HomeMy WebLinkAbout12-29-08 (2)`, 15056041125
R~ Y -1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
Poeox2aosol INHERITANCE TAX RETURN 2 1 0 7 0 7 7 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1. 8 8 0 5 3 4 7 5 0 8 1 2 2 0 0 7 0 1 1 8 1 9 2 1
Decedent's Last Name Suffix Decedent's First Name MI
D I F F E N D E R F E R M A R I E B
(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
FILIL INAPPROPRIATE 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)
QX 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 TO:
Name Daytime Telephone Number
rya
H A R O L D S I R W
I N
I I I } ; ^,
7 1 7 ~-4, 3 6 ~~ 9 0
'
- - , _..~
Firrn Name (If Applicable)
I R W I N L A W O F F I C E
First line of address
6 4 S O U T H P I T T S T R E E T
Second line of address
City or Post Office
C A R L I S L E
Correspondent's a-mail address: irwinlawoffice~@gmail.com
State ZIP Code
OpILY ,
n~
-,-.
c..~
_~
CT
DATE FILED
j
PA 1 7 0 1 3
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 ~s based on all information of which preparer has any knowledge.
SIGN F PERSON R SP NSIB-L FAR FILING RETURN
1~~~~~~ ~/'~~S~Z%~ ~~~Lr/ DATE
12 //~ / 0~
ADDRESS
24'7 WEST BALTIMORE STREET CARLISLE PA 17013
SIGNA U F PREPARER OTHER RESENTATIVE DATE
12 / /'~' / 0~
64 SOUTH PITT`~TRE~T CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056041125 15056041125
. ;~'
15056042126
REV-1500 EX Decedent's Social Security Number
Decedent's Name: MARIE B. DIFFENDERFER 1 8 8 0 5 3 4 7 5
RECAPITULATION
1. Real estate Schedule A 1. 0 0 0
2. Stocks and Bonds (Schedule B) .................................. 2. 0 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0 0 0
4. Mort a es & Notes Receivable Schedule D
9 9 ( ) ..................... 4.
... 0 0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... ... 5. 1 0 9 2 1 6
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 0 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 0 0 0
(Schedule G) ^ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines 1-7) ........................ ... 8. 1 0 9 2 1 6
9. Funeral Ex enses & Administrative Costs Schedule H
P ( ) ......... g.
....... 5 2 2 7 1 9
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ....... 10. 2 2 9 5 3
11. Total Deductions (total Lines 9 & 10) .................... ....... 11. 5 4 5 6 7 2
12. Net Value of Estate (Line 8 minus Line 11)
..................
.......12. - 4 3 6 4 5 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 0 0
an election to tax has not been made (Schedule J) ........... ....... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ....... 14. - 4 3 6 4 5 6
TA;{ 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.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 0 0 0 16
17. Amount of Line 14 taxable
0
0
0
at sibling rate X .12 17
18. Amount of Line 14 taxable
0
0
0
at collateral rate X .15 18.
19. Tax Due ................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
15056042126 15056042126 J
REV-150G EX Page 3
Decedent's Complete Address:
File Number
0776
DECEDENT'S NAME
MARIE B. DIFFENDERFER
STREET ADDRESS
1 WEST PEMN STREET
APARTMENT 519
CITY STATE ZIP
CARLISLE PA 17013
Tax Payrrlents and Credits:
1. Tax Due (Page 2 Line 19) (~) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (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) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PILEASE 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 : ................................................................. ..... ^ ^X
b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^
c. retain a reversionary interest; or .......................................................................................... ...... ^ 0
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 "intrust for" or payable upon death bank account or security at his or her death? ... ...... ^ 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................................................ ...... ^ 0
IF THE ANSiWER 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-1502 EX + (6-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARIE B. DIFFENDERFER
FILE NUMBER
0776
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
e;<changed between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real roe which is "ointl -owned with ri ht of survivorshi must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE er.t30
TOTAL (Also enter on line 1, Recapitulation) ~ $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1503 EX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Md1R1E B, DIFFENDERFER 0776
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE Qt,fl:~
TOTAL (Also enter on line 2, Recapitulation) ~ $
0.00
(If more space is needed, insert additional sheets of the same size)
REV-1504 EX+i;6-98) SCHEDULE C
CLOSELY-HELD CORPORATION,
COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP OR
INHERITANCE TAX RETURN SOLE-PROPRIETORSHIP
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARIE B. DIFFENDERFER 0776
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporationlpartnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
NONE
0.00
TOTAL (Also enter on line 3, Recapitulation) I $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1507 EX + (1i-98)
COMMON~NEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF FILE NUMBER
MARIE B. DNFFENDERFER 0776
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE 0.®0
TOTAL (Also enter on line 4, Recapitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHE=RITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARIE B. DIIFFENDERFER 0776
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 Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M 8~ T BANK 722.16
Checking Account No. 776173
Value based on bank statement attached as Exhibit "B"
2. 1 WEST PENN APARTMENTS 120.00
Refund of Security Deposit
3.
MISCELLANEOUS PERSONAL PROPERTY
TOTAL (Also enter on line 5, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
250.00
1,092.16
REV-1509 EX + (6-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARIE B. DNFFENDERFER 0776
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVI\/ING JOINT TENANT(S) NAME
A.
B
C
JOINTLY-OWNED PROPERTY:
RELATIONSHIP TO DECEDENT
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OFPROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTERESI
1. A. NONE 0.00 0.00
TOTAL (Also enter on line 6, Recapitulation) I $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX i- (6-98)
COMMOIVWEALTH OF PENNSYLVANIA
INHIERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS 8~
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
MARIE B. DIFFENDERFER 0776
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER.ATTACHACOPYOFTHEDEEDFCRREALESTATE.
DATE OF DEATH
VALUE OF ASSET
%OFDECD'S
INTEREST
EXCLUSION
(IFAPPLICABLE)
TAXABLE
VALUE
1. NOINE 0.00 ®,00
TOTAL (Also enter on line 7 Recapitulation) I $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
SCHEDULE H
COMMOIVWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INFIERITANCETAXRETURN ADMINISTRATIVE COSTS
13ESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARIE B. [IIFFENDERFER 0776
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1, HOFFMAN-ROTH FUNERAL HOME 8~ CREMATORY, INC. - Funera; Expenses 4,631.19
B.
1
2.
3.
4.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s) _
Street Address
City State _
Year(s) Commission Paid:
Attorney Fees IRWIN LAW OFFICE
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State _
Relationship of Claimant to Decedent
Probate Fees REGISTER OF WILLS
5 Accountant's Fees
6. Tax Return Preparer's Fees
7, I REGISTER OF WILLS -Filing Fees for Inventory and Appraisement
Zip
Zip
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
500.00
66.00
30.00
.19
REV-151'L EX + Q12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
MARIE B. DIFFENDERFER 0776
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. COMCAST
Utility Bill
2. I PP8~L
Utility Bills
TOTAL (Also enter on line 10, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
9.82
219.71
229.53
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
REESIDENT DECEDENT
ESTATE OF
MBER
MARIE B. DIFFENDERFER 0776
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 [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. MARK S. KAUFFMAN Lineal
247 West Baltimore Street 1/3 Residue
Carlisle PA 17013
2. JI°_FFREY D. KAUFFMAN Lineal
3:t9 West Penn Street 1/3 Residue
Carlisle PA 17013
3. CYNTHIA A. KAUFFMAN Lineal
30 Reeping Way 1/3 Residue
Oi¢ean View DE 19970
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. NCINE 0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. NONE 0.00
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
I, MARIE B. DIFFENDERFER, of 1 West Penn Street, Apartment 519, Carlisle,
Cumberland County, Pennsylvania 17013, do hereby make, publish and declare this to be my last
will and testament, hereby revoking all wills heretofore made by me.
1. I direct my personal representative to pay all of my debts, funeral and
administrative expenses as soon as convenient after my decease.
2. I authorize and empower my personal representative to sell any realty and/or
personalty owned by me at my death and not specifically devised or bequeathed herein, at public
or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee
simple, as I could do if living. My representative is authorized and empowered to engage in any
business in which I may be engaged at my death, for such period of time after my death as seems
expedient to said representative.
3. I give, devise and bequeath all of my estate of whatever nature and wherever
situate to my grandchildren, share and share alike, the child or children of any beneficiary taking
the share their parent would have taken if living.
4. I nominate and appoint Mark S. Kauffman to be the personal representative of my
e:>tate, to serve without bond. If he cannot or does not serve, then I appoint Jeffrey D. Kauffman
to be the substitute personal representative, also without bond.
5. I suggest that my personal representative retain the services of Harold S. Irwin, III,
Carlisle, Pennsylvania in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ `~~ day of
:March, 1997.
~J.~_ (SEAL)
ARIE B. DIFFEND ER L/"
Signed, sealed, published and declared by the above-named person as and for a last will
and testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
Q~ //,.,
J
ACKNOWLEDGMENT AND AFFIDA VIT
WE, MARIE B. DIFFENDERFER, JOY S. ZERANCE and GAY L. IItWIN, the
testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being
ifirst 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 his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the testator, signed the will as a witness and that to the best of their
~:nowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under
r~o constraint or undue influence.
~,
RIE B. DIFFEIV ERFELI
Z RAN
,-- ' ~.~
~G~AY IN
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
:ss:
Subscribed, sworn to and acknowledged before me by MARIE B. DIFFENDERFER,
the testatrix herein, and subscribed and sworn to before me by JOY S. ZERANCE and GAY L.
IRWIN, witnesses, this 2~~"day of March,
~ NI~eT Ba~ilc
~~
ACCOUNT NO. ACCOUNT TYPE
7'76173 CLASSIC CHECKING
STATEMENT PERIOD PAGE
AUG.04-SEP.03,2007 1 OF 1
00 1 04319M M 021
MARIE B DIFFENDERFER
JEFFREY KAUFMAN POA
1 W PENN ST APT 519
CARLISLE PA 17013-2356
862
HIGH STREET-CARLISLE
ACCOUNT SUMMARY
BEGINNIIG
BALANCE DEPOSITS 8
OTHER ADDITIONS
CHECKS PAID OTHER
SUBTRACTIONS CURRENT
INTEREST PD ENDING
BALANCE
N0. AMOUNT N0. AMOUNT N0. AMOUNT
941.47 0 0.00 1 175.00 4 766.47 0.00 0.00
ACCOUNT ACTIVITY
POSTING
DATE
TRANSACTION DESCRIPTION DEPOSITS,INTEREST
8 OTHER ADDITIONS CHECKS 8 OTHER
SUBTRACTIONS DAILY
BALANCE
08-04-07 BEGINNING BALANCE 5941.47
OS-06-07 CHECK NUMBER 5270 175.00
08-06-07 MONUMENTAL LIFE INS PREM 18.80
08-06-07 MONUMENTAL LIFE INS PREM 13.51
OS-06-07 THE SENTINEL RENENAL 12.00 722.16
OS-21-07 CLOSEOUT 722.16 0.00
ENDING BALANCE 50.00
CHECKS PAID SUMMARY
5270 08-06-07 175.00
L008A (6/07)