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HomeMy WebLinkAbout12-05-13 l t 1505610140 REV-1500 EX OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Cade Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 1 2 1 6 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 1 0 2 2 2 0 1 3 0 9 0 6 1 9 2 8 Decedent's Last Name Suffix Decedent's First Name MI S 0 U D E R R A L P H 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 IN APPROPRIATE OVALS BELOW Q 1. Original Return 0 2.Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 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 8,Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9.Litigation Proceeds Received E] 10-Spousal Poverty Credit(date of death El 11.Election to tax under Sec. 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 R O G E R B I R W I N E S Q U I R E 7 1 7 N 9 2 3 5 3 aEGISTE -OO WiLk LY C? - -rj CrnD W First line of address W M M I R W I N & M C K N I G H T , P - C - cCn uT CZ7 Ti C> % Second line of address O "XS -n 6 0 W E S T P 0 M F R E. T S T R E E T �c fir' M City or Post Office State ZIP Code -tb--=- TE FICED C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address: 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.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. 61 ATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE t.�,-t•� Slate I X_ y - I ADDRESS 1230 CLAREMONT ROAD CARLISLE PA 17015 SIGNATURE PREPARER OTHER TAN REPRESENTATIVE DATE lj- 3 ADDRESS 60 WEST R0 RET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J J 1 r Ofi20'C9505'C 0h20495052 Z apis iN3WAVdH3AO NV d0 ONnnti V'SNUS3n03N 3NV nOA di lVAO 3H1 N1111:1 OZ -6t _.. ._.. ... .. ... ._ ... ... .. ... .. ... ... ...... .. .... .. 3n0 XVi '6t 0 0 • o 0 0 ' 0 st 0 0 ' 0 4 algexelL aull;olonowv st 0 D • 0 Li 0 0 0 Zt'X elei hulas le olgaxel bL cull to lunowV 'LL 0 0 ' 0 -9L 0 0 . 0 —0.x ales leauil le algexel 4 L aull to lunowV '9L 0 0 . 0 -9t 9 0 "C 5 R 5 0 2 — o x(Z"0(8) 9L L6'oaS japun s/alsuejl jo'elej xel lesnods 041 le algexel YL au!l to lunowV 'g S31YU 319VOilddV NOd SNouonaiSNJ 33S•NOI1VlnolVo xVl 9 0 * T 5 R 5 0 1 vt . .. .. ... ... ........ . .. (£t cull snuiw Z ouil)"i of l0ergnS anleA 19N K ' -£t . .. . ..... ..... . . .. . .. (f alnpa4oS)apew uaaq lou se4 xei of u0pale ue 4o14m jol slsml£L L6 oaS/sisanbaS Ielu8wulano0 Pue algellle4o '£L 9 0 "C 5 2 5 0 T Zt .. .. ........ ... ..... . .. ... .. (Ltaui lsnuiwgauil)ale4s3loanieAlaN ZL 0 5 ' E I L 9 t L .. ... .. ..... ... ........ ... ... .. (OL Pue 6 scull lelol)suollonpe0 lelol It • 'OL .'' '' ''' '' ' (I alnpa4oS)suoil pue`sall!ligell a6e6lioW luop0000 to slgao 'OL 0 5 * E 2 L 9 -6 . .. .. . .. ... .... ... (H ainpagoS)slso0 angeilslulwPV pue s0suadx3 IeJaund '6 9 5 h 9 8 T T T .8 () 46nowgl t scull lelol)slassV ssa0 JInoI -8 .L . ... . . . palsanbad 6u!IIIe aleledaS (O alnpe4oS) Ayadmd alegoad-u N sno0ue1100sgry g sialsueJl sonlA-lalul 'L .9 palsanbaa 6upll13 aiejedaS (d alnpa4oS)Ryadwd paum0 dpulor '9 "(3 alnpa4oS)6lladwd leuosJad snoauellaosllry pue sl!soda0 Hueg '4seo '9 .� . .... . .. .. . ... . . .. . . . . . . . . (Cl alnpa4oS)algenle0ad saloN Pue sa6e6laop4 'q • '£ (o alnpa4oS)digslola4doid-aloS to dl4w9uPBd 'uogeiodlo0 PIOH Alasolo '£ 9 5 h 9 B 2 2 2 ,Z . ... . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. (S alnpa4oS)spuog pue sXoo1S 'Z ' .L . . .. . . . ... . .. .. . . . .. . ... . . . . . . . . . . . . . . . . . . (V 9lnpa4oS)alels3 IBG'd 't NOI1VlnlldV33N X3 009 L-AMI Ofi20z990SZ r REV-1503 FX+(8-12) pennsyivania SCHEDULE B DEPARTMENT INHERITANCE STOCKS & BONDS INHERITANCE TAX RETURN N n RESIDENT DECEDENT ESTATE OF FILE NUMBER RALPH L. SOUDER 21 13 1216 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. AMERIPRISE FINANCIAL-ACCOUNT#0930 0147 0676 4 004 62,006.93 2. AMERIPRISE FINANCIAL-ACCOUNT#0930 0410 8404 5 004 49,857.63 TOTAL(Also enteron Line 2,Recapitulation) $ 111 864.56 If more space is needed,insert additional sheets of the same size REV-7511 EX-(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER f RALPH L. SOUDER 21 13 1216 f Decedenfs debts must be reported on Schedule t. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Years)Commission Paid: 2. AttomeyFees: IRWIN&McKNIGHT, P.C. 6,000.00 3, Family Exemption:(If decedents 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 33&50 6 Accountant Fees: 6. Tax Return Preparer Fees! PATRICIA A. ROSENDALE, CPA 375.00 7. TOTAL(Also enter on Line 9,Recapitulation) $ 6,713.50 If more space is needed,use additional sheets of paper of the same size. REU-55'13£X+(Ct-107 pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER; RALPH L. SOLIDER 21 13 1216 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 dWbutlons and transfers under Sec.9116(a)(1.2).] 1. PATRICIA A. SOLIDER Spousal 105,151.06 1230 CLAREMONT ROAD REMAINDER CARLISLE, PA 17015 ENTER DOLLARAMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. ll. 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 If-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. II I11111101111111111IIIIIIN III IIIIIINN11111111R[I III IIIIII1111 llll1111111111 MGM .JOHN VZ00000 L-ma «I sill m 'rn o � ma °f m pC (p O (O (O ice, O N G c 47 10n oN1 O 0 rn O O .0 'a fR M LO f9(9 (A OA m t m O H ,M N O N W > ° N C c� eC> tV 1,0 R P" O^ ti E m C am •�U C V M0 M .. O G E O+ m (p V (O N U � a u! t9 1A vi m h a H (y C ,m tom, d O T N H (p to ? m « c c y G O CD CD o°a O O 000 00 m N w g y 00 °1 O q O c0 N W " � 1� N W O O U« N O 0 N Oi y O a C 0 N M� z 1«GO 0 3 0 E a o « ° 3y ceD o- mtm me wErom (NO m ('moo °..° aMO• o '" a o . Y ryy� o ro Cj O M -M (o �' � � �= m — N � N Vm (n 'yam O) N M M m j 0 O (OO 1� m ccoo l� (ND � ""� M � y ; C a U O C BFI a fA t9 C f9 f9 to f9 f9 N UO (qE o 0 00 0 �° � � o � q °xc ►_�+ �� co CD ` O O OO 100 a m o CL M M M m a3 ° 13 0 = rn rn rn rn rn a o h v N E a C g °o o M o 0 00 0 � m ,9 " s (°, � � � C N (o L y0 G U C m Z' N o �C GQm T = N (O N N G EO E .m � o in ([i 3 -Qc m L e ° a C) 00 o 0 a Q� U mo $ m � 3 ° E ° ° o ` ° a « o' m O ¢ � bp ao , 3E «? da a m = ae a Ems° c oc m n a L1 L N O2- p ¢ C-ni QQ ¢ (6 z m LU m m o > > a om O — ❑ -� � U O L m E ca � m m m „yo mc H� Na°. M O N W ¢ W � y « Q cm � a°i � yr10 J � JJ ii ' J .o � 'X- c m 0 3 m � N o.a UO W S W y Q w (i ¢ = m t OJ ° cum c°i � NEto, � >r3x ¢ m yNd mv-. tn ¢ C Via ° '? C 'co E Q � � Ric Q U1 Q Q g m E y °7 Q > O � 0 ¢ o m m V U o. ♦ ♦ ♦ ♦ Cm � mmmny «. m a a � w 8 v in rn .°, ♦ C o a in a m m o 0? lz N Pj O tV al N N }�.I i a W H Q�iTn a M @ a > o O LO 2 ei i " e i C) `o cui° d a � o g $ N a O cl LL tl 9 {S. rf O r4 y t > c O j E f70 00 M CJ G S 5. a ftl O fJ O n O fn N N °u 0 ANA ¢ z, q w c y p G er-t > q - O aR a O t ; O O QQ $i� ppy O O ��qq m 0 H CL p u� o m e'S W .i O w w w w w w > O m ao 00 00 00 y�� E co N p p w CN OD Ix S I- O m .p a O n O N N O r M n a � mi CN o aca ffi m m m E Z 0 C14 W n n O > Z p' o a C'4 E Q - d o LO arrnm nj aom t $ 7 N CD wIr 00"�'� '� i ~ N CN NO a " za bmfi ui o cqv ro O p E E _ !9 .y g� m IL u!•C Q Cl m a c m o ti .` d So .� G N C/) d � m z � l W zc'ciw LAST WILL AND TESTAMENT I, RALPH L. SOURER, of Middlesex Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executrix to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate to my wife, Patricia A. Souder,providing she shall survive me by sixty days. 4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my son, Shane L. Souder, and if he is not living at the time of my death,to his children, share and share alike. 5. I nominate and appoint Patricia A. Souder to be the executrix of this my Last Will and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Shane L. Souder, as substitute executor, also to serve as such without bond, with the same powers as are given herein to my executrix. 6. 1 hereby suggest that my personal representative retain the services of Irwin, i 4 McKnight&Hughes,as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seat this 23RD day of April, 1997. V.ALPH L.SOLIDER Signed, sealed, published and declared by RALPH L. SOLIDER, the above named testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. 2 b D ACKNOWLEDGMENT AND AFFIDAVIT WE, RALPH L. SOUDER, CHERYL L. CLELAND and MARTHA L. NOEL, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly swom, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. p PH L.SOLDE L RYL L. CLEL MARTHA L.NOEL COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by RALPH L. SOLDER,the testator herein, and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL,witnesses,this 23RD day of April, 1997. otary Public Notadal Seal Roger B in Notary Public Carlisle flora,Cumberland County My Commisswn Expires Oct.3,2000 Member,Pennsylvania Association of Notaries