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Home My WebLink About10-04-07 -.J 15056051058 REV.1500 EX (06-05) PA Department of Revenue * Bureau of Individual Taxes .l:Ioi . PO BOX 280601 Harrisburg, PA 17128-{)601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY CountyGode Year INHERITANCE TAX RETURN RESIDENT DECEDENT Rle Number I 00 ~ Date of Birth 201-18-7059 10/17/2006 07/21/1925 Decedent's Last Name Suffix Decedent's First Name MI MATTER Harold E (If Applicable) Enter Surviving Spouse's Infonnation Below Spouse's Last Name Suffix MATTER Spouse's First Name Sarah MI J Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW {W:J 1. Original Retum c::::> 2. Supplemental Return c::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C:J 4. Limited Estate c::::> eel c::::> 4a. Future Interest Compromise (date of death after 12-12-82) c::::> 7. Decedent Maintained a Living Trust (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 CONRDENTlAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telepho~~~ber ;.:...;.l.,) 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c::::> John D. Killian (717) 232-1851 Firm Name (If Applicable) City or Post Office State '-. REGISTER OF ONlY KILLIAN & GEPHART, LLP First line of address 218 Pine Street Second line of address ZI P Code DATE FILED Harrisburg PA 17101 Correspondent's e-mail address: Under penalties of perjury, I dedare th t I have examined this retum, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true. and co . eda tio of reparer other than the personal representative is based on all information of which preparer has any knowledge. DATEL I ID L{ Oi .!,ine Street, Harrisburg, PA PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL F 15056051058 Side 1 15056051058 --.J --.J 15056052059 REV-1500 EX Decedent's Name: Harold E. MATTER, JR. 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:J Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:J 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, 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 19. TAX DUE. . . . .. . . . . . . . . . . . . . . " . . . . . . . .. .. . . . . . . . . . . . .. . . . . . . .. . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15. 16. 17. 18. 201-18-7059 Decedent's Social Security Number 0.00 0.00 0.00 0.00 3,657.72 293,890.00 52,423.00 349,970.72 1,803.00 1,631.04 3,434.04 346,536.68 346,536.68 0.00 15056052059 0.00 c:J --.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Harold E MATTER STREET ADDRESS 325 Wesley Drive DECEDENTS SOCIAL SECURITY NUMBER 201-18-7059 CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 0.00 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits ( A + 8 + C ) (2) 0.00 -. TotallnteresVPenalty ( 0 + 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, Line 20 to request a refund. (4) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 0.00 0.00 0.00 0.00 0.00 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. 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 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ D 00 c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefrts 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 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 00 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. 99116 (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. 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-1508 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF HAROLD E. MATTER, JR. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 2006-00936 ITEM NUMBER DESCRIPTION CASH 2 SOCIAL SECURITY CHECK 3 BELCO CREDIT UNION ACCOUNT INCOME 4 PATRIOT NEWS REFUND 5 WASHINGTON MUTUAL REFUND 6 SILBER PROSTHETICS REFUND VALUE AT DATE OF DEATH 915.08 1,182.00 1,200.00 116.75 4.00 239.89 TOTAL (Also enter on line 5, Recapitulation) $ 3,657.72 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTlY-OWNED PROPERTY ESTATE OF HARRY E. MATTER, JR. FILE NUMBER 2006-00936 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. SARAH JANE MATTER 325 WESLEY DRIVE, MECHANICSBURG, PA 17055 WIFE B. C, JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DE CD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. PNC BANK CHECKING ACCOUNT 86,817.00 50 43,409.00 2 A HALIFAX NATION AL BANK CHECKING ACCOUNT 2,451.00 50 1,226.00 3 A BELCO COMMUNITY CREDIT UNION SAVINGS ACCOUNT 10,963.00 50 5,482.00 4 A PNC CERTIFICATE OF DEPOSIT 210,848.00 50 105,424.00 5 A BELCO COMMUNITY CREDIT UNION CERTIFICATE OF DEPOSIT 109,472.00 50 54,736.00 6 A UNITED SAVINGS BONDS 77@ 1,000.00 FACE VALUE 77,000.00 50 38,500.00 24@ 500.00 FACE VALUE 12,000.00 50 6,000.00 51 @ 100.00 FACE VALUE 5,100.00 50 2,550.00 7 A BELL SOUTH STOCK (12.28 sh.) 542.00 50 271.00 8 A VERIZON STOCK (1,910.1 sh.) 72,584.00 50 36,292.00 TOTAL (Also enter on line 6, Recapitulation) $ 293,890.00 (If more space is needed, insert additional sheets of the same size) REV-1737-6 EX + (9-00) .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY Use Schedule G, Part 2, ONLY for proportionate method of tax computation. FILE NUMBER HAROLD E. MATTER, JR. 2006-00936 Part 1 must include all transfers of real estate and intangible personal property located in Pennsylvania. Complete Part 2 ONLY WHEN THE PROPORTIONATE METHOD OF TAX COMPUTATION IS ELECTED. Include in the description of property the date the transfer was made and the name and relationship of the transferee. This schedule must be completed and filed if the answer to questions 1 through 4 on the reverse side of the REV-1737 cover sheet is yes. PART 1 - PROPERTY OR TANGIBLE PERSONAL PROPERTY LOCATED IN PENNSYLVANIA THAT WAS TRANSFERRED DESCRIPTION OF PROPERTY ITEM Include the name of the transferee, their relationship to Decedent and the date of transfer. DATE OF DEATH % OF DECD'S EXCLUSION NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE 1. IRA - BELCO COMMUNITY CREDIT UNION (SPOUSE IS 52,423.00 100.00 52,423.00 0.00 BENEFICIARY) PART I TOTAL 52,423.00 100.00 52,423.00 0.00 PART 2 - ALL OTHER TRANSFERS DESCRIPTION OF PROPERTY ITEM Include the name of the transferee, their relationship to Decedent and the date of transfer. DATE OF DEATH % OF DECD'S EXCLUSION NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE 1. PART 2 TOTAL 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 7, Recapitulation) 0.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF HAROLD E. MATTER, JR. FILE NUMBER 2006-00936 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: NEUMYER FUNERAL HOME 733.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) JOHN D. KILLIAN Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 218 PINE STREET City HARRISBURG .State PA Zip 17101 Year(s) Commission Paid: 2006 2. Attorney Fees 1,000.00 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 ORPHAN'S COURT CLERK 70.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,803.00 REV-1512 EX+ (12-03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HAROLD E. MATTER, JR. FILE NUMBER 2006-00936 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. KILLIAN & GEPHART 1,270.50 2. LLOYD SILBER ORTHOPEDICS 307.32 3. BONNIE MILLER, TREASURER 11.00 4. ALERT PHARMACY 42.22 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,631.04