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HomeMy WebLinkAbout03-09-09 J 15056051047 REV-1500 EX (06-06) OFFICIAL USE ONLY PA Depadment of Revenue Bureau of Individual Taxes s; County Code Year File Number Po Box zeossl INHERITANCE TAX RETURN Harrisburg PA 17128-0601 RESIDENT DECEDENT ~ / Q ~ © 7 ~?Cl' ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 3 8' 7 1 4 j 6-0 7 3 0 6 2 7 2 0 •P 8 0 6 2"0 2 9 1: 9 Decedents Last Name Suffix Dece_dent's First Name MI G art ma n Wil m'e r, ~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW O 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election [o tax under Sec. 9113(A) be4Neen 12-31-91 and 1-1-96) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SH Name OULD BE DIRECTED TO: Daytime Telephone Number P e t e r B Fo s t e r 7 1 7 2 3 4 9 3 2 1 Firm Name (If Applicable) P e t e r B F o s t e r E s q u i r e First line of address 1 1 4 S o u t h S t r e e t Second line of address City or Post Office H a r r i s b u r g State P A ZIP Code c7 ^~ REGISTER O S USE Y ti~ m I_ C7 3 - r- %.7 t_n ! • i~;~ 0 > _~ IV :c DATE FILED 1 7 1 0 1 Correspondent's e-mail address: pBFoster114(eaol oom Under penalties of perjury, I tleclare that I have examinetl 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. SIGNATeER~N RE9ff~J~LE FOR FILING RETURN ,,._~ . 114 South Street, Harrisburg, PA 17101 ADDRESS 114 South Street, Harrisbur¢ PA 17101 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 15056051047 i v_ 1 REV-1500 EX Decedent's Social Security Number oeoade~r's Name. Wilmer Gartman 3 8 7 1 4 6 0 7 3 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. See attached 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. 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 11. Total Deductions (total Lines 9 8 10) ................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ............................ 12. 13. Charitable and Governmental BequestslSec 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at [he spousal tax rate, or transfers under Sec. 9116 (a)(L2) 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. 18. Amount of Line 14 taxable - at collateral rate X .15 ' 18 19. TAX DUE .... ... .......................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~' ~ `~ ~ ~ 15056052048 1505652048 Side 2 1 8 1 7.6 1 O 15256052048 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Wilmer Fred Gartman STREET ADDRESS 2204 Logan Street CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E Penalty Total InterestlPenalty (D + E ) 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. Total Credits (A + B + C) (2) 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. (3) (4) (5) (5A) (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 : ..................................... ....... ^ ^ c. retain a reversionary interest) or .........................................................._....................................................... ....... ^ ^ d. receive the promise for life of either payments, benefits or care? .........................................................._... .....,. ^ ~] 2. Ii 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? ........ ...... ^ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefciarv 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 (O) 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 defned, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. aev-iweex.r~-sr~ SCHEDULE E eommo"wen~moFae""svwnwn CASH, BANK DEPOSITS, & MISC. I"HR soEnciEOECE~ENTR" PERSONAL PROPERTY .STATE OF FILE NUMBER Wilmer Gartman Include the proceeds of litigation and the date the proceeds were received by the estate. All property pintly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH t~ Interest income from investment in United Hardware Distributing Co. $1,527.15 2. Interest income from Northwestern Mutual Life Insurance Co. life insurance policy $137.14 3. Interest income from savings account in PNC Bank, Account 11 004050-0351-4042 $124.72 4• Interest income from Northwestern Access Fund investment, Account 11 611121541 $28.60 TOTAL (Also enter on line 5, Recapitulation) I $ 1 817 61 more space is needed, insect addibonal sheets of the same size) PAVER'y name. atldrass, ann telephone no. United Hardware Distributing Co 5005 Nathan Lane Plymouth, MN 55442 RECIPIENT'S name :mtl address WILMER F. GARTMAN ESTATE %KEITH GARTMAN 2204 LOGAN ST CAMP HILL, PA 17011 PayeYS' RTN (optional) ~ OMB No_ 7545-01 72 t Imerestincamu 2~OQ $ 1,527.15 (UJ 2 Early withdrawal penally $ Form '1099-INT 3 Inlerest on 115. Savings Bonds and Treas. obllgalions income lax withheld G Foreign tan PAVER'S federal identificallon number ~ RECIPIENT'S identification number ~ 8 Tax~xempl Inlerest 41-0640978 ~ 26-6479701 Acnnonl ni,nnber (see instructions) "`MANCH000594 $ Form 1099-INT (keep for your I nstructions for Recipient Account number. May show an account or other uniyue number the payer assigned to distinguish your account. Aox 1. Shows taxable interest paid [o you during the calendar year by the payer. This does not include interest shown in box 3 May also show the total amount of the credits from clean renewable energy bonds and Gulf tax credit hoods that must be included in your ioteresl income. These amounts were treated as p;tid to you during 2005 on the credit allowance dates (March 1 ti, Juue I5, September I5, and December 15). For more infornwtion, sec form 5912, Credits for Clean Renewable Energy mid Gulf Tax Credit Bonds. Box 2. Shows inleresl or principal forfeited because of early withdrawal of time savings. You may deduct this amowrt to figure your adjusted Gross income on your income tax return. See the ins'nuctiuns for Form 1(14(1 to see where to take the deduction. 13ox 3. Shows inleresl on U.S. Savings Bonds, Treasury bills, Treasury bonds, and Treasury notes.'I'his may or may not be all taxable. See Pub. 550, Investment Income and Expenses. This interest is exempt from state and local income taxes. This interest is not included in box I. Box 4. Shows backup withholding. Generally, a payer must backup withhold at a 28°/, rate if you did not famish your taxpayer identification number (T'IN) or you did not furnish the correct T1N to the payer. See Form W-9, Request for Taxpayer Identification Number and Certificatioq for information on backup withholding. Include this amount on your income tax return as tax withheld. Investment expenses 7 Foreign country or U. S. possession 9 Speci(ietl pnvale activity bond inleresl Interest Income Copy B For Recipient Thls is important tax information and is beiny furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be iniposetl on you It this income is taxable and the IRS determines that it has not been reported. of the Treasury -Internal Revenue box 5. Any amount shown is your share of investment expenses of a single-class REMIC, if you file form 1040, you may deduct these expenses on the "Other expenses" line of Schedule A (Form 1040) subject to the 24~ limit. 'this amount is included in box 1. Box 6. Shows foreign tax paid. Yon may he able to claim this tax as a deduction or a crecht on your Form IU40. tine your Fomr ]040 instructions. Box 8. Shows lax-exempt interest, including exempt-inleresl dividends from a muhml fiord or other regulated invcsbnent company, Paid to you during the calendar year by the payer, Repot[ this amount on line Sb of Fonn IU4(1 or Fonn 1040A. This amount may be subject to backup withholding. See box 4. Rox 9. Shows tnx-exempt interest subj ccl to the al teruative minimum tax. This amount is included in box S. See the Htshuctions for Fonn 6251, Alternative Minimum'fax-- htdividuals. Nominees. If this form includes amounts belonging to another person(s), you are considered a nominee recipient. Complete a Form 1099-1NT for each of the other owners showing the income allocable to each. File Copy A of the form with the IRS. Famish Copy B to each owner. List yourself as the "payer" and the other owner(s) as the "recipient." Pile Form(s) 1099-iNT with Form 1096, Annual Summary and Transmittal ofU.S. Information Returns, with the internal Revenue Service Center for your area. On Fonn 1096 list yourself as the "filer." A husband or wife is not required to file a nominee return to show amounts owned by the other. 664 01/28/2009 ~VOk'PIiWFSTIiR~' MUTCAL LIFE INS CO LIEF! I3Y:h6FI7:S IiG I'0 130X ?97? MILWAUFFIS, WI i3?01 7EP94768 1131 ti26t to12 W F' GARTMAN ESTATE KEITH D GARTMAN EXR 2?Od LOGAN ST CAMP HILL, PA 1701 I 01 / 14/?009 IFyou have questions conlacC LIFE RENEFI'PS Phone: 100-635-1155 Ext 7316 Instructions for Recipient Account number. May show an account or other unique number the payer assiynctl to distinguish your arrow nt. Box 5. Any amount shown is your share of investment expenses of a Boz 1. Shows taxable interest paid to you during the calendar year by the payer. This do¢s not inrludc interest sh i singleclass REMIC If you file Form 1040, you may deduct these expenses on the "Other expenses" line of Schedule A (Form 1040) own n box 3. May also show the total amount of the credits from clean renewable ener bo d subject to [he 2 limit This amount is included in box 1. Box 6. Shows foreign [ax aid Y gy n s and Gulf tax credit bonds that must be included in your interest income. These amounts were treated as paid to you p . ou may he able to claim this tax as a deduction or a credit on your Form 1040. See Yuur Form 1040 in t i during 2008 on the credit 'allowance dates IMarch 15 June 15 s ruct ons. , , September t5, and December 151. For more information, see Form 8912, Cretlit for Clean Renewable Energy antl Gulf T C di Box 8. Shows [ax-exempt interest, incluUinq exempt-interest dividends from a mutual fund or other re l i ax re t Bonds. Box 2. Shows interest or principal forfeited because of earl with- gu ated nvestment company, paid to you during the calendar year by the payer. Report drawal of time savings. You may deduct this amount to figure your adjusted gross income on your incom [ may be subject to ba kup Fwiththo0r409 rs or box04 OA. This' amount e ax return. See the inshu4 bons for Fnrm 1040 to see where to take the deduction. Box 9. Shows tax-exempt interest subject to the altorna[ive minimum Box 3. Shows imeres[ on U.S. Savinys Bonds, Treasur bills, Trea- Bury bonds, and Treasury notes This ma o tax. This amount is included in box 8. See the Instructions for Form 6251, Alternative Minimum Tax -Individuals . y r may not be all taxable. See Pub. 550, Investment Income and Expensrs. This interest is . Nominees. If this form includes amounts belonging to another exempt from state and local income taxes. This interest is not in- eluded in box 1. Personlsl, you are considered a nominee recipient. Complete a Form 1099-INT for each of the other ow h Box 4. Shows backup withholding. Generally, a payer must backu ners s owing [he income allocable to each. File Copy A of the form with the tRS. Furnish Copy B to h withhold at a 28 % rate if you did not furnish your taxpayer identif P cation number (TINI or you did not furnish the correct TIN to the eac owner Gst yoursel(as the "payer" and the other ownerlsl as the "recipient." File Formisl 1099-INT with Forrn 1096 Annual payer. See Form W-9, Request for Taxpayer ldantifica6on Number and Certification, for information On backup withholdin In l d , Irnter al Reve~ ueaService iCenterSforfyouraarea. On Form 1~096hlist g. c u e this amount on your income tax return as tax withheld ---- Yourself as the "filer." A husband or wife is not required to file a . nominee return to show amounts owned by the other. TaxablC Slate: PA CORRECTED (ii checked) ' PAVER S name, street address city, state, ZIP code, antl telephone no. North westuR M uluul L i (c Payer's RTN loptionap v rwe Nti. 1 a4s-o 1 t z Lil'e Insurance Company PO BOX 3171 t Inrn~est income n !± ~ ~ G~ I Milwaukee, WI 5320 1-3 1 7 1 $ 137.14 nterest Income PAYER'S huderal idornlficanon number RECIPIENT'S identifiration numb $ Form t099-INT er 3e-o5orls~n a6-6a~mo1 3 Interest on U.S. Savings HO~ds and Treas. obligations -._ cau~ eB -___ RECIPIENTS name, strenr address Gnclutling apt no.l. city, state, and ZlP Code 4 Federal income tax withh ld - For RCtlpient i W ('GARTMAN ES'PA'I'H e 5 Investment expenses eia is im KEITH ll G ARTM A N EX R imm~nau"na„~„ °"na'°m'shed r° n1e X204 LOGAN ST $ $ mrernal ge~Pnu.a CAMP1llLL PA 17011 6 Foreigotax paid J Foreign counvy or LL5- o i Scrvmo l1 yn" a"~ reamrenrorileo~dn~~i. , p ssess on $ n~,yoecnca newlm or 8 Tax~zem tinterest 9 P Specified private activity otl""ano0on "'ay no im o . d -_.-..-___-.. bond inlnresl p - e on ~o~onnn ---.- Account number lseo instrucrionsl L Fy 1 mo. Is r' lie and ,. 36R a ws,remr ns Tar $ n n„not ecru Form 7099-INT g r,.POnea (Keep for yo Department of the Trcasur Imoinal Reve ur records.) v- nue Service BR8029 L000 ,, PNCBANK, NATIONAL ASSOCIATION PU BO% 535230 00001 PITTSBURGH, PA 15253-5230 E.1.N. ~2-1146430 WILMER FRED GARTMAN DECD 2204 LDGAN ST CAMP HILL PA 17011-3848 4D 00857635 For Inquiries Please Call 1-888-762-1099 calendar year _,200.8, ~_~ -_ t Ixp IycTr Id -..~ ll 2_G 6479.701 -~ THIS STATEMENT IS A FORM 1098 OMB NO. 1545-0901, OR A FORM 1098-E OMB NO. 1545-1576, 1099-A OMB NO. 1545-0877, 1099.8 OMB NO. 1545.0715, 1099-C OMB NO. 1545-1424, 1099-DIV OMB NO. 1545-0110, 1099-INT OMB NO. 1545.0112, 1099-MIS[ OMB NO. 1545-0115, 1099-OID OMB NO. 1545.0117 U.S. INFORMATION RETURN 2008 - 1099-INT, INTEREST INCOME ACCOUNT NUMBER BOX 1 INTEREST PERFORMANCE MM 0040 50-0351-4042 BUX 1 INTEREST INCOME .124.72 124.7 TOTAL INTEREST 124.72 PROE AMDI~ FY APF'LV MIN gL1pI1K N~ YOU MA VI~ON LY pEOUCT 61N gMOUNT OFEMOR i6gG INT ER [ST ITONT HE PS TENT~T WgSCiNCOU RR Ep Gy y011 gC}UN.LV PFlIp GY VOU, qNU MUr RFIMRUNSCD BV ANOTH EII VERSO N. f li1ND Vql U(_OFTIIE SECURfp T11E IN I'ORMq}ION IN HO%I S p. g, gplp 3 1§ IM VO RTHNT iq% INLOR MpTION glJp S pCI11G FUFlNISHEp TO }pIE INT EIi IJgL I1 EV EilUE SERVII'f. IF VOU FlRF fIFOUINEp IO I IlC q HETIIRN. A NEGLIG GNCF PLNq LI V OR OTHER SANCTION MAV 9E IMPOSED ON YOU IF TI1E IRS DEI ERMIN E9 THAT qN UNp R2PAYMENf OF IAR IiE5U lT5 AECgUSC YOII OF INTEREST ON YOUR RFIURN. UVERS fgiCp q DFO UCIION FOR THIS MORTG qGG INTEREST OR FOR STUDENT LOAN INTEREST OR FOR TH ES[ VDINtS OR pECAUSE YOU AID NOT REVORT rll6 REPUNO THIS IS IMPORTq NT TA% INFORMATION AND IS BEING FU RNISNEN i0 THE INTERNAL REVENUE SERVICE. IF VOU ARE REQ UIREp 'f0 PILE A RETURN, q NEGI IG F.NCE PF NAL TV OR OiHFH RANI iION MAV ^E IMPOSE N OIJ VOU IF TiI IS INCOME IS iA%gGLE qN0 THE IRS DETERMINE-S THAI li Hq5 PIOi RECN REPOR T[O. 'FOR FOIt MS 1U99pIU~ TIIIS MI1V NOL RF THE CORR EC I FIf URE TO BFPO RI ON YOUR INCOME TqX RETURN. SEE INS (RUCTIONS ON TIIE BgCK. COPY 6 FOR RCCIPIENT . . S i> z ifl s=r v n w x c r a a x a 0 O O W m f i w r J G C V w w 0 O ~- <n v ~, E- LJ is r 4. n i, i l.] 1 ~1 F. b, ^ y rn ci`~_i i~ ~ ~ _~ :a :~: u a F~ m iii tN o ~ :v y k. w i O n ~ 5 n ~ ~ n i" Li w i v ~ ° N ~ ti un ~ s , ~ ~ i ~ ~ in w w r w ll t+ O o ~ i o w ;, Q t] S] ~W m U r I ~ F > a 4 O P ~~ Z ~w ~ ~ c>m 0 ~g N s ,-~ * W W p U O H Z H H f W rn rx W W a EH ~l E~ r 1 i~ F. i ti ~ ~ no ~~ \ F x 5 ~ a W o a 1~ a ~~ x t ti a~ u, N .y ti ti i9 0 0 0 O ~ ~~ ~ y ily : ~ C W~ 2 .a Sys ~l ~ I S ~ J - .~ z a n ~ U 0 F y ~ H a i O CJ W ' i. a `n t a F H z H ~ Q o l7 ~ o u E 5 N ~ i a v H '" a c o r. 0 ti {~ S. La ~ it N of z x ~ H x _' -. l , N ~ s W k I u ~_. R ~ W W F ( "~ N I PETER B. FOSTER, ESQUIRE ATTORNEY AT LAW 114 SOUTH STREET HARRISBURG, PENNSYLVANIA 17101 PETER B. FOSTER March 3, 2009 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17011 TELEPHONE: (717) 234-9321 FAX: (717)234-7832 E-mail: pbfoster114@aol.com Re: Estate of Wilmer F. Gaztman; D.O.D.: 6/27/08 File No. 2008-00770 Dear Sir/ Madam: Enclosed are duplicate supplemental inheritance tax returns for this Estate. Please file these documents. Very truly yours, ~', Peter B. Foster c~ c; c=O . ~~ ? ' T n - ~, ~' ; + -m ~ i " v3~ ~ ~ 1, ~ c c- :~ -F 7v~ N Sri O _ - ~ ' ~~ p N d ~~, ~~ t ~ , ~ /~1 i ~ ~k. ( w~ ~, ~~~~ ~~ P ~~~~,, r' ~ ~ ~,~ (` i ~~~ 9 S ~ i' P ti7' ~, ~,'~ ~ ~~ J ~, Y 5 I' .~. .~ C J ~_ .~ r~ J r_ ~!> v" ~1 ,~