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05-12-15
mt'j pennsylvania 1505618403 DEPARTMENT OF REVENr:X(03-14) REV-150110 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 14 1056 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 09 06 2014 03 28 1937 Decedent's Last Name Suffix Decedent's First Name MI WOLPERT JAMES E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI WOLPERT MARY D THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Ed 1. Original Return 2. Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) F4, Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) ❑X 7. Decedent Died Testate 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) 13, Business Assets 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number HEATHER D ROYER ESQ ( 717) 234 2401 First Line of Address 4431 N FRONT ST 3RD FL Second Line of Address City or Post Office State ZIP Code HARRISBURG PA 17110 Correspondent's email address: hroyer(M-sasllp.com REGIST a OF WILLS Ug*NLY�o REGISTER OF WILLS USE ONLY © 6') DATE FILED MMDDYYYY t C7 C"� C7>r*r7 ""� Cr) C 71) DATE`Oh-EDISTAiP CIO Cn Side 1 I III II I III II II IIIII IIIII II� IIII IIIII I III II II IIII IIII 1505618403 1505618403 UU 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: WOlpert, James E. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 8 -1565 - 25 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. 71B39 - 17 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 3 5 9 , 4 5 0 - 11 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 375 ,054 - 53 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 9 ,376 - 41 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 9 ,376 - 41 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 3651678 - 12 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. 365-,678 - 12 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.00 365,678 - 12 15. 11 - 00 16. Amount of Line 14 taxable at lineal rate X .045 0 . 110 16. 0 . 0 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 0 . 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has any knowledge. SI N TURE OF PER ON RESPONSIBLE F R FILING RETURN Mary D.Wolpert DATE S ADDRESS 623 W. ain StrdetMechanicsburg, PA 17055 SIGN ER ER THAN REPRESENTATIVE Heather D. Royer Esq. /E 5-- ADDRESS 4431 N. Front St., 3rd FI., Harrisburg, PA 17110 L 1111111111111111111111111111111111111II 1111111111 II1111 Side 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-14-1056 Decedent's Complete Address: DECEDENT'S NAME Wolpert,James E. STREET ADDRESS 623 W. Main Street CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00 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;............................................................................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ ❑x d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x 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?.................................................................................................................. 0 ❑ 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 January 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 21ears of age or younger at death to or for the use of a natural parent,an adoptive parent,or a step-parent 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+(08'-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wol ert, James E. 21-14-1056 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 459200101 44.733 shares of International Business Machines-Com 191.475 8,565.25 TOTAL(Also enter on Line 2, Recapitulation) 8,565.25 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OFPERSONAL PROPERTY INHERITANCE TAXAXRETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wol ert, James E. 21-14-1056 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AmeriChoice FCU-Checking Account No.219-0013 992.74 2 2005 Honda Accord EX-Value per sale 6,000.00 3 Andrews&Patel Associates, P.C. -Refund 46.43 TOTAL(Also enter on Line 5, Recapitulation) 7,039.17 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.08-12) Rev-1510 EX+(09.09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE �+ INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT . ESTATE.OF FILE NUMBER Wolpert, James E. 21-14-1056 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 DESCRIPTION OF PROPERTY. DATE OF DEATH %of OECD's ExcLusloN TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND IF APPLICABLE)) INTEREST THE DATE OF TRANSFER. ATTACK A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET VALUE 1 AXA Equitable Variable Annuity IRA-Account No. 171,806.00 100.000% 171,806.00 306677265 Beneficiary-Mary D.Wolpert, Spouse 2 Lincoln Financial Group-Non Qualified Variable 187,644.11 100.000% 187,644.11 Annuity Beneficiary-Mary D.Wolpert,Spouse TOTAL(Also enter on Line 7, Recapitulation) 359,450.11 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1511 EX+(08.13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND TAX RESIDENTNCE DECEDENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Wolpert,James E. 21-14-1056 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,704.70 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attorney's Fees Smigel,Anderson &Sacks, LLP 3,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD Relationship of Claimant to Decedent 4. Probate Fees 180.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 491.21 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 9,376.41 Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Wolpert,James E. 21-14-1056 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Malpezzi Funeral Home 4,978.86 2 Strocks Catering 725.84 H-A 5,704.70 Other Administrative Costs 3 Spankys Auto Body-Service to vehicle before sale 491.21 H-B7 491.21 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) a REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Wol ert,James E. 21-14-1056 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S)RECEIVING PROPERTY Do Not List Tru teefs) (Words) ($$$) ITAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.91 16a 1.2 Mary D.Wolpert Spouse One Hundred 623 W. Main Street Percent of Mechanicsburg, PA 17055 Residuary Estate Total Enter dollar amounts for distributions shown above on lines 15 through 18 or Rev 15)0 cover sheet as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA Ow O U No. 2014- 01056 PA No. 21- 14- 1056 Estate of: JAMES E WOLPERT QD/ �® (First,Middle,Last) V Late Of: MECHANICSBURG BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 204-28-1846 1750 WHEREAS, on the 6th day of November 2014 an instrument dated August 30th 1980 was admitted to probate as the last will of JAMES E WOLPERT (First,Middle,Last) late of MECHANICSBURG BOROUGH, CUMBERLAND County, who died on the 6th day of September 2014 and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, LISA M. GRA YSON, ESQ. Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: MARY D WOLPERT who has .duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VA NIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 6th day of November 2014. Registe of Wi/! Deputy **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT OF F-• o JAMES E. WOLPERT I, JAMES E. WOLPERT, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and under- standing, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and the memorial service from my estate as soon after my death as conveniently may be done. Further, it is my desire and I so direct my personal representative that my body be cremated and my ashes disposed of in a appropriate manner. . It is my desire that no viewing of my body be held and that any memorial service conducted shall be done as inexpensively as possible. I hereby confirm the donation of my bodily organs. I direct that at the time of death my eyes and other bodily organs shall be utilized in accordance with the pledges made by me during my lifetime. All my other bodily parts to the extent practical shall be utilized for medical education, research, advancement of medical science, therapy or transplantation to individuals in such manner as my attending physician shall direct, either @Ipuah =sachn ,rn private arrangements as he shall make, or through deliver ;4o the::: Humanity Gifts Registry. Any necessary costs of transporting RY body to the proper place which are not paid by the recipient sh'a1lfge paid by my personal representative up to $300.00. - ry -n SECOND I give, devise and bequeath all the rest, residue and remainder of my estate to my beloved wife, MARY D. WOLPER.T, absolutely and in fee simple, if she survives me by thirty (30) days. THIRD In the event that my wife, MARY D. WOLPERT, fails to survive me by thirty (30) days, then I give, devise and bequeath all the rest, . residue and remainder of my estate unto my daughter, ROSEMARY J. WOLPERT, per stirpes. FOU RTH In the event my wife, MARY D. WOLPERT, predeceases me, I appoint my sister-in-law, ANN KOEHLER, Guardian of the person and property of my minor child. FIFTH I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate.. SIXTH In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in his or her absolute discretion: (a) to retain in the form received, or to sell either at public or private sale any real or personal property; (b) to manage real estate; (c) to invest and reinvest in all forms of property without being confined to legal investments and without recTard to the principle of diversification; (d) to exercise any option or rights arising from ownership or investment. SEVENTH I do hereby nominate, constitute and appoint my wife, MARY D. WOLPERT, to act as .Executrix of this my Last Will and Testament. Provided, however, that if she is unwilling or unable to act as Executrix, I direct that the duties of Executor be performed by -2- DAVID A. LOGAN. I direct that no personal representative appointed under this instrument shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, JAMES E. WOLPERT, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three typewritten pages, the first two of which bear my signature in the margin for identification, this day of '#j_* 1980. (SEAL) James E. Wolpert( Signed, sealed, published and declared by the above-named Testator, JAMES E. TATOLPERT, as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of said Testator and of each other. —Address 7 Address n;?.! -3-