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Home My WebLink About06-21-12150561D140 REV-1500 EX ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number Po Box 2sosol 2 1 1 2 0 0 2 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW 0 1 0 3 2 0 1 2 0 4 2 7 1 9 2 9 Decedent's Last Name Suffix Decedent's First Name MI W E L L S F R A N K L I N C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N / A 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 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ prior to 12-13-82) 5. Federal Estate Tax Return Required ^X 6 D d t Di d T death after 12-12-82) 0 . en ece e estate ~ 7. 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 Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number E L I Z A B E T H H F E A T H E R 7 1 7 ~3 2 7 ~-#~ 6 1 ~; ~- n ~ ~ REGISTERCDF I,LS USELY ~ ~~ First line of address Wit' "- - --- ~Y c• i t~s ~~~.. - ors C A L D W E L L & K E A R N S P C -, :: ~ ~=~ ~~ ,. Second line of address v ~...` ~ t~J ._ t`t-tj 3 6 3 1 N O R T H F R O N T S T R E E T ,~._.f •• '~'-' '~' ` ~.~~ --r, ~ . City or Post Office State ZIP Code DATE FILED H A R R I S B U R G P A 1 7 1 1 0 Correspondent's a-mail address: efeather (a~ckle gal.net 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. SIGN RE OF PERS~ESPt~LE~ AFOR FILING RETURN AT Q 1 ADDRESS ~ (I' '.'V ~~ CJ /a-0~ u1-- 72 SPRINGERS LANE NEW CUMBERLAND PA 17070 SI <ipW?UR R~~OTHER THAN REPRESENTATIVE DATE 7„/'+3' ~~ t~ti G l1 k l l i_ -- ~-o- 3631 NORTH FRONT STREET HARRISBURG PA 17110 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J ~ 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: FRANKLIN C• WELLS RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. • 2. Stocks and Bonds (Schedule B) ................................... ... 2. 3 5 • 0 0 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. 1 2 1 3 8 6 . 0 1 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Ng~-Probate Property (Schedule G) U Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................ ... 8. 1 2 1 4 2 1 . 0 1 9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. 9. 1 3 2 1 9 . 4 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... .. 10. 9 2 ? . 7 0 11. Total Deductions (total Lines 9 and 10) ............................. .. 11. 1 4 1 4 ~ . ], 0 12. Net Value of Estate (Line 8 minus Line 11) .......................... .. 12. 1 0 7 2 ~ 3 . 9 1 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. 1 0 7 2 7 3 . 9 1 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.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 0 7 2 7 3. 9 1 1s. 4 8 2 7. 3 3 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g, 0. 0 0 19. TAX DUE .................................................... ..19. 4 8 2 7. 3 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505610240 1505610240 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 12 0028 FRANKLIN C. WELLS STREET ADDRESS 46 ERFORD ROAD CITY CAMP HILL STATE PA ZIP 17011 Tax Payments and Credits: 1~ Tax Due (Page 2, Line 19) (1) 2. Credits/Payments 4,827.33 A. Prior Payments 4,446.00 B. Discount 200.07 Total Credits (A + B) (2) 3. Interest 4,646.07 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 181.26 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; ............................... ^ 0 c. retain a reversionary interest; or ................................................................................................ ^ X^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ O 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 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 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 i; 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(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)]. 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-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANKLIN C. WELLS 21 12 0028 All property jointlyowned with right of survivorship must be disclosed on Schedule F, ITEM NUMBER Savings Bond DESCRIPTION VALUE AT DATE OF DEATH 35.00 TOTAL (Also enter on line 2 Recapitulation) I $ 35 00 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE INHERITANCE TAX RETURN CASH, BANK DEPOSITS, & M~SC-. RESIDENT DECEDENT PERSONAL PROPERTY ~V ~~~ ~ ter. FILE NUMBER: FRANKLIN C. WELLS 21 12 0028 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be dis l d ITEM c ose on Schedule F. NUMBER DESCRIPTION VALUE AT DATE 7• Members 1st Savin A OF DEATH gs ccount 80,716.81 2. Members 1st Checking Account 9, 334.46 3. Metro Bank Account 176.91 4. 3 very old motor vehicles that do not run 1,300.00 5. Truck motor vehicle 12,500.00 6. Trailer 200.00 7. 2011 Federal Income Tax Refund 236.00 8. Auto Insurance Refund 272.00 9. Fishing Items and Tools 16,051.50 10. Holy Spirit Hospital Refund 125.00 11. Magazine Subscription Refunds 473.33 TOTAL (Also enter on Line 5 Recapitulation) I $ 121 386 01 If more space is needed, Insert additional sheets of paper of the same size REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS w i r+~ c yr FILE NUMBER FRANKLIN C. WELLS 21 12 0028 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: 1. Parthmore Funeral Home 2. J. C. Snyder Florists 3. Meal after funeral B. 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 decedents address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• ~ Probate Fees: 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Members 1st Estate Bank Account Checks 8. Members 1st costs of duplicate bank account statement 9. Donna Laird -Preparation of 2011 Income Tax Returns 10. Central PA AAA -Notary fees 11. Bendinsky and Company -Garage cleanout TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. AMOUNT 9,715.02 222.55 707.53 500.00 408.50 15.95 2.00 48.75 10.00 1,589.10 13,219.40 REV-1512 EX+ (12-OS) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE( DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS t51AiE OF FILE NUMBER FRANKLIN C. WELLS 21 12 0028 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION vAOF DEATDHTE 1. Internists of Central Pennsylvania 25.00 2. (Golden Living Center I 354.09 3. (East Pennsboro Ambulance Service I 151.00 4. Verizon 41.36 5. Holy Spirit Hospital 356.25 TOTAL (Also enter on Line 10, Recapitulation) I $ 927 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (Ot-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: FRANKLIN C. WELLS 21 12 0028 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. Karen W. Porr Lineal 72 Springers Lane 50% New Cumberland, PA 17070 2. Tina E. Landis Lineal 426 Overland Way 50% New Cumberland, PA 17070 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ If more space Is needed, use addltlonal sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 4 446 00 Discount: 200.07 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1981 1982 1983 1984 1985 1986 1987 1988 throu h 1991 1992 1993 throu h 1994 1995 throw h 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 throw h 2012 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: Last Will and Testament :~ OF -~ `_ :~ ; _ ~..,_ FRANKLIN C. WELLS -" =' ;; _~_~ _. ; ; I, FRANKLIN C. WELLS, of Fairview Township, York County, Pennsyl.wa~aia, do make, publish and declare this to be my Last Will and Testament, hereby revoking all~Wills and Codicils by me at anytime made. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by .any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. ITEM III: death all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles; wearing aYparel and all other articles of household Ur perSOlld.i U5c UL adul'i'1I1"leiii and all policies of insurance thereon, to be divided among them as they shall agree. Should there be no agreement, the Executor shall divide this property among them in as nearly equal portions as the Executor, in the sole discretion of the Executor, deems appropriate, having due regard to the personal preferences of my children. ITEM IV: I give, devise and bequeath all the rest, residue and remainder of my estate, not disposed of in the preceding portions of this Will, to my daughters, KAREN W. PORK and TINA E. LANDIS, in equal shares, per capita. Page 1 d' , i I give to my children living at the time of my ITEM V: The Executor shall possess the following powers, exercisable without court approval and in a fiduciary capacity only: (a) To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have rained that bank as the Executor. (b) To vary in~,7estments and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without beins restricted to so-called. "legal :Ii'restiilents," aild WltllOUt belig liir~ited by any statute or rule of law regarding investments by fiduciaries. (c) In order to divide the principal of my estate or make distributions, the Executor is authorized to distribute personal property and real property partly or wholly in kind, and to allocate specific assets among beneficiaries so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor is authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either. at public or private sale any or all real or personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee Sinlpla. title. l~,Ti) pLlr~.lZacer ~h~ll l,a ~1Jligated tG see t0 tl;P appl.?r'at]Cn of the purchase money or to make inquiry into the validity of any sale. The Executor is authorized to make, execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to carry out the powers conferred upon the Executor. (e) To mortgage real estate, and to make ]eases of real estate. Page 2 °-~~ r Gc (f) To borrow money from any person, including the Executor, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate. (h) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, ire such rnanner and in such amo!tnts as my Executor deems prudent and appropriate. (i) To vote shares of stock which form a part of my estate, and to exercise all the powers incident to the ownership of stock. (j) To unite with other owners of property similar to property in my estate to carry out any plans for the reorganization of any company whose securities form a part of my estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under athird-party beneficiary contract. (l) To prepare, execute and file tax~returns of any type required by applicable law, and to make all tax elections authorized by law. Page 3 ~' ~ (m) To allocate administrative expenses to income or to principal, as the Executor deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (n) To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor deems appropriate, and to compensate these persons from assets of my estate, without affecting the compensation to which the Executor is entitled. (o) To do all other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. ITEM VI: I appoint KAREN W. PORK to be the Executrix, referred to in this Will as "Executor." In the event of her death, inability or refusal to serve, I appoint TINA E. LANDIS to be the Executrix. The Executor is specifically relieved from the obligation of filing bond or entering security. IN WITNESS ~?VHEREOF, I have set my hand and seal to this,' my Last Will and Testament, consisting of this and the preceding three (3) pages, at the end of ea,page of which I have also set my initials for greater security and better identification this ~ ~:; day of ~'' ~' ~: p~~ , 2008. :~:°L~~• ;[.,~ ("~ ~1+-~'Y~ti/ (SEAT..) NKLIN C. WELLS Page 4 We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and We certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. /..~ jycitt,L,~' ~ ,`,... /,~ (SEAL) Residing at ~~~~ ~~ ~ ~ ... ,• ~~. `` f ^^ ~~ f' ~NV ~,~ ~' t.. -~-~ ~-~ ~~~ (SEAL) '-J .7 ~ti r 1 ~, ~~ Residing at z; ~'' ~~ ~ ~ ! ? ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS.. I, FRANKLIN C. WELLS, 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. ~f ~ti'r'.~ .~lJ y /~,~.c~~-(SEAL) FR-A.NKLIN C. WELLS Sworn to and subscribed before me this /6~~i day of~1q~Ufi2Y ,2008. ~~~~,~~ N tary Public My Commission Expires: (SEAL) - .. w, , J._ .., ~ 4 ` ... .~.... ~......~.~ ,z.. Page 5 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~ ~ u ~H r/`1 SS.: We, Q. ~ A ~ t ~L A l,.TLA rJ ~ and S H ~ f~Z L..~~ M ~ 2/~ the Witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, FRANKLIN C. WELLS, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly acid that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing aild sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ,~ ~~ Witness ;~ ~ ~~~- Witness Swom to and subscribed before me this /6~1, day of ~ rf tJ ~9 2 Y , 2008. ~~ ~ i~~~._~-~ tary Public IVIy Commission Expires: (SEAL) 07506-001 /127003 ~~. Page 6