HomeMy WebLinkAbout05-14-15 -� REV-1500 EX(01-10)
1505610143
Ta 1505610143
USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 14 1087
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
10 05 2014 01 26 1936
Decedent's Last Name Suffix Decedent's First Name MI
SCOTT CAROLE W
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
SCOTT CLAYTON O
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 ❑ 2. Supplemental Return ❑ 3.Remainder Return(date of death
prior to 12-13-82)
❑ 4. Limited Estate ❑ 4a.Future Interest Compromise ❑
(date of death after 12-12-82) 5. Federal Estate Tax Return Required
® g Decedent Died Testate ❑ 7 Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
❑ 9. Litigation Proceeds Received ❑ 10.=Poverty Credit(dale of death ❑ 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
CRAIG A DIEHL ESQUIRE CPA 717 763 7613
REPPTER OF Wap USE30 Y
C Q f r1 t7
First line of address 7: '0 �?
t:7 -.0 C CIS
C7.
3464 TRINDLE ROAD r . r— F— rn I`11
Second line of address
Ci or Post Office _DATE FILED
City State ZIP Code
CAMP HILL PA 17011rco
L� ITI
Correspondent's e-mail address: cdiehl@cadiehilaw.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.
SIGNATUR 6f P RSON R SPONSIBLE Q R FILIN5RETUf6LL DATE
LJ r Clayton O. Scott
ADDRESS
426 Woodcrest Drive, Mechanicsburg, PA 17050
SIGNATURE OF PREPARER OTHER THAN R P SENTATIVE DATE
r Craig A Diehl Esquire CPA
ADDRESS
3464 Trind a Road, Camp Hill, PA 17011
Side 1
1505610143 1505610143 J
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedents Name: SCOTT, C A R O L E W
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................... 2. 1 , 179 , 991 . 24
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 121 , 199 . 37
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7. 7 , 278 . 38
8, Total Gross Assets(total Lines 1-7)....................................................................... 8, 1 , 308 , 468 . 99
9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 19 , 389 . 15
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1)................................ 10.
11. Total Deductions(total Lines 9&10).......................................... 11. 19 , 389 . 15
...........:................
12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 , 289 , 079 . 84
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13. 30 , 000 . 00
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 1 , 2 5 9 , 079 . 84
TAX COMPUTATION-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 1 , 259 , 079 . 84 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 16.
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. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21 - 14 - 1087
Decedent's Complete Address:
DECEDENT'S NAME
Scott, Carole W
STREET ADDRESS
426 Woodcrest Drive
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +B) (2) 0.00
3. Interest
(3) 0.00
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;....................................
ncome:.................................... Nx
c. retain a reversionary interest;or..................................................................................................................
d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑x
2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without
receiving adequate consideration?....................................................................................................................... ❑ n
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
containsa beneficiary designation?...................................................................................................................... ❑x ❑
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 reiiurn 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 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)1. 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.
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Scott, Carole W 21 - 14- 1087
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNITVALUE VALUE AT DATE OF
NUMBER DEATH
1 Alliancebernstein Mutual Fund 9.69 14,938.30
(quoted by NASDAQ)
2 Capital World Growth & Income Mutual Fund 45.84 78,544.09
(quoted by NASDAQ)
3 Delaware Group Equity Mutual Fund 17.68 117,941.69
(quoted by NASDAQ)
4 Europacific Growth Mutual Fund 47.78 72,164.05
(quoted by NASDAQ)
5 Fundamental Investments Mutual Fund 53.69 141,663.21
(quoted by NASDAQ)
6 Growth Fund America, Inc. Mutual Fund 45.53 163,643.02
(quoted by NASDAQ)
7 Ivy Funds, Inc. Mutual Fund 19.29 138,591.13
(quoted by NASDAQ)
8 Munder Series TR Mutual Fund 44.66 90,011.34
(quoted by NASDAQ)
9 PIMCO Funds Mutual Fund 10.91 100,784.83
(quoted by NASDAQ)
10 Royce Fund Mutual Fund 15.69 88,657.29
(quoted by NASDAQ)
11 Sun America Series, Inc. Mutual Fund 17.61 53,901.57
(quoted by NASDAQ)
TOTAL(Also enter on line 2, Recapitulation) 1,179,991.24
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN continued
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Scott, Carole W 21 - 14- 1087
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
12 Washington Mutual Investment Fund, Inc. 41.6 119,150.72
(quoted by NASDAQ)
Page 2 of Schedule B
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF TAXPENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Scott, Carole W FILE NUMBER21 - 14- 1087
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Cash in Mutual Fund with Janney Montgomery Scott, LLC 121,199.37
Account No. 7488
TOTAL(Also enter on Line 5, Recapitulation) 121,199.37
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Scott, Carole W FILE NUMBER
21 - 14- 1087
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE
NUMBER Include the name of the transferee,their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE}
and the date of transfer. Attach a copy of the deed for real estate. INTEREST
1 IRA-Janney Montgomery Scott, Account No. 5686 7,278.38 100% 7,278.38
Beneficiary-Clayton 4. Scott
TOTAL(Also enter on line 7,Recapitulation) 7,278.38
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUWMAL E)CPEINSES&
INHERITANCE TAX RETURN
RESIDENT DECEDENT rDMINISTGWTE CASTS
ESTATE of Scott, Carole W FILE NUMBER21 - 14- 1087
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Malpezzi Funeral Home- Funeral Services 3,086.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission paid
2. Attorney's Fees Law Offices of Craig A. Diehl 15,000.00
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 Cumberland County Register of Wills 970.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Law Offices of Craig A. Diehl - Postage Reimbursement for DPW Letter 6.49
TOTAL(Also enter on line 9, Recapitulation) 19,389.15
Page 2ofSchedule H
REV-1513 EX+(11.08)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Scott, Carole W
21 - 14 - 1087
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustees)
ITAXABLE DISTRIBUTIONS(include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Clayton O. Scott Husband 100% of Residue
426 Woodcrest Drive
Mechanicsburg, PA 17050
Enter dollar amounts for distributions shown above on lines 15 through 18 on 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
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 James H. Quillen College of Medicine 10,000.00
East Tennessee State University, Johnson City, TN 37604
2 Joseph T. Simpson Public Library 10,000.00
16 North Walnut Street, Mechanicsburg, PA 17055
3 Hampden Township Ambulance Association 10,000.00
295 South Sporting Hill Road, Mechanicsburg, PA 17050
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 30,000.00
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CAROLE W.SCOTT M,
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1, CAROLE W. SCOTT, of Hampden Township, CuAerland Ginty, 71
Pennsylvania, being of sound and disposing mind, memory and understanding, do make,
publish and declare this to be my Last Will and Testament,hereby revoking and making void
all previous Wills and Codicils heretofore made by me.
FIRST
The expenses of my last illness and funeral shall be paid from the property of my
estate. It is my ffirther desire that upon my death, my body will be cremated and any costs
will be expended from my estate for this purpose.
SECOND
I give and bequeath the following:
A. Ten Thousand Dollars ($10,000.00) to the JAMES H. QUILLEN
COLLEGE OF MEDICINE,East Tennessee State University,Johnson City,Tennessee;
B. Ten Thousand Dollars($10,000.00)to the JOSEPH T.SIMPSON PUBLIC
LIBRARY,Mechanicsburg,Pennsylvania; and
C. Ten Thousand Dollars ($10,000.00) to HAMPDEN TOWNSHIP
AMBULANCE ASSOCIATION,Mechanicsburg,Pennsylvania.
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
THIRD
I give,devise and bequeath the rest,residue and remainder of my estate,together with
all insurance proceeds thereon of whatsoever nature and wheresoever situate to my beloved
spouse, CLAYTON O.SCOTT,providing that he survives me by thirty(30)days.
FOURTH
Should my spouse, CLAYTON O. SCOTT, predecease me or die on or before the
thirtieth(30th)day following my death,then I give,devise and bequeath the rest,residue and
remainder of my estate,together with all insurance proceeds thereon of whatsoever nature and
wheresoever situate in equal shares to MARY WASHINGTON COLLEGE of
Fredericksburg, Virginia, and FRANKLIN AND MARSHALL COLLEGE of Lancaster,
Pennsylvania, for scholarships as the school administration determines to be in the best
interests of the institution.
All tangible personal property shall be liquidated into cash.
FIFTH
Except as otherwise provided in this Will, I have intentionally failed to provide for
any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar
as I have failed to provide in this Will for any of my issue now living or later born or adopted,
such failure is intentional and not occasioned by accident or mistake.
Page 2 of 7
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
SIXTH
I grant my personal representative the following powers in addition to -and not in
limitation of such powers as my personal representative shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary
acting hereunder,provided such property remains productive.
(b) To join in any corporation, partnership, recapitalization, merger,
reorganization or voting trust plan; to delegate authority with respect thereto; to deposit
investments under agreements and pay assessments; and generally to exercise all rights of
investors, including but not limited to,the voting of shares.
(c) To manage,operate,repair,improve,mortgage or lease on any terms any real
estate held or owned by my estate.
(d) To operate any business that I may own at my death.
(e) To invest any funds of my estate in any stocks,bonds,notes or other securities
or property, real or personal, without regard to the principle of diversification or any other
statute or general rule of law in his absolute discretion, it being my intention to give my
personal representative the broadest investment powers possible,providing such investments
do not unnecessarily prevent the prompt settlement of my estate.
(f) To sell or otherwise dispose of any property, real or personal, tangible or
intangible, at any time forming a part of my estate in any manner and on such terms and
conditions as my personal representative shall see fit in his absolute discretion.
(g) To borrow money for the payment of taxes or for any other proper purposes
in the administration of my estate,and to mortgage or pledge estate assets as security.
Page 3 of 7
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
(h) To compromise claims without court approval including, but not limited to,
any controversies with the United States of America or the Commonwealth of Pennsylvania
concerning estate and inheritance taxes on any interests that may pass under this my Last Will
and Testament.
(i) To distribute in cash or in kind upon any division or distribution of my estate.
(j) To undertake any and all acts deemed necessary and proper by my personal
representative for the proper, advantageous and prompt management of the settlement of my
estate.
(k) In general, to exercise all powers in the management of my estate which any
individual could exercise in the management of similar property owned in his own right,upon
such terms and conditions as to him may seem best and to execute and deliver all instruments
and to do all acts which he deems necessary or proper to carry out the purposes of this, my
Last Will and Testament.
SEVENTH
No interest of any beneficiary of my estate, either in income or in principal, shall be
subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any
beneficiary have the power in any manner to charge or encumber his interest either in income
or principal, nor shall the interest of any beneficiary be liable or subject in any manner while
in the possession of my personal representative for the liability of such beneficiary.
Page 4 of 7
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
EIGHTH
I nominate,constitute and appoint my spouse,CLAYTON O.SCOTT,and CRAIG
A. DIEHL, ESQUIRE as Co-Executors of this my Last Will and Testament. I direct that
my personal representative shall not be required to give or post bond for the faithful
performance of his duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I hereunto set my hand to this my Last Will and
Testament this J 10 Oday of September, 2014.
WITNESS:
6//
Page 5 of 7
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, CAROLE W. SCOTT, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge
that I signed and executed the instrument as my Last Will and Testament; that I signed it
willingly, and that I signed it as my flee and voluntary act for the purposes therein expressed.
`-AROLEW. SCOTT
Sworn or affirmed and acknowledged before me by CAROLE W. SCOTT, the
Testatrix, this. jl day of September, 2014.
vcol, rl-�,t
NOTUY PUBLIC
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
STEPHANIE M.RIDER,Notary Public
Camp Hill Boro.,Cumberland County
My Commission Expires November 19,2017
Page 6 of 7
LAST WILL AND TESTAMENT OF CAROLE W.SCOTT
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
WE, s-�6&a �• F�'/4- and A. }lnou-)A- , the witnesses whose
names are attached to the foregoing document, being duly qualified according to law, do
depose and say that we were present and saw Testatrix sign and execute the instrument as her
Last Will and Testament; that she signed willingly and that she executed it as her free and
voluntary act for the purposes therein expressed;that each subscribing witness in the hearing
and sight of the Testatrix signed the Last Will and Testament as witnessed and that to the best
of our knowledge the Testatrix was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
U
Sworn or affirmed and subscribed before me by (� • LY �s, :fi, S r
and J v .r, ,i,�r,,i;c {" this day of September, 2014.
NOTOY PUBLIC
COMMONWEALTH OF PENNSYLVANIA
Page 7 of 7 NOTARIAL SEAL
STEPHANIE M.RIDER,Notary Public
Camp Hill Boro.,Cumberland County
My Commission Wres November 19,2017
Law Offices of
Craig A. Diehl
3464 Trindle Road
Camp Hill,Pennsylvania 17011
Telephone(717)163-7613
Fax(717)763-8293
www.cadiehllaw.com
In Spring Grove,Pennsylvania
Craig A.Diehl,Esquire,CPA
Fiona K.Fadness,Esquire May 12, 2015 119A West Hanover Street
Spring Grove,PA 17362
Telephone:(717)225-1929
Lisa M. Grayson, Esquire
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Carole W. Scott
Estate No. 21 .14 1087
Dear Ms. Grayson:
Enclosed for filing please find an original and two (2) copies of the Inheritance Tax Return
REV-1500.
Please time-stamp and return a copy .of the Inheritance Tax Return in the enclosed self-
addressed envelope. Should you have any questions,please feel free to contact me.
Sincerely,
Craig A. iehl, Esquire, CPA
CAD/daf
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