HomeMy WebLinkAbout12-23-13 RETURN FILED BY GAYE CHARLENE WOLF,
EXECUTRIX, FOR ESTATE OF ROSCOE C. WARD
� 150561D105
REV-1500 EX�oz_��,�F�, .ti:
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
�E Aw*�E��F aE�E��E County Code Year File Number
Bureau of Individual Taxes � INHERITANCE TAX RETURN
PO BOX z8o6oi
Harrisburg,PA 1�128-0601 RESIDENT DECEDENT ; 2� ' `� ���-�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_ _ _ _ __ _ _
',235-20-0975 '. 03/25/2013 ' 03/16/1923 '
DecedenYs Last Name Suffix DecedenYs First Name MI
'WARD ' ROSCOE C '
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
,N/A ' ' ' ; '
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_ REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return p 2.Suppiemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4.Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust � 8. 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 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
'JAMES D. CAMERON, ESQ. (717) 236-3755 '
REr6�5TER OF WILIT��SE O�£.Y��r�
C � G.,r� �
= x �� t'm"7 �.y
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First Line of Address ' ��� `�'� '�j
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1325 NORTH FRONT STREET � c�, �r� � �y; i�';
Second Line of Address � '
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City or Post Office State ZIP Code ,
HARRISBURG PA ' 17102 __ �x _., �� � �
, c.n
Correspondent's e-mail address:jdCesq@1oC21net.COm
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.
SIG E OF P ON R PONSIB� F ING ETURN �A�
0 3
ADD ES
11 E yn Lane, Mechanicsburg, PA 17050
SIGNATUR P ARER HER THAN REPRESENTATIVE DATE
% /,�-19-/3
A R S
1 North Front Street, Harrisburg, PA 17102
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 15056101�5 150561�105 J
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
oecedent's Name: ROSCOE C. WARD, DECEASED '235-20-0975 ,
RECAPITULATION
__
1. Real Estate(Schedule A). ..... ........ ............ .............. ..... 1. "', 0.00 ',
2. Stocks and Bonds(Schedule B) .................... ... ................ 2 ` 30.10 ''
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. �i 48,689.54 ;
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. ..... 6. i 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. ' 48,719.64 ;
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. l 9,700.66 ',
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)........... ... . 10. `; 5,236.82 '
11. Total Deductions(total Lines 9 and 10)............ ..................... 1L ' 14,937.48 '
12. Net Value of Estate(Line 8 minus Line 11) ... ... ... ................. .... 12. ', 33,782.16 ',
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ... ................. .... 13. 337.82 '
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. '; 33,444.34 '
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. 0.00
16. Amount of Line 14 taxable �"�� � � - - - _. .. . _m�
at lineal rate X.0 45 33,444.34 3 16. 1,505.00 �
._..�__.._ �_. _ _ .. � _ �� ___. _.,.w,. �. _....__.� .___,_ __._„_ ...,._. ..__.
17. Amount of Line 14 taxable ;
at sibling rate X.12 17. 0.00 I
_ _.. ,. ..__w_ ..._ �. _... ��...� �_.._._.. ______.. -
18. Amount of Line 14 taxable
at collateral rate X.15 �g, 0.00 ,
19. TAX DUE ........ .. ......... ................. ... .................. 19. 1,505.00 '
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
ROSCOE C. WARD
STREETADDRESS
4905 East Trindle Road
CITY ' STATE ', ZIP
Mechanicsburg PA ', 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,505.00
2. CreditslPayments
A.Prior Payments 1,500.00
B.Discount 78.95
Total Credits(A+B) (2) 1,578.95
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) 73.95
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS,AGENT.
�vu ��"e�^.'��..�k.s..�£_�.' ��.� ,.:-. . ..m�� � : �a '�i!�'� �N u r �?,r i �a q�^,^,s„.,„ }?�� ip'�� 4 . ,...
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..__.. ... ..s_..._.�;.>.x._:�.
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 ............................................ ❑ �
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?.............................................................................................................. � ❑
3. Did decedent own an"in trust for"or payable-upon-death bank acwunt 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? ........................................................................................................................ ❑ �
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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For tlates 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)j.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 imposetl on the net value of transfers from a deceased chiltl 21 years of age or younger at tleath 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 decedenYs 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.
REV-i5o3 EX+(8-iz)
� pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Roscoe C. Ward, deceased 21-13-0528
All property jointly owned with right of survivorship must be disciosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' .891 shares Exelon Corporation common stock 30.10
TOTAL(Also enter on Line 2, Recapitulation) $ 30.10
If more space is needed,insert additionai sheets of the same size
REV-15o8 EX+(08-12)
� pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX REfURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Roscoe C. Ward, deceased 21-13-0528
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
�, American Express(refund of overpayment on account) 14.95
2. Apria Healthcare(refund of overpayment on account) 2.g2
3. Apria Healthcare(refund of overpayment on account) 8.46
4. Birds and Blooms(refund on subscription) 10.00
5, Capital One(refund of overpayment on account) .pg
g, Cash received in mailings .10
7. Cigna account number 240718488(please see attached) g,42g.2g
g, Country Meadows Associates(refund of overpayment on account) 1,594.19
g. Country Extra(refund on subscription) 8.33
10. Erie Insurance(refund of unearned premium) 25.00
11. GE Pensioner Claim Center(health insurance payment) 90.01
�2. GE Pensioner Claim Center(health insurance payment) 5.23
13. GE Pensioner Claim Center(health insurance payment) 168.20
14. GE Pensioner Claim Center(health insurance payment) 4.54
15. GE Mutual Funds(net proceeds of sale executed prior to death) 14,875.93
16. Genworth Life(payment under long-term care policy) 4,867.00
�7. Glen Haven Memorial Park(refund of overpayment) 466.78
�g, Good Old Days(refund on subscription) �9.97
�g, Pentagon Federal Credit Union money market savinqs account 43474646-03-4(please see attached) 39.31
20, Pentagon Federal Credit Union(refund of overpayment on Visa account) 7.55
2�, Reminisce(refund on subscription) 13.71
22. Smithsonian(refund on subscription) 27.00
(please see attached continuation sheet)
TOTAL(Also enter on Line 5, Recapitulation) $ 48,689.54
If more space is needed,use additional sheets of paper of the same size.
Estate of Roscoe C. Ward, deceased
No. 21-13-0528
SCHEDULE E (continued)
23. State of West Virginia 7.50
24. The Limbaugh Letter (refund on subscription) 17.47
25. Wells Fargo Bank savings account number 3000233304583 1,574.88
(please see attached)
26. Wells Fargo Bank checking account number 1000046757507 8,793.13
(please see attached)
27. Wells Fargo Bank certificate of deposit ending in 2093 7,611.61
(please see attached)
28. Wired (refund on subscription) 7.50
REV-1510 EX+(08-09)
. � pennsylvania SCHEDULE G
�� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERifANCETAXRErURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Roscoe C. Ward, deceased 21-13-0528
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM D.ESCRIPTION OF PROPERTY
INQUDE THE NAME OF THE TRANSFEREE,THQR REIATIIXJSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF 1MNSFER ATfACH A COPY OF THE DEED FOR REAL ESTAIE. VALUE OF ASSET INTEREST iF arrucne�� VALUE
1• One-half interest as joint tenants with right of survivorship in 51.6813 shares g�,151.98 50% 3,000.00 0
General Electric Company stock given to Ronald G.Ward(child)01/31/2013
2 One-half interest as joint tenants with right of survivorship in 51.6813 shares g1,164.90 50% 3,000.00 , 0
'General Electric Company stock given to Rickey D.Ward(child)0210512013
3 One-half interest as joint tenants with right of survivorship in 51.6813 shares ' g1,164.90' 50%0 3,000.00 0
General Electric Company stock given to Mark B.Ward(child)02/05/2013
TOTAL(Also enter on Line 7, Recapitulation) $ ; 0.00 -
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
� pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Roscoe C. Ward, deceased 21-13-0528
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Glen Haven Memorial Park 2,519.16
2. Rev. Dennis Fulk(honorarium--service at Country Meadows) 1,000.00
3. Rev.Steve Sheldon(honorarium--service at Wrightsdale Baptist Church) 200.00
a. Wrightsdale Baptist Church(luncheon following service) 300.00
5. Janet Welch(honorarium--organist) 75.00
s. Diane Huat(honorarium--church secretary) 50.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2• Attorney Fees:
5,000.00
3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 178.50
5. Accountant Fees:
6, Tax Return Preparer Fees 250.00
�• Cumberland Law Journal(legal advertising) 75.00
8. The Paxton Herald(legal advertising) 48.00
s. Register of Wills of Cumberland County(purchase additional short certificate) 5.00
TOTAL(Aiso enter on Line 9, Recapitulation) $ 9,700.66 `
If more space is needed,use additional sheets of paper of the same size.
Rev-lsiz Ex+(12-12)
� pennsylvania SCHEDULE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABILITIES &LIENS
RESIDENT DECEDENT
ESTATE OP FILE NUMBER
Roscoe C. Ward, deceased 21-13-0528
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• Elfun Society(check written prior to death which cleared after death) 20.00
2. Diamond Pharmacy(medical expense not covered by insurance) 70.73
3. West Shore EMS(medical expense not covered by insurance) 134.18
4. United States Treasury(tax due per Form 1040,tax year 2012) 74.00
5. Verizon(final bill) 40.91
6. Genworth Life(refund of overpayment on long-term care policy) 4,867.00
TOTAL(Also enter on Line 10, Recapitulation) $ 5,236.82
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
-.,
� ��� : pennsylvania SCHEDULE �
( DEPARTMEMT OFREVENUE
INHERITANCE TAX REfURN BEN EFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Roscoe C. Ward, deceased 21-13-0528
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• Please see attached.
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:
L
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.
Estate of Roscoe C. Ward, deceased
No. 21-13-0528
SCHEDULE J (continued)
I.Taxable Distributions:
G. Charlene Wolf child 21% residue
11 Emlyn Lane
Mechanicsburg, PA 17055
Ronald G. Ward child 16% residue and
1747 Trestle Street 100% Schedule G.1.
Mt. Airy, MD 21771
Rickey D. Ward child 16% residue and
24604 Showbarn Circle 100% Schedule G.2.
Damascus, MD 20872
Mark B. Ward child 16% residue and
101 Vanderbilt Circle 100% Schedule G.3.
Locust,NC 28097
Christopher Dulany grandchild 2% residue
1526 62°d Street
Emeryville, CA 94608
Derek T. Wolf grandchild 2% residue
2093 Ashbury Drive
Harrisburg, PA 17112
Rachael A. Ward Tucker grandchild 2% residue
5669 Winsor Drive
Stanfield,NC 28163
Marci L. Ward McLain grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
Nathaniel B. Ward grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
SCHEDULE J (continued)
Matthew R. Ward grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
Christina V. Ward(minor) grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
James T. Ward(minor) grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
John C. Ward(minor) grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
Timothy M. Ward (minor) grandchild 2% residue
101 Vanderbilt Circle
Locust,NC 28097
Shannon E. Ward grandchild 2% residue
24604 Showbarn Circle
Damascus, MD 20872
Ross D. Ward (minor) grandchild 2% residue
24604 Showbarn Circle
Damascus, MD 20872
Hannah M. Ward grandchild 2% residue
24604 Showbarn Circle
Damascus, MD 20872
Kyle S. Wolf grandchild 2% residue
11 Emlyn Lane
Mechanicsburg, PA 17055
Britney L. Wolf grandchild 2% residue
11 Emlyn Lane
Mechanicsburg, PA 17055
SCHEDULE J (continued)
II. Non-Taxable Distributions
B. Charitable and Governmental Distributions:
Wrightsdale Baptist Church 1% residue
310 Little Britain Road S.
Peach Bottom, PA 17563
LAST WILL AND TESTAMENT
OF
ROSCOE C. WARD
I, ROSCOE C. WARD, of the Township of Hampton, County
of Cumberland and Commonwealth of Pennsylvania, do hereby make,
_._.�.. �__�.._.�., .. ._--.._. _ _ _ .:_.._ .� _ ._ _. _ _ __.
publish and d�ciare this to be my Last Wi1l and Testament,
hereby revoking all prior wills, codicils and testamentary
writings . This Will does not govern and shall not be deemed to
limit my right to make or change beneficiary designations or re-
title my assets at any time .
ARTICLE I : '
- T give all of my estate after payment ��f debts, costs
of adtministration and taxes, including lifetime taxes���nd estate
or inheritance taxes on property passing under' this `wi:ll, all of
which shall be paid out of the pr�nr,ipal of the residue of my
estate as if they were expenses of administration, as follows :
A. I give sixty-four percent (64�) thereof in four
(4) equal share.s, per stirpes, 'to my children, RrJNALD G. WARD,
RICKEY D. WARD, GAYE CHARLENE WOLF and MARK B . W:�RD.
B. I give two percent (2%) each to my fifteen (15)
grandchildren, CHRISTOPHER DULANY, SHANNON E. WARD, ROSS D.
WARD, HANNAH M. WARD, DEREK T. WOLF, KYLE S . WOL�, BRITNEY L.
WOLF, MARCI L. WARD, RACHAEL A. WARD, NATHANIEL B . WARD, MATTHEW
R. WARD, CHRISTINA V. WARll, JAMES T. WARD, JOHN C. WARD and '
TIMOTHY M. WAR�.
C. I give one percent (1�) to WRIGHTSDALE BAPTIST
CHURCH.
D. I give five percent (5%) to GAYE CHARLENE WOLF if
she survives as Executrix hereunder. If she does not, I give
this gift in equal shares to those taking under paragraph A of
this Article .
ARTICLE II
If any beneficiary hereunder has not attained twenty-
- ......_ ..��•<....,���"�:_ .�:�v�s-,_:�.��--^�^�..,�.�:. , �,�i!.�`�.,,�~3'�R1t?- :'��,.,;��r. ��,�,,�.� {*kt.�.t __
beneficiary' s share shall be paid to a custodian named by my
personal representative under the Uniform Transfers to Minors
Act in effect at the time of my death in the jurisdiction in �
which my estate is settled. This custodianship is to continue
until the time said beneficiary attains the age of twenty-one
(21) years . I= no Uniform Transfers to Minors Act is in effect
in such jurisdiction, my personal representative ~nay elect to
appoint a fiduciary pursuant to a substantially e�uivalent Act
in such jurisdiction. In the absence of a Unifor:n Transfers to
Minors Act or an equivalent, as determined in my personal
representative ' s sole discretion, that beneficiary' s share shall
be paid to a custodian under the Pennsylvania Transfers to
Minors Act in effect at the time of my deatYi. T authorize my
personal representative to select any person or trust company,
including my personal representative, to serve as custodian or
fiduciary.
ARTICLE IIT
I nominate, constitute and appoint GAYE CHARLENE WOLF
to be the E�ecutrix of this my Last Will and Testament, and in
the event that GAYE CHARLENE WOLF should be unable or unwilling
2
to serve in said capacity, I do then nominate, constitute and
appoint RONALD G. WARD to be my Executor. I direct that my
Executrix or Lxecutor shall not be required to post bond or
sure�ies in any jurisdiction.
IN WITNESS WHEREO�, I have hereunto set my hand and
seal this ���"h day of �C� , 2013 .
�E�j,sQ, �-' /"� �4�1/,� (S EAL)
ROSCOE C. WARD
SIGNED, SEALED, PUBLISHED and DECLARED by the above-
named Testator, as and for his Last Will and Testament, in our
presence, who in his presence, at his request and in the
presence of each other, have hereunto set our hands and seals as
a esting witnesses .
_... .
(S EAL) L�C/ (S EAL)
3
Estate of Roscoe C. Ward, deceased
No. 21-13-0528
EXPLANATION OF APPLICATION OF TAX PAYMENTS
On June 25, 2013, the Estate made a payment on account of Inheritance Tax due, in the
amount of$1,500.00. This payment is shown on page 3 of the REV-1500 filed by the Estate, on
line 2.A. of the section titled "Tax Payments and Credits". The Discount shown on line 2.6. of
this same section, $78.95, is calculated upon the $1,500.00 payment on account. A copy of the
Receipt for the payment is attached to the Return.
On the same date, the decedent's daughter, Gaye Charlene Wolf, in her individual
capacity, also made a payment on account of Inheritance Tax due, in the amount of$2,000.00.
This payment was made to the same file number as the Estate, but is intended to be payment
for tax due as calculated on a separate Rev-1500 filed by Mrs. Wolf, herself, (the same being
filed contemporaneously with the filing of this Return) reporting jointly-owned assets and lifetime
transfers, as well as related deductions.
Both payments on account have been credited to the same Revenue file number(there
being only one decedent but two Returns). Only $1,500.00 is to be applied against the tax due
on this REV-1500, filed by the Executrix. The second payment, of$2,000.00, is to be applied
against the tax due upon the separate REV-1500 filed by Gaye Charlene Wolf, individually,
under the same Revenue file number.
COMMONWEALTH OF PENNSYLVANIA � � � - � � � ' REV-1162 EX111-y(i)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES - -
DEPT.280601
HARFISBURG,PA 17128-0601 r� � f
PENNSYLVANIA '� ''
RECEIVED FROM: INHERITANCE AND ESTA,,^�E,7"qX , �`"' �"�: i
OFFICIAL RECEIPT, t -�-.- • � - � -•
�NO. CD 017790
WOLF GAYE CHARLENE
11 EMLYN LANE
MECHANICSBURG, PA 17055-8017
` ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
"""'" fold _____""'
101 � $1 ,500.00
ESTATE INFORMATION: ssN: 235-20-0975 I
FILE NUMBER: 2113-0528 I
DECEDENT NAME: WARD ROSCOE C �
DATE OF PAYMENT: 06/25/2013 I
POSTMARK DATE: 06/24/201 3 (
COUNTY: CUMBERLAND �
DATE OF DEATH: 03/25/2013 �
�
TOTAL AMOUNT PAID: 51 ,500.00
REMARKS: RCPT TO ATTY
CHECK# 1001
INITIALS: DB1
sEa� RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
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1_..�._.iL----- �-��--r•----- -----�----`-�-----�- --- -�- � - - -- - -.. i_ _ n.•_. . • . .t • �ni�inn�n
' -_.1 _....._ .
Tammy D.5059410
Client Services Specialist
;
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JUL 1�S 2013 ` °��---
Cignao-
JUIy 8� ZO13 PO Box 22328
�r�r�Nr�to�o�a��r�°�arwsW
Pittsburgh, PA 15222-0328
Telephone 1-800-Z38-2125
Facsimile 412-402-3221
James D Cameron, Esq
1325 North Front St
Harrisburg, PA 17102
Account Holder Name: Roscoe Ward
— ----�+cc�uirt Numl��r: _ _ 2407-�8488 _ _ _ _ _ . _ __
Dear Mr. Cameron:
This is in regards to a letter that we received on the above referenced CIGNAssurance� account.
I am sorry to learn of the death of Roscoe Ward. The above account is an interest bearing
account that was set up based on Roscoe Ward being named a beneficiary on Virginia Ward's
Group Term Life insurance policy. The account opened on July 21, 2007 and earns a variable
y - Py e nd the value of the ac�count as of todayl Is I$8,4 `
monthl interest that is ost "" "
i 1.56. Accrue
interest since a e o eat is $3.28. There are no beneficiaries listed on this account. This
account is only payable to The Estate of Roscoe Ward.
We have processed your request to close the account. You should receive a check made payable
to the Estate of Roscoe C Ward within the next week. There are no other accounts in Roscoe
Ward's name.
If you have any questions, please call me. You can reach me at our toll free number
1.800.238.2125,extension 5059410 from 6:30 a.m. to 3:00 p.m. Eastern Time, Monday through
Friday. If you call and get my voice mail, leave a message and your call will be returned within
one business day.
Sincerely,
�I'ammy 1�. SOS9410
Tammy D. 5059410
CIGNA Group Insurance is a registered service mark of CIGNA Intellectual Property,Inc.,licensed for use by insurance company subsidiaries of CIGNA Corporation,induding
Life Insurance ComPany of North America,CIGNA Life Insurance Company of New York and Connecticut General Life Insurance Company.Products and services are provided
by these insurance company subsidiaries and not by CIGNA Corporation.
i��
"' PENFED
PENTAGON FEDERAL CREDIT UNION Box 247009,Omaha,NE 68124-7009 800.247.5626 PenFed.org
June 7,2013
Mr.James D.Cameron, Esq. RE: Roscoe C.Ward
1325 North Front Street File#: 3116356
Harrisburg,PA 17102
_ - -- - - � ---
___ .__ _. .-- - _ __-- -_
_ _-- _ -- - - ----
_..___. . __ : ___-- -�;__
Dear Mr.Cameron,
This letter is in response to Ms.Gaye Charlene Wolf's request as Executrix of Mr.Ward's Estate.
Our records confirm the following ownership for Mr.Ward's accounts with PenFed:
Account# Account Tvpe Ownership Tvpe Joint Owner(s)/Co-borrower
******6-01-9* Share Savings Joint Owner With Survivorship Gaye Charlene Wolf
******6-03-4* Money Market Savings Individual N/A
******9-56-0** Money Market Certificate Joint Owner With Survivorship Gaye Charlene Wolf
************0784* Visa Platinum Credit Card Individual N/A
- *These accounts were all opened on April 2,2008 with no changes in ownership requested.
*�`This account was opened June 2,2010 with no change in ownership requested.
Please find below the date of death values for Mr.Ward's deposit accounts per your request:
Account Number Principal Balance Dividend Accrued Total DOD Balance
******6-01-9 $5.00 $0.00 $5.00
******6-03-4 $39.31 $0.00 $39.31
******9-56-0 $5,662J0 $1.11
$5,663.81
If you have any further questions, please contact us at 1(800)247-5626.
___.—�_--- --
_ ---_—___ ----.. ------
_ _ ___. -----_._
__�---- --_-___——- . _�..____ ------
Sincerely, ----- —
C�i9��� _
Chandra Varn
Estate Account Specialist
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