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Home My WebLink About10-01-08 (2)J 15056041125 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisbu , PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 7 5 5 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 9 1 1 6 6 2 7 5 0 7 0 7 2 0 0 8 0 1 0 2 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI MAR T I N G E N E V I E V E L (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 O 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) OX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J AN L B R O W N 7 1 7 5 4 1 5 5 0 0 Firm Name (If Applicable) ~~' JAN L B R O W N & A S S O C First line of address 8 4 5 S I R T H O M A S Second line of address City or Post Office H A R R I S B U R G Correspondent's a-mail address: brendailb@verizon.net C T S T E 1 2 State ZIP Code REGISTER A~1 I~It4LS USE OpteY -~ ~.~ Z7 ~ = - `-=a . . x~ I __.- =. ; :>: =; -'t~% ~ . ~ ~-- y~ -:) ~ ~ .. DX~TE FILED w C {" i i --,~3 P A 1 7 1 0 9 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 alt information of which preparer has any knowledge. SIGNAT~ OF PERSO~sa~NSIBL FILING RETURN DATE ~`"'moo' ~.r.`_~''~/ ~'~ -.~--- 9/ 3 0/ 2 0 0 8 ADDRESSQ 1930 DEER PATH ROAD HARRISBURG PA 17110 SIGNATURE O R AR R T~ AN REPRESENTATIVE DATE ADDRESS f~ -~•1.~I+..i 9/ 3 0/ 2 0 0 8 845 S~'~HOMAS COURT SUITE 12 HARRISBURG PA 17109 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 J 15056042126 REV-1500 EX Decedent's Social Security Number DecedenrsName: GENEVIEVE L. MARTIN 1 9 1 1 6 6 2 7 5 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) g, 2 9 1 6 6 4 . 4 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. 6 1 4 8 ~ 1 3 8. Total Gross Assets (total Lines1-7) ........................... 8. 2 9 7 8 1 2 5 7 9. Funeral Expenses & Administrative Costs (Schedule H) , , , , , , , , , , , , , , , , g, 2 3 7 9 6 ~ 0 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10. 4 6 1 1 . 9 5 11. Total Deductions (totalLines9&10) ,,,,,,,,,,,,,,,,,,,, 11 2 8 4 0 8 0 1 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 2 6 9 4 0 4 ~ 5 6 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 l2 minus Line 13) , . , , , , , , , . , . „ . „ . 14 2 6 9 4 0 4 . 5 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X.0 ,_ 0 0 0 15, 0, 0 0 16. Amount of Line 14 taxable at lineal rate X .045 2 6 9 4 0 4, 5 6 16 1 2 1 2 3. 2 1 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0. 0 0 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042126 1 2 1 2 3. 2 1 15056042126 J REV-1500 EX' Page 3 Decedent's Complete Address: GENEVIEVE L. MARTIN STREET ADDRESS 4905 E. Trindle Road __ -__ cITY Mechanicsburg Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) 2. CreditsJPayments A. Spousal Poverty Credit _ B. Prior Payments C. Discount 606.16 3. InteresUPenalty if applicable D. Interest E. Penalty (3) 0.00 File Number 21 08 0755 STATE ZIP PA 17050 (1) 12,123.21 Total Credits (A + g + C) (2) 606.16 Total InteresUPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. (4) 0.00 (5) 11, 517.05 (5A) (5B) 11, 517.05 Make Check Payable to: REGISTER OF WILLS, AGENT 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 : ......................................................... ^ Q ............. b. retain the right to designate who shall use the property transferred or its income; ^ Q ............................... c. retain a reversionary interest; or ................................................................... ^ 0 ............................. d. receive the promise for life of either payments, benefits or care? .............................................. ^ 0 ......... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................ ....................................... ^ a ................................ 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS 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 for 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 p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 (O) 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. §9116(a)(1.3)]. Asibling 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 ESTATE OF GENEVIEVE L MARTIN 21 08 0755 Include the roceed f liti ti p s o ga on and the date the proceeds were receNed by the estate A . ll property jolMly-owned with right of survivorship must be disclosed on Schedule F ITEM . NUMBER DESCRIPTION VALUE AT DATE 1. Franklin Bank OF DEATH Checking Account No. 02000018560 3,851.77 2. Franklin Bank Savings Account No. 02020001162 7,701.11 3. Franklin Bank Certificate of Deposit No. 02460000183 55,188.51 4. Franklin Bank Certificate of Deposit No. 02460000184 55,188.52 5. PSECU Regular Shares, S01 8,608.44 6. PSECU Certificate of Deposit, C53 54,295.35 7. PSECU Certificate of Deposit, C54 54,295.35 8. Northern Trust Western-Southern Life Account No. 9800141181 38,563.27 9. Erie Insurance Group, premium refund 107.00 10. Country Meadows Associates, refund 665.12 11. Household Goods & Personal Effects 12,000.00 12. United States Treasury, stimulus payment 1,200.00 SCHEDlJLE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY _ TOTAL (Also enter on line 5 Recapitulation) I S 291 (If more space is needed, insert addrt~onal sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE ...,,.,,,~~ GENEVIEVE L. MARTIN 21 08 0755 Thb schedule must be completed and filed 'rf the answer to any of questans 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. Met-Life Total Control Account No. 4054019389 Son, Stephen F. J. Martin, is beneficiary DATE OF DEATH % OF DECD'S VALUE OF ASSET INTEREST 6,148.13 100. TOTAL (Also enter on line 7 (If more space is needed, insert additional sheets of the same size) EXCLUSION TAXABLE (IFAPPLICASLE) VALUE 6,148.13 13 REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER GENEVIEVE L. MARTIN 21 08 0755 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: 1. Neill Funeral Home 2. Pealers, funeral flowers 3. Minister, honorarium 4. Monument B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commission Paid: State Zip AMOUNT 10,684.49 874.45 100.00 1,900.00 2, Attorney Fees Jan L Brown & Associates 8,934.00 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Street Address City State Zip Relatbnship of Claimant to Decedent 4• Probate Fees Register of Wills, Cumberland County 410.00 5 Accountant's Fees 6. Tax Return Preparers Fees Parks & Company, 1040 & 1041 preparation 500.00 7. Cumberland Law Journal, legal advertising 75.00 8. The Patriot-News, legal advertising 318.12 TOTAL (Also enter on line 9, Recapitulation) I s 23 796 06 (If more space is needed, msert additronal sheets of the same size) • REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE / DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBER GENEVIEVE L. MARTIN 21 08 0755 Report debt incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION ~AOF D~DHTE 1. Discover Card, outstanding balance 10.00 2. IGM Card, outstanding balance I 40.00 3. United States Treasury 822.00 Form 1040, tax year 2007 4. Verizon, final bill 14.76 5• West Shore EMS Ambulance Service for 6/21/08 646.30 6. K of C Life Premium, premium 23.08 7• Country Meadows (written pre-death cashed post-death) 2,984.00 8. Verizon (written pre-death, cashed post-death) 50.95 9. (Susquehanna Internal Medicine I 20.86 TOTAL (Also enter on line 10, Recapitulation) I S 4 611 95 (If more space is needed, insert additional sheets of the same size) REY-1513 EX ++(9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER GENEVIEVE L. MARTIN 21 08 0755 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 (indude outright sppoousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Stephen F. J. Martin, son Lineal 1930 Deer Path Road tangible property Harrisburg, PA 17110 75% residue, Sch G 2. Arthur J. Martin, Jr. Lineal 806 Avondale Avenue 25% residue Haddonfield, NJ 08033 II. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S (If more space Is needed, insert additional sheets of the same size) r- O °° _ c, , LAST WILL AND TESTAMENT . 's ~ ' c ~ - `' -l ~ t ~. ~ OF -_ ~ ~ ~ , ~ ~ - _ , GENEVIEVE L. MARTIN ~ -~ ~ .,~ ~, ~., I, GENEVIEVE L. MARTIN, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article N I give and bequeath all personal property, including but not limited to my jewelry, household items, furniture and photographs to my son, STEPHEN F. J. MARTIN, of Dauphin County, Pennsylvania. Article V All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath as follows: SEVENTY FIVE PERCENT (75%) to STEPHEN F. J. MARTIN; and TWENTY FIVE PERCENT (25%) to my son, ARTHUR J. MARTIN, JR. of Haddonfield, New Jersey. If STEPHEN F. J. MARTIN predeceases me or fails to survive me, I give and bequeath his share to THE ORDER OF FRIAR SERVANTS OF MARY, or its successor(s), 3121 West Jackson Boulevard, Chicago, IL 60612 to be used at its discretion. If ARTHUR J. MARTIN, JR. predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath his share to STEPHEN F. J. MARTIN. -2- Article VI I nominate, constitute, and appoint STEPHEN F. J. MARTIN as Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and appoint my attorney, JAN L. BROWN of JAN L. BROWN & ASSOCIATES, or its successor(s), or any attorney with JAN L. BROWN & ASSOCIATES or its successor(s) as successor Executor of my Last Will and Testament. I direct that my Executor or successor Executor be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executor or successor Executor shall receive reasonable compensation for services rendered to my estate. Article VII In addition to the powers conferred by law, I authorize my Executor and successor Executor, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, -3- (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, GENEVIEVE L. MARTIN, hereby set my hand to this my Last Will and Testament, on ~' 2008. ENEVIEVE L. MARTIN In our presence, the above-named GENEVIEVE L. MARTIN signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name ~, /i ~~~ '~l~c Sl"~ Address 845 Sir Thomas Court. Suite 12 Harrisburg PA 1 ~ 109 845 Sir Thomas Court Suite 12 Harrisbur8 PA 17109 -4- I, GENEVIEVE L. MARTIN, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by GENEVIEVE L. MARTIN, the Testatrix on /- Z 2008. ~1 a~~o~L W~~~.. Notary Public N LTN o~v NOTARIAL SEAL PAUU K WHITE, NOTARY PUBLIC LOWER PAXiON TWP., DAUPIiiN COUNTY MY COMMISSION EXPIRES APRIL 5, 2008 ENEVIEVE L. MARTIN We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) yeazs or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ., and ~ ~ I_ ~ , witnesses, on _ /- , 2008 Notary Public MON A TH F P N Y NOTARIAL SEAL PAUU K. WHITE, NOiARYPUBIIC MY COMMI~ ~N EXPiRES APRIL 5, 2008 -$- ~ u Witness tness