HomeMy WebLinkAbout06-23-15 �i � ■ i� �
� `�:�( pennsylvania 1505618403
�(A�j UEPARTMENTOFREVEN
�X(03-14)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes Caunty Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisbur4,PA 17128-0601 RESIDENT DECEDENT 21 �� � (� �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
� 09 23 2014 07 28 1936
DecedenYs Last Name Suffix DecedenYs First Name MI
LEYON ROBERT E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
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. 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)
� 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 �X 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 T0:
Name Daytime Telephone Number
IVO V OTTO III 717 243 3341
First Line of Address
10 EAST HIGH STREET
Second Line of Address
City or Post Office State ZIP Code
CARLISLE PA 17013
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CorrespondenYs email address:
iotto�martsonlaw.com ,-, `-r' � ��
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REGISTER OF WILL,�-U��ONLY `�J 7
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REGISTER OF WILLS USE ONLY N
DATE FILED MMDDYYYY ; J ��
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DATE FILED STAMP -- �-,, � -'�1
Side 1
I I��I�I II��I�IIII I�I�I�III��II�I II��I I�III IIIII�II��I II I��I
� 1505618403 15U5618403 �
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� 1505618411
REV-1500 EX
DecedenYs Social Security Number
Decedent's Name: L@�/011, Robert E
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
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.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
(Schedule G) on-Probate Property
7. Inter-Vivos Transfers&Miscellaneous� Separate Billing Requested............ 7. 5 4 5 ,4 9 8 • 6 6
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 5 4 5 ,4 9 8 • 6 6
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 5 ,4 7 0 • 0�
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 5 ,4 7 0 • 0 0
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 5 4 0 ,0 2 8 • 6 6
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. 5 4 0 ,0 2 8 • 6 6
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(�.2)X.o0 136 ,301 • 16 15. O • 00
16. Amount of Line 14 taxable
at linea�rate X .045 4 0 3,7 2 7 • 5 0 16. ],8 ,16 7 • 7 4
17. Amount of Line 14 taxable
at sibling rate X.12 0 • 0 0 17. 0 - 0❑
18. Amount of Line 14 taxable
at collateral rate X .15 0 • 0 0 18. 0 • 0 0
19. TAX DUE................................................................................................................ 19. 18 ,16 7 - 7 4
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 responsibie for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE 0 PERSO SPO IBLE FOR ILI G ETURN Carol A.WilllafYlS
/���� ���' .�c -�/� �ir
ADDRES�
121 White Birc Lane, Carli , PA 17013
SIGNATU E 0 OT AN REPRESENTATIVE IVO V. OttO III �T� t��
✓
ADDRESS
10 East High Street, Carlisle, PA
I I��I�I II��I IIIII��I�I�III��II�)II��I I�III�I��I II��I II�I I�' Side 2
� 1505618411 1505618411 �
REV-1500 EX Page 3 File Number 21
Decedent's Complete Address:
DECEDENT'S NAME
Leyon, Robert E
STREET ADDRESS
1210 White Brich Lane
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 18,167.74
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) �$,�67.7Q�
Make Check Payable to REGISTER OF WILLS, AGENT.
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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:.................................. ❑ �
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
receivingadequate 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?.................................................................................................................. ❑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.
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For dates of death on or after Juiy 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 stil�applicable even if the surviving spouse is the only benefciary.
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 step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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-1510 EX+(OS-09)
SCHEDULE G
pennsylvania lNTER-VIVOS TRANSFERS AND
DEPARTMENTOFREVENUE MISC. NON-PROBATE PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leyon, Robert E 21
This schedule must be completed and filed if the answer to any of questions 1 lhrough 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.SATTACN A COPY OF T�E DE�ED�OREREAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Dickinson College Early Retirement Plan Contract No. 152,719.98 152,719.98
IP171847-Beneficiaries: Carol A.Williams,spouse,
20%; Christopher E. Leyon,son,40%; Rebecca Leyon
daughter,40%
2 Pershing LLC, Roth IRA,Account#5HU073416- 194,295.96 194,295.96
Beneficiaries: Carol Williams,spouse,34°/a;
Christopher E. Leyon,son,33%; Rebecca Leyon,
daughter, 33%
3 TIAA-CREF Contract No.C8385109-Beneficiaries: 27,853.37 27.853.37
Carol A.Williams,spouse, 20%; Christopher E. Leyon,
son,40%; Rebecca Leyon, daughter,40%
4 TIAA-CREF Contract No.C8405105-Beneficiaries: 108,356.02 108,356.02
Carol A.Williams, spouse, 20%; Christopher E. Leyon,
son,40%; Rebecca Leyon, daughter,40%
5 TIAA-CREF Contract No.C8413109-Beneficiaries: 62,273.33 62,273.33
Carol A.Williams,spouse, 20%; Christopher E. Leyon,
son,40%; Rebecca Leyon,daughter,40%
TOTAL(Also enter on Line 7, Recapitulation) 545,498.66
(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+(OS•13) gCHEDULE H
pennsylvania
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leyon, Robert E 2�
Decedent's debts must be reported on Schedule I.
�TEM DESCRIPTION AMOUNT
N MBER
q. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
Z, Attorney's Fees 5,455.00
See continuation schedule(s) attached
3, Family Exemption: (If decedenYs address is not the same as claimanYs, attach explanation)
Claimant
Street Address
City State Zio
Relationshi�of Claimant to Decedent
4. Probate Fees
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 5,470.00
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
Leyon, Robert E 21
ITEM
NUMBER DESCRIPTION AMOUNT
Attorney Fees
1 Martson Law Offices-Estimated attorneys'fees 5,455.00
H-62 5,455.00
Other Administrative Costs
2 Cumberland County Register of Wills-Filing fee, Inheritance Tax return 15.00
H-B7 15.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-7513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BEN EFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Le on, Robert E 2�
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY po DE CS DEN e g (Words) ($$$)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 Christopher E. Leyon Son 204,598.75
6 Schoolhouse Drive
Medford, NJ 08055
2 Rebecca Leyon Daughter 204,598.75
2126 S. East Woodword St.
Portland,OR 97202
3 Carol A.Williams Spouse 136,301.16
1210 White Birch Lane
Carlisle, PA 17013
Tota I 545,498.66
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
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)
F�.\PILES\Clients\10497 Leyon\If497.h.will_?014.wpd
. ' ' �
LAST WILL AND TESTAMENT
I, ROBERT E. LEYON, of the Borough of Carlisle, Cumberland County, Pennsylvania,
being of sound and disposing mind and memory,do hereby make,publish and declare this to be my
Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and
all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property)shall be paid from my residuary estate as soon as practicable atter my decease and as part
of the administration of my estate. My Executrix shall have no duty or obligation to obtain
reimbursement for any such tax so paid,even though on proceeds of insurance or other property not
passing under this Will. I further specifically direct that any mortgage existing on my residence,
whether such residence is titled in my name alone or jointly with my spouse, shall be discharged
from the residue of my estate.
2.
If she survives me by thirty(30)days,I give,devise and bequeath all of my estate,both real
and personal property, unto my spouse, CAROL A. WILLIAMS, absolutely.
3.
In the event my said spouse predeceases me or fails to survive me by thirty (30) days,then
I give, devise and bequeath all of my estate, both real and personal property, in equal shares, unto
my children, CHRISTOPHER E. LEYON and REBECCA LEYON, absolutely.
4.
I nominate,constitute and appoint my spouse, CAROL A. WILLIAMS,as Executrix of my
estate. In the event she is unwilling or unable to so act,then I appoint my son, CHRISTOPHER E.
LEYON, as Executor of my estate.
5.
I direct that my Executrix shall not be required to file a bond to secure the faithful
performance of her duties in any jurisdiction.
����
��p�t�a�s�
Page 1 of 3 Pages
6.
I authorize and empower my Executrix, in her sole and absolute discretion, to purchase or
otherwise acquire and retain any investments of which I die seized or any real or personal property
of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in
regard to any or all property of any kind forming a part of my estate for such terms and such prices
as she may deem advisable; to borrow money for any purposes connected with the protection and
preservation of my estate;to mortgage or pledge any real or personal properly forming a part of my
estate or to join in or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
share to be composed of cash, property or undivided fractional shares in property different in kind
from any other share; to employ agents, attorneys and proxies and to delegate to them such power
as my Executrix considers desirable and to pay reasonable compensation for such services as may
be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as
may be necessary to carry out any of these powers. In addition,I direct that my Executrix shall have
the power to conduct an inventory of any safe deposit box necessary to the administration of my
estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this p�v��day of
�f'�j=}'y,�/ , 2014.
�„�� (SEAL)
Robert E. Leyon
SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testator,as and
for his Last Will and Testament, in the presence of us,who at his request,have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testator and of each other.
�_ _.
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,
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, Robert E. Leyon, Ivo V. Otto III, and {'j'I15�/ZG'l� Y �arri�77�r� , the
Testator and the witnesses,respectively,whose names are signed to the 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 the Testator has signed willingly, and that the Testator
executed it as his free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the
best of his/her knowledge the Testator was at that time eighteen years of age or older,of sound mind
and under no constraint or undue influence.
d�i,�" �
R bert E. Leyon, Testator
Witness
� ' ��:.;,.t,.._ l ��,,-r ,��,,`
Witne s ,�
J
Subscribed, sworn to and acknowledged before me by Robert E. Leyon,the Testator, and
subscribed and sworn to before me by Ivo V.Otto III and J'I'1�9�2 G�'%f1 � «P7��'7 ,the
witnesses, this a��day of m , 2014.
Notary P lic
COMMONW�AL7H I� F�BNNSYLVANIA
NOTARIAL SEAL
Dena S.Brumbaugh,Notary Public
Carlisie Boro,Cumberland County
My Commission Expires Feb.18,2018
h1EMBER, PENNSYLVANIA ASSOCIATION OF NOTARIES
Page 3 of 3 Pages
.
. �
T�� Page 3 of 4
CREF Chcck Numbcr
P.o.eoX izsi 4702877727
Charlotte,NC 28201-1281
FnrANaA�sEt+v►Ces 800-842-2252
December 22, 2014
DICKINSON COLLEGE
ATTN ARLENE J BONES
PO BOX 1773
CARLISLE PA 17013
Below is information for your records about a transfer that was made on the above-referenced
date from TIAA-CREF to an account with your company. If yau have any questions or need
additional information, please write to us at the above address.
� ..
� Participant's Name: I�.QBERT-E-I�EYON
� TIAA.-CREF Accounts Transferred: IP 171847 /
� Amount of Transfer: $152,719.98
�
� Your Account Number(if available):
�
�
� Plan Name:
�
� Type of Plan:
..� Cash Available Under Plan Rules based
� on information available to TIAA-CREF: $0.00
�
�
� Include the following in your records for plan administration and IRS distribution requirements.
— This information is accurate to the best of our knowledge and is based on the information that
was received:
Contributions Earnings
Accumulation on 12/31/86 y().00
Accumulation on 12/31/88 $0.00
Post-1988 Employee Before-Tax �0.00 $0.00
Roth Date of First Contribution
Roth Year-To-Date ,�',0.00 $0.00
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. Page 1 of 1
Participant/ Beneficiary Summary (Account#: �HU073416)
Tit1e:IRA FBO ROBERT E LEYON RETIREMENT- IRA- ROLLOVER
PERSHING LLC AS CUSTODIAN
ROLLOVER ACCOUNT Home Phone:
1210 WHITE BIRCH LANE Business Phone: (717)245-0732 US Tax ID #: 011-28-2505
CARLISLE PA 17013-3591 Cell Phone: Primary IP#: 59X
Account Holder Summary
Name Participant Role US Tax ID # Home Phone Business Phone E-mail
ROBERT LEYON ACCOUNT (717)Z45-0732
HOLDER
Beneficiary Summary
Name Beneficiary Type US Tax ID #Relationship Gender Date of Birth Allocation(%)
CHRISTOPHER LEYON PRIMARY 1 SON MALE 33.00
REBECCA LEYON PRIMARY ► DAUGHTER FEMALE 33.00
CAROL WILLIAMS PRIMARY SPOUSE FEMALE 34.00
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January 28, 2015
PST'93360374
Mrs. CAROL A WILLIAMS
1210 White Birch Lane
Carlisle PA 17013
Re: Valuation of Annuity Contract(s)/CerNficate(s) at Decedent's Date of Death
Dear Mrs. CAROL A WILLIAMS,
� You have requested the value of the annuity contract(s)/certificate(s), held by TIAA-CREF, on the date of
.� death of Robert E Leyon. This statement has been prepared for you based on the following information:
= Name of Decedent: Robert E Leyon
� DecedenYs Date of Birth: 07/28/1936
� Decedent's Date of Death: 09/23/2014
=
_ VALUE OF ANNUITY CONTRACT(S)/CERTIFICATE(S)AT
— DECEDENT'S DATE OF DEATH
=
� ContracbCertificate Date of Death
� Number Value of the
= Contract/Certificate �j
_ ����� I
C8405I05 $108,356.02 ���-�� �` ti
U8405I03 $0.00 � �, !,Y l �j
C8413109 $62,273.33 - ���,���, ���
U8413t07 $0.00 � �C � .�
t
C8385I09 $27,853.37 �� C�. � �
U8385107 $0.00
Total Date of Death $198,482.72
Value
Investment in $476.32 �
Contract Total Value
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TIAA-CREF Individual&Institutional Services,LLC Member FINRA,SIPC. BENEBLJND-VD
Headquarters: 730 Third Avenue.New York 10017-3206 Tel: Z 12-490-9000
If you have any questions or need additional information,please call us at 888 380-6428, Monday to
Friday from 8 a.m. to 7 p.m., (ET). One of our consultants will be happy to help you. If you're hearing
impaired and are a TTY phone user, please call us at 800 842-2755.
Sincerely,
�C�t���,C��tt� .��J1uiCed /Caott
Beneficiary Services Team
(TIAA-CREF reserves the right to correct any clerical error in correspondencc.)
Annuity contracts and certificates are issued by Teachers Insurance and Annuity Association(TIAA) and
College Retirement Equities Fund(CREF),New York,NY.
Securities products are distributed by TIAA-CREF Individual&Institutional Services,LLC and Teachers
Personal Investors Services, Inc.,members FINRA.
�2010 Teachers Insurance and Annuity Association-College Retirement Equities Fund(TIAA-CREF),
730 Third Avenue,New York,NY 10017
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