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Home My WebLink About05-30-07 .. .-J 15056051047 REV-1500 EX (06-05) PA Department of Revenue . Bureau of Individual Taxes PO BOX 280601 Harrisbu ,PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Securi Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth MI ~ Decedent's Last Name Suffix (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return -c::) - :C::) 3. Remainder Return (date of death prior to 12-13-82) 1:) 4a. Future Interest Compromise (date of c::t 5. Federal Estate Tax Return Required death after 12-12-82) f.. I _1 c::) 7. Decedent Maintained a Living Trust \.~ ENT),. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 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: Name Daytime Telephone Number ' 2. Supplemental Return c::t 4. Limited Estate c::) 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received (.) L) ( ) -~-i Correspondent's e-mail address: be ctmer-cS ~ i x. r1et 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, and co plete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. PONSIBLE FOR FILlNu.RETURN DATE if- / ""if) IS- DATE .~ 5/U ~ z mech4mCsbu~1 fJA 11f)~ PLEAS USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ...J -.J REV-1500 EX 15056052048 ~ecedent's Name: HIIU,y e. ZIIHIltEJeAtA-N RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) C=> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C=> Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 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. 12. Net Value of Estate (Line 8 minus Line 11) ... .. .. ... ... ... .. .. .. .. .. " .. 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subjectto Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . . . 14. 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 .O~ 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 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Decedent's Social Security Number 15. 16. 17. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052048 Side 2 C=> 15056052048 --.J - REV-1500 EX Page 3 .. File Number ,;2/-/), -lISt) Decedent's Complete Address: DECEDENTS NAME fill-MY E: 2.1/lfAl~I&JfIf/l -~- STREET ADDRESS ------- 7::1 .sNEltJfl~I)~ {)/lII"E -- CITY e.thtt.ISL.~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 6. Prior Payments C. Discount 3. InterestlPenalty if applicable D. Interest E. Penalty 4. TotallnteresllPenalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. f) (3) (4) (5) (SA) (56) o o tJ o 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. 6. Enter the total of Line 5 + SA. This is the BALANCE DUE. o 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 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D IXl c. retain a reversionary interest; or.......................................................................................................................... D lkl d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [}5] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D I2S 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 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. 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. 99116 (a) (1.1) (ii)]. 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 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 . (f.!l7j '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY IIA-miY E COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 21 ~A' ~ ~I I11IJ1 t ,,/11 n7V I FILE NUMBER ;It - 0{, - If!:"~ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. d. J.. 1. s: 6, DESCRIPTION ))/"tJ dep;$tf ererit CI1/ry re: -/rq( He.eIuc:."~n~ IIMt/ w"M~/d"~ .fro," Ff'D! ~ S/4l,'kh /J1ft,~. ~ (!~1/1"S/el /Jf H/kJ, -fr-a,'/er tfr ttt.t~l,'Il'Y heu-//YlJ' ete.. fJOAJ- .{;om un;tai &he.lwprker.s 1 A-/l1e.rical LotA1 "1'1' ilA/yerJIJI WrtrletAJ(,'f-e,r5 GI'f)Hf I /l~ :t sM 1 Hu'r.J F. ~i/11lHerl/l'Jn ft.: ert-ll/f &tne,{"/; h:>r uneQrJ'u! ehfLrl/H "n /lJan, ;:;//"'~#'lfJ ~ ~lIld"h;'/I.1 ~ak",u f4t;r~ 19/11 ;~ if, ;14,.1;.' RI.~J ek L.o~ I~ Re..furr'l VALUE AT DATE OF DEATH ~/I.iPh f#' JSP. ~" ~;J7..93 ~ .3~ 3J~ ,2- 17/,3(' ~ ~ I." .: TOTAL(Alsoenteronline5,Recapitulation) $ 3, "~'I f)! (If more space is needed, insert additional sheets of the same size) . REV-1t11 EX+ (12-99) . *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Z I Mmg MA-JJ I HA-~Y E. FILE NUMBER ,v-f)' -/ISO Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) (lA- TS Y J. Zlm ME1UItI1-N /f)A-lv!tb Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 72 ~kl"lJ/,tJtI IJ,./ye City ellrl/~/t State I'~ Zip /7DIS Year(s) Commission Paid: M,4lyE1) 2. Attorney Fees ~I/A-UES E; $1I11:!ZJJ5,:m;. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant /lA/5Y v: Z/Allllahl.ll-N Street Address 7<< Skt'ItI"t/ !l,./ye. City &r/,sk State~ZiP 17~/S 7iJ I!JE" D€ 7/i1IIIII IAJIIf) tA~ ~~ d,UnJ ~y. ~ 3) S~/).. eJ ~ Relationship of Claimant to Decedent AJ/I)~u) Probate Fees htI or'll".! i~~ltt. ,f sJ,,,.1 t! e.rl;'6'e..:J-i:4 5. Accountant's Fees .". I;t. ~o 4. 6. Tax Return Preparer's Fees 7. F/~/1 Fu /l' ,f~~ (;1 J/,'//S 'Is: 00 TOTAL (Also enter on line 9, Recapitulation) $ 3, S"33, 00 (If more space is needed, insert additional sheets of the same size) REV-1.513 EX+ (9-00) . . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER :l!-I){g - / IS-O 2/ /J1A1Ete/J(~ fltI-~~Y IE: 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ;J J. rsy.:J; 21M IIIE L.IH II-AI tu IOl>eu 72 JIID(Jtlppj) f)~. tJ1.~J..ISLE/ PA 17p/f AMOUNT OR SHARE OF ESTATE NUMBER I 1001. 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. 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) . ' .. - LAST Wll.L AND TESTAMENT OF HARRY E. ZIMMERMAN I, HARRY E. ZIMMERMAN, of the Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved wife, PATSY J. ZIMMERMAN, to her own use and benefit absolutely. 3. . In the event, however, that my said wife should predecease me, or should die at about the same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said estate in equal shares, per stiI:pes, unto my children, TAMMY SUE REISINGER and TONY E. ZIMMERMAN. 4. I nominate, constitute and appoint my wife, PATSY J. ZIMMERMAN, to be the Executrix of this my Last Will and Testament. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my daughter, TAMMY SUE REISINGER and my son, TONY E. ZIMMERMAN, to be Co-Executors in her place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this J..a<< day of a'f~,d , A.D. 1995. ~~N.-J (SEAL) Signed, sealed, published and declared by the above-named HARRY E. ZIMMERMAN as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~E.~w ~~ ..... '.. D~ &J-6:) ~c\ 30.00 "-l~t>D CHARLES E. SHIELDS, III AITORNEY-AT-LAW 6 CLOUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 GFORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 May 30, 2007 Register of Wills Cumberland County Court House 1 Court Square Carlisle, P A 17013 Re: Estate of Harry E. Zimmerman No. 21-06-1150 Dear Register of Wills: ". Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Harry E. Zimmerman Estate as well as Check No. 890, in the amount of$15.00 for the filing fee. Thank you for your kind attention to this matter. ~=8~r Charles E. Shields, III Attorney-At-Law -,~ :} CES/mjj Enclosures <;~ c.) o C'J -n -n r'0 ..,:- 0,;)