HomeMy WebLinkAbout10-31-07
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue.
~~~~:~~~~~uaITaxes -' INHERITANCE TAX RETURN
Harrisburg, PA 17126-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
c9 \ Gl
"B35
Date of Birth
18628 5 6 6 8
o 5 1 7 2 0 0 7
o 7 0 5 1 9 3 6
Decedent's Last Name
Suffix
Decedent's First Name
DYARMAN
VIOLA
MI
M
(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
~ 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate
(Attach Copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return 0 3. Remainder Return (date of death
prior to 12-13-82)
o 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required
death after 12-12-82)
o 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
o 10. Spousal Poverty Credit (date of death 0 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
8. Total Number of Safe Deposit Boxes
,
STEPHEN
J .
HOG G I E S QUI R E
717 245 2 698
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY
1 9 S. H A N 0 V E R
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First line of address
Second line of address
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SUI T E
1 0 1
City or Post Office
State ZIP Code
DATlfFJL'i~ ~"
CAR LIS L E
PA 17013
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Correspondent's e-mail address:shogg@nexspot.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 pre parer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
W" JJ, - 2 ') .. D
ADDRESS
Side 1
L
15056041125
15056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: VIOLA M. DY ARMAN
RECAPITULATION
186285668
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) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. . . . . .. 7.
7412.55
8. Total Gross Assets (total Lines 1-7)
........................... 8.
7412.55
1739.27
9767.72
11506.99
-4094.44
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 Govemmental 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.
-4094.44
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 _ o . 0 0 15. o . 0 0
16. Amount of Line 14 taxable
at lineal rate X .012- l' o . 0 0 16. o . 0 0
17. Amount of Line 14 taxable o . 0 0 o . 0
at sibling rate X .12 17. 0
18. Amount of Line 14 taxable o . 0 0 o . 0 0
at collateral rate X .15 18.
19. Tax Due . ., . . . . . . . . . . .. . '" . . . . . . . . . . . . . . . . . . . . . . . . . ... . 19. o . 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
D
Side 2
III
-, r;q2126
:'12126
.
--a
REV-1500 EX 'Page 3
Decedent's Complete Address:
File Number
21 07 0535
DECEDENTS NAME
VIOLA M. DYARMAN
STREET ADDRESS
4 FAIRFIELD ST., APT. 2
CITY I STATE I ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
0.00
Total Credits ( A + 8 + C) (2)
0.00
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, Line 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)
0.00
0.00
0.00
A. Enter the interest on the tax due.
8. Enter the total of line 5 + SA. This is the BALANCE DUE.
(SA)
(58)
0.00
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; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... D 00
c. retain a reversionary interest; or .......... ....... ...................................................................... ......... 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... D 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. D 00
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. ~9116 (a) (1.1) (ii)). The statute does not exemot 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. 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. ~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.
~~-1508 EX'+ (6-98)
*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VIOLA M. DYARMAN
FILE NUMBER
21 07 0535
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
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.
DESCRIPTION
M&T Savings Account #15004198151795
VALUE AT DATE
OF DEATH
3,608.59
M&T Savings Account Interest #1504198151795
0.46
2006 Federal Income Tax Refund
124.00
Proceeds from sale of Vehicle
500.00
Adams County National Bank - Estate Account #2263947 interest - June 2007
0.17
Adams County National Bank - Estate Account #2263947 Interest - July 2007
0.34
Adams County National Bank - Estate Account #2263947 Interest - August 2007
0.57
Adams County National Bank - Estate Account #2263947 Interest - September 2007
0.84
Sale of Personal Property
2,810.00
Carlisle Regional Medical Center - Refund
29.85
Suburban Propane - Refund
123.23
Nationwide Insurance - Refund
65.50
PA Income Tax - Refund
80.10
PP&L Refund
59.95
Readers Digest Refund
8.95
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
7412.55
REV-1511 EX + (12-99)
*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VIOLA M. DYARMAN
FILE NUMBER
21 07 0535
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) William Dyarman 370.63
Social Security Numbe~s)/EIN Number of Personal Representative(s) 211-58-6244
Street Address 4 Fairfield Street #2
City Newville State P A Zip 17241
Year(s) Commission Paid:
2. Attorney Fees Stephen J. Hogg, Esquire 1,000.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 98.00
5. Accountanfs Fees
6. Tax Return Preparets Fees
7. Advertising
Cumberland Law Journal 75.00
Carlisle Sentinel 150.64
8. Filing Inheritance Tax Return 30.00
9. Filling Petition 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 1.739.27
(If more space is needed. insert additional sheets of the same size)
" ,
REV-1512 EX + (12-03)
*'
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VIOLA M. DYARMAN
FILE NUMBER
21 07 0535
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. M&T Bank Loan Payoff Acct. # 100001 77254430001 2,189.98
2. Property Tax 129.79
3. York Waste Disposal Inc. 41.67
4. Pine Ridge Lot Rent 374.00
5. Embarq 33.71
6. P P & L Electric 25.05
7. P P & L Electric 59.95
8. P P & L Electric - Final Bill 68.99
10. Bronstein Jeffries 22.68
12. Carlisle Regional Medical Center - Acct # 7688988 819.05
13. Carlisle Regional Medical Center - Acct # 7683861 205.66
15. Carlisle Regional Medical Center - Acct # 7691244 186.23
16. Carlisle Regional Medical Center - Acct # 7696382 45.00
17. Walnut Bottom Radiology - Acct # 142016 83.46
18. Walnut Bottom Radiology - Acct # 151114 119.79
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9,767.72
. "
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
VIOLA M. DY ARMAN
Decedent's Name
Page 1
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
19. Walnut Bottom Radiology - Acct # 148669 89.79
20. Apex - Collection Agency for Central Penn Mgmt. 424.23
Acct # 434198 $217.73, Acct # 444316 $206.50
24. Carlisle Regional Medical Center - Account # 9368425 900.00
25. Carlisle Regional Medical Center - Account # 6395453 193.12
26. Carlisle Regional Medical Center - Account # 6395454 137.73
27. Carlisle Regional Medical Center - Account #6400957 91.62
28. Carlisle Regional Medical Center - Account # 6400960 54.09
29. Carlisle Regional Medical Center - Account # 6792702 166.11
30. Carlisle Regional Medical Center - Account # 6792858 932.00
31. Carlisle Regional Medical Center - Account # 6844593 181.94
32. Carlisle Regional Medical Center - Account # 6896559 586.99
33. Carlisle Regional Medical Center - Account # 6931199 447.65
34. Carlisle Regional Medical Center - Account # 7016502 568.72
35. Carlisle Regional Medical Center - Account # 7016518 588.72
SUBTOTAL SCHEDULE I 5,362.71
GRAND TOTAL SCHEDULE I $ 9,767.72
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REV.'5'3EX+(*
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VIOLA M DYARMAN
FILE NUMBER
21 07 0535
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. WILLIAM C. DYARMAN Lineal One Third
4 FAIRFIELD ST, #2
NEWVILLE, PA 17241
2. WANDA L. WEARY Lineal One Third
414 A STREET
CARLISLE PA 17013
3. MICHAEL E. DYARMAN Lineal One Third
1365 RED HILL ROAD, LOT 1
NEW OXFORD, PA 17350
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)