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15[]5b[]41147
EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes ~
PO BOX.280601 ~
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
REV-1500
OFFICIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN 21 07
RESIDENT DECEDENT
File Number
0042
Date of Birth
12232006
03241908
Decedent's Last Name
Suffix
Decedent's First Name
VERNON
MI
P
HOFFMAN
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X 1 Original Return
2. Supplemental Retum
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4 Limited Estate
4a. Future Interest Compromise
(date of death after 12-12-82)
X
6 Decedent Died Testate
(Altach Copy of Will)
7. PAif:~he~~~~i~:~~~~t Living Trust
o
8. Total Number of Safe Deposit Boxes
9 Litigation Proceeds Received
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
IVO V OTTO III 7172433341
Firm Name (If Applicable)
MARTSON LAW OFFICES
----",.
REGISTER-b(-)WILLS usi ONLY
First line of address
i-;
10 EAST HIGH STREET
f', ~
G:;'
Second line of address
City or Post Office
CARLISLE
State
PA
ZIP Code
17013
DATE' FILED
-.J
Correspondent's e-mail address:
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 bel,ef.
,t ,s true, correct 'lnd complete. Declaration of preparer other than the personal representative is based on a ion of which preparer has any knowledge
S~N:'T'/fOF1:j' SO,N,RE?_O_ 2I-EFJ~~! NGRETURN Philip V. Hoffman 71 "O;TE1o!
/ L..., ',( / /);/ X._ u _ rf"_
.,CCRESS I / . //) I '
/
DA E
Ivo V Otto III
'"\ )1- 0 ~
10 East High Street, Carlisle, PA 17013
Side 1
L
15[]5b[]41147
15[]5b[]41147
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-I
15056042148
REV-1500 EX
Decedent's Name: Ve rn 0 n Pa u I i n e H offma 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) Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 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 Subject to 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, of
transfers under Sec. 9116
(a)(1.2) X .00
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
o . 0 0
15.
522,817.25
16.
o . 0 0
17.
o .00
18.
19. Tax Due.
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
Decedent's Social Security Number
530,000.00
5,343.15
23,804.52
559,147.67
35,383.52
946.90
36,330.42
522,817.25
522,817.25
o .00
23,526.78
o . 0 0
o . 0 0
23,526.78
D
15056042148
-I
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Vernon Pauline Hoffman
STREET ADDRESS
72 Ladnor Lane
File Number 21-07-0042
CITY
STATE
ZIP
Carlisle
17015
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
23,526.78
20,000.00
1,052.63
3 Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
21,052.63
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE
(3)
(4)
(5)
(5A)
(5B)
2,474.15
2,474.15
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:............................................................................. x
b. retain the right to designate who shall use the property transferred or its income;................................ x
c. retain a reversionary interest; 0["......................................................................................................... x
d. receive the promise for life of either payments, benefits or care?........................................................... x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?......................................................................................... no.................... x
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.?....... x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?............................................................................................................... x
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. 99116 (a) (1.1) (i)l.
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)J. The statutedoes not exempta 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. 99116 (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. 99116 1.2) [72 P.S. 99116 (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. 99116 (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.1502 EX+ (6.98)
,*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
All real property owned solely or as a tenant In common must be reported at fair market valuliair market value IS defined as the price at which property would be
exchanged between a wilhng buyer and a wilhng seller. neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts.
Real property which Is Jointly-owned with right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Real Estate - Residence situate at 72 Ladnor Lane, South Middleton Township,
Cumberland County, PA, known as Tax Parcel No. 40-11-0288-045A, being
described in Deed dated January 3,1974, and recorded in Cumberland County, PA,
Deed Book "0", Volume 25, Page 1055, and being conveyed to P. Reynolds Hoffman
and Vernon P. Hoffman. P. Reynolds Hoffman died July 23,1984, leaving title vested
soley in Vernon P. Hoffman. See attached appraisal.
VALUE AT DATE
OF DEATH
530.000.00
TOTAL (Also enter on Line 1, Recapitulation)
530,000.00
(If more space is needed. additiDnal pages of the same size)
Copyright (C) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
Rev-1503 EX. (6-98)
'.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 29078E105 12 shares of Embarq Corp 52.21 626.52
Accrued dividend on Item 1 through date of death 6.00
2 852061100 250 shares of Sprint Corp - Com Fon 18.8175 4.704.38
Accrued dividend on Item 2 through date of death 6.25
TOTAL (Also enter on Line 2, Recapitulation) 5.343.15
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev 6-98)
Rev-1508 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
Include the proceeds of Iillgation and the date the proceeds were received by the eslate.
All property jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Citizens Bank, checking account #610072-808-0, date of death balance
VALUE AT DATE
OF DEATH
3,711.11
2 Masland Associates, refund
124.37
3 PacifiCare Life and Health Insurance Co, premium refund
234.04
4 United Health Care Services, Inc., refund
170.00
5 United Health Care Services, Inc., refund
85.00
6 1988 Jeep Grand Wagoneer, Kelley Blue Book value
1.425.00
7 1996 Cadillac DeVille Sedan, Kelley Blue Book value
3.795.00
8 Personal property and household goods, per attached appraisal
14.260.00
TOTAL (Also enter on Line 5, Recapitulation)
23.804.52
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (12-991
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -0042
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
9,505.83
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2
Attorney's Fees
Martson Law Offices (estimated)
20,000.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Philip V. Hoffman
Street Address 72 Ladnor Lane
3,500.00
City
Carlisle
State PA
Zip
17015
Relationship of Claimant to Decedent Son
4.
Probate Fees
Cumberland County, PA Register of Wills
414.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
1,963.69
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
35,383.52
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Hoffman-Roth Funeral Home, Carlisle, PA
9.505.83
Subtotal
9.505.83
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.*
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
ITEM
NUMBER
AMOUNT
DESCRIPTION
1
Boyer & Ritter, preparation of 2006 personal income tax returns
515.00
2
Cumberland County Recorder of Deeds, filing fee
39.50
3
Cumberland County Register of Wills, additional probate fee
100.00
4
Cumberland County Register of Wills, filing fee, Inheritance Tax Return
15.00
5
Cumberland Law Journal, advertising Letters Testamentary
75.00
6
EVP, online stock valuation
3.10
7
Linden Hall Antiques, appraisal fee
165.00
8
Martson Law Offices, reserved for miscellaneous costs and filing expenses
200.00
9
Met-Ed, electric service pending disposition of real estate
377.16
10
Postage-Certified mailing to Department of Public Welfare
4.64
11
S.W. Barrett Real Estate & Appraisal Service, real estate appraisal fee
325.00
12
The Sentinel, advertising Letters Testamentary
144.29
Subtotal
1.963.69
Copynght (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-B? (Rev. 6-98)
Rev-1512 EX+ (6.98)
,~
~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
,:'OMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hoffman, Vernon Pauline
FILE NUMBER
21-07 -0042
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Carlisle Regional Medical Center, account payable
VALUE AT DATE
OF DEATH
216.13
2 Citizens Bank, checking account #610072-808-0 - Outstanding checks on date of
death
81.67
3 Embarq, account payable
46.84
4 Kenetic Imaging, Inc., account payable
52.19
5 Lancaster HMA Phys Mgmt Cent Pen, account payable
49.09
6 Met Ed, account payable
282.98
7 PA Department of Revenue, 2006 PA-40 income tax
218.00
TOTAL (Also enter on Line 10, Recapitulation)
946.90
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV.1513 EX> (9-00)
.*
SCHEDULE J
BENEFICIARIES
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Hoffman, Vernon Pauline
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-07 -0042
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
1
Helen Mae Heiges
cIa 72 Ladnor Lane
Carlisle, PA 17015
Sister No funds
available to pay
Item 4 Specific
Bequest
Granddaughter Portion of Sch.
E, Line 8 assets
750.00
2
Kimberly Ann Hoffman
cIa 72 Ladnor Lane
Carlisle, PA 17015
3
Philip V. Hoffman
72 Ladnor Lane
Carlisle, PA 17015
Son Sch. A, Line 1;
balance of Sch.
E, assets, less
expenses
522,067.25
Total 522,817.25
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
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copynght (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)