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HomeMy WebLinkAbout08-22-07 ~EV-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 I- Z W C w o w C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Diehl Mar'orie DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 11/16/2006 12/13/1904 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~L COUNTY CODE ....QL 0023 _ _ _ YEAR NUMBER B SOCIAL SECURITY NUMBER 194-26-6488 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~ :!Ul ()~~ W Q.() 7:00 ()~...J Q.al Q. <( 001 04 006 09 Original Retum Lim~ed Estate o 2. Supplemental Retum 0 3. Remainder Retum (dale of death prior to 12-13--82) o 4a. Future Interest Compromise (date at death after 12-12-82) 0 5. Federal Estale Tax Return Required o 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes o 10. Spousal Poverty Credit (date of death between 12-3'-9' and ,.'-95) 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0) Decedent Died Testale (Attach copy at Will) Litigalion Proceeds Received THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z w C Z o c- oo w It: It: o U Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman,P.C. TELEPHONE NUMBER 44 West Main Street Mechanicsburg, PA 17055 717-697-8528 ,~<) 1. Real Estate (Schedule A) 0.00 0.00 0.00 0.00 (- ..... J bfriClAL USE O~, (1) 2. Stocks and Bonds (Schedule B) (2) -, c 3. Closely Held Corporal ion , Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivabie (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested i= :3 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) :J (Schedule G or L) I- 0:: 8. Total Gross Assets (total Lines 1-7) <C 0 W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) a:: 10. Debts of Decedent, Mortgage Liabil~ies, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 1\..1 r.,) :'!'-.... 6,992.52 0.00 c") <....> -) 0.00 (8) 2,506.70 68,361. 35 6,992.52 (13) 70,868.05 (63,875.53) 0.00 (11) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) (63,875.53) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) z o i= <( I- :;) Q. ::E o () >< <( I- 0.00 x .0 ~(15) 0.00 x .0 45 (16) 0.00 x .12 (17) 0.00 x .15 (18) (19) 0.00 0.00 0.00 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 20. [KJ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 0.00 19. Tax Due > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W46451.000 ~ Dec~dent's Complete Address: STREET ADDRESS 732 Messiah Villa Cumberland County CIIY Mechanicsbur er Allen Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA "' ~ 170sd (1) 0.00 0.00 0.00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 0.00 0.00 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 ;s 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) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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 . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either 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? . . . . . . . . . . . . . . . . . . . . . . . . . . " D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 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. Under penalties of perjury. I declare that I have examined this retum, including accompanYing scheduies and statements. and to the best of my knowledge and belief. it is true. correct and complete Declaration of preparer oth~:r..,Q1an the personal representa "t{"'J:I:fteS on all information of which preparer has any knowledge. SIGNATURE OF PE TUR , DATE Yes No D D D D [Jg [Jg ~ ~ ~ ~ ADDRESS 1315 Fieldstone Drive, Mount ADDRESS Richard C. Snelbaker, Esquire .a"t..-- For dates of death on or after July 1. 1994 and before January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS 99916 (a) (1.1) (il]. For dates of death on or after January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9 9116 (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 nalurai parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefciaries is 4.5%. except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 9 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. 9 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has aI/east one parent in common with the decedent, whether by blood or adoption. 3W4646 1.000 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Mar;orie B. Diehl ITEM NUMBER 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. FILE NUMBER 21 07 0023 DESCRIPTION VALUE AT DATE OF DEATH 1 Messiah Village refund on resident care 586.32 2 PNC Bank, N.A. checking account # 5070101977 6,260.68 3 Washington National Insurance Company unused premium refund 145.52 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulation\ $ (If more space is needed, insert additional sheets of the same size) 6,992.52 RoEV-1511 E~; (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marjorie B. Diehl SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TIVE COSTS Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: Auer Memorial Home and Cremation Services, Inc. funeral services 1. B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Name of Personal Representative(s) David H. Diehl Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 1315 Fieldstone Drive City Mt. Joy State PA Zip 17552 Year(s) Commission Paid: 2. Attorney Fees Snelbaker & Brenneman, P.C 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 Cumberland Law Journal advertising Executor's notice 2 Patriot News advertising Executor's notice Total from continuation schedules 3W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 07 0023 $ AMOUNT 459.10 349.00 925.00 83.00 75.00 100.60 515.00 2,506.70 Estate of: Marjorie B. Diehl 194-26-6488 Schedule H Part 7 (Page 2) 3 Register of Wills filing fee for Inheritance Tax Return 15.00 4 Reserve for filing fees and miscellaneous costs assosicated with the administration of the Decedent's estate 500.00 Total (Carry forward to main schedule) 515.00 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marjorie B. Diehl SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. FILE NUMBER 21 07 0023 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Commonwealth of Pennsyvlania Class 3 claim in the amount of $23,290.60 and a class 6 claim in the amount of $45,070.75 68,361. 35 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 68,361. 35 ~EV-1513 Ex+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mar,orie B. Diehl NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] David H. Diehl 1315 Fieldstone Drive Mount Joy, PA 17552 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 1 Son 2 Frederick P. Diehl 910 Charter Hills Road Banor Elk, NC 28604 Son 3 Michael S. Diehl 863 McAllister Street Hanover, PA 17331 Grandson 4 Stephen H. Diehl 1117 Apple Drive Mechanicsburg, PA 17055 Grandson FILE NUMBER 21 07 0023 AMOUNT OR SHARE OF ESTATE 0.00 0.00 0.00 0.00 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3W46AI 1.000 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) $ 0.00 J'~', ,~~ J """ LAW OFFICES SNELBAKER & ELICKER LAST WILL AND TESTAMENT I, MARJORIE B. DIEHL, of the Township of Upper Allen, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executor, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, unto my husband, PALMER DIEHL, absolutely and in fee simple, if he survives me by as many as sixty (60) days. i)~C::.l"7U",,'LI 4 L4~1 ci.<.-e~j THIRD. If my husband, PALMER DIEHL, does not survive me by as many as sixty (60) days, then and in that event, I order and direct my Estate be distributed and disposed of in the following manner: A. I give and bequeath the several articles of personal property unto the persons named on a certain list or schedule signed by either me or my said husband, or both, and filed with this, my Last Will and Testament, said list or schedule being incorporated herein by reference thereto, whether prepared contemporaneously or sUbsequently to the execution of this, my Last Will and Testament. Said list or schedule shall not be interpreted as a separate testamentary writing, but merely a supplement to this, my Last will and Testament, to identify items and persons to fulfill the terms of the foregoing bequest. It must be understood that said list or schedule may change from time to time, thus accounting for its possible preparation subsequent to the date hereof. \ \ ~ X l B. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my three (3) sons, namely, STEPHEN B. DIEHL, FREDERICK P. DIEHL and DAVID H. DIEHL, share and share alike, absolutely and in fee simple. If any of my said sons should predecease me, I order and direct that the above residuary share attributable to each such deceased son shall be distributed unto his issue per stirpes by representation and not per capita. LASTLY. I nominate, constitute and appoint my husband, PALMER DIEHL, to be the Executor of this, my Last will and Testament, but if for any reason he should fail to qualify as such Executor or cease so to serve, then and in that event, I nominate, constitute and appoint my son, namely, DAVID H. DIEHL, to be the Executor hereof. If both of the above named persons should fail to qualify as my personal representative hereunder or cease so to serve, then and in that ultimate event, I nominate, constitute and appoint my son, namely, STEPHEN B. DIEHL, to be the Executor of this, my Last Will and Testament. I order and direct that none of the above named LAW OFFICES SNEL8AKER a ELICKER persons shall be required to post bond or other security as a -2- condition of qualification as my personal representative hereunder. IN WITNESS WHEREOF, I, MARJORIE B. DIEHL, have hereunto set my hand and seal to this, my Last Will and Testament which consists of three (3) typewritten pages to each of which I have d, aff ixed my signature this:;; 7 - day of June A. D., One Thousand Nine Hundred Ninety-one (1991). r 7k,u/~ j( )4 (SEAL) I The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the Testatrix, was on the date thereof signed, sealed, published and declared by MARJORIE B. DIEHL, the Testatrix therein named, 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 ~ /J~ ( . /" //' /~k ~ . ____ LAW OFFICES SNELBAKER Be ELICKER -3- II I COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS. CUMBERLAND We, MARJORIE B. DIEHL, RICHARD C. SNELBAKER and JANET R. STEGNER, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and vOluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. /----2 ~ ,/~ c~ ..;~~r-;<- " ~r~~ :? 'Wit'ne s . SUbscribed, sworn to and acknowledged before me by MARJORIE B. DIEHL, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET R. STEGNER, witnesses, this 7~ day of June, 1991. c~ ---f2 "~ (.6'; . n /...,U; ~, /~6-C.:""~4<...c.-"vt.... Notary Public LAW OFFICES SNELBAKER 8< ELICKER C'?':'::in(,;'-~:7g~~~~~~;j~~:~;";~;-:-~l 'I "e"~"'l"".,,'''''il'''~'hur;l L~[):'(}..~. A~.j, !.-,.'U: r :.02. ,.C/,](.1 ,A.-I.H '[I I '" G. .u. ...." "'. '"' 27 1"n4 r,Ay C(Jn~rll!ssioj \ EXplfG3 I-UO. I \Xl Memoor.Pennsy!vania A.~tion 01 Notaries