HomeMy WebLinkAbout12-18-07
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15056041147
REV-1500 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
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 7
0710
Date of Birth
176325575
04102007
04251930
Decedent's Last Name
Suffix
Decedent's First Name
MI
MATTER
WI:LLI:AM DEAN
(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 D 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[K] 6. Decedent Died Testate D 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal Poverty Credit (date of death D 11 . Election to tax under Sec. 9113(A)
. between 12-31-91 and 1-1-95) (Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
EDWARD P. SEEBER 7175333280
Firm Name (If Applicable)
JAMES, SMI:TH, DI:ETTERI:CK &
",
REGISTER ~WILLS USe'!Jto.IL Y
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f'l
C)
Second line of address
~
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co
First line of address
SUI:TE 204, 5020 RI:TTER ROAD
City or Post OffIce
MECHANI:CSBURG
State
PA
ZIP Code
17055
DATEFlLED
m
Correspondenfs 8-mall address: e p.@j.d c. com
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 belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER,~N RESPONSIBLE FOR FILING RETURN DATE
~ /1". ~. t:~o A "'. Jane W. Kohn /.::J/J<../ 107
A~ ' ~ ~
'1-
-"
Edward P. Seeber
i:j
ulte 204, 5020 Ritter Road, Mechanlcsburg, PA 17055
Side 1
L
15056041147
15056041147
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15056042148
REV-1500 EX
Decedent'sName: William Dean Matter
Decedent's Social Security Number
176325575
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)................
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested.............
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested.............
8. Total Gross Assets (total Lines 1-7).......................................................................
9. Funeral Expenses & Administrative Costs (Schedule H).........................................
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................
11. Total Deductions (total Lines 9 & 10)......................................................................
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).................................................
14. Net Value Subject to Tax (Line 12 minus Line 13).................................................
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 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 0 . 0 0
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.
Side 2
L
15056042148
10.
11.
12.
13.
14.
15.
16.
17.
18.
5.
32,679.06
6.
7.
6,849.40
39,528.46
10,605.49
27,443.08
38,048.57
1,479.89
1,479.89
0.00
8.
9.
0.00
0.00
0.00
0.00
0.00
D
15056042148
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
William Dean Matter
STREET ADDRESS
803 N Hanover Street
File Number 21-07-0710
Carlisle
I STATE
PA
IZIP
17013
CITY
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
0.00
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
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 the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(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:
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?........................................................................................................ ..............
Yes
o
o
o
o
o
[!J
No
[!J
[!J
[!J
[!J
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?...................................................................................................................... 0 ~J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~J
[J
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 exemDt 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.
RlIY.1508 EX": {8.98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Matter, WIlliam Dean
FILE NUMBER
21.07.0710
ESTATE OF
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property JoIntly-owned with the rtght of aurvlvonhlp muat be dlaclOMd on achedule F.
ITEM
NUMBER DESCRIPTION
1 CNA - reimbursement for Insurance premium
VALUE AT DATE
OF DEATH
5.200.50
2 IRS - 2006 Income tax refund
212.00
3 M & T Bank checking account # 58277668 - valued per letter dated August 23, 2007
22.149.42
4 Patriot News - reimbursement for subscription
100.00
5 The Church of God Home, Inc. - security deposit
4.929.00
6 Personal property - valued per sale price
88.14
TOTAL (Also enter on Line 5, Recapitulation)
32.679.06
(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)
Rllv.1110 EX+ (1.881
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
FILE NUMBER
21-07-0710
This schedule must be completed and filed ~ the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM DESCRIPTION VI", ,~, _. T DATE OF DEATH 'A, OF DECD'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Jesse H. Geigle Funeral Home, Inc. . prepaid 6,849.40 100.000 0.00 6,849.40
funeral account
TOTAL (Also enter on Line 7, Recapitulation) 6.849.40
(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 G (Rev. 6-98)
~.11S1 EX+ (12"')
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-47-4710
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 6,916.93
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees James, Smith, Dletterlck & Connelly, LLP 3,000.00
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 141.00
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 547.56
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 10,605.49
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rey.1502 EX.. ,....,
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
FILE NUMBER
21-07-0710
ITEM
NUMBER
1
DESCRIPTION
Jesse H. Geigle Funeral Home, Inc. - prepaid funeral account
AMOUNT
6,916.93
Subtotal
6,916.93
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-A (Rev. 6-98)
Rev-1M2 EX~ (....)
.
SCHEDULE H-B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, WIlliam Dean
FILE NUMBER
21-47 -4710
ITEM
NUMBER
1
DESCRIPTION
Register of Wills, Cumberland County - probate fee
AMOUNT
81.00
2
Register of Wills, Cumberland County - reservation for additional probate fee
60.00
Subtotal
141.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-B4 (Rev. 6-98)
Rev-1502 EX:' (I-H)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
FILE NUMBER
21-07-0710
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal - estate notice advertisement fee
75.00
2
James, Smith, Dletterlck & Connelly, LLP - reservation for estate administration
closing costs
100.00
3
Register of Wills, Cumberland County - filing fee for Return & Inventory
30.00
4
Register of Wills, Cumberland County - reservation for Accounting filing fee
160.00
5
The Sentinel - estate notice advertisement fee
182.56
Subtotal
547.56
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
RlIv-11112 EX. (II-Ill)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
FILE NUMBER
21-07-0710
Includ. unrelmbul'HCl medlcel .xpen....
ITEM
NUMBER DESCRIPTION
1 The Church of God Home, Inc. - check written before death & cashed In after death
VALUE AT DATE
OF DEATH
12.000.00
2 The Church of God Home, Inc. - check written before death & cashed In after death
8.000.00
3 The Church of God Home, Inc. - unrelmbursed nursing home bill
4.929.00
4 The Church of God Home, Inc. - unrelmbursed nursing home bill
212.00
5 The Church of God Home, Inc. - unrelmbursed nursing home bill
2.302.08
TOTAL (Also enter on Line 10, Recapitulation)
27,443.08
(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)
MEv 1513 eX. '1.00)
*'
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Matter, William Dean
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not Ust Trusteel.'
FILE NUMBER
21-47-4710
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
ll. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX. IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
See continuation schedule(s) attached
1,479.89
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
1,479.89
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
fl'eY.1'502 EX+ 18-18}
*'
SCHEDULE .I.IIB
CHARITABLE AND GOVERNMENTAL
DISTRIBUTIONS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Matter, William Dean
FILE NUMBER
21'{)7 '{)71 0
ITEM
NUMBER
1
DESCRIPTION
Cross Point United Methodist Church - residuary charitable bequest
AMOUNT
1,479.89
Subtotal
1,479.89
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J-IIB (Rev. 6-98)
1\\11.......\111111)11111..1(1.~\:..((1.\.\1111111. 1\\ (J,lll!'" J.S.).(
December 17, 2007
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013
THE
ESTATE
SECURITY
FORJ\1lJLit"
Re: Estate of William Dean Matter, deceased
File No. 21-07-0710
Cheryl 1. Baker, CP
Certified Paralegal
717-298-2094
clb@jsdc.com
Dear Ms. Farner Strasbaugh:
Enclosed are an original and two (2) copies ofthe Pennsylvania Inheritance Tax
Return and Inventory to be filed in the above-referenced Estate, along with a check
for Thirty Dollars ($30.00) representing the filing fee for these documents. Please
time-stamp the additional copies and return them to me in the enclosed self-
addressed, stamped envelope.
If you have any questions, please feel free to give me a call.
Very truly yours,
JAMES, SMITH, DIETTERICK & CONNELLY, LLP
Enclosures
cc: Jane W. Kohn, Executrix
134 SIPE AVENUE
HUMMElSTOWN. PA 17036
Reply to:
Suite 204
5020 Ritter Road
Mechanicsburg, P A 17055
Direct Dial: 717-298-2094
MAILING ADDRESS
P.O. BOX 650
HERSHEY, PA 17033
TOll FREE 1.800.942.3660
TEL. 717.533.3280
FAX 717.533.7771
www.jsdc.com
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