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Home My WebLink About12-15-08 (2)15056051058 R~~~~ ~~~ EX (06-OS) OFFICIAL" USE ONLY PA Department of Revenue Bureau of Individual Taxes ~ County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 0363 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 164-30-3520 03/17/2008 03/01/1917 Decedent's Last Name Suffix Decedent's First Name MI MATTER GLADYS p (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 DUPLIC~4TE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 1. Original Return 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 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) 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) (F~ttach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFClRMATION SHOULD BE DIRECTED TO Name Daytime Telephone Number William L. Grubb, Esq. (717) 763-5580 Firm fame (If Applicable) RI~GiBTER OF WILLS USE ONLY r-~ First line of address ;- j ,-`"'~ "~! 3803 Gettysburg Road C~ _, a r., " _, rr~ `-O , r i-i - ~~ r1 t ~ -j J 4,.~ ` ~ SPSUnd I~ne of address ' -! r -- % _ _ _ t...1 City or Post Office DATE Ftkt"'fJ~'~ State ZIP Code ; ; "'~ = rt '-r-S ~ _ ~ Camp Hill PA 17011 -" ~ ~..;~ tTS ; - 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RES ONSIBLE FOR FILING RETURN DATE. }~ _ /L~/J~ O ~_ _ ADDR S - _ - - _ . 400 Poplar Street, Ne Cu erland, PA 17070 ---- SIGNA, RE O^F PREF'ARER N REPRE~TIVE DATE ADDRESS `~V ~ 3803 Gettysburg Road, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 '\[ 15056052059 REV-150D EX Dece;dent's Social Security Number GLADYS P MATTER ' 164-30-3520 s Name: ozcedent RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. 0.00 5. Cash, BanF: Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 2,129.67 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. 14,537.29 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested...... .. 7. 0.00 R. Total Gross Assets (total Lines 1-7) .................................. .. 8. 16,666.96 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 2,228.02 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........ ..... .. 10. 325.33 11 Total Deductions (total Lines 9 & 10) ................................. .. 11. 2,553.35 12. Net Value of Estate (Line 8 minus Line 11) .................... ....... .. 12. 14,113.61 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. 14,113.61 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____ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 14,113.61 1 g, 635.11 1 7. F•mount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ...................................................... ... 19. 635.11 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 08 0363 DECEDENT'S NAME DECEDENT'Si SOCIAL SECURITY NUMBER GLADYS P MATTER 164-30-3520 STREETADDRESS Mallard Run Apt. 406 820 Lisburn Road __ _ _ - _ _ _ __ _ _ _ - I CITY STATE ~~ ZIP Camp Hill PA ~ 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 635.1 1 2. Credits/Payrnenis A. Spousal Poverty Credit B. Prior Payments 600.00 -- ---_ __ C. Discount - - - Total Credits (A+ B + C) (2) 600.00 3. InterestlPenalty if applicable D. Interest E. Penalty __ Total InterestlPenalty (D + E) 3 0.00 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) 35.11 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 35.11 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 : .................................... ........ ^ c. retain a reversionary interest; or .................................................................................................................. ........ ^ QJ 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? ...... ........ ^ 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 o2~:~h 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)]. 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)]. 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-1503 EX+ (6-98) Y' COMMONWEALTH OF PENNSYLVANIA INHERITANCE= TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER GLADYS P. MATTER 21-08-0363 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedlule F. (If 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 E5TATE OF FILE NUMBER GLAYDYS P. MATTEFZ 21-08-0363 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. Eugene R. Matter B C. JOINTLY-OWNED PROPERTY: 400 Poplar Street, New Cumberland, PA 17070 ~ child ITEM NUIoIBER rETTER FOR JOINT TF_NANT DATE fdADFi JOIN I DESCRIPTION OF PROPERTY INCLUDE NAh9E OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIPAILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET / DF OECD'S INTEREST DATE GF DEATH VALUE OF DECEDENT'S INTERESI ~' A' 01101186 Penna. State Employee's Cretlit Union - C.D. # 0164303520 21,592.30 50 13,796.15 2 A 011011E36 P.S.E.C.U. Checking Acct # 0164303520 ' ,097.83 50 548.92 3 A 011011E36 P.S.E.C.U. Savings Acct. # 0164303520-S7 384.44 50 192.22 TOTAL (Also enter on line 6, Recapitulation) $ 14,537.29 (If more space is needed, insert additional sheets of the same size) HEV-1517 EX+ (i2-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER GLAD'(S P. MATTER 21-08-0363 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL. EXPENSES: ~ ~ Rev. Carl Ford 100.00 2 Funerall_uncheon 279.85 3 Trinity U.M. Women -food service 75.00 a Hoover-E3oyer Funeral Home 330.52 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City .State Y'earjs) Commission Paid: 2. Aftornev Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ,Street Address City State F;elationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Executor's supplies Zip Zip TOTAL (Also enter on line 9, F~ecapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,300.00 131.00 11.65 2,228.02 REV-1512 EX+ t12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER GLADYS P. MATTER 21-08-0363 o.,..,,.r .~ar,r~ . ~~~~~ed by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) pennsylvania SCHEDULE J DEP,~RT"~`NT OE REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER GLADYS P. MATTER 21-08-0363 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DI~iTRIBUT10N5 [Include outright spousal distributions and transfers under Sec. 2116 (a) (1.2).] 1. Eugene R. Matter, 400 Poplar St., New Cumberland, PA 17070 child 33.3% 2 Susan A. A4atter, 322 10th St., New Cumberland, PA 17070 grandchild 33.3% 3 Cathy A. Miller, 618 State St., Lemoyne, PA 17043 grandchild 33.3% I ~' ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 CO'JER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. 6. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON L[NE 13 OF REV-1500 COVER SHEET. $ If more space Is needed, insert additional sheets of the same size. WILL I, GLADYS P. MATTER, of Lower Paxton Township, Dauphin County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do make, publish and declare this to be my last will and testament, hereby revoking and making void any and all wills by me at any time heretofore made. ITEM I. I direct that al_t my lust debts, funeral expenses, and inheritance taxes be paid by my Executor, hereinafter named, as soon after my death as may :be convenient and proper. ITEM II. All the rest, residue, and remainder of my estate, real, personal and/or mixed, of whatever nature and ~~,f •~~ ~ ~~:•~ wheresoever the same may be situate, I give, devise, and ~~ _. bequeath equally unto my son, EUGENE R. MATTER, my grand- daughter, SUSAN A. MATTER, and my granddaughter, CATHY A. ~, ~,,~ - ~~~.::=' a ~~ MA`I"1 ER, share and share alike. In the event either fail to ~~~ survive, the residue shall be divided among the survivors herein named. i1'EM lII. I nominate, constitute, and appoint my son, EUi,E\E R. r1A`1'TER, to be the Executor of this my last will and testament, and, in the event he fails to survive me, I c7 ~; c_. ~ ~ nominate, constitute, and appoint my granddaughter, SU-~~ ~~ -'ate, ~-m [ MATTER, t.o be the Executrix of this my last will and t~,~~~nt...._ ~ C7C7~ (~ C ~ ~ :~ ~ O CT nano ~ nt ~ Hanes. ITEM IV. My personal representative shall ~zot be required to give bond for the faithful performance of said duties in any jurisdiction. IN WITNESS WHEREOF, I, GLADYS P. MATTER, have hereunto set my hand and seal to this, my last will and testament, this n ~~ day of OCTOBER, 1987. ~I~C`j~-~",z ~ Y !i 1 ~ i ~t~t'~`~ ( SEAL ) GLADYS P. MATTER SIGNED, SEALED, PUBLISHED, and DECLARED by the above Testatrix, as and for tier last will, in the presennce of us, who ~,, thereupon, at her request, in her presence, and in the presence ;`. ~.._, f '~,......_..~ ~,, of each other, have hereunto subscribed our names as witnesses. ,~ ~~~ ~~~ } ~~- ~. ,,tip .~ Page 2 cr 2 Pages. COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ss: We, GLADYS P. h1ATTER, ,~K~l~(~ ~. ~jIQ~`~' and _ ~ '-~~-y~Q the testatrix and witnesses, re ec ivel whose names are signed to the attached or foregoing instrument, being >=irst duly sworn do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly and that she executed it as her :tree and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as witness and that to the best o:E our knowledge, the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint o:r undue influence. ~ ~~~ GLADYS P. MATTER Witnes ~,~ t ,~ ~ ,~ '~- ~~ ~~~' ~:~.. ' :~' W i t n~s,~ SUBSCRIBED, sworn to and acknowledged before me by GLADYS P. MATTER, the testatrix, and subscribed and sworn to before me by _E17ELYN J. SLOAT and H. JOSEPH HEPFORD _, the witnesses, on the __ ~~ day oL OCTOBER, 1987 . Notar~ic JACQUfIYN A. ZETTIEMOYER. NOTARY PUBItC HARP„$BURG, DAUPHIN COUNTY MY COMMISSiOM EXPIRES JAN. Z'9. 1941 Member, Pennsylvania Association of Notaries