HomeMy WebLinkAbout06-01-05
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217
REV-1500 E.X (6-00)
D 2. Supplemental Return
0...
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
010. spousalf>oYBnyCred~((laleofdealhDlnween12-31-91 alld 1.1-95)
PliE1'ED, ALL C()RRESPONDENCE'ANDCONFlDENTlAL TAX INFORMATlElN SHOULD BE DIRECTED TO:
COMMONWEALTH 0
PENNSYLVANIA
DEPARTMENT OF REVE UE
DEPT. 280601
HARRISBURG, PA 17128 0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AN MIDDLE INITIAL)
S Ivester A Mixell
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-OD- YEAR)
1/10/2005 7/2/1920
(IF APPLICABLE) SURVIVING SPOUSE NAME (LAST. FIRST, AND MIDDLE INITIAL)
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Kathleen C. Mixeli
01. Original Return
D 4. Limited Estate
06
D 9. litigatiOn Proceeds Received
THIS"8El::1'IElN!,MUST BE C
NAME
COMPLETE MAILING ADDRESS
5 South Hanover Street
Carlisle PA 17013
Future Interest Compromise (date of death after 12-12-82)
Decedent Died Testate (Attach copt of Will)
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Robert M. Fre
FIRM NAME (If Applicable)
717243-5838
1. Real Estate (Schedule A)
(1)NONE
(2) NONE
(3) NONE
(4) NONE
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2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, partners~p or Sole-Proprietorship
,
4. Mortgages & Notes Receivable (Sct1edule 0)
5. Cash, Bank Deposits & MjSCellaneo~ Personal Property
(Schedule E) I
6. Jointly Owned Property (Schedule ~
Dseparate Billing Requested :
I
7. Inter-Vivos Transfer & MiscellaneOU$ Non~Probate Property
(Schedule G or l) i
(7) NONE
(5)
(6)
8. TOTAL GROSS ASSETS (totallin~ 1-7)
9. Funeral Expenses & Administrative ~osts (Schedule H) (9)
10. Debts of Decedent, Mortgage liabili~ies, & liens (Schedule I) :10)
11. TOTAl DEDUCTIONS (total lines ~& 10)
12. NET VALUE OF ESTATE (line 8 mt.. us line 11)
13. Charitable and Governmental Bequ stslSec 9113 Trusts for which an election to tax has not
been made (Schedule J) ;
I
14. Net Value Subject to Tax (line 12 m nus line 13)
(8)
(11)
(12)
(13)
(14)
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SEE INSTRUCTION ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the s~usaltax
rate ,or transfers under Sec.9116 (al{1.2) 668,048 x .0
(15)
16. Amount of Une 14 taxable at lineal ~te
x .0
(16)
17, Amount of line 14 taxable at sibling tate
x .12
(17)
18. Amount of line 14 taxable at cOllatetl rate
x .15
(18)
19. Tax Due
OFFICIAL USE ONLY
FILE NUMBER
21-05-0249
COUNTY COOE
'EAR
NUMBER
SOCiAl SECURITY NUMBER
204-03-1929
THIS RETURN MUST BE ALEC IN OUPUCA TE WITH THE
REGISTER OF WILLS
SOCiAl SECURITY NUMBER
191-18-3865
03
D 5. Federal Estate Tall. Return ReQuired
Remaincle,ReWtn(dateo/dellthprio,1012.1J..82j
8, Total Number of Safe Oeposll Boll.es
011. Election to tax under Sec. 9113(A) (AUach Sch 0)
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OFFI~ use 9Nl!-:
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123,687
546.413
C)
670,100
2,052
2,052
668,048
66B,048
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(19)
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> >BE SURET Atlswe~ ALL QUESTIONS ON REVERSE SIDE AND REGHECK MATH < <
217
Decedent's Com
STREET ADDRESS
177 Centerville R
Sylvester A Mixeli
204-03-1929
CITY
Newville
STATE
PA
ZIP
17241
Tax Payments and Credits:!
1. Tax Due (Page 1 Une 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C_ Discount
(1)
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TotaICredits(A+B+C) (2) n
3. Interest/Penalty if applicable
o Interest
E_ Penalty
4.
Total Interest/Penalty ( 0 + E )
If Line 2 is greater than Line 1 + Line 31' enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(3)
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5.
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2.
a. retain the use or i~come of the property transferred;
b. retain the right to ~esignate who shall use the property transferred or its income;
c. retain a reversion~ry interest; or
d. receive the promisF for life of either payments, benefits or cafe? . . . . . . . . . . . .
If death occurred after becember 12,1982.did decedent transfer property within one year of death
,
without receiving adeq~ate consideration?
Did decedent own an "~n trust for" or payable upon death bank account or security at his or her death?
,
Did decedent own an Ipdividual Retirement Account, annuity or other non-probate property which
contains a beneficiary esignation?
3.
4.
Under penallies of perjury, I declare that I have exam
and lete. Declaration of rer other than the
SIG TURE OF PERSON ESPONSIBLE F
~
ed this return, induding accompanying schedules and statements, and 10 the best of my knowledge and belief, it is true,
rsonal re resenlalive is based on all information of which re arer has an knowled e.
R FILING RETURN DATE
5/9/2005
177 Centerville Road Newville PA 7241
SIGNATURE OF PREPARER OTHER THAN EPRESENTATIVE
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AODRESS , \
5 South Hanover Street, Carlisle P~ 17013
DATE
5/9/2005
For dates of death on or after July " 1994 and before!January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
{72 P.S. Section 9116 (a}(1.1)(i)]
For dates of death on or after January 1, 1995, the ta~ rate Imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(1.1){ii)].
The statute does nol exempt a transfer to a surviving ~pouse from tax, and the statulory requirements fot disclosure of assets and fiJlng a tax return are slill 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 Ihe net value of transfers frorfl a deceased child twenty-one years of age Of younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0%(72 P.S. Section 911~(a)(1.2)J.
The tax rate imposed on the net value of transfers to 9r for the use of the decedent's lineal beneficlaries is 4.5%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 9116(a)(1)J.
The tax rate imposed on the net value of transfers to ct for the use of the decedent's siblings is 12% (72 P.$. Section 9116{a)(1.3)) .A sibling is defined, under Section 9102, as an
individual who has at least one parent In common wlthithe decedent, whether by blood or adoption.
217
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DeCEDENT
ESTATE OF
Sit AM. II
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
,Vives er Ixe , - -
Incl~~~J~ei~roceedS of litigation and the date the proceeds were received by the estate.
All pro 'ointlv-owned with riaht of survivorshio must be disclosed on Schedule F.
ITEM ! VALUE AT DATE
NUMBER , DESCRIPTION OF DEATH
1 Orrstown Bank, Che king Acct#10621379 34,137
2 Orrstown Bank, Cert ficate of Deposit #5060058939 50,050
3 Automobile, 2003 Li . coin 15,000
4 Automobile, 2004 4/poor Ford Truck 24,500
TOTAL (Also enter on line 5, Recapitulation) $ 123,687
.,
FILE NUMBER
21 05 0249
(If more space IS needed, Insert additional sheets of the same sl2e)
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ORRSfOWN
BANK
April 26, 2005
TO: Frey & Tiley
Allorneys-at-la'^'1
5 South Hanover! Street
Carlisle, PA 170113
FROM: Timothea MOQse
Cust. Servo Op.
PO. BOX 25<1
SHIPPENSBlJiRG PA 17257-0250
RE: ESTATE OF S~lvester A Mixell
DATE OF DEP\TH: January 10, 2005
IT IS HEREBYiCERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUI\lTS WITH ORRSTOWN BANK: .
CHECKING AqCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
106213879 'SylvesterAMixell 1/22/01 34,117.45 19.63
SAVINGS ACqOUNTS
ACCOUNT NO! TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
CERTIFICATE~ OF DEPOSIT
ACCOUNT NO!. TITLE OF ACCOUNT DATEOPENED PRINCIPAL & ACCRUED INTEREST
5060058939 ' Sylvester A Mixell 9/24/97 50,000.00 50.07
.
PO Box 250. Shippen5bu~q. PA 17257. (7171532-6114. (7171 ~~7..A.14~ ~~v. .......UM_._..._ ---
217
REV.1509 EX+ (&-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Sylvester A Mixell
FILE NUMBER
21-05-0239
If an asset was made Joint within one year of the decedent's date of death. it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
,
ADDRESS
RELATIONSHIP TO DECEDENT
A. Kathleen C. Mlxell
177 Centervllle Road
Newville PA 17241
Spouse
8.
C.
JOINTLY-OWNED PROPERTY-
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INClUDE ~AME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT ID~NTIFYING NUMBER. ATTACH DEED FOR JOII>(TLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A Real EstatE1, House and Land at 177 Centervllle Road 150,000 50.00% 75,000
2. A Real Estat~ House and Land at 171 Centerville Road 175,000 50.00% 87,500
3. A Mobile Ho e Park, 75 Bonnybrook Road 750,000 50.00% 375,000
4. A Real Estate~ 5 Movile homes located in Mobile Park at 15,000 50.00% 7,500
75 Bonnybr ok Road at $3,000 each.
5. A 1.20.98 M&T Bank, r::ertificate of Deposit #031003914691710 2,826 50.00% 1,413
. TOTAL (Also enter on line 6 Recaoitulation
$ 546413
(If more space is needed, Insert additional sheets of the same size)
J~p- ~ ~ ~~ /.P4c!'
93 ENCKS MILL ROAD
17013
Phone: (717) 243.5102
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REAuon-
April 13, 2005
Mrs. Kathleen Mixell, Executrix of the
I
Estate of Sylvester f.. Mlxell, Deceased
clo Robert M. Frey,IEsquire
5 South Hanover S~reet
Carlisle, PA 17013
Re: Appraisal of ~eal Estate owned by
Sylvester A. Mixell and Kathleen Mixell
Dear Mrs. Mixell:
I have apprai~ed the real estate owned jointly by you with your husband,
Sylvester A. Mixell, ~ince his death on January 10, 2005, now owned solely by
you, located in Sou~h Middleton Township and West Pennsboro Township, and in
my opinion the fair rrarket value of these properties as of January 10, 2005 is as
follows:
1. MobilE! Home Park located at 75 Bonnybrook Road, $750,000.00.
2. Five nlobile homes located in mobile home park at 75 Bonnybrook
Road, $3,000.00 eaCh or $15,000.00 total.
3. House and land at 177 Centerville Road, $150,000.00,
4. House and land at 171 Centerville Road, $175,000.00.
I have no int~rest of any kind in the estate of Sylvester A. Mixell, and this
appraisal is submitt$d by me based on my more than 45 years experience as a
real estate broker i~ Cumberland County.
L. B. Phillips, Jr.
LBP/tI
~M&T~
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934.2955
May 2, 2005
Frey & Tiley
Attorneys At Law
5 South Hanover Strellt
Carlisle, Pennsylvani4 17013
Re:
Dear Sir or Madam:
Per your inquiry dated April 2~, 2005, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1. Type of Account Certificate of Deposit
Account Number 031003914691710
Ownership (Names4) Kathleen Mixell .
Sylvester A Mixell .
Opening Date 01/02/98
Balance on Date olpeath $2,797.65
Accrued Interest. $ 28.82
_ __~"u___.nn.+'n___._ _+__n+_,__n_~_______
Total $2,826.47
Please be advised, there was nq safe deposit box found for the above decedent.
* For further account inforQt1ltion, regarding ownership, closures and/or reimbursement of funds, etc., please call
the Carlisle West Office # 711.240-6717.
Sincerely,
~a~
Nancy Clagett
Records Management
217
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
21-05-0249
Sylvester A Mixell
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:'
1.
B. ADMINISTRATIVE CO~S:
1. Personal Representativ~'s Commissions
Name of Perso~al Representative (5)
Social Security!Nurnber(5) I EIN Number of Personal Representalive(s)
Street Address i;
City i State Zip
Year(s) Commi~slon Paid:
2. Attorney Fees 1,750
3. Family Exemption: (If d~ent.s address is not the same as claimant's. attach explanation)
Claimant
Street Address "
City i State Zip
Relationship of ~Iajmant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fejes
7. Register of Wills, Prob~te Will 173
8. Register of Wills, (1) Short Certificate 4
9. Register of Wills, Addi~onal Probate Fees 125
.
TOTAL (Also enter on line 9 Recaoitulation $ 2052
(If nilore space is needed, insert additional sheets of the same size)
217
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYL VANI"-
INHERITANCE TAX RETURN
RESIOENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Svlvester A Mixell 12-05-0249
NAME AND ADDRE~S OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER Do Not List Trustee(s} Of ESTATE
I. TAXABLE DISTRIBUTIONS [i~~Ude outright spousal distributions, and transfers under
S!>C. 9116 (a) (1.2)J
Kathleen C. Mixell Spouse 100% residue of estate
177 Cenlerville Road
Newville PA 17241
ENTER DOLLAR AMOUNTS FOIR DISTRIBUTIONS SHOWN ABove ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBlITION~:
A. SPOUSAL DISTRIBlITlONS ~NDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNIIIENTAL OISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
-,
LAST WILL AND TEST AMENT
OF
SYLVESTER A. MIXELL
I, SYLV A. M\XELL, of West Pennsboro Township (mailing address: 177
Centerville Road, Newville, PA 17241), Cumberland County, Pennsylvania, being of sound and
disposing mind, emory, and understanding. do hereby make, publish. and declare this as and for
. ., my Lsst Will and estament, hereby revoking and making void any and all Wills by me at any time
heretofore made.
1. I direc~ti my hereinafter named Ex.ecutrix or Executors to pay all of my just debts and
funeral expenses s soon after my death as may be found convenient to do so. I direct that my
body be cremated nd that my funeral services be conducted by Ewing Brothers Funeral Home, 630
South Hanover S e~ Carlisle, Pennsylvania, and that my ashes be delivered to my Executrix or
Executors for disp ,sitlon in whatever manner is deemed appropriate by my Executrix or Executors.
2. I directa'that all inheritance, (mnsfer, estate, succession, and death taxes which may be
payable on accoun of my death, including interest and penalties thereon, shall be paid from the
residue of my esta regardless of whether the assets upon which such taxes are based are included
in my probate estat
3". All the :;rest, residue, and remainder of my estate, real, personal, or mixed, and
wheresoever the sa,pe may be situate, I give, devise, and bequeath to my wife, KATHLEEN C.
MIXELL, her heirs ,nd assigns, to the exclusion of my children, born and unborn,
,
4. ShOUld~my said wife, Katltleen C. Mixell fail to survive me, I give and bequeath all
lawn care equipmen and tools including tractors and mowers to my son, PAUL A. MIKELL, but
should he predeceas me then the same shall lapse and be included in the residue of my estate.
'I
5. If at the ~me of my death I am the owner of the mobile home park located at 75
Bonnybrook RQad inouth Middleton Township, Cumberland County, Pennsylvania, I give, devise,
and bequeath the sa e, including aU mobile homes and equipment located at said park which are
owned by me, in ual shares 10 my two sons, PAUL A. MIXELL and WAYNE MELVIN
MIXELL, their heirs nd assigns, provided each of them shall survive me by a period of ninety (90)
days, but should eith r of them fail to so survive me then tlte share such deceased son would have
received shall pass t<1 such of his legitimate issue as shall survive me by a period of ninety (90)
days, thelr heirs and a~signs, per stirpes.
6. Should m*said wife, Kathleen C. Mixell faU to survive me, then in such event, all the
rest, residue and remai der of my estate, real personal and mixed, and whereooever the same may be
situate, 1 give, devise a d bequeath as follows:
,
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(a) 5%',to my grandson, PAUL A. MIXELL, JR., his heirs and assigns,
provided he Sh~1 survive me by a period of ninety (90) days, but should he fail to
so survive me t en to such of his legitimate issue as shall survive me by a period
of ninety (90) ays, their heirs and assigns, per stirpes, and if there be no such
issue the same hall lapse and be added proportionately among the other legatees
set forth in subf-iragraphs below.
I
(b) 5%~mY granddaughter KATHY FREDERICK, nee MIXELL, her
heirs and assig s, provided she shall survive me by a period of ninety (90) days,
but should but should she fail to so survive me then to such of her legilimate
issue as shall s ive me by a period of ninety (90) days, their heirs and assigns,
per stirpes, and if there be no such issue the same shall lapse and be added
proportionalely ~mong the other legalees set forth in subparagraphs above and
below. '
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(c) 5% t\J my grandson, ANTHONY WAYNE MIKELL, his heirs and
assigns, provided he shall survive me by a period of ninety (90) days, but should
he fait to so sun.~ve me then to such of his legitimate issue as shall survive me by
a period of ninet (90) days, their heirs and assigns, per stirpes, and if there be no
such issue the s me shall lapse and be added proportionalely among the other
legatees set forth in subparagraphs above and below. .
(d) 5% td my great-grandson TYLER A. MIXELL, his heirs and assigns,
provided he shall survive me by a period of ninety (90) days, but should he fail to
so survive me thet to such of his legitimate issue as shall survive me by a period
of ninety (90) da S, their heirs and assigns, per stirpes, and if there be no such
issue the same sh. 11 lapse and be added proportionately among the other legatees
Page I of 2 pages
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set forth in ~ubparagraphs above and below.
(e) ,\0% to my son, PAUL A. MIXELL, his heirs and assigns, provided
he shall sU~ive me by a period of ninety (90) days, but should he fail to so
survive me en to such of his legitimate issue as shall survive me by a period of
ninety (90) ays, their heirs and assigns, per stirpes, and if there be no such issue
the same sh II lapse and be added proportionately among the other legatees set
forth in subP!'ragraphs above and below.
(I) 2b% to my son, WAYNE MELVIN MIXELL, his heirs and assigns,
provided he ~hall survive me by a period of ninety (90) days, but should he fail to
so survive 1 then to such of his legitimate issue as shall survive me by a period
of ninety (9) days, their heirs and assigns, per stirpes, and if there be no such
issue the sa e shall lapse and be added proportionately among the other legatees
set forth in s bparagraphs above.
7. The meaning of "legitimate issuen as used in this Last Will and Testament shall
be limited to a child pr children born to a female descendent of Testator regardless of whether the
mother is married tOi'the father of such child or children, and shall be limited to a child or children
born to a male dese dent of Testator where the father of such child or children is married to the
mother either before r after the birth of the child or children. In any case the meaning of child or
children or legitimate, issue as used above shall not include any adopted child or children.
8. 1~'erebY nominate, constitute, and appoint my wife, KATHLEEN C. MIXELL,
as Executrix of this y Last Will and Testament, but should she predecease me or fail to qualify, or
cease serying as such then in such event I nominate, constitute, and appoint my two sons, PAUL A.
MIXELL and WANE MELVIN MIXELL, as ailemate or successor Executors and I further
direct that none of th m shall be required to post any bond to secure the faithful pelformance of his
or her duties in the C mmonwealth of Pennsylvania or in any other jurisdiction.
IN WlTNES~ WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament written on ~ pages, this 10th day of lune, 2003.
#J~ J!l~SEAL)
S VESTER A. MlXE
Signed, sealedf.' published and declared, by SYLVESTER A. MIXELL, the Testator above
named, as and for his st Will and Testament, in our presence, who, in his presence, at his request,
and in the presence of 3ch other, have hereunto subscribed our names as attesting witnesses,
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Page 2 of 2 pages
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