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Home My WebLink About06-21-12pr~-w.V 1505610105 REV-1500 ~ (oav) (Fq eDDSylVania OFFICIAL USE ONLY PA Department of Revenue PF .. County Cade Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX Zl3o6ot 2~ «. 0232 HarrtsburD PA 1.71z8-o6ot RESIDENT DECEDENT --- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ' 02/15/2012 06/05/1932 Decedent's Last Name Suffix Decedent's First Name MI Walton I Richard A (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 m 1. Original Return O 2. Supplemental Retum O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (tlate of O 5. Federal Estate Tax Return Required death after 12-12-62) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O t0. 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 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOl~1,8E DIRECTEDrT01 Name - Daytime Telepho bar c+-' ti ~ x Lisa Marie Coyne, Esq. o , ~- (717) 737-04~P,- --p ~ 2 A w REGISTER ~~Ti3 USE Vra.V ~ First Line of Address _ Coyne & Coyne, P.C. Second Line of Address 3901 Market Street City Or Pos[ Offce Camp Hill State ZIP Code PA 17011 v~..- ~ ~ ~' a'-'t tV c~ L'1 DATE FILED `7 7 j f:U 'f,y ] r .'~ t r__) t`;~ "~.) c O -T Correspondent's e-mail address: 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 lma, wrrett and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge. Kathleen M. Havran 4115 Mountainview Road, Mechanicsburg, PA 17050 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 REV-1500 EX (FI) Decedent's Social Secudty Number Decadeat's Name Richard A. WaltOtl RECAPITULATION 1. Real Estate (Schedule A) .......................................... ... 1. 0.00 '' 2. Stocks and Bonds (Schedule B) .................................... ... 2.' 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 2$,061.07 6. Jointly Owned Property (Schedule F) m Separate Billing Requested .... ... 6. 30,154.58 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property "- (Schedule G) O Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. '. 2$,061.07 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9.:' 12,400.57 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. ...._. $,746.09 '.. _. 11. Total Deductions (total Lines 9 and 10) ......... ......... ........ ... 11.. 19,14$.66 '.. 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. : $,914.41 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~"' '""" -"` an election to tax has not been made (Schedule J) ..................... ... 13. 0.00 14. Net Value SubJect to Tax (Line 12 minus Line 13) ..................... ... 14. $,914.41 '.. 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. i6. Amount of Line l4 tazable """" -° at lineal rate X .0 45 8,914.41 is. 401.15 17. Amount of Line 14 taxable "`° "` at sibling rate X .12 17, 18. Amount of Line 14 taxable - .. _.... _ " .. ,... at collateral rate X .15 1 g, 19. TAX DUE ....................................................... .. 19. 401.15 ''. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 150561205 1505610205 155610205 J REV-1500 EX (FI) Page 3 Decedent's Complete Address: Fite Number a ~~ ~ Z- - (] ~. 32 DECEDENT'S NAME Richard A. Walton STREET ADDRESS 216 S. Enola Drive CITY - _- --- _ _ _ _. STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) Itl 2. CreditslPayments A. Prior Payments 500.00 B. Discount 20.06 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. 401.15 Total Credits (A+ B) (2) 520.06 (3) (4) (5) 0.00 118.91 0.00 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 dght 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 "intrust 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 benefciary 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 dales of death on or after Jan. t, 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 benefciary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of Vansfers 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)]. 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-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Richard A. Walton 21-12-0232 Include the proceeds of litigation and the dale the proceeds were received by the estate. (If more space is needed, insert additional sheets of the same size) '~-___. ~,, , METRO B/r"'~I V K Harri burg, PA 17111 J March 9, 2012 Coyne & Coyne 3901 Market St Camp Hill PA 17011 RE: Estate of: Richard A. Walton Tax Identification Number: 193-24-0765 Date of Death: February 15, 2012 888.937.0004 mymetrobank.com To Whom It May Concern: Thisietteris~in reference to decedent account information you requested for the igdividual listed above. Weare~able to provide the following: Account Type: Checking Account Number: 513305110 Date Opened: 4/12/01 Date Closed: 2/28/12 Primary Owner: Richard A. Walton Date of Death Balance: $16561.07 Please feel free to contact me at (717) 412-6122 if I may be of further assistance. Sincerely, :~~ Diana Reynolds ~- Metro Bank, Support Associate/Deposit Services ~ ~~\ ~ 0 s~ /> 2 (y u~ { ~. ,~ 4 ~. Y REV-1509 EX+(a-9a) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Richard A. Walton 21-12-0232 1/ an easel waa made Jolnt within one year o/the deeedent'a data of death, It moat be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Frank Irwin B. C. JOINTLYAWNED PROPERTY: 126 Dorseys Lane step-son Dillsburg, PA 17019 ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMDER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLYAELO REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST DATE OF DEATH VAWEOF OECEDENT'$INTEREST t ~ A. Members 1st Cert~cate of Deposit No. 44604-00 60,050.10 50 30,025.09 2, q, Members 1st Savings Account No. 44604-00 258.96 50 129.49 TOTAL (Also enter on line 6, Recapitulation) 5 30,154.58 (If more space is neetletl, insert additional sheets of the same size) ,~ Nl. MEMBERS lrt ' FEDERAL CRBDTT UNION 7 REGULAR SAVINGS ACCOUNT: Account Number/Suffix 44604A0 Date Account Established 04/15/1986 Principal Balance at Date of Death $258.96 Accrued Interest to Date of Death $.02 Total Principal and Accrued Interest_ $258.98 Name of Joint Owner Franklin Irvin date Joint Ownership Established 05/04/2001 CERTIFICATES OF DEPOSIT: Account Number/Suffix 4460440 Date Account Established 04/11/2011 Principal Balance at Date of Death $60,000.00 Accrued Interest to Date of Death $50.17 Total Principal and Accrued Interest $60,050.17 Name of Joint Owner Franklin Irvin. Date Joint Ownership Established 04/11/2011 'Opened by transfer of funds from 44604-00. VISA ACCOUNT: Account Number/Suffix 4672090000123752 Date Account Established 04/14/1988 Principal Balance at Date of Death $.00 Joint Cardholder None p ~C~~Od~ MAO 9 2012 D By Estate of: RICHARD A. WALTON Date of Death: 02/15/2012 Social Security Number: 193-24-0765 t ME BE S 1sT FEDERAL CR DIT ~n~~~-- anielle .Kline Lending Insurance Support Specialist February 7, 2012 v , -`~ . 5000 Louise Drive PO. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 www.memberslst.org REV-1511 EX+(12-99) SCHEDULE N FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATNE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Richard A. Walton 21-12-0232 Debts of decedent must ba reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Sullivan Funeral Home 6,810.00 z. Reception 300.00 a. Honorarium 200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Scanty Number(s)IEIN Number of Personal Representatlve(s) _ Street Address City .State Zip Year(s) Commission Paid: 2. Attorney Fees 2,000.00 3. Family Exemption: (I(decedent's address is not the same as claimant's, adach ezplanalion) Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 65.50 5. Aceountant's Fees 6. Taz Return Preparer's Fees 500.00 ~. Patriot News -legal advertisement 116.45 a. Cumbedand Law Journal --legal advertisement 75.00 s. Recorder of Deeds -- copy fee 2.00 to. Inheritance Tax filing fee 15.00 tt. Postage 88.00 12 Continuation from Schedule H, Page 2 2,228.62 TOTAL (Also enter on line 9, Recapitulation) S 12,400.57 (It more space is needed, insert additional sheets or the same size) ESTATE OF_RICHARD A. WALTON _ CONTINUATION OF SCHEDULE H Number: Item: _ Value: 12 - -- - - West Shore EMS _ __ ~ 1,728.62 - _ 13 - _ _ Reserves $ 500.00 - TOTAL: _ _ _ $ 2,228.62 -- - -- i - -- REV-1512 EX+ (12-OB) ~ Pennsylvania SCHEDULE I DevaarmeNT OE REVENDE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDEM DECEDENT ESTATE OF FILE NUMBER Richard A. Walton 21-12-0232 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (tl-OB) ~ pennsylvania SCHEDULE 1 wnERtrnNCE rax RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Richard A. Walton 21-12-0232 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Kathleen M. Havran daughter 1/2 of residual 2. Carol M. Oliviera daughter 1/2 of residual ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX [S NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART R -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space Is needed, Insert additional sheets of the same size. COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne Jaime L. High Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Dear Madam: 3901 Market Street Camp Hill, Pennsylvania 17011-4227 June 19, 2012 ,...~ N ~'~ '- C_ , Wm -O i = Lri L z? c.: °r'. -v -° -n ~~}j~~' _ n ; f c y~ W (~ m Re: Estate of Richard A. Walton, Deceased No. 21-12-0232 We represent the Estate of the Late Richard A. Walton. Enclosed are an original and two copies of the Inheritance Return for this Estate. Kindly docket the original and return to me a "clocked-in" copy with the enclosed envelope. Also enclosed is estate check No. 114 in the amount of $15.00 which represents the filing fee for this Return. Please issue a receipt for payment of this filing fee. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, COYNE & COYNE, P.C. ~ ,w`"L Lt~-~- Li Marie Coyne J LMC/amd Encl. Cc: Kathleen M. Havran 717-737-0464 Fax:717-737-5161 www.coyneandcoyne.com