HomeMy WebLinkAbout06-04-14 REV-1500 EX(02-10) IV 1505610101
PA Department of Revenue pennsylvatNa OFFICIAL USE ONLY
Bureau of Individual Taxes .°°°"'" County Code Year File Number
PO BOX 28D6ot INHERITANCE TAX RETURN r �
Harrisburg,PA 17128-0601 RESIDENT DECEDENT J/
ENTER DECEDENT INFORMATION.BELOW
Suffix Decedent's First Name MI
o Z S o
(If Applicable)Enter Surviving Spouse's Information Below
Spouses Last Name Suffix Spouse's First Name MI
Halno $ aR I I 1 1111 [=] 11#57171 1 11 1 1 1 1 1 Q
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
F J - I I I I I n REGISTER OF WILLS
KLCIN APPROPRIATE OVALS BELOW '
tW 1.Original Return C=) 2.Supplemental Return CD 3. Remainder Return(date of death
,I ,.t, .. - prior to 12.13-82)
,p 4.Limited Estate C—� 4a.Future Interest Compromise(date of C=) 5. Federal Estate Tax Return Required
i �- -,� ,, t death after 12-12-82) '
i 6.Decedent Died Testate C=D 7.Decedent Maintained a Living Trust Q 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 C= 11. Election to tax 4Q'er Sec.9113(A)
+ between 12-31-91 and 1-1-95) Rach Sch,O)o =
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOR IOIbSHOULD EOTBD
Name {.. Dayti hgn"{e`N—car G> C>
0, h! ,4 R-L ES SN1 L 1�S t /I/I I �
REG. 4 KOF WILLS U$gOMtY
C? K7 -n -ri
First line of address O C= W 'C).4 �
W ICILIONISIFIA 1401,01A I I I I I :",a _' lw co �n°-�
Second line of address
City or Post Office _ State ZIP Code " DATE FILED
11�jQNkAl1CJ8 R' Pk �j �1SyT I
Correspondent's e-mail address: (��s/}rs.3Q C0/h 'Lust+HB!
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUERSON 0 SI%E FOR FI RETURN DATE
X A �
ADDRE$� +rl��R T f, !a"lC �/�l'.�Q 7 011l�r�6Jt 4lflr� �YtISLj Aft
SIGNATURE OF PREP RER O ER TH PR E TATIVE DATE
ADORE -Af-4 21&'$ F .51114C-WS &r, 4? (11045el' Rd, f004 J70SS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 �,�
t 1505610105
REV-1500 EX
RECAPITULATION
c'
1. Real Estate(Schedule A). ..t..:......... ......... .......... .......... i. W 2. Stocks and Bonds(Schedule B) .... ... .... ......... ....... ............ 2. • 7 A 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .. ... 3. • 0 D 4. Mortgages and Notes Receivable(Schedule D)... ... ..... .......... .... .. 4. O 0
5, Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5. 1 "y0
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, O Q
8. Total Grass Assets(total Lines 1 through 7)........ .............. .... ... 8. 3 ( 7 $"/Q •i 7
T
9. Funeral Expenses and Administrative Costs(Schedule H)................ ... 9.
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I).......... .... 1p. )Qd
�•
11, Total Deductions(total Lines 9 and 10)................. .... .......... .. 11. ✓ 3•� b'
12, Net Value of Estate(Line 8 minus Line 11).............................. 12. 3 3 w, -"-517
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax,has not been made(Schedule J) ..........:..s.........:
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14.
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.00- 3 3 o S 3 •tSji 15.
16. Amount rate 4.5,Line 14 taxable '�� ��• O {D A
at lineal rate X.0 D 16.
17. Amount of Line 14 taxable
at sibling rate X.12 ± 17. .. d
18. Amount of Line 14 taxable "
at collateral rate X.15 18. •�D
i9. TAX DUE.. ........ .............. .......
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. C=
Side 2
1505610105 1505610105 J
REV-1500 EX,Page 3 FIIe Number
Detcedent's Complete Address:
DECEDENT'S NAME
__ Lawr�nee k. lho.�spson .�'
STREET ADDRESS ---_�__�__—._, ----
CITY
Tax Payments and Credits:
I. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments a
A.Prior Payments
B.Discount
Total Credits(A+B) (2) �
3. Interest
(3) 0
4. if Line 2 is greater than tine 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) D
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;...___.........,........................ ❑
c. retain a reversionary interest;or.......................................................................................................................... ❑
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 account or security at his or her death?.............. ❑ X
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)(11)(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
fling a tax return are still applicable even if the surviving spouse is the only beneficiary.
=or 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(1.2)[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+(6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
L 2wrcnce k. /7/oiilpsoh SIT" FILE NUMBER
ITEM All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
NUMBER DESCRIPTION - - - VALUE AT DATE
1_ OF DEATH
:510 k of oNC �ira�c;d/
h%�k �6z3/ /ew e/,Yy are. = ci8P xsgysA- 6.36, 75-6.7z
Csee vq4a6 A elaf X71,40,6,w)
TOTAL(Also enter on line 2,Recapitulation) $ 36 75 6. 72—
(it more space is needed.insed additional sheets of the same size)
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REV.151O EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
RESIDENT DE EDENTTURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT '
ESTATE Of
4Qwry� K. 7TApoVsen FILE NUMBER
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 1-13- 4
ITEM DESCRIPTION OF PROPERTY
NUMBER INCLUDE THE NAME OF THE TRpnsFEREE,THEIR RIIARMS",To DECFDFNT AVD MOFECDS EXCLUSION TAXABLE
THE DALE OF TRANSFE0.ATTACH p COPY Of THE pFED FOR REAL ESTATE,
IFArvuuDU_ VALUE
1. Tia�e�FF �JS'amr,,v1- Acs/ I'll
/f1a� Loy T/Ii�pSnN� /iAs lr.it�ew. tiac,s r- .� !diet fur 6tir r9/ /Wde Aeel �yuz%mitn� ®T i%��nrma7iivia� X114 a�u/hes .e./yrQerCo/efiEef �,a�AXes
TOTAL(Also enter on Line 7, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(10-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF y
L aw r&nc 2 ;k &lwrrpq• F,1— FILE NUMBER
ITEM Debts of decedent must be reported on Schedule L
NUMBER
A. FUNERAL EXPENSES: DESCRIPTION
1.
AMOUNT
B. ADMINISTRATIVE COSTS: -
-1. Personal Representative's Commissions
Name of Personal Representatives) 1)1$P L
Street Address
7 /�Zoin O[uS__— G _� /17�J`SmH G,2/✓G[!�.
City :T A State_ Zip 1701S
Year(s)Commission Paid:
2. Attorney Fees
9. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation)
Claimant -�'/'Cgty�ise lflo/y/��Sen
Street Addressss���/7 d La•/7G
City (mss/SIG
Slate ✓./ �Zjp 170/:� -
Relationship of Claimant to Decedent L//, pW
4. Probate Fees a-W p�•;a� �S SHG Bf f�jOt/
o G'PSh.oLa�es
5.
Accountant's Fees
6. Tax Return Preparer's Fees
T. //Oral;/2ona/ lz�rnbi to jii�, 4 7,, , k , 6IC
�. /reiAt�/,(rSunen7s 10 Clios-��: .E: �!.'e/dci!, e-
TOTAL(Also enter on line 9, Recapitulation)
(lf more space is needed,insert additional sheets of the same size)
RECEIPT FOR PAYMENT
GLENDA Cumberland CountyA - Register Of Wills
One Courthouse S uare Receipt Date : 31453843
q Receipt
Carlisle, PA 17013 Receipt No. : 1073304
THOMPSON LAWRENCE K III
Estate File No. : 2013-00266
Paid By Remarks : CHARLES E SHIELDS III
DMB
-------- ---------------- Receipt Distribution -----____
Fee Tax Description Payment Amount Payee Name
PETITION LTRS TEST 30 . 00
WILL CUMBERLAND COUNTY GENERAL FUN
15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 30 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY
INS TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 15 . 00 CUMBERLAND COUNTY GENERAL FUN AUTOMATION FEE 23 .50 BUREAU OF RECEIPTS & CNTR M.D
__ 5_00 CUMBERLAND COUNTY GENERAL FUN
Check# 1781 ------
Total Received. . . . . . . . . 3 . 50
M3 . 50
REV-1513 EX+ (01-10) _
s pennsylvania SCHEDULE ]
DEPARTMENT DF REVENUE -
INHERITANCE TAX RETURN
BENEFICIARIES _
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
�a wrencc k, 7hovson
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. ni4r Louise 73v apsa.i 4);dow lr�op
7 hoowpon Lana
ea,,11 stt, 70 s
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 OF LAWRENCE K.THOMPSON,III
1,LAWRENCE K.THOMPSON,111,currently of Dickinson Township,Cumberland County,
Pennsylvania,being of sound and disposing mind,memory and understanding,do make,publish and declare
I
this my Last Will and Testament,hereby revoking and making void any and all prior Wills by me at any
time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the same
can conveniently be done. -
2.
All the rest,residue and remainder of my Estate,real,personal and mixed,whatsoever and
wheresoever situate,l give,devise,and bequeath to my wife,MARY LOUISE THOMPSON,a.k.a.
MARY LOU THOMPSON,to her own use and benefit absolutely.
3,
In the event,however,that my said wife,MARY LOUISE THOMPSON,a.k.a,MARY LOU
THOMPSON,should predecease me or die at about the same time as I die,such as from an accident or
disaster common to both of us,I give,devise and bequeath my said Estate to my three children,
LAWRENCE K.THOMPSON,IV,MARK B.11IOMPSON and ELIZABETH THOMPSON
JUST,in equal shares,per srimes. '
4.
I nominate,constitute and appoint my wife,MARY LOUISE THOMPSON,a.k.a.MARY
LOU THOMPSON,to be the Executrix of this my Last Will and Testament. In the event that MARY
LOUISE THOMPSON,a.k.a.MARY LOU THOMPSON,is unable or unwilling to act as Executrix,
I appoint my daughter,ELIZABETH THOMPSON JUST,to be Executrix in her place and stead. In
the event that ELIZABETH THOMPSON JUST is unable or unwilling to act as Executrix,I appoint
my son,LAWRENCE K.THOMPSON,IV,to be Executor in her place and stead.. In the event that
LAWRENCE K.THOMPSON,IV is unable or unwilling to act as Executor,I appoint my son,
MARK B.THOMPSON,to be Executor in his place and stead. I further direct that they shall not be
required to file bond or other security in the Office of the Register of Wills for the purpose of
administering my Estate.
IN WITNESS WHEREOF,I have hereunto set my hand and sea)this "✓W day of
aAq 4ltG ..,A.U.2006.
� � s lj/• (SEAL)
LAWRENCE K.THOMPSON,117
t
II7,as and or his Last Will linded and declared
The presence of um d LAWRENCE K.TIIOWSON,
and in the presence of each other,have hereunto subscribed our namewbO at his s as witnesses.��d in his presence,
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CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG,PA 17055
GEORGE M.HOUCK TELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
May 29, 2014
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Lawrence K.Thompson
No.21-13-0266
Dear Register of Wills:
�. Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Lawrence K.
Thompson Estate as well as Check No. 1629 in the amount of$60.00 for additional Probate due.
Thank you for your kind attention to this matter.
Very truly yours, O�
Charles E. Shields, III
Attorney-At-Law
CES/mjj
Enclosures
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