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Home My WebLink About02-27-08 --.J 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 0670 Date of Birth 171 28 2369 07 08 2007 07 15 1936 Decedent's Last Name Suffix Decedent's First Name MI KATZMAN MARJORIE C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI KATZMAN RONALD M 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 [R] D 6. Decedent Died Testate (Attach Copy of Will) D D D D 48. Future Interest Compromise (date of death after 12-12-82) 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 7. ~i:~he~::i~;~~~)a Living Trust o 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 1 D Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) D 11.Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RONALD M. KATZMAN ESQ 717 234 4161 Firm Name (If Applicable) GOLDBERG KATZMAN PC REGISTER OF:YVILLS USE ONLY First line of address , , 320 MARKET STREET r 0 , Second line of address ...; POB 1268 -~ I HARRISBURG State PA ZIP Code 17108 DATE fiLED (oJ City or Post Office c") Correspondent's e-mail address:rmk@goldbergkatzman.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. SIGNAT~ OF PE~SO~ R,ES 18 E FOR FILING RETURN DATE f.:{;, IV: Ronald M. Katzman . 20 ' ~ ADDRESS 320 Market Street, Harrisburg, PA 17108 SIGNATURE OF PREPARER OTHER THA PRESENTATIVE :2iJ~c.r: A ~~NeiIE.HendershotEsq. ESS DATE O:l../~ /0;- , , 320 Market Street, Harrisburg, PA 17108 Side 1 L 15056041147 15056041147 --.J ~ ...J 15056042148 REV-1500 EX Deceden!'sName Marjorie C. Katzman Decedent's Social Security Number 171 28 2369 RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 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. 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 ~ 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 10,791.38 15. 18,343.05 16. 0.00 17. 0.00 18. 19. Tax Due... ..................... .................... ...................... ............ ........ .................. ............. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 2. 23,159.48 18,343.05 41,502.53 12,343.10 25.00 12,368.10 29,134.43 29,134.43 0.00 825.44 0.00 0.00 825.44 D 15056042148 ...J Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katzman, Marjorie C. All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-07 -0670 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 1,193 shares of Sovereign Bancorp, Inc. - Common 22.222.06 stock held in brokerage account 2 59 shares of Sovereign Bancorp, Inc. - Common stock 937.42 held in dividend reinvestment plan TOTAL (Also enter on Line 2, Recapitulation) 23.159.48 (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-1509 EX+ (6-98) SCHEDULE F JOINTLY -OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Katzman, Marjorie C. FILE NUMBER 21-07 -0670 ESTATE OF 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 A. Deborah E. Katzman ADDRESS RELATIONSHIP TO DECEDENT 120 North 27th Street Camp Hill, PA 17011 Daughter B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH FOR JOINT MADE DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE 1 A Approx. Commerce Bank Savings Account - 36.686.09 0.500% 18.343.05 2000 Savings Account No. 0480003364 in joint names of Decedent & daughter, Deborah E. Katzman TOTAL (Also enter on Line 6, Recapitulation) 18.343.05 (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 F (Rev. 6-98) REV.1151 EX+ (12.99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katzman, Marjorie C. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07 -0670 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 8,531.42 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees Goldberg Katzman, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Ronald M. Katzman Street Address 3600 Logan Court City Camp Hill Relationship of Claimant to Decedent 3,500.00 State Spouse PA Zip 17011 4. Probate Fees 102.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 209.68 TOTAL (Also enter on line 9, Recapitulation) 12,343.10 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 Katzman, Marjorie C. FILE NUMBER 21-07 -0670 ITEM NUMBER DESCRIPTION AMOUNT 1 JDK Catering - Funeral luncheon 4.485.42 2 Myer-Harner Funeral Home - Purchase of columbarium 2.766.00 3 Trinity Lutheran Church - Purchase of columbarium 680.00 4 Trinity Luthern Church - Honorarium for pastoral & soloist services 600.00 Subtotal 8.531.42 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 Katzman, Marjorie C. FILE NUMBER 21 ~07 -0670 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Carlisle Sentinel - Publication of Estate Notice in newspaper 134.68 2 Cumberland Law Journal - Publication of Estate Notice in law journal 75.00 Subtotal 209.68 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Katzman, Marjorie C. FILE NUMBER 21-07 -0670 ESTATE OF Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Andrews & Patel - Medical bill VALUE AT DATE OF DEATH 25.00 TOTAL (Also enter on Line 10, Recapitulation) 25.00 (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 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Katzman, Marjorie C. 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 -0670 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. Ronald M. Katzman 3600 Logan Court Unit 6-A Camp Hill, PA 17011 Husband 29,134.43 Total 29,134.43 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 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)