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HomeMy WebLinkAbout06-01-12 1505611185 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box zsosol INHERITANCE TAX RETURN 21 11 1089 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date Of Blrth MMDDYYYY 05032010 03171953 Decedent's Last Name Suffix Decedent's First Name M I WASHINGTON WILLIAM L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Return ~~ 2. Supplemental Return ^ 3. Remainder Return (Date of Death ^ 4 Limited Estate ~~ Prior to 12-13-82) 4 F t I ^ . a. u ure nterest Compromise (date of 5. Federal Estate Tax Return Required 6 Decedent Di d T t t C~ death after 12-12-82) 7 . e es a e . Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ^ 9. Litigation Proceeds Received ^~ 10. Spousal Poverty Credit (Date of Death ^ 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 TO: Name Daytime Telephone Number BRIDGET f1 • WHITLEY, ESQ - 717-233-1,000 First Line of Address SKARLATOSZONARICH LLC Second Line of Address 17 S 2ND ST FL 6 City or Post Office State ZIP Code -~ARRISBIIR; P!~ ]:71Dy Correspondenf'se-mail address: BMWa9SKARLATOSZONARICH • COM REGISTER OF WILLS USE ONLY n.~ c:~~ Q r..~ ~~p ~ ~ c_ rl - ~ ~ ~+ r-r e .G C!~ :~ - d ~~ ;_,; ~.. ~ -- g ~ Cl'Y cxl ~~ ~r7 ; ~-t (-1'l i r,r1 + { Y} r-~~ '~ 7 ~_;; ? ~~ t`ri cn 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, correci and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG TORE OF PERSON F~ESPONSIBLE FOR FILING RETURN DATE ~i~n~~ ~-S.ed-~, i h ~ • y -~ ola.. ADDRESS 1397 CREEK ROAD, APT• A BOILING SPRINGS, PA 170D7 o-l~lvfuurtt UI- N TR~HAN REPRESENTATIVE DATE /1v1JRCJJ V v ' 17 S 2N ST FL 6 HARRISBURG, PA 171D1 PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 OM46473000 15(J5611185 ,,~; 1505611285 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name:lllASHINGTON WT TAM L RECAPITULATION 1. Real Estate (Schedule A) 1 O . 0 0 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. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1 through 7) 8 9. Funeral Expenses and Administrative Costs (Schedule H). g_ 10. Debts of DecedESnt, Mortgage Liabilities, and Liens (Schedule I) 10 11. Total Deductions (total Lines 9 and 10) , 11 12. Net Value of Estate (Line 8 minus Line 11) 12 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 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 16. Amount of Line 14 t xable ~ at lineal rate X 0 4 . D • D D 16. 17. Amount of Line 14 taxable at sibling rate X .12 O• W O 1 ~ 18. Amount of Line 74 taxable at collateral rate X .15 Q • ~ ~ 18. 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505611285 Side 2 15D5611285 0.00 0.00 0.00 1, 424 •00 D.oo 0.00 1,424.00 1D,963.00 o•oo 10,963.00 (9,539.00) o.oa (9,539.00) 0•DO 0.00 0.00 o•ao 0.00 OM4648 3.000 REV-150D EX (FI) Page 3 Decedent's Complete Address: File Number a~. i. i. i.nAq DECEDENT'S NAME WASHINGTON WILLIAM L STREET ADDRESS f1 ROAD CUMBERLAND COUNTY CITY CARLISLE STATE PA ZIP 17015- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) D , D D 2. CreditslPayments A. Prior Payments D . D D e. Discount D • 0 0 Total Credits (A + B) (2) D . D D 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) D , D D 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ D•00 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 ~~ ^X 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? . ~~ O 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 'I, 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)]. • 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. OM4671 2.000 REV-1508 EX+ (17-10) Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, ~ MISC. R soEr~oEC DENTTURN PERSONAL PROPERTY ESTATE OF FILE NUMBER: William L. Washington 21 11 1089 Include the proceeds of litigation and the date the proceeds were received by the estate. OwaBAO 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (~ 0.09) Pennsylvania DEPARTMENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER William L. Washincrton 21 11 1089 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Hoffman-roth Funeral Home 10,536 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State ZIP 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address 4. 5. 6. 7. 1 City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: William J. Mansfield, Inc. Estate Advertising Total from continuation schedules . 85 267 75 TOTAL (Also enter on Line 9 Recapitulation) ~ $ 10 963 9W06AG 2.000 If more space is needed, use additional sheets of paper of the same size. Estate of: William L. Washington Schedule H Part 7 (Page 2) 2 Information Network Associates, Inc. Fee to locate PR named in Will 21 11 1089 75 Total (Carry forward to main schedule) 75 ~tt~Y ~i11 ~cn~ OF C?~ ~` iJ! _rJ- 'C;; f~~~- C-. :z rn --- C~7~. ~~~~tm~ert~~~ ~ ~ X ,~~; ~, __. .~ -~ `-=' [, WTi.I.IAM L, WASHINGTON I, WILLIAM L. WASHINGTON, of 532 Second Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my Executor hereinafter named to pay all of my just debts, funeral expenses and expenses involved or connected with the administration of my estate, including all taxes that may be assessed in consequence of my death, as soon after my death as is reasonably possible from the proceeds and assets of my estate prior to any other distributions. However, my Executor need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. If I do not own a burial plot or a grave marker at the time of my death, I authorize my Executor/Executrix, in his, her or its sole discretion, to purchase a burial plot and to erect a suitable grave marker at my grave, and to expend sums from my estate for this purpose. GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 200 NORTH HANOVER STREET Page 1 of 8 CARLISLE, PA 17013 14 NORTH MAIN STREET SUITE 307 CHAMBERSBURG, PA '17201 Z~ ;- l./ -:-~ ,_-_-;. -i ~ _ ~ ~~ `J I r SECOND I give, devise and bequeath my entire estate of whatsoever nature and wheresoever situate, together with all insurance proceeds thereon, in equal shares to my children, BRANDON ASHLEY HETRICK and BRIDGER PURNELL WASHINGTON, who survive me by sixty (60) days, per stirpes. I direct my Executor/Executrix to divide among such beneficiaries all personal property of a sentimental or family nature (excluding cash, stocks, bonds and the like), including but not limited to jewelry, household goods, antiques, furniture and memorabilia, in accordance with a separate memorandum which I may place with my Will or deposit with my attorney. In the absence of such disposition by memorandum, I direct that the said tangible personal property be divided between my residual beneficiaries with due regard for their personal preferences in as nearly equal ~, , shares as practical, with the value of such dispositions being credited to the share of each r z l.- respective recipient. If the said beneficiaries do not agree to the division of the personal _ property provided for hereunder, the decision of my Executor/Executrix, including the decision to sell the property at public or private sale and distribute the proceeds therefrom as provided hereinafter, shall be final and conclusive on all parties. THIRD I have specifically chosen to make no provision in this, my Last Will and Testament, for my daughter, HEIDI T. WASHINGTON, of York, Pennsylvania, not out of want of affection, but because I have provided for her during my lifetime as I desired. FOURTH In the event it is necessary to appoint a Guazdian for my son, BRIDGER, then I nominate, constitute and appoint my son, BRANDON ASHLEY HETRICK, as the GRIFFIE & ASSOCIATES Attorneys At Law 200 N. Hanover Street Page 2 of 8 38 N. Main Street Carlisle, PA 17013 Chambersburg, .PA 17201 guazdian of the person of BRIDGER. If BRANDON ASHLEY HETRICK is unable or unwilling to serve as Guardian, I nominate, constitute and appoint my dear and eiose friend, KATHY FAILOR, to serve instead. It is my specific desire and instruction that BRANDON actively engage in any type of negotiations or litigation necessary in order to prohibit BRIDGER from being placed in the custody of his mother, CRYSTAL L. ROWAN YOCUM, due to the fact that she has abandoned him on more than one occasion and has illustrated a complete inability or lack of desire to provide any type of parenting for BRIDGER, which is further evidenced in the pleadings set forth in the Court of Common Pleas of Cumberland County to Docket No. 93-3873 Civil Term. It is my express desire, based upon my true and sincere feelings, that BRIDGER should not be in his mother's caze for any extended periods of time and, further, it is BRIDGER's expressed desire not to be in the care of his mother for any extended period of time. I nominate, constitute and appoint my dear and close friend, KATHY FAILOR, as azdian of an roe which asses to said child due tom death. Said ~ Y P P rtY P y guazdian shall have the power and authority in their discretion to apply income or principal to the \~ ~.~ support and education of said children, and to make payments for these purposes. ~`~' ~. Further, my Guazdian shall disburse all proceeds held for my said child or children upon that child's reaching the age of 18 years. I direct that no Guardian shall be required to give or post bond for the faithful performance of the Guardian's duties in this or any other jurisdiction. FIFTH I grant my Executor/Executrix the following powers in addition to and not in limitation of such powers as my Executor/Executrix shall hold bylaw: GRIFFIE & ASSOCIATES Attorneys At Law ?00 N. Hanover Street Page 3 of 8 38 N. Main Street Carlisle, PA 17013 Chambersburg, PA 17201 (a) To retain all property received including the stock of any corporate fiduciary acting hereunder, provided such property remains productive. (b) To join in any corporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors, including but not limited to, the voting of shares. (c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my estate. (d) To operate any business that I may own at my death. (e) To invest any funds of my estate in any stocks, bonds, notes or other securities or property, real or personal, without regard to the principle of diversification or any other statute or general rule of law in his, her or its absolute discretion, it being my intention to give my Executor/Executrix the broadest investment powers possible, providing such investments do not unnecessarily prevent the prompt settlement of my estate. (f) To sell or otherwise dispose of any property, real or personal, tangible or intangible, at any time forming a part of my estate in any manner and on such terms and conditions as my Executor/Executrix shall see fit in his, her or its absolute discretion. (g) To borrow money for the payment of taxes or for any other proper purposes in the administration of my estate, and to mortgage or pledge estate assets as security. Z00 N. Hanover Street Carlisle, PA 17013 GRIFFIE & ASSOCIATES Attorneys At Law Page 4 of 8 38 N. Main Street Chambersburg, PA 17201 C (h) To compromise claims without court approval including, but not limited to, any controversies with the United States of America or the Commonwealth of Pennsylvania concerning estate and inheritance taxes on any interests that may pass under this my Last Will and Testament. (i) To distribute in cash or in kind upon any division or distribution of my estate. (j) To undertake any and all acts deemed necessary and proper by my Executor/Executrix for the proper, advantageous and prompt management of the settlement of my estate. (k) In general, to exercise all powers in the management of my estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as to him, her or it may seem best and to execute and deliver all instruments and to do all acts which he, she or it deems necessary or proper to carry out the purposes of this, my Last Will and Testament. SIXTH No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have the power in any manner to charge or encumber his interest either in income or principal, nor shall the interest of any beneficiary be liable or subject in any manner while in the possession of my Executor/Executrix for the liability of such beneficiary. 200 N. Hanover Street Carlisle, PA 17013 GRIFFIE & ASSOCIATES Attorneys At Law Page 5 of 8 38 N. Main Street Chambersburg, PA 17201 ~ SEVENTH I nominate, constitute and appoint my son, BRANDON ASHLEY HETRICK, and my dear and close fi-iend, KATHY FAILOR, or their survivor, as Co-Executors of this my Last Will and Testament. I direct that my ExecutorBxecutrix shall not be required to give or post bond for the faithfiil performance of his, her or its duties in this or any other jurisdiction. EIGHTH I hereby declare it to be my expressed desire that my Executor/Executrix employ the law firm of Cmffie & Associates, of Carlisle, Pennsylvania, for legal advice and assistance regarding this my last Will and Testament, they having considerable knowledge of my affairs, views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WI~REOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of ~ ()typewritten pages, the first `~ () of which bear _. •~~ my signature on the side margin, for purpose of identification, this ____~~ day of r ?t ~~I !~,_ ~,,~, ~ ~. .2002. t v~c~vESs (~;~/ ' ` S .'7.~-j n~~~ {~.. c.~ % i L. ; i ~.. 'r J 200 N. Hanover Street Carlisle, PA 17013 ~, ~ l~if'~-~f~i~ ter! ~ Y`- /t~il~"~_ (~' F_.J' WILLIAM L. WASHINGTON /_ GRIFFIE & ASSOCIATES Attorneys At Law Page 6 of 8 38 N. Main Street Chambersburg, PA 17201 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SS. I, WILLIAM L. WASHINGTON, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. k~ f }~~~ , ~. WILLIAM L. WAS TON Sworn or armed and acknowledged before me by WILLIAM L. WASHINGTON the Testator this ; ``} ~~ day of ~ /~~ ~L ~~ 2002. ~~~f~~r :~ ~i ~ ' 6~~~~~ Notarial SEaI ______~_ tCarisa J. Lehman, Notary ~ubiic CarUsle 13oro, Cumberland County My Commisslon Expires Aug. 25, 2003 GRIFFIE & ASSOCIATES Attorneys At Law !DO N. Hanover Street Page 7 of 8 38 N. Main Street Carlisle, PA 17013 Chambersburg, .PA 17201 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA: SS. COUNTY OF CUMBERLAND - . ~~ ,.~` t ~ 7 1 WE, '~.)f C'l~rf ~ ~~ ~ ' ~ Y 1 r and ~~1~'f U ~.;,•1;'t, ~ ~~ I~~{~r, ~J. J the witnesses whose names aze attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testator was at the time 18 or more yeazs of age, of sound mind and under no constraint or undue influence. Sworn or athrmed and subscribed before me by~',~~%: ~'~~ L- ~~~~~ f -~~t' and '~~ '~ ..: ~'-~ i-`~`~' S thi t ~ ~ ~ ! f s C `~ day of of ~(~ l!j , 2002. J ~ ll t s .G~-` ~ -~_ ~tary Publi¢~ Notarial Seal tCarisa J. Lehman, Notary Public Carf~sle Boro, Cumberland County My Comrrilsslon Expires Aug. 25, 2003 200 N. Hanover Street Carlisle, PA 17013 GRIFFIE & ASSOCIATES Attorneys At Law Page 8 of 8 38 N. Main Street Chambersburg, PA 17201