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HomeMy WebLinkAbout04-05-12J 1505610143 REV-1500 Ex (°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENDE Po Box.2sosoi INHERITANCE TAX RETURN 21 10 00872 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 172 18 1751 08 05 2010 06 26 1920 Decedent's Last Name Suffix Decedent's First Name MI LEE GUST R (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 ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) ir, 4. Limited Estate ~ ~, 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) hI g Decedent Died Testate Lx (Attach Copy of Will) ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) i~ 9. Liti ation Proceeds Received 9 ^ 10. Spousal Povert Credit ((date of death 11. Election to tax under Sec. 9113(A) between 12-31 Y91 and f-1-95) J (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MARK A MATEYA 717 241 6500 ~~~ First line of address 55 W CHURCH AVENUE Second line of address City or Post Office State ZIP Code CARLISLE PA REGISTEILLS USA ONLYr? -'-~ '~ ' ~ -~ T-i _~ _ ~ I-~ ~ ?~° i _ i-,-t t °=~7 c..17 , r. °CI~; - ; -,r: - \.7 , __ ti ~ ~ ~ DBE FILED ~. > -r i >< 1 Correspondent's a-mail address: rTlarll@n'lateyalaW.CBFiI Under penalties of perjury, I declare that I 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. ADDRESS 55 W. Church Avenue, Carlisle, PA Side 1 1505610143 1505610143 ~ ~~, 7006 Sundays Lane, Frederick MD 21702 SIGNAT RE OF PR~RERIOTHER THAN REPRESENTATIVE D E ~~,,,~, I~ta~ Mark A. Mateya ~ ~~/~L REV-1500 EX Decedents Name: Lee, Gust R 1505610243 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) ........................................................ 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 7. Inter-Vivos Transfers & Miscellaneous fin-Probate Property (Schedule G) u Separate Billing Requested............ 8. Total Gross Assets (total Lines 1-7) ..................................................................... 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 4. Decedent's Social Security Number 172 18 1751 5. 5,020.00 6. 237,030.19 7~ 120,900.00 $~ 362,950.19 9. 19,053.74 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12, 13. Charitable and Governmental BequestslSec 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. 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 343 896.45 16 at lineal rate X .045 , . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 19,053.74 343,896.45 343,896.45 0.00 15,475.34 0.00 0.00 15,475.34 Side 2 1505610243 1505610243 REV-1500 EX Page 3 File Number 21-10-00872 Decedent's Complete Address: DECEDENT'S NAME Lee, Gust R STREET ADDRESS 1319 N. Pitt Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 15,475.34 2. Credits/Payments A. Prior Payments 6,596.72 B. Discount 78.69 Total Credits (A + g) (2) 6,675.41 3. Interest (3) 177.01 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8,976.94 Make Check Payable t©~ 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 ............................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ............................................................ ^xJ ^ 2. If death9 ccurgred after Decembe'12, 1982, did decedent transfer property within one year of death without ^ receiwn ade uate consideration .................. ~_ u 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? .................................................................................................................. ^ ^x 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 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. Rev-1508 EX+t6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Lee, Gust R 21-10-00872 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. (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 E (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lee, Gust R 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Betty Bennett B. James Lee C. Robert Bennett 7006 Sundays Lane Daughter Frederick, MD 21702 1194 Irwin Court Son Winter Springs, FL 32708 115 Polaris Dr Grandson Walkersville, MD 21793 JOINTLY OWNED PROPERTY: ITEM NUMBER FOR JOINT TENANT MADE JOINT DESCRIPTION OF PROPERTY INUMBDER ORR SEMILARNDENTIFY NG INUMBERAATTACHKDEEDOFOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENT'S NTEREST 1 A 08/26/1991 M8~T Bank -Savings Account No. 1,980.37 50.000% 990.19 15004200904181 Jointly owned with Betty L. Bennett ($1,980.37 total value of account) 2 A 08/30/2001 M&T Bank -Certificate of Deposit Account 1,367.19 50.000% 683.60 No. 31003911905304 Jointly owned with Betty L. Bennett ($1,367.19 total value of account) 3 B 08/30/2001 M8~T Bank -Certificate of Deposit Jointly 1,367.19 50.000% 683.60 owned with James R. Lee. Account No. 31003911905297 ($1367.19 Total Amount of Account) 4 B 09/03/1996 M&T Bank -Certificate of Deposit Account 21,600.29 50.000% 10,800.15 No. 31003911177854. Jointly owned with James R. Lee ($21600.29 total value of account) 5 A 10/28/1991 M8~T Bank -Certificate of Deposit Account 10,001.10 50.000% 5,000.55 No. 31003911161378 Jointly owned with Betty L. Bennett ($10,001.10 total value of account) Total of Continuation Schedules See attached a es TOTAL (Also enter on Line 6, Recapitulation) I 237,030.19 (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 F (Rev. 6-98) Rev-1509 EX+ (6.98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Lee, Gust R 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE, DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 6 A 10/06/1998 MS<T Bank -Certificate of Deposit Account 3,639.56 50.000% 1,819.78 No. 31003910187622. Jointly owned with Betty L. Bennett. ($3639.56 total value of account) 7 A 10/29/2009 Members 1st -Savings account No. 50195-00 1,665.11 50.000% 832.56 Jointly owned with Betty Bennett 8 A 04/10/2006 Members 1st -Certificate of Deposit Account 62,865.40 33.333% 20,954.92 No. 50195-40 Jointly owned with Betty Bennett and James Lee 9 A 04/10/2006 Members 1st -Certificate of Deposit Account 44,676.08 33.333% 14,891.88 No. 50195-41 Jointly owned with Betty Bennett and James R. Lee 10 A 04/10/2006 Members 1st -Certificate of Deposit Account 30,845.66 33.333% 10,281.78 No. 50195-42 Jointly owned with Betty Bennett and James Lee 11 A 10/29/2009 Members 1st -Savings Account No. 59195-00 1,270.68 50.000% 635.34 Jointly held with Betty Bennett 12 A 02/17/1996 Members 1st -Savings Account No. 156573 831.54 33.333% 277.18 -00 Jointly held with Betty Bennett and James Lee 13 C 04/10/2009 Members 1st -Certificate of Deposit Account 6,166.32 50.000% 3,083.16 No. 34253-44 Jointly owned with Robert Bennett 14 B 02/05/2004 Members 1st -Savings Account No. 240709 2,024.99 33.333% 674.99 -00 Jointly owned with Tyler Lee and James Lee Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Lee, Gust R 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % ~F DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 15 C 02/05/2007 Members 1st -Savings Account No. 300707 1,260.39 33.333% 420.13 -00 Jointly owned with Rowan Bennett 16 A 05/16/1987 Members 1st -Savings account No. 34251-00 6,145.52 33.333% 2,048.49 Jointly owned with Susan Bennett and Betty Bennett 17 A 07/31/2009 Members 1st -Certificate of Deposit Account 1,778.75 50.000% 889.38 34251-41 Jointly held with Susan Bennett 18 C 08/05/1983 Members 1st Federal Credit Union -Jointly 1,794.30 33.333% 598.09 owned account No. 34253-00. Jointly owned with Betty Bennett 8r, Robert Bennett 19 A 09/16/2003 Orrstown Bank -Money Market Account - No. 5,459.15 50.000% 2,729.58 106800199 jointly owned with Betty E. Bennett 20 A 11/13/2009 Sovereign Bank -Checking Account No. 39,630.65 50.000% 19,815.33 1691031887 Jointly owned with Betty E. Bennett 21 A 11/13/2009 Sovereign Bank -Certificate of Deposit No. 79,277.20 50.000% 39,638.60 1675204919 -Jointly owned with Betty E. Bennett 22 A 11/13/2009 Sovereign Bank -Certificate of Deposit 2,640.30 50.000% 1,320.15 Account No. 1675321416 Jointly owned with Betty E. Bennett 23 A 11/13/2009 Sovereign Bank -Certificate of Deposit 6,188.44 50.000% 3,094.22 Account No. 1695489433 jointly owned with Betty Bennett Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+ (6-981 SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Lee, Gust R 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 24 A 11/13/2009 Sovereign Bank -Certificate of Deposit 4,795.59 50.000% 2,397.80 Account No. 1695540169 Jointly owned with Betty Bennett 25 B 07/13/2005 Sovereign Bank -Certificate of Deposit 11,707.86 50.000% 5,853.93 Account No. 1695540326 Jointly owned with James R. Lee 26 A 11/13/2009 Sovereign Bank -Certificate of Deposit 11,712.14 50.000% 5,856.07 Account No. 1695540334 Jointly owned with Betty Bennett 27 B 08/01/2005 Sovereign Bank -Certificate of Deposit 17,551.07 50.000% 8,775.54 Account No. 1695540383 Jointly owned with James R. Lee 28 A 11/13/2009 Sovereign Bank -Certificate of Deposit 17,551.07 50.000% 8,775.54 Account No. 1695540391 Jointly owned with Betty Bennett 29 B 09/01/2005 Sovereign Bank -Certificate of Deposit 11,668.54 50.000% 5,834.27 Account No. 1695540508 Jointly owned with James R. Lee 30 A 11/13/2009 Sovereign Bank -Certificate of Deposit 11,668.54 50.000% 5,834.27 Account No. 1695540524 Jointly owned with Betty Bennett 31 B 10/05/2005 Sovereign Bank -Certificate of Deposit 11,634.46 50.000% 5,817.23 Account No. 1695540532 Jointly owned with James R. Lee Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Gust R FILE NUMBER 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 32 B 10/05/2005 Sovereign Bank -Certificate of Deposit 11,634.46 50.000% 5,817.23 Account No. 1695540565 Jointly owned with James R. Lee 33 A 11/13/2009 Sovereign Bank -Certificate of Deposit 11,634.46 50.000% 5,817.23 Account No. 1695540573 Jointly owned with Betty Bennett 34 A 11/13/2009 Sovereign Bank -Certificate of Deposit 10,634.46 50.000% 5,317.23 Account No. 1695540581 Jointly owned with Betty Bennett 35 A 11/13/2009 Sovereign Bank -Certificate of Deposit 11,634.46 50.000% 5,817.23 Account No. 1695540599 Jointly owned with Betty Bennett 36 B 11/04/2005 Sovereign Bank -Certificate of Deposit 11,604.47 50.000% 5,802.24 Account No. 1695540615 Jointly owned with James R. Lee 37 A 11/13/2009 Sovereign Bank -Certificate of Deposit 11,604.47 50.000% 5,802.24 Account No. 1695540623 Jointly owned with Betty Bennett 38 B 01/20/2006 Sovereign Bank -Certificate of Deposit 1,193.14 50.000% 596.57 Account No. 1695540706 Jointly owned with Tyler Lee 39 B 09/05/2006 Sovereign Bank -Certificate of Deposit 1,128.65 50.000% 564.33 Account No. 1695541316 Jointly owned with James R. Lee Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+(6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Lee, Gust R 21-10-00872 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 40 A 09/05/2006 Sovereign Bank -Certificate of Deposit 1,128.65 50.000% 564.33 Account No. 1695541324 Jointly owned with Betty Bennett 41 A 11/13/2009 Sovereign Bank -Certificate of Deposit 1,389.54 50.000% 694.77 Account No. 3385088046 Jointly owned with Betty Bennett 42 A 11/13/2009 Sovereign Bank -Certificate of Deposit 6,188.44 50.000% 3,094.22 Account No. 1695489466 jointly owned with Berry Bennett 43 B 07/13/2005 Sovereign Bank -Certificate of Deposit 11,668.54 50.000% 5,834.27 Account No. 1695540516 Jointly owned with James R. Lee TOTAL (Also enter on Line 6, Recapitulation) 237,030.19 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+~6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Lee, Gust R 21-10-00872 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSERSATTACFi ACOPY OFTHE DEIED ~OR REAL ESTAT~ . DATE OF DEATH VALUE OF ASSET k OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Real Estate Life Interest -Life estate for real estate 120,900.00 120,900.00 located at 1319 N. Pitt Street, Carlisle Parcel ID No. 06 -18-1371-009A TOTAL (Also enter on Line 7, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 120,900.00 Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Lee, Gust R 21-10-00872 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) 11,335.42 Street Address City State ZiD Year(sl Commission Daid 2. Attorney's Fees Mark A. Mateya 5,500.00 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 5. Accountant's Fees 175.00 6. Tax Return Preparer's Fees 100.00 7. Other Administrative Costs 1,943.32 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 19,053.74 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 (FILE NUMBER Lee, Gust R 21-10-00872 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Cumberland Valley Memorial Gardens -Opening and closing of grave site 2 Ewing Brothers Funeral Home, Inc. -Funeral Expense H-A Other Administrative Costs 3 Cumberland County Register of Wills -Probate Fee 4 Cumberland County Register of Wills -Filing fee for Inh. Tax Return & Inventory 5 Cumberland County Register of Wills -Short Certificates 6 Cumberland Law Journal -Legal Advertisement of Estate 7 Evening Sentinel -Legal Advertisement of Estate 8 John H. Broujos -Initial Legal fees for estate administration 9 Pain 8~ Mouldon -Fee to prepare initial REV-1500 1,595.00 9, 740.42 11,335.42 H-B7 127.50 30.00 12.00 75.00 123.82 1,500.00 75.00 1,943.32 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-OS) SCHEDULE J COM INDHERITANCE T~ RETURN ANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Lee, Gust R ~ 21-10-00 872 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not ist T t e s I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 1 Betty E Bennett Child 174,087.11 7006 Sundays Lane Frederick, MD 21702 2 Robert G Bennett Grandson 11,840.63 115 Polaris Drive Walkersville, MD 21793 3 Susan Bennett Granddaughter 11,468.95 149 West South Street Frederick, MD 21701 4 James R Lee Child 93,263.81 1194 Irwin Court Winter Springs, FL 32708 5 Tyler F Lee Grandson 53,235.96 1194 Irwin Court Winter Springs, FL 32708 Total 343,896.46 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 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) • ~~ ~ Will . • 's c Clu»berland County. Pennsylvania. declare Gust R. _,cc~-I~ 131 North Pitt SU-cet. (.a-li.l e. 1, this to he m~° last ~4ill and rc~~e~ic an~~ will previously made by -n Item One: (direct that all my debts and funeral expensnes decease as a part of tlae expe sle of paid from my residuary estate as soon as practicable after y the ad-ninistration of my estate. entire estate to my wife Ellen K. Lee, if she Item Two: I give, devise, and bequeath my survives me by 60 days. In the event that she pr ea~~ ~ een re estate as follolws:g on the 61st day after my death, then I give, devise, and bequ Y A. I give and bequeath the sum of $10,000.00 each to my <~randdGwghtcr Susan L. Bennett it-~d Cif ;rv ~~*ranCltiCnl J~.ilhC'.t'1 ~_i 4~3t'.?inrlt' Ynd it?e t't;_,l'dlt1~{~!' a4 `+t',t (-1Plh [1,;'1n~~ . B. 50 `% to my daughter Betty L. Bennett, per stirpes. C. 25 % to my son James R. Lee, per stirpes. 25 % to my grandson Tyler Francis Lee. In the event that he deceases prior to his 25t~' D. `,~' ~ birthday, then the remaining share together with any accrued interest shall pass to his fat er James R. Lee; otherwise to my daughter Betty L. Bennett. ` I a oint my wife Ellen K. [.~ee Executrix of this my last will. Should she fail to t'~i Item Three pP ~' qualify or cease to act as Executrix.l appont my daughter Betty L. Begnnett o 7e006aSd dut es. Lane, Frederick, Maryland 21702 t~~ act as [~xec~~-tr-x with the same ri hts, p I a »oint my daughter Betty L. Bennett Guardian/Trustee of any property which ~ Item Four; [ [ passes to any person under the age of 25 years and with respect to which I am authorized to ~~°~ ` appoint a Guardian/T'rustee and have not otherwise specifically done so. Should she fail or cease to act as Guardian/Trustee, I appoint my grandson Robert G. Bennett to act with the same r-ghts, d duties. Guardian shall establish separate guardianship accounts and shChn cal and powers, an power to use income from time to thou f tra el s upport, and welfare without regard to his or her vocational training and graduate sc , parents' ability to provide for suchcduc'-~sillitt'~`t~l•gltptrc~-t~ficicrr~v,lfftcet[~rh~~mtike,~~yment iv- iii:~~, p~irp0?~,`i. "1,Iiii~Ut {ln~h~-~ ic.?p~- parents or to any person taking care of the be-lelicia-y. Gu<-rdi.-n shalt <-ilnun~stcr tht accutu~t til the beneficiary becomes 18 years of age, at which time the hunt to mslTrustee~being the un principal and income remaining m the separate guardianship acco same person as my designated Guardian, who shal ed to the a counts designat d, fo ~ h oth principal and income and any other funds transferr beneficiary's education, in~,luding technical and vocatio ~ ust account ids e ssdthan $10000 00 or support, health, and welfare. When the guardianship or the beneficiary of the separate trust becomes 25 years of age, the share of the beneficiary _. _.__. remaining fry thy` account shall Mr paid try the benefician: itt i`idl and thr ~uardianshlp ar trust terminated. [n ills c;vont oi'tlic death c~l~bc:ncliciary "l'ylc;r f~re-ncis l,ec offer my dc:cra.~ anc! prier to reaching the age: of'2i years, his shore shall pass to his rather James R. l,ec, {Kr stirpc::; otherwise to my daughter Betty 1.. Bennett. Guardian and "Crustee shall not be required to file accountings with any court. In the event that any provision of this will shall be interpreted to violate the Rule Against Perpetuities, then the remaining provisions of this will shall not be invalid. Trustee shall administer the trust and dispose of assets so as not to violate the rule, making distribution as required to a life or lives in being plus 21 years. Item Five: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. In the event that a substantial portion, as determined in the sole and absolute judgment and discretion of my Executor, of the non-probate assets such as an annuity or mutual funds are directed to be paid to a beneficiary or beneficiaries, so that the taxes referred to herein would tx paid out of the probate residue passing to the beneficiary or beneficiaries of this will (whether or not thr same ~ the beneficiary or beneficiaries under the non-probate assets), my Executor, in the Executor's sole and absolute judgment and discretion, shall direct or have the right to allocate the full or partial payment of the taxes to the beneficiary or beneficiaries of the non-probate assets. Item Six: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Item Seven: In addition to the rights and powers given to the fiduciaries by law or elsewhere in • this will, I give to my Executor during the full time necessary for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. g. To invest in any real or personal property without restrictions as to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property. and to give options for leases. E. To make distribution in kind. F. To compromise claims. _ __ hind thlt~//,"~. '~.sj~"r ~.. ~.,..,,., _-_- ___ tN WITNESS WI;F1t~;t)1~.1 Itav~ h~rcunto lit m ~ ._... Signed ~ Gust R. Lee ewritten pages each identified by the The preceding instrument, consisting of this and two other typ and date thereof signed, published and declared by the resence of us, who 'request, in his signature of the Testator was on the day Testator therein named as and for his last will, in the p es. resence and in the presence of each other have subscribed our i p COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND d ,witnesses whose names are sil;ned to the We, John H. Broujos an ualified according to law, do depose and say that we that e slgne attached or foregoing instrument being duly q nt and saw the Testator sign and execute th for the~~'1' as his last will; oses therein expressed; that each were prese willingly and executed it as his free and voluntary act i ht of the Testator signed the will as witne ound andaand under no f our of us m the hearing and s g ears of age, of s knowledge, the Testator was at the time 18 or more y constraint or undue influence. _ Sworn and subscribed to before Notarial Seal y ~~--~/`'` ~~~ Bridget Ann Corcoran, Notary met ' _ f ' fie' 20 Public ---~~ Carlisle Boro, Cumberland County My Commission Expires June 10, 2006 NO ARY P LIC Member,PennsylvaniaAssociati~nofNotanes COMMON~ALTH OF PENNSYLVANIA ss COiTNTY OF CUMBERLAND been dul ualified whose name is signed to the atta shend and xecut d the instrument as my last will; I, Gust R. Lee, according to law, do hereby acknowledgachfor ~gpurposes therein expressed. that I signed it as my free and voluntary ~- ` , Gust R. Lee; Testator Sworn and affirmed to daa of Jnune 1200 d befo me thls ~' y ~,t/~ TARP UBLIC Notarial Seal public Bridget Ann Corfu ber and County Carlisle Boro, Tres June 10, 2006 My Co~ussion Exp Member, Pennsylvania association of Notaries Codicil ~,t ~~ 1 ~.~ 'sle Cumberland County, Pennsylvania, having made my last will and I, Gust R. Lee of Carli ' 2005, do hereby make, publish and declare this to be a Codicil to my said testament dated June ____, last will and testament. NE: I amend my will to delete Item Three thereof and to substitute therefore the following: ITEM O " Item Three: I appoint my daughter Betty L. Bennett of 7006 Sunday Lane, Frederick, Maryland 21702 to act as Executrix. Shea ~ rin~f Flonda,aor, in hiseabsencecor failure Executrix, I appoint my son James R. Lee, of W int p ~ isclaimer my granddaughter Susan L. Bennett to act as Executrix with the same rights, to act or d powers, and duties." ITEM TWO: I hereby ratify and confirm my said lastd fled bd this Codicil all other respects excepting insofar as any part thereof is revoked or mo Y ~ WITNESS WHEREOF, I have hereunto set my hand this 6th day of August, 2008. y~ / L- ~ ~-.~._._ Gust R. Lee Qes was on the day and date thereof signed, The preceding Codicil, consisting of two typewritten pab , d and declared by Gust R. Lee as a Codicil to his last will and testament, and we, in the publishe presence of each other, have subscribed our names as COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBE~,AND '~ 'witnesses whose names are signed to the We John H. Broujos and ualified according to law, do depose and say that we were attached or foregoing instrument being d ly q d saw the Testator sign and execute the instrument as a codicil to his last will; that he signe present an us in the hearing and sight of the Testator signed the codicil as witnesses; and that to the best of our knowledge, the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. (~ (~"~~~ j -~ ~~~ Sworn and subscribed to before me this 6th day of August, 2008. / Tye r / i ?tit;,) J ;'llt`f` }'C_t}~L:it tutMQNW EALT~-~ Ut- r~:NNSYI_VANIA Notarial Seat Warxia K Hunter, Notary Pubib Carlrsie Eioro, C.utnbei:larrd bounty My C,~tnmtssbn Expires hAaY 1®, 2009 Member; FetYnSyivanl-~ :~s~aolaticn M ~}tle~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, Gust R. Lee, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as codicil to my last will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~~ Gust R. Lee ,`'iwti~l'il ittld ii}~trttl~:(~ t[) i1t1(j ~tr:knc7wled~ed before me this 6t}~ clay of Augntst, 2008. Notarlai Seal Warxta tc. Hunter, Notary PubAc 8 t3oro, G~r-betiand Courrit+ t+Ay won Exg~ltes NAay 90, 2009 Member, i:'~~n~v!,~,.;; , _ '~,, of Notaries