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HomeMy WebLinkAbout05-13-13 (2) REV-1500 Ex 101^0' 1505610140 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 1 2 1 0 0 8 Hamsbum,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMODYYYY Date of Birth MMDDYYYY 0 8 1 5 2 0 1 2 1 2 0 4 1 9 2 9 Decedent's Last Name Suffix Decedent's First Name MI W 0 0 D S C L A R A L (If Applicable)Ender 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 ❑X 1.Original Return 2.Supplemental Return 3.Remainder Return(date of death prior to 12-13-82) E] 4.Limited Estate 4a.Future Interest Compromise(date of 5.Federal Estate Tax Return Required death after 12-12.82) ® 6.Decedent Died Testate 7.Decedent Maintained a Living Trust U 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9.Litigation Proceeds Received C] 10.Spousal Poverty Credit(date of death ❑ 11.Election to tax under Sea 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 TO: Name - Daytime Telephone Number G E 0 R IS E B a F A L L E R J R 7 1 71, 2 4 3 3�4 rn REG�S}ERAF VdLLSII$E ONL�6 mzF First line of address t— n m rrt rn W M A R T S 0 N L A W O F F I C E S " p C7 C7 CD Second line of address 1 0 E A S T H I G H S T R E E T C T _ City or Post Office State ZIP Code - DATE FILED Cn O t„ C A R L I S L E P A 1 7 0 1 3 Corresponderese-mailaddress: (OFALLERCoMARTSONLAW.COM Under Penalties of penury,1 declare that I have examined this return,Including accompanying sdwdules and statements,and to the best of my knowledge end belief, It is tore,correct and complete.Declaration of preparer other than the personal representative Is based on all Information of whldr preparer has any knowledge. SIGNATUREOF P PONSIBLE FOR FILING RETURN / DATT ADDRESS S f/ 186 RUFFALO HOLLOW ROAD GLEN GARDNER NJ 08826 SIGNA OF PREP TH N PRESENTATNE 5 A ADD 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J i i . ; =t 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: CLARA L . WOODS RECAPITULATION ' 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 1. 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. 1 5 6 6 0 , 7 1 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) n Separate Billing Requested . . . . . . . 7. 1 9 3 6 , 4 6 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . I . . . . . . . . . 8. 1 7 5 9 7 • 1 7 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . .. . . . . . . . 9. 8 8 1 4 . 0 0 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . .. . . . 10. 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 8 8 1 4 . 0 0 12. Net Value of Estate(Line 8 minus Line 11) . . .. . . . . . . . . .. . . . . . . . . . . . . . . 12. 8 7 8 3 . 1 7 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. 8 7 8 3 . 1 7 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 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x.045 8 7 8 3 . 1 7 16. 3 9 5 . 2 4 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 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 19. 3 9 5 • 2 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 12 1008 DECEDENTS NAME CLARA L.WOODS STREET ADDRESS 2300S Road CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) 0) 395.24 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest 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) 395.24 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;or ................................................................................................ ❑ 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? ....................................................................................... ❑ ❑X 3. Did decedent own an'in trust for or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. X❑ ❑ 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 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)].A sibling is defined,undE Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1508 EX+(11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE INHERITANCE TAX RETURN CASH, BANK DEPOSITS, & MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: CLARA L.WOODS 21 12 1008 Include the proceeds of litigation and the date the proceeds were received by the estate. All properlylointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank, checking account No.9830139029 6,661.70 See attached. 2. M&T Bank, IRA Account No.35004200218467-payable to estate 6,901,59 Beneficiary:Ralph A. Woods,deceased See attached. 3, CenturyLink-refund 50.02 4. Woman's Day-refund 31.98 5. Constitution Life Insurance-refund of premium 1,515.42 6, 1994 Plymouth sedan 500.00 TOTAL(Also enter on Line 5,Recapitulation) $ 15 660.71 If more space is needed,insert additional sheets of paper of the same size REV-1510 EX-(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER CLARA L. WOODS 21 12 1008 This schedule must be completed and fled if the answerto any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDETHE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE 1. Washington National Insurance Company, annuity policy 1,936.46 100.00 1,936.46 no. 00158522;Beneficiary: Ralph Woods(deceased);secondary beneficiary: Wilmale Thomas, daughter. See attached. TOTAL (Also enter on Line 7,Recapitulation) $ 1,936.46 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER CLAP L. WOODS 21 12 1008 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Hoffman Roth Funeral Home 5,086.14 2. Hoy's Greenhouse LLC-flowers 212.00 3. Eby Granite Works 1,491.50 B. ADMINISTRATIVE COSTS: 1, Personal Representative Commissions: Names)of Personal Representative(s) Street Address City State ZIP Years)Commission Paid: 2. Attorney Fees: Martson Law Offices 1,750.00 3. Family Exemption:(If decedent's address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Register of Wills,Cumberland County 75.50 6 Accountant Fees: 6. Tax Return Preparer Fees: 7. Register of Wills, inheritance tax filing fee 15.00 8. Aetna Life Insurance Company,overpayment 93.36 9. Death certificate for Ralph A. Woods 28.00 10. Commonwealth of Pennsylvania,duplicate vehicle title 22.50 11. Register of Wills,additional probate 40.00 TOTAL(Also enter on Line 9,Recapitulation) $ 8,814.00 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CLARAL. WOODS 21 12 1008 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. Stephen L. Woods Lineal 2,282.24 186 Buffalo Hollow Road 1/3 of residue Glen Gardner,NJ 08826 2. Robert A.Woods Lineal 2,282.24 614 Longview Drive 1/3 of residue Elliotsburg, PA 17024 3. Wilmale W. Thomas Lineal 4,218.69 1134 Pheasant Drive,North 1/3 of residue and Carlisle,PA 17013 Sch. G 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 TAX IS 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. $ If more space is needed,use additional sheets of paper of the same size. 9 FTILES liens\11031 Woods\11031.1 will.2012 LAST WILL AND TESTAMENT I,CLARA L.WOODS,of North Middleton Township,Cumberland County,Pennsylvania, being of sound and disposing mind and memory,do hereby make,publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all death taxes(whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My 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. 2. I give, devise and bequeath all of my estate, both real and personal property, unto my children, WILMALE W. THOMAS, ROBERT A. WOODS and STEPHEN L. WOODS, in equal shares, absolutely. 3. I nominate,constitute and appoint my son,STEPHEN L.WOODS,as Executor of my estate. In the event he is unwilling or unable to so act, then I appoint my daughter, WILMALE W. THOMAS, as Executrix of my estate. 4. I direct that my Executor, or his successor, shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 5. I authorize and empower my Executor,or his successor,in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable;to borrow money for any purposes connected with the e"J• !u, [Initials] Page 1 of 3 Pages protection and preservation of my estate;to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate;to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my Executor, or his successor, consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my Executor, or his successor, shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. WITNESS WHEREOF I have hereunto set my hand and seal this-" day of �PYZ (SEAL) Clara L. Woods SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testatrix,as and for her Last Will and Testament,in the presence of us,who at her request,have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND (} c n' ) We,Clara L.Woods, a. L —f . and CCf �t�( it the Testatrix and the witnesses,respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix,signed the Will as a witness and that to the best of his/her knowledge the 'Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Clara L. Woods, Te tri 't-1, All. P) Witnes Witness Subscribed, sworn to and acknowledged before me by Clara L. Woods,the Testatrix, and subscribed and sworn to before me by !4_ r and the witnesses, this tday ofc�r< X12 G t G C:C.Ctr� Notary Public cosutorsw>;nt.TK o��rttn Nt7fARtAL 3 Public Victoria L.Otto,Notary Carliate Boro,C��1Secsmber20,2014 MY commission ezp Page 3 of 3 Pages © M&TBank 499 Mitchell Road,Millsboro,DE 19966 Adjustment services Phone 888-5024349 Fax (302)934-2955 October 23,2012 Martson Deardorff Williams Otto Gilroy & Faller 10 East High Street Carlisle,PA 17013 Re: Estate of Clara L. Woods Social Security: Date of Death: August 15, 2012 Dear Sir or Madam: Per your inquiry on October 18, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type of Account Checking Account Account Number 9830/39029 Ownership(Names oj� William W. Tlwmas(POA) Clara L Woods Opening Date 0410412002 Balance on Date of Death $6,661.70 Accrued Interest $ .00 {{-- Total $6.66!.70 `JC11, t � � 2. 7}peofAccount Individual Retirement Account Account Number 35004200218467 Ownership(Names of) Clara L Woods Opening Date 0312311999 Balance on Date of Death $6,891.95 Accrued Interest $ 9.64 Total � $6.90!59 5ch. CE z�em a WAS11INC ION NAMNAL INSi_unvcL COMPANY P.O.❑ac x1556 Lincoln.NE 68501-1556 (866)553-5958 May 9, 2013 Melissa Scholly Martson Law Offices 10 East High Street Carlisle, PA 17013 Policy Number: 00158522 Insured: Clara L Woods Dear Melissa Scholly, Thank you for contacting Washington National Insurance Company. As of the date of Clara L Woods's death on August 15, 2012, the Fund Value for the policy referenced above was$1,936.46. If you have any questions, please call the Client Service Center at the number shown above, Monday through Friday from 8:00 AM to 5:00 PM Central Standard Time. Sincerely, Client Services S� C Z�em 1