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HomeMy WebLinkAbout07-28-08 15056041147 -' REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county coda Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 80X.280601 2 1 0 8 0 0 6 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 139 12 8127 11 14 2007 06 19 1920 Decedent's Last Name Suffix Decedent's First Naame MI PAULDING MARY W (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 IIV DUPLICATE WITH THE REGISTER OF~ WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 8 Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Witl) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. spousal Poverty Credit (date of death 11, Election to tax under Sec. 9113(A) between 12-31- 1 and i-1-95) (AtiaCh SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Diaytime Telephone Number EDWARD P. SEEBER 717 533 3280,E ,, Firm Name (If Applicable) JAMES, SMITH, DIETTERICR & First line of address SUITE C-400, 555 GETTYSBURG Second line of address City or Post Office State ZIP Code MECHANIC5BURG PA 17055 Correspondent's a-mail address: e p S@ j S d C. C O m REGISTEI2~~IILLS USE.ANLI!: ` ! ' -- ~_7 -r-~ r~.~ --t~ c r; ~`-,; -~' -,~ ~ ._ D1CTE FILED W Cif ,~ ~.; -, `~ _,, ,i of I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, on of preparer other than the personal representative is based on all information of which preparer has any knowledge. Robert A. Paulding ~9 /~ /©~ 1700 ertin Road, Monkton, MD 21111 SIG R F PREPARER OTHER THAN REPRESENTATIVE DATE r~ Edward P. Seeber 7~lb~G $ ~ ,quite C-400, 555 Gett I Pike, Mechanicsburg, PA 17055 Side 1 15056041147 15056041147 15056042148 REV-1500 EX Decedent's Social Security Number oecedenc~s Name: Mary W . Paulding 13 9 12 812 7 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) ................ 5. 1 2 , 2 6 4 . 0 4 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 3 4 0, 7 7 7. 6 0 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 3 5 3, 0 4 1. 6 4 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 1 , 2 0 6 . 7 5 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................ 10. 2 , 4 5 5 . 9 4 11. Total Deductions (total Lines 9 8~ 10) ...................................................................... 11. 1 3 , 6 6 2 . 6 9 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 3 3 9 , 3 7 8 9 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 2 1 , 5 0 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 3 1 7 , 8 7 8 . 9 5 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 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 3 17 , 8 7 8. 9 5 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due .................................................. .................................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 14,304.55 0.00 0.00 14,304.55 SidB 2 15056042148 1!5056042148 J Rev-1508 EX+ (6.981 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSriVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Paulding, Mary W. 21-08-0069 Include the proceeds of litigation and the date the proceeds were received by the eslate. All property Jointlyowned with the right of survivorship must be dlacloaed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Aetna -refund of health insurance premium 27.04 2 Citizens Bank Checking Account No. 6100682668 -valued per letter dated 2!6/08 10,134.88 3 Citizens Bank Savings Account No. 6140217539 -valued per letter dated 216/08 1,200.03 4 Citizens Bank Savings Account No. 6140217539, accrued interest -valued per letter 0.09 dated 2/6108 5 Pinnacle Health Emergency Department -refund of account 902.00 TOTAL (Also enter on Line 5, Recapitulation) I 12,264.04 (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) ReviS10 EX+ (698) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANUI INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Paulding, Mary W. 21-OS-0069 This schedule must be completed and filed 'd the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER D IP I N R P RTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Auer Memorial Home 8 Cremation Services, Inc. 619.00 100.000 0.00 619.00 - prepaid funeral account 2 Miscellaneous personal property -titled in the 200.00 100.000 0.00 200.00 name of the Mary W. Paulding Living Trust dtd 12/13/1995 -valued per Trustee 3 Morgan Stanley Account No. 633-044188 -titled 74,907.89 100.000 0.00 74,907.89 in the name of the Mary W. Paulding Living Trust dtd 1211311995 -valued per letter dated 1118/08 4 Morgan Stanley Account No. 633-044568-170 - 82,400.24 101D.000 0.00 82,400.24 titled in the name of the Mary W. Paulding Living Trust dtd 12/13/1995 -valued per letter dated 1 /18/08 5 Venue Annuity II held by Morgan Stanley 182,650.47 100.000 0.00 182,650.47 Account No. 633-044568-170 -titled in the name of the Mary W. Paulding Living Trust dtd 12/13/1995 -valued per letter dated 1/18108 TOTAL (Also enter on Line 7, Recapitulation) 340,777.60 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Farm PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES $ COMMONWEALTH OF PENNSYLVANIA INRESIDENTED CE EDENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Paulding, Mary W. 21-08-0069 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 4,916.75 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) ! EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees James, Smith, Dietterick ~ Connelly, LLP 6,000.00 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 60.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. I Other Administrative Costs I 230.00 TOTAL (Also enter on line 9, Recapitulation) I 11,206.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rav~1502 EX+ (686) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE7AX RETURN RESWENT DECEDENT ESTATE OF (FILE NUMBER Paulding, Mary W. _ _ 21-08-0069 Copyright (c) 2002 form software only The Lackner Group, Inc. F=orm PA-1500 Schedule H-A (Rev, 6-98) • ~ ' Rev-1502 EX+ (8-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA continued INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Paulding, Mary W. 21-08-0069 Copyright (c) 2002 form software only The Lackner Group, Inc. Farm PA-1500 Schedule H-67 (Rev. 6-98) Rev1512 EX+ (8.98) COMMONWEALTH OF PENNSYLVANIA INHERRANDE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Paulding, Mary W. 21-08-0069 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Aetna -health insurance premium 30.00 2 Andrews & Patef Associates, PC -unreimbursed medical bill 12.04 3 AT8~T -telephone service 56.52 4 Links2Care -unreimbursed nursing care 636.38 5 PA Department of Revenue - 2007 individual income tax 279.00 6 Pinnacle Health Emergency Department -unreimbursed medical bill 451.00 7 Pinnacle Health Hospitals -unreimbursed medical bill 65.00 8 US Treasury - 2007 individual income tax 926.00 TOTAL (Also enter on Line 10, Recapitulation) I 2,455.94 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule I (Rev. 6-98) REV•1513 EX+ (9.00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA B E N E F I C IARI E S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Paulding, Mary W. 21-08-00 69 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trus s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(ax1.2)] 1 Mary C. Ketchum Daughter 113. of residue 105,959.65 94 Pershin Lilac Road Etters, PA 17319 2 John H. Paulding Son 113 of residue 105,959.65 Apt. G-11, 1141 Snyder Road Lansdale, PA 19446 3 Robert A. Paulding Son 1/3 of residue 105,959.65 17000 Gerting Road Monkton, MD 21111 Total 317,878.95 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on. Rev 1500 cove r sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS See continuation schedule(s) attached 21,500.00 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I ~-i,avu.vu Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule J (Rev. 6-98) Rev~1502 EX+ (688) COMMONWEALTH OF PENNSYLVANIA INHERRANGE TAX RETURN RESIDENT DECEDENT SCHEDULE J-IIB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued ESTATE OF (FILE NUMBER Paulding, Mary W. 21-08-0069 ITEM NUMBER DESCRIPTION AMOUNT 1 American Cancer Society - PA Division -specific bequest 3,000.00 2 American Red Cross Central PA Chapter -specific bequest 3.000.00 3 Christ Presbyterian Church -specific bequest 5,000.00 4 Habitat for Humanity -Cumberland Valley -specific bequest 3,000.00 5 PKD Foundation -specific bequest 2,500.00 6 The Salvation Army -specific bequest 5,000.00 Subtotal 21,500.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-116 (Rev. 6-98) July 25, 2008 L~~~ ~~~~ ~~ ~E°? ~~: ~ j Glenda Farner Strasbaugh, Registe~P~'~'C?~ills '! ,~'-' Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Mary W. Paulding File No. 2008-00069 Dear Ms. Farner Strasbaugh: Enclosed are the following documents to be filed in the above-referenced Estate: 1. An original and two (2) copies of the Pennsylvania Inheritance T,ax Return. 2. An original and two (2) copies of the Inventory. 3. Check number 139 made payable to the "Register of Wills, Agent" in the amount of Four Hundred Nine and 81!100 Dollars ($409.81) representing the additional inheritance tax due. 4. Check number 140 made payable to the "Register of Wills, Cumberland County" in the amount of Thirty Dollars ($30.00) representing the additional probate fee due. 5. Check number 141 made payable to the "Register of Wills, Cumberland County" in the amount of Thirty Dollars ($30.00) representing the filing fee for the Return and Inventory. Please time-stamp the extra copies and return them to me in the enclosed seflf-addressed, stamped envelope. Additionally, please update your records to reflect Attorney Seeber's n:ew mailing address: Suite C-400 555 Gettysburg Pike Mechanicsburg, PA 17055 Reply to: Suite 204 5020 Ritter Road Mechanicsburg, PA 17055 Direct Dial: 717-298-2094 Direct Fax: 717-298-2095 . ~ ~ ::: ESTATE SECURITY Cheryl L. Baker, CP Certified Paralegal clb@jsdc,com 134 SIPE AVENUE HUMMELSTOWN, PA 17036 MAILING ADDRESS P.O. BOX 650 HERSHEY, PA 17033 TOLL FREE 1.800.942.3660 TEL. 717.533.3280 FAX 712533.7771 www. jsdc.com Glenda Farner Strasbaugh July 25, 2008 Page 2 of 2 If you have any questions, please feel free to contact me. Very truly yours, JAMES, SMITH, DIETTERICK & CONNELLY, LLP ery L. Baker, CP ert' ed Paralegal Enclosures cc: Robert Paulding, Executor