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Home My WebLink About03-05-09 (2)1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 Harrisburg, PA 1712t3-o6o1 RESIDENT DECEDENT 2 1 0 8 0 6 3 5 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 172 34 4814 06 05 2008 09 15 1943 Decedent's Last Name Suffix Decedent's First Name MI MULLER MELINA M (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 X^ 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise ^ ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) g. Decedent Died restate ^ T. Decedent Maintained a Living Trust 1 8. Total Number of Safe De (Attach Copy of Will) (Attach Copy of Trust) posit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 1231-91 and i-1-95) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number NEIL W. YARN ESQ. 717 533 3280 Firm Name (If Applicable) JAMES, SMITH, DIETTERICK & CONNELLY, L First line of address 134 SIPE AVENUE Second line of address City or Post Office HUMMELSTOWN Correspondent'se-mail address: nwY~1SdC.COm State ZIP Code PA 17036 ~~ N w t-t~ ~? ~~:~ '-=i ~... ,;`-y c ~,~-1 "T~ 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. SIG~ATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE , ., n / 7 , Meegan Muller 4 is Valley Road, Andover, NJ 07821 RePtARER OTHER THAN REPRESENTATIVE Neil W. Yahn Esq. REGISTER OF WILLS USE ~LY o ~~ ~ ~n - ."Y~7 .a7 r ` ' t11 ~ - ~ C? -z-t DATED DATE 3~z~~~, 134~ipe /jlvenue, Hummelstown, PA 17036 1505607120 Side 1 1505607120 J 1505607220 REV-1500 EX Decedent's Social Security Number Decedents Name: M e l i n a M. Muller 17 2 3 4 4 814 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2 3 0, 4 0 9. 2 0 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 1 2 6, 5 4 4. 8 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits 8~ Miscellaneous Personal Pro e p p rty (Schedule E) ................ 5. 1 0 , 4 3 1.16 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 3 6 7, 3 8 5. 2 0 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 4 , 2 6 4 . 0 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 2 9 , 16 4 . 5 2 11. Total Deductions (total Lines 9 8~ 10) ...................................................................... 11. 5 3 , 4 2 8 . 5 7 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 3 1 3 , 9 5 6 . 6 3 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. 3 1 3 , 9 5 6 . 6 3 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 .o0 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable at lineal rate x .045 3 13 , 9 5 6 . 6 3 16. 14 , 12 8 . 0 5 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. 1 4 , 12 8 . 0 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0635 DECEDENT'S NAME Melina M. Muller STREET ADDRESS 3 Creekside Lane CITY Camp H[II STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable p. Interest E. Penalty 0.00 Total Credits (A + B + C ) (1) 14,128.05 (2) 0.00 (3) (4) (5) 14,128.05 (5A) (56) 14,128.05 Total Interest/Penalty (D + E,l 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. 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 reversignary interest; or .................................................................................................................. ^ 0I~ d. receive the promise for life of either payments, benefits or care? .............................................................. ^ u 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?......... ^ x^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ x^ 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)]. 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. Rev-1502 EX+ (8-86) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 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 exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real properly which is Jolndy-owned with right of survivorship must be disclosed on schedule F. tlr more space Is neeaea, aaalnonal pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev-1503 EX+ (8.96) SCHEDULE B STOCKS 81: BONDS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 All property jolntlywwned with right of survlvorshlp must be dlaclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 330 shares of CISCO Sys Inc held in Smith Barney 27.235 8,987.55 Account No. 277-007892-1-4-290 -valued per public listing 2 27 shares of Citadel Broadcasting Corp held in Smith 1.74 46.98 Barney Account No. 277-007892-1-4290 -valued per public listing 3 100 shares of Foundry Networks Inc held in Smith 13.68 1,368.00 Barney Account No. 277-007892-1-4-290 -valued per public listing 4 38.6739 shares of General Electric Co held in Smith 30.8 1,191.16 Barney Account No. 277-007892-1-4-290 -valued per public listing 5 Legg Mason Partners Government Securities Fund 5.16 Class A held in Smith Barney Account No. 277-007892-1-4-290 -accrued dividend 6 1,508.265 shares of Legg Mason Partners Government 9.44 14,238.02 Securities Fund Class A held in Smith Barney Account No. 277-007892-1-4-290 -valued per public listing 7 403.6771 shares of MFS Multimarket Incm Tr SBI held 5.83 2,353.44 in Smith Barney Account No. 27T-007892-1-4-290 - valued per public listing 8 150 shares of Microsoft Corp held in Smith Barney 27.95 4,192.50 Account No. 277-007892-1-4-290 -valued per public listing Total of Continuation Schedule See attached page TOTAL (Also enter on Line 2, Recapitulation) 126,544.84 (Ir more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-7503 EX+ (6-98) SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Muller, Melina M. 21-08-0635 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 9 3,092 shares of Pennsylvania Commerce Bankcorp Inc 26.525 82,015.30 - common shares -valued per public listing 10 200.0502 shares of Walt Disney Co held in Smith 34.405 6,882.73 Barney Account No. 277-007892-1-4-290 -valued per public listing 11 200 shares of Yahoo Inc held in Smith Barney Account 26.32 5,264.00 No. 277-007892-1-4-290 -valued per public listing TOTAL (Also enter on Line 2, Recapitulation) 126,544.84 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (~ga) SCHEDULE E CASH, BANK DEPOSITS, 81: MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 Include the proceeds of litigation and the date the proceeds were received by the estzte. All property jolntlyowned with the right of survivonhlp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Sovereign Bank Checking Account No. 2331032742 -valued per letter dated 9/16108 1,970.80 2 Miscellaneous personal property -valued per Executrix 500.00 3 Cash held in Smith Barney Account No: 277-007892-1-4-290 -valued per letter 7,092.77 4 Cash held in Smith Barney Account No. 277-007892-1-4-290, accrued interest - 0.15 valued per letter 5 Coins found in safe deposit box -valued at face value 251.50 6 United States Treasury -stimulus check 600.00 7 West Shore Tax Bureau - 2008 indvidual income tax refund 2.46 8 West Shore Tax Bureau - 2007 indvidual income tax refund 13.48 TOTAL (Also enter on Line 5, Recapitulation) I 10.431.16 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+(12-99) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INRESDENTEDECEDENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 4,949.07 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees James, Smith, Dietterick 8~ Connelly, LLP 15,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip _ Relationship of Claimant to Decedent 4. Probate Fees 410.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 3,904.98 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 24,264.05 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Neill Funeral Home -funeral services 4,949.07 H-A subtotal 4,949.07 Other Administrative Costs 2 Arcadian Lawn Care -lawn maintenance 348.48 3 AT8~T Consumer -telephone service for residence 101.32 4 ATB~T Consumer -telephone service for residence 148.52 5 ATBT Consumer -telephone service for residence 48.79 6 Comcast -cable service for residence 167.39 7 Comcast -cable service for residence 68.52 8 HB McClure - furance repair 661.25 9 James, Smith, Dietterick 8~ Connelly, LLP -reservation for estate administration 200.00 closing costs 10 PAWC -water service for residence 63.46 11 PAWC -water service for residence 45.63 12 PPL -electric service for residence 171.42 13 PPL -electric service for residence 47.41 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Muller, Melina M. 21.08-0635 ITEM NUMBER DESCRIPTION AMOUNT 14 Register of Wills, Cumberland County -filing fee for Return & Inventory 30.00 15 Registrar and Transfer Company -loss certificate fee 393.91 16 Smith Barney -annual fee 100.00 17 State Farm Insurance Co -homeowners insurance premium 590.00 18 UGI -gas service for residence 82,25 19 UGI -gas service for residence 70.24 20 UGI -gas service for residence 566:39 H-B7 Subtotal 3,904.98 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1512 EX+(6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Accounts Recovery Bureau - unreimbursed medical bill -Pinnacle Health 214.00 2 American Express -credit card account ending in 04002 2,473.21 3 American Express -credit card account ending in 52001 1,109.64 4 AT&T Consumer -telephone service for residence 105.21 5 Bloomingdales -credit card account 1,110.98 6 Bon Ton -credit card account 622.36 7 Capital Blue Cross -health insurance premium 390.84 8 Comcast -cable service for residence 106.68 9 Daimler Chrysler -automobile lease 9,417.75 10 Estate Recoveries Inc. -Saks credit card account 470.47 11 FIA Credit Services -credit card account 8,055.78 12 Gloria Hassman -needlework commissioned prior to death 307.86 13 Macys -credit card account 627.85 14 Nordstrom -credit card account 557.41 15 PA Department of Revenue - 2008 individual income tax 326.00 16 PAWC -water service for residence 84.00 17 PPL -electric service for residence 303.55 I Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 29,164.52 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (8-88) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Muller, Melina M. 21-08-0635 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Muller, Melina M. 21-08-0635 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not Llst Trus s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)) 1 Meegan Muller Daughter 156,978.32 4 Columbia Valley Road Andover, NJ 07821 2 Molly Muller Daughter 156,978.31 188 Salvas Drive Morrisville, VT 05661 Total 313,956.63 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T,4X IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTA L OF PART II -ENTER TOTAL NON-TAXAAI F r)ISTRIRI ITIr1NR C1N 1 ItiF 1 ~ nG oGV_~ inn rnvrD cu~~~r n nn Copynght (c) 2002 form software only The Lackner Group, Inc. ~ Form PA-1500 Schedule J (Rev. 6-98)