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Home My WebLink About04-18-07 -.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Hanisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death OFFICIAL USE ONLY ,~u.".tygode,Year INHERITANCE TAX RETURN RESIDENT DECEDENT Rle Number 21 06 0508 Date of Birth 05/06/2006 02/10/1914 Decedent's Last Name Decedent's First Name GLEIM ABIGAIL (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix First Name Spou.se's Social Se~urio/ ~u.mber THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ca:J 1. Original Retum 2. Supplemental Retum c;, c;, 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required <=l 4. Limited Estate c;, c;, 4a. Future Interest Compromise (date of death after 12-12-82) c;, 7. Decedent Maintained a Living Trust (Attach Copy ofTrust) c;, 10. Spousal Poverty Credit (date of death c;, 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Namel:>~ytime Te~~p'~,~~e Number C'::l 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C) THOMAS E. FLOWER ,,' "'i"':) , ! (717) 737-3405 0 g, L";=:::.::::.:::.::::::.::::..::=::::..,~~"."m::::.:::.:::.::~:'" j i REGISTER OF Wl~f5 ONLTO i i '.f: ~ r-;:; ~ I E ""--:- -TJ i i: en 7;:: 0:> i I -'C10 >1 Ii ~ -:1 ~.-.' i,1 -..j i o! I N i DATE FILED , .__R.N______...____......._.__._...._._______.___.E Firm Name SAlOIS, FLOWER & L1NDSA First line of address 2109 MARKET STREET Second line of address or Post Office ZIP Code 17011 Correspondent's e-mail address:tfI0wer@sfl-law.com Under penalties of pe~ury, I declare that I have examined this return, 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 hes any knowledge. SIGN E OF PERSON RES F. FILING RETURN DATE 7 I '} --t) AD SS THOMAS E. FLOWER, 2109 MARKET ST., CAMP HILL, PA 17011 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS SAlOIS, FLOWER & LINDSAY, 2109 MARKET ST., CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 -.J MI C MI 0i ...J 15056052059 REV-1500 EX Decedent's Social Security Number ...,.......~......n............'.......m.'............._........ _ _ .. Decedent's Name: ABIGAIL C GLEIM 184-12-4187 RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. l 2. Stocks and Bonds (Schedule B) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.: 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . .. 3. i 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.! 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.' 1,199.90. ~ 6. Jointly Owned Property (Schedule F) Cl Separate Billing Requested . . . . . .. 6.; 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Cl Separate Billing Requested.. . . . . .. 7.: 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.: 1,199.90 1,207.09 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). .. . . . . . . . . .. . . . 10. ! 11. Total Deductions (total Lines 9 & 10). . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . 11. ! 1,207.09 12. Net Value of Estate (Line 8 minus Line 11) . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . 12. ! O. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~----^"_~_'______""'__""""m_'~'~~=.....v.,.."<, an election to tax has not been made (Schedule J) ... . . . . . . . . . . . . . . . . . . . . . 13. : 0.00 . ;.........=....----~.,~~____~m...............__,______; 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. i TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a}(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 ; , .......- ............ .......-....--................--............ .............................. ..................... 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT <=> L 15056052059 Side 2 15056052059 ...J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME ABIGAIL C GLEIM STREET ADDRESS CHAPEL POINTE 770 S. HANOVER STREET CITY CAMP HILL 01~~ DECEDENT'S SOCIAL SECURITY NUMBER 184-12-4187 STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Une 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. (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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;.......................................................................................... D [iJ b. retain the right to designate who shall use the property transferred or its income; ............................................ D [iJ c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ,receiving adequate consideration? .............................................................................................................. D [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [iJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D [iJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~- ~I~ .." I o.L ~ 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 three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute doe~ 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 zero (0) percent [72 P.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 four and one-half (4.5) percent, 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 decedent's siblings is twelve (12) percent [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. REV-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ABIGAIL C. GLEIM FILE NUMBER 21-06-0508 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION FEDERAL DEATH BENEFIT, payable to decedent due to her pre-deceased son's federal employment. By way of further explanation, the only reason this estate was opened is that the heirs believed the federal . possible to determine the amount of the benefit without taking out Letters. death benefit payable to the decedenfs estate would be a much more substantial amount, and it was not TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 1,199.90 1,199.90 ,-:: 'M.~~~"ti~,:;;'~', :7_),.c~ '_"! Personnel Management ,nt r'rbgrams Ifent Operations Center ,rs, PA 16017 I .. TO OPEN. INSERT FINGER AND CAREFULLY SLIDE UNDER :rH:IS"I;~~,-;;;;..:~:. y;, .;,'" ""''''....." "I f{."'~'" ''-" ""'.;0"' ~' ,jr!t--" ....fI"":!.'4.~~ .....-:--_...,................... l/ f'C'~ 1 e"'L6.:t~;~1~r_, n --~~M'l" t; '\' .i 1 ,', ,U ;, ",f;-.," ~~.(. ~"~I - Ul '1 9' _ ." , : .e~rt~~ ,- ',_. ",... III . iPS,...--_1 : ., L~ JIII',4 I 1:L.,Jt,'.li. ,-A .~...~ 7{i<1547ti! u.s, h}srt~Gi: " ---.* OFFICIAL BUSINESS PENALTY FOR PRIVATE USE, $300 FORWARDING SERVICE REQUESTED THOMAS EFLOWER ADMIN ESTATE ABIGAIL GLEIM 2109 MARKET STREET CAMP HILL PA 17011 t i 7Cii 1+4723-99 .-. <J-. __ '-l_=,t:. e ',..11I11.111. 111"11..,11,1,,11,,.1,,1,111 11.1,1 Jf 1,1,"11"1 ,- - - --, _,~I - - -,-I , -:- -- - ":::':.' L_-,-_I FINAL STATEMENT OF LUMP SUM DEATH BENEFIT PAYMENT You are entitled to a lump sum payment because of the death of a former employee. This payment, shown in Block 5, covers only benefits due from the Civil Service Retirement and Disability Fund and consists of any unused contributions the former employee made to the Fund or any accrued annuity payable at the time of his or her death, or the Basic Employee Death Benefit payable to a surviving spouse under the Federal Employees Retirement System. 1. Name of Deceased Federal Employee 2. Claim Number 3. Date of Birth 4. Date GLEIM ROBERT L CSF 2968959' 10/29/43 10/18/06 5. You Will Receive a Lump Sum Payment For 6. To Be Sent By 7. Interest (Included in Item 5) S. Tax Withheld $ 1199.90 11/02/06 $ NONE $ NONE 9. Remarks , , REV-1511 EX+ (12'99* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ABIGAIL C. GLEIM FILE NUMBER 21 ~06~050B Debts 01 decedent must be reported on Schedule I. ITEM NUMBER A. Fl,JNI;RA~ I;XPI;NSI;S: 1. DESCRIPTION AMOUNT 2. AlIomey Fees B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City Year(s) Commission Paid: 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 Retum Preparer's Fees 7. EXECUTOR'S NOTICE, SENTINEL 8. EXECUTOR'S NOTICE, CUMBERLAND LAW JOURNAL TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size)