HomeMy WebLinkAbout08-04-05
REV.lSOO EX 16-00)
'* COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
. DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lowther, Romeyn M.
DATE OF DEATH (MM-DD-YEAR)
05/13/2005
FILE NUMBER
21 05
0555
DATE OF BIRTH (MM-DD-YEAR)
02/09/1906
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
None
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II. III
II.
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~ 1. Original Return
D 4. Limited Estate
o 6. Decedent Died Testate (Allach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dale of death afler 12.12.82)
D 7. Decedent Maintained a Living Trust (AllachcopyolTrust)
D 10. Spousal Poverty Credit (date of death between 12.31.91 and 1.1.95)
COUNTY CODE YEAR
NUMBER
SOCIAL SECURITY NUMBER
186-24-9955
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (dale of deaD, pMor to 12.1H2)
o 5. Federal Estate Tax Return Required
8. Tolal Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AIIach Soh 0)
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NAME
Joseph William Lowther
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
54 Old Farm Road
Camp Hill, PA 17011
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TELEPHONE NUMBER
(717) 761-2214
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5,945.04
0.00
(8)
5,792.25
8,981.76
(11)
(12)
(13)
319,837.15
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. JoinUy Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(1)
(2)
(3)
(4)
(5)
0.00
304,434.53
0.00
0.00
9,457.58
14,774.01
305,063.14
0.00
(14)
305,063.14
(6)
(7)
8. Total Gross Assets (tolal Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(9)
(10)
14. Net Value Subject 10 Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.o _ (15)
305,063.14 xO ~ (16)
13,727.84
(19)
13,727.84
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
Messiah Villaae
100 Mount Allen Drive
CITY Mechanicsburg I STATE I ZIP 17055
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
13,727.84
686.39
Total Credits ( A + 8 + C ) (2)
686.39
3. Interest/Penalty if applicable
D. Interest
E. Penalty
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5A)
(58)
0.00
0.00
13,041.45
0.00
Total Interest/Penalty ( D + E ) (3)
4. 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 (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
13,041.45
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;........................................................................................ 0 [i]
b. retain the right to designate who shall use the property transferred or its income; .......................................... 0 [i]
c. retain a reversionary interest; or.......................................................................................................................... 0 ~
d. receive the promise for life of either payments, benefits or care? ..................................................................... 0 [K]
2. If death occurred after December 12, 1982, did decedent transfer property within one year {If 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? .............. 0 [i]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................... ......... 0 [i]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this retum, 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 personal representative is based on all information of which preparer has any knowledge.
RSON RES~ONS:LE FOR FILlN~ ~?
ADORES ~
5401 Farm Road, Camp Hill, PA 17011
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE 0- j" /....
.~ C;-
DATE
ADDRESS
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. 99116 (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
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclo
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 a1
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, e'
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.
individual who has at least one parent in common with the decedent, whether by blood or adoption.
nAPD
116 (a) (1.1) (ii)l.
Ipplicable even if
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I adoptive parent,
1116(a)(1)J.
:tion 9102, as an
REV-1S03 EX+ (6-9B*
COMMONINEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Romeyn M. Lowther
FILE NUMBER
21-05-0555
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Vanguard Account 9881976260 - High Yield Corporate Investor - 16,051.41 shares @ 6.12/share
Vanguard Account 9881976260 - Federal Money Market Fund
VALUE AT DATE
OF DEATH
3.
Vanguard Account 9881976260 - dividends accrued as of date of death
98,234.61
6,817.33
257.96
2.
4. Banc of America Account L76156221 (formerly Quick & Reilly Account 219-20035)
Money Market Fund
3,422.75
8,652.60
10,048.00
10,120.00
Dell - 220 shares @ 39.33/share
Intel - 400 shares @ 25.12/share
Microsoft - 400 shares @ 25.30/share
Thornburg Mortgage, Inc. - 5,450 shares @ 28.90
157,505.00
5,634.00
T. Rowe Price Group - 100 shares @ 56.34
Misc. dividends accrued as of date of death
3,742.28
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
304,434.53
REV-1508 EX+ (6-98) .
COMMONINEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Romeyn M. Lowther
FILE NUMBER
21-05-0555
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
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Misc. household goods and clothing
500.00
2. Engagement ring and wedding band - appraisal attached
4,775.00
1,657.58
2,436.00
3. Prepaid funeral expense contract - Neill Funeral Home, Camp Hi!, PA 17011
4. 2004 federal income tax refund
5. Donegal Insurance refund
89.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
9,457.58
REV-150S EX+ (6-SB.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTlY-OWNED PROPERTY
ESTATE OF
Romeyn M. Lowther
FILE NUMBER
21-05-0555
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 Joseph William Lowther
54 Old Farm Road
Camp Hill, PA 17011
Son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HElD REAl ESTATE VAlUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A. M& T Bank checking account 28860969 3,881.15 100 3,881.15
2. A Members First Credit Union account 2354 2,063.89 100 2,063.89
TOTAL (Also enter on line 6. Recapitulation) $ 5,945.04
(If more space is needed. insert additional sheets of the same size)
REV-1511 EX+ (12-99)W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Romeyn M. Lowther
FILE NUMBER
21-05-0555
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Neil Funeral Home, Camp Hill, PA 17011 - prepaid funeral expenses (Sch. E) net of adjustments
Pastor's honorarium
Family expenses and travel for memorial weekend services
1,497.95
150.00
2,098.01
2.
3.
B. ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
0.00
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
1,500.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
0.00
Claimant
Street Address
City Slate .Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Legal advertising
383.00
0.00
0.00
163.29
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
5,792.25
REV-1512 EX. (12-03)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Romeyn M. Lowther
FILE NUMBER
21-05-0555
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbun;ed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
I
Messiah Village, 100 Mount Allen Drive, Mechanicsburg, PA 17055 (residence fees for April, 2005)
6,361.00
2.
Messiah Village, 100 Mount Allen Drive, Mechanicsburg, PA 17055 (residence fees for May 1-13, 2005)
2,484.00
35.76
3.
Alert Pharmacy
4.
Estimated PA income tax, 1st quarter 2005
101.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8,981.76
REV-1513 EX+ (9-00)
'*'
SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Romeyn M Lowther
FILE NUMBER
21-05-0555
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
] TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Joseph William Lowther, 54 Old Farm Road, Camp Hill, PA 17011 Son 305,063.14
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REY-1500 COYER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
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iGn!lt mill nub IDe!ltnmeut
of
ROHEYN M. LOWTHER
BE IT REMEMBERED, that I, ROMEYN M. LOWTHER, of 847 Mandy
Lane, Hampden TownShip, Cumberland County, Pennsylvania, being of
sound mind, memory and understanding, do make, publish and
declare this as and for my Last Will and Testament, hereby
revoking and making null and void any and all Wills and
Testaments and writings in the nature thereof by me, at any time
heretofore made.
ITEM 1: I direct that all my just debts, expenses of my
final illness, funeral expenses, and costs of administering my
estate be paid as soon after my demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estate,
of whatsoever nature and wheresoever situate, whether it be real,
personal, or mixed, including property over which I have a power
of appointment, I give, devise and bequeath unto my son, JOSEPH
WILLIAM LOWTHER. Should my said son predecease me, then all the
rest, residue and remainder of my estate, of whatsoever nature
and wheresoever situate, whether it be real, personal, or mixed,
including property over which I have a power of appointment, I
give, devise and bequeath in equal shares unto my granddaughter,
ANNE CHRISTINA GOODRICH, and my grandson, JOSEPH CHARLES LOWTHER.
Should either of my said grandchildren predecease me leaving
surviving issue, then such grandchild's share shall be
distributed to his or her surviving issue per stirpes. Should
either of my said grandchildren predecease me leaving no
surviving issue, then such grandchild's share shall be
distributed to the remaining grandchild.
ITEM 3: I appoint my son, JOSEPH WILLIAM LOWTHER, as
Executor of this my Last Will and Testament. Should my said son
predecease me, fail to qualify, cease to act or renounCe probate,
I then appoint my grandson, JOSEPH CHARLES LOWTHER, as Alternate
Executor of this my Last Will and Testament.
rTEM 4:
No fiduciary under this will shall be required to
give bond or other security for the faithful performance of the
fiduciary's duties.
Any such fiduciary shall have the following powers
in addition to those given by law:
To invest in, accept and retain any real or
personal property, including stock of a corporate
fiduciary or its holding company, without
restriction to legal investments;
To sell, exchange, partition or lease for any
period of time any real or personal property and
to give options therefor for cash or credit, with
or without security;
To borrow money from any person including any
fiduciary acting hereunder, and to mortgage or
pledge any real or personal property;
To hold shares of stock or other securities
in nominee registration form, including that of a
clearing corporation or,depository, or in book
entry form or unregistered or in such other form
as will pass by delivery;
~~~
To engage in litigation and compromise,
arbitrate or abandon claims;
To make distributions in cash, or in kind at
current values, or partly in each, allocating
specific assets to particular distributees on a
non-pro rata basis, and for such purposes to make
reasonable determinations of current values; and
To make elections, decisions, concessions and
settlements in connection with all income, estate,
inheritance, gift or other tax returns and the
payment of such taxes, without obligation to
adjust the distributive share of income or
principal of any person affected thereby.
ITEM 5:
I direct my Executor to pay all inheritance,
estate, succession and legacy taxes of whatsoever nature and
kind, to which my estate or the transfer of any property passing
hereunder or otherwise passing by reason of my demise may be
subject, and to charge such taxes against my residuary estate
without reimbursement from or apportionment among the
beneficiaries, recipients or owners of such property for any such
taxes.
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IN WITNESS WHEREOF, I have hereunto set my hand and seal
this
:<'f-
of JU~97. .
. n H_~
RO ~LOW~Jf
(SEAL)
day
signed, sealed, published and declared by the above named
Romeyn M. Lowther as and for her last will, in the presence of us
and each of us, who, at her request and in her presence and in
the presence of each other, have hereunto subscribed our names as
witnesses thereto the day and year last above written.
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resiping at 7()~ I&f('r..",~r P-
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COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
I, Romeyn M. Lowther, the testatrix, whose name is
signed to the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; and that I signed it
willingly and as my free and voluntary act for the purposes
therein expressed.
We, ;?~L~/54rr'-J'<-'
and
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the attached or foregoing
the witnesses whose names are signed to
instrument, being duly qualified according to law, do depose and
say that we were present and saw the testatrix sign and execute
the instrument as her Last Will; that the testatrix signed
willingly and executed it as her free and voluntary act for the
purposes therein expressed; that each ~ubscribing witness in the
hearing and sight of the testatrix signed the will as a witness;
and that to the best of our knowledge the testatrix was at the
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn to or affirmed and acknowledged before me by
Romeyn M. Lowther, the testatrix, and by KL,.J S-. Morr./.,~
and ~/'v,E'. -:s/oner- , witnesses, this .;J,LJ day of
. /
July, 1997.
(SEAL)
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{I Witness
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Witness
cl~N!!a~f~ic
Notarial Seal
Carolyn H. Sider. No1ary PtNc
lP" Alan Twp.. CumbeI1ilnd Ca.nlV
My Cornrnissic:l'\ Expires Oc;t. 4, 1'Hf
Mf.;f"":Jer. Penr.:..,4va'~. ':;.'ii...C:.1~: of ". Jlr..i iRS
~ratsall
MOUNTZ
JEWELERS
3780 TRINDLE ROAD
CAMP Hill, PA 17011
(717) 763-1199
TO WHOM IT MAY OONCERN:
Thi,; is t.o certify that we are eng8~ in the ~(1wf!lry business, appraising diamonds, watr:hes, jewelry and
precious stoneS of all descriptions.
We herewith certify that we have this day carefully examined the following listed and described
articles, the property of:
NAME
Romeyn Lowt.her
ADDRESS 847 Mandy Lane. Camp Hill. PA 17011
We estimate the value as listed for insurance or other purposes at the current retail value. excluding.
Federal and other taxes. In making this Appraisal. we DO NOT agree to purchase or replace the
articles.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
LOWTHER JOSEPH WILLIAM
54 OLD FARM ROAD
CAMP HILL, PA 17011
______n fold
ESTATE INFORMATION: SSN: 186-24-9955
FILE NUMBER: 2105-0555
DECEDENT NAME: LOWTHER ROMEYN M
DATE OF PAYMENT: 08/04/2005
POSTMARK DATE: 08/04/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 05/13/2005
REMARKS:
CHECK#1003
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX( 11-96)
NO. CD 005649
AMOUNT
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I $13,041.45
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$13,041.45
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS