HomeMy WebLinkAbout09-04-09-~ REV-1500 1505607120
EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County iode Year File Number
PO 80X.280601 INHERITANCE TAX RETURN 2 1 0 8 0 12 8 3
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12072008 03141927
Decedent's Last Name Suffix Decedent's First Name MI
TIMINSKY MATTHEW
(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
® 1. Original Return ^ 2. Supplemental Retum ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. limited Estate ^ qa, Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-92)
1
® g 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 ^ 1 p. 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
CRAIG A. DIEHL, ESQUIRE, CPA 71776376 ~ c
C c>
Firm Name (If Applicable) -q-; ;=`
LAW OFFICES O F CRAIG A . DIEHL REGISTER OF WI ~ ~ ONL~rj ~-j ;_
First line of address
3464 TRINDLE ROAD
Second line of address
City or Post Office
CAMP HILL
State ZIP Code ~-
PA 17011-4436
Correspondent'se-mail address: cdlehl@CadiehllaW.COm
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DATE FILED
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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, co ct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUR F PERSON SPONSIBLE FOR FILING RETURN DATE
Beth E. Fisher 9-3 -D 9
ADDRE ~
1788 Winterhaven Drive, Mechanicsburg, PA 17055-5191
SIGNATURE OF PREPARER 1ER HAN REP~SENTATIVE - DATE
Craig A. Diehl, Esquire, CPA
ADDRESS // " / " { T
3464 Trindle Road, Camp Hill, PA 17011-4436 /
Side 1
1505607120 1505607120
REV-1500 EX
oecede~t~s Name: T I M I N S K Y, M A T T H E W
Decedent's Social Security Number
RECAPITULATION
256,100.00
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.
172,795.45
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5.
10,157.50
6. .
Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ . 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 4 4 9, 1 6 1. 3 6
(Schedule G) ^ Separate Billing Requested ............ . 7.
g, Total Gross Assets (total Lines 1-7) ...................................................................... . g, 8 8 8, 2 1 4 3 1
66,663.19
9. Funeral Expenses & Administrative Costs (Schedule H) ........................................ . 9.
10,304.32
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... . 10.
7 6 , 9 6 7 5 1
11. Total Deductions (total Lines 9 & 10) ..................................................................... . 11 •
12• Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12.
811,246.80
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................ . 13.
811,246.80
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 the spousal tax rate, or
transfers under Sec. 9116
(a){1.2) X .00 15.
16. Amount of Line 14 taxable $ 1 1 , 2 4 6 8 0 16 3 6, 5 0 6. 1 1
at lineal rate X .045 .
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. 3 6. 5 0 6 1 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
1505607220
Side 2
1505607220 1505607220
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 08 - 01283
DE E NAM
Timinsky, Matthew
STREET ADDRESS
Room 32, Wagner Street
100 Mt. Allen 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 if applicable
p. Interest
E. Penalty
32,300.00
1,700.00
Total Credits (A + B + C)
(1) 36,506.11
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.
(2) 34,000.00
(3) 0.00
(4)
(5) 2,506.11
(5A)
(5B> 2,506.11
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 :.................................................................................. ^ ^x
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? .............................................................. ^ x^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................................................................... ^ ^x
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 (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.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX. RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
FILE NUMBER
ESTATE OF Timinsky, Matthew 21 - 08 - 01283
All real property owned sole)y or as a tenant in common must be repported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a wiling seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 I Primary Residence - 1467 Lakeview Drive, White Haven, PA 18661
(See Attached Appraisal)
256,100.00
TOTAL (Also enter on Line 1, Recapitulation) ~ 256,100.00
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CONIMnNWEALTH pF ?ENNSYLVA.NLO.
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Timinsky, Matthew ~ 21 - 08 - 01283
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 PNC Bank -Interest Checking Account 33,034.67
2 Refund from Wesley Village United Methodist Homes 2,088.00
3 Refund from Verizon 6.54
4 Veteran Benefit Burial 100.00
5 PNC Money Market Account (4 CDs) 130,843.56
6 Gross Proceeds from Public Auction 1,705.25
7 Refund from Auto Insurance Policy 24.00
8 Seven (7) $2.00 U.S. Dollar Bills 14.00
9 Three (3) $1.00 U.S. Silver Certificates 6.00
10 First National Bank Corporation 198.44
Checking Acct # 701595019
11 Refund from Montour Home Oil 811.99
12 Refund from Travelers Home Insurance 494.00
13 Auction of Antique Toys, Trains, and Games 3,457.00
14 Refund from PA Dept. of Revenue -Personal Income Tax 12.00
TOTAL (Also enter on Line 5, Recapitulation) I 172,795.45
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Timinsk ,Matthew FILE NUMBER
Y 21 - 08 - 01283
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
Maria H. Lombard
q 26 Holcomb Road
Shavertown, PA 18708 Granddaughter
Nicholas M. Lombard
g 26 Holcomb Road
Shavertown, PA 18708 Grandson
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT C~~SCRIPT.IO~C~F PRO~ER~Y
Include name o Inanclal ms I u Ion an ban 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 INTEREST
1 A Prior to One (1) U.S. Savings Bond Type HH - $5000.00 5,000.00 50% 2,500.00
12/7/2007 Denomination
Maria H. Lombard -Joint Owner
2 B Prior to One (1) U.S. Savings Bond Type HH - $5000.00 5,000.00 50% 2,500.00
12/7/2007 Denomination
Nicholas M. Lombard -Joint Owner
3 A Prior to Eleven (11) U.S. Savings Bonds Type E - 4,731.52 50% 2,365.76
12/7/2007 $100.00 Denomination
Maria H. Lombard -Joint Owner
4 B Prior to Eleven (11) U.S. Savings Bonds Type E - 5,583.48 50% 2,791.74
12/7/2007 $100.00 Denomination
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I Nicholas M. Lombard -Joint Owner
TOTAL (Also enter on line 6, Recapitulation) 10,157.50
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT , MISC. NON-PROBATE PROPERTY
ESTATE OF Timinsky, Matthew
FILE NUMBER
21 - 08 - 01283
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
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ITEM
NUMBER ~ ,
DESCRIPTION OF PROPERTY
Inclutle the name of the transferee, their relationship to decedent
and the date of transfer. Attach a copy of the deed for real estate.
DATE OF DEATH
VALUE OF ASSET
% OF
DECD'S
INTEREST
~ EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
1 First National Bank Corporation 109.000.00 100% i 9,000.00 ! 100,000.00
Checking Acct # 101135960 ~
(3) Exclusions: Beth Fisher, Meg Lombard, Lynn
Brislin i
2 ,
PNC Bank -IRA
~ 10,504.18
' 100%
' 10,504.18
Acct#55001910198
3 PNC Bank -IRA 128,409.03 100% 128,409.03
Acct#65000818103
4 PNC Bank -IRA 33,986.25 100% 33,986.25
Acct #65000857650
5 TransAmerica Life Insurance Company - Nonqualified 176,261.90 100% 176,261.90
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I Tax Deferred Annuity
TOTAL (Also enter on line 7, Recapitulation) 449,161.36
CHEDULE H
FUNEfiAL D~EfVSES &
COMMONWEALTH OF PENNSYLVANIA '~+~'p n /~ /~/~~+~+
INHERITANCE TAX RETURN ~~INIJ 1 RATI V C vW 1 J
P.ESIOENT DECEDENT
i
FILE NUMBER
ESTATE OF Timinsky, Matthew 21 - 08 - 01283
Debts of decedent must be reported on Schedule I.
ITEM
DESCRIPTION AMOUNT
NUMBER ~ FUNERAL EXPENSES: II
A. 1 I Joseph E. Lehman Funeral Home -Funeral Expense i 8,093.00
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2 !, Beth Fisher -Memorial Luncheon ' 600.00
3 Walters Monument Company -Tombstone Inscription i 395.00
B.
1
2.
3.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Beth E. Fisher
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 1788 Winterhaven Drive
City Mechanicsburg state PA zip 17055-519
Year(s) Commission paid
Attorney's Fees Law Offices of Craig A. Diehl
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4.
5. I
6.
7.
1
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills, Cumberland County
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
PNC Bank -Estate Checks
22,700.00
19, 000.00
518.00
16.99
TOTAL (Also enter on line 9, Recapitulation} 66,663.19
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
Funeral E~enses &
Aldminisfiative Costs continued
ESTATE OF
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16 Iii
17
18
19 ~
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Timinsky, Matthew
Cumberland Law Journal -Estate Advertisement
The Sentinel -Estate Advertisement
Law Offices of Craig A. Diehl -Certified Mailing of DPW Letter
Aqua Pennsylvania -Sewer
PP&L -Electric
1-800-GOT-JUNK -Remove Junk at Penn Lake Property
David Cordier -Consultation and Verbal Appraisals
Margo Beckerman, Tax Collector -Real Estate Taxes
Montour Home Comfort Services -Fuel Oil
Stanley Steamer -Carpet Shampoo
A Step Above Cleaning -Cleaning Service
Traveler's Indemnity -Home Insurance
Matt Harkenreader -Lawn Maintenance
Slenzak, Inc. -Tree Removal
Slenzak, Inc. -Well Pressure Tank
Haar's Auction -Auctioneer Fees
Cordier Antiques -Auction Advertising for Real Estate
Cordier Antiques -Auction Commission from Train Sale
Lynn Brislin -Reimbursement of Mileage for Clean-up Trips
FILE NUMBER
21 - 08 - 01283
75.00
174.58
5.32
387.33
231.44
1,117.00
50.00
1,194.06
1,623.98
157.94
100.00
693.00
200.00
1,700.00
796.00
511.58
1,697.40
864.26
1, 597.74
Page 2 of Schedule H
Schedule H
COMMONWEALTH OF PENNSYLVANIA ~,u~{~,,., /~-y,~
INHERITANCE TAX RETURN ~ AdCTU~l1Sbd~11/e C06LS COIliltlUed
RESIDENT DECEDENT
ESTATE OF Timinsky, Matthew FILE NUMBER
21 - 08 - 01283
21 I Beth Fisher -Reimbursement of Mileage for Clean-up Trips I, 2,163.57
Page 3 of Schedule H
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS
INHERITANCE TAX RETURN ~
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Timinsky, Matthew 21 - 08 - 01283
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Messiah Village -Nursing Home Expense 7,245.80
2 Law Offices of Craig A. Diehl -Consultation and Power of Attorney 315.50
3 PPL -Electric Bill 95.42
4 Montour Home Comfort Service -Oil Heat 297.00
5 Alert Pharmacy -Medications 398.60
6 Paul Dalbey, DPM -Podiatry Medical Services 27.00
7 Aqua Pennsylvania -Sewer Bill 70.00
8 Penn Lake Park Borough -Trash Service 210.00
9 United States Treasury - 2008 Federal Income Tax Liability 1,645.00
TOTAL (Also enter on Line 10, Recapitulation) ~ 10,304.32
REV•1513 EX+ tg-00) kt-.
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SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Timinsky, Matthew
21 -08-01283
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER ~ NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Truateels)
I~
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers --
under Sec. 9116 (a) (1.2)]
1 ,Beth E. Fisher ;Daughter ~ 1/3 of Residue
1788 Winterhaven Drive ~
!, Mechanicsburg, PA 17055-5191
2 ~ Lynn A. Brislin ~ Daughter 1/3 of Residue
42 Harford Avenue
Shavertown, PA 18708
3 Meg H. Lombard Daughter 1/3 of Residue
26 Holcomb Road
Shavertown, PA 18708
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Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on Rev 1500 cover sheet
II NON-TAXABLE DISTRIBUTIONS:
. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
I NOT BEING MADE
8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 0.00
REV-1513 E7(+ (9-00)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued
INHERITANCE TAX RETURN
P.ESIDENT DECEDENT _~ _
ESTATE OF FILE NUMBER
Timinsky, Matthew 21 - 08 - 01283
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
4 under Sec. 9116 (a) (1.2)]
Nicholas M. Lombard i
Grandson
Specific Bequest
~ 26 Holcomb Road
Shavertown, PA 18708
5 ; Maria H. Lombard i Granddaughter ; Specific Bequest
26 Holcomb Road I
Shavertown, PA 18708
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Page 2 of Schedule J