HomeMy WebLinkAbout07-02-13 1505610105
REV-1500 EX(o2-u)(F)p qtr
nlvanta OFFICIAL USE ONLY
PA Department of Revenue P ensyll
m Y County Code Year File Number
Bureau oflndividual.Taxes INHERITANCE TAX RETURN
PO BOX 28obo1 I 1
Harrisburg 6 17128-0601 RESIDENT DECEDENT I (59 Y 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09/21/2012 05/17/1922
Decedent's Last Name Suffix Decedent's First Name MI
Atkinson E-7 I Roy _ __ _ _ C❑
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Atkinson [Patricia
Spouse's Social Security Number u
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
170-18-9185 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Gill 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a. Future Interest Compromise(date of O S. Federal Estate Tax Return Required
death after 12-12-82)
m 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 S. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-96) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytim elephone Number
Taylor P Andrews, Esq (717}2430123 m �
------ c_— >,-p
krGISiEB".OF WILLS USt Ol
A
70 r-- ; Tl
IFTI CJ
First Line of Address r C, S. C� G�,
GJ C _ c}'
Second Line of Address �T_-- — ----_ ( M
O of> O
--- — _ � — --� DATEWED �
City or Post Office State ZIP Code
Carlisle _ _ PA
Correspondent's e-mail address: t andrews a.ne__
Under penalties of perjury,I declare that I have exa ed is re including accompanying schedules and statements,and to the best of my knowledge and belief,
R is We,correct and m ete.Declaration of pre rer a an the personal representative is based on all information of which preparer has any know) dge.
SIGNATSIR O ESPONSIBLE F F G R DATE
0 0�
ADDRESS
18 Blue M tin Vista Mecha icsburg, PA 17050
SI DATE
ADDRES
78 Mornfret St., Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 7
L 1505610105 1505610105
(Y%
J 1505610205
REV-1500 EX(Fl) Decedent's Social Security Number
Decedent's Name: Roy C Atkinson
RECAPITULATION
1. Real Estate(Schedule A). . . . . . . . .. . ....... ... .... ......... . .... ... ... 1. C 0.00
2. Stocks and Bonds(Schedule B) ......... . ....... ..... ......... . ...... . 2. 16,501.00
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. 23,836.00
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. ..... 6. 184,780.00
7. Inter-V'ivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested... ..... 7. 0.00
8. Total Gross Assets(total Lines 1 through 7).... ...... . .. .. . ..... ....... . 8. 225,117.00
9. Funeral Expenses and Administrative Costs(Schedule H)... ..... ...... .. ... 9. 0.00
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). .... . ....... .. 10. 0.00
11, Total Deductions(total Lines 9 and 10)........ . ..... ..... ..... ....... 0.00
12. Net Value of Estate(Line 8 minus Line 11) . ...... ..... ...... ............ 12. 225,117.00
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. 225,117.00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 225,117.00
(a)(1.2)X.0 0 15. 0.00
16. Amount of Line 14 taxable
at lineal rate X.0_ 0.00 16. 0.00
17. Amount of Line 14 taxable
at sibling rate X.12 0.00 17. 0.00
18. Amount of Line 14 taxable
at collateral rate X.15 0001 18 0.00
19. TAX DUE ... .................... ...... ..... .. . .......... ..... ..... 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
L 1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Roy C Atkinson
STREETADDRESS
18 Blue Mountain Vista
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments 0.00
B.Discount 0.00
Total Credits(A+B) (2) 0.00
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in 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) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
r
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0
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?.............................................................................................................. ❑ E
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑ E
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 for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
All real estate owned solely or as a tenant in common should be reported at fair market value with is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to sell,both having reasonable knowledge of the relevant facts.
Property jointly-owned with Right of Survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Residence at 18 Blue Mountain Vista,Mechanicsburg, PA 17050 [Silver Spring Twp]
Owned jointly with Patricia G. Atkinson so value reported on Schedule F
Parcel#: 38-06-0011-034
Tax assessment: 235,200,
Common level ratio: 1
Total(also enter on Line 1,Recap)
SCHEDULE E
CASH,BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
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 disclosed on Schedule F
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
CD's at Nary Federal Credit Union,Merrifield,VA 22119:
391080630018 $13,318.00
391080630022 $10,518.00
7
TOTAL(also on line 5,Recapitulation) $23,836.00
SCHEDULEF
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
if an asset was made joint within one year of the decedent's death,it must be reported on Schedule G
Surviving Joint Tenant(s):
NAME ADDRESS RELATIONSHIP TO
DECEDENT
A Patricia G.Atkinson 18 Blue Mountain Vista,Mechanicsburg,PA 17050 Wife
B
C
Jointly-owned property:
ITEM NUMBER LETTER FOR DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF TOTALVALUEOF DECDS%INT. DOLLAR VALUE OF DECEDENTS
IOMT TENANT JOINT INSTITUTION AND BANK ACCOUNT NUMBER OR ASSET INTEREST
SIMILAR IDENTIFYING NUMBER.ATTACH DEED
FOR JONTLY-HELD REAL ESTATE
1 A 15-Aug-02 Home at 18 Blue Mtn Vista* $235,200 50% $117,600
Pre 2011 Navy FCU accts and CD's:
2 A Savings account $5,717 50% $2,859
3 A CD 391080630014 $21,036 50% $10,518
4 A CD 391080630016 $14,857 50% $7,429
5 A CD 391080630021 $10,518 50% $5,259
6 A 11-Sep-02 Orrstown Bank acct 111000364 $14,857 50% $7,429
7 A 17-Apr-06 Orrstown Bank acct 711000519 $63,148 50% $31,574
8 A 2002 2002 Cadillac DeVille $4,227 50% $2,114
* see schedule A for details
TOTAL(also on line 6,Recapitulation) $184,780
NAVY
FED
_®
Credit 1 Inio; In reply refer to:
lJ 187384
26 March 2013
Mrs. Patricia Atkinson
18 Blue Mountain Vis
Mechanicsburg, PA 17050-1813
Dear Mrs. Atkinson:
On behalf of Navy Federal's staff and membership, I wish to extend our heartfelt sympathy to
you and your family on the loss of your husband in 2012.
We have completed settlement of his accounts and I hope that the following information is of
assistance to you. On 21 September 2012, your husband's savings account reflected a balance of
$5,716.76. A direct deposit of$25.00 from the Defense Finance and Accounting Service was
received and credited to the account on 28 September. The funds have been deducted from the
account for return to the paying agency. Transactions on the account since that date resulted in a
savings balance of$5,718.52 as of 16 October 2012. As joint owner of the account, you are
entitled to the savings balance. The funds have been transferred to your savings account.
Your husband's checking account had a balance of$9,324.42 on 21 September. Transactions on
the account since that date resulted in a checking balance of$9,954.79 as of 2 October 2012. In
accordance with your request as joint owner, your husband's checking account has been retitled
in your name under your access number on 2 October. At the beginning of 2014, two IRS 1099
forms will be generated; one will be issued in your husband's name for 2013 dividends earned
prior to the account being retitled and the other will be in your name for dividends earned on the
account for the remainder of the year.
The certificates in your husband's name had the following balances:
Account Number Balance
00391080630014 $21,036.21
00391080630016 $14,856.89
00391080630018 $13,318.16
00391080630021 $10,518.11
00391080630022 $10,518.11
Dividends credited to the certificates since 21 September increased the balances as follows:
PO Box 3000 Merrifield VA 22119-3000
Access Number 187384
Page 2 of 2
Account Number Balance
00391080630014 $21,046.07
00391080630016 $14,884.25
00391080630018 $13,722.93
00391080630021 $10,523.04
00391080630022 $10,563.37
As joint owner of the 14, 16 and 21 certificates, you are entitled to the proceeds including
dividends earned since 21 September. In accordance with your request, they have been rolled
over to certificates in your name. The present status of the certificates is as follows:
Account Number Tenn Dividend Rate Maturity Date Balance
68000602696601 18 months 0.95% 03/06/2014 $21,126.75
68000602696602 30 months 1.98% 07/21/2013 $15,003.41
68000602696603 18 months 0.95% 03/16/2014 $10,563.38
Our Federal regulatory agency, the National Credit Union Administration, requires that the
account of a deceased member be closed within a reasonable period of time. Since we have
received no reply to our previous correspondence, the funds in your husband's remaining
certificate accounts are subject to state abandoned property laws. State statutes prescribe that if
any remaining funds are not claimed, they must be turned over to the state. To avoid having the
accounts closed and the balance transferred to the custody of the state, you must respond to this
letter. Your husband's savings account is now closed and the final statement will be forwarded
at a later date.
We have noted that your savings and checking accounts as well as your certificates do not reflect
joint owners. You may use the enclosed Change of Infornation/Add Joint Owner form if you
would like to add a joint owner. We have also enclosed a Payable on Death (POD) Designation
form if you would like to name a Payable on Death beneficiary. A postage-paid return envelope
is provided for your convenience.
If you have any questions or need additional asslsta cc,please do not hesitate to call rile Moll-ffee
at 1-800-883-3323, extension 44530. You may also reach me by fax at 1-703-255-7963.
Sincerely,
cc
Becky Harshfie d
RB:br
Enclosures:
NFCU 97CI
NFCU 250ep
Return Envelope
ORRSTOWN
BANK
A Tradition of Excellence
June 12, 2013
Andrews&Johnson
Attorneys at Law
78 West Pomfret St
Carlisle,PA 17013
Fax: 243-0061
Re: Estate of Roy C. Atldnson
Social Security Number 382-14-8104
Date of Death 9/21/2012
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE
FOLLOWING ACCOUNT WITH ORRSTOWN BANK:
CFIECKING ACCOUNT
Account No. 111000364
Account Type- Relation interest Checking
Account Title- Roy C Atkinson/Patricia G Atkinson
Date Opened- 09/11/2002
Joint Account(name/datc)- Yes/Patricia G Atkinson
Balance- $14,854.87
Accrued Interest- $1.83
STATEMENT SAFTNGS
Account No: 711000519
Account Type- Prime Statement Savings
Account Title- Roy C Atkinson/Patricia G Atkinson
Date Opened- 04/17/2006
Joint Account(name/date)- Yes/Patricia G Atkinson
Balance- $63,112.43
Accrued Interest- $35.88
Best Regards,
2
Lisa R.Kline
Deposit Processing Clerk
2695 Philadelphia Avenue •Chambenbur& PA 17201
100/100 'd E60E60LL1L(XHA) SMoilud3d0 RIM IMISd'd0 S011 (03m)UO2-21-lor
SCHEDULE H
FUNERAL EXPENSES,ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
Debts of decedent must be reported on Schedule f.
ITEM DESCRIPTION AMOUNT
NUMBER
A. Funeral Expenses:
1
2 No expenses claimed because tax rate is 0%
B. Administrative Costs:
I Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s)commissions paid:
2 Attorney fees to Andrews&Johnson
3 Family Exemption
Claimant
Street:
City: State&Zip
Relationship of Claimant to Decedent: Daughter
4 Probate Fees to Register of Wills
5 Accountant Fees to Patricia Rosendale,CPA
6 Tax Return Preparer's Fees
7
8
9
10
11
12
13
14
15
16
17
18
19
TOTAL(also on line 9,Recapitulation) $0.00
SCHEDULEI
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
Report debts inc cd y e ecedwt prior to deat��rema'm unp�e —aid as of the d�deaai,including unmiin urs�aic a pcnsca� s.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
No debts claimed because tax rate is 0%
TOTAL(also on line 10,Recapitulation) $0.00
SCHEDULEJ
BENEFICIARIES
ESTATE OF FILE NUMBER
Roy C Atkinson 21-13-0348
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBU➢ONS linclodmuvight spousal disvib.U.,and v.mfcn wwU S..9116(.$11)]
1 Patricia George Atkinson, 18 Blue Mountain Vista Wife 100%
Mechanicsburg,PA 17050
II NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B.Charitable and Governmental Bequesb.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS(also enter on line 13,Recapitulation) $0
WILL
I, ROY CHARLES ATKINSON, of 18 Blue Mountain Vista, Unit 31, Mechanicsburg,
Cumberland County, Pennsylvania, 17050, declare this to be my last will and revoke any will
previously made by me.
Item One: I direct that all my debts and funeral expenses, including my gravernarker shall be
paid from my residuary estate as soon as practicable after my decease as a part of the expense of
the administration of my estate.
Item Two: I give, devise, and bequeath my entire estate to my wife Patricia George Atkinson
if she survives me by 60 days. In the event that my wife Patricia George Atkinson predeceases
me or is not then living on the 61st day after my death, then 1 give, devise, and bequeath my
entire estate to my son Jeffrey Hughes Atkinson, per stirpes.
Item Three: I appoint my wife Patricia George Atkinson, Executrix of this my last will.
Should my wife Patricia George Atkinson fail to qualify or cease to act as Executrix, I appoint
my son Jeffrey Hughes Atkinson to act as Executor with the same rights, powers, and duties.
Item Four: I appoint the wife of my son Jeffrey Hughes Atkinson, Rebecca Rosenlund
le Atkinson, Guardian/Trustee of any property which passes to any person under the age of 21
years and with respect to which I am authorized to appoint a Guardian/Trustee and have not
otherwise specifically done so. Guardian/Trustee shall establish separate guardianship accounts
and shall have the power to use income from time to time for the beneficiary's education,
including technical and vocational training and graduate school, travel, support, and welfare
without regard to his or her parents' ability to provide for such education, travel, support, and
welfare, or to make payment for these purposes, without further responsibility, to the beneficiary
or to the beneficiary's parents or to any person taking care of the beneficiary. Guardian shall
administer the account until the beneficiary becomes 18 years of age, at which time the Guardian
shall transfer the principal and income remaining in the separate guardianship account to my
Trustee, being the same person as my designated Guardian, who shall then administer a trust
account, of both principal and income and any other funds transferred to the accounts designated,
for the beneficiary's education, including technical and vocational training and graduate school,
travel, support, health, and welfare. When the single guardianship or trust account is less than
$10,000.00 or the beneficiary of the separate trust becomes 21 years of age, the share of the
beneficiary remaining in the account shall be paid to the beneficiary in full and the guardianship
or trust terminated. In the event of the death of any beneficiary after my decease and prior to
reaching the age of 21 years, his or her share shall be distributed equally, share and share alike,
among his or her children; otherwise to my surviving children or child, per stirpes, equally, share
and share alike, to be administered in accordance with the guardianship and/or trust provisions.
Guardian and Trustee shall not be required to file accountings with any court. In the event that
any provision of this will shall be interpreted to violate the Rule Against Perpetuities, then the
remaining provisions of this will shall not be invalid. Trustee shall administer the trust and
dispose of assets so as not to violate the rule, making distribution as required to a life or lives in
being plus 21 years.
Item Five: All estate, inheritance, succession, and other taxes, imposed or payable by reason
of my death, and interest and penalties thereon, with respect to all property comprising my gross
estate for tax purposes, whether or not such property passes under this will, shall be paid out of
the principal of my residuary estate, without apportionment or right of reimbursement.
Item Six: I direct that my personal representative or guardian shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
Item Seven: In addition to the rights and powers given to the fiduciaries by law or elsewhere in
this will, I give to my Executor during the full time necessary for the administration of my estate
the following rights and powers to be exercised in his or her sole discretion.
A. To retain any real or personal property which may at any time form a part of my estate so
long as he or she deems it advisable.
B. To invest in any real or personal property without restrictions as to legal investments.
C. To repair, alter, improve or lease for any period of time any real or personal property and
to give options for leases.
D. To sell at public or private sale, for cash or credit, with or without security, to exchange
or to partition, to mortgage or pledge real or personal property, and to give options for
leases.
E. To make distribution in kind.
F. To compromise claims.
IN WITNESS WBEREOF, I have hereunto set my hand this 1q 't- day of August, 2009.
'qsSigned ' �� 1ay�.2x
ROY dHARLES ATKINSON
The preceding instrument, consisting of this and two other typewritten pages each identified by the
signature of the Testator was on the day and date thereof signed, published and declared by the
Testator therein named as and for his last will, in the presence of us,who at his request, in his
presence and in the presence of each other have subscribed o ames.
c�ta '
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ss
We, John H. Broujos and 1 t A�""' J %S 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 the Testator sign and execute the instrument as his last will; that he signed
willingly and executed it as his free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our
knowledge, the_Testator was at the time 18 or more years ge, sound and under no
constraint or undue influence.
Sworn and subscribed to before
me this /y� day of August, 2009.
T I YLVANIA
Notarial Seal
Wanda K.Hunter,Notary Public
Carlisle Boro,Cumbenantl County
My Commission Expires May 10,2013
Member,Pennsylvania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ss
I, ROY CHARLES ATKINSON, whose name is signed to the attached document, having been duly
qualified according to law, do hereby acknowledge that I signed and executed the instrument as my
last will; that I signed it as my free and voluntary act for the purposes therein expressed.
ROY_QHARLES ATKINSON, Testator
Sworn and affirmed to and acknowledged
before me this ,yam„ day of August, 2009.
COMMONWEALTH OF PENNSYLVANIA
Notarial seal
Wanda K.Hunter,Notary Public
Carlisle Sono,Cumberland County
My Commission Expires May 10,2013
n+?m7er,Pennsylvania Association of Notaries