HomeMy WebLinkAbout11-30-05~F~,SOOEx~~oo~,
COMMONWEALTH OF R E V-15 0 Q ~;;. ._ ~~.E~~~,
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, PENNSYLVAN{A
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INHERITANCE TAX RETURN F~E~NUMBE
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DEPT.2806~1 y
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R E S 1 D E N T D E C E D E N T `~ f
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COUNTY CODE YEAR - N~MBER
~ DECEDENT'S NAME (LAS7, FIRST, AND MIDDLE INITIAL)
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` SOCIAL SECURITY NUMBER
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W DATE OF DEATN ~MM-DD-YEAR)
~ DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST 8E F1LED IN DUPLICATE WITH THE
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W (IF APPLICABLE~ SURVIVWG SPOUSE'S NAME (LAST, FIRST, AND MfDDLE INITIAL) SOCIAL SECURITY NUMBER
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W ~ 1. Original Return ~ 2. SupplemeMaf Retum ~ 3. Remainder Retum ~aaie o~ deam P~~o~ co iz is-az~
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^ 4. Limited Estate ~ 4a. Fuiure Interest Compromise ~dace or dea~n aher ~z-~z-az~
~ 5. Federal Estate Tax Retum Required
U a m ~ 6. Decedent Died Testate ~a~cacn ~o~y or wiiq ~ 7. Decedent Maintained a Living Trust ~a,ua~n oopy os rr~5q ~ 8. To1al Number of Safe Deposit Boxes
a
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~ 9. Litlgation Proceeds Received ~ 1Q. SpoUSal PoveRy C~edit (date of death be~ween t2-37-s~ and t-t-s5)
~ 11. Election to tax under Sec. 9113(A) ~anacn scn o,
~ THI~ SECTI~N MUST BE:CfJMPLETED. ALL CORRESPONDENCE-AND CONFtDEPtTtAt, "t'AX INFORMATIQN SHQULO BE DIREGTED 70:
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1. Real Estate (ScheduieA) ~~) ~":'~
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2. Stocks and Bonds (Schedule B) l2) i~ f l~ 4~ ' ~~
;
3. Closely Held Gorporation, Partnership or Sole-Proprietorship (3) :_ -
4. Mortgages 8 Notes Receivable (5chedule D) ~41 t~ ~
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5. Cash, Bank qeposits & Miscellaneous Personal Property (5) ~/ r` ~~ -
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(Schedule E) ~ ~ ~ - ~ ~=,
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6. JoiNiy Ownetl Property {Schedule F) 16)
~ Separate Bil6ng Requested
7. inter-Vlvos Transfers ~ Miscellaneous Non-Probate Property ~7)
(Schedule G or L)
8. Total Gross Assets (totai Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) 19) l~
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (7~)
11. Totai Deductions (total Lines 9& 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmentai Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
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(14)
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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. Amount of Line 141axabie at sibling rate
18. Amount of Line 14 taxable ai collateral rate
1~U ~`~I~
x .0 ._ (15)
x .o ~ i~s) °~ ,~ --~ ~''
x .12 (17)
x .15 (16}
19. Tax Due ~19~
20.~ • e . • •
>?`B8 SURE TO ANSW~R !0.Ll. C~UESTfQNS:ON I~E\/~RSE ;SID~ ~#R!D R~~
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~ Dec~dent's Complete Address:
STREETADDRESS n
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CITY ~ ~\ STATE ~ Z~p
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Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments ('~" J .~ ~
C. Discount -~ ~' ~.,
(~) i ~ ~ ~
Total Credits ( A+ B+ C) (2)
3. InteresUPenaity if applicable
D. Interest
E. Penalty
Totai 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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5+ 5A. This is the BALANCE DUE.
(5)
(5A)
(5B)
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Make Check Payable to: REGISTER OF W1LLS, AGENT
PLEASE ANSWER 7HE F~LLOWING QUESTl01VS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No,
a. retain the use or income of the property transferred :................................................................................... ....... ~
b. retain the right to designate who shall use the property transferred or its income : .....................................
....... ^ ~
c. retain a reversionary interest; or ....................................................................................................................
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d. receive the promise for life of eikher payments, benefits or care? ................................................................ ...... ^ ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................................................................................................
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3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...........
...................................................................................................... ^
...... ~Y
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 return, including accompanying schedules and statements, and to the best of my knowledge and belieL it is [rue, wrrect and complete.
Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIG OF PEf~SON RESPONSI LE FO LING RETURN DA7
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SIGNATURE OF PREPARER OTHER THAN REPRESENT ~'fV ' ~~~' ~ DATE
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ADDRESS ,' _
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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%
~~z P.s. §s~~s ~a) (~.~) (i)1.
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. §9116 (a) (1.1) (ii)],
The statute does not exemot 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 iI
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. §9116(a)(1.2)).
The tax rate imposed on the net value of transfers to or for the use of the decede~Ys lineal beneficiaries is 4.5°fo, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenYs s+blings is 12% (72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
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cor~,r~~oNw~,v~,r,or ~~r~rasY~vHr~in STQCKS & ~ONDS
INHERf~ANCE TAX RETURN
RESIDENTl~E~EDENT
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ES7A7E OF , ~ ~ FiLE NUI~~ER
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All property jointly-owrsed w+th right of survivorship must be disclosed on Schadule f.
ITE(~1 VALUE AT DATE
NUMBER DESCRIPTION OF DEA7H
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TOTAL (Also enter on line 2, Recapitulation) ~$ (~ ~"' ~~ ~:~'~' '~~
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REV-750B EX + (1~97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEpENT
SCHEDULE E
CASH, BANK DEPOSlTS, & MISC.
PERSONAL PROPERTY
ES7ATE OF FILE NUMBER
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Include the proceeds of litigation and the date the proceeds were received by the estate. All p~operty jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
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TOTAL (Also enter on line 5, Recapitulation) $ ``T ,^.- ~~
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
~~~b> sc~EDU~E N
COMMONWEALTH OF PENNSYLVANIA • FUNERAL EXPENSES 8t
INHEflITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1. ~
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B. ADMiNiSTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Numher(s)lEIN Number of Personai Representative(s)
Sireei Address
City ~ State _ Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedenYs address is not the same as claimanYs, attach explanation)
Claimant
Sireet Address
City State Zip
Refationship of Claimant to Decedent
4. Probate Fees ~ ~~~
5. AccountanYs Fees
6. Tax Return Preparer's Fees /! O~
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TOTAL (Also enter on line 9, Recapitulation) I~ ~'~ la ~~
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
~
'~~.~ ~` :~~1~1E~I~LE J
CONIMONWEALTH OF PENNSYLVANIA SENEfICIARfES
INHERITANCE TAX RETURN
RESIDENT DECEDEN7
ESTATE OF FILE NUMBER
~ ~ ~ ~ ~~ _ ~~ t~~~ ~ ~~ ~, ,.. .:~ , . _ ~' ~ ~:~ ~`~ ~~:~ ~ 2 ~-`~
RELATIONSHIP TO DECEDEN7 AMOUNT OR SNARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE _
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transiers under
Sec. 91t6 (a) (1.2)] ~ j
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EN7ER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LVNES 15 THR~UGH 18, AS APPROPRIATE, ON REV-150~ COVER SNEET
-I NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
S. GHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PAR'f II - ENTER TOTAL NON-TAXABLE DISTR~BUTIONS ON LINE 13 OF REV-1500 COVER SHEET I$
(If more space is needed, insert additionaf sheets of the same size)
Investment holdings of Mary C. Keyser at her date of death, March 3, 2005
Quantitv Name Fair Market Value
100 Amerigas Partners LP $2,957
280 Bank America 6.5% 10/15/32 $7,286
1138 Blackrock Muni lnc Tr 2 $19,521
100 Exelon Corporation $4,551
465.645 Dryden Muni Bd Fd Insd-B $5,108
570 JP Morgan Chase 7% Cap X $14,911
280 Natl Ruraf Utifs 7.625% $7,350
264 PPL Corporation $14,261
6637.915 P/G Multi Sect Sh Trm-C $32,128
3.744 Smith Barney Income CI C $44
433 Salomon Eq-Linked DJIA $7,924
918.347 Strat Prtnrs Mod Grwth C $11,121
108 Viacom Inc CI B $3,807
6000 Household 7°/a 6/15l17 $6,013
10000 Penn St 5% 6/1/15 10 757
$147,739
1VJ/ ~lVVT 14Ta!/ 1
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LISTENING.
~~~~~~~~~i~~~ n ~~~~~~~~~~~~~~~~~~~~~~~~ n ~i~~~~~~u~~~i~~~~i~~
MARY C KEYSER
2 N CHE5TNUT ST
DILLSBURG PA 17019-1307
9,137.75
.00
1 ENCLOSURES
0
FULTON CLASSIC CHECKING ACCOUNT: 3619-51183
PREVIOUS DEPOSITS/ CHECKSi SERVICE ENDING
STATEMENT BALANCE CREDITS 4 DEBITS 1 FEES BALANCE
9,137.75 1,906.81 9,137.75 .00 1,906.81
ACCOUNT/INTEREST INFORMATION
INTEREST PAID THIS YEAR 4.60
DATE ACTIVITY DESCRIPTION REFERENCE
03-11 BEGINNING BALANCE
03-11 CHECK 1512 03251307780
04-O1 FIDELITY INVESTM 00077900000
PENSION XXXXX6922B
04-01 FIDELITY INVESTM 00077900000
PEN5ION XXXXX6922B
04-01 FIDELITY INVESTM 00077900000
PENSION XXXXX6922B
04-08 INTEREST CREDIT
04-10 ENDING BALANCE
DEPOSITS/ CHECKS/
CREDITS DEBITS BALANCE
9,137.75
277.04
504.42 ~lg~(,,
1,125.17
.18
CHECK SUMMARY
* INDICATES SKIP IN CHECK NUMBERS
CHECK NO AMOUNT CHECK NO
1512 9,137.75
TOTAL NUMBER OF CHECKS 1 TOTAL AMOUNT OF CHECKS
AMOUNT
9,137.75
*yy ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 3-11-05 THROUGH 4-10-05 ***
ANNUAL PERCENTAGE YIELD EARNED .359~
AVERAGE DAILY COLLECTEB BALANCE 615.04
INTEREST EARNED .18
SERVICE FEE BALANCE INFORMATION FROM 3-11-05 THROUGH 4-1Q-~5
AVERAGE LEDGER BALANCE 615.04 AVERAGE COLLECTED BALANCE
MINIMOM LEDGER BALANCE .00 MII3IMUM COLLECTED BALANCE
DIRECT FULTON BANK DIRECT BANKING CENTER
INQUIRIES T0: P. 0. BDX 504
F.ACT PF.TF.RSRTiRl: PA 1757f1-n5f)la
STATEMENT OF ACCOUNTS
3619-51183
STATEMENT PERIQD
FROM THROUGH
3-11-05 4-10-05
PAGE 1 OF 2
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~5.ia3 aev. 2ta~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
~ CERTIFICATE OF DEATH _
NAME OF DECEDEM (Finl, Mid~la, Lenl) - SEX SOCIAL SEGURITY NUMBER DATE OF DEATH(Monlh, Oay. Year)
~. Mar C. Ke ser s.Female a. 178 - 18 - 6922 ~. Ir1C1~th ~`~00
AGE (Lasl Bi~ltWay) OATE OF 81RTH BIRTMPLAGE (Ciry enG ~
MonNa Daya Fqun Minules (MonN, Day, Yeaq Slale a FwMqn Can1ry) NOSPITl~L: OTMER:
84 r~. 2-8-1921 ~hiladelphia
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6. !. Ra~~~
a. nom~ isa.dM
' COUNTY QF DEATH CI7Y, BpRO, TWP OF DEATH FAqLITY NAME (If nol insU~utim, qve slteet end number) WAS DECEDENT OF HISPANIC ORIGIN9 RACE - Amedcan InCian, Black, White, et
~/ ~~ No~Yes~nyes,cpeciryCuben, ~SP~~y1
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ee. Cumberland
~~ast Pennsboro ~. 0
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DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS! INDUSTRY AS DECEDENT EVER IN DECEDENT'S EOUCATION MARITAL STATUS - MartieU, SURVIVING SPOUSE
~c~atneoiwonoon.a moH U.S.ARMEDFORCES7 ts~a oNyrv NQ.acomp.ieal NeverMarri80 VNdoweO, U~•+ie.yv.m.imnname~
oi ww`rw w.: m na ~.al
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. Divorced (S`
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' ~+.. Housewife »e. Domestic ~z ~a. ~013~ 12 ~""8"1 u. Widow ~e.
DECEDEM'S MAILING ADDRESS (Slreel, City/favn, $la~e, 2ip Code)
100 Mt. Allen Dr3ve OECE~ENT'S ~~,, s~,ePenns lvania Did ~7c, Vea, decedent lived in
ACTUAL Y ~ Upper Allen ~a
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REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No . 2005- 00229 PA No . 21- 05- 0229
Estate Of: MARY C KEYSER
(Firs(, Middle, LaSU
La te Of : UPPER ALLEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Soci al Securi ty No : 178-18-6922
WHEREAS, on the llth day of March 2005 an instrument dated
June 2lst 1993 was admitted to probate as the Iast will of
MARY C KEYSER
(First. Midd/e. Lastl
Iate of UPPERALLEN TOWNSHIP, CUMBERLAND County,
who died on the 3rd day of March 2005 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, here.by
certify that I have this da~r granted Letters TESTAMENTARY to:
MARJORIE K STRAYER
who has duly qualified as EXECUTOR(R1X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set m~ hand and affixed the seal
of my offi ce on the 11 th day of March 2005.
~J9Ct~-. , ~ __
egister o Wils
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epu y
**NOTE* * ALL N~IMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
~j LAST WILL AND TESTAMENT _
~~ _, ~
~ ~~ I
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; ¢ MARY C. REYSER i . -
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`! I, MARY C. KEYSER, of Ambler, Montgomery County, Pennsylvania,~
~~ do hereby make and declare this to be my Last Will and Testament and
;';
;~ hereby revoke all Wills and Codicils heretofare made by me.
~;
;~; FIR5T: I direct that all of my just debts, and the expenses of
~: ~
fi my funeral and last illness, be paid from my general estate as part
`~
;~ of the cost of the administration as soon after my decease as
. 4
' ~ practical .
;~
':a SECOND: I direct that all taxes that may be assessed in
~~
~~
'!, consequence of my death, of whatever nature and by whatever
~r jurisdiction imposed, shall be paid from my residuary estate as part
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;~
;; of the expenses of the administration of my estate, without
;' apportionment or right of reimbursement.
THIRD: I give and bequeath to my Husband, J. LAWRENCE KEYSER,
;; JR. , a~l ~f r,~y tar~g~ble pers~nal property, including any household
ti
j; goods, furnishings and personal effects, and any automobiles, together
;~
~i with all policies of insurance thereon, provided my said Husband is
;i
living at my death. If my said Husband does not survive me, I give
:;
'' such property to my children living at the time of my death to be
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divided among them as they may agree. In the event that no agreement
;
~ is reached on certain items or certain items are not wanted, those
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;
items shall be sold and the proceeds distributed as part of my
residuary estate.
In the event that my Husband does not survive me, I direct
that any home that I may own at the time of my death be sold and
become part of my residuary estate.
FOURTH: All the rest, residue and remainder of my estate, real,
personal and mixed, of whatsoever kind and wheresoever situate, I
give, devise and bequeath to my Husband, J. LAWRENCE KEYSER, JR., ;
j
absolutely. ,
FIFTH: In the event that my said Husband predeceases me, then ~
i
I give, devise and bequeath the residue of my estate in equal shares ;
~
to my children, MARJORIE K. STRAYER, ALAN C. KEYSER, and BRUCE G. i
i
KEYSER. In the event that any one of the aforesaid beneficiaries ~
shall predecease me, then that share shall be divided into equal
i
shares among his or her then living spouse, if not remarried, and his ~
or her then living issue, per stirpes. If the spouse of such deceased
child has remarried, then that share shall lapse and be divided among
the living issue of such deceased child, per stirpes.
SIXTH: Any share of my estate, income or principal, which
becomes distributable to a minor shall be held IN TRUST by his or her
then living parent, as TRUSTEE during minority. My Trustee is
authorized to retain, invest and reinvest in any form of property r
1
without restriction to le al investments and to a 1 such amount of ~
g . PP Y ~
~
income and principal as my Trustee, in its sole discretion, deems
proper for the support, education and weZfare of such minor and shall !
~
2 '
accumulate any unexpended balance of income. Such amounts may be
applied directly or may be paid to the person with whom such minor
resides or who has the care or control of such minor, without the
interrvention of a guardian.
SEVENTH: I nominate, constitute and appoint my Husband, J.
LAWRENCE KEYSER, JR., Executor of this, my Last Will and Testament.
In the event that my said Husband is unable to act or ceases to act
for any reasan, then I appoint my children, MARJOR3E K. STRAYER, ALAN
C. KEY5ER and BRUCE G. KEYSER, or the survivor of them, as Substitute
Executors.
I direct that no fiduciary acting under this, my Will,
whether or not named herein, shall be required to post bond or furnish
security in any jurisdiction in which the said fiduciaries may act.
Any reference to my fiduciaries, whether executors or
trustees, shall refer to those from time to time who are acting as
such, whether stated in the masculine or feminine gender, or whether
stated in the singular or plural,
EIGIiTH: In addition to the powers given by law, any fiduciary
acting under this my Will, whether or not named herein, shall have the
following powers applicable to all property held by them effective
without court order and until actual distribution:
A. To retain any or all of the assets of my estate, real
and persanal;
B. To repair and improve real property;
3
i
1
i
C. To sell at public or private sale, to exchange or to ~
;
lease for any period of time, any real or personal property, and to i
give options for sales or leases;
D. To make distribution in cash or in kind;
E. To compromise controversies;
F. To borrow money and to pledge any property of the estate
as security therefor; ~ ~
i
G. To execute and deliver all instraments of writing
~~ necessary or appropriate for the exercise of any of their powers.
i~ IN WITNESS WHEREOF, I, MARY C. KEYSER, have hereunto set my hand
,r
,.
c;
;~ and seal to this, my Last Will and Testament, which consists of four
i.~ (4) pages, this .:ll~day af ~~~-- , A.D. 1993.
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_ '~--~,.~-,,r ~..:, ,4-=~i,~,.ls~~..,.-, 4,; ~gFAT,~
~; MARY C. KEYSER . ~
4
~
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named
Testatrix as and for her Last Will and Testament, in the presence of
us, who, at her request, and in her presence, and in the presence of
each other, have hereunto subscribed our names as witnesses.
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