HomeMy WebLinkAbout10-14-05
REV-1500 EX (6-00)
OFFICIAL USE ONLY
COMMONWEAL TH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
~L
COUNIY CODE
-.J1L 0089 _ __
YEAR NUMBER
....
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
pennin ton Elizabeth
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
1/16/2005 6/14/1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
w
SOCIAL SECURI1Y NUMBER
203-07-6646
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURI1Y NUMBER
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[i] 1. Original Return
D 4. Limited Estate
[i] 6. Decedent Died Testate (Attach copy 01 Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return D 3. Remainder Return (date 01 death prior to 12-13-82)
D 4a. Future Interest Compromise (date 01 death after 12-12-82) [U 5. Federal Estate Tax Return Required
[i] 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) L 8. Totai Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (dale of dealh between 12-31-91 ard 1-1.95) D 11. Election to tax under Sec. 9113(A) (AllachSch 0)
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THIS SECTION MUST BE COMPLETED. All CORRESPONDENCE AND CONFIDENTiAL TAX INFORMATION SHOULD BE DiRECTED TO:
NAME COMPLETE MAILING ADDRESS
Stanle A. Smith, Es ire
FIRM NAME (If Applicable)
Rhoads & Sinon LLP
TELEPHONE NUMBER
717-233-5731
P. O. Box 1146, One S. Market Sq.
Harrisburg, PA 17108 ,
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2. Stocks and Bonds (Schedule B)
(2)
. I
--:n
-,." 1-1
'.)
" -)
'.: J
)
. 1
". ')
)
'1
!
)
. 1
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
1,300,000.00
42,501. 94
0.00
OFFICIAL USE ONtv'
1. Real Estate (Schedule A)
(1)
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(4)
0.00
I.)
u.)
'./ ,')
-'n
(5)
70,418.95
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6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
74,155.83
1,648,829.91
8. Total Gross Assets (total Lines 1-7)
3,135,906.63
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
(8)
158,967.11
15,509.30
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
11. Total Deductions (total Lines 9 & 10)
(11)
174,476.41
(13)
2,961,430.22
20,000.00
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
2,941,430.22
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)
~ 16. Amount of Line 14 taxable at lineal rate
~
;:)
~ 17. Amou nt of Line 14 taxable at sibling rate
o
o 18. Amount of Line 14 taxable at collateral rate
X
~ 19, Tax Due
20.0
0.00
x.O ~(15)
x .0 ~(16)
x.12 (17)
x .15 (18)
(19)
0.00
2,916,430.21
10,000.00
15,000.00
131,239.36
1,200.00
2,250.00
134,689.36
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER AlL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W48451.000
Dec.edent's Complete Address:
STREET ADDRESS
100 Mt. Allen Drive
Cumberland
CITY I STATE I ZIP
Mechanicsbura PA 17055-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
134,689.36
0.00
120,000.00
6,315.79
Total Credits (A + 8 + C) (2)
126,315.79
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty (D + E) (3)
0.00
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)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
8,373.57
A. Enter the interest on the tax due.
(SA)
0.00
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Pa able to: REGISTER OF WILLS, AGENT
(58)
8,373.57
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;. . . . . . . . . . . . . . . [X] D
b. retain the right to designate who shall use the property transferred or its income; . [X] D
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . [X] D
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D [l!l
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. IX] D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D []I
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IiJ D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA,RE OF PERSON RESPONSI~LE F~R FILING RETURN
~~;Adut0 (~(j.vJ
C/6Rhoads & Sinon LLP, PO Box 1146
OGNA~eE;'EtiX"
~RESS ~
Rhoads & Sinon LLP, PO Box 1146
DATE
/t --Itl-~
Harrisburg, PA 17108
DATE
IO-lll-O)
Harrisburg, PA 17108
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value oftransfers to or for the use ofthe surviving spouse is 3%
[72 P.S. S 9916 (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. S 9116 (a) (1.1) (i1)]
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. 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%, except as noted in 72 P.S. S 9116(1 .2) [72 P.S. 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% (72 P.S. S 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common w~h the decedent, whether by blood or adoption.
3W46461.000
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
REV-1502 EX + (6-98)
ESTATE OF
FILE NUMBER
Elizabeth W. Pennington 2105 0089
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Residence and outbuildings
situate on 15.902 acres of
real property, known as 2421
Mt. Allen Drive, Lower Allen
Township, Cumberland County,
PA. Deed dated January 17,
1975, and recorded in
Cumberland County Deed Book Z,
Vol. 25, page 852, et seq.
Valued per attached appraisal
1,200,000.00
2
3.5 acres of vacant land
adjoining residence on Mt.
Allen Drive, Upper Allen
Township, Cumberland County,
PA. Deed dated Dec. 17, 1957,
recorded in Cumberland County
Deed Book E, Vol. 18, p. 325,
et seq.
Valued per attached appraisal
100,000.00
3W46951.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
1,300,000.00
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Elizabeth W. Pennington
21 05 0089
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. 13 Shares
Denison Mines, Inc.
VALUE AT DATE
OF DEATH
12.22
2 2 Shares
Forte Res Inc.
2.85
3 423.122 Shares
Merrill Lynch Global Allocation CL
I
CUSIP: 589939107
6,871.50
4 744.657 Units
Merrill Lynch Florida Muni Bond
Fund A
CUSIP: 589919851
7,729.54
5 2,547 Shares
Munienhanced FD Inc.
CUSIP: 626243109
27,885.83
3W46961.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
42,501. 94
REV-1504 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
I T
ESTATE OF
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR SOLE-PROPRIETORSHIP
FILE NUMBER
Elizabeth W. penninqton
21050089
Schedule C.1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
Shares of two closely-held
corporations, Milfred Corporation
and Andrew S. McCreath & Son, Inc.
are owned by the decedent's
Revocable Trust reported on
Schedule G
3W4697 1.000
TOTAL (Also enter on line 3, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
0.00
REV-1505 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF
FILE NUMBER
Elizabeth W. Penninqton
2105 0089
1. Name of Corporation Milfred Corporation
Address P. O. Box 1453
State of Incorporation PA
Dateoflncorporation 10/1/1957
City Harrisburq
State PA
Zip Code 17105
Total Number of Shareholders
5
2. Federal Employer I.D. Number 23 -1624200
Business Reporting Year 6/30/2005
Product/Service Hold and sell real estate
3. Type of Business Real es ta te holdinq
BER OF SHARES
D BY THE DECEDENT
4.
Common
SEE ATTA
$
Preferred
$
Provide all rights and restrictions pertaining to each class of stock.
5. Was the decedent employed by the Corporation~ . . . . . . . . . . . . . . . . . . . . . .. 0 Yes
o No
If yes, Position Consul tan t
Annual Salary $
6 . 000 Time Devoted to Business As needed
6. Was the Corporation indebted to the decedent? . .
If yes, provide amount of indebtedness $
. OYes
00 No
o
7. Was there life insurance payable to the corporation upon the death of the decedent? ... 0 Yes 00 No
If yes, Cash Surrender Value $
Owner of the policy
o Net proceeds payable $
o
8. Did the decedent sell or transfer any stock in this company within one year prior to death or within two years if the date of death was prior to 12-31-82?
o Yes [j] No If yes, 0 Transfer 0 Sale Number of Shares 0
Transferee or Purchaser Consideration $ 0 Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death?. 0 Yes
If yes, provide a copy of the agreement.
[j] No
10. Was the decedent's stock sold? . . . .
....................... OYes
og No
If yes, provide a copy of the agreement of sate, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? . . . . . . . . . " 0 Yes 00 No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . . .0 Yes 00 No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E List of officers, their salaries, bonuses and any other benefits received from the corporation.
E Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
4W46981.000
Milfred Corporation Common Stock
(5,000 Shares, $100 Par Value)
Record Owner Date Issued Certificate No. No. of Shares
Trustees of the Residuary Trust 6/6/01 21 1,129
Under Article Three I of the Fred A.
Pennington, Sr. Trust as Amended
and Restated
Trustees ofthe Elizabeth W. 6/6/01 22 163
Pennington Trust Agreement dated
September 28, 1982
Fred A. Pennington, Jr. 9/18/74 8 80
12/27/78 11 30
1/2/79 13 30
Cynthia Pennington Clippinger 9/18/74 9 70
12/27/78 12 30
1/2/79 14 30
7/98 18 10
Milfred Corporation 9/18/74 10 75
383016.1
REV-1505 EX + (6-98)
COMMONWEAL 1H OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF
FILE NUMBER
Elizabeth W. Penninqton
21 05 0089
1. Name of Corporation Andrew S. McCreath & Son, Inc.
Address 610 Willow Street
State of Incorporation PA
Date of Incorporation 12/30/1957
Zip Code 17105
Total Number of Shareholders
6
City Harrisburq
State PA
2. Federal Employer I.D. Number 23 -1519989
Business Reporting Year 6/30/2005
3. Type of Business Analvtical chemists
ProducUService Mineral and chemical testinq
4.
Common
$
Preferred
$
Provide all rights and restrictions pertaining to each class of stock.
5. Was the decedent employed by the Corporation~ . . . . . . . . . . . . . . . . . . . D Yes
00 No
If yes, Position
Annual Salary $
o. 00 Time Devoted to Business
6.
Was the Corporation indebted to the decedent? .
If yes, provide amount of indebtedness $
. Dyes
00 No
0.00
7. Was there life insurance payable to the corporation upon the death of the decedent? ... Dyes 00 No
If yes, Cash Surrender Value $
Owner of the policy
0.00 Net proceeds payable $
0.00
8. Did the decedent sell or transfer any stock in this company within one year prior to death or within two years if the date of death was prior to 12-31-82?
D Yes 00 No If yes, D Transfer D Sale Number of Shares 0
Transferee or Purchaser Consideration $ 0 . 00 Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death? . DYes
If yes, provide a copy of the agreement.
00 No
10. Was the decedent's stock sold? . . . .
....................... Dyes
[!I No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? . . . . . . . . . . .. D Yes 00 No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . . .00 Yesk* D No
**See references to wholly-owned subsidiaries on page 2 of ap-praisal.
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-Zfor each interest.
THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/so If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
4W46981.000
ANDREW S. McCREATH & SON. We. COMMON STOCK
(1,000,000 Shares $1.00 Par Authorized)
6/6/01
Record Owner New Cert. No. No. of Shares
Trustees of the Exempt Unified Credit Trust 151 142,000
Under Article Three I of the Fred A. Pennington
Sr. Revocable Trust as Amended and Restated
Trustees of the Exempt QTIP Trust Under 152 94,040
Article Three I of the Fred A. Pennington, SI. Trust as
Amended and Restated
Elizabeth W. Pennington, Trustee Under the Second 150 132,260
Restated Elizabeth W. Pennington Trust dated
October 11, 1996, as amended
Fred A. Pennington, JI. 120 5,500
106 4,750
109 4,600
112 4,600
116 6,450
118 4,140
124 4,440
127 6,470
130 7,370
133 7,370
143 4,480
148 4.480
64,650
Cynthia P. Clippinger 103 5,500
107 4,750
110 4,600
113 4,600
117 6,450
119 4,140
125 4,440
128 6,470
131 7,370
134 7,370
144 4,480
147 4.480
64,650
ings.RSDOCS-
#382937-vl-
Robert W. Watkins, Jr. 153 2AOO
2,400
5000.000
Common Stock No. of Shares % Held
Trustees of the Exempt Unified Credit Trust 142,000 28.4%
Under Article Three I of the Fred A. Pennington
Sr. Revocable Trust as Amended and Restated
Trustees of the exempt QTIP Trust Under 94,040 18.808%
Article Three I of the Fred A. Pennington, Sr. Trust as
Amended and Restated
Elizabeth W. Pennington, Trustee Under the Second 132,260 26.452%
Restated Elizabeth W. Pennington Trust dated
October 11, 1996, as amended
Fred A. Pennington, Jr. 64,650 12.930%
Cynthia Pennington Clippinger 64,650 12.930%
Robert W. Watkins, Jr. 2AOO .480%
5000,000 100.000%
ANDREW S. McCREATH & SON PREFERRED STOCK
Class A Preferred Stock (5000 SHARES AUTHORIZED)
Stockholder Certificate Number Date Issued N umber of Shares
Trustees of the Residuary Trust PA12 6/6/01 1,700
Under Article Three I of the Fred
A. Pennington, Sr. Trust as
Amended and Restated
PA14 6/7/01 400
Fred A. Pennington, Jr. P13 12/20/66 60
P16 1/03/67 60
P19 4/19/68 60
P22 5/22/68 60
P29 4/22/71 60
P31 1/21/73 375
P36 6/30/74 27 Yz
P43 12/12/74 60
P48 1/28/83 375
P53 6/30/88 200
Fred A. Pennington, Jr., P41 12/12/74 60
Custodian Under Uniform Gifts
to Minors Act for Jon
Pennington
P54 6/30/88 50
Cynthia Pennington P14 12/20/66 60
P17 1/03/67 60
P20 4/19/68 60
P23 5/22/68 60
P28 4/22/71 60
P33 6/10/74 375
P37 6/30/74 27 Yz
P44 12/12/74 60
P50 1/21/86 375
P52 6/30/88 200
Robert W. Watkins, Jr. PA15 5/23/01 5
383008.1
James P. Flannery, Trustee PA7 9/15/95 -1lQ
Under Agreement of Trust for 5,000
Stephen C. Pennington dated
June 15, 1994
Class B Preferred Stock (10,000 SHARES AUTHORIZED)
Stockholder Certificate Number Date Issued Number of Shares
Trustees of the Residuary PB13 6/6/01 4,866
Trust Under Article Three I
of the Fred A. Pennington,
Sr. Trust as Amended and
Restated
Fred A. Pennington, Jr. PB2 6/30/79 55
Cynthia Pennington PB3 6/30/79 55
Clippinger
Robert W. Watkins, Jr. PB16 5/23/01 24
5,000
REV-1S08 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Elizabeth W. penninqton
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlY-<lwned with the right of survivorship must be disclosed on Schedule F.
FILE NUMBER
2105 0089
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1 4 $50 American Express Travelers
Cheques
200.00
2 Allmerica Financial Life Insurance
and Annuity Company, annuity
payments:
Check dated 1/10/2005, $1,284.12;
check dated 1/11/2005, $270
1,554.12
3 Income checks from decedent's
revocable trust account issued
before death: MFS Muncipal High
Income Fund-A, $23.56; MFS
Municipal High Income Fund-A,
$23.56; Raymond James, $786.50;
Raymond James, $508.75
1,342.37
4 Merrill Lynch CMA PA Municipal
Money Fund
6,731.34
5 PA Department of Revenue, refund
for overpayment of 2004 income
taxes
346.00
6 Refund, State Farm Mutual
Automobile Insurance Company
55.41
7 Household furniture and
furnishings and personal articles
Valued per attached appraisal
60,174.00
8 Verizon, refund, telephone service
at Messiah Village
15.71
3W46AD 1.000
TOTAL (Also enter on line 5 Recaoitulation\ $
(If more space is needed, insert additional sheets of the same size)
70,418.95
REV-1509 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Elizabeth W. Pennington
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21 OS 0089
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.
Clippinger, Cynthia
16 Mumma Avenue, Mechanicsburg, PA
17055
Daughter
B.
c.
JOINTL Y.OWNED PROPERTY:
lErTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FQRJOINT MADE INCLUDE NA.ME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
f'UvlBERORSlMllAR IDENTIFYING NUMBER. ATTACH DEED FOR
NUMBER TENANT JOINT JOIrffi..V-rELDREAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A.
1 A 7/13/1998 Citizens Bank Acct.
#6100905292 111,035.53 50.0000 55,517.77
2 A 7/13/1998 Citizens Checking Acct.
#6100716856 37,276.11 50.0000 18,638.06
TOTAL (Also enter on line 6 RecaDitulationl $ 74,155.83
3W48AE 1.000
(If more space is needed, insert addnional sheets of the same size)
REV-1510 EX + (6-98)
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Elizabeth W. Pennington
FILE NUMBER
21 05 0089
ITEM
NUMBEF
1.
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPER1Y
INClLOE n-e i'l'IME OF n-e TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND
n-e DATE OF TRANSFER ATTACHACOPf OF THE DEED FOR REAL ESTATE.
TAXABLE
VALUE
Gifts to decedent's son,
totalling $10,000 within a year
of death
2
Allmerica IRA Contract
#AQ403085
Beneficiary: Cynthia
Pennington, decedent's
daughter.
Valued per Allmerica
3
Allmerica Non-Qualified Annuity
Contract #AN435851
Beneficiary: Fred A.
Pennington, Jr., decedent's son
Valued per Allmerica
4
M&T IRA Acct. #035004201765152
Beneficiaries: Decedent's
grandsons, Jon Pennington and
Stephen Pennington
Interest accrued to 1/16/2005
Valued per 2004 year end
statement
5
Third Amended and Restated The
Elizabeth W. Pennington
Revocable Trust under Agreement
dated June 2, 2000.
Copies of the Trust Agreement,
an Amendment dated 3/21/2004
and a listing of Trust assets
are attached as exhibits to
this Return.
DATE OF DEATH
VAlUE OF ASSET
% OF DECO'S
INTEREST
10,000.00 100.0000
93,103.10 100.0000
39,274.92 100.0000
4,458.91 100.0000
33.89 100.0000
1,504,959.09 100.0000
3W46AF 1.000
(If more space is needed, insert additional sheets of the same size)
TOTAL (Also enter on line 7, Recapitulation) $
EXCLUSION
(IF APPLlCABLE1
3,000.00
0.00
0.00
0.00
0.00
7,000.00
93,103.10
39,274.92
4,458.91
33.89
1,504,959.09
1,648,829.91
'REV-1511 EX + (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Elizabeth W. Pennington
ITEM
NUMBER
A.
B.
3W46AG 1.000
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
1.
Cynthia Clippinger, reimbursement
for funeral expenses
Total from continuation schedules . .
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Cynthia Clippinqer
Social Security Number(s) I EIN Number of Personal Representative(s) 168 - 3 6 - 3 374
Street Address 16 Mumma Avenue
City Mechanicsburg
State PA
Zip 17055
Year(s) Commission Paid: 2006
2.
Attorney Fees
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's Fees
6. Tax Return Preparer's Fees
7.
1
ADT Security Services, service to
residence
2
AT&T, phone 766-2996D, residence
Total from continuation schedules . .
FILE NUMBER
2105 0089
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
AMOUNT
2,992.50
10,301.90
20,000.00
75,000.00
1,045.00
332.91
104.77
49,190.03
158,967.11
Estate of: Elizabeth W. Pennington
Item
No.
2
203-07-6646
Schedule H Part 1 (Page 2)
Description
Amount
Malpezzi Funeral Home
Funeral and burial expenses
10,301.90
Total (Carry forward to main schedule)
10,301.90
Estate of: Elizabeth W. Pennington
203-07-6646
Schedule H Part 7 (Page 2)
3
AT&T, phone 766-6204, residence
120.41
4
Brown Schultz Sheridan & Fritz
Appraisals of closely-held
corporations, Milfred Corporation
and Andrew S. McCreath & Sons,
Inc.
10,000.00
5
Clearwater Pool Care, Inc.
Pool maintenance at residence
807.11
6
Commonwealth of pennsylvania
Registration renewal for 1957
Willys Jeep
60.00
7
Cumberland County Reporter
Advertising Grant of Letters
Testamentary
75.00
8
Cynthia Clippinger
Reimbursement, rental of dumpster
1,450.00
9
Cynthia Clippinger
Reimbursment, Lester Erb, fuel oil
at residence
3,464.55
10
Davis Country Living
Expenses at residence
19.60
11
Greenleaf Environmental
Chemical disposal services
1,862.00
12
Hobbie Auctions
Appraisal, personal and houssehold
articles
675.00
13
Lester Erb, Incorporated
Fuel oil, residence
1,021. 05
14
Linden A. Shoffner
Painting, labor and materials
1,250.00
15
Marlin Yohn, Sr., Treasurer
Real estate taxes
11,542.92
16
PPL, service to residence
804.75
Total (Carry forward to main schedule)
33,152.39
Estate of: Elizabeth W. Pennington
203-07-6646
Schedule H Part 7 (Page 3)
17
Rhoads & Sinon LLP
Reserve for expenses and filing
fees
5,000.00
18
RSR Appraisers & Analysts
Real estate appraisals
7,500.00
19
Secco Home Services, Inc.
Repair work on furnace at
residence
585.63
20
State Auto Insurance Companies
Premium, homeowners' policy
Homeowners' insurance premium
2,307.00
21 State Farm
Insurance on 1957 Willys Jeep
114.25
22
The Patriot-News Co.
Advertising Grant of Letters
Testamentary
151. 59
23
Verizon, Acct. #766-2996, service
to residence
206.03
24
Verizon, Acct. #766-6204, service
to residence
173.14
Total (Carry forward to main schedule)
16,037.64
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Elizabeth w. Pennington
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 05 0089
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
Checks clearing after death
10,565.26
2
Cynthia Clippinger, reimbursement
for household expenses
458.51
3
Cynthia Clippinger, reimbursement
for payment of balance due to
Alert Pharmacy
2.73
4
Messiah Village, final bill
3,028.80
5
Pulmonary and Critical Care
Medicine Associates, P.C.
Balance due
110.00
6
United States Treasury
2004 Federal Income Tax
1,242.00
7
WE STAB
2004 local tax
102.00
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
15,509.30
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
El1zabeth w. Penn1naton
NUMBER
I
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Fred A. Pennington, Jr.
47 South 18th Street
Camp Hill, PA 17011
FILE NUMBER
2105 0089
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Allmerica Non-Qualified Annuity
Contract #AN435851
Beneficiary: Fred A. Pennington,
Jr., decedent's son
Inventory Value: 39,274.92
Household furniture and
furnishings and personal articles
Inventory Value: 30,087.00
Gifts to decedent's son, totalling
$10,000 within a year of death
Inventory Value: 7,000.00
50% Residue: 1,314,114.78
Son
1,390,476.70
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 WH ICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1
Lycoming College, to be added to
the Fred A. and Elizabeth W.
Pennington Scholarship Fund
700 College Place
Williamsport, PA 17701-5192
Cash bequest, ART. III (G)
Rev. Trust
10,000.00
3W46A11.000
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)
$
20,000.00
Estate of: Elizabeth W. Pennington
203-07-6646
Schedule J Part 1 (Page 2)
Item
No. Description
Relation
Amount
2 Cynthia Clippinger
16 Mumma Avenue
Mechanicsburg, PA 17055
Allmerica IRA Contract #AQ403085
Beneficiary: Cynthia Pennington,
decedent's daughter.
Inventory Value: 93,103.10
Household furniture and
furnishings and personal articles
Inventory Value: 30,087.00
Citizens Bank Acct. #6100905292
Inventory Value: 55,517.77
Citizens Checking Acct.
#6100716856
Inventory Value: 18,638.06
50% Residue: 1,314,114.78
Daughter
1,511,460.71
3 Jon Christopher Pennington
2130 Browning Street
Berkeley, CA 94702
General Bequests: 5,000.00
M&T IRA Acct. #035004201765152
Beneficiaries: Decedent's
grandsons, Jon Pennington and
Stephen Pennington
Inventory Value: 2,229.46
Accrued: 16.94
Grandson
7,246.40
4 Trust flblo Stephen C. Pennington
General Bequests: 5,000.00
M&T IRA Acct. #035004201765152
Beneficiaries: Decedent's
grandsons, Jon Pennington and
Stephen Pennington
Inventory Value: 2,229.46
Accrued: 16.94
Grandson
7,246.40
Estate of: Elizabeth W. Pennington
Schedule J Part 1 (Page 3)
Item
No. Description
5 Nancy Watkins Lucas
3616 Kramer Street
Harrisburg, PA 17109
General Bequests: 10,000.00
Sister
6 Dale Bower
560 Sand Hill Road
Montoursville, PA 17754-9563
General Bequests: 5,000.00
Friend
7 Harvey R. Cressler
1023 East Lisburn Road
Mechanicsburg, PA 17055
General Bequests: 5,000.00
Friend
8 Catherine Kaercher
740 Hummel Avenue
Lemoyne, PA 17043
General Bequests: 5,000.00
Friend
203-07-6646
Relation
Amount
10,000.00
5,000.00
5,000.00
5,000.00
203-07-6646
Estate of: Elizabeth W. Pennington
Item
No.
2
Schedule J Part 2 (Page 2)
Description
Amount
Grace United Methodist Church
216 State Street
Harrisburg, PA 17101-1188
Cash bequest, ART. III (H)
Rev. Trust
10,000.00
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Ki~ S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
589
10/14/2005
Pennington. Elizabeth W
21-2005-0089
RHOADS & SINON
1 SOUTH MARKET ST
P.O. BOX 1146
HARRISBURG, PA 17108
CMM
Qty
1
Fee Description
Additional Probate
Fee
Total
300.00
$300.00
Total:
$300.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
RlIOADS
& SINON LLP
Yvonne R. Durham
Phone (717) 231-6677
Fax (717) 232-1459
ydurham@rhoads-sinon.com
FILE NO 152/05
October 14, 2005
Re: Estate of Elizabeth W. Pennin2:ton
PA File No.: 21-05-0089
Ms. Glenda Farner-Strasbaugh
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
Dear Ms. Farner-Strasbaugh:
Enclosed are the following in connection with the above-captioned Estate:
1. Pennsylvania Inheritance Tax Return, in duplicate;
2. Inventory;
3. Copy of Federal Estate Tax Return;
4. Check in the Sum of$8,373.57 in payment ofthe balance oftax due;
5. Check in the sum of $30.00 in payment of your filing fees for the Return and
Inventory; and
6. A copy of this letter, with the first page of Return attached, which we ask that you
time stamp and return to our messenger.
Very truly yours,
RHOADS & SINON LLP
Enclosures
By: ~~
e R. Durham
ralegal
581760.1
Rhoads &: Sinon LLP . Attorneys at Law' Twelfth Floor' One South Market Square' PO. Box 1146
Harrisburg, PA 17108-1146 . ph (71 7) 233-5731 . fx (71 7) 232-1459 . www.rhoads-sinon.com
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CLIPPINGER CYNTHIA
16 MUMMA AVENUE
MECHANICSBURG, PA 17055
_____n_ fold
ESTATE INFORMATION: SSN: 203-07-6646
FILE NUMBER: 2105-0089
DECEDENT NAME: PENNINGTON ELIZABETH W
DATE OF PAYMENT: 10/14/2005
POSTMARK DATE: 10/14/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 01/16/2005
NO. CD 005895
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $8,373.57
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$8,373.57
REMARKS: C CLIPPINGER
CHECK#196
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
, Fr(''(.~Jfr-:r;l l~':r:lll"'\r r,'~
" .".,', ......' j \ .', . '._A~, '
Register of Wills of Cumberland County
2rir t....,.....T' I,
",.' "J ," ' ; i.,
r- ,'. '). ')9
r II ',' Co
INVENTORY
Estate of Elizabeth W. Pennington
Estate No.: 00089 0[2005
also known as Mildred Elizabeth Pennington,
Deceased
Date of Death: January 16,2005
Social Security No.: 203-07-6646
I, CYNTHIA CLIPPINGER, Personal Representative of the above Estate, deceased, verify that the
items appearing on the following inventory include all of the personal assets wherever situate and all of the real
estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate
outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory
(PEF ~3301). I verify that the statements made in this inventory are true and correct. I understand that false
statements herein made are subject to the penalties of 18 Pa,C.S. Section 4904 relating to unsworn falsification to
authorities.
Name of Attorney: Stanley A. Smith, Esquire
Personal Representative: Cynthia Clippinger
LD. No.: 33782
Address: c/o Rhoads & Sinon LLP
P.O. Box 1146
1 S. Market Square
Harrisburg, P A 17108-1146
Address: c/o Rhoads & Sinon LLP
P.O. Box 1146
1 S. Market Square
Harrisburg, P A 17108-1146
Telephone: (717) 233-5731
Signature: ~/ (' ~u.../
Date: ~r' ~/ ~};
Description
Value
See attachment
1.412.920.89
(Attach Additional Sheets if necessary)
Total: 1,412,920.89
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the
personal representative, include the value of each item, but such figures should not be extended into the total of the
Inventory.
RW-4
578516.1
Estate of Elizabeth W Pennington
Estate Inventory
Valued as of Date of Death
Cash & Cash Equivalents
Merrill Lynch CMA PA Municipal
Money Fund $ 6,731.34
Total Cash & Cash Equivalents $ 6,731.34
No. of
Shares Stocks
13 Denison Mines, Inc. $ 12.22
2 Forte Res Inc. 2.85
Total Stocks 15.07
Tangible Personal Property
Household furniture and furnishings
and personal articles
$ 60,174.00
Total Tangible Personal Property 60,174.00
Miscellaneous
4 $50 American Express Travelers
Cheques $ 200.00
Allmerica Financial Life Insurance
and Annuity Company, annuity
payments:
Check dated 1/10/2005, $1,284.12;
check dated 1/11/2005, $270 1,554.12
Income checks from decedent's
revocable trust account issued before
death: MFS Muncipal High Income
Fund-A, $23.56; MFS Municipal
High Income Fund-A, $23.56;
Raymond James, $786.50; Raymond
James, $508.75
1,342.37
Page 1 (1)
Estate Inventory (Continued)
Miscellaneous
P A Department of Revenue, refund
for overpayment of 2004 income
taxes $ 346.00
Refund, State Farm Mutual
Automobile Insurance Company 55.41
Verizon, refund, telephone service at
Messiah Village 15.71
Total Miscellaneous $ 3,513.61
Real Property
Residence and outbuildings situate
on 15.902 acres ofrea1 property,
known as 2421 Mt. Allen Drive,
Lower Allen Township, Cumberland
County, P A. Deed dated January 17,
1975, and recorded in Cumberland
County Deed Book Z, Vol. 25, page
852, et seq.
$ 1,200,000.00
3.5 acres of vacant land adjoining
residence on Mt. Allen Drive, Upper
Allen Township, Cumberland
County, P A. Deed dated Dec. 17,
1957, recorded in Cumberland
County Deed Book E, Vol. 18, p.
325, et seq.
100,000.00
Total Real Property 1,300,000.00
No. of
Shares Mutual Funds
423.122 Merrill Lynch Global Allocation CL
I $ 6,871.50
744.657 Merrill Lynch Florida Muni Bond
Fund A 7,729.54
Page 2
(2)
.
Page 3
-
No. of
Shares
Estate Inventory (Continued)
Mutual Funds
2,547
Munienhanced FD Inc.
Total Mutual Funds
$
27,885.83
Total Inventory
(3)
$
42,486.87
$ 1,412,920.89