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Home My WebLink About00-010715056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Count Code Year File Number Bureau of Individual Taxes y PO BOX 280601 INHERITANCE TAX RETURN ' Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 00 0107 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204-28-2201 01/22/2000 07/08/1935 __ _ _ Decedent's Last Name Suffix Decedent's First Name MI _. Brehm Jr William C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI __ __ Brehm Yasuko __ _ __ . Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE _ _ REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW C!s 1. Original Return ; 2. Supplemental Return ,;,~ 3. Remainder Retum (date of death prior to 12-13-82) C,M: ` 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ~.:~~ 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) f_:.~ 9. Litigation Proceeds Received '",,.,~ 10. Spousal Poverty Credit (date of death S 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 James D. Flower Jr ' (717) 243-6222 Firm Name (If Applicable) _ __ _ _ _ _ _ _ REGISTER OF WILLS USE ONLY Saidis, Flower & Lindsa First line of address _. __ ___ _._._ _ r "'• r7 ~:~ 26 W. High St `- ~~ ~ __? ~; Second line of address.... _ _ _ _ _ _ __ . _ ' ;~ C-;7 ---s _ , ;~ s -J- -~..I _ __..... DA1E'FIL-~8. City or Post Office _ _ _ State ZIP Code _ _ ~,~,._i, '~?~~ Carlisle Pa 17013 _~~ ~,,y !~.) Correspondent's a-mail address: jflOWerjr@Sfl-IaW.COm ~' Under penalties of pery'ury, I deGare 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. SI RE OF PER ON RESP E FOR (LING RETURN DATE 571 Wlillcrest Drive, Carlisle, Pa. 17013 ~SIG/N~A~TURE OF PREP ER AN REPRESENTATIVE DATE W. High St., Carlisle, Pa. 17013 15056051058 PLEASE Side 1 FORM ONLY 15056051058 J '~ i ~-; _ -7 ~~ J 15056052059 REV 1500 EX Decedent's Social Security Number __ . . ___ ~ Decedent's Name: Wllllam C Brehm _.___ __._~_._ .__..,~..._._. __._.__..__.._ _ . . . 204-28-2201 _ . .. _ .~~...._...._._..__..~._...~.... ~ _._..~.v. _...~...___ 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. 2,940.62 6. Jointly Owned Property (Schedule F) "`= Separate Billing Requested ....... 6. ' 82,500.00 7. Inter-vvos Transfers & Miscellaneous Non-Probate Property °" °"""" (Schedule G) ~ Separate Billing Requested........ 7. ', 8. Total Gross Assets (total Lines 1-7) .................................... 8. 85,440.62 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. i 7,458.54 11. Total Deductions (total Lines 9 & 10) ................................... 11. 7,458.54 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.; ~ `"~ ~ ~~ p~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or trans ers under ec. 9116 (a)(1.2)X.0_ ~~~ ~,~.25 ~ O ,._, . 15. _. - 16. _.,...._ Amount of Line 14 taxable . at lineal rate X .0 _ ' 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. _ Amount of Line 14 taxable . _... .. at collateral rate X .15 18, i 19. TAX DUE ......................................................... 19. '; .... __ _. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Flle Number Decedent's Complete Address: 21 00 0107 _. DECEDENTS NAME DECEDENT'S SOCIAL SECURITY NUMBER William C Brehm 204-28-2201 STREET ADDRESS / CITY ~ J~ l/L- STATE /~ ZIP / Q / ~U ~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenal If a licable Total Credits (A + B + C) (2) ty ~ PP D. Interest E. Penalty Total InteresUPenalry (D + E) (3) 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. (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 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income :............................................ ^ [/f c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? .................................................................. ^ [V]' 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ -Q' 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 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 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 [72 P.S. §9116 (a) (1.1) (ii)J. 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. §9116(a)(1.2)J. 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)J. 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)]. 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. r REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER William C. Brehm, Jr 21-00-0107 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (Ir more space is needed, insert additional sheets of the same size) - REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY OWNED PROPERTY ESTATE OF FILE NUMBER William C. Brehm, Jr 21-00-0107 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A• Yasuko Brehm ~ 571 Hillcrest Dr. Carlisle, Pa. 17013 ~ wife 8 C. JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNi NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET Y. OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST ~' A' 06/30177 real estate at 571 Hillcrest Dr. and all furniture, furnishings and personal 165 000 00 50 82 rt , . ,500.00 nrnna v ~ TOTAL (Also enter on line 6, Recapitulation) I s 82,500.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER William C. Brehm, Jr 21-00-0107 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical erneneee in more space is neeaea, msen aoaluonal sheets of the same size) ~~ ADV NTA Business Cards 2 ACCOUNT NUMBER: 5477 5386 7175 0000 B4 DESIGN INC PREVIOUS BALANCE (-F) PURCHASES & < GASH ADVANCES {)PAYMENTS > ' (I GFi~D[T8 (+.).MISCELLANEOUS FEE& ,. „ , ,' (})'F'INANCE" CHARQE ' .. (--) ~j~yy ;;::.:.$ALit1NCE ' 7,327.12 218.98 165.00 0.00 0.00 77.44 7,458.54 Nominsl Ann a De eriodic Rate 0.03661% BY 0.03661% RCENTAGE RATE 2.79% 12.78% FINANCE Due b Ic Rsb 1S.8B 82.Os 'GHARG . Transaction Fns 0.00 0.00 Paymdnt:Gtuo' + Amoulft pear Credit UmR.> 'd- Aast:i)uto Amount Nlih(mum Peyir!orr( Oue :. 188.00 0.00 D.00 . 188.00 Awrop• Daily-BalanoM Rurchss~s ~AveraOe.flally Bafanc~~~' ''Ca:h:Advatwss. 1,496.07 8,026.70 "Cash Advance Cndit Llmit is a por0on of your Total Credit Limlt. If the New Belsnce Is paid In full by the payment Due Dab, no FINANCE CHARGE will be ~mpoaed on purchases itemized on your ne# etatemem. NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION If you have arty questions about our bill, lease contact us at: Advanta Bank Corp. P.O.Box 30715 Salt Lake City, UT 84130-0715 1-800-705-7255 (~ ~~~~ .~ fi962 DID 1 12 7 Pege 2 of3 8374 8800 94NL 0008 OD0218 01AA6982 13287 allfirst WILLIAM C BREHM JR SPECIAL ACCOUNT 571 HILLCREST DR CARLISLE PA 17013-4333 Page 1 0/ 3 Relationship With Interest Octot,er 10, 2001 thru November 7, 2001 ~iiii7.m i 3rat„ii .;, I1t;CL i~iu uu:,~su-~ i 9 i-ii ~ aiifirsi.com ~ ld.,-uur Special Account Customer Service 1-800-533-4630 Activity Summary Annual percentage yield earned 0.452 Balance on 10/09 S2,939.57 Avg. daily ledger balance S2,939.60 Deposits and additions 1.05 Avg. daily collected balance S2,939.57 Balance on 11/07 S2,940.62 Interest earned this statement S1.05 Interest paid this statement S1.05 Interest paid this year S18.89 Days covered by this statement 29 Deposits and additions Date Description Amount 11/07 INTEREST PAID S1.05 51.05 End of Day Ledger Balance Account balances are updated in the section below on days when transactions posted to this account. Date Balance 10/09 52,939.57 11!07 2,940.62 Click or Call to reorder your checks! Just go to www.allfirst.com to find check reorder options and select Check Reorder Express(SM). Or, call Service Line Plus(SM) at 1-800-355-8123. It's the easy and convenient way to reorder checks when no name or address changes are needed. You can change your check choice and order selected accessories -like planners, covers, and calculators. Access and Convenience - just one more way that Allfirst is making it easier for you. 000456 0003-99317920997 050 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 JAMES D FLOWER JR SALDIS ETAL 26 W RIGHT ST CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE _.,..,.,.,, NOTICE OF INHERITANCE TAX ',, ,` ~1~'PPRA2'9'F~~B~N7u. ALLOWANCE OR DISALLOWANCE OF-.DEDUCTION'S'AND ASSESSMENT OF TAX '~'~' _i : ~i~ ~ REV-1547 EX AFP CO1-09) ~~~~ ~~~ J~ I P~1 «~ ~ ~ ESTATE OF BREHN JR09 WILLIAM C DATE OF DEATH 01-22-2000 r` ~~'~/ f~" FILE NUMBER 21 00-0107 ~~~~' ~ Q~p; ',;,?+..i ~, ' ~s~)~,r COUNTY CUMBERLAND ~i ~~~"g•; ` _ ;.~,. ~i7 ACN 101 APPEAL DATE: 05-29-2009 (See reverse side under Objections) PA 17013 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -~ RETAIN LOWER PORTION FOR YOUR ----------------------------------------------------------- RECORDS E~ --------------- ----------------- REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEM ENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX ESTATE OF BREHN JR WILLIAM C FILE N0. 21 00-0107 ACN 101 DATE 03-30-2009 TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds [Schedule B) (2) ,00 credit to your account, 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 2,94 0.6 2 6. Jointly Owned Property (Schedule F) (6) 82,500.00 7. Transfers [Schedule G) (7) .00 e. Total Assets fig) 85,440.62 APPROYED DEDUCTIONS AND EXEMPTIONS: .00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 10. Debts/Mortgage Liabilities/Liens [Schedule I) C10) 7.458.54 11. Total Deductions C11) 7.458.54 12. Net Value of Tax Return C12) 7 7,98 2.08 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00 14. Net Value of Estate Subject to Tax C14) 77,982.08 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and I9 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) 77,9$2.08 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) •00 X 06 = .00 17. Amount of Line 14 at Sibling rate (17) •00 X 00 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00 19. Principal Tax Due (19)= .00 TAY CQFTITTC• PAYMENT DATE REC IPT NUMBER SCOUN C+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 r- ~ * IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 61, NO PAYMENT IS REQUIRED. t ` FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)