HomeMy WebLinkAbout05-23-12~ ~ 1505610143
REV-1500 Ex(°'-'°'
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county code rear File Number
Bureau of Individual Taxes °^^^armEa*oF aEVE~e
PO 60X.280601 INHERITANCE TAX RETURN ~~~~ ~~ ~
Harrisburg, PA 77128-0601 RESIDENT DECEDENT 21 I ~ - LTI~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2011 01 10 1932
Decedent's Last Name Suffix Decedent's First Name MI
PATTISON JOHN W
(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. Remaintler Return (date of death
prior to 12-13-82)
4. Limitetl Estate ~ qa Future Interest Compromise
(date of death attar 2-12-82) ~ 5. Federal Estate Tax Return Required
g Decedent Died Testate
C
f Wi
l ~ 7. (gt~ech NGOpy of Truasdt a Living T
) mst 8. Total Number of Safe DepOSit BDxeS
(Attach
opy o
l
)
9. Litigation Proceeds Received ^ c
10. b~1Otwaen i22~3,r~1 e^Et1(aatse5)f death ~ 71. EleQion to tax untler 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
FOREST N MYERS 717 532 9046
First line of address
137 PARK PLACE WEST
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Second line of address
City or Post Office
SHIPPENSBURG
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DATE FILED
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State ZIP ode
PA 172579212
correspondent's a-mail address: fnmyers@lawofficeforestmyers.com
schetlules antl statements, antl to the best of my knowledge antl belie(,
is basetl on all information of which preparer has any knowledge.
Winnefred M PATTISON 5 - 2 t - 2-o t2..
91 Firehouse Rd, Walnut Bottom, PA 17266
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
~ ~~ Forest N Myers ~_ it _ 2A t,2
ADORESs
137 Park Place West, Shippensburg, PA
Side 1
1505610143 15U5610143 J
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REV-1500 EX
o~aa~r~ Name. pATTISON, John W
Decedent's Social Security Number
198 22 8282
RECAPITULATION
1. Real Estate (Schedule A) ...................................................................................... . 1. 2 7 9 , 100.00
2. Stocks and Bonds (Schedule B) ........................................................................... .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3.
4. Mortgages R 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 ryoq Probate Property
(Schedule G) u Separate Billing Requested........... . 7.
g. Total Gross Assets (total Lines 1-7) ................................................................... .. 8. 279, 100.00
9. Funeral Expenses & Administrative Costs (Schedule H) ............................... ........ 9. 1 , 754.25
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 10.
t 1. Total Deductions (total Lines 9 & 10) ........................................................... ........ 11. 1 , 754.25
12. Net Value of Estate (Line 8 minus Line 11) .................................................. ........ 12. 277 , 345 - 75
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. 2 7 7 , 345.75
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 277 345.75 15.
(a)(1.2) X .00 r
16. Amount of Line 14 taxable
0 . 0 0
16
at lineal rate X .045 .
17. Amount of Line 14 taxable
0
0 0
17
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0
0 0
18
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
L 1505610243 1505610243
1505610243
0.00
0.00
0.00
0.00
0.00
J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-11-00349
DECEDENT'S NAME
PATTISON, John W
STREETADDRESS
91 Firehouse Rd
CITY
Walnut Bottom STATE
PA ZIP
17266
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
0.00
3. Interest
q, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Cheek 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 Check Payable to: REGISTER
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
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 ............................................................................................................... ^ 0
d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^ ^x
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 imposetl 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
adaptive 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.
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** LAST WILL AND TESTAMENT **
I, JOHN W PATTISON, of South Newton, Cumberland County, Pennsylvania,
revoke my prior wills and declare this to be my Last Will:
FIRST: PAYMENT OF EXPENSES - I direct that the expense of my last illness and funeral be
paid from my estate as soon as may conveniently be done.
SECOND: BEQUEST - I give, devise and bequeath my estate, real or personal, tangible or
intangible, together with all insurance policies thereon unto my wife, WINNEFRED M
PATTISON, provided she shall survive me by thirty (30) days. In the event my wife fails to
survive me by thirty (30) days, I then give, devise and bequeath all my estate whether real
or personal property, tangible or intangible, together with all insurance policies thereon to
my children, in as nearly equal shares as possible, per stirpes.
THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and
remainder of my estate unto my wife, WINNEFRED M PATTISON, provided she shall
survive me by thirty (30) days. In the event my wife fails to survive me by thirty (30) days,
then give, devise and bequeath all the rest, residue and remainder of my estate to my
children provided they shall survive me by thirty (30) days, in as nearly equal shares as
possible, per stirpes.
FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before
actual payment to a beneficiary, no interest in income or principal shall be (i) assignable to
a beneficiary or (ii) available to anyone having a claim against a beneficiary.
FIFTH: DEATH TAXES -All federal, estate and other death taxes payable on the property
forming my gross estate, whether or not it passes under this wil I, shall be paid out of the
prircipa! of my prnhate estate just as if they were my debts, and none of those taxes shall
be charged against any beneficiary. This provision shall not apply to any property over
which I have a general power of appointment of federal estate tax purposes.
SIXTH: MANAGEMENT PROVISIONS - I authorize my Executrix, as follows:
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A. Retain/Invest: To retain and to invest in all forms of real estate andonal '~"
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property, including common trust funds, mutual funds and money maG pos~ U : ~' ;
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accounts and certificates of deposit, regardless of any limitations impose lawn =:
investments by executors or any principle of law concerning investme~p~ ~ `- ,
diversification; ~, _T7
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B. Compromise: To compromise claims and to abandon any property which, in my
Executrix's opinion, is of little or no value;
C. Borrow: To borrow from and to sell property to my wife or others, and to
pledge property as security for repayment of any funds borrowed;
D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any
period of time, any real or personal property and to give options for sales of leases;
E. Capital Changes: To join in any merger, reorganization, voting-trust plan or
other concerted action of security holders, and to delegate discretionary duties with
respect thereto;
F. Distribute: To distribute in kind and to allocate specific assets among the
beneficiaries (including any custodian hereunder) in such proportions as my Trustee
may think best, so long as the total market value of any beneficiary's share is not
affected by such allocation.
These authorities shall extend to all property at any time held by my Executrix or my
Trustee and shall continue in full force until the actual distribution of all such
property. All powers, authorities and discretion granted by this Will shall be in
addition to those granted by law and shall be exercisable without court
authorization.
SEVENTH: EXECUTOR - I appoint my wife, WINNEFRED M PATTISON, Executrix of my
Will. In the event of the death, resignation, renunciation or inability of my wife to act as
Executrix, I appoint my sons, STEPHEN M PATTISON and MICHAEL L PATTISON,
Executors of this, my Will. Neither my Executrix, nor any successor shall be required to
give bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 31~` day of October,
2003.
'' _~'~~SEA~~
JOH ~ SON, Te'~t
In our presence, the above-named Testator signed this and declared it to be his will, and
nowt at his request and in his presence and in the presence of each other, we sign as
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STATE OF PENNSYLVANIA
COUNTY OF FRANKLIN
SS
I, JOHN W PATTISON, having been duly qualified according to law, acknowledge that I
signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the
purposes therein expressed.
JOF~N W PATTISON~'es~~~"~CJJ/
We, JOHN W PATTISON, the Testator in and the undersigned witnesses to the Will, the
attached or foregoing instrument, who have signed the instrument, having been qualified according
to law do depose and say:
(a) that I, the Testator, do hereby acknowledge that I signed the instrument as my Will, that
I signed it willingly and as my free and voluntary act for the purposes therein expressed;
and
(b) that we, the witnesses, were present and saw the Testator sign and execute the
instrument as his Will, that he signed it willingly and executed it as his free and voluntary
act for the purposes therein expressed; that each of us in the hearing and sight of the
Testator signed the Will as witnesses and that to the best of our knowledge, the Testator was
at that time eighteen or more years of age, of sound mind and under no constraint or undue
influence.
Subscribed, sworn to or affirmed,
and acknowledged before me by the
above-named Testator and by the
witnesses whose names appear on
this 31"day of October, 2003.
~~_
Nota Public
NOTARIAL SEAL
FOREST N..MYERS, NOTARY PUBLIC
SFiIFPEN58URG BOROUGH, COUNTY OF FRANKLIN
MY CDMMISSION EKPIRES DECEMBER 17, 2005
Rev-1503 EXi 111-09)
SCHEDULE A
REAL ESTATE
COMMONWEALTHOF PENNSYLVANIA
INHERITANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PATTISON, John W 27-17
All real property ownetl solely or as a tenant In common must be reported et fair market value. Fair market value is tlefinetl as 0e price et which property woultl bB
exchanged between a willing buyer end a willing seller, neither being compel led to buy or sal I, both having reasonable knowletlge of the relevant facts.
Real property which is jointlyowned with fight of survivorship must be dlsclosetl on schedule F.
Attach a copy of the settlement sheet i1 the property has been sold
Include a copy o(the deed showing decetlent's interest If owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate -Real Estate and improvements located at Stoughstown Road, Cumberland 122,100.00
County, Pennsylvania, based on tax assessment records
2 I Residence -Real Estate and improvements located at 91 Firehouse Lane, Walnut Bottom, 157,000.00
South Newton Township, Cumberland County, Pennsylvania, based on tax assessment
records
TOTAL (Also enter on Line 1, Recapitulation) I 279,100.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08)
REV-1151 E%+110-06)
SCHEDULE H
COMM NEWRITANTkiEOFpEryry_$YLVANIA FUNERAL EXPENSES &
~ESIDEN oTT€PGLX`ERROF~E~~`~Y``NN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
PATTISON, John W 21-11-00349
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER _ __
A, FUNERAL EXPENSES:
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
Year(sl Commission paid
State Zio
2. ~ Anornev's Fees Law Office Forest N Myers ~ 1,218.75
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio _
Relationship of Claimant to Decedent
4. I Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 535.50
See continuation schedules) attached
TOTAL (Also enter on line 9, Recapitulation) 1,754.25
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
PATTISON, John W 21-11-00349
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Cumberland County Recorder of Deeds -Recording fees for 2 Deeds 124.00
2 Cumberland County Register of Wills -Probate fees 411.50
H-67 535.50
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule H (Rev. 6-98)
REV-1513 EX~ (11-08)
SCHEDULE J
COMrr10NW 1EALN1{OFnPENE N$VRNARIA BENEFICIARIES
ESTATE OF FILE NUMBER
PATTISON, John W 21-11
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
. distributions, and transfers
under Sec. 9116 a 1.2
Winnefred M PATTISON Spouse Rest, residue 279,173.48
91 Firehouse Rd and remainder of
Walnut Bottom, PA 17266 net distributable
estate
Total 279,113.48
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 rover 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. Forth PA-1500 Schedule J (Rev. 11-08)
T.4W OFFLQE
May 21, 2012
JE~OREBT TT. M.YERiS
137 Pork Places Wast, Shlppansburg, Pannsylvo nla 77257
717.632.9046
Fox 717.632.8879
fn myersc~lowoff icefores7myers.com
Register of Wills
Cumberland County
One Court House Square
Carlisle PA 17013
Re: PATTISON, John W. (deceased)
Inheritance Tax Return
Dear Sir or Madam:
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Enclosed please find for filing the Inheritance Tax Return on the above-captioned
decedent along with my check for $15.00 for filing fee.
Please return the time-stamped file copy for my records along with the receipt in
the envelope I have provided.
Thank you for your assistance.
Sincerely,
~"
Forest N. Myers
ash /enclosure
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