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Home My WebLink About03-07-08 (2) REV-1500 EX + (&-00) ~,- ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -0 7 1 1 3 9 "'COuNTY"'COOE ----rEA-;r-- - - N'iiMiiER- - DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U w C LAUDERMILCH, VERA DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 1 79- 1 2 - 5 829 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w ~ :.c: :!!:en u a::.c: w~u J: a:9 u l1.1II l1. < 12/04/2007 01/04/1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) D 3. Remainder Retum (date of death prior to 12-13-82) D 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) z o i= ~ ::::) l- ii: <( u w 0::: z o i= <( I- ::::) D.. :E o U ~ I- [Xl 1. Original Retum D 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrus!) D 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED. TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III ESQUIRE 54 EAST MAIN STREET FIRM NAME (If Applicable) PA 17055 OFFICIAL USE ONLY 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) ~ Z W C Z o l1. en W a: a: o u TELEPHONE NUMBER 717.697-4650 MECHANICSBURG 'J 165,304.03 I --J (6) (7) 165,304.03 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 6,071.13 2,242.99 0.00 X _(15) 0.00 156,989.91 X .045 (16) 7,064.55 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 7,064.55 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 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 elecbon to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) (8) 16. Amount of Line 14 taxable at lineal rate (11) (12) (13) 8,314.12 156,989.91 17. Amount of Line 14 taxable at sibling rate (14) 156,989.91 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 317 SILVER SPRING ROAD CITY I STATE I ZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 7,064.55 6.700.00 353.23 Total Credits (A + B + C) (2) 7,053.23 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. Check box on Page 1 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 11.32 11.32 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 [X] b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [X] c. retain a reversionary interest; or ...................................................................................................... 0 [X] d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [X] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 0 [X] 3. Did decedent own an .in trust for" or payable upon death bank account or security at his or her death? ................. 0 [X] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [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. ADDRESS MURREL R. WALTERS, III, ESQ. 54 EAST MAIN STREET, MECHANICSBURG ADDRESS PA 17055 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 3% [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 0% [72 P.S. ~9116 (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 0% [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 4.5%, except as noted in 72 P.S. ~9116{1.2) [72 P.S. ~9116{a){1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. REV-1508 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF LAUDERMILCH. VERA FilE NUMBER 21 07 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. 1139 ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. DESCRIPTION VALUE AT DATE OF DEATH 8,164.87 CITIZENS BANK SAVINGS ACCOUNT PENNSYLVANIA STATE EMPLOYEES FEDERAL CREDIT UNION CHECKING ACCOUNT 4,620.59 PENNSYLVANIA STATE EMPLOYEES FEDERAL CREDIT UNION CERTIFICATE OF DEPOSIT 126,521.03 PRUDENTIAL ALLIANCE ANNUITY 9,247.66 ERIE FAMILY LIFE ANNUITY 12,875.06 INTERNAL REVENUE SERVICE 2007 INCOME TAX REFUND 310.00 VERIZON REFUND AND CASH 177.18 COMCAST, HABAND & MONTOUR OIL REFUNDS 228.85 COINS 120.72 UROLOGY OF PA REFUND 14.20 PENNSYLVANIA STATE RETIREMENT 53.70 CULLIGAN REFUND 4.91 PENNSYLVANIA STATE EMPLOYEES FEDERAL CREDIT UNION SAVINGS ACCOUNT 2,965.26 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 165,304.03 REV-1511 EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF LAUDERMILCH VERA Debts of decedent must be reported on Schedule I. 21 07 1139 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HETRICK FUNERAL HOME 3,661.13 2. FUNERAL MEAL - MT. OLlVET METHODIST CHURCH 285.00 3. HONORARIUM - ORGANIST 50.00 4. HONORARIUM - MINISTER 150.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) LINDA S. FETROW - RENOUNCE Social Security Numbe~s)/EIN Number of Personal Representative(s) Street Address 5016 WOOD BOX LANE City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: 2. Attorney Fees MURREL R. WALTERS, III, ESQ. 1,650.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 275.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 6,071.13 (If more space is needed, insert additional sheets of the same size) R~V-1512 EX + 16-98) . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LAUDERMILCH. VERA FILE NUMBER 21 07 1139 Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Frey Village - residential care 1,019.34 2. Pinnacle Health - medical 17.90 3. Penn Waste. trash 44.35 4. Culligan - water treatment 15.76 5. Verizon - telephone 108.10 6. PP&L - electric 98.00 7. ABC Oil - fuel oil 500.45 8. RPEP - PA State Employee Retirement Group. membership renewal 15.00 9. Health South - medical 24.00 10. West Shore EMS - medical 152.69 11. Com cast . cable TV 53.20 12. Urology of Central PA - medical 14.20 13. Montour Oil - fuel oil 180.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,242.99 RELA TIONSHI P TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (12)] 1. James Laudermilch, Jr. Lineal 28,177.24 209 Poplar Ave. Hummelstown, PA 17036 2. Linda S. Fetrow Lineal 28,177.24 5016 Wood box Lane Mechanicsburg, PA 17055 3. Vicki D. Zuvich Lineal 28,177.24 15 Sunset Court Dillsburg, PA 17019 4. Thomas W. Laudermilch Lineal 28,177.24 4117 Crestview Rd. Harrisburg, PA 17112 5. James A. Laudermilch Lineal 2,903.08 128 Ashley Road Phoenixville, PA 19460 6. Jason D. Laudermilch Lineal 2,903.08 401 Conoy Avenue Elizabethtown, PA 17022 7. Thomas W. Laudermilch, Jr. Lineal 2,903.08 428 W. Simpson Street Mechanicsburg, PA 17055 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 $ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LAUDERMILCH VERA SCHEDULE J BENEFICIARIES FILE NUMBER 21 07 1139 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent LAUDERMILCH, VERA Decedent's Name 21 07 1139 File Number Page 2 Schedule J - Beneficiaries - 1 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) 8. Amy Laudermilch Lineal 2,903.08 341 Caravan Court Middletown, PA 17057 9. Rebecca L. Zuvich Lineal 2,903.08 3715 Waterford Circle Nashville, TN 37221 10. Alan E. Fetrow Lineal 2,903.08 5287 E. Trindle Road (Rear) Mechanicsburg, PA 17050 11. Grant J. Fetrow Lineal 2,903.08 5016 Wood box Lane Mechanicsburg, PA 17055 12. Lisa M. Laudermilch Lineal 2,903.08 4117 Crestview Road Harrisburg, PA 17112 13. David M. Laudermilch Lineal 2,903.08 4117 Crestview Road Harrisburg, PA 17112 14. Alex Cook Lineal 2,903.08 1224 Enders Road Halifax, PA 17032 15. Christopher Cook Lineal 2,903.08 1224 Enders Road Halifax, PA 17032 16. Breeanna Laudermilch Lineal 939.29 341 Caravan Circle Middletown, PA 17057 17. Kevin Welsh Lineal 939.29 428 W. Simpson Street Mechanicsburg, PA 17055 18. Scott J. Laudermilch Lineal 939.29 428 W. Simpson Street Mechanicsburg, PA 17055 19. Alexis Laudermilch Lineal 939.29 428 W. Simpson Street Mechanicsburg, PA 17055 20. Nathan Laudermilch Lineal 939.29 128 Ashley Road Phoenixville, PA 19460 21. Darrius West Lineal 939.30 341 Caravan Court Middletown, PA 17057