Payable to: REGISTER OF WILLS, AGENT.
,. E~ 1st ,.... .t,~~
(3)
(4)
(5)
0.00
0.00
~.~~
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 :............................................................................... ^ U
b. retain the right to designate who shall use the property transferred or its income :.................................. ^ ^x
c. retain a reversionary interest; or ............................................................................................................... ^ 0
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 death without
receiving adequate consideration? .................................................................................................................... ^
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................................. ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
- _ - _---
z
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 January 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)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
(1)
Total Credits (A + B) (2)
Rev-150 EX+ (6-98)
SCHEDULE B
STOCKS ~ BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Laughlin, Hughie D.
FILE NUMBER
21-10-1213
All property jointly-owned with right of survivorship must be disclosed on Schedule F,
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 53 shares of Prudential Financial, Inc. 32.88 1,742.64
TOTAL (Also enter on Line 2, Recapitulation) 1,742.64
(If more space is needed, additional pages of the same size)
Copyright (c} 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
REV-1151 EX+ (10-061
,.
COMMNHEWRRITAN EOTAXERETSURNANIA
RESIDEN~ DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Laughlin, Hughie D. 21-10-1213
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zia
Year(s1 Commission oaid
2. Attorney's Fees Weigle & Associates, P.C.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation}
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. I Probate Fees Register of Wills, Cumberland County
6,826.10
300.00
67.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 7,208.60
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF IFiLE NUMBER
Laughlin, Hughie D. 21-10-1213
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex enses
1 Fogelsanger-Bricker Funeral Home 6,826.10
H-A 6,826.10
Other Administrative Costs
2 Register of Wills, Cumberland County -filing Insolvent PA Inheritance Tax Return 15.00
H-B7 15.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
REV-151,3 EX+ (11-08)
SCHEDULE J
COMMNHERITANCE~Fq}P~ RNET~jRNANIA BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lau hlin, Hu hie D. ~ 21-10-1 213
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
1. Dorothy M. Laughlin Spouse NOT RELEVANT ESTATE IS
37 Turnpike Road
Newburg, PA 17240 ~gQ~',V'
Tota I
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
Prudential
001181
~~II'~i~~tll~~l~l~~~~~l~~~il~~~ll~l~~~ii~ll~i~~l~I~ili~l~i~lll~l
DOROTHY M LAUGHLIN EX EST HUGHIE D LAUGHLIN
CIO WEIGLE 8~ ASSOCIATES PC
126 EAST KING ST
SHIPPENSBURG PA 17257
omputershare ~'
Computershare Trust Company, N.A.
PO Box 43033
Providence, RI 02940-3033
Within USA, US territories & Canada 800 305 9404
Outside USA, US territories & Canada 732 512 3782
www.computershare.comfinvestor
Holder Account Number
y~~Iep IIYI
I ~A p1FIAIpDBI
INN N1
~ NI ~ MII ~ 111 ~ 74 tl11l~ IN
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Prudential Financial, Inc. -Sale Advice
This advice is a result of the sale of Plan andlor Direct Registration shares.
Trade Transaction Description Shares/Units Price Per Gross Amount Deduction Deduction Net Amount
DateRil~te Sold SharelUnit ($) of Sales ($) Amount ($) Type of Sale ($)
01/07/2011 14:08 Sale 53.000000 60.029477 3,181.56 15.24 Transaction Fee 3,166.32
The IRS requires that we report the cost basis of certain shares acquired after January 1, 2011. If your shares were covered by the legislation and you have sold or transferred the shares and requested a spec cost basis
calculation method, we have processed as requested. ff you did not specify a cost basis calculation method, we have defaulted to the first in, first out (FIFO) method. Please visit our website or consuls your tax advise if you
need additional information about cost basis.
Computershare Trust Company, NA., as agent, upon written request, will provide the name of the executing broker dealer associated with the transaction(s), and within a reasonable amount of time will disclose the source
and amount of compensation received from third parties in connection with the transaction(s), ffany. ff trade time is not included above, it may be available upon written request.
1 L T R P RU ~"
001CD70003 us.ltr.c.sal.il_3050/001181/001181/i
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LAST WILL AND TESTAMENT
OF.
HUGHIE D. LAUGHLIN
I, HUGHIE D. LAUGHLIN, of Hopewell Township (mailing address: 37
Turnpike Road, Newburg, Pennsylvania 17240), Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament hereby revoking and
making void any and all Wills by me at anytime heretofore made.
1. I direct my hereinafter named Executrix or Executors to pay all of my just
debts and funeral expenses as soon after my death as may be found convenient to do
so.
2. All of the rest, residue and remainder of my estate, real, personal and mixed,
and wheresoever the same may be situate, I give, devise and bequeath to my wife,
Dorothy M. Laughlin, her heirs and assigns, to the exclusion of my children, born and
unborn, provided my said wife, Dorothy M. Laughlin, shall survive me by a period of
ninety (90) days.
3. Should my said wife, Dorothy M. Laughlin, predecease me or fail to survive
me by the aforesaid period of ninety (90) days, then in such event all of the rest, residue
and remainder of my estate, real, personal and mixed, and wheresoever the same may
be situate, I give, devise and bequeath as follows:
a) if at the time of my death I am the owner of the following items, I give and
bequeath the same as follows:
1) To my daughter, Janice M. Chamberlin, the two white gold rings
and one gold necklace and luggage which belong~d.to her mother, together with the
clock which had belonged to my wife's mother and all of the pins which had belonged
to her mother; in addition if she has not by the time of my death received a corner
cupboard from her aunt, then she shall also have my corner cupboard, otherwise my
corner cupboard shall be included in the residue of my estate;
2} I give and bequeath to my granddaughter, Lisa Chamberlin, one
gold necklace and set of three pearl rings which had belonged to my wife together with
a cedar chest and white duck;
,. ,
3) ` I give and bequeath to my granddaughter, Laura Davidson, who is
the daughter of my son Daniel` G. Laughlin, the opal ring and all scarabs which had
belonged to my wife, together with a cedar chest;
4) I give and bequeath all of my tools and equipment and hunting and
fishing equipment in equal shares to my two sons, Lee H. Laughlin and Daniel G.
'~ ~ Laughlin, and my son-in-law, Wilbur Chamberlin, to be divided among them as they
~, ~ may agree and in the absence of an agreement, as my hereinafter named Executors
~' shall determine, and if any of such items owned by me are not desired by any of them
then the same shall be divided equally among my then living grandsons.
b~) ~~e balance thereof I give, devise and bequeath in equal shares to my
`~~,~ two sons, Lee H. Laughlin and Daniel G. Laughlin, and my daughter, Janice M.
-~ ~~ ~~ Chamberlin, their heirs and assigns, provided each of them shall survive me by a
period of ninety (90) days, but should any of them fail to so survive me then the share
l such deceased erson would have received shall ass to such of his or her issue as
P P
,, shall survive me by a period of ninety (90} days, their heirs and assigns, per stirpes.
l
4. I have intentionally made no provision herein for my son, Richard H.
~' Laughlin, not because of any want of affection for him, but because he has already
~~ ~ ~~ received all that I wish him to have.
,,
~~ ~,_, Page 1 of 2 Pages
5. I hereby nominate, constitute and appoint my wife, Dorothy M. Laughlin, as
Executrix of this my Last Will and Testament but should she predecease me or fail to
qualify or cease serving as such, then in such event I nominate, constitute and appoint
as alternate or successor co-Executors my two sons, Lee H. Laughlin and Daniel G.
Laughlin, and my daughter, Janice M. Chamberlin, or any of them, and I further direct
that none of them shall be required to post any bond to secure the faithful performance
of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last
Will and Testament written on two (2) pages, this 30th day of September , 1991.
~~.- ~~ :,.~-~.-.---- ' (SEAL}
Hughie D. Laughlin
Signed, sealed, published and declared by HUGHIE D. LAUGHLIN, the Testator
above-named, as and for his Last Will and Testament, in our presence, who, in his
presence, at his request, and in the presence of each other, have hereunto subscribed
our names as attesting witnesses.
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