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HomeMy WebLinkAbout08-28-06 . REV.1500 EX 16-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 w '"' lI:~1I) olt::lI: wCLO xOO olt::..J CLIll CL 01( INHERITANCE TAX RETURN RESIDENT DECEDENT t- Z w C w U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) IXX>LI'ITLE, RUTH CRULL DATE OF DEATH (MM-DD-YEAR) 07/03/2006 FILE NUMBER 21 - 06 0610 DATE OF BIRTH (MM-DD-YEAR) 07/29/1915 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A [2g 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 044 24 5768 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) z o ~ ~ ::) 0- :E o u ~ I- Z W C Z o CL II) W It:: It:: o o NAME JAMES D. CAMEROO, ESQ. FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 1 325 NORI'H FROOT S'I'REEI' HARRISBURG, PA. 17102 TELEPHONE NUMBER (717) 236-3755 1'...;) (,,,, C) ~I S~~ z o ~ ...J ::) t:: 0- <( U W a:: 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. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total 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) (1 ) (2) (3) (4) (5) -0- -0- ;...0- -0- 176,908.95 -0- (8) 176,908.95 (6) (7) -0- (11) (12) (13) 17,474.66 159,~34 79 159.434.66 (9) (10) 9,329.51 8,145.15 (14) -0- 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) 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- o -0- -0- (19) g 16. Amount of Line 14 taxable at lineal rate x .0_ (16) 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 . ~~Y_.T_1 AWl ,_~. - co'.. ~...,.._~ ..".....___ - LAST WILL AND TESTAMENT OF RUTH CRULL DOOLITTLE I, RUTH CRULL DOOLITTLE, presently residing and domiciled in the Borough of Lewisberry, York County, Pennsylvania, hereby declare this to be my Last Will and Testament, and I hereby revoke any and all prior wills and codicils previously made by me. ITEM I: I hereby give and bequeath the sum of Five Thousand Dollars ($5,000.00) unto SCOTT E. MILLER and LILA M. MILLER, or their survivor, in recognition of their offers of assistance. ITEM II: All the rest, residue, and remainder of my estate I give, devise, and bequeath as follows: A. Five percent (5%) to the LEWISBERRY FIRE COMPANY, Lewisberry, Pennsylvania, for the general uses and purposes of said Company; B. Five percent (5%) to the NEWBERRY TOWNSHIP FIRE DEPARTMENT, Etters, pennsyivania, for the general uses and purposes of said Company; C. Thirty-one percent (31%) to the HELEN O. KRAUSE ANIMAL FOUNDATION, for the general uses and purposes of the Foundation; D. ~hirty-one percent (31%) to DICKINSON COLLEGE, Carlisle, Pennsylvania, for the general uses and purposes of the College; and . E. Twenty-eight percent (28%) to the ANNIE E. STERLINE LIBRARY, Lewisberry, Pennsylvania, for the general uses and purposes of the Library. ITEM III: All estate, inheritance and other death taxes, together with interest and penalties thereon, payable with respect to property or interests passing under my will or any codicil thereto, shall be paid out of the principal of my residuary estate without apportionment. It is my intention that ,any. tax due upon the legacies hereunder of finite ~- ---. C!h~ll be borne pro-rata by the remaindermen, and shall no1' ~) specific legatees, even though the remainderman J - ~ ~ cJ. taxable charities. c.2? () ~ ~Jry,o c~ .. ITEM IV: I appoint JAMES D. CAMERON, ESQ., as Executor of this my Last will and Testament. I direct that my Executor shall not be required to furnish security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this 7th day of March, 2001. '~~ ~~ .. ~~ R~ CRU- LImE WITNESSETH: The foregoing instrument was, on the date stated above, signed, published, and declared by RUTH CRULL DOOLITTLE, the Testatrix named therein, as and for her Last will and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. t ~ L~j{A 'f/tl47l~/'l-II--..J (W tness) ( /31:;.fJ. ~ifSf--' (Address) /31> tJtJr-~ h-o"L ~Jv.",L (Address) IJa/I/tA<:1 bU'2f ;1t n Nd- (Address) / U-N';S 1 ,I-a P4 /1/0'1- (Address) 2 - "---'';.?-'.''.r.~ ~ ACKNOWLEDGMENT Commonwealth of Pennsylvania ';;[k"~ County of Dauphin SSe AND NOW, this 7th day of March, 2001, I, 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 the instrument as my Last Will and Testament, that I signed it willingly and as my free and voluntary act for the purposes therein expressed. CX\~. RU~L ll&LITTLE Sworn to, subscribed, and acknowledged before me by RUTH CRULL DOOLITTLE, the Testatrix, this 7th day of March, 2001. -~01~~ My commission expires: Notarial Seal Shana R. Geyer, Notary Public Harrisburg, Dauphin County My Commission expires July 20, 2002 Ment>er, Pennsytvsnl8 AssncI8t1on ot Notaries ""'.'I~i'.~"~~;nn~" Ji!-v'r h...a~:p~n:;~~!;;:'-' ,J"."-~';';'~",\'f';"t; ,-,f.'.~' .,~":},;.~,',; '. ...~.. AFFIDAVIT Commonwealth of Pennsylvania : : ss. County of Dauphin " ~~w, ~S 7th day of March, 2001, we, JAMES D. CAMERON and . (t L '-aJ'1'1e!MN , the witnesses, whose names are signed to the ttache or foregoing 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 and Testament; that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us 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 that time at least eighteen (18) years of age, of sound mind, and under no constraint or undue influence. ~~t3X~ wi ess ~ A ~wor~ ~..~nd subscribed before me by JAMES D. CAMERON and L~~~/~ b~nN , the Witnesses, this 7th day of March, 20 1. AIoro~~ Notary Pub ic My commission expires: Notarial Seal Shana R. Geyer, Notary Public HarrIsburg, Dauphin County My CommIssiOn Exp(rus July 20, 2002 Member, PennIytv8nlB AssocIatIon 0' NotarIes 04'jli>:i..,'...~!J..""--.Ji/>'8!~:-"" ,-..,.,-""""~->-..',-"...."'""'-- ' -,. . -~'....."'~ ,,~ ,'".~,', ,.-... ..,,- ,~' " ~~.. '. ~ ',' .. . .......... - CODICIL TO THE LAST WILL AND TESTAMENT OF RUTH CRULL DOOLITTLE I, RUTH CRULL DOOLITTLE, of the Borough of Lewisberry, York County, Pennsylvania, declare this to be a codicil to my Last Will and Testament d~ted March 7, 2001. FIRST: I hereby revoke Item I of my Last Will and Testament and substitute the following: "ITEM I: I hereby give and bequeath the sum of Five Thousand Dollars ($5,000.00) unto GLENN ORRIS, in recognition of his acts of kindness and assistance." SECOND: In all other respects, I do hereby ratify and confirm my Last will and Testament dated March 7, 2001. I have signed my name this 17th day of October, 2001. Signed by RUTH CRULL DOOLITTLE, the Testatrix, as a codicil to her Last will and Testament dated March 7, 2001, in the presence of us, who at her request, in her presence, and the presence of each other, have signed our names as witnesses. ' ~0.e-- , wu::( -Z'JJ.~ 1-1.,.1/.. rr..~L Sk& (Address) ~r~'v.J~;'- .p~ /7/02.- (Address) ~g.~ wi ess J'3dS 1\. ~ Ab " (Address) ~~(J fft hl()J- (Address) I .-~-,--- 'i~~~-A~~.ir;'~"i~';~'~i~'f";""" f "1,:,1' ....,.... ~.,.-....... "':'fl~~~:~:=: ACKNOWLEDGEMENT AND AFFIDAVIT Commonwealth of Pennsylvania . . SSe County of Dauphin We, RUTH CRULL DOOLITTLE, JAMES D. CAMERON, and CYNTHIA L. CAMERON, the Testatrix in and the witnesses to the Codicil, the ;lttached or foregoing instrument, having been qualified according 'to law do depose and say: ,,~. . (a) that I, the Testrix, do hereby acknowledge that I signed ~~~the instrument as a codicil to my Last will and Testament, that I ''''i.i~},~ai9ned it ,willingly and as, my free and voluntary act for the '~~~~~~ses:,therein expressed, and ' , ~:?~~fl:l~ j: (b)' that we, the witnesses, were present and saw the Testatrix "~~',.,;~I!t:' ,,'i:'i' sign and execute the instrument as her codicil, that she signed it "M,' . . willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the codicil as a witness and that to the best of our knowledge the Testatrix at that time was eighteen or more years of age, of sound mind, and ~nder no constraint or undue influence. ~~ RU H ULL OLITTL J Sworn and subscribed before . ~f October, Notary pu lie 2001. M:f commission expires: Notarial Seal Shana R. Geyer. Notary Public Harrisburg. Dauphin County My Commission ExpIres July 20, 2002 Member, Pennsylvania AssoctatIon of Not8I1es SECOND CODICIL TO THE LAST WILL AND TESTAMENT OF RUTH CRULL DOOLITTLE I, RUTH CRULL DOOLITTLE, of the Borough of Lewisberry, York County, pennsylvania, declare this to be a second codicil to my Last Will and Testament dated March 7, 2001. FIRST: I hereby confirm and republish my intention to delete of Item I of my Last Will and Testament dated March 7, 2001. SECOND: In place of the gift to Glenn Orris of Five Thousand Dollars ($5,000.00) contained in my Codicil dated October 17, 2001, I hereby substitute, instead, the following gift to Glenn, so that Item I shall now read: !lITEM I: I hereby give, devise, and bequeath my real property located at 215 South street, Lewisberry, pennsylvania, as well as all of my tangible personal property, inclu4ing insurance thereon, unto GLENN ORRIS, in recognition of his numerous acts of kindness and the assistance he has provided to me." THIRD: It is my specific intention that Glenn shall not be responsible for the payment of any inheri tance tax or administrative expense related to the foregoing bequest. Rather, it is my intention that he shall receive my real and tangible personal property without reduction or charge for any inheritance tax or ordinary administrative expense. . FOURTH: In all other respects, I do hereby ratify and confirm my Last will and Testament dated March 7, 2001, and my COdicil dated October 17, 2001. I have signed my name this 27th day of December, 2002. ... n ~"<K~';t.~~<// ,'. tl~ RJ~~ D~OLITTLE Signed by RUTH CRULL DOOLITTLE, the Testatrix, as a second codicil to her Last Will and Testament dated March 7, 2001, in the presence of us , who at her request, in her presence, and the presence of each other, have signed our names as witnesses. wfl/i}r?:=sw w~~~ (Address) (Address) IJ---r;s.!> , "'"J. P417WL.. ld~rY{fi bU';?/ jl/J- /7 /(j ~ (Address) (Address) ACKNOWLEDGEMENT AND AFFIDAVIT ~.,~,., iF":-;""', '. .' i.;.~ .~'., .'_ . Commonwealth of Pennsylvania County of Dauphin : ss. We, RUTH CRULL DOOLITTLE, JAMES D. CAMERON, and CYNTHIA L. CAMERON, the Testatrix in and the witnesses to the Second Codicil, the attached or foregoing instrument, having been qualified according to law do depose and say: (a) that I, the Testatrix, do hereby acknowledge that I signed the instrument as a second codicil to my Last will and Testament, that I signed it willingly and as my free and voluntary act for the purposes therein expressed, and (b) that we, the witnesses, were present and saw the Testatrix sign and execute the instrument as her codicil, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the codicil as a witness and that to the best of our knowledge the Testatrix at that time was eighteen or more years of age, of sound mind, and under no constraint or undue influence. ~t_~O~ RU . ._..CRULL qOLITTLE J#Q~ ~.JR~ CY THIA L. CAMERON Sworn and subscribed before me this 27th day of December, 2002. My commission expires: NaI8IIII Sell ShIn R. Geyer, Notary PWIc QvOlHantstug. ~ CoII'Ily My COl......., EJcpfresJlly 20. 2008 Member. ~ AsIOIiaIion OfNolarles . REV-l508 EX. (1-91) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF iT TI'LE RUTH CRULL IXXJJ..JI RLENUMBER 21-06-0610 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2 3 4 5 6 7 8 VALUE AT DATE OF DEATH DESCRIPTION Sovereign Bank P.o. Box 841005 Boston, MA 02284 Certificate of deposit humber 2565041338 81,524.51 Sovereign Bank Accrued interest, certificate of deposit humber 2565041338 ')28'J l4 Wach6via Bank, N.A. P.O. Box 40028 Roanoke, VA 24022 Certificate of deposit number 247412081556012 50,000.00 Wachovia Bank, N.A. Accrued interest, certificate"of deposit number 247412081556012 438.33 PNC Bank 500 First Avenue Pittsburgh, PA 15219 Checking account number 5140095462 9,544.76 PNC Bank Accrued interest, checking account number 5140095462 1.55 PNCBank 500 First Avenue Pittsburgh, PA 15219 Money market account number 5004771999 35,282.30 PNC Bank Accrued interest, money market account~number 5004771999 89.36 TOTAL (Also enter on line 5, Recapitulation) $ 176,908.95 (If more space is needed, insert additional sheets of the same size) Sovereign Bank Ruth C. Doolittle 044-24-5768 July 3, 2006 ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Account #: 2565041338 Type: In the name of: Ruth Crull Doolittle Date of Death Balance: Int.(YTD) from 1/1/2006 to Accrued interest to date of death: Other Info: CD Open date: 1/8/2002 $81,524.51 6/30/2006 $28.14 $1,011.38 Page 1 of 1 Fax Transmission 7/24/2006 4:06 PM PAGE 1/002 Fax Server . ~HOVIA Ret<<e~ ill' 16958.50 Wachovia Bank N.A. Balaoc,e Confirmation Serl,lces POBox 40028 Roanoke, VA 2402:2.'7313 July 24, 2006 JAMES DURYEACAMlliRON ATIORNEY AT LA W 1325 NOR'Ilf FRONT STREET HARRISBuRG. PAL i 102 SUBJECT: Verification! Confirmation of Account and Balance lnformatlon provided for: Customer: RUTH C DOOLItTLE (SSNj 044-24-5168) Date of Deatb: July 3,1006 Deoosit Account Jnformatioo AaDurlt T-'lpe ..\ocomt Number Date of [)eeth Balll.lJCe Average Balance. lAte Opened ~;8t,l!'lty lnwoo Accrued YTD Date Dole Rate In1ere!lt In1C:rc~1 P<lid Closed CER'fIfIlCATE OF DEPOSIT 2474l2(l81556012 LEGAL TITI..E: RUTH CRULL !JOO:JTTL.E JAMES DCAMUON . POA $50 ,lJCO. iJO 7:6i2GO: S4J8.33 $88644 7d&i2006 * Due to ~y5tem limitnions, we l'lm only proviJe a twd~e month avc:ragc balilllCe ou deposittJry ac.,;ounu; o PNCBAN< August 10,2006 James D. Cameron Attorney at Law 1325 North Front Street Harrisburg, P A 17102 RE: Estate of Ruth C. Doolittle, deceased SSN: 044-24-5768 DOD: 7/3/2006 Dear Mr. Cameron: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140095462 Established 02/28/1990 RUTH CRULL DOOLITTLE DOD balance: $9,544.76 + $1.55 accrued interest Savings Account Account #5004771999 Established 03/12/2001 RUTH CRULL DOOLITTLE DOD balance: $35,282.30 + $89.36 accrued interest Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~~- Rachelle Wells 1-800-762-1775 P7 -PFSC-04-F 500 first Ave. Pittsburgh P A 15219 Member FDIC . REV-1511 EX+ (12-99) . *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER RUTH CRULL IXX)LI'ITLE 21-06-0610 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT N/A B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) James D. Cameron Social Security Number(s)/EIN Number of Personal Representative(s) 1325 North Front street 3,500.00 Street Address City Harr i sburg SPA Z' tate _ rp 17102 Year(s) Commission Paid: 2006 2. Attorney Fees James D. Cameron, Esq. 5,300.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address N/A City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills of Cumberland County 332.00 5. Accountant's Fees 6. Tax Return Preparer's Fees N1A N/A 7. Cumber land law Journal (legal advertising) 75.00 122.51 8 The Sentinel (legal advertising) TOTAL (Also enter on line 9, Recapitulation) $ 9 , 329. 51 (If more space is needed, insert additional sheets of the same size) REV.1512 EX+ (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF RUTH CRULL lXX)LI'ITLE FILE NUMBER 21-06-0610 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Alert Pharmacy Services (final bill) 718.77 2 Messiah Village (billing statement 06/30/06) 6,854.38 3 James D. Cameron, Esg. (billing statement 06/30/n6) Messiah Village (final statement 07/01/06 - 07/03/06) 100.00 4 472.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,145.15 REV.'S13 EX+ (9-OO. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rum CRULL IXX>LI'lTLE SCHEDULE J BENEFICIARIES FILE NUMBER 21-06-0610 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. 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. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. PLEASE SEE ATrACHED LISTING. - . TOTAL OF PART II - 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) SCHEDULE J (Attachment) Ruth Crull Doolittle, deceased No. 21-06-0610 II.B. Charitable Distributions. 1. Lewisberry Fire Company Post Office Box 269 Lewisberry, PA 17339 2. Newberry Township Fire Department 2145 York Haven Road Etters, PA 17319 3. Helen o. Krause Animal Foundation, Inc. Post Office Box 311 Mechanicsburg, PA 17055 4. Dickinson College Post Office Box 1773 Carlisle, PA 17013 5. Annie E. Sterline Library 308 Market street Lewisberry, PA 17339 5% residue 5% residue 31% residue 31% residue 28% residue