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Home My WebLink About09-28-15 pennsytvania 1505614105 DEPARTMENT OF REVENUE EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT j ' C� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ..... .... . 1230201401081926 .. . .... ..... .... ..... ...... ....... Decedent's Last Name Suffix Decedent's First Name MI Williams SIR Lawrence E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI .. .... .. ........ .. ..... ...... C" s . .. ...... .....� _........_ _...... ._......_........ ..........__....._ ..__... .. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OID 1. Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Agriculture Exemption(date of C=) 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) OD 7. Decedent Died Testate O 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) O 10. Litigation Proceeds Received O 11. Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 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 Harry Gebert [(71"7) 214-6905 First Line of Address 834 Northern Spy Drive I Second Lineof ...�.v..._..........._.............. _ .._. ,..,_._.-„,... .... . _..,...__ Address rn i G •- � n -1 s t 3 •J { r y City or Post Office State ZIP Code r'_1 71 Mechanicsburg [_PA71, 117055 j aD Correspondent's email address: harry@abwe.Org REGISTER OF WILLS USE ONLYJ REGISTER OF WILLS USE ONLY DATE FILED MMODYYYY': I 1” DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 1111111111111111 111�gill[11ti 1111ppillil 1111111111111 1 4 1505614105 1505614205 REV-1500 EX(FI) Decedent's Social Security Number .........................._................................................... .......................................... ..._.............. Decedent's Name: Williams SR , Lawrence E RECAPITULATION 1. Real Estate(Schedule A). . .. ... ..... ......................... ....... . 1. 0.00 2. Stocks and Bonds(Schedule B) . .. .............................. ...... 2. 20,743.36 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. ? 0.00 4. Mortgages and Notes Receivable Schedule D 4. 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). ...... 5. 122,433.90 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. 8. Total Gross Assets total Lines 1 through 7 8. 143,177.26 9. Funeral Expenses and Administrative Costs(Schedule H)..... ........ ...... 9. 11,032.67 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). .............. 10. 272.01 11. Total Deductions(total Lines 9 and 10)................................. 11. 11,304.68 12, Net Value of Estate(Line 8 minus Line 11) ....................... ....... 12. 131,872.58 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. 131,872.58 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.0_ j 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 131,372.58 16, 5,911.77 17. Amount of Line 14 taxable at sibling rate X.12 € 17. 18. Amount of Line 14 taxable at collateral rate X.15 500 00 18. 75.00 19. TAX DUE ....... . ............... ..... .. .... .... .................. . 19. 5,986.77 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O 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. SIGH TUR F �ERSOf�_ PONSIBLE FOR FILING RETURN DATE ADD ES 834 Northern Spy Drive, Mechanicsburg, PA 17055 SIG TURE OF PREPA R OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE S' A DRESS 6300 Rockside R ad Ste 100, Independence, OH 44131 u 11 It Side 2 1505614205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Lawrence E. Williams SR. STREET ADDRESS 834 Northern Spy Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 5,986.77 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(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) 5,986.77 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 ............................................ ❑ 0 c. retain a reversionary interest .............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 2. If death occurred after Dec. 12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 0 3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death?.............. ❑ 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 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 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 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+(02-15) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lawrence E Williams Sr. 21-15-0031 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 415 shares Sun Life Financial Inc 15,155.80 2 153 shares Sun Life Financial Inc 5,587.56 TOTAL(Also enter on Line 2, Recapitulation) $ 20,743.36 If more space is needed,insert additional sheets of the same size REV-1508 EX+(02-15) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Lawrence E Williams Sr. 21-15-0031 Include 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 on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• Fulton Bank of New Jersey Savings account 119,433.90 2 Personal Property 3,000.00 TOTAL(Also enter on Line 5, Recapitulation) $ 122,433.90 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (02-15) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lawrence E Williams Sr. 21-15-0031 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. DuBois Funeral Home 7,726.10 2. Funeral refreshments 507.39 3. Flowers 262.15 4. Speaker:Rev Dan Smith 500.00 5. Picture frames for casket 27.53 6. Haddon Heights Baptist Church 300.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 697.50 • 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: 5. Accountant Fees: 1,000.00 6. Tax Return PreparerFees: 7• Bank Fee 12.00 TOTAL(Also enter on Line 9, Recapitulation) $ 11,032.67 If more space is needed,use additional sheets of paper of the same size. REV-7.512 EX+ (02-15) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lawrence E Williams SR 21-15-0031 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. OmniCare King-Pharmaceuticals 243.01 2. Taxes-Carroll Township 29.00 TOTAL(Also enter on Line 10, Recapitulation) $ 272.01 If more space is needed,insert additional sheets of the same size. REV-3.51.3 EX+ (02-15) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Lawrence E Williams Sr. 21-15-0031 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. Lawrence E Williams JR 10 Otter Place,Whiting,NJ 08759 Son 64,936.29 2. Janice Lee Gebert 834 Northern Spy Drive Mechanicsburg,PA 17055 Daughter 64,936.29 3. Anna Kober 5 Hunt St,Ft.Bragg,NC 28307 Granddaughter 250.00 4. Grace King 340 Morgan Dr,Lancaster,PA Granddaughter 250.00 5. Julia Hershey 408 Belmont Dr,Cherry Hill,NJ 08002 Granddaughter 250.00 6. Clara Lutz 2 Desford Lane,Boynton Beach,FL 33426 Granddaughter 250.00 7. Emma Moore 251 W 18th St,Apt 1 E,New York,NY 10011 Granddaughter 250.00 8. Greg Williams,7352 Beta Lane,Pensacola,FL 32504 Grandson 250.00 9. Susan Williams 10 Otter Place,Whiting,NJ 08759 Daughter-in-law 250.00 10. Harry F.Gebert 834 Northern Spy Drive,Mechanicsburg,PA 17055 Son-in-law 250.00 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. Da-e Tiede 11/'/00 LAST WILL AND TESTAMENT WE, JOAN R. WILLIkIMS AND LkWRIENCiE E. WILLIAMS,of the borou.-,h of Haddon V 4-[eigh'ts, in the County of Camden, and the state of New Jersey, being of sound nmind, met-nory and understandin.:-,r, d, hereby -make, publish. and declare the. fol-flow-il-1- as and for our last, Will and Testament, andt hereby revoke any and all Wills and Codicils by us at any time, heretofore made . FIRST: We order and direct our Executorp-xecutrix,. herinafter nazr.,iedA, to pay and discharge all of our debts, funeral and testamentary expenses, as soon as conveniently possible, after our individual death. SECOND: We bequeath to each other all real, personal and mixed properties should one predecease the other. In the event of common disaster whereby both of us should die simultaneously or within a short time of each other. our mutual bequest is as follows: All real, personal and mixed properties and possessions, includin- house , land, auto-nobiles , aircraft, furnishin-,;s, insurance , investments, bank accounts, etc . , with the exception of those special bequests as contained in the attached Appendix, is to be equally divided between our two children, Lawrence E. Jr. and Janice Lee .Should both children predecease either of us, our estate is to be divided equally between our six grandchildren, Anna Lee , Grace Elisabeth, Julia Ruth, Clara Louise , and Emma Abigail Gebert, and Gregory Mark Williams .Our son' s adopted daughter Yvette is expressly omitted by her choice . LASTLY: We nominate, constitute and appoint Jean Bryson as :Executor/ .Executrix of this our last Will and Testament. In the event , however, that said Jean Bryson should fail to -qualify or die before us or before final distribution of our estate is made, We nominate , appoint and constitute Harry F. Glebert as Executor of this our last Will and Testament. We further direct that our Executors shall not, be required to furnish bond or other security in any jurisdiction whatever for the faithful performance of their several duties hereunder and that they be reimbursed for any expenses incurred in connection with the settlement of this estate . IN, WITNESS WHEREOF: "We have hereunto set our hand(s ) and seal this day of jLiin the year of our Lord,,77cl-,-k-) L. S. -1A ISO, a-e ? . N. SPECTXL 3EQUESTS: These beq;Jests arc to individuals , if li'711= all wale time of o- death. if a des L= atreci-plant s'^.oU'Ld predecease our death, the particular bequest is to revert to the estate . 1 . 'TIo our son, Lawrence E. , T-. AAnand ai