HomeMy WebLinkAbout11-21-13 (3) 1505610105
REV-1500 Ex(m-ii)tFr,
PA Department of Revenue pennsytvania OFFICIAL USE ONLY
Bureau of Individual Taxes OF" N°` County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN ^ f �t '
Harrisburg,PA 17128-06o1 RESIDENT DECEDENT a l n `('
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
10/04/2013 10/12/1932
Decedent's Last Name Suffix Decedent's First Name MI
Massie Helen B
(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 IN APPROPRIATE OVALS BELOW
CV 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4.Limited Estate C=) 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
OD 6.Decedent Died Testate C=:) 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received C=3 10.Spousal Poverty Credit(Date of Death (= 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TD:,
Name Daytime Telephone Number
r�
Linda M. Gunn (8,14)652-58"
EGISTER�,WILL'r SJ NLY
C i C7
First Line of Address = rrrt
173 Avalon Ln. (J"- o
c� C3 rl
Second Line of Address Q
C ~ f' M
City or Post Office -0 DAMFILE&'� C>
State ZIP Code
Hopewell PA 16650
Correspondent's e-mail address:avalont_bedford.net
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete. eclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN PERSO SIBLE FOR FILING RETURN ATE
ADDRE
Avalon Ln., Hopewell, PA 16650
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105
1505610205
WiJ
i
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's Name: Helen B. Massie
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. ,° 0.00
2. Stocks and Bonds(Schedule B) ...............
...... ................ 2. 244,690.00
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. . 41,476.89
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets(total Lines 1 through 7)............................. 8. • 286,166.89
K
Expenses and Administrative Cost
9. Funeral Ex
pe s(Schedule H).................... 9. 5,727.02
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 2,383.67
11. Total Deductions(total Lines 9 and 10).......:.......:.................. 11. 8,110.69
12. Net Value of Estate(Line 8 minus Line 11).............................. 12. 278,056.20 .
: _ .....-_-,__..�._-_.___.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .. • ,• .
an election to tax has`n6f been made(Schedule J) ........................ 13. 79,996.86
14. Net Value Subject to Tax(Line 12 minus Line 13) ......"................. 14. , 198,059.34
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0- " ! 16.1
17. Amount of Line 14 taxable"
at sibling rate:X.12 1, 17.
18. Amount of Line 14 taxable ,198,059.34 s 29,708.90;
'at collateral rate X;15 t 18.: '
19. TAX DUE ......................."..............."................. 19. 29,708.90
20. FILL IN THE OVAGIF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C '
Side 2
L 1505610205 1505610205
REV-35o3 EX+(8-u)
i pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Helen B. Massie 21-13-1074
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' IRA Regular-Susquehanna Finacial Advisors;account FFC000493
244,690.00
TOTAL(Also enter on Line 2, Recapitulation) $ 244,690.00
If more space is needed,insert additional sheets of the same size
REV-15o8 EX+(o8-l2)
SCHEDULEE
�, pennsylvania
' DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Helen B. Massie 21-13-1074
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Member's First checking account 5,334.51
2. Member's First savings account 54.16
3. Wells Fargo checking and savings accounts 21,953.65
4. Cash in wallet 95.50
5. Proceeds from sale of apartment furnishings 450.00
6. 2009 Toyota Corolla LE good conditon 11,400.00
7. Proceeds from sale of coins and silverware 1,233.00
8. Proceeds from sale of old jewelry 112.00
9. Prerpaid minutes on phone 216.29
10. Coins and bills and 45 pound notes found in house 173.12
11. Insurance refunds-car,renters 37.00
12. Magazine refund 7.47
13. Comcast refund 48.07
14. U.K.final pension payment 39.83 pounds 63.73
15. Security deposit and rent refund 298.39
TOTAL(Also enter on Line 5, Recapitulation) $ 41,476.89
If more space is needed,use additional sheets of paper of the same size.
REV-15.11 EX+(08-13)
i 'Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Helen B. Massie 21-13-1074
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Jesse Geigle Funeral Home-gifts registry transport,death certs and obit 774.89
2. Taraland Granite Works-engrave stone 250.00
3. Estate Notice-Patriot News 158.03
4. Estate Notice-Cadise Sentinel 147.06
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 2,000.00
Name(s)of Personal Representative(s) Linda M. Gunn
Street Address 173 Avalon Ln.
City Hopewell State PA ZIP 16650
Year(s)Commission Paid: 2014
2, Attorney Fees:
0.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
0.00
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 463.50
5. Accountant Fees: 750.00
6. Tax Return Preparer Fees:
7. Postage to mail mementos and geneology notebooks to UK and Austrailia 341.43
8. international long distance to notify people of death 135.86
9. Reimburse Executrix tolls and mileage-three trips Harriburg/Carlise 206.30
10. Susquehanna Financial-brokerage fees to close account 404.45
11. Copies and postage 95.50
TOTAL(Also enter on Line 9, Recapitulation) $ 5,727.02
REV-1512 EX+ (12-12)
SCHEDULE I
♦, pennsylvania
lib DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Helen B. Massie 21-13-1074
-Report debts 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. Long Meadows Assoc.-water bill through 8/30 44.97
2. Community Life Team-ambulance 40.00
3. Heartland Pharmacy of PA 49.74
4. UGI final gas bill 19.70
5. Pinnacle Health Care-copay Misas 30.00
6. Long Meadows-final water bill 17.39
7. PPL final electric bill 81.87
8. Hospice of Central Pennsylvania -October final bill 1,500.00
9. IRS-final personal income taxes 600.00
TOTAL(Also enter on Line 10, Recapitulation) $ 2,383.67
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Helen B. Massie 21-13-1074
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
2 TAXABLE DISTRIBUTIONS{Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
1. Patricia A.Ross;335 Wesley Dr.,Mechanicsburg,PA friend car;1/3of70%residue
2. Linda M.Gunn;173 Avalon Ln.,Hopewell,PA friend 1/3of70%residue
3. Esther M.Witmer; 1528 Main St.,Mechanicsburg,PA friend 1/3of70%residue
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.
Helen 0.Krause Animal Foundation; Mechanicsburg,PA 1/4of30%residue
2. The Ronald McDonald House; Hershey,PA 1/4of30%residue
3. PAWS; Camp Hill,PA 1/4of30%residue
4. Compassionate Hearts Animal Rescue; Mechanicsburg,PA 1/4of30%residue
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.
I, HELEN B.MASSIE, of East Pennsboro Township, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death,whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my death as a part
of the expense of the administration of my estate.
ITEM II. I hereby make a specific bequest to my friend PATRICIA A. ROSS of any
automobile that I may own at the time of my death.
ITEM III. I direct that my Executrix shall divide whatever personal property I have at
the time of my death in accordance with a directive that I have placed with my last Will. In the
event that there is any personal property that is not specifically referenced, I give my Executrix
full authority to distribute or dispose of that property as she deems appropriate.
ITEM 'V. I give, devise,and bequeath all the rest, residue,and remainder of my
possessions and estate of every nature and wherever situate as follows:
A. Seventy (70%)Percent to be divided evenly among the
following individuals or the survivor of them who survive my death by
thirty(30)days:
1. My friend PATRICIA A. ROSS of 335 Wesley Drive,Apt.
226, Mechanicsburg, Pennsylvania;
2. My friend LINDA M. GUNN of 173 Avalon Lane,Hopewell,
Pennsylvania; and
3. My friend ESTHER M. WITMER of 1528 Main Street,
Mechanicsburg,Pennsylvania.
B. Thirty(30%)Percent to be divided evenly among the
following charities:
1. HELEN O.KRAUSE ANIMAL FOUNDATION of
Mechanicsburg,Pennsylvania;
2. THE RONALD McDONALD HOUSE of 745 West Governor
Road,Hershey, Pennsylvania;
3. PAWS of Post Office Box 855,Camp Hill,Pennsylvania; and
4. COMPASSIONATE HEARTS ANIMAL RESCUE of Post
Office Box 353, Mechanicsburg,Pennsylvania.
ITEM V. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM VI. I appoint my friend LINDA M. GUNN executrix of this my last will. Should
she predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I
appoint MICHAEL L. BANGS,Esquire,executor of this my last will.
2
ITEM VII. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind,or partly in cash and partly in kind,and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them;to
invest in all forms of property,including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper,without regard to any principle of risk or diversification;
to retain any or all assets of my estate,real or personal,without regard to any principle of risk or
diversification;to sell at public or private sale,to exchange,or to lease for any period of time,
any real or personal property and to give options for sales,exchanges,or leases,for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VIII. I direct that my personal representatives and fiduciaries shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF,I have hereunto set my hand this _day of
th 4Q4. 2012.
fiELEK B. MASSIE
3
♦ .A
... . . ..............
The preceding instrument,consisting of this and THREE other typewritten pages,each
i
identified by the signature of the testatrix was on the date thereof signed,published, and declared j
by HELEN B.MASSIE,the testatrix therein named,as and for her last will,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.
LVke-i
i
4
,.. .
x-;
Ax
:, �, :.,. �,
T,
tr Vii, t:}r. `.i i :eh'.1' - a .:.Y. .:Z.. s
'-. . . .Y .
1. 1
(SS:
COUNTY OF cuMBERLAND . )
The undersigned,being the testatrix whose name is signed to the attached or foregoing
instrument,having been duly qualified according to law,does hereby acknowledge that I signed and
executed the foregoing instrument as my last will,that I signed it willingly;and that I signed it as my free
and voluntary act for the purposes therein expressed.
NFi.F B.MASSIE
r; ed to and acknowledged
UFU;i� COMMONWEALTH OF PENNSYLVANIA
NOTARIAI SEAL
Wendy K.Straub, Notary Public
Lower Allen Township,Cumberland County
My Commission Expires Moy 10,2015
COMMONWEALTH OF PENNSYLVANIA (SS.
COUNTY OF CUMBERLAND/ )
WE, L and ���.1 �ul�' S the
witnesses whose names are signed to th attached or forego' g
instrument,bein qualified according
to law,do depose and say that we were present and saw the testatrix sign and execute the instrument as
her last will;that she signed it willingly and that she executed it as her free and voluntary act for the
purposes therein expressed;that each of us in the hearing and sight t t the time testatrix
or signed re the ears of age,of
witnesses;and that to the best of our knowledge,the testate
sound mind,and under no constraint or undue influence.
Sworn or affirmed told acknowledged
befog o day of
2012.
o Public
COMMO ( ALTH OF PENNSYLVANIA
NOTARIAL SEAL
Wendy K.Straub, Notary Public
Lower Allen Township,Cumberland County
My Commission Expires May 10,2015
5
. , .
_ r _ _ .-. -
. . �,
,,
Holdings by Investor
Helen B Massie Edward P Gormley CPA,CFP® Combined Account Portfolio
2a Richland Ln Apt.T3 Susquehanna Financial Advisors Date: 10/04/2013 �-
Camp Hill,PA 17011 LLC Created: 10/22/2013
SUS��i�-��,l�NA 4999 LOUISE DRIVE
1,Znanm1 AdvL":Fi,w SUITE 101
MECHANICSBURG,PA 17055
717-506-2100
Helen B Massie
Acct Name:NFS/FMTC IRA FBO HELEN B MASSIE 2 RICHLAND LN APTT3 CAMP HILL PA 17011
Acct No:FF0000493 Acct Type:IRA Regular
Rep.No:G66
Asset Name Ticker Asset Type Mgt.Name Quantity Price{$) Value{$)
AMERICAN FUNDS EUROPACIFIC AEGFX INTERNATIONAL AMERICAN 405.59 46.23 18,750.29
:GR F EQUITY FUNDS
AMERICAN FUNDS GR FND OF GFAFX LARGE GROWTH AMERICAN 688.30 42.09 28,970.50
AMER F FUNDS
!FIDELITY ADV NEW INSIGHTS A FNIAX DOMESTIC EQUITY FIDELITY 1,091.48 27.86 30,408.52
FUNDS
i I
FIDELITY ADV STRATEGIC INC-A FSTAX FIXED INCOME FIDELITY 1,273.89 12.22 15,566.87
FUNDS
'HARBOR INTERNATIONAL INV HIINX NON-US STOCKS HARBOR 328.84 68.45 22,509.231
FUNDS
HARTFORD DIVIDEND&GROWTH A IHGIX DOMESTIC EQUITY HARTFORD 1,060.07 24.45 25,918.74
MUTUAL
FUNDS
'LA SHORT DURATION INCOME LALDX BONDS LORD,ABBETT 3,448.28 4.56 15,724.14,
FUND CLASS A &CO
MAINSTAY ICAP SELECT EQUITY ICSRX US STOCKS MAINSTAY 635.98 45.49 28,930.64
FUND A
[OPPENHEIMER DEVELOPING MKTS ODMAX INTERNATIONAL OPPENHEIMER 320.41 37.54 12,028.19;
IA EQUITY FUNDS
PIMCO TOTAL RETURN D PTTDX INTERMEDIATE- PIMCO FUNDS 1,459.76 10.83 15,809.23
TERM BOND -RETAIL
'PRIME FUND CAPITAL RESERVES FPRXX CASH FIDELITY 10,771.70 1.00 10,771.70;
,CLASS FUNDS
PRINCIPAL INVESTORS MID CAP PEMGX US STOCKS PRINCIPAL 1,002.71 19.25 19,302.07.
BLEND FUND CLASS A FUNDS
Account Total: $244,690.13
Investor Total: $244,690.13
Incomplete if presented without accompanying disclosure pages Page 1 of 2
Holdings by Investor
Helen B Massie Edward P Gormley CPA, CFP® Combined Account Portfolio
2a Richland Ln Apt.T3 Susquehanna Financial Advisors Date: 10/04/2013
Camp Hill, PA 17011 LLC Created: 10/22/2013
4999 ST st TG•� SUIT 101 DRIVE
lJ `-s�V-7,1. lAdzn'sorsuc SUITE 101
MECHANICSBURG,PA 17055
717-506-2100
Disclosure:
Advisory services offered through SSN Advisory,Inc..Securities offered through Securities Service Network,Inc.,member FINRA/SIPC.Securities
Service Network,Inc.,SSN Advisory,Inc.and Susquehanna Financial Advisors LLC are non-affiliated companies.Values are as of 10104/2013.We
believe the sources to be reliable,however,the accuracy and completeness of the information is not guaranteed.In the event of any discrepancy,the
sponsor's valuation shall prevail.
Performance data quoted represents past performance and does not guarantee future results.The investment return and principal of an investment
will fluctuate so that an investor's shares,when redeemed,may be worth more or less than original cost.The values represented in this report may
not reflect the true original cost of the client's initial investment.
For fee-based accounts only:The figures may or may not reflect the deduction of investment advisory fees.if the investment is being managed
through a fee-based account or agreement,the returns may be reduced by those applicable advisory fees.
The Information contained in these reports is collected from sources believed to be reliable.However,you should always rely on your statements
received directly from product sponsors.If you have any questions regarding your report,please call your representative.
The source data for the following accounts was provided by Fidelity:
FFC000493
Page 2 of 2
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