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HomeMy WebLinkAbout08-10-09 (3)--~ REV-1500 1505607120 PA Department of Revenue ~ (06-05) Bureau of Individual Taxes OFFICIAL USE ONLY PO BOX.280801 INHERITANCE TAX RETURN ca,mY code veer Fila Numper Harcisburg, Pq 17128-0601 RE3IDENT DECEDENT 21 p 8 ENTER DECEDENT INFORMATION BELOW 0 1 12 7 Social Security Number Date of Death Date of Birth 209127834 11082008 Decedent's Last Name 0 2 2 619 2 7 D I L LMAN Suffix Decedent's First Name MI PAUL (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 FILL INAPPROPRIATE OVALS BELOW REGISTER OF WILLS ® 1. Original Retum ^ 2. Supplemental Return ^ 3. Remainder Retum (tlate of death ^ 4. Limited Estate ^ qa. Future Interest Compremise Prior to 12-13-82) (eats or deem crier ta12-92) ^ 5. Federal Estate lax Retum Required ^ B. Detxtlent Died Testate (Anecn Copy M Will) ^ ~' (AD HetleC PY o Trust a Living Tmst O _.___._ e. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Receivetl ^ 1D Spousal paverry credit (seta a deem C Eetween 12x1-B1 antl 14-95) ^ 71, Election t0 tax under Sec. 9113(A) NarReESPONDENT • (Attach Sch. O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: DEBRA R. WALLET Daytime Telephone Numtxr Finn Name (If Applicable) 717 7 3 713 0 0 LAW OFFICES OF DEBRA R. WALLET REGISTER OF WILLS USE ~MLV First line of adtlress CC'-~> ~O .°o --, 24 NORTH 32ND STREET ~^'~ ~ ~zc~ ~ ~ ~_ 3eeond line of address ~,~ 7 nT r ' _ -°rn~ O ''Tl "C7c7 ~ City or Post OfFlce U ~~ -'~ -~ - ,~, CAMP $ I L 1, Smote ZIP Code DATE ED _ --, PA 17011 ~ o ''% rn correspondene'se-mall address: walletdeb~aol.com Under penaMiea M perjury, I tledare that I have examined this return, indudin a it is true, contact antl complete, Declaration of preparer other than the personal Pre resentatiive Is~based on eldl In~foMnrmiet,o^~of whchhprepasrerf has anYO k w ledge. S/IG~NATURE OF PERSON RES~PO~NS,IB~~L-E~.JO(~~R F}I`L/I yNG~RETURN Y ge and belief, A~ pRES ~ - - - B@tt~r M. BrUbal(e- DATE 8 7 ~ D 6 1303 Kelton Road, Camp Hill, PA 17011 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~~ Debra K Wallet DATE \DORFCc 24 North 32nd Street, Camp Hill, PA 17011 L Side 1 1505607120 1505607120 J ~~ G~ ~~ ~~` ~~ ' v ~ ? ~ /~ l_ _1 1505607220 REV-1500 FJ( __°eCe°e"''N81"a DILLMAN, PqV~ Decedent's Social Security Number RECAPITULATION --- ----------.____,_.__ 2 0 9 12 7 8 3 4 1. Real Estate (Schedule A) .................................... ___ ...................................................... 1. 2. Stocks and Bonds (Schedule B) ............................ ................................................... 2. 3. Closet' 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. 6. Jointly Owned Properly (Schedule F il i 7 Re I t ^ 69,776.64 e ~ . n quested ............. 5. er-Vivos Transfers & Miscellaneous Non -P obate pr p (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1 7) ...... - _ - 6. 9. Funeral Expenses d Adminishatrve Costs (Schedule H) ....... - 69,77 - - 6 • 6 4 ......... s. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ...... 13,232.75 .......................... 1p. 11. Total Deductions (total Lines 9& 10) ................................. 2 2, 3 2 9. 6 9 ..................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . 35,562.44 ............... .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........... 3 4 , 2 1 4 2 0 ...................................... 1a 14. Net Value Subject to Tax (Line 12 minus Line 13) .............................. 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 .00 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 74 taxable at sibling rate X . t2 18. Amount of Line 14 taxable 6 , 8 4 2 at collateral rate X .15 27,371. 19. Tax Due......_. ................ 14. 15. 16. 8 4 n. 3 6 16. ................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L 1505607220 Side 2 1505607220 34,214.20 821.14 4,105.70 4,926.84 J REV-1500 EX page 3 Decedent's Complete Address: Dillman, Paul 3520 September Dr., qpt, 3 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty FIIe Number y1 . Og _ 01127 STATE - _ !ZIP -------- PA 17017 (1) 4,926.84 Total Credits (A + B + C) 4. If Line 2 is greater than Line 1 + Total InteresVPenalty (D + E) Line 3, enter the difference. This is the OVERPAYMENT. 5. If Line 1 + Line 3 is greater thatn L ne 2, ante tithe differencetoTh~isri$ the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + gq, This is the BALANCE DUE. Make Check Payable to: REG/STER OF W/LLS, AGENT sasb:~~ K,x..~.~..a_...___ (2> 2,831.58 (5> 2,295.26 (3> 0.00 ------- (4) (5A) - ------- - _- - (5B> 2,295.26 ___._._w.~,n,,,~~„ ,u,~P,n mss. tt~. .~ti~t~k~dl~~ki=~';i4~'~i~ll`nu~it~tii;'t~ti,~,~~t LEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred :............ Yes I Xo b. retain the right to designate who shall use the ro any ~ ~~ ~ _, ............................................... x ~. P P transferred or its income :.................................... ~ ~ ~ ~~ c. retain a reversionary interest; or ...................... d. receive the promise for life of either aments, benefits or carpe?.P..~.~~nin ~one~year~of~death~without ~.-JI 2. If death occurred after December 12, 1982, did decedent transfer roe ~ x receiving adequate consideration? ................ ~ X- .................................................. _ ............................................ ! J ix 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 ro ~ r eontainsabeneficiarydesignation? ................... P perry which ~ `x~ .................................................................................. I i -, IF THE ANSWER TO ANY OF THE ABOVE gUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~X' For dates of tleath on or after Juty 1, 1894 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 p2 P.S. §9116 (a) (1.1) (i)]. (0) Percent [72 P.S. §9116 (a) (1.1 )]. 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 (ii The statute does n t exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still appkceble even if the surviving spouse is the only beneficiary. For dates of death on or after Juty 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one natural parent, an adoptive parent, or a stepparent of the child is zero 0 e ( ) P rcent [72 P.S. §9116 (a) (1.2)1 The tax rate imposed on the net value of transfers to or for the use of the decedent's linear) bane( c ariesU S9ouraandaone-haH (4.5) percenta except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. sibleing is definePd under Segiont9102, as an~ndivitltual who has at least one parent nscelmmon wtith Ithe decedent, whether by blood or adoption. ( ) percent p2 P.S. §9116 (a) (1.3)l. A 2,500.00 5131 58 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEKTN OF PENNEVLVgryIN INNEgITp~CE TPX gETUgry PERSONAL PROPERTY gESIDENTOECEDENT - - --- -- -J----_ ESTATE OF Dillman, Paul --- ~ ---- -- ~ FILE NUMBER ----------- - ' 21 - OS - 01127 Include the proceeds of litigation and the date the proceeds were received by the estate. All ro survivorship must be disclosed on schedule F. P party jointly-owned with the right of -___ _ __---- _ ITEM ---- NUMBER - --_-_ __ ---__ _____ DESCRIPTION 1 M&T Bank Acct. #015004216637776 2 M&T Bank Acct. #28543386 3 1998 Ford Taurus (proceeds from actual sale) 4 Furniture in apartment (proceeds from actual sale -items not sold were donated to charity) 5 Erie Insurance refunds 6 Comcast Cable refund 7 PP&L refund 8 Union Fidelity refund 9 Blue Shield refund (Dodson & Chase LLC) 10 Virginia Surety insurance refund VALUE AT DATE OF DEATH - _ 25,291.41 41,505.75 2,000.00 625.00 78.00 114.50 76.06 20.53 3.06 62.33 -- _ TOTAL (Also enter on Line 5, Recapitulation) - 68,776.64 CdAMONWEIITN OF PENNEVLVµIA INMEgRµCETPx gENRN gE81DENT DECEDENT ESTATE OF Dillman, Paul Debts of decedent must be ITEM ~ --------- NUMBERFUNERALFroeuc A. H -~FUtCRALD~p~g -- -_ -_---------I--- __ i FILE NUMBER on Schedule I. ------ --------_ 21 _ 08 - 01127 - ----_ 1 ~ Myers-Harner Funeral Home, Inc. 1903 Market St., Camp Hill, PA 17011 B• ~IADMINISTRATIV E COSTS: ~~ i Personal Representative's Commissions ~ Social Secudry Number(s) / EIN Number Street Adtlress City ~-~ Year(s) Commission paid 2 ~ A Personal State - Zi- p ~- -- 7------_- ---__ AMOUNT -----._._------- 7,714.00 ttorneys Fees Debra K. Wallet, Esq. 3. ~ Family Exemption: (If tlecedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ciry Relationship of Claimant to Decedent State Zip ~~~' 4. Probate Feas 5. ' Accountant's Fees s• '~ Tax Retum Preparer's Fees H & R Block 7. ~ Other Administrative Costs 1 ;Storage Depot West (furniture storage) i -__ TOTAL (Also enter on Ilne 9, Recapltulatlon) - -- - 4,500.00 169.00 158.00 328.60 DESCRIPTION ~,wc. r a ALTH OF Pen ESTATE OF Dillman, Paul SchedlleH Acirtitis4slhle Costs oantlnl,ed FILE NUMBER --- ` --_ ~ Postage, photocopies, mileage, etc. -- ---__ ~ 21 - 08 - 01127 --L ---- 3 ~ Camp Hill Apartments move out fee 50.00 4 ~ The Patriot News (Estate advertising) 128.63 5 !Cumberland Law Journal (Estate advertisin I 109.52 ~ 9) 75.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONV/F.gLTN OF PENNBYLVMIIR INNERRANCETPX gEiUgN LIABILITIES, & LIENS RESIDENT DECEDENT --- I ESTATE OF Dillman, Paul Include unreimbureed medical expenses. ITEM - -------- NUMBER 1 Podiatry Group - 2 Camp Hill Apartments (rent) DESCRIPTION 3 I PP&L (electric) 4 ~ Verizon 5 ~ Comcast Cable 6 I Dodson Chase, Attorney (for Golden Living Center bill for wife, Geraldine) (see attached letter) 7 US Treasury (2008 final income tax return) 8 Pulmonary & Critical Care Medicine Associates FILE NUMBER - -- _ - - 21_ OS - 01127 ----- AMOUNT -------3.06 70TAL (Also enter on Line 10, Recapitulation) 936.88 186.66 93.65 116.41 19,232.08 1, 721.00 39.95 22,328.ti9 REV-161J EX~ (S-00) COMMONWEgLTH OF PENNSYLVANIA INHERITANCE TAX RETNRN RESIDENT DECEDENT ESTATE OF -- Dillman, Paul NUMBER ~ NAME AND ADDRESS OF PERSON(S) SCHEDULE) BENEFICIARIES FILE NUMBER --- I RELATIONSHIP TO ~ -~ _-~- 21 - 08 - 01127 SH - - -------__.____ _ -RECEIVING PROPERTY ~ DECEDENT --_____ Do NOt LIN Tru~IN(~) j ~ TAX '~ ARE OF ESTATE iAMOUNT OFESTATE ~ (WOfd3) ($$ _ , ABLE DISTRIBUTIONS[include outright s ousel -r - distributions and transfers I $) ~ -- 1 _ J - _ - - under Sec. X118 (a) (1.2)] ~ 1 ~ Betty M. Brubaker 1303 Kelton Rd. i Sister Cam Hill PA ' 1/5 of residuary p , 17011 ~ Estate 2 ~ Audrey D. Dillman t 7322 Byeforde Ct. ~ Niece i 1/15 of residuary Springfield, VA 22150 ~ Estate 3 ;Craig Dillman 175 West Rd. i Nephew Beacon F ll 11/15 of residuary a s, CT 06403 !Estate j Enter dollar amounts for disMbutions shown above on lines 15 through 18 as I ~ , appropriate, I](, iNON-TAXABLE DISTRIBUTI ONS: on Rev 1500 cover ~ sheet ~A. SPOUSAL DISTRI BUTTONS UNDER SECTI ~ NOT BEING M ON 9113 FOR WH ADE ICH AN ELECTION TO TAX IS I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ITI17•u .. __ ~. -- -~ • ^~-~ ~~ - orv I en I OTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, 0.00 • REV.1 ti1J EX. 180) ESTATE OF Dillman, Paul SCHEDULE) BENEFICIARIES continued NUMBER NAME AND ADDRESS OF PERSON(S) - ---___I__.__-_ .RECEIVING PROPERTY j, i TAXABLE DISTRIBUTIONS [inGude outright spousal distributions antl transfers under Sec. X116 (a) (1.2)] 4 i Karen B. Reynolds ~ HC62 Box 376 Colica Rock, AZ 72519 5 ~ Loretta Kiely 1500 Woodcrest Ci. Harrisburg, PA 17112 6 i Theodore Dillman i 4276 N. 6th Street Harrisburg, PA 17110 7 ;Joseph A. Magaro ~ 5144 Limewood St. i Knightsdale, NC 27545 8 !Ronald Crawford (address unknown) 9 i Teens Hittie 4571 Admira Rd. Thomasville, PA 17364 i --- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Do Not Niece Niece Nephew Nephew Nephew Niece _____ -_ __ _ _ -- i FILE NUMBER _ 21-08-01127 TO i SHARE OF ESTATE j AMOUNT OF ESTATE q i (Wortls) ~ (~$) ___-. -1-. -__ -- _-- ~I 1/15 of residuary Estate ~ it 1/10 of residuary i Estate ~ 1/ 10 of residuary ii Estate i 1/10 of residuary Estate 1/10 of residuary i Estate ~ 1/5 of residuary Estate i Page 2 of Schedule J DODSONCHASE G'~ ATTO R N EY5 AT LA\u L: 13x1.~~ Duoso~, Ea;. nul )t ),a 1 V ~I )I In51 )\'cl ~ i>.I'..U 1\I December 15, 2008 Estate of Paul Dillman Betty Brubaker, Exec. 1303 Kelton Road Camp Hill, PA 17011 Cw!1 ~I:,\ D Cn.iv:, Esp. ~ cFl>SI~ ., N,~n Ltv T. (;uns'r, Es11. t~ {LL~DIIU41NIJh1.i9Gf11AI ~\f:Ll {y11r4,iDU1)`UNLVIddP_C1I~11 .µ-~ J ~ gl®~ RE: Refund and Receipt of Payment ©a ~'~ P~) Dear Ms. Brubaker: ~ ~~ ~~ Please find the enclosed check for~3.06 for the refund reouested. Also I am writin I did receive you payment for the Golden Llvmg Center balance and I have forwarded your check o he billing agent overseeing that account. Finally, in regard to the cash payments made by Mr. Dill, 1 ~v~lc~~ ~~ g ~ # ~~ O were received and attributed to his balance. that those a ments CPS- ~- ,~~ ~[ .~,~ Should you need anything further, please do not hesitate to contact me. Since/rely 'V Nathan T. Chase, Esq. North Paxk Office • 98G0 \lclinigh[ Rd. • Building A • juire 332 • Pittsburgh, PA 1523? Phone: (41T 635-9314 • Fax: (412) 635-9358 • an*.M1VDodsonChase.com Enclosure