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HomeMy WebLinkAbout07-08-0815~56~41158 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Nu tuber PO BOX 280601 INHERITANCE TAX RETURN 21, ~ 7 0 81,1 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2U4-03-6448 B82gZ007 B5U11922 Decedent's Last Name BAUGHMAN Suffix Decedent's First Name NAOMI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL iN APPROPRIATE BOXES BELOW Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS M! G MI ^ 1. Griginal Return ~ 2. Supplemental Return ^ 3. Remainder Return (date of death ~j LJ 4 Li it d E t ^ prior to 12-13-82) ^ . m e s ate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required 6 Decedent Died Testate rr----~. 7 I death after 12-12-82) D d t M i i t i i d ] . . _____~ ece en n a a ne a L v ng Trust ,_ 8. Total Number of Safe Deposit Boxes (Attach Copy of Wili) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 1 1. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Nf ~ er RICHARD C• SNELBAKER ~ 717-697-8~~~ ~-r_~}~-~`-i Firm Name (If Applicable) cn c_., `r ~:1 C_=" s - -~ .-_ ~ :~ !.:,~ REGISTER OF yV}tal.~,[1 SE O LY ~ ~~~ -~ ^ SNELBAKER & BRENNE~1AN, P C _-~ ~y~ ~ C 1 i „S~ . ' .- . ~, First fine of address - -`~ ~ ~'ea - C= '. .. 44 WEST {CAIN STREET ~~ ' r"I ~`- ~`~' F 1 t _r:~ ~ s Second fine of address t` Q ~ ..,~ ~~ - P•0• BOX 31,8 ~ t~ ~ City or Post Office State ZIP Code DATE FILED f1ECHANICSBURG PA 1,7055 Correspondent's e-mail address: lfnder 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. IG RE OF PERSON SPO BLE FOR FILING RETURN ATF 0 N DLA-. J . F 4 HA THAN REPRESENTATIVE DATE A17055 RICHARD C• SNELBAKER, ESQUIRE 44 WEST (hAIN STREET, f~ECHANICSBURG, PLEASE USE ORIGINAL FORM ONLY ~5 Side 1 ],5056Q411,58 6MA6A73.D00 150156041158 ~.~ ],5D56042]~59 REV-1500 Ex Decedent's Social Security Number 204-03-b44B UeceeenYs NemeB A U G H (7 A N N A O ('1 I (,_ RECAPITULATION 1. Real estate (Schedule A) s 1, 0•DD 2. Stocks and Bonds (Schedule B) . 2. D • D D 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ~ 3. D , D D 4. Mortgages & Notes Receivable (Schedule D). , 4. D • D D 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 5941, • 53 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. D • D D 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7, D•DD 8. Tota4 Gross Assets (total Lines 1-7). 8, 59 41, . 5 3 9. Funeral Expenses & Administrative Costs (Schedule H) . g, 5 ~, S • D D 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . 10. 5 ~ 5 • D D 11 . Total Deductions (total Lines 9 & 10) . 1 1. 1, O 9 D • D D 12. Net Value of Estate (Line 8 minus Line 11) 12. 4 8 51, • 5 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an Election to tax has not been made (Schedule J) . 13. D • D D 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. 4 B 51, • 5 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or tran.>fers under Sec. 9116 (a>(1.2) x .o j~ D, p D 15. 0• D D 16. Amount of Line 14 taxable at lineal rate x .oL15 4 B 51.5 3 16. 218.3 17. Amount of Line 14 taxable at sibling rate x .12 p. p p 17. 0- D D 18. Amount of Line 14 taxable at collateral rate x .15 D. 0 0 18. D- D D 19. TAX DUE 19. 21, 8 • 3 ? 20. FILL 1N THE BOX IF YOU ARE REQUESTWG A REFUND OF AN OVERPAYMENT Side Z ],5~56Q427,59 snnasaez.ooo 1505bf742159 REV-1500 EX F'age 3 Decedent's Complete Addrecs• File Number n>q i, i, DECEDENTS NAME BAUGH~1AN NAOf~I G STREET ADC)RESS U T R R O 0 TOWNSHIP CU~16ERLAND COUNTY CITY STATE ZI p CAMP HTLL Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit Q • Q Q B. Prior Pa}rments Q . Q Q C. Discoun° Q • Q Q 3. Interest/Penalty if applicable D. Interest 1, • 2 5 E. Penalty (] . Q Q Total Credits (A + 8 + C) Total InterestlPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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. (1i 21,8-~2 (2) Cl • d 0 (3) 1, . 2 5 (5) 21~ 9. 5 ~ (5A> a.ao B. Enter the total of Line 5 + 5A. This is the BALANGE DUE. (58) 219 - 5 7 Make Check Payable to: REGISTER UFW/LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Gid decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ~ ~ fu b. retain the right to designate who shall use the property transferred or its income; ~ ^ } c. retain a reversionary interest; or j L __1 ' ~ u 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? . ,~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? O i X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS YES, YOU MUST COMPLETE SCHEDULE G AND FILE fT A5 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 far 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. F9116 (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 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. §9116(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. F9116(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. 6M4611 1.000 REV-1508 EX + (6~ 38) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY _ ESTATE OF FILE NUMBER Naomi G. Baughman 21 07 0811 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITE~II VALUE AT DATE NUMBERi DESCRIPTION OF DEATH 1 IGenworth Financial refund unused premium on long term care policy 2 Highmark Blueshield refund unused premium on medical insurance 3 Pershing LLC ~uncashed dividend check 4 United States Treasury 2008 Economic Stimulus Payment (Abate interest on this asset) 4,890.00 410.C2 341.51 300.00 TOTAL (Also enter on line 5 Recapitulation) $ I 5 , 941.53_ 3w46ao 1.000 (if more space is needed, insert additional sfieets of the same size) REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address - - --_ _ -- ESTATE OF FILE fdUMSER Naomi G. Baughman 2107 0811 Debts of decedent must be reported on Schedule f. ITEM I NUMBER DESCRIPTION I AMOUNT A. FUNERAL EXPENSES: ~ ~ None B. 1 2 3 4 5. 6. 7. 1 City Year(s) Commission Paid: SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE CASTS State Zip Attorney Fees Snelbaker & Brenneman, P . C . Family Exemption: (1f decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip _ Refatlonship of Claimant to Decedent Probate Fees Accountant's Fees fax Return Preparer's Fees Register of Wills filing fee for Supplemental Inheritance Tax Return 500.00 15.00 TOTAL (Also enter on line 9, Recapitulation) ~ $ 515. 0 7W46AG 1,000 (If more space is needed, insert additional sheets of the same size) REV-1512 EX r (~2-(J3) COMMONWEALTH OF PENNSYLVANIA 4NHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE( DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Naomi G. Baughman 21 07 0811 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medicaV expenses. ITEM VALUE AT DATE, NUMBER , DESCRIPTION OF DEATH 1, United States Treasury tax due on 2007 Final Individual Income Tax Return (Form !1040) 84.00 2 Commonwealth of Pennsylvania tax due on 2007 Final Individual Income Tax Return (PA--40) TOTAL (Also enter on line 10, Recapitulation) 5 3W46AH z.ooo (If more space is needed, insert additional sheets of the same size) 481.00 75.00 REV-1513 EX+(9-00) COMMONWEALTH OF PENNSYLVANIA WHERITANCETAX RETURN RESIDENT DECEDENT VV~~DV~~ BENEFICIARIES ESTATE OF FILE NUMBER Naomi G. Bau hman 21 07 0611 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 Donna J. Farnham I 406 Darla Road jMechanicsburg, PA 17055 600 of Residue: 2 Kimberly A. Petrides 310 Reeser Drive York Haven, PA 17370 20~ of Residue: Daughter Granddaughter 2,910.91 970.31 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVEP. SHEE T ION-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECT{ON TO TAX IS NOT BEWG MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ $ 0.00 (If more space is needed, insert additional sheets of the same size) 3W46Ai 1.000 Estate of: Naomi G. Baughman 204-03-6448 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 3 Kristin C. Nickel 33 Halleck Drive East Berlin, PA 17316 20o of Residue: Granddaughter 970.31 _ .. _ ., ~-, ,'_~ _ - CODICIL TO WILL OF 93AOMI BADC~IMAN I, NAOMI BAt~IlKAN, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my sole codicil to my last will dated 18 January 1982. ITEM I. I hereby revoke and cancel ITEMS III, IV, and V of my will dated 18 January 1982. ITEM II. In all other respects, I hereby ratify, confirm and republish my last will dated 18 January 1982, together with this sole codicil as and for my last will. IN WITNESS 6~iE'RF~F, I have hereunto set my hand and seal this `~' day ,,,. of 4: ~:..~ . , 1990. ~> ~ ` g", _ NAOMI BAUGHMAN ,~~ Signed, published, and declared on the date hereof by the above--named testatrix as `and for the sole codicil to her last will dated 18 January 1982 in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. {'d 1 I~AOI~.I BAUGF31%1AN I, NAOMI BAUGI-~~IAN, of Lower Allen Township, County of Cumber- <land, and State of Pennsylvania, declare this to be my last will ;;and revolve any vai 11 previously made by me . Item I. I direct that all my just debts and funeral expenses, .'including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under- ...this will or otherwise, shall be paid from my residuary estate ;as soon as practicable after my decease as a part of the expense of the administration of my estate. Item II. I give, devise, and bequeath all my possessions ;.and estate of every nature and wherever situate as follows; ,~ t~~ry A. Sixty (60%) percent thereof to my daughter, DONNA J. FARNHAR'i, provided she survive ~, .; ; my death by sixty (60} days; and B. Twenty (20°a) percent thereof to my ,;' _..,_. '~`;~ granddaughter, KIMBERLY A. FARNI3AM, provided 1 she survive t~ death by sixty (60) days; and '1 { C. ~I`wenty (20%) percent thereof to my ~,~ , ~=;~, granddaughter, KRISTIN C. FARNHAM, provided she .~;`..,~ '`~' survive my death by sixty (60) days. ~'~~ ,''Should any person entitled to a share of my estate under this Item ~, ~; II of this my last will predecease me or be deceased on the sixty- 1` i- ~~ R-ti first day following my death, I give, devise, and bequeath their 0 said share to such of their issue, per stirpes, as survive my death by sixty (60) days and, should they so die leaving no issue, then to the other persons taking hereunder in the proportions in which they take. Page 1 of 4 Pages OF u Item TII. Should any of my issue entitled to a share of my estate not have attained the age of 25 years at the time for ".distribution to him or her, I devise and bequeath the share of ,such issue to my hereinafter named trustee, IN SEPARATE TRUSTS, ''`to hold, manage, invest, and re-invest, the shares so received, `';:and the accumulation of income thereon, and to use and apply from :time to time such portion of income and principal thereon as my 3trustee thinks proper for the comfortable support, maintenance, ;.:health, welfare, and education of the issue without regard to the ~, .?issue's parent's ability to provide such support or education, or to make payment for such purposes, without further responsibility, 'directly to such issue or directly to such issue`s parent, or directly to any person taking care of such. issue. Az~y principal 'or income not so applied shall be distributed to such issue when he or she attains the age of 25 years, or if he or she dies prior thereto, to his or her personal representative. Item TV. I appoint DONALD A. GELBAUGH trustee of the trust ~'or trusts created by this my last will, Should my said trustee ;a 4:, ;~•~ predecease me or ~i:herwise fail to qualify or cease to serve as a ~~trustee of any trusts created by this my last will, I appoint ,L, DOLVNA ~i . FARNF3AM to serve as trustee of any trusts created by :this my Last will. In addition to the other powers and authorities ~~:: 'i`~ranted to ray trustee by Pennsylvania Law and by the preceding .paragraph of this my last will, I hereby give my trustee the y E~'following special powers and authorities: ~: ~'~; A. To retain any or all of the assets of `,:' ~ my estate, real or personal, without regard to any ,~`~ principle of diversification, risk, or productivity; ,, ~ ~~'- B. To invest and re-invest in all forms of property without restriction to investments authorized for Pennsylvania Fiduciaries, as my trustee deems c' -~.,~ proper, without regard to any principle of diversi- `~~'~ fication, risk, or productivity; C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and Page 2 of 4 Pages ~1 ~G upon such terms or conditions as mY trustee deems proper and in the best interests of the beneficiary or beneficiaries of said trusts. D. To allocate recei~ts and expenses to ~r $: j _' principal or income or par~ly to each as my trustee ~` from time to time deems proper in its sole discretion. a: E. To compromise anylclaim or controversy. ;~ ~ F. To exercise any option, right, or privilege granted in insurance polices or in other investments. G. My trustee may accumulate the income from this trust during the termthereof but may, from time to time, distribute from current income or from accumulated income or fromjprincipal such amounts as my trustee, in its sole discretion, deems advisable for the education, welfare;, and comfort of the trust 09 I ~` beneficiary. ~' '? Item V. All of the interests of the beneficiaries hereunder -shall not be subject to anticipation or to voluntary alienation. Item VI. I appoint my daughter, D`+(~NNA J. FARNHAM, executrix ;; of this my last will, Should my said daughter predecease me or a ~; ';otherwise fail to qualify or case to serve as executrix of this i °my last wi1_l, I appoint DONATED ~ A. GEI~BAUGH, executor of this my last will . ~r '= Item VII. I direct that ~ personal representatives shall ~` not be required to give bond f~r the faithful performance of their ~,;, ;duties in any jurisdiction, ~s. IN WITNESS WHEREOF, I have hereunto set my hand and seal ~t i 'this ~~, day of ~ ~~ °_.~ 1982. ~' ;~ ~a ~ . ~ ~ .: '`~ ~ Naomi Baughman Pag~ 3 of 4 Pages The preceding instrument, consisting of this and three .'other typewritten pages, each identified by the signature of the ~` testatrix was on the date thereof signed, published, and declared '`: by Naomi Baughman, the testatrix therein named, as and for her ~w. 'last will, in the presence of us, who at her request, in her prresence,' i -and in the presence of each other, have subscribed our names as ~' !witnesses hereto. ,,.--.,. ,- ;,r-.t ~~-~..~:.~=--µ-~--~- tic- i~ ~~ ~,e. Lx : z_ ~ '~.. Page 4 of 4 Pages C.OI~iNiONW hAL`I'F [ UL' PENN SYLVAI`lI A ) ( SS.: COUDT'I'Y OF CUMBERLAND ) I, NAOMI BAUGF3MAN, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed 'the instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purpGSes therein expressed. ? ,--, ;~ }} C ''Sworn or affirmed to ana ~laomi Baughman/~,~ 'acknowledged before me by `Naomi Baughman, the testatrix this ~~.~"~'~1 day of ~ -~~~.~~~-~,~_(~~~1 1982. ~. E ~ '_, r~ ~ r inn (.~ n'~ Ft~. ~~, Notary 1Public ~°, ~~,_:~T~ , ~ rya.; ~.,:~, i•~a~s i:, COMMONhTEALTH OF PENNSYLVANIA ) ( SS.. CUUNZ'Y OF CU~'IBERLAND ) 4JE , SAMUEL L. AI~TDES and GEORGE A. VAUGHN, III , the witnesses whose names are signed to the attached or foregoing instrument, ~' :being duly qualified according to law, do depose and say that 'we were present and saw the testatrix sign and execute the instru- ment as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our l~n.owledge, 'the testatrix was at that dime 18 or more years of age, of sound i, '..mind and under no constraint or undue influence. ~' °a.~ l * ,7f ~ ~ s D~„ / r ,. i Sworn or affirmed to and ,~ ~/``f acknowledged before me ~y '.Samuel L. Andes and George A. :`Vaughn, III, this j`<J~:#~ day of r;t.~ t 1982. ~ ~_~_L1'L;~.t, ~ _~ . 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