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Home My WebLink About08-01-11--~ REV-1500 °`~°'-'°' 150'5610143 PA Department M Revenue ~ OFFICIAL USE ONLY pennsylvanla county code Yesr Fte Nurttt~ Bureau of Individual Taxes oo.~~ Po aox.isOSO1 INHERITANCE TAX RETURN 2 1 1 0 0118 5 Harrisburg, PA 1712&0601 RESIDENT DECEDENT ENTER DECEDENT INFORaIATroa BELOW Social Security Number Date of Death pate of Birth 201 16 4007 11 18 2010 02 12 1924 Decedent's Last Name Suffix Decedent's First Name M~ BURR>3LL JEAN C {If Applicable) Enter Survhring Spouse's IrNormation Below Spouse's Last Name Sufl"uc 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. Origins{ Retum [] ,~, ~ Retum ^ 3. Remainder Retum (date of death prior io 12-13-82) [~ 4. Limited Estate ^ {a, FuWre e~est compomise ^ 5. Federal Estate Tax Rum Required {dole d dssth after 72-12.92) DeaedeM Died Testate ® e. (/ltterh copy a wxp ^ 7~ (Atcapiue~rye ~ T"i8r ___-- 8 Total Number of Sate OCpoEit Boxes ^ 9. Litigation Proceeds Received ^ 10. ~+w Crods tdeAe d deem 71. Election to ~t under Sec. 971 befwee„ n-s1 tend -1-0tS) ^ 3(N U-ttach sd,. o~ C012RE3PONDENT - THE 8ECTION MUST 8E COMPLETEQ, ALL COtiRESPONDENCERND CONFIDENML TAX II~iNiMAT10N SHOULD BE DIRECTED 70: Name Daytime Telephone Number JOSEPH D RBRWIN 717 362 3215 First Itne of address 4245 STATE ROIITB 209 Second floe of address City or Post Office BLIZABBTHVILLB State ZIP Code PA 17023 REGISTER OF WILfCS)USE ONLY t ~~ C7 ~:.,_~>_ -~.:~: m .~ ~~~,: - ;"7 _>.:~`~ DATE FILED -? ! corresponderrPse~neiladdreas: jdk~kerwinlawfirm.com It ids true ~azfd~urycomMeteDedar~ab~ Ion o~# examined Brie rotum,utdudfrrttpp axompanymg schedules and sfatetnertts, ant to the best of prepafer tNtl~ than the penwnsl repr'eserttetlve is based on aN intormetlon of whidt pfeparer t s aRyKnO knor,~~' SIGNATURE OF PERSON RESPONSIBLE FOR FILING RFTt1RN DATE ~_ - o Craig A. Burrell ~/aS /a o ! / ADDRESS 873 Hyson ~IGNATURE OF P NJ 08527 - ---.._..._.,,....,,...~ DATE Joseph D Kerwin ~ aS ~~ ~aafesss 4245 S outs 209, Elaabethville, PA 17023 Side 1 1505610143 1505610143 -~~ --:C ~'~ REV-1500 EX 1505610243 Decedent's Social Security Number oeceaencsName. BURRELL, JEAN C 2 0 1 1 6 4 0 0 7 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. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5. 251,278.19 6. Jointly Owned Property {Schedule F) ^ Separate Billing Requested ............ . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............ . 7. 8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. 2 5 1, 2 7 8 1 9 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... .. 9. 10,770.95 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. ... 10. 10,055.69 11. Total Deductions (total Lines 9& 10) ................................................................... ... 11. 2 0, 8 2 6 6 4 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. 230, 451.55 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. 230,451.55 TAX COMPUTATION -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 .00 15. 16. Amount of Line 14 taxable at lineal rate x .045 2 3 0, 4 5 1. 5 5 16. 1 0, 3 7 0. 3 2 17. Amount of Line 14 taxable at sibling rate X 12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................................................................................................... .. 19. 1 0, 3 7 0. 3 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 10 - 01185 D D NT' NAME Burrell, Jean C STREET ADDRESS - --- 211 Messiah Circle CITY Mechanicsburg STATE ZIP PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 10,370.32 2. Credits/Payments --- A. Prior Payments 10,000.00 B. Discount 518.52 Total Credits (A + B) (2) 10,518.52 3. Interest (3> 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 148.20 Check box on Page 2 Line 20 to request arefund - -- 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 APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No 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 .................................................................................................................. ^ ^x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ...................................................................... ^ ^ ................................................. x 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? ...................................................................................................................... ^ 0 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. §9196 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of 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)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Burrell, Jean C 21 - 10 - 01185 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER _ DEATH 1 Checking Account No. 112892910 at Halifax National Bank 246,145.62 2 Statement Savings Account No. 100671121 at Halifax National Bank 5,132.57 TOTAL (Also enter on Line 5, Recapitulation) I 251,278.19 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT S(:i~DULE H /~Fi~JN~ER~A- L~D~~F]~d/S-/E~S`~8'~~ ~'LJIrA1~71IW I IYC VV~71~7 FILE NUMBER ESTATE OF Burrell, Jean C 21 - 10 - 01185 _ Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION --AMOUNT NUMBER FUNERAL EXPENSES: A. I B. 1. z. 3. 4. 5. 6. 7. 1 , ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid Attorney's Fees Kerwin & Kerwin 10,042.07 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 Probate Fees Register Of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs The Sentinel -advertisement of estate 369.50 261.88 -- TOTAL (Also enter on line 9, Recapitulation) 10,770.95 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Sc~eduie H w~,~,~, Fune~alME^xpe,,n,~ses & /"1~.~ 1 ^1 ~pflllc ~-~A~ FILE NUMBER ESTATE OF Burrell, Jean C 21 - 10 - 01185 2 Cumberland Law Journal -advertisement of estate ~ 75.00 3 Notary fees 5.00 i 4 i FedEX 17.50 Page 2 of Schedule H SCHEDULEI - DEBTS OF DECEDENT, MORTGAGE COM NHERNITANCEOTAX RETURNANIA LIABILITIES, 8~ LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF Burrell, Jean C 21 - 10 - 01185 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM _. -- -- -- -- NUMBER DESCRIPTION AMOUNT 1 2010 State Income taxes 324.00 2 Verizon 3.71 3 Alert Pharmacy 129.87 4 Messiah Village -nursing home 9,598.11 TOTAL (Also enter on Line 10, Recapitulation) I 10,055.69 REV•1513 EX+ (11-08) ,~ ~ SCHEDULE) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Burrell, Jean C FILE NUMBER __ _ 21 -10-01185 NUMBER ~ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY _ RELATIONSHIP TO DECEDENT Do Not List Trustee(s) r SHARE OF ESTATE I (Words) AMOUNT OF ESTATE ($$$) I, TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1 Craig A. Burrell Son 50% 873 Hyson Road Jackson, NJ 08527 2 Deanna Burrell Granddaughter 10% ~! 873 Hyson Road Jackson, NJ 08527 3 Melinda K. Ellis Granddaughter 10% j 8140 High Hampton Chase Alpharetta, GA 30022 i Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover i sheet, as appropriate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV-1573 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell, Jean C NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I, TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 4 Meghann Ellis Crider 171 Van Buren Avenue Biloxi, MS 39531 5 R. Justin Ellis 8140 High Hampton Chase Alpharetta, GA 30022 6 Andrew I. Burrell 873 Hyson Road Jackson, NJ 08527-1168 FILE NUMBER 21 - 10 - 01185 RELATIONSHIP TO SHARE OF ESTATE ~ AMOUNT OF ESTATE DECEDENT (Words) ($$$) Do Not Llst Trustee(s) _ _. _ ~ -- - Great-granddaughter ~ 10% Great-grandson ~ 10% Grandson ~ 10% Page 2 of Schedule J ,. L'. "~ Nr',,:~~G ~'~~~ .. , LAST WILL AND TESTAMENT 20(0 OEC -2 AN 10~ 28 OF CLERK C~ JEAN C. B URRELL ~RPNAN ~,~ CtJRT I, JEAN C. BURRELL, of the Township of Halifax, County of Dauphin and Commonwealth ofPennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Executor to pay all my legally enforceable debts, funeral expenses, administration expenses, and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. SECOND: I give, devise and bequeath all of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death to my husband, ROBERT G. BURRELL, if he survives me by thirty (30) days. THIRD: In the event my husband, ROBERT G. BURRELL, predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath all of my property, be it reai, personal and mixed, whatsoever and wheresoever the same may be situate at the time of my death as follows: A. Fifty Percent (50%) of my estate shall pass to my son, CRAIG A. BURREL, ifhe survives me. h~ the event my son, CRAIG A. BURREL,L, predeceases me or fails to survive me, I direct that leis share of my estate shall pass in GREGORY M. KERWIN TER RENCE J. KERWIN JoSERrI D. KERWIN JLLY MCC LURE KERWIN ATTORNEYS AT LAW equal shares to his children. It is my desire that any monies received by my son, CRAIG .A. BURRELL, under this, my Last Will and Testament shall be held in an account in my son Craig's name alone. Yage 1 of 3 Pages AN C. BURRELL B. Ten Percent (LO%) of my estate shall pass to my grandson, ANDREW I. BURRELL, providing he has attained the age of eighteen (18) years at the time of my death. In the event my grandson, ANDREW I. BURRELL, has not attained the age of eighteen (18) years at the time of my death, I direct that his share of my estate shall be held In Trust by his father, CRAIG A. BURRELL, until he reaches the age of eighteens (18) years. C. Ten Percent (10%) of my estate shall pass to my granddaughter, DEANNA BURRELL, providing she has attained the age of eigleteen (18) years at the time of my death. In the event my granddaughter, DEANNA BURRELL, has not attained the age of eigleteen (18J years at the time of my death, I direct that her share of my estate shall be held In Trust by her father, CRAIG A. BURRELL, until she reaches the age of eighteen (18) years. D. Ten Percent (10%) of my estate shall pass to my granddaughter, MELINDA K. ELLIS. E. Ten Percent (10%) of my estate shall pass to my great-granddaughter, MEGHANN ELLIS providing she has attained the age of eighteen (1 S) years at the time of my death. In the event my great-granddaughter, MEGHANN ELLIS, has not attained the age of eig/:teen (18J years at the time of~ my death, I direct that her share of my estate shall be held In Trust: by her mother, MELINDA K. ELLIS, until she reaches the age of eighteen (18) years. F. Ten Percent (10%) of my estate shall pass to mygreat-grandson, R. JUS'CIN ELLIS, providing he has attained the age of eighteen (18) years at the time of my death. In the event my great-grandson, R. JUSTIN ELLIS, has not attained the age of eighteen (I8) years at the time of my death, I direct that his share of my estate shall be held In Trust by her mother, MELINDA K. ELLIS, until he reaches the age of eighteen (18) years. aaEGORV M KEFWIN ~ERRENEE ~ KERww Page 2 of 3 Pages ~~~ ~~' ~'~~ ,~ 2~L (SEAL JOSEPH D KEawirv LLY M«~~qE KEawiN /~fiEAN C. BURRELL ATTORNEYS AT LAW I FOURTH: I nominate, constitute and appoint my husband, ROBERT G. BURRELL, as Executor of this, my Last Will and Testament, authorizing and empowering him to sell and convey any and all real estate which I own at the time of my death. In the event my husband, ROBERT G. BURRELL, fails to survive me, or is unable or unwilling to serve as Executor of this, my Last Will and Testament, I nominate, constitute and appoint my son, CRAIG A. BURRELL, and my granddaughter, MF,LINDA K;. ELLIS, as Co- Executors of this, my Last Will and Testament. I further direct that my Executor or personal representatives shall not be required to i REGORY M. KERWIN ~ERRENCE J. KERWIN JOSEPH D. KERWIN ~LLY MCC LURE KERWIN ATTOft NEYS AT LAW post bond to act in said capacity. IN WITNESS WHEREOF, I, JEAN C. BURRELL, have hereunto set my hand and seal, to this my Last Will and Testament, this ~r~ day of_ /~~ ~ , 2000. SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, JEAN C. BURRELL, as and for her Last Will and Testament, in the presence of us, who at her request and in the presence of each other, have sere to ~t °~r names as ~itn~set0: /;~~ / ~ ~/ at: Resi~Iing at ~ 1 ' ~ ; - ; r ~-.;~ ~ , Pa e 3 of 3 Pag s ` d-./1 Dli/pjw/buRCl I.j~ b /' ~- i~~,~/(SEAL) AN C. BURRELL ~ll~~]C~IlI~~Y ~~~Il®Il~l~l~ ~~~~ ®peaatdrng Divisiorns: .~. ,u, ~~ Ht,~l%~+`acr 11r!r~,t!'tu~rr~l BrtiiJ~i' Mrn~er KCNC December 24, 2010 Kerwin & Kerwin Attorney at Law 4245 Route 209 Elizabethville PA 17023 Account Number(s) RE: Jean C Burrell SS#: 201-16-4007 DOD: 1 l / 18/2010 112892910 100671121 Type of Account _ Checking Statement Savings _ Date Opened May 19, 1986 February 4, 2002 Principal Balance at date of death $245,919.20 $5,130.07 Interest Rate 2.0490% 0.8500% Accrued Interest not disbursed as of date of death $226.42 $2.50 Maturity Date Primary Owner of Account Robert G Burrell Robert G Burrell Name of Joint Owner(s), if any Jean C Burrell Jean C Burrell Beneficiary, if any Date Joint Ownership was Established If within l year of death of Decedent could prior Account Be traced into a prior Joint Account in existence over 1 year prior to death of Decedent By: None None N/A N/A N/A N/A None Safe Deposit Box(s) and Location Misty Novinger * J l ational of Marysville