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Home My WebLink About12-01-08 ®® 15056041046 ^\EV-'I 5OO EX (05-04) OFFICIAL USE ONLY PA Department of Revenue ~ County Code Year File Number Bureau of Individual Taxes ~ ~` INHERITANCE TAX RETURN Dept. 280601 Harrisburg, PA 17126-0601 - ~ ~- RESIDENT DECEDENT ~- ~ t? $ ' ~' ~ 4` ~o ~ ENTER DECEDENT INFORMATION BELOW of Death Date of Birth Decedent's Last Name Suffix Decedent's First Name MI ~"~' (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffx 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 Return +~ 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate !1 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Firm Name (If Applicable) REGISTEl4 b (ILLS US NLY ~ First line of address ,Z .~ Ul- M M I ~ Second line of address City or Post Office State ZIP Code I- ~~ j 7 ~ / ~ a~ ~ 77 ~ T te- ~ C'7 r , T ~. l ~ ~ r~ __ - ~ -- -G -I 1> N DATE FILED V Correspondent's a-mail address: ~~~* ~^°°"* ~ °~° E/~ ~,,o wtC-~~'~~°, t.,( ~~'" Under penalties of perjury, I declare that I have examined this r n, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other han a personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FO ILING R TUR DATE //-/4-~~ - --- ADDRESS ~,,,, THAN DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056041046 15056041046 15056042047 REV-1500 EX 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. ~ C; O o . ~ a 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. - 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. y'~' ~ ~ ~ ~, ~ `~ 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, li< Liens (Schedule I) ................ 10. 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 12. Net Value of Estate (Line 8 minus Line 11) ...........:....:.......... ... 12. t.1 -T ~ 0 O ~ ~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to ta:x has not been made (Schedule J) ..................... ... 13. ~ 3 ~ ~ ,fl J 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. ! % ~' ~ o ° 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 _ ,' 16 17. Amount of Line '14 taxable at sibling rate X .12 ~ ~ `~ ° . `, ° 17. ~ ~ ' ~` . J ° 18. Amount of Line '14 taxable at collateral rate X .15 1 g. - 19. TAX DUE ...................................................... ... 19. ~ ~ ~~ REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 15056042047 ],5056042047 REV-15c/0 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME STREET ADDRESS ,/'JCS (1'\t^''- __ - - _. CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~„ O ~ ~ ~ 2. CrediislPayments - A. Spousal Poverty Credit _. B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable - D. Interest E. Penalty Total InteresUPenalty (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) ~~„ O ~ , ~ ~ 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. Ditl decedent rriake 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 ..................................................:....................................................................... ^ 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 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)]. 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)]. 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.~soa ex . M.ev~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~~' FILE NUMBER ~-~l - ~ ~ -- ~ ~ ~ ;,~ ,~,„ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointy-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~~~. ~~ TOTAL (Also enter on line 5, Recapitulation) I ~ ~ ~ O ~ , 'O ^~ (If more space is needed, insert additional sheets of the same size) REV-1513 tX+ (y-UU) +~ F_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~CI~EDIL~LE J BENEFICIARIES ESTATE OF ~ FILE NUMBER ~l.n-~ -r-'- ~-~- - ~,, ~~ , ~-~- ~ ~.r ~-I - O 8 - O o ~ (~ ~ NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. /- ~ ~ ~. , ~~, ~ ~ f,~ / ti~ 1 ~~~~, r~ R S~~ o ~,. ~.. ,~ i . ~ .~ .~ ~., ~. -, ~4 ~._ .~ ~ ~~. ~: ,_ „t w 1. ..~..-. qq'~~ ~-- ~ ^7 J ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH i6, AS APPROPRIATE, ON REV-1500 COVER SHEET it NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. ~ ~ / ' ~, TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ~ ~ ~ ~~~, tir more space is neeaea, insert atltlitional sheets of the same size) rm 1040 2007 RUTH H MARTIN 195-26-3258 Pa e 2 fax and 38 Amount from line 37 (adjusted gross income) .......................................... 38 45, 34 6 . Credits 39a Check _ if: X You were born before January 2, 1943, Blind• Total boxes Standard I Deduction _ Spouse was born before January 2, 1943, Blind. checked ~ 39a 1 b If your spouse itemizes on a separate return, or you were adual-status alien, see instrs and ck here ~ 39 b 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ..................... 40 4 5 , 9 97 . for - • Peo le who 41 Subtract line 40 from line 38 .......................................................... 41 - 651 . p checked any box on line 39a or 42 If line 38 is $117,300 or less, multiply $3,400 by the total number of exemptions claimed on line 6d. If line 38 is over $117,300, see the instructions ....................... 42 3, 400. 39b or who can be claimed as a 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter •0 . ....................................................... 43 0 . dependent, see instructions. q,q Tax (see instrs). Check if any tax is from: a c 8 Form(s) 8814 b ~ Form 4972 Form(s) 8889 ......................... 44 0 . • All others: 45 Alternative minimum tax (see instructions). Attach Form 6251 ........................... 45 Single or Married ~ Adcilines 44 and 45 ................................................................ ~ 46 0 . filing separately, 47 Credit for child and dependent care expenses. Attach form 2441 .......... 47 $5,350 48 Credit for the elderly or the disabled. Attach Schedule R ..... 48 Married filing 49 Education credits. Attach Form 8863 ....................... 49 jointly or Q l f 50 Residential energy credits. Attach Form 5695 ............... 50 ua l ying widow(er), 51 Foreign tax credit. Attach Form 1116 if required ............. 51 $10.700 52 Child tax credit (see instructions). Attach Form 8901 if required ........... 52 Head of 53 Retirement savings contributions credit. Attach Form 8880 ... 53 household, 54 Credits from: a ~ Form 8396 b ~ Form 8859 c ~ Form 8839 .. 54 $7,850 55 Other credits• a ~ ssoo b ~ Form c ~ F r 55 • 8801 o m 56 Adcilines 47 through 55. These are your total credits ................................... 56 57 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- .................. ~ 57 0 . 58 Self~employment tax. Attach Schedule SE ...................................................... 58 Other 59 Unreported social security and Medicare tax from: a ~ Form 4137 b ~ Form 8919 .................. 59 Taxes 60 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required ................... 60 61 Advance earned income credit payments from Form(s) W-2, box 9 ....................... 61 62 Household employment taxes. Attach Schedule H ....................................... 62 63 Add lines 57-62. This is your total tax ...................................................... ~ 63 0 , Payments 64 Federal income tax withheld from Forms W-2 and 1099 ...... 64 65 2007 estimated tax payments and amount applied from 2006 return ........ 65 4 000 . If you have a ~ 66a Earned income credit EIC qualifying ( ) ................................ 66a child, attach ~ b Nontaxable combat pay election ..... ~~ 66b~ Schedule EIC. 67 Excess social security and tier 1 RRTA tax withheld (see instructions) ....... 67 68 Additional child tax credit. Attach Form 8812 ................ 68 69 Amount paid with request for extension to file (see instructions) .......... 69 70 Payments from: a ~ Form 2439 b ~ Form 4136 c ~ Form 8885 70 71 Refundable credit for prior year minimum tax from Form 8801, line 21 ...... 71 72 Add lines 64, 65, 66a, and 67 through 71. These are your total payments ............................................................ ~ 72 4 , 0 0 0 . Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid ................ 73 9 , 000 . Direct deposit? 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here .. ~ ~ 74a 4 , 000 . See instructions - b Routing number ........ XXXXXXXXX I - c Type: ~~hecking ~ Savings and fill in 74b, - d Account number ....... XXXXXXXXXXXXXXXXX 74c, and 74d or Form 8888. 75 Amount of line 73 you want applied to your 2008 estimated tax ........ ~ 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see instructions ............... ~ 76 You OWe 77 Estimated tax enalt see instructions ....................I 77 Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? .......... X Yes. Complete the following. No Designee's Phone Personal identification Designee name -Preparer no number (PIN) - SI n Under penalties of perjury, I declare that I have examined This return and accompanying schedules and statements, and to the best of my knowledge and g belief, they sire true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your si n;3ture Joint return? g Date Your occupation Daytime phone number See instructions. / DECEASED Keep a copy Spouse's signature. It a joint return, both must sign. Date Spouse's occupation for your records. ~ /---~ Paid Preparer's Use Only Preparer's ' signature Firm's name Vernon M. artin (or yoiuP iy )~ self•em to ed 12 Summi ~ DT Z~Pcodeand DillSburQ Dale 10/03/2008 Check it . , CPA PA 17019 FDIA0112 12/06/07 Preparer's SSN or PTIN P00236811 EIN 04-3698679 Phone no. (717) 7 6 6 - 815 6 Form 1040 (2007) REGISTER OF 1NILLS CUMBERLAND COUNTY PENNSYLVANIA No . 2008- 00466 Estate Of : RUTH H MARTIN CERTIFICATE OF GRANT OF LETTERS PA No . 21- 08- 0466 (First, Middle, Lastl Late Of : UPPER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: WHEREAS, on the 24th day of April 2008 an instrument dated June 5th 200! was admitted to probate as the last will of RUTH H MARTIN _ /First, Middle, Lastl late of UPPER ALLEN TOWNSH/P, CUMBERLAND County, who died on the 15th day of April 2008 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE`, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: ~. VERNON M MARTIN JR who has duly qualified as EXECUTOR(R/Xl ~• ,,.... and has agreed to administer the estate according to law, aII of which ~"" fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal 4M of my office on the 24th day of April 2008. egiste~ o Ills Deputy * *NOT.E* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) WILL --~ OF ~' - ~ ,, _-- n ~ . , , R UTH H. MAR TIN _`~ ~ ~ ~~ N -~ _~~ ~, - _ . I, RUTH H. MARTIN, currently of Upper Allen Township, CumberfanY~ County, _-~ ~~T Pennsylvania, declare this to be my Last Will and Testament, hereby revokirr~any and~ll `~ ' ~ _-- prior Wills and Codicils made by me. I. I direct that all. my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all properly includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath as follows: A. Twenty-one and one-fourth (21'/4%) percent unto my sister, Esther M. Heisey or her issue per stirpes; B. Twenty-one and one-fourth (21'/4%) percent unto my brother, Clarence James Martin or his issue per stirpes; C. The remainder unto the Brethren In Christ Foundation, Grantham, Pennsylvania, to be used as it determines best. IV. I appoint Vernon M. Martin Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my sister, Esther M. Heisey, Executrix of this my Will. V. I direct that no bond be required of my fiduciary for the faithful performance of his duties in any jurisdiction. -1- IN WITNESS WHEREOF, I, RUTH H. MARTIN, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including the attestation clause and signatures of witnesses, this 5~' day of Sc.,v~,~, , 2007. Gfi` SEAL) RUTH H. MARTIN Signed by RUTH H. MARTIN, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this ~"da of ~./ ~.~L., , 2007. - ~..., residing at--~~,, ,~~~_ %~ ~~~L_c.~ ~ ~I.~ ~r r.~~ residing at ~l; .f"~2~~(~11'c.~ C" -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF L~PJ/k~lOtil WE, RUTH H. MARTIN, GERALD J. BRINSER and I~A~7 Ff ~/ ~ . PE`j~.~ S , the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free 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 witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ,° ~i ~ ~ RUTH H. MARTIN TNES S c._. _ ~ WI ESS;~~" Subscribed, sworn or affirmed and acknowledged before me by RUTH H. MARTIN, the testatrix, GERALD J. BRINSER and K 1~71f y l4. ~~t: `~Y~S ,witnesses, this ~ day of ~~~-- , 2007. ~~ ~ (SEAL) tart' Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL WENDY L. CRAWFORD, Notary Public Palmyra Boro., Lebanon County Commission Ex ices Se tember 10, 2009 -3-