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Home My WebLink About04-02-08 ---I 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 INHERITANCE TAX RETURN 21 RESIDENT DECEDENT Year File Number 07 01146 Date of Birth 210267506 12092007 12311932 MILLER Suffix JR. Decedent's First Name WILLIAM MI C Decedent's Last Name (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 181 1. Original Return 0 2. Supplemental Return o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death afler 12-12-82) 181 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) o o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number GREGORY M KERWIN 7173623215 Firm Name (If Applicable) KERWIN & KERWIN 4245 ROUTE 209 REGISTER OF WILLS USE ONLY r--.;) = c:= CIQ >- -0 ::::u I N (") Co ~::o CO-o ~B~g "-;;~ ~ ::0 ".7" (j') ~~- ^ o 0 -n ED -0 :z: First line of address Second line of address o City or Post Office ELIZABETHVILLE State FA ZIP Code 17023 ..~~ C .N ;- ~~ ~~) Correspondent's e-mail address: 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, rect and complete. Decl tlon of preparer other than the personal representative IS based on all information of which preparer has any knowledge. SIGN)" F.PERSON RESP'J' OR EILlNrl "=URN DATE , fIJ "'" .J..J..J-- William C. Miller, III <"'; -, 6 - ~ g ADORES 3 -.;)6 - ()3 DATE Gregory M Kerwin 4245 Route 209, Elizabethville, PA 17023 Side 1 L 15056041147 15056041147 ---I ---1 15056042148 REV-1500 EX Decedent's Name: MILLER, WILLIAM C JR. RECAPITULATION 1. Real Estate (Schedule A)...................................... 2. Stocks and Bonds (Schedule B)............................................................................... 2. ~I. 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............. 6. 1'. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 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/Sec 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 .00 16. Amount of Line 14 taxable at lineal rate X .045 1/'. Amount of Line 14 taxable at sibling rate X .12 HI. Amount of Line 14 taxable at collateral rate X .15 15. 33,098.84 16. 17. 18. 19. Tax Due........................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Decedent's Social Security Number 210267506 1. 5. 38,711.50 38,711.50 4,342.04 1,270.62 5,612.66 33, 098 . 8 4 33,098.84 1,489.45 1,489.45 D 15056042148 ---1 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 07 - 01146 DECEDENT'S NAME Miller, William C Jr. STREET ADDRESS '-. 770 Poplar Church Road _...~.~_._--_.._-_._,----,._~_. CITY I STATE IZIP~----- Camp Hill PA 17111 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,489.45 1,300.00 68.42 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 1 ,368 .42 TotallnteresVPenalty (0 + 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 121.03 121.03 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes o D D D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............ ........................... ..................... ....................... ............................... 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. 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? ............................. .......................................................... .................. No [~ [X] [x] "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 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 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, William C Jr. FILE NUMBER 21 - 07 - 01146 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ---~ r--~---_.__..__._- ITEM NUMBER 1 VALUE AT DATE OF DEATH --~f---------~ Power Checking Account #112019838 at Susquehanna Bank PA, 26 North Center St, PO Box 27,350.43 1000, Litiz, PA 17543-7000 DESCRIPTION 2 Certificate of Deposit #311167491 at Susquehanna Bank, PA, Litiz, PA 10,837.29 3 Teamsters Pension Check 317.00 4 Cumberland County Veterans 1 00.00 5 Commonwealth of Pennsylvania, escheat refund 106.78 -- -- --- TOTAL (Also enter on Line 5, Recapitulation) 38,711.50 SCHEDULEH FUNERAL EXPENSES & ADIVIINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, William C Jr. FILE NUMBER 21-07-01146 Debts of decedent must be reported on Schedule I. ITEM ! NUMBER FUNERAL EXPENSES: A. VA, funeral donation DESCRIPTION T-~------- I AMOUNT I .--+---------~ . 50.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions William C. Miller, III Social Security Number(s) / EIN Number of Personal Representative(s): 208-38-7123 Street Address 52 Bragg Drive City East Berlin 1,93600 State P A Zip 17316 2. Year(s) Commission paid 2008 Attorney's Fees Kerwin & Kerwin -- Gregory M Kerwin 1,936.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Register of Wills 128.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Notary fee on Oath 5.00 TOTAL (Also enter on line 9, Recapitulation) 4,342.04 Schedule H Funeral Expenses & Adminis1rative Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 2 I . I Cumberland Law Journal, Estate Advertisement I I The Sentinel, Estate Advertisement ~ ~U~~~6 _=~=~~-~~~= 75.00 ESTATE OF Miller, William C Jr. 3 70.84 4 U.S. Postmaster, Stamps 8.20 5 Register of Wills, Short Certificates 8.00 6 Register of Wills, filing Inheritance Tax Return and Inventory 25.00 7 Reserved for closing costs 100.00 Page 2 of Schedule H '. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, William C Jr. Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Choice Critical Care, account payable 2 Holy Spirit Hospital, account payable 3 Quantum Imaging, account payable 4 Camp Hill Emergency Physician, account payable 5 Medical Billing Services, account payable 6 Tax Preparation 7 East Pennsboro Ambulance Service, account payable 8 Moffit Heart & Vascular Group, account payable 9 Spirit Physician Services, account payable -~--'-----. ..--------." -'-- [FILE NUMBER-~--- _~~____H 21 - 0~~_146__ ____ _ _ ~._-----~~-,..- AMOUNT 32.04 843.20 3.36 27.34 19.26 40.00 37.95 90.09 177.38 ------- ----e--- TOTAL (Also enter on Line 10, Recapitulation) 1,270.62 RE:V-1513 EX+ (9-00) .". .. . I , SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, William C Jr. I FILE NUMBER ___ . I 21-07-01146 ~ I~LATIONSHIPTO- _]SHAREOFE-STATE-----r AMOUNT OF-ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY I Do Not List Trustee(s) -L-TTAXA~L~DISTRIBUTIONS[inCIUdeoutrightspo~sal ;-_.~-- ~-- -- -.- --- -- I distributions, and transfers I under Sec, 9116 (a) (1,2)] I William C. Miller, III Son 1/2 of Estate 52 Bragg Drive East Berlin, PA 17316 2 Jeffrey S, Miller 150 Fort Hunter Road Harrisburg, PA 17110 Son 1/2 of Estate ! I 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 S, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I I I I ; TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI ,_____._ ____ ______ J._ 0.00 KERWIN & KERWIN ATIORNEYS AT LAW 4245 ROUTE 209 ELIZABETHVILLE, PA 17023 GOVERNORS' ROW 27 NORTH FRONT STREET HARRISBURG, PA 17101 PATRICK E KER\\?lN (1913-1987) G, (117) 362-3215 (117) 896-9089 FAX (717) 362-4459 E-m"i!' kkl@epix.net (717) 238-4765 FAX (717) 238-8455 GREGORY1'-!. KERWlN - Gi'IK@K.,rwinlawfinn.com TERRENCE J. KERWIN - KK@Kerwinlawfinn.com JOSEPH D. KERWIN - JDK@Kerwinlawfinn.com 1-I0LLYi'1cCLURE KERWIN - KK@Kerwinl.nvfinn.com please l?ef'ly To: () ELIZABETHVILLE OFFICE II HARRISBURG OFFICE March 31, 2008 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: The Estate of William C. Miller, Jr. Date of Death - December 09, 2007 Dear Sir or Madam: As per your letter of March 28, 2008, please find enclosed herewith an additional check for $5.00 to cover the $30.00 for the filing fee. Would you kindly time stamp the enclosed file copies and return them to me in the enclosed, stamped, self-addressed envelope? Thank you for your help. Very truly yours, d <Y{/ fr:- G~RY M. KERWIN GMK:bmk Enclosure c..-:> ~O (j:D :';"1 -0 'b :::c (") ,__ 1> r- >~ :z; S9 -cZ v') ^ "--)00 00" .::;) c . ::0 :0...... ):> r....:> =. = = )> -0 ::::0 I N r- .. -0 :x ~ o N ~~) , , - - "~~~", , .' . ,')