HomeMy WebLinkAbout01-1040
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
//-;20 -/1 '*' '7t
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
Recore,-
Registc~'
__c; of
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-31-2001
MCQUILLEN
08-21-2001
21 01-1040
CUMBERLAND
101
ROBERT G FREY
5 S HANOVER ST
CARLISLE
.02 Jl\N -4 Pl2 :32
REV-1S47 EX iFP U2-00)
EVELYN
I
~i6lR~13
GUlnberla,--d 1 PA
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is'4-j-ix-"Fji'-fi2':olff-No'ficE"-OF-':ftiHiiiiTAirci-y"Ax-APPRAisiMENT~--"Li-oWAiici-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MCQUILLEN EVELYN I FILE NO. 21 01-1040 ACN 101 DATE 12-31-2001
TAX RETURN WAS: (XJ ACCEPTED AS FILED
J CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15J
16. Allount of Line 14 taxable at Lineal/Class A rate (16J
17. Allount of Line 14 at Sibling rate (17J
18. Allount of Line 14 taxable at Collateral/Class B rate (18J
19. Principal Tax Due
TAX CREDITS:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule AJ
2. Stocks and Bonds (Schedule BJ
3. Closely Held Stock/Partnership Interest (Schedule CJ
4. Mortgages/Notes Receivable (Schedule OJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule FJ
7. Transfers (Schedule GJ
8. Total Assets
UJ
(2J
(3J
(4J
(5J
(6J
(7]
.00
.00
.00
.00
11.907.00
34.980.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule IJ
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9J
UOJ
7,387.00
.00
NOTE:
.00 X 00 =
39,500.00 X 045=
.00 X 12 =
.00 X 15 =
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
46,887.00
U1J
(12J
U3J
(4)
7.387 no
39,500.00
.00
39,500.00
U9J=
.00
1,778.00
.00
.00
1,778.00
PAYMENT RECEIPT DISCOUNT (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-J
11-14-2001 CDOO0524 88.90 1,693.00
TOTAL TAX CREDIT 1,781.90
BALANCE OF TAX DUE 3.90CR
INTEREST AND PEN. .00
TOTAL DUE 3.90CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-' '62 EX{' '-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MCQUILLEN DANA L
209 CAVALRY STREET
CARLISLE, PA 17013
_nn___ fold
ESTATE INFORMATION: SSN: 174-05-0962
FILE NUMBER: 21-2001- 1040
DECEDENT NAME: MCQUILLEN EVELYN I
DA TE OF PAYMENT: 11/14/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/21/2001
NO. CD 000524
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,693.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,693.00
REMARKS: DANA L MCQUILLEN
CHECK#1788
SEAL
INITIALS: SK
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
"~ /
>1\.
c..
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Evelyn I. McQuillen
Date of Death:
August 21, 2001
Will No.
21-01-1040
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respgct to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete':
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this r~port.
3~,
January 8, 2002
Date:
Robert G. Frey
Name (Please type or print)
rl!8I1a~~t: sHanover Street, Carlisle, P A 17013
Lv: e \t . (717) 243-5838
V L Nl/f 'tl}.l. No.
\fd
Slfirv: !it: ~r;r..?tC; i t y :
~ "-.'C- ...) !; )SI::J
to 8'" 03PIO~)at:l
Personal Representative
(MAH: rmf/AM3)
X Counsel for personal
representative
'-'
Il- ),{/'-- J /
S-;(
c
217 -.J
REV-1500 EX (6-00) REV-1500 OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN
DEPT. 280601 FILE NUMBER
HARRISBURG, PA 17128-0601 2 1 - 0 1 ... Jot/o
RESIDENT DECEDENT
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I- McQuillen, Evelyn I. 174-05-0962
Z DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
W THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W 8/21/2001 7/20/1913 REGISTER OF WILLS
u
w (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
w 01. Original Return o 2. Supplemental Return 03. Remainder Return (date of death prior to 12-13-82)
I-
<I: V> 04. 04a. Future Interest Compromise (date of death after 12-12-82) 05.
:':ii::.: Limited Estate Federal Estate Tax Return Required
0"-0
wOO 06. o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
"0::-" o 8.
0"-,,, Decedent Died Testate (Attach copy of Will) Total Number of Safe Deposit Boxes
"-
<I: 09. 010. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1.95) 011. Election to tax under Sec. 9113(A) (Attach Sch 0)
Litigation Proceeds Received
I- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
z NAME COMPLETE MAILING ADDRESS
W
c Robert G. Frev 5 South Hanover Street
z
0 FIRM NAME (If Applicable) Carlisle, PA 17013
D..
en
w Frey & Tiley
0::
0:: TELEPHONE NUMBER
0
U 717-243-5838
OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1) NONE
2. Stocks and Bonds (Schedule B) (2) NONE
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE
4. Mortgages & Notes Receivable (Schedule D) (4) NONE
5. Cash, Bank Deposits & Miscellaneous Personal Property
11,907 I
(Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6) 34,980
Z D Separate Billing Requested
0
i= 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property
<
...J (Schedule G or L) (7) NONE
:::l
l-
ii: 8. TOTAL GROSS ASSETS (total Lines 1-7) 46,887
< (8)
U
W 7,387
0:: 9. Funerai Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10) NONE
11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 7,387
12. NET VALUE OF ESTATE (Line 8 minus Line 11) (12) 39,500
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J) (13) 0
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 39,500
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate ,or transfers under Sec.9116 (a)(1.2) x .0 -- (15) 0
Z
0
i= 16. Amount of Line 14 taxable at lineal rate 39,500 x .045 (16) 1,778
< -
I-
:::l
D.. 17. Amount of Line 14 taxable at sibling rate .12 0
:ii: x (17)
0
U
X 18. Amount of Line 14 taxable at collateral rate x ,15 (18) 0
<
I-
19. Tax Due (19) 1,778
20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
217
Decedent's Com lete Address:
STREET ADDRESS
McQuillen, Evelyn I.
209 Caval Street
CITY
Carlisle
174-05-0962
STATE ZIP
PA 17013
(1 ) 1,778
1,693
85
Total Credits ( A + B + C ) (2) 1,778
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Pena Ity
4.
Total Interest/Penalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(3)
5.
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
o
o
o
o
1.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and:
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;
Yes
D
D
D
D
D
o
2.
c. retain a reversionary interest; or
d. receive the promise for life of either payments, benefits or care?
If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
3.
4.
Did decedent own an Individual Retirement Account, annuity or other non-probate property which
contains a beneficiary designation?
o
[g]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
No
[g]
[g]
[g]
[g]
[g]
[g]
DATE
November I ~ 2001
ADDRE
5 South Hanover Street
DATE
November :J 2001
13
For dates of death on or after July 1. 1994 and before January 1, 1995, the tax 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 tax 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 )(il)].
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 twenty-one 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%[72 P.S. Section 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%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 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% [72 P.S. Section 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.
AT
REV-15GB EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
McQuillen, Evelyn I.
FILE NUMBER
21-01-
Include the proceeds of litigation and the date the proceeds were received by the estate. ALL PROPERTY JOINTL V-OWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F.
ITEM
NUMBER
1.
DESCRIPTION
First Union Account No. 247412056280041
accrued interest on above account to date of death
First Union Account No. 3000324261580
accrued interest on above account to date of death
VALUE AT DATE
OF DEATH
2.
6,568
119
5,218
2
TOTAL (Also enter on line 5, Recapitulation $
(If more space is needed, insert additional sheets of the same size)
11,907
AT
REV-1509 EX + (1-97) (i)
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL V-OWNED PROPERTY
ESTATE OF
FILE NUMBER
McQuillen, Evelyn I.
21-01-
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. Dana L. McQuillen
209 Cavalry Road
Carlisle, Pennsylvania 17013
Son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financiai institution and bank account number or similar identifying number. DATE OF DEATH DE CD'S VALUE OF
NUMBER TENANT JOINT Attach deed for 'ointlv-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 6/15/92 M & T Bank, acct. no. 916358, noninterest bearing 69,959 50.00% 34,980
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 6, Recapitulation , $ 34,980
(If more space is needed, insert additional sheets of the same size)
AT
REV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
McQuillen, Evelyn I.
21-01-
Debts of decedent must be reoorted on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Funeral Home 3,622
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 250
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Dana L. McQuillen
Street Address 209 Cavalry Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent Son 3,500
4. Probate Fees 15
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, RecaDitulation $ 7,387
(If more space is needed, insert additional sheets of the same size)
217
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
McQuillen Evelvn I. 21-01-
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONISI RECEIVING PROPERTY Do Not List Trusteelsl OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
1. Dana L. McQuillen
209 Cavalry Road
Carlisle, PA 17013 Son 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. None.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
None.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0
(If more space is needed, insert additional sheets of the same size)
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LAST WILL AND TEST AMENT
OF
EVELYN 1. M<:QUILLEN
-,
, 1
I, EVELYN I. McQUILLEN, widow, of North Middleton Towns~ip (~ailing Address:
209 Cavalry Road, Carlisle, PA 17013), Cumberland County, PennsylvanIa, bemg ,?f sound and
disposing mind, memory and understanding, do hereby make, publish and declare thIS as and for
my Last Will and Testament hereby revoking and making void any and all Wills by me at any time
heretofore made.
1. I direct my hereinafter named Executor to pay all of my just debts and funeral
expenses as soon after my death as may be found convenient to do so. I direct that my services
be conducted by Ewing Brothers Funeral Home, 630 South Hanover Street, Carlisle,
Pennsylvania, in a manner which my Executor deems appropriate, and that my body be interred
beside that of my husband, Alvin K. McQuillen, on- our burial lot located in Cumberland Valley
Memorial Gardens along Ritner Highway near the Borough of Carlisle, Pennsylvania.
2. I direct that all inheritance, estate and death taxes which may be payable on account of
my death, including penalties and interest thereon, shall be paid from the residue of my estate
regardless of whether the assets upon which such taxes are based are part of my probate estate.
3. All of the rest, residue and remainder of my estate, real, personal and mixed, and
wheresoever the same may be situate, I give, devise and bequeath to my son, Dana L. McQuillen,
his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he
fail to so survive me then to such of his hereafter born legitimate issue who shall survive me by a
period of ninety (90) days, per stirpes, and if there by no such issue the same shall lapse.
4. Should my said son, Dana L. McQuillen, predecease me or fail to survive me by the
aforesaid period of ninety (90) days and should no legitimate issue of his survive me by a period
of ninety (90) days, then in such event all of the rest, residue and remainder of my estate, real,
personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my
son, Victor D. McQuillen, his heirs and assigns, provided he shall survive me by a period of
ninety (90) days, but should he fail to so survive me then to such of his legitimate issue as shall
survive me by a period of ninety (90) days, their heirs and assigns, per stirpes.
5. I hereby nominate, constitute and appoint my son, Dana L. McQuillen, as Executor of
this my Last Will and Testament but should he predecease me or fail to qualify or cease serving as
such, then in such event I nominate, constitute and appoint my son Victor D. McQuillen, as
alternate or successor Executor, and I further direct that neither of them shall be required to post
any bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania
or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament written on one (1) page, this 19th day of June ,1992.
4~~t f) '?J; ,.tp,,<.--t&.. (SEAL)
ve y, . McQuillen
Signed, sealed, published and declared by Evelyn I. McQuillen, the Testatrix above-named,
as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and
in the presence of each other, have hereunto subscribed our names as attesting witnesses.
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