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Home My WebLink About06-11-091505607120 --~ REV-15~O EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code near FUe Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.28oso~ 21 0 8 113 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 443 54 1239 09 11 2008 11 19 1952 Decedent's Last Name Suffix Decedent's First Name MI SCHMIEDING WILLIAM R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI KLICK SUSAN M Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW XD 1. Original Return 4. Limited Estate ^ g Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12.82) ~. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Sp ~nPo2v~erttygCr~t'da95~death I.VRRGJrV1`1{JG191 - 11'11) JGV 11V1~ n1VV ~ cat vv~..r r~.rv Name J. RONALDO LEGASPI ESQ. Firm Name (If Applicable) GOLDBERG KATZMAN, P.C. First line of address 320 MARKET ST. Second line of address Pos 1268 City or Post Office HARRISBURG State ZIP Code PA 17108 3. Remainder Return (date of death prior to 12-13-tit) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes ~ ~, Election to tax under Sec. 9113(A) (Attach Sch. O) Daytime Telep umber L.. (717) ~1~. REGISTER OUSE ONLY 4 - - v . , C~ f - ro ~. w Y, -r t Q ~ -~~s~ C1D DATE FILED Correspondents e-mail address: 1 r l@ g o I d b e r g k a tZ m a n. C O m Under penalties of perjury, I declare that.l have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DtadaraUon9f preparer other than the personal representative Is based on all inforrnaGon of which preparer has any knowledge. Susan Marie Klick ADDRESS 2421 Rolling Hills Drive, Mechanicsburg, PA 17055 G . ~. ZOO ~ SIGNA~ OF P THER THAN REPRESENTATIVE DATE ,._, J. Ronaldo Legaspi, Esq. ~~~n/~~ 320 Market St., Harrisburg, PA 17108 Side 1 1505607120 1505607120 J 1505607220 REV-1500 EX oeceaenrsName: William Robinson Schmieding Decedents Social Security Number 44 3 54 12 3 9 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 8 Miscellaneous Personal Property (Schedule E) ................ 5. 7 2 , 7 1 2 . 7 6 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 0 . 0 0 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 7 2, 7 1 2. 7 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 6 , 8 7 5 . 5 1 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 3 , 0 3 4 . 0 0 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11, 1 9 , 9 0 9.51 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 5 2 , 8 0 3 . 2 5 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. 5 2 , 8 0 3 . 2 5 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 2 6, 4 0 1. 6 3 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 6 , 4 01.6 3 1s. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 0.00 1,188.07 0.00 0.00 1,188.07 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-1134 DECEDENT'S NAME William Robinson Schmieding STREET ADDRESS 2421 Rolling H[Ils Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty ifapplicable p. Interest E. Penalty 0.00 Total Credits (A + B + C) Total Interest/Penalty (D + E) 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 (1) 1,188.07 (2) 0.00 (3) (4) (5) 1,188.07 (5A) (56) 1,18 8.0 7 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 :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. x d. receive the promise for life of either payments, benefits or care? .............................................................. x 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?......... ^ ^x 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 exemot 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 (O) 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 decedents 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. Rw-1508 EX+ (8-98) COAMAOIIWFILLTH OF PENNSYLVANIA W NL.RRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Schmieding, William Robinson 21-08-1134 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolndyownad with the right of survNorshlp must bs disclosed on schWule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Decedent's Final Payroll Check - ID: 9000370174 1,364.77 2 PSECU Certificate of Deposit -Valued per attached statement 32.479.57 3 PSECU Checking Account -Checking account in Decedent's sole name valued per 509.47 attached statement 4 PSECU Money Market Account -Valued per attached statement 4.990.66 5 PSECU Savings -Regular share account in Decedent's sole name valued per 68.29 attached statement 6 Antique Violin with Two (2) Bows and case -Valued per attached appraisal 18,150.00 7 Ciothing and miscellaneous -Clothing and miscellaneous personal articles 150.00 8 Sartory Violin Bow -Valued per attached appraisal 15,000.00 TOTAL (Also enter on Line 5, Recapitulation) I 72,712.76 (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-78t0 E7(+ (8-88) SCHEDULE G INTER-VIVOS TRANSFERS 8L MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA e1HERRANCE TA% RETURN RESDENT OECEDEN7 ESTATE OF FILE NUMBER Schmieding, William Robinson 21-08-1134 This schedule must be completed and filed'rf the answer to any of quesUOns 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PR ER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH x of oeco~s ExcLUSION TAXABLE THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE ) VALUE 1 American Funds IRA -Individual Retirement 0.00 0.00 Account No. 6754-8819 held by Decedent at American funds, valued per attached report $ 26,859.79 2 American Funds IRA -Individual Retirement 0.00 0.00 Account No. 6754-8818 held by Decedent at American funds, valued per attached report at $25,800.29 3 Ariel IRA -Retirement Account No. 3249976 held 0.00 0.00 at Ariel Investments, valued per attached statement at $62,991.77 4 Calvert IRA -Retirement Account No. 3249422 0.00 0.00 held at Calvert Investments, valued per attached statement at $7,617 5 Calvert IRA -Retirement account No. 3249976 0.00 0.00 held at Calvert Investments valued per attached statement at $16,124.40 6 Old Mutual IRA -Retirement account no. 5331634 0.00 0.00 held by Decedent at Old Mutual valued per attached statement $2685.13 TOTAL (Also enter on Line 7, Recapitulation) 0.00 (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 G (Rev. 6-98) REV-1151 Ex+ (12A9) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INH~ESDENrDECEDENr N ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Schmieding, William Robinson 21-08-1134 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,140.76 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Susan Marie Klick Social Security Number(s) / EIN Number of Personal Representative(s): Street address 2421 Rolling Hills Drive city Mechanicsburg state PA z;p 17055 Year(s) Commission paid 2,500.00 2. Attorney's Fees Goldberg Katzman, P.C. 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3 500.00 Claimant Susan Marie Klick SUeet Address 2421 Rolling Hills Drive city Mechanicsburg state PA zip 17055 Relationship of Claimant to Decedent SpOUSe 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparers Fees 7. Other Administrative Costs 2,234.75 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 16,875.51 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 Schmieding, William Robinson 21-08-1134 ITEM NUMBER DESCRIP7lON AMOUNT Funeral Expenses 1 Malpeui Funeral Home 5,140.76 H-A Subtotal 5,140.76 Other Administrative Costs 2 Cost of appraisal of Sartory violin bow -Isaac Salchow 500.00 3 Cost of appraisal of violin and two bows - Christophe Landon 216.75 4 Cumberland Law Journal -Legal Advertising 75.00 5 Funeral Luncheon - EI Sol Restaurant 250.00 6 Obituaries -Tulsa, OK newspaper-$350, Harrisburg Patriot News-$500, Yukon, OK 950.00 newspaper-$100 7 Probate fees 88.00 8 The Sentinel Newspaper -Legal Advertising 155.00 H-B7 Subtotal 2,234.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rav-1512 EXa (6-98) cowaoNwEUTN of vENNSnvANw INMERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Schmieding, William Robinson 21-OS-1134 Include unrelmburaed medial expanses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 American Express Credit Card 3,034.00 TOTAL (Also enter on Line 10, Recapitulation) I 3 034 00 (If more space Is needed, addltlonal pages of the same size) ' Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1(Rev. 6-98) REV-151 EX~ (9-00) SCHEDULE J ANIA COM MH R TAL E R BENEFICIARIES IN I NC TAX ETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Schmieding, William Robinson 21-08-1 134 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 t n di ib ti d t f r s u ons, an ra s ers under Sec. 9116(a)(1.2)] Susan Marie Klick Wife 1/2 Residue of 26,401.63 2421 Rolling Hills Drive Estate Mechanicsburg, PA 17055 Ellen R. Schmieding Daughter 1/2 Residue of 26,401.63 34 S. Holman Way Estate Apt. #46 Golden, CO 80401 Total 52,803.26 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)