HomeMy WebLinkAbout03-25-11J ],5056],0],05
REV-1500 Ex toz-~~, (FI,
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes °"~""'ME"'°`"`"`""E County Code Year File Number
PO Box 28o6oi INHERITANCE TAX RETURN
Harrisburg, PA 1128-o6oi RESIDENT DECEDENT ~~ ~ I C; ~~~a
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
007-22-0544 03/05/2010 04/27/1922
Decedent's Last Name Suffix Decedent's First Name
MI
Beaudry Jacqueline C
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust U 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) {Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name
Daytime Telephone Number
Tricia D. Naylor, Esquire (717) 249-6873
First Line of Address
Baric Scherer
Second Line of Address
19 West South Street
City or Post Office
Carlisle
Correspondent's a-mail address: tnaylor@baricscherer.com
State ZIP Code
PA 17013
REGISTER OF WILLS USE Ot~IY
C~ „;,.
-°r
~ J ~~:J:.
.i -~- c:7
~~,-~ =73
:.,~' s
. _, r-'.~
,:.~ -n
DATE FF~ D ~-
r~.
~^~~
-~'=.'-
~;
.-. . .
_..._ ~ ~
-,--~
. -. ~..>
~_.._..
~~ Q
__~.~
Under penalties perjury, I declare th have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, corr t nd comple .Dec ion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT E F PER E NSIBLE FOR FI G RETURN r.
~~ DATE
---- - - - ~X ~~ ~~ ~ ~ _ ~ / --~ -. 1.
~~ ~3r
E OF P RER O THAN REPRESENTATIVE
ADDF~ESS
law ~~~. ~-
1505610],05
E USE ORIdINAL FORM O LY
Side 1
1505610105
c~j
J
1505610205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedents Name: Jacqueline C. Beaudry 007-22-0544
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 and Notes Receivable (Schedule D) ........................ . 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 45,861.73
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested..... ... 7.
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 45,681.73
9. Funeral Expenses and Administrative Costs (Schedule H) .... 9. 3,772.50
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 89,307.24
11. Total Deductions (total Lines 9 and 10) ..................
............
.. 11. 93,079.74
12. Net Value of Estate (Line 8 minus Line 11) .............. 12
13. .............
Charitable and Governmental Bequests/Sec 9113 Trusts for which ..
. 0.00
an election to tax has not been made (Schedule J) .................... .. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 0.00
TAX CALCULATION
-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0 -
15.
16. Amount of Line 14 taxable
at lineal rate X 0 _ 16.
17. Amount of Line 14 taxable
at sibling rate X 12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 .,,
19. TAX DUE .. ................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610205 150561020
5
O
J
REV-1500 EX (FI) Page 3
. Decedent's Complete Address:
DECEDENT'S NAME
Jacqueline C. Beaudry
__
_ ...
STREETADDRESS
700 Walnut Bottom Rd.
CITY
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments ___ __
B. Discount
3. Interest
File Number
STATE - ---_r ZIP
PA ! 17013
Total Credits (A + B) (2)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3)
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE AP
PROPRIAT E BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred ................................................................................ Yes
.......... ^ No
^
b. retain the right to designate who shall use the property transferred or its income .................................. .......... ^
c. retain a reversionary interest .................................................................................................................... .......... ^
d. receive the promise for life of either payments, benefits or care? ............................................................ .......... ^ ^
2. If death occurred after Dec. 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? .... .......... ^
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
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-i5o8 EX+ (il-io)
• ~ Y ~;' Pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF;
Jacqueline C. Beaudry FILE NUMBER:
21-10-1036
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorshi
must be dis
l
d
p
c
ose
on Schedule
ITEM F,
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1. NYL Annuity check for the cash surrender value requested
rior to de
th
p
a 6,439.12
2, 2009 Federal Income Tax Refund
5,431.00
3. Acacia Life Insurance benefit paid on the death of Robert Beaudry
5,221.07
4, TD Bank Interest Checking Account #18813755-629-T
10,705.59
5, Federal Employees Group Life Insurance benefit paid on the death of Robert Beaudry
15,478.15
6, Cash distribution from the Estate of Robert Beaudry
185.80
7, 2010 Federal Income Tax Refund
452.00
g. U.S. Department of State -survivor annuity payment
1,949.00
TOTAL (Also enter on Line 5, Recapitulation) $ I 45,861.73
If more space is needed, use additional sheets of paper of the same size.
FEV-151.Q EX~ (08-09)
~ pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
w i H i ~ yr
Jacqueline C. Beaudry FILE NUMBER
21-10-1036
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is
yes.
ITEM DESCRIPTION OF PROPERTY
NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'5 EXCLUSION
INTEREST (IF APPLICABLE)
1~
Members 1st Federal Credit Union Savings Account#377135 _
transferred to decedent's daughter Catherine Beaudry on 2/3/2010 2,783.13 100 2,783.13
2 Members 1st Federal Credit Union Savings Account #377135
transferred to decedent's daughter Catherine Beaudry on 2/3/2010 1,658.00 100 216.87
Please bill Item #2 directly to decedent's daughter Catherine Beaudry,
118 West South Street, Carlisle, PA 17013
TOTAL (Also enter on Line 7, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size,
TAXABLE
VALUE
0.00
1,441.13
1,441.13
REV 1511 EX+ (10-09)
• ~ pennsylvania
DEPARTMENTDFREVENUE
INHERITANCE TAx RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
CJIHIt Ur
Jacqueline C. Beaudry
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A, FUNERAL EXPENSES:
1' St. Peter's Cemetery -inscription on monument
FILE NUMBER
21-10-1036
AMOUNT
760.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
500.00
Name(s) of Personal Representative(s) PaUI S. Beaudry
Street Address 4055 W. 166th Street
city _Cleveland_ _ _ _ _ _ _ state CH ZIP 44135 -
Year(s) Commission Paid: 2011
Z~ Attorney Fees. 2,000.00
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City _____ ____ _ State ZIP
Relationship of Claimant to Decedent
4, Probate Fees:
111.50
5~ Accountant Fees:
6• Tax Return Preparer Fees;
265.00
~~ Death Certificates -Hoffman-Roth Funeral Home & Crematory
Inc
,
.
72.00
$• Short Certificates
4.00
s. Inheritance Tax filing fee
15.00
~ o. Additional Probate Fees
45.00
TOTAL (Also enter on Line 9, Recapitulation) $ 3,772.50
If more space is needed, use additional sheets of paper of the same size,
E~EV-1512 EX+ (12-051
. ~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
FILE NUMBER
Jacqueline C. Beaudry 21-10-1036
Report debts incurred by the decedent prior to death that remainarl ~~nna~~ ~t rtia a~fe ,.~ a.,...~ :.._~..~,__ .
_...._. _ _,. ...... ... ....",,.,,, ,,,,~~ ~ ouu,~,~„a. anee~s or the same size.
LAST WILL AND TESTAMENT
of
JACQUELINE C. BEAUDRY
BE IT REMEMBERED, that I, JACQUELINE C. BEAUDRY, of SCARBOROUGH in
the COUNTY OF CUMBERLAND and STATE OF MAINE, being of sound and disposing
I
mind and memory, but mindful of the uncertainty of this life, do make,
publish and declare this my LAST WILL AND TESTAMENT, hereby revoking all
former Wills by me made.
II After the payment of my legally owing debts, funeral charges ar.d
..
I' expenses of administration, I dispose of my estate as follows:
FIRST: I direct that all costs of administration of my estate be paid by
il' my estate, and I hereby authorize and empower my Personal Representative
to sell, exchange, convey, transfer, sign, mortgage, pledge, lease or rent
the whole or any part of my real or personal estate, to invest, re-invest
~I
or retain investments, of my said estate and to perform all acts and
I
execute all documents which my said Personal Representative may deem
necessary, convenient or proper in regard to my property without first
i obtaining any license from Court. My said Personal Repesentative, using
his own discretion, has the power to accelerate any pa ment due
~' Y on an
~' Y
~j mortgages which may be charged against my estate and such payments may be
I~ made at his discretion before the distribution of m es
', y tate,
j SECOND: My husband, ROBERT M. BEAUDRY, is livin a~
g ~ the time of execution
I
of this will and we have four children born of our marriage; namely, 1?AUL
;' S. BEAUDRY, JOHN J. BEAUDRY, CATHERINE A. BEAUDRY and MARY E. BEAUDRY
FIENUP, In the event that we adopt any children in the future, they :;hall
be consi
de
red as children of ours for all purposes under this will, it
being my intent to provide for any after-adopted children.
THIRD: I give, devise and bequeath all of my estate, real, personal, and
mixed wherever situated and whenever and however acquired to my beloved
husband, ROBERT M, BEAUDRY, to his heirs and assigns forever, in the event
that he survives me,
I!
ii
FOURTH: In the event my said beloved husband, ROBERT' M, BEAUDRY,
~' predeceases me or dies in the course of
li or as a direct result. of the same
it accident, epidemic or other ca ].amity which causes my death and his
death
cuFFORns ' occurs for these or any other reasons within thirty (30) da
SAW OFFICES ~ ys after my
ArTORNE~~A, ~~s. ~ death, z direct m Will is to be read as
9.w Y though he predeceases me, and I
ReeaoR7 nna,Neoaoar, II give, bequeath, devise all of the real, personal and m'
axed property which
i
--
I own at the time of my dear_h to my children, namely: PAUL, S, BEAUDRY,
JOHN J. BEAUDRY, CATHERINE A. BEAUDRY, and MARY E. BEAUDRY ~IENUP,
equally, share and share alike to be take as absolute owners thereof for
per stirpes and not per capita.
i In the event that any of my children predecease me and leave any of their
children living, I give, bequeath and devise the share of my said deceased
child to the children of said deceased child equally, share and sh<sre
alike, to take as absolute owners thereof, and not per capita. And .if
said deceased child does not leave children living, then in that event I
I~
give, devise, bequeath the deceased child's share t.o said child's brothers
and sisters equally, share and share alike, to take as absolute owners
thereof, per stirpes and not per capita.
The use of the word child or children shall include in its meaning natural
and adopted children.
FIFTH: I hereby nominate and appoint my husband, ROBERT M. BEAUDRY, to be
~i the Personal Representative of this my Last Will and Testament, and
II request that the Court require no security on his bond. In the event tha
t
i
~; he is unable to serve for any reason whatosever, then in that event. I
nominate and appoint WALTER E. HINKLEY, JR, of AUBURN, COUNTY OF
ANDROSCOGGIN, STATE OF MAINE to serve in his stead and request that the
~,' Court allow him to serve without bond.
i
i SIXTH: Zf any person, legatee or devisee shall directly or ].ndrectly
contest or dispute any provision of this Will either before a probate
court or before any judicial body that this is not my Last Will and
Testament or call in question before any court or tribunal tme provisions
of any legacy, devise or provision herein, then I revoke all~,provisions in
this Will made in his or her behalf and declare the same void and of no
effect and give said legacy, devise or share that person wouljd have taken
to the remaining beneficiaries in this, my Last Will and Testament.
I~
I
I!
ii
CLIFFORDS' II
LAW OFFICES
ATTORNEYS AT LqW
~i
~EEPOR7-, MAINE 04031 I
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
29th day of June, 1988, iri the County of Cumberland, State of Ma~.ne.
~'
JACQUELINE C, BEAUDRY
CLIFFORDS'
LAW OFFICES
ATTORNEYS AT LAW
~~i}
2EEPORT, MAINE 04032
I, JACQUELINE C. BEAUDRY, testator, sign my name to this instrument
this 29th day of June, 1988 and being duly sworn, do declare to the
undersigned authority that I sign it willingly, that I execute it as my
free and voluntary act for the purposes herein expressed, that I am 18
years of age or older, of sound mind and under no constraint or undue
influence,
I I
I
I
~~
I ~ - ---
jl
i
l
We, -._ ~hP~.yl Smith and
= Sharri Rr :~ -At$~^, the
witnesses sign our names to this instrument being duly sworn'', and do hereby
declare to the undersigned authority that the testator signs, and executes
'' this instrument, her Last Will and Testament and that she signs it
willingly and that each of us in the presence and hearing of the Testator
!'
hereby sign this Will as witnesses to the Testator signing, and to the
best of our knowledge the Testator is 18 years of age or older and of
sound mind and under no constraint or undue influence,
~ ~~ ~ ~'
i -; ~ c..~
Witness Address
~-
I / - 'i ice-
~~ witness Address
I!
I
I
I'
I
~i
STATE OF MAINE
Cumberland, ss. June 29 1988
Subscribed, and sworn to and acknowledged before by
Jar~Pi;nP Raa„~r, Testator, subscribed and sworn tc me by
Cheryl Smith and Sherri Brackett, witnesses, this
~at-, day of June, 1988. `~A'- ~
~Wl C ~~
,. ;
~~~''~~ ;Notary Public/ korney At Law
I
1~
I
CLIFFORDS'
LAW OFFICES ~
i
ATTORNEYS AT LAW
~I~f
tEEPORT. MAINE 04032
FIRST CODICIL TO LAST WILL ANll TESTAMENT OF JACQUELINE. C BEAUDRY
I, JACQUELINE C. BEAUDRY, declare that this is the first Codicil to Amy Last Will and
Testament dated June 29, 1988 (hereinafter referred to as my "Will")
1. I hereby delete the Paragraph titled "FIFTH" of my Will and substitute the following
Paragraph titled "FIFTH" therefore:
FIFTH: I hereby nominate and appoint my husband, ROBERT M. BEAUDRY, to be the
Personal Representative of this my Last Will and Testament, alnd request that the
Court require no security on his bond. In the event that he is unable to serve for
any reason whatsoever, then in that event I nominate and appolint my son, PAUL
S. BEAUDRY, of CLEVELAND, COUNTY OF CUYAH(hGA, STATE OF
OHIO, to serve in his stead and request that the Court allow hi~n to serve without
bond.
2. In every other respect, I confirm and republish my Will dated June 29,~ 1988.
IN WITNESS WHEREOF, I have executed this Codicil at '~
~ ,
__., ~:
Pennsylvania, on A,p~il :,, 200 ~~ : {
JACQUELINE C. BEAliDR
~MOIMI AMO tuM~'~IY/~~1+"0~ Ilt t~
OiAYCF,r r, -
w
~~
~~ ~~
1
' ire forego~ng~ns~i-wmentwas s~gnea ~n oUr presenceby JAC 1~ELIN
Q ~ C. BEAUDRY who
acknowledged and declared this instrument to be the first Codicil to her Will da ed
June 29, 1988. We,
at her request and in her presence, and in the presence of each other, have si ed b
_ , _ gn I elow as subscribing
rt ... ~~
witnesses on April ~ , 2006r ~ , -t
Witnesses:
~'" -- ..
~`
`~ ~~
Addresses: I,
r ~'
_ ...
2 ~
- _ I