HomeMy WebLinkAbout02-21-14 1 1505610105
REV-1500 EX(o2-��)(FI)r1!2;
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number
i -'
_ Harrisburg,PA 17128-o6o1 RESIDENT DECEDENT �� J 13 (Q I
EI 'IR DECEDENT INFORMATION BELOW
S at Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08/10/2013 03/07/1921
Decedent's Last Name Suffix Decedent's First Name MI
Mackenzie i 1—Jr— Donald
Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
C _ __-_ __ _ Tl C
Spouse's Social Security Number
—r THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER.017 WILLS
FILL IN APPROPRIATE OVALS BELOW
CD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate C=) 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
M 6.Decedent Died Testate O 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 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 TO:
Name Daytime Telephone Number
Richard S. Friedman, Esq. (717)234-3441
REGISTER OFI1LZS USE ONLY..!
--rl
First Line of Address _t; �� ' c-D
—
1300 C1 00 N. 2nd St. ------_____�—____-_ -----.� -r
Second Line of Address C_ I'
..Suite 402
City or Post Office �—Stta-tee ZIP Code DATE FILED
Harrisburg I PA [17101
-JL.__�_ I
Correspondent's e-mail address: rsf13 @live.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.
SIGN_ATURE,OF Mel SP NSIBL F FILIN ETURN, DAT
°ADDRESS Sandra LJV MCN1CPZ0 , Executrix
110 Strayer Dr., Carlisle, PA U15
SIGNATURE OF PREPARER OTHER T41AN REP ESENTATI D T�/
ADDRESS Richard �S. Friedman, Esquire
300 N. 2nd St., Suite 402, Harrisburg, PA 17101
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's Name: Donald Mackenzie, Jr.
RECAPITULATION
- .-...__ ----........._,.__.... -.......--....--._...__,.
1. Real Estate(Schedule A). ... . . .. ... ..... . .......... .... .............. 1.
2. Stocks and Bonds(Schedule B) . . .. ........ ..... . ...... ..... .......... 2. 3,223.20
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D) . ........ . . ... ........... .. 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 250,900.86
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested... . . . .. 7. 147,920.89
8. Total Gross Assets(total Lines 1 through 7).... . . ...... ... . . . ..... ...... 8. 402,044.95
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 39,066.41
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1).... . . . ........ 10. 297.73
11. Total Deductions(total Lines 9 and 10)... . .................... ......... 11. 39,364.14
12. Net Value of Estate(Line 8 minus Line 11) . . ............... .......... . . . 12. 362,680.81
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . ....... . ............. . . 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ... .. .... . .... .. ........ 14. 362,680.81
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.0.4_, 5% � 362 68081^I 16. 16,320.64
17. Amount of Line 14 taxable'
at sibling rate X.12 17,
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE .... . . ..... ....... . ..... ....... .. .. ........... ....... ... . 19. 16,320.64
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610205 1505610205
REV-1500 EX(Fl) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Donald Mackenzie, Jr.
STREET ADDRESS
110 Strayer Drive
CITY STATE ZIP
Carlisle PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 16,320.64
2. Credits/Payments
A.Prior Payments 16,500.00
B.Discount 825.00
1 Interest Total Credits(A+B) (2) 17,325.00
(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) 1,004.36
5, If Line I +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE, (5)
Make check payable to: REGISTER OF WILLS,AGENT.
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 ............................................ ❑ N
c. retain a reversionary interest................................................___......__................................................___ ❑ N
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?.........._......___...... ............. ......._ ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0
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.
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.
REV-1503 EX+(8-12)
pennsylvania SCHEDULE 6
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald Mackenzie, Jr. 21-13-0896
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' Prudential Stock
3,223.20
I
i
TOTAL(Also enter on Line 2, Recapitulation) $ 3,223.20
If more space is needed, insert additional sheets of the same size
REV-!5o8 EX+(o8-i2)
. K 7 pennsytvania SCHEDULE E
DEPARTMENT OF REVENUE CASH BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donald Mackenzie, Jr. 21-13-0896
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. PNC Checking(Acct.#5140240391) 16,493.74
2. PNC Savings(Acct.#5003503626) 11,738.30
3. A.G.I.A., Inc.(hospital and income plan insurance-refund) 25.25
4. HCR Manor Care(refund) 6,762.00
5. PNC Investment Acct. (#004-946664) 215,865.57
6. Prudential Financial, Inc.(dividend) 16.00
TOTAL(Also enter on Line 5, Recapitulation) $ 250,900.86
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
i�pennsylvania SCHEDULE G
f DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald Mackenzie, Jr. 21-13-0896
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.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLICABLE) VALUE
1. Transamerica Life Ins.Co,-Annuity 147,920.89 100 147,920.89
1
i
I
i
I
i
I
i
i
i
1
I
- J
1 A
TOTAL(Also enter on Line 7, Recapitulation) $ 147,920.89
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
iL-pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Donald Mackenzie, Jr. 21-13-0896
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Neill Funeral Home(newspaper notice) 28.97
2. Rock Bass Grill(funeral luncheon) 227.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 19,081.80
Name(s)of Personal Representative(s) Sandra L. McNichol
Street Address 110 Strayer Drive
City Carlisle State PA ZIP 17015
Year(s)Commission Paid: 2013/2014
2. Attorney Fees:
19,081.80
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 488.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Carlisle Sentinel(advertising) — 83.34
8. Cumberland Law Journal(advertising) —f 75.00
I
TOTAL(Also enter on Line 9, Recapitulation) $ 39,066.41
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donald Mackenzie, Jr. 21-13-0896
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 Heartland Pharmacy 297.73
1 _ �
1 ,
1
1 �
1
i
� 1
1
4 _
-
1
1 i
1
TOTAL(Also enter on Line 10, Recapitulation) $ 297.73
If more space is needed,insert additional sheets of the same size.
RtV-1513 EX+(01-10)
'Is pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Donald Mackenzie, Jr. 21-13-0896
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).]
I. Sandra L.McNichol, 110 Strayer Dr.,Carlisle,PA 17015 Daughter 1/2 of estate
2. Kathy L.Mackenzie,3 Colatosti Place,Apt.7,Albany, NY 12208 Daughter 1/2 of estate
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.
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.
LAST WILL AND TESTAMENT
AND
CODICIL TO LAST WILL
OF
DONALD MACKENZIE, JR.
LAST WILL AND TESTAMENT
OF
DONALD MACKENZIE, JR.
I, DONALD MACKENZIE, JR., of the Township of Silver Spring, County of Cumberland,
Commonwealth of Pennsylvania, declare this to be my Last Will and revoke any will or codicil
previously made by me.
ITEM 1: Upon my demise, I direct my body be released to Neill Funeral Home, Camp
Hill,Pennsylvania where I have prearranged and prepaid my funeral services. I direct my body be laid to
rest in Fort Indiantown Gap National Cemetery,Annville,Lebanon County,Pennsylvania.
ITEM 2: I direct that all my just debts and funeral expenses be paid as soon as practical
after my death.
ITEM 3: I direct that all taxes and interest and penalties thereon that may be assessed in
consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from
my residuary estate as a part of the expense of the administration of my Estate.
ITEM 4: I give, devise and bequeath all the rest, residue and remainder of my estate of
every nature and.wheresoever situate, together with insurance thereon, in equal shares to my daughters,
z SANDRA LEE McNICHOL of Carlisle, Pennsylvania and KATHY LYNN MACKENZIE of Albany,
UNew York,per stirpes.
A
ITEM 5: Should my daughter, SANDRA LEE McNICHOL predecease me or fail to
Z survive me for a period of thirty(30)days, I direct her share be divided as follows:
4 O
A A. Fifty Percent (50%) to be divided equally between her children, MEREDITH
ANNE McNICHOL and SEAN PATRICK McNICHOL;and
B. Fifty Percent(50%) unto my daughter,KATHY LYNN MACKENZIE.
Page 1 of 3
ITEM 6: Should my daughter, KATHY LYNN MACKENZIE predecease me or fail to
survive me for a period of thirty (30) days, I give, devise and bequeath her share to my daughter,
SANDRA LEE McNICHOL, or her issue,per stirpes.
ITEM 7: Until distributed, no gift or beneficial interest shall be subject to anticipation or
voluntary or involuntary alienation.
ITEM 8: I appoint my daughters, SANDRA LEE McNICHOL and KATHY LYNN
MACKENZIE as Co-Executrices of my Last NN"ill.
ITEM 9: I direct that my personal representative or their successors 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 and seal to this, my Last Will and
Testament,this day of 2005.
iDPLD4AM&AICKVNZIE,JR.
Signed, sealed,published and declared by the above-named Testator as and for his Last Will and
Testament in our presence, who, at his request, in his presence and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
residing at /d f. � Jett o
u4v , residing at D( 42-e e
/ 0
Page 2 of 3
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMB ss:ERLAND )
We, DONALD MACKENZIE, JR 44AZ �, ! O'tme(c_. and
S*('n ��' /'c yA-j the Testator and the witnesses respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, 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 therein
expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the will as .
witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years or
older,of sound mind and under no constraint or and influence.
D D MACKE ZIE,JR.
}- &r
Witness
Witness
t
Subscribed, sworn and acknowledged before me An 67 Lt�jL4'e, by
DONALD MACKENZIE, JR., the Testator, and subscribed and sworn to before me by
2 Mme- and v���,� �' Gj -- o&e,,,) the witnesses, this
day of 4 ,2005.
aJA
Notary Public AL
Mb Ins or
NOTARUU.SEAT.
HENRY F COME,NOtARY
ffiWDEN 1WP,CUMBERLAND COU
MY COMMISSION EJIPIRES JUNE Y t0@t
Page 3 of 3
CODICIL TO LAST WILL
OF
DONALD MACKENZIE, JR.
I, DONALD MACKENZIE, JR., of the Township of Silver Spring, Cumberland County,
Pennsylvania,declare this to be the sole Codicil to my Last Will,dated May 26,2005.
Item 1: I hereby revoke Item 8 of my Last Will and replace it with the following: I appoint my
daughter, Sandra Lee McNichol, Executrix of this my Last Will and Testament. In the event my
daughter, Sandra Lee McNichol, predeceases me, fails to qualify or ceases to act as Executrix, I appoint
my daughter,Kathy Lynn MacKenzie,alternate Executrix of this my Last Will.
Item 2: In all other respects,I hereby ratify, confirm and republish my Last Will, dated May 26,
2005,together with this sole Codicil,as and for my Last Will.
IN WITNESS WHEREOF, I have hereunto set my hand this 2' day of
2011.
DO ALD MACKENZIE,JR.
Signed, published and declared on the date thereof by the above named DONALD
MACKENZIE, JR., as and for the sole Codicil to his Last Will, dated May 26, 2005, in the presence of
us, who, at his request, in his presence, in the presence of each other, have subscribed our names as
witnesses hereto.
residing at 2o�
residing at ��'
COMMONWEALTH OF PENNSYLVANIA )
)ss:
COUNTY OF CUMBERLAND )
We, DONALD MACKENZIE, JR., /� ..� M 0'.h CX— and
JA I Mi the Testator and the witnesses respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as the sole Codicil to his Last
Will, dated May 26, 2005, and that he had signed willingly, and he executed it as his free and voluntary
act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the
Testator, signed the Codicil as witness and that to the best of his or her knowledge, the Testator was at
the time eighteen(18)years of older,of sound mind and under no constraint or undue influence.
�Q6_'Vo_o --wrj _7P
DO D MACKENZ ,JR.
Witness
to
Subscribed, sworn and acknowledged before me 7��/►4 ?. by DONALD
MACKENZIE, JR, the Testator, and subscribed and sworn to before me by
k y,V h 6,o,,t HC---(L and J-,, r r► the witnesses, this
01" day of Jy,,P),!C ) 2011.
Kzi 71-7.e/ IAII�
Notary Public (SE )
.COM1�/01HWEAL�HbF PEJVNSY V*NlA
NQ ATA RIA 5EAL
#lenry F. Coyne:Notary
Hamden Township,CumberlandCouhty
My Commission Expires June 10
2012
RICHARD S. FRIEDMAN, P.C.
300 N. 2nd Street, Suite 402
Harrisburg,PA 17101
(717) 234-3441
(717) 232-9946 (fax)
rsf13 @live.com
Richard S.Friedman
February 19, 2014
Register of Wills
Cumberland County Courthouse
1 Courthouse Square, Room 102
Carlisle,PA 17013
In re: Estate of Donald Mackenzie, Jr.
Estate No. —21-13-0896
Dear sir or madam:
Enclosed herewith for filing please find an original and two (2) copies of the Inheritance
Tax Return for the above-referenced estate.
After filing, please return a copy to this office in the enclosed envelope.
Thank you.
Very truly you ,
Rich;d S. Friedman
0 r' :ra
RSF/bp - a 7r: c
FT]`CJ rVI
Enclosures G- CD
cc: Sandra L. McNichol, Executrix
Kathy Mackenzie
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