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Home My WebLink About08-15-12r 1505610140 REV-1500 Ex (°'-'°' PA Department of Revenue `%`-"'ivl~i~ v~es1 rJwi'~ Bureau of Individual Taxes Po Box zaosof INHERITANCE TAX RETURN County Code Year File Number Harrisburg PA 17126-0601 RESIDENT DECEDENT 2 1 1 1 0 5 9 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 6 2 0 1 1 0 5 3 1 1 9 3 4 Decedent's Last Name Suffix Decedent's First Name MI Wal t er Car r yl L (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 INAPPROPRIATE OVALS BELOW ^X 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) ® 6. Decedent Died Testate ~ 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 SECTH)N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number KARL E. R O M I NGER , E S O 7 1 7 2 4 1 6 0 7 0 First line of address ROMI NGER & Second line of address 1 5 5 S OU T H City or Post Office CARL I S L E A S S O C I ATE S H A N O V E R S T R E E T State ZIP Code - P A 1 7 0 1 3 'r' =i_ C> a~ ,>. t =` ~-' ~<~<- C7 G; `;; ~~ c-. 1% C11A FILED uz l -r] -;S 7 1:~ i/ f'rl ~n r~~ Correspondent's a-mall address: Under penalties of perjury, I declare that 1 have examined Mis return, including accompanying schetlules and statements, and to the best of my knowledge antl belief, it is hue, correct and wmplete. Declaretion of preparer oMer than the personal representative is based on all information of which preparer has any knowledge. S~~IG~NA~y~+g}E OF PERSON RESPONSIB~ FOR FILINGRETURN DATE 40 ~R ENMONT DRIVE ENOLA PA 17025 Sl~pliiy~rpF PREPA(tER OTHER TH~rq/N REPRESENTATIVE TE _ ADDRESS ~ /~~--~7-~;r~G (L_~~- /.S 155 SOUTH HANOVER STREET ~ CARLISLE PA 17013 L 1505610140 USE ORIGINAL FORM ONLY Side 1 :L505610140 USE tom. r.~ A c. G7 J 1 1505610240 REV-1500 EX Decedent's Social Security Number Decedent'aName: Carry) L. Walt@~ RECAPITULATION 1 . Real Estate (Schedule A) ....................................... .... 1. 4 9 9 0 0, 0 0 2 . Stocks and Bonds (Schedule B) .................................. .... 2. 2 2 1 0 . 9 5 3 . Closely Held Corporation, Partnership or Sole-Propdetorship (Schedule C) . .... 3. 4. Mortlgages and Notes Receivable (Schedule D) ....................... ... 4. , 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 2 3 5 3 5 9 , 7 4 6. Jointly Owned property (Schedule F) ^ Separate Billing Requested .... ... 6. 0 . 0 0 7. Inter-Vivos Transfers 8 Miscellaneous !~{gq Probate Property (Schedule G) Lf Separate Billing Requested .... ... 7. 2 0 6 0 4 9, 0 2 8. Total Gross Assets (total Lines 1 through 7) 6. 4 9 3 5 1 9, 7 1 9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9. 5 7 1 3 8 . 7 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10. 3 7 0 6. 6 4 11. Total Deductions (total Lines 9 and 10) ............................ ... 11. 6 0 8 4 5. 4 1 12. Nat Value of Estate (Line 8 minus Line 11) ......................... ... 12. 4 3 2 6 7 4. 3 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ... 13. 1 3 5 1 2 5. 2 8 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 2 9 7 5 4 9 , 0 2 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(tz)x.o _ 0. 0 0 t5. 0. 0 0 76. Amount of Line 14 taxable at lineal rate x .045 2 4 7 5 4 9. 0 2 ts. 1 1 1 3 9. 7 1 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 t 7. 0. 0 0 18. Amount of Line 14 taxable at collateral rate x.t5 5 0 0 0 0. 0 0 tfi. 7 5 0 0. 0 0 19. TAX DUE .................................................... ..19. 1 8 6 3 9. 7 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505610240 1!i05610240 J REV-1500 EX Page 3 Decede~tt's I CITY Address: Tax Payments and Credits: t Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line i +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. File Numlxer 21 11 0593 STATE PA ZIP 17015 (t) 18 639.71 Total Credits (A. + 6) (2) 0 00 (3) (4) 0 00 151 18 639.71 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 D'd i decedent make a transfer and: Y a. retain the use or income of the property transfened; b es No . retain the right to designate who shall use the property transfened or its income; a . . •..::.... c. re am a reversions interest or d . receive the romise for life of either a menu, benefits or cares ........... . 2. If death occuned after December 12,1982, did decedent transfer properly within one year of death .. without receiving adequate consideration? ............... 3 Di " . d decedent own an intrust for" orpayable-upon-death bank account or secudty at his or her death? .... 4 QX . 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 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 far 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(x)(111, r 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(x)(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-1502 EXt (01-10) ' ~pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE Of: FILE NUMBER: Carrvl L. Walter L1 11 0593 All real property owned solely or as a tenant rn common must be reported at fair market value. Fair market value Is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real properly that Ia joindy-owned with right of survivorehip must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ~ Mobile home on lot #253 at Leiby's Mobile Home Park, Carlisle, PA 17015 49,900.00 Appraised by Terry Kimball on 8/15/11 TOTAL (Also enter on Line 1 Recapitulation) I S If more space b needed, use additional sheets of paper of the same size. REV-1503 EX+(6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carryl L. Walter FILE NUMB r1 11 i All property jointty•owned with right of survivorship must be disclosed on Schedub F. ITEM NUMBER DESCRIPTION 1. 35 Shares of Prudential Financial, Inc. Common Stock. Value as of May 27, 2011 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH REV-1504 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Carts L. Walter 21 11 0593 Schedule C-1 or C-2 (including all supporting information) must be attached for each Gosely-held corporatbNpaMership interest of the decedent, other Man a sole-proprietorship. See instructions torthe supporting information to be submitted for sale-proprietorships. ITEM NI1MRFa ..__.,_.__._.. VALUE AT DATE _ TOTAL (Also enter on line (It more space is needed, insert additlonal sheets of the same size) RHJ-1505 EX• (6-9e) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE C-1 CLOSELY•HELD CORPORATE STOCK INFORMATION REPORI Carts L. Walter FILE NUMBER 21 11 0593 1. Name of Coryoration Address City 2. Federal Employer I.D. Number 3. Type of Business 4. ProducUService Business Reporting Year YOfMn ^> ~~EB` Ti4I~IG `' , AAR YALtIE' ~~~M' ~fp * Preferred Provide all rights and restrictions pertaining to each class of stock. E 5. Was the decedent employed by the Corporation? ....................................... ^ Yes ^ No If yes, Position Annual Sala $ ry Time Devoted to Business 6. Was the Corporation indebted to the decedent? ....................................... ^ Yes ^ No If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? ............... ^ Yes ^ No If yes, Cash Surrender Value $ Net proceeds payable $ 8. Owner of the policy Did the decedent sell or transfer stock in this company within one year prior to death or within two years if the date of death was pdor to 12-31-82? ^ Yes ^ No If yes, ^ Transfer ^ Sale Number of Shares _ Transferee or Purohaser Consideration $ Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ............ ^ Yes ^ No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? ................................................. ^ Yes ^ No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? ....................... ^ Yes ^ No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? ............ ^ Yes ^ No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. Date A. Detailed calculations used in the valuation of the decedent's stock. 8. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market v;tlue/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. State Slate of Incorporation Date of Incorporation _ Zip Code Total Number of Shareholders (If more space is needed, insed additional sheets of the same size) REV-1506 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Carts L. Walter 21 11 0593 Name of Padnership Address 2. 3. 4. 5. City Federal Employer I.D. Number Type of Business Decedent was a ^ General A. B. C. D. Date Business Commenced Business Reporting Year Slate Zip Code Product/Service _ ^ Limited partner. If decedent was a limited partner, provide initial investment $ 6. Value of the decedent's interest $ 7. Was the Partnership indebted to the decedent? ................................ ^ Yes ^ No If yes, provide amount of indebtedness $ 8. Was there Iffe insurance payable to the partnership upon the death of the decedent? ........ ^ Yes ^ No If yes, Cash Surrender Value $ Net proceeds payable $ _ Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prtorto 12-31-62? ^ Yes ^ No If ves. ^ Transfer ^ Salo p Transferee or Pumhaser Attach a separate sheet for additional transfers and/or sales. ercentage transfernsd/sold Consideration $ _ Date 10. Was there a written partnership agreement in effect at the time of the decedent's death?........ ^ Yes ^ No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? .................................. ^ Yes ^ No If yes, provide a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated after the decedent's death? ................. ^ Yes ^ No If yes, provide a breakdown of disidbutions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? ................................ ^ Yes ^ No If yes, explain 14. Did the partnership have an interest in other corporations or partnerships? ................. ^ Yes ^ No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT REy-7507 EX * (6-98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE Carryl L. Walter 2'1 11 0593 All property Jointlyowned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. TOTAL (Also enter on (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) ' SCHEDULE Ep ^~ /+ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, st M~Sb. IN RESIDENT DECEDENT N PERSONAL PROPERTY ES7AiE of FILE NUMBER Carry) L. Walter 21 11 0593 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property joiMlyovmed xrith right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sovereign Bank 8,650.73 5/25/11 2. Refund from Triston Associates 11.48 711 /11 3. Sovereign Bank 13.00 10/20/11 4. Refunds, various 1,639.41 7/1/11 through 1/3/12 5. Rental and utility fees received from Tenant 4,040.08 10/28/11 through 5/9/12 6. Proceeds from sales of household goods and vehicle 19,229.58 7/1/11 through 918/11 7. Dividends and interest 50.75 8/31/11 through 1/3/12 8. Money Market account no. 008123 with Orrstown Bank 107,880.19 5/25/2011 9. Interest from bonds cashed prior to death 1,517.88 10. Proceeds from sale of coins from safety deposit box 92,326.64 TOTAL (Also enter on line 5, Recapitulation) ~ ; (I(more space is needed, insert additional sheets of the same size) REV-1509 EX+ (07-10) ~pennsylvania DEPARTMEPfT OP REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDULEF JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Carts L. Walter 21 11 0593 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A B. C. JOINTLY•OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIALINSTI7UTION AND BANKACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FORJOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTERESI ~' A' 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on Line 6, Recapitulation) S If more space is needed, use additional sheets of paper of fhe same size. REV-1510 EX+ (DB-09) ESTATE OF ' pennsylvania DEPARTMEM OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER•VIVOS TRANSFERS AND MISC. NON•PROBATE PROPERTY FILE NUMBER Carts L. Walter 21 11 0593 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page Ihree of Me REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NPME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE DF TRANSFER. ATTACHACOPV OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °k OF DECD'S INTEREST EXCLUSION pFARFUCAaIE~ TAXABLE VALUE t. Members 1st FCU savings account 9,102.31 100.00 9,102.31 Lynn Walter, beneficiary, ex-daughter-in-law date of transfer: 5/1412011 2. Members 1st FCU investment savings account 189,884.21 100.00 189,884.21 Lynn Walter, beneficiary, ex-daughter-in-law date of transfer: 5/14/2011 3. Members 1st FCU checking account 7,062.5() 100.00 7,062.50 Lynn Walter, beneficiary, ex-daughter-in-law date of transfer: 5/14/2011 TOTAL (Also enter on Line 7 Recapitulation) I E 206 049.02 If more space U needed, use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ITEM NUMBER 1 Carts L. Walter 21 11 0593 Decedent's debts must be reported on Schedule I. A. B. FUNERAL EXPENSES: SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS DESCRIPTION AMOUNT ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)ofPersonalRepresenktive(s) Lynn M. Walter 20,147.12 Street Address 40 Greenmont Drive city Enola state PA zIP 17025 Year(s) Commissbn Paid: 2012 p, AttomeyFees: Rominger&Associates 20,147.12 3. Family Exemption: (If decedenCs address is not the same as claimant's, attach explanation.) Claimant Street Address Cdy State ZIP _ Relationship of Claimant to Decedent 4. Probate Fees: 343.50 6 Accountant Fees: 6. Taz Retum Preparer Fees: 7. Cumberland Law Journal, advertise Letters $. The Sentinel, advertise Letters 75.00 9. Deluxe Checks 200.16 10. Rominger &Associates, reimburse costs 23.25 11. Various utilities 366.26 12. Leiby's Mobile Home Park, lot rent 2 811 96 13. Maintenance and upkeep at mobile home 5,359.64 14. Real estate taxes 5,443.63 15. Miscellaneous fees 1,307.13 914.00 TOTAL (Also enter on Line 9, Recapitulation) S more space is needed use additional sheets of paper of tl1e same size. REV-1512 EX+ (12-08) •pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, iNNERiTANCernxRETURN MORTGAGE LIABILITIES, S LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Carry) L. Walter 21 11 0593 Report debb Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. The Hearst Corporation, magazine subscription 7.00 2. Verizon, services rendered 102.43 3. Blair, credit card charges 60.82 4. ATBT Universal Card, credit card charges 194.39 5. Discover, credit card charges 503.16 6. West Shore EMS 1,000.34 7. PPL, electric provider 83.47 8. ADT, security system 35.29 9. CVS, prescription 15.00 10. ATBT, credit card final invoice 13.95 11. Holy Spirit Hospital, invoice incurred by decedent 42.50 12. Discover, credit card charges 80.07 13. Silver Spring Ambulance, services rendered to decedent 875.00 14. Miscellaneous debts 693.22 TOTAL (Also enter on Line 10, Recapitulation) I E If more space is needed, insert additional sheets of the same size. REV-1513 E%t (01-10( Pennsylvania DEPARTMENT OF REVENUE INHERITANCE 7AX RETURN RESIDENT DECEDENT NUMBER I. 1, 2. 3. 4. 5. 6. SCHEDULE) BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY E DISTRIBUTIONS [Include outright spousal distdbutions and transfers under Sec. 9116 (a) (1.2).] Bruce Walter, Jr. 79 Kemmerer Drive Marysville, PA 17058 Greg Walter 329 Sharon Drive New Cumberland, PA 17070 Joni Moyer 315 North Hanover Street Hershey, PA 17033 Meagan Walter 40 Greenmont Drive Enola, PA 17025 Mitchell Walter 40 Greenmont Drive Enola, PA 17025 Lynn Walter 40 Greenmont Drive Enola, PA 17025 Do Not List Lineal Lineal Lineal Lineal ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: IUNT OR SHARE OF ESTATE 500.00 500.00 500.00 20, 000.00 20,000.00 50,000.00 4S APPROPRIATE. 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. National Military Family Association 92,314.00 2500 North Van Dorn Street, Suite 102 Alexandria, VA 22302 2. The Salvation Army Carlisle Corps 19,889.39 20 East Pomfret Street Carlisle, PA 17013 3. Bethesda Mission 19 889.39 611 Reily Street , Harrisburg, PA 17102 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 135 125.28 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent Carryl L. Walter 21 11 0593 Decedent's Name Page 1 File Number Schedule J -Beneficiaries - 28 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 4. Volunteers of America 675 Silver Spring Road Mechanicsburg, PA 17050 5. Goodwill Keystone Area Lemoyne, PA 6. Humane Society of Harrisburg Area 7790 Grayson Road Harrisburg, PA 17111 7. Guatemala Mission Fund 56 Cross Country Court Gaithersburg, MD 20879 8. The Salvation Army Harrisburg, PA 200.00 250.00 100.00 300.00 2,182.50 SUBTOTAL SCHEDULEJ•2B I 3,032.50 REV-1514 EX+ (4-09) , pennsylvania DEPARTMENT OF REVENUE Bureau of Individual Taxes PO Box 260601 Hardsburg PA 17126-0601 Carrvl L. Walter 21! 11 0593 This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death Nom 5-1-89 to 430-99, and in Alpph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to fhe tax return. ^ Will ^ Intervivos Deed of Trust ^ Other tN1NEYiFf.~~T~1~A1~~{ OATBOFBIRTN NNA'I'~>AT11fitR~`" AA O~ OEA ~t0~}~l1iR$`,.:. ; t.IFE ~$TXTE 19,pAY. ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years t. Value of fund from which life estate is payable,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 2. Actuarial factor per appropriate table .................... . ........................... Interest table rate - ^ 3.5°/ ^ 6% ^ 10% ^ Variable Rate °/, 3. Value of life estate(LinetmuNiplied by Line 2) ......................................$ 1. Value of fund from which annuity is payable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, $ 2. Check appropriate block below and enter corresponding number .. . . . . . . . . . . . . ...... . . . ... . Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quartedy (4) ^Serni-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per pedod ......................................................E 4. Aggregate annual payment, Line 2 multiplied by Line 3 ... . . . . . .. . . . . . ...... . . . .... . 5. Annuity Factor (see inswctions) Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate % 6. Adjustment Factor (See instructions) , , , , , , , , , , , , , , , , , , , , ,,,,, , , , ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 7. Value of annuity - If using 3.5%, 6%, 10°/ , or if vadable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 8 ...........................$ If using variable rate and period payout is at beginning of period, calculation is (Line4x Line Sx Line B)+Line3 .................................................$ SCHEDULE K LIFE ESTATE, ANNUITY 8 TERM CERTAIN K BOX 4 ON REV•1500 COVER SHE rvu i t: I he values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. It more space is needed, use addiGOnal sheets of the same size. REV-1644 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT Walter, Car L. INHERITANCE TAX SCHEDULE L REMAINDER PREPAYMENT OR INVASION OF TRUST CORPUS Thls schedule Is appropriate only for estates of decedents dying on or before December 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust corpus (principal). II. REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of Wills on _ (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on date or Annuitant(s) of Election Tenn of Years Income or Annuity is Payable C. Assets: Complete Schedule L-1 1. Real Estate .............................. $ 2. Stocks and Bonds ......................... $ 3. Closely Held StocWPartnership ............... S _ 4. Mortgages and Notes ....................... $ 5. Cash/Misc. Personal Property ................ $ 6. Total from Schedule L-1 .................... ............. . D. Credits: Complete Schedule L-2 1. Unpaid Liabilities .......................... $ - _ 2. Unpaid Bequests .......................... $ 3. Value of Non Includable Assets ............... $ 4. Totalfrom Schedule L-2 .........:.......... ................. ...............$ E. Total Value of Trust Assets (Line C-6 minus Line D-4) ................ ............... $ F. Remainder Factor ........................... ................. ............... G. Taxable Remainder Value (Multiply Line E by Line F) .............. ............... $ (Also enter on Line 7, Recapitulation) III. INVASION OF CORPUS: A. Invasion of Corpus _ (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth or Annuitant(s) C. Corpus Consumed ...........................................................$ D. Remainder Factor ........................................................... E. Taxable Value of Corpus Consumed (Multiply Line C by Line D) ........................ $ (Also enter on Line 7, Recapitulation) Age on Date Term of Years Income Corpus or Annuity is Payable Consumed REV-1645 EX+ (11-09) 'pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT I. ESTATE OF Walter, Carryl L. II. ITEM NO. Total Value of Cash/Miscellaneous Personal Property $ III. ~ TOTAL (Also enter on Section II Line C-6 on Schedule L) $ If more space rs needed, attach additional sheets of paper of the same size. INHERITANCE TAX SCHEDULE L-1 REMAINDER PREPAYMENT ELECTION -ASSETS- DESCRIPTION A. Real Estate (Please describe.) Total Value of Real Estate Include on Section il, Line C-1 B. Stocks and Bonds (Please list.) Total Value of Stocks and Bonds (Include on Section II, Line C-2 on Schedule L ) c.. Closely Held Stock/Partnership -Please list. (Attach Schedule C-1 and/or C-2.) Total Value of (Include on SE D. Mortgages and Notes (Please list.) Held/Partnership Line C-3 on Sche Total Value of Mortgages and Notes $ (Include on Section II Line C-4 on Schedule L ) E. Cash and Mrscellaneous Personal Property (Please list.) 21 11 0593 VALUE REV4646 EX+ (17-0g) Pennsylvania DEPARTMEN70F REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT I. ~ ESTATE OF Walter, Carryl L. II. ITEM NO. INHERITANCE TAX SCHEDULE L-2 REMAINDER PREPAYMENT ELECTION -CREDITS- FILE A. Unpaid Liabilities Claimed against Original Estate and Payable from Assets Reported on Schedule L-1 (please list) Total Unpaid Liabilities (include on Section II, Line D-1 on Schedule L) $ B Unpald Bequests Payable from Assets Reported on Schedule L-1 (please Irst) Total Unpaid Bequests (include on Section II, Line D-2 on Schedule L) $ C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are Not Included for Tax Purposes or that Do Not Form a Part of the Trust. Calculation as follows: Total Non Includable Assets (include on Section II, Line D-3 i r+t_ lHlso enter on Section II, Line D-4 on Schedule L) If more space Is needed, attach addltlonal sheets of paper of the same size. $ 21 11 0593 REV-184] EX~ (02-10) pennsylvania SCHEDULE M DEPARTMENTOF REVENUE FUTURE INTEREST COMPROMISE INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4a on REV-1500) This schedule is appropriate onty for estates of decedents who died after Dec.12,1982. ~~ i T ~ u593 This schedule is to be used for all future interests where the rate of tax which will be applicable wflen the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a I;opy to the tax return. Will ^ Trust ^ Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP ~ DATE OF BIRTH II. For decedents who died on or after July 1, 1994, if a survivil nine months of the decedent's death, check the appropriate exercises such withdrawal right. ^ Unlimited right of withdrawal III. Explanation of Compromise Otfn.• AGE TO the surviving spouse of withdrawal oummary or compromise Offer: 1. Amount of future interest ................................................ . 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ...... $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check one. ^ 6°k, ^ 3°~, ^ 0°k ................ $ (Also include as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Check one. ^ 6°~, ^ 4.5°h ...................... $ (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) ...... $ 6. Value of Line 1 taxable at collateral rate (15°k) (Also include as part of total shown on Line 18 of REV-1500.) ...... $ 7. Total value of future interest (sum of Lines 2 thru 6 must a ual Line 1 Q ) .....................$ use exercised or intends to exercise a and attach a copy of the document in t ^ Limited If more space is needed, use addl6onal sheets of paper of the same size. REV4e4Q EX102-09) Pennsylvania DEPMTMENI OF gEVENUE Bureau of Intlivitlual Taxes This SCHEDULE N SPOUSAL POVERTY CREDIT FOR DATES OF DEATH 01/01/92 TO 12/31/94 roust oe completed and filed if you checked ~. credit box on the 1. Taxable assets total from Line 8 (cover sheet) ...................................................................................... 2. Insurance proceeds on life of decedent ................................................................................................ 3. Retirement benefits ............................................................................................................................... 4. Joint assets with spouse ....................................................................................................................... 5. PA Lottery winnings ................................................................................................. 6a. Other nontaxable assets: List and attach schedule if necessary .. 6. SUBTOTAL (Lines 6a, b, c, d) ............................ 7. Total gross assets (Add Lines 1 thru 6) ............... 8. Total actual liabilities ........................ . ................................................................................................... 9. Net value of estate (Subtract Line 8 from Line 7) .............. . If Line 9 is greater than 5200.000 - smP TIU aeb._ ,_ __' _„_,. .................................................................... Income: a. Spouse ............................. b. Decedent ......................... c. Joint ................................. d. Tax-exempt Income......... e. Other income not listed above ..................... 9. 493,519.71 4. Average joint exemption income celculatlon Elf. 4a. Add joint exemption income from above: (1~ + (2f) + (3~ 4b. Average joint exemption income ................. ...................................... . () !Neater then .... ............................... Iil/rle 4 6 is ' """"" 540,000-STOP. The estate is nor eligible ro cla/m the cnatl/t ifnnl ~...,x.,.,e .,, e_~.., ~~~~~~~ 1. Insert amount of taxable transfers to spouse or $100,000, whichever is less ....................... ................... Multiply by credit percentage (see insWctions) ........................................................: 3. This is the amount of the Resident S ~~~~~~~~~~~~~~ pousal Poverty Credit. Include this figure in the calculation of total credits on Line 18 of the cover sheet ................................................................ 4. For nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate .......................................................................................................................... 5. Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Incude this figure in the calculation of total credits on Line 18 of the cover sheet .......... 6. `I i (+3) REV-1649 EX + (6-98) •. . COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) Do not complete this schedule unless the estate is making the election to tax assets under Section 911; (A) o the In0 eritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form rtlust be filed for each trust. This election a lies to the If a tmst or similar arrangement meets the requirements of Section 9113(A), and: Trust marihal, residual A B By-pass Unified Oredit etc 1 a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional ortion or liar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is irnc)lud d as autaxable transterlon Scledule 0, the pereo al representative shall be considered to have made the election only as to a fraction of the tmst or similar arrangement. Tha. numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or similar arrangement Part a• Fnror ~ti„ .r.,,,_--`-- ~~~~iyuon and value of all Interests both tax ~ arru non iaxaDie, regardless of location, which pass to the decedents surviwng spouse under a Section 9113 (A) trust or similar arrannemanr Total (If more space is needed, insert additional sheets of the same size) . ,. . LAST 4V'ILL & TESTAMENT OF CARRYL L. WALTER I, Carryl L. Walter, of 253 Key West Boulevard, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Wiil and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. i The expenses of my last illness and funeral shall be paid from. the property of my estate. I direct my Executrix to provide for a funeral service in conformity with my station of life. 2 I give, devise and bequeath to my son, Bruce Walter, Jr., $500.00. 3 I give, devise and bequeath to my son, Greg Walter, $500.00. 4 I give, devise and bequeath to my daughter, Joni Moyer, $500.00. 5 I give, devise and bequeath to my granddaughter, Megan Walter, $20,000.00. 6 I give, devise and bequeath to my grandson, Mitchell Walter, $20,000.00. 7 I give, devise and bequeath to my Ex Daughter-in-law, Lynn Walter, $50,000.00. -1- ... . LAST WILL AND TESTAi~/IENT OF CARR4'L L. WALTER 8 I give, devise and bequeath to my mother, Evelyn Setlock, a ;fife estate in 253 Key West Boulevard, Carlisle, Cumberland County, Pennsylvania and any and all of my personal effects and furnishings therein. 9 I give, devise and bequeath to the National Military Family Association of Alexandria, Virginia, all of my gold, silver, coins, and ingots. 10 I give, devise and bequeath the rest, residue and remainder of my estate, real or personal, and my property of every kind and description (including lapsed legacies and devises), wherever situate and whether acquired before or after the execution of this Will, to the Bethesda Mission and Salvation Army in equal shares. I have provided for each of my children as I see fit, keeping in mind the loyalties they chose in life, and the treatment and love which they both and gave and withheld. 11 I grant my personal representative the following powers in addition to and not in limitation of such powers as my personal representative shall hold by law: (a) To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my estate. (b) To operate any business that I may own at my death. (c) 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 personal representative sha;fl see fit in his, her, or its absolute discretion. . ~. , LAST WILL AND TESTAMENT OF CARRYL L. 4L'ALTER (d) 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. (e) 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. (~ To distribute in cash or in kind upon any division or distribution of my estate. (g) To undertake any and all acts deemed necessary anti proper by my personal representative for the proper, advantageous and prompt management of the settlement of my estate. (h) hi general, to exercise all powers in the management of my estate, which any individual could exercise in the management of similaz 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 a:fl acts which he, she or it deems necessary or proper to cazry out the purposes of this, my Last Will and Testament. 12 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 personal representative for the liability of such beneficiary. 3 ~ s > LAST w'ILL AND TESTAtiIEtiT OF CARRYL L. FALTER 13 I nominate, constitute and appoint, Lynn Walter, as Executri:K of this my Last Will and Testament. In the event my executrix is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint Orrstown Bank, as personal representative of this my Last Will and Testament. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. 14 I hereby declare it to be my express desire that my personal representative employ the law firm of Karl E. Rominger, Esquire, of Cumberland County, 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. Any mention of Karl E. Rominger, Esquire in this, my Last Will and Testament, is my free and voluntary act and through no influence by any person. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this ~~ day of Q(~~/.P.4u-~J(Y , ~_. WITNESS: Carry~l L. palter 4 ,. . LAST ~4'ILt AtiD TESTAMEVT OF CARRYL L. WALTER ftCIC1VOWL EDGIdIElVT COMMO!~tiVEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, Carryl L. Walter, the testatrix 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. Carryl L. alter Sworn or affirmed and acknowledged before me by C~rryl L. Walter, the testatrix, this ~~ day of/_~,~ ~~ COMMONWEALTH OF PENNSYLVANIA NofaAal Seal Tammie L Peters, Notary Public Cadlale eoro, Cumberland Caany My Con!missior! E~irse Sept 9, 2011 Member, Pennsy!vanin Associaaon of Notaries J ~.. . LAST WILL AND TESTAivtENT OF CARRYL L. WALTER AFFIDAVIT CONII~I0I~IWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND '1 1 WE ~~ f /;' -' ; I '?~~! (' ''~ ='i~ and ~ d~~>„ %,~.ryt ,the witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw Carryl L. Walter 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 testatrix signed the Last Will and Testament as witnesses and that ro the best of our knowledge he was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed and subscribed before me by ~~- ~s k ~~-L'- COMMONWEALTH OF PENNSYLVANIA Notarlel Seal Tammie L Peters. Nohary Pubis CaAlele eoro, Cumbtatlard Cwnty My Canmission E~irse Sept 9, 2011 Member, PennsNvanie Aasocletlon of Notaries 6 \f'~nc ek o~ ecln az,e