HomeMy WebLinkAbout09-24-13 � M
� „,,,���� 150561D1�5
R�Y�1�,7�V E%(oa-�i}�Fi}y,ry'
�a OFFICIAL 11SE ONLY
PA Oepartment of Revenue pennsylvania
Bureau of Individuat Taxes �`" ";�°` County Cotle Year File Number
Pa sox zso6oz HfRSTANCE TA7C RETURN �,.!, �1 J� (���
Harrisburg PA i'7xz8-o6oi RESIpENT OECEDENT J tJ
ENTER pECEDENT INFORMATION BELOW
t76/27t2Q12 0910911919
DecedenPs Last Narre Suffix Decedenfs First Name MI
Wilkinson Annie C
(If Applicable)Enter Surviving Spouse's Information 6elow �
Spouse's last Name Suffix Spouse's First Name MI
Na
Spouse'e Social Seourity Number �
THIS RE7URN MUST BE FILED IN DUPLICATE WITH THE
42EGISTER C}F W1l.�S
FI�L IN APPROPRIATE OVALS BELOW
� 1.Original Return (� 2.Supplemental Retum p 3. Remainder Retum(Date of Dea[h
PMOr to 1&13-62}
O 4,Limited Estate O Ca.Puturs interest Compromise(date of p 5. Federal Estate Tax Return Required
deeth after 12-12-82)
� 6. Decedent Died Tes[ate G7 7.Decetlent Maintained a Living Tmst � 8. Total Number of Safe Deposit Boxes
(Aflach Gopy of W Ni) {Attach Copy of Trust)
O 9. �itigation Proceeds fteceived O 76. SF�usai Poverty Credit(Date pf Death O 71. Eiection to Tax under Sea 9tt"s(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.A4L CORRESPONDENCE AND CONPIDENTWL TA%INFORMATION SHOFl,I�D 6E UIRECTEP T0:
Name Daytin+e TelephtaT,p Num�ee
. . . .. . .T. �� .
Adam R. Deluca, Esq. (717)249-1 Q7'7,
rr, :
REGISTffR-bF WILLS US�,pNLY :�
First Line of Address �
^.
81 West Louther Street "
. .. . . . . . . .. _ -. r..,.,.: '
Second L.ine of Address �
. . . :.::u .,._ (.:. . ,
�7
City or Post Office State ZIP Code p�TE FIiEv
Carlisle PA 17013
CorrespondenPs e•meil address:8fdelUC285@801.001Y1
Under penal[ies of perjury,I Oeclare that I have examinad this reWrn,inclutling acrompanying schedules and statements,and to the best pf my knowletlge and belipl,
i{��NS,iwrxt and ccxnpiete.Dedaration af preperer other than the personai represe�tative is hased on aiV i�formatian o(which p�e(�[mer has any krrowledge.
SIGNpTyR�E O�RS�N RESPO,NSBLE FO F�IiNG RETURN.� yA�� j �
i.._Lr71 ,�.1�� % I �� �
ADDRESS
13 Victory Church Road, Gardners,PA 17324
SI TU E OF PREPf,7iRT7'QT AN R SENTATIVE DAy�� / �
��/'�—�.�r � C�� �
AD�RESS F� �
6� West Louther Street, Carlisle, PA 17413
PLEASE USE ORIGITFAL FORM ONLY
Side 1
L 15C15610105 1505610105 J
��,�
� �5�561�2�5
REV-1540 EX{Ft}
RECAPI7ULATION
1. Reai Estate(Sohedule A). .... . .. . .... .... . ........ ... ... ... .... .. . ... 1. : 5H,2�0.00 �;
2. Stocks and 8onds{Schedule S) .................._.......... ._...... 2. ...�
3. Closely Held Gorporation, Partnership or Sole-Proprieforship(5chedule C) .... . 3. :� ��
4. Mortgages aad Notes fteceivabie{SChedule D)....._.................... 4. I ��.
5. Cash, 8ank Deposits and Miscellaneous Personal Property(9chedule Ej. .. , ... 5. '�, 3,$Sg.15 j
_......._. ....._._. .._.._ ..:.
8. Joinily Ownad Propedy(Schedute P} p Sepprate Bif6ng ftequested ....... 6. '�.
7. tnier-VivosTransfers&MiscellaneausNon-ProbataProperiy ��--�� �����-- ��--- - � � ������
(Schedule G} O Separate Billing Requested... . .... 7. ��, "
...._._.._ ..._ .. . . ._._ .... . .......:
8, To{ai Gross Assets(fota!�ines t through 7)..................... ........ 8. � $2,058.15 '
9. Funeral Ezpenses and Administrative Costs(Scheduie H). .... ..... . .. . .... . 9, � b,G41.3$ -�.
76, Debts of�ecedent,Mprtgage liabi6tles and Liens(Schedule i)............... 1d. ��. � 3,053.52 -��.
11. Total Deductians(rotal Lines 9 and 10}... . .. ..... . . .. . ... .. ... ... _... . 11. ���' .... .. .. , ........$,$94.90 ��!�
12. Net Vatue af Estate{Line$minus line 11} .............................. i2. 5$,�u63.25 ';
13. CharitableandGovernmentatBeques,slSec9'113Trustsforwhich " ���" � � '������� �-����� " -���.
en election to tax has npt been made(Schedule J) . . .. .. . .. . .. .. . .. . ... . .. 13. :�
1'. Net Vatue Subject to Tax(Line i2 minus line 13) ............._......... 'i4, ��� . .. . . $3,$�3.25
TAR CALCULATION-SEE INSTRUCTIONS FOR APPL(CABLE RAFES
15. Amount of Line 14 taxable
et the spousal tax rate,pr
uansfersur�CerSec.911G ..... . .__ _.... .._._ ...._.. __.... ..
(&)(t2)X.0...- : 15.�i. .,.
16. Amount of Line 14 taxa6le ����" �� � �������� ���-��� "�� � � ���� � �� �
. _. . , ....._.
at lineal rate x.0 45 53,36325 ' �6. 2 401.35 '
17. Amount cf E.ine 14 taxabie ..... .. ..... . ° ,.__.. ._..i .... _____. __.__ , . ....
at sibiing rate X.12 � �� 1Z ! -
18. Amoun[oF Line 14 taxable .. .. . ,.,".:. ..,..... � ...... . . . .... ....... � �
at collateral rate x.15 � � 18. ��'� �.
_.__._ . ____ . . ,_.
19. TAX DUE . . . .. ... . .. . . ...... ... . . ... . ... ..... ..........._........ 19. I . ._,_ _..2�4d1.3$ ;
20. FILL IN THE OVAI IP YOU ARE REC}UESTING A REFUN6 OF AN OVERPAYPAENT O
Side 2
L 1517561�205 1565610205 J
REV-1500 EX(FI) Page 3 File Number
DecedenYs Complete Address:
OECEDENT'S NAME
Annie C. Wilkinson
STREETADDRESS
11 Victory Church Road _
CIN STATE ZIP
Gardners PA 17324
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 2,401.35
2. CreditslPayments
A.Prior Payments __ 1,000.00
B.Discount 52.63
Total Credils(A+g) (2) 1,052.63
3. Interesl
(3) 18.00
4. If Line 2 is greater ihan Llne 1 +Line 3,enter the difference. This is ihe OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater lhan Line 2,enter lhe difference.This is the TAX DUE. (5) 1,36672
Make check payable to: REGISTER OF WILLS, AGENT.
... ....i :ii: :... .a_v % ��. 4..ti �.
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 propedy lransferred..............................................._..._.................................._ ❑ �
b. retain the nght to designate who shall use ihe property transferred or its income ............................................ ❑ �
c. retain a reversionary inlerest..............._.......................................................................,..................................._ ❑ �
d. receive the promise for life of eilher payments,benefts or care?..............................................................._..._ ❑ �
2. If death ocwrred aker Dec. 12, 1982,did decedenl lransfer propedy within one year of death
withoul receiving adequate consideration?...............................__........................................................................... ❑ �
3. Did decedent own an"in trusl for"or payable-upon-death bank account or security al his or her death?.............. ❑ �
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a benefciary designation? ..............................................................................._.._....._.._........................ ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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_. .. .:: _ .._. ,f, .. . .. ,_, �. _,,.., _. ., ,..r. � „ . r_
For dates of death on or after July 1, 1994,and before Jan. t, 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 afler Jan. 1, 1995, the tax rate imposed on fhe net value of transfers to or for lhe use of the surviving spouse is 0 percenl
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from lax,and the statuiory requirements for disclosure of assets and
f ling a tax relurn are still applicable even if the surviving spouse is the only beneficiary.
For daies of death on or after July 1,2000
. The tax rate imposed on the nel vaiue of iransfers 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 lransfers to or for the use of the decedenYS lineal beneficiaries is 4.5 percenl,except as noted in[)2 P.S.§9116(a)(1)].
• The tax rate imposed on the nel value of lransfers to or for the use of lhe decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defned,
under Section 9102,as an individual who has at least one parenl in common wilh the decedenl,whether by blood or adoption.
REV-}soz Ex+ (iz-iz)
� pennsylvania SCHEDULE A
DEPARTMENTOFREVENUE REAL ESTATE
INHERITANCE TAX REfURN
RESI�EM DECEDENT
ESTATE OF: FILE NUMBER:
ANNIE C. WILKINSON 21-12-0870
All real property owned solely or as a tenant in comman must be reported at fair market value.Fair market value is defned as the price at which property
would be exchangetl between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disciosed on Schedule F.
Attach a mpy of the settlement sheet if the property has been sold.
REM Indude a mpy of the deed showing decedenYs interest if ownetl as tenant in common. VAWE AT DATE
� NUMBER OFDEATH
DESCRIPTION
i 11 Vicbry Church Road, Gardners, PA 17324 58,200.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 58,200.00
If more space Is needed,use additional sheets of paper of the same size.
REV-i5o8 EX+(a8-iz)
j�t pennsylvania SCNEDULE E
ry� oeanarMENTOFnEVENUe CASH, BANK DEPOSTTS & MISC.
INHEAITANCE TAX kENRN PERSONAL PROPERTY
RESIDENT DECEOEtlT
ESTATE OF: FILE NUMBER:
ANNIE C. WILKINSON 2�-12-0870
Indude 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 VALUE AT DATE
NUMBER DESCRIP'TION OF DEATH
�. Adams County National Bank,PO Box 3129, Gettysburg, PA 17325 Checking Acct#1972421 2�27g,g7
2. Washington National Health Insurance,11825 N. Pennsylvania St.,Carmel, IN 46032 Acct:855737 refund 505.39
3. AmeriGas utility refund check 45.64
4, Adams Electric Coopertive, Inc utility refund check 13520
5. Household items sold(dishes,glassware,toys,baskets) 378.00
g. Personal items sold at auction(Norm's Auction Service-attachment A) 51525
TOTAL(Also enter on Line 5, Recapitulation) $ 3,858.15
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (OB-13)
� pennsylvania SCHEDULE H
oEanaTMeN-oFaEVENUe FUNERAL EXPENSES AND
t""ERIT""cET"XR�r"R" ADMINISTRATIVE COSTS
RESIDENrDECEDENT
ESTATE OF FILE NUMBER
ANNIE C. WILKINSON 21-12-0870
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A� FUNERALFXPENSES:
1.
e. ADMINISTP,ATIVE COSTS:
1. Personal Representative Commissions �
Name(s)of Personal Representative(s)
Street Address
���1� Sta[e ZIP
Year(s)Commission Paid:
Z Atmmey Fees: 3,723.49
3. Family Exemption: (If decedent's adtlress is not the same as daimant's,attach explanation.)
Claimant
Sheet Address
City State ZIP
Relationship of Claiman[to Decedent
4� Pro6ate fe.es: 285.50
5. Acmuntant Fees:
6� Tax Return Preparer Fees:
� Estate advertisement in Patriot News and Cumberland Law Joumal 181.59
e. Norm's Auction Service cammission 195.80
e. Diversified Appraisal Services(land appraisal) 350.00
io. Jerry D. Larue,Surveyor 905.00
TOTAL(Also enter on Line 9, Recapitulation) $ 5,641.38
If more space is needed, use adtlitional sheets of paper of the same size.
REV-1512 EX+(12-12J
� pennsytvania SCHEDULE I
oeanRrMeNroFaeveNUe DEBTS OF DECEDENT�
MHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS
RESIOENT DEfEDENT
ESTATE OF FILE NUMBER
ANNIE C. WILKINSON 21-12-0870
Report debts incurred by the decedent priar to death that remained unpaid at the date o(death,including unreimbursed medical expenses.
ITEM VALUE Ai DATE
NUMBER DESCRIPTION OF DEATH
1 Pennsylvania Department of Public Welfare Medical Assistance Claim 1,048.45
2 Robert C.Caims,Tax Collector, Pennsylvania School Real Estate Tax 2012 846.87
3. Robert C.Caims,Tax Collector, Pennsylvania School Real Estate Tax 2013 857.39
4. Robert C. Cairns,Tax Collector, Pennsylvania Property Tax 259.63
5. West Asset Management(collecting for Pendrick Capital Partners) 41.18
TOTAL(Also enter on Line S0, Recapitulation) $ 3,053.52
IF more space is needed,insert additional sheets of the same size.
aEV-isi3 Ex+ �ai-io�
� pennsylvania SCHEDULE )
�EPARTMENfOFPEVENUE
IN„ERI,pN��,ax R�,,,RN BEN EFICIARIES
RESIDENT DLCEDENT
ESTATE OF: FILE NUMBER:
ANNIE C. WILKINSON 21-12-0870
RElATI0N5HIPTODECEDENT AMOUNTORSHARE
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 Helen Boyer,4 Two Churches Rd., East Bedin, PA 17316 daughter 1/7
2. Anna Schoffstall,550 Meals Road, Gardners, PA 17324 daughter 1/7
3. Kenneth Wilkinson,215 Chestnut Hill Road,Aspers,PA 17304 son ��7
4. Sherman Wilkinson, 15 Victory Church Rd.,Gardners, PA 17324 son �/7
5. Connie Saritiago, 13 Victory Church Rd.,Gardners,PA 17324 daughter 1/7
6. Vonnie Purdue,48 Oxford Road, Gardners,PA 17324 daughter 1/7
7. ShitleyTorres,25 Kennedy Ln.,Sfeelton,PA 17113 daughter �/7
ENTER DOLL4R AMO�NTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH IB OF REV-1500 COVER SHEET,AS APPROPRIATE.
It NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABI.E AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF DART 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.
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LAST WILL AND TESTAMENT OF `��� �� � �
ANNIE C. WILHINSON
I, ANNIE C. WILIiINSON, of Cumberland Counry, Pemisylvania, declare tttis to
be my Last Will and Testament and hereby revoke all prior Wills and Codicils.
l. I direct that all my just debts, fiuieral expenses, and administrative
expenses shalt be paid fiom my estate as soon as practicable after my death. It is my
wish that upon my death, my body shall be buried, next to my beloved husband, in otiu
plot in Mount Victory Cemetery, Gardneis, PA.
2. I direct that all of my real and personal property that I own at tl'ie time of
n�y death shall be sold and tl�e proceeds shall be distributed accordinQ to tlus Last Will
and Testament y
Z
� 3. I direct that the proceeds from my estate shall be aiven to my seven (7)
children, Helen Boyer, Amia Schoffstall, Kenneth Wilkinson, Shiriey Tones, Shet7nan
� ��'i l kinson, Comue Santiago, and Vomue Perdue, in equal shares; per stiipes.
J 4. I appoiut my dauehter, Connie Santiaeo, as Executri�of this mv Last u�ill
�'�, and I'estament In the event that Coimie is deceased, unable or unwilline to serve or shall
� cease to serve for any reason whatsoever, then I nominate, constitute a�zd appoint my
gr�lddaughter, Maria J. Coover; as altemate Executrix of this my Last Will aud
,�� Testament.
�J
J �. I direct tl�at no Executrix acting under this Will shall be required to enter
�-� bond in any jurisdiction.
�' ES. I reconunend that my Personal Representative retain the law fiim of Allied
�
J Attorneys of Cenu�al Peimsylvaiva, L.L.C., to probate my estate.
��
IV WIT'NESS WHEREOF; I have hereunto set my hand tlus 7�j�~da
_ Y
of _��-�1C� -- �012.
t/ > ,
��vYU-S� � C�i� J �ti�Z,LiS�vc�--
ANNIE C. WILKINSON
Fa�e 1 of 4
The preceding inshument consisting of this and tlu�ee other paQes was on the day aud date
hereof si sned, published and declared by ANNIE C. WILKINSON, as and for her Last
Will and Testament in the presence of us, who at her request, in her presence and in the
presence of each other have subscribed our names as witnesses hereto.
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Witness �itness V �
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Page 2 of 4
ACKNOWLEDGNLENT
COMMONWEALTH OF PENNSYLVANIA
: SS
COiII��TY OF CUMBERLAND
I, ANNIE C. WILKINSON,the TESTATRIX;whose nanie is sianed to the
attached or foregoin�inshl�ment, havine been duly qualified accordui�to lacv, d.o hereby
ackno�vled�e that I sig�ied and eaecuted the instnmient as my Last Will and Testament;that
� I si�ied it willingly, and that I siened it as my free and voluntary act for the puiposes thereui
� expres�ed.
a �� / y. � , ,
� � �,LI�'l�'L(��-1 � ��.���G I'IJ�TV�-
� ANNIE C. WILKiNSON
-___)
�' COMNIONtiVEALTH OF PENNSYLVANIA
'� S.S.
^� COUN'TY OF CUNLBERLAND .
� I
i�n this��day of L�l , 2012, before me personally
� appeare3 Ai�'NIE C. `VILHINSON, knowzi -�me (or satisfactorily proven) to be the
' person�vhose name is subseribed to the cvithin instrumeilt, ancl she aekno�vledged that
� she �vas the declarant who eYecuted the sanie for the pmposes therein contained.
C�c IN WITNESS WHEREOF I hereto set my hand and c�fFcial sea1.
�
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i�otary ublic
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° �"ar;is:e�o�a, G�:mbedand Gr,.�sr.tv
' P,av Ci�!1liFi!}5'6;} m;:kitcc'.';��lCit�"� �O�:
'�,.__.�.�.7.�.��� -_
Page 3 of 4
AFFIDAVIT
COM�QONtiVEALTH OF PENNSYLVANIA .
SS
COilI�TY OF CUMBERLAND
� WE, /�Qv�n PC ��uc"c� and �Cli,��U `"4"�� �,Cl�'1��,
? - �
�� the�vituesses whose names are attached to the foregoin� document, being duly qualified
; � according to law, do depose and say that we were present and saw testah'ix sio;n and
„� execute tl�e instniment as her Last Will; that she si�ned willinoly and that she executed it
� � �
'� as her fiee and voluntaiy act for the puiposes therein expressed; that each subscribina
'� � �vihiess in the hearing and sight of the testatrix sianed the Last Wilt and Testaii7ent as
'� wimesses and that to the best of our knowled�e the testatrix was at the time 18 or more
� `
yeats o:f ase, of sound mind and under no constraint or tmdue iiLfluence.
� /�\ ,
C� 1 %l ✓��/1 ./ ` �� v/i�' �I��"'•I i1 '\ Y� -u�
� � � �� ��
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� 3�com or affiinied and subscribed before me by �'�
��; /I/A(6r1'� � ��vc� and �d�n.2-��- -f-�--d�, _this
:�
z3 -- day of__��� , 2012.
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