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Home My WebLink About08-07-15 � � pennsytvania 15 0 5 61410 5 EPARTMENTOFPEVENUE EX(03-14)(FI) REV-1500 C7�F'E'ICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box z8o6o1 INHERITANCE TAX RETURN -,�I 1 / /�� Q Harrisburg, PA 17128-0601 RESIDENT DECEDENT r_ � / / ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 362- 10242011 10231912 DecedenYs Last Name Suffix DecedenYs First�;�me M� McDonald Clinton W (If Applicable)Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's Fir,t Nane MI THIS RETURN MUST BE FILED IN DUPLICATE WlTH Y'F'll_ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Originai Return p 2.Supplemental Return � 3. Remainder Retum(date of death prior to 12-13-82) p 4.Agricuiture Exemption(date of p 5.Future Interest Compromise(date of � 6. Federai Estate Tax Retum Required death on or after 7-1-2012) death after 12-12-82) � 7. Decedent Died Testate p 8. Decedent Maintained a Living Trusf __.—_ 9. Total Number af Safe Deposit Boxes (Attach copy of wili.) (Attach copy of trust.} � 10. Litigation Proceeds Received O 11. Non-Probate Transferee Return �� 12. DeferrallE�ecGon of Spousal Trusts (Schedule F and G Assets Oniy) O 13. Business Assets � 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TI�X IhI�ORMATION SHOULD BE DIRECTED T0: Name C'aytime Telephone Number Phyllis M. Preston (630) 362-7498 First Line of Address 1219 N. Eagie St. Second Line of Address City or Post Office State ZIP Code Naperville tL 60563 �� CorrespondenYs email address: stamm1750@yahoO.Com _______ t'a � � � � rn REGIS �i WI�LS ONL� p 'L7 c� cn � REGISTER OF WILLS USE ONLY � � � �� :'?7 +.y j--' _ ., . DATE FILED MMDDYYYY y .� �"' -�.] � '� Y Y % , � . � �� _.�� -r� �y�; � "�'1 ,. �p :� t'7 QAT�FILED STAT�P �� ------- � �r� �7 CO PLEASE USE ORIGINAL FORM ONLY Side 1 i iiiiii iiiii iiiii i�i��ii��i��i��i�iii iiii�ii��iiii 15 0 S 61410 5 ...� � ... � � 15056142�5 REV-1500 EX(FI) !JecedenYs Social Security Number �e�eaenrs Name: Clinton W. McDonald �_ 362-09-3793 RECAPITULATION 1. Real Estate(Schedule A). .. .... .. . . ... .. .. . ............. . ... . ..... .. . '6. 2. Stocks and Bonds(Schedule B) .. . .. .. .... . .... .. ....... .. .. .. ...... . . 2. 3. Closely Held Corporation,Partnership or Soie-Proprietorship(Schedule C) ..... 3. 4. Mortgages and Notes Receivable(Schedule D) . ... .. . .. ... ..... . . ... .... . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Scheduie E). . .. ... 5. 7,494.37 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Misceltaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets total Lines 1 throu h 7 8. 7,494.37 � 9 ).. .... . .. ........ .. ........ . . 9. Funeral Expenses and Administrative Costs(Schedule H)... .. .. ... ... ... .. . 9. 8,120.44 10. Debts of Decedent,Mortgage Liabilities and Lie�s{Schedule I). .... . .. . .. .... 1d. 1,219.42 11. Totai Deductions(total Lines 9 and 10).. ..... .. .. .. ... .. ..... .. .. ... . .. 11. 9,339.86 12. Net Value of Estate(Line 8 minus Line 11) ... .. ...... .... . .. . ...... .. ... 92. -1,845.49 13. Charitable and Govemmental BequestslSec.9113 Trusts for which an election to tax has not been made(Schedule J) .. ... .. ... . ..... . . . . . . .. 13. 14. Net Value Sub'ect to Tax Line 12 minus Line 13 14 -1,845.49 1 � ) ........ .... . ..... .... . . TAX CALCULATION-SEE INSTRUCTIONS FQR APPLICABIE RATES ^ 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0_ 15 0.00 16. Amount of Line 14 taxable at lineal rate X.0_ 1E�. 0.00 17. Amount of Line 14 taxabie 0.00 at sibling rate X.12 �� 18. Amount of Line 14 taxabie 0.00 at collateral rate X.15 ��' 19. TAX DUE ... .. ... . ... . . .. . ..... . .. ........ . . . ...... ........ . .. .. . . 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMERIT 0 Under penalties of perjury,I deciare I have examined this retum,including accompanying schedules and statem�erits,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 t�ased on all information of which preparer has wledge. _�_.. SI UR F PE ON R ONSIB FOR FILING RETURN DATE � T, 07/25/2015 ADDRESS 1219 N. Eagle St., Naperville, IL 60563 SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN �Y� DATE ADDRESS i iiiiii iiiii iii�i i�i��ii��i�uiii iiiii ii�i iui Side 2 � � 1505614205 �.,,,.,,��,��,�.. , REV-1500 EX (FI) Page 3 File NurmP.��r Decedent's Complete Address: __ DECEDENT'S NAME Clinton W. McDonald STREETADDRESS 210 Big Spring Rd. -- —__ _ ___ ------ ---- ---- CITY u1fA7E � ZIP Newville ' PA i 17241 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credi4s(�A,�B) (2) 3. Interest (3) 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) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) Make check payable to: REGISTER OF WILLS, ��GENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN '"X'" IIV 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 ............................................................................................................................. ❑ � 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�f deatf without receiving adequate consideration?................................................................................ ............................. ❑ � 3. Ditl decedent own an"in trust for"or payable-upon-death bank account or security at his or t E:r death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate prope�ty,�N�'ich containsa beneficiary designation? ................................................................................. ........ ............................. ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEpULF 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 vali.ie o`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 ta or f��r the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute tloes not exempt a transfer to a surviving spouse from tax,and ihe 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 young�e+ 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 imposetl on the net value of transfers to or for the use of the decedenYs lineal beneficiaries�is��.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 �s 12 p��rcent[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 tlecedent,wrt7eth�r by blood or adoption. ..�m�=ir-�v��rri�r- i i pennsylvania SCHEDULE E � DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN pERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Clinton W. McDonald 2011-01159 Indude 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 ci�n Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION �_J__ OF DEATH �� F&M Trust Checking Account 411.61 2 F&M Trust Burial Trust Account 7,082.76 TOTAL(Also enter on L�ne 5, (tecapitulation) $ 7,494.37 If more space is needed,use additional sheets of paper of t:he saiT e°size. ��11 l'If"11 7PTI71'� � . � SCHEDULE H � � pennsylvan a � DEPARTMENTOFREVENUE FUNERAL EXPENSES AND 1 INHERITANCETAXRETURN ADMINISTRATIVE COSTS � RESIDENT DECEDENT ��._.-_._. ESTATE OF i_.�.Y V PILE NUMBER Clinton W. McDonald 2011-01159 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION �_,__ AMOUNT A. FUNERAI EXPENSES: 1' Egger Funeral Home 7,907.94 2 Eby Granite Works 116.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s)_____ Street Address City ------ ---------- State._____ZiN___-- Year(s)Commission Paid: ____ �. Attorney fees: 3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanatior.) Claimant __________ ---- Street Address --- ---------------- CitY -----___5tate t 1 P___. --- ---- Retationship of Claimant to Decedent______ _____ ____.___—_..__ 4. Probate Fees: 96.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also ent�r+a�i Li�e 9, Recapitulation} $ 8,120.44 If more space is needed,use additional sheets of paper of the s�3me:>ize. „�"A ��I 11 71'llfl " - _ i i pennsylvania SCHEDULE I � DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF y FILE NUMBER Clinton W. McDonald _____ 2011-01159 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,i;nclaxling unreimbursed medical expenses. ITEM VALUE AT dATE NUMBER DESCRIPTION _______ OF DEATH l� Quantum Imaging 1.75 2 Ca�lisie Regional Hospital 1,132.00 3 Milienium Pharmacy 16.20 4 Presbyterian Homes,Inc. 69.47 TOTAL(Also enter on L�ne 10, F;ecapitulation} $ 1,219.42 If more space is needed,insert additional sheets of the same size. � i ii 7t trnfr � REGISTER OF WILLS CERTIFiCATE �F CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA ,� , No. 201 1- D 1 159 .PA 1Vo. 21- 11- 1159 Es ta te Of: CLINTON WINCHESTER MCDONALD lfi�st,Middle,LasU Late Of: WESTPENNSBORO 7�OWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 3&2_C?9-3793 WHEREAS, on the 28th day of Octot�er 2011 an instrLunent dated October 26th 2007 was admitted to probate as the .Iast wi12 of CLINTON WINCHESTER MCDONALD (Fi�st,Middle,LasU late of WEST PENNSBORO TOWNSH/P, CUMBERLAND County, who died on the 24th day of October 2011 and, WHEREAS, a true copy of the will as probated i.s annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , I2egister of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: PHYLLIS M PRESTON who has duly qualified as EXECUTORfR/X) 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, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 28th day of October 2011. E% �` � , „ i � � r ,. 4 . ....� < < � . , 1� ,. ' �'-• �� JC � �.s..��! � �, ' =* �� r, r.�� -- Regis7er of i s •' ,1J . � � (�t, �, ,,�'r �'j ��--.� I��. �..- �''p ';�eputy � �� **NOTE** ALL NAMES ABOVE APPEAR (FIRST, �IIDDLE, LAST) _.,�n rir u irri�r � c� LAST WILL Ai�iD TESTAPvIEti T ='� _ - __ OF -� -=-'�, _. _ ---- CLI:�iT0�1 W. V�CDONALI} _�-�_�;_; � � ��-1 ,. . .- I, Clinton W. NlcDonald, of West Pennsboro, To�vnship, Cumberland Eounty;�-�_; Pennsylvania, declare this to be my Last Will and Testament and revoke any and all wills and codicils heretofore made by me. ITEM I: My persanal representative shall pay from the residue of my estate the exnt°nses of my last illness, funeral and burial debts duly allo�ved a��iinst my estate, and all death taxes(Pennsylvania inheritance tax and feu�ral estate tax)occasioned l�y my death and incurred with respect to all property taxed to my estate regardless of whether such p1-operty passes by this Will or passes outside of this Will. ITEM II: I bequeath those articles of my aut�mobiles, personal effects, household goods, and other tangible personalty of like nature �not iilcluding cash or securities}, together with any existing insurance thereon,if any,as set forth in a separate memorandum which 1 shall place with my Will to the persons therein designated. If I shall le�ive no separate memorandum, �r�;�;t�;regar�to my au?om.�bil�s,personal effects,nouse�old goe�s,and other tangible personalty of like nature(not inclu�ing cash or securities)not referenced by such�nemorandum, l bequeath such property to my children,3ames C.1Vl�cDon�ld,Gerald D.Mcllonalcl,and Phy�lis M.Preston,to � �� be divided amon th�m b �mv Execut��r�vith due regard for their personal preferences in as nearly� � � y . ��r� ��"� equal shares as practical. �;% - ,ti� �� - �J ..s+m+ll I'II' '91'11'Flfl 5 � ITENI III: I de�ise and bequeath the residue of rny estate, of every� nature and wherever situate as follows: A) 1/3 to my son, James C. McDonald. If my son sha11 predecease me, I give and bequeath this share to his wife, Linda McDonald. If Linda McDonald shall also predecease me, 1 give and bequeath this share to my then surviving issue. B) 1/3 to my son, Gerald D. McDonald. If my son shall predecease me, I give and v��i.:3i3;'�'_;1�tC:'iiS:`:iF?'�ur�-,,n�rn��,.,��?. ifnehr�N[cDonald shal�also nredecease me,l�ive and w • �J _- • bequeath this share in equal parts to my �rands�n, Christopher P. Anderson and my step- granddaughter, Katie Brinsen. C) 1/3 to my daughter, Phyllis M. Preston. If my daughter shall predecease me, I give and bequeath this share to her husband, Bradley Preston. If Bradley Preston shall also predecease me, I give and bequeath this share to her son, Christopher P. Andersun. ITEM VI: I appoint my daughter,Phyllis M.Preston,Executrix of this my Last Will and Testament. Should she cease to qualify or cease to act as Executrix, I appoint my son, Gerald D. McDonald, as Executor of my estate. Should he cease to qualify or cease to act as Executor, I appoint my son, James C. MeDonald as Executor of my estate. ITEM VIL• I direct that my Executrix and her successors shall not be required to ��,�� ) :��1� give bond for the faithful performance of their duties in this or any c�ther jurisdiction. � ti `� '�,y � .»�n ,ir..0 ,rmr. , I�i WTTNE�S WHEREOF,I;Clinton W.McDonald,have hereunto set my hand and seal to this my Last Will and Testament, consisting of four (4) printed pages, each of which bears my signature, this ``� day of �J��j��;�� 200;1 !-� „ =y ; '� '--}��h �'�C.�,�,�- �. itj� 1 �• �..,r�_.�,� Clinton W. McDonald, Testator Signed,sealed,published and declar:•:i by the above-named Testator,Clinton W.MeDonald, a� �.�:� :c:��;� Lasi �1:'z?: :1.-•L'':;�s:�:F:•j :i? ,!�?�r:;=cA�l�� :�f�.��. ��h� at h:s rrauFst, in his sight and presei�ce, and in the sight and presence c` each other, have hereunte� subscr:bed our name� as witnesses. < , � �l , � --'1 � ' �` -_-; �f t: , #` . c� L :L-C. t-�=ti. �L � u�CG-�-�� / ` - ::.�n.i�ir..�u��rn�i� e 4 CON�Ii�10NWEALTH OF PEi�NSYLVANIA ) : SS. COUIvTY OF CUMBERLAND ) WE, CLINTON W. MCDONALD, =-1t�H'k.' _��'r_��—��---• and �;�� ,�,i�,`,-��,1 �.��q ,the Testator and witnesses,respectively,whose ziames --�T� � . •. are signed to the foregoing or attached instrument,being first duly swarri, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as and for his Last Will and Testament and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in tlle presence and hearing of tl�e Testator,signed the Will as witnesses and that to the best of their knowledge the Testator was at the time eighteen(18)or more years of age,of sound mind and under na co�istraint or undue influence. � �� G''��``�f �' ` `��--- ��inton �'. 1Vic �onalu, i estator � �� J .--. l�cc-��,� ,, �_. ,, ` �� , Witness �� ,�, -,��'�`"�-_ �Witness Subscribed, sworn to and acknowledged before me by Clint�n'dJ. McDonald,the Testaand and subscribed to and sworn or affirmed to before me by '��;�:-}�i-z-.�� '��i�r 2i10?. 1 �i >i�c: ��.-,�;E:'•�tr•'- ,witnesses,this �,l�d�yof L�:� _ ._-- . �t�r --�- . ----- : � ; ' �3y_' ,• 1 _�.. , , �;�1 '_��,_`,-i;;:��-�.�----�SEAL) Notary Public " CflMNiO�VWEr�LfH OF PENNSYLVANIA Nt�tarial Seai Vicki L.Fiopkins.Notar�l Pubkc West Pennsbcxo Twp.,Cumberland Cou�h' My Commissi�n Expires Jan.15.2008 Member.Pennsylcania Association Of NoLries �n.i.ii..,7� trmr R • . � ��. �.:m.��.�, , � y�' � � f_ �,,,,� M� S ��(_ , _ /� .,�,.r1 as ,�� u�� '1 ��C�I�..cC.lC. �.y..�.. O � � � � , �1�. �� .� - �.�, �'?��t� O t`( S� � . _ � � �, �� ► a� m r� �'" rn e� � �r � �� - ;��-, � tz3 -c� � .w...� c-� {-s"� ^;- � ...,r� �`t� "�'3 �� J ��7 ,�..,, _.,� C.7 -�r �j 'vC1 "��. . ...�� ;^1 . _� ' `� � c�s `t',r C�V � � .:.,a� "''; � � �'J :fi y "'^" Ilf'll 7ff111 r, a �, I I17 �� ` � � � ��c��V�U c� ; � , - �� n+c�-r..'-s �. `i i r � a., . .. . 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