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Home My WebLink About11-30-091505607120 J REV-1500 EX (06-05) OFFIC WL USE ONLY PA Department of Revenue Bureau of Individual Taxes covmy code veer File Numher INHERITANCE TAX RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT 2 1 Q$ 1 1 1 7 DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 195077293 10312008 04021917 Decedent's Last Name Suffix Decedent's First Name MI LEMKE ROSE A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Sutfx 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. Odginal Return ® 2. Supplemental Retum ^ 3. Remainder Retum (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Fuwre Interest Compromise ^ 5. Federal Estate Tax Return Required (date d death alter 12-1242) ® fi. Decedent Died Testate ^ T, Decedent Maintelrietl a LiWn9 Truel (Aaach Copy d Wis) (Attach Copy d Trust) 8. Total Number of Sale De sit Boxes ~ ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date d death 11. Election to tax under Sec. 9113(A) behvBen 1231-87 end 1-1-95) ^ (AttaU $ch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: (Jame Daytime Telephone Number L. PETER TEMPLE, ESQUIRE 610444}37 0 Firm Name (HAppllcable) CO ~°o -~~ LARMORE SCARLETT LLP REGISTERt~V~~11a~~1LY ~; ~ jr,j } r a ~ r - i First Ilne of address , ~~ ~ 0 ? ; - P O BOX 384 ~ _ c'>~m "0 5i ~ ;~7 . . iu 7C - -T i Second Tine of address D ~ N F ^ 7 - ;;~;~ 0 r. --~ City or Poat OfFlCe Stat DATE FILED N e ZIP Code KENNETT SQUARB PA 19348 Correspondent's email address: schedules end is based on all John D. Lemke P.O. Box 802771, Dallas, TX 75380 L. Peter Temple, Esquire P. O. Box 384, Kennett St 1102-D~ DATE PA 19348 Side 1 1505607120 1505607120 J J 150560722 REV-1500 EX Decedent's Social Security Number Deceaem's wme. LEMKE, ROSE A. 195077293 RECAPRULATION 1. Real Estate (Schedule A) ........................................................................................ .. 1. 1 9 3, 6 7 4. 0 0 2. Stocks and Bonds (Schedule B) .............................................................................. . 2. 13 9 , 5 8 8 . 8 5 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... . 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ .. 4. 5. Cash, Bank De osits & Miscellaneous Personal Pro e ) p p rty (Schedule E ............... . 5. 9 , 9 9 8 • 5 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ . 6. 2 9 , 2 8 4 . 4 2 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Properly (Schedule G) ^ Sepaate Billing Requested ............ . 7, 8. Total Gross Aasets (total Lines 1-7) ...................................................................... . 8. 3 7 2, 5 4 5. 8 5 9. Funeral Expenses 8 Administrative Costs (Schedule H) ........................................ . 9. 5 0, 4 8 1. 4 8 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. .. 10. 2 2 . 8 2 3 . 4 0 11. Total Deductions (total Lines 9& 10) .................................................................... .. t t. 7 3, 3 0 4. 8 8 12. Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 2 9 9 , 2 4 0 . 9 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................ . t3. 14. Net Value SubJeM to Tax (Line 12 minus Line 13) ................................................ . 14. 2 9 9 , 2 4 0 . 9 7 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. Amounl of Line 14 taxable atlineal ratex .045 276,740.97 t6. 12,453.34 17. Amount of Line 14 taxable at sibling rate x .t2 2 2, 5 0 0. 0 0 f 7~ 2, 7 0 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 18. ts. rax Due .................................................................................................................... . ts. 15 , 15 3 . 3 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505607220 1505607220 J REV-7500 EX Page 3 Decedent's Complete Address: Flle Number 21 - 08 - 1117 Lemke, Rose A. STREET ADDRESS 914 Indiana Ave. CITY Lemoyne STATE PA ZIP 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (t) 15,153.34 2. Credits/Payments A. Spousal Poverty Credit e. Prior Payments 17,791.26 C. Discount 757.67 3 Total Credits (A+e+C) I t dP l f (2) 18,548.93 . n eres ena ty i applicable p, Interest E. Penalty Total InteresUPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 3, 395.59 Check box on Pape 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. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Q , Q Q 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 .................................................................................................................. x d. receive fhe promise for life of either payments, benefts or care? .............................................................. 2. If death oxurced after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ ^x 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 benefciary designation? ...................................................................................................................... ^ Q 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 Vansfers 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 p2 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 lwentyone years of age or younger at death to or for the use of a natural parent, an adoptlve 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. SCHEDULE A COMMONWEALTH OF RENNEYLV/J!M REAL ESTATE INXERRANLE TAX RETURN REEIOENi DECEDENT FILE NUMBER ESTATE OF Lemke, Rose A. 21 - 08 - 1117 All real property owned solely or as a tenant in common must be repoRed at Lair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wilting 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 VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 House and tract of ground situate in the Borough of Lemoyne, Cumberland County, PA (known 193,674.00 as 914 Indiana Ave., Lemoyne, PA). Deed reference: John H. Lemke to John H. Lemke (deceased) and Rose Dalbey Lemke, his wife, dtd 12/10/43, and recorded in the Office of the Recorder of Deeds in and for Cumberland County In Plan Book 1, page 24 (sale price) TOTAL (Also enter on Line 1, Recapitulation) ~ 193,674.00 SCHEDULE B COAMIONWEILT1 Or PENNEYLVPNW STOCKS & BONDS WNERRRNCE TA%RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Lemke, ROSe A. 21 - 08 - 1117 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 Stocks and Bonds per attached list 139,588.85 TOTAL (Also enter on line 2, Recapitulation) 139,588.85 ESTATE OF ROSE A. LEMKE STOCKS AND BONDS Vanguard 7,630.79 shs. Vanguard Intermediate Treasury Fund @ 11.33 86,456.85 1,717.276 shs. Vanguazd Growth & Income Fund @ 21.02 36,097.14 Stifel Nicolaus 200 shs. American Capital Ltd., c. @ 13.915 2,783.00 160 shs. General Motors Corp., c. @ 5.84 934.40 200 shs. Giant Oil & Gas Inc., c. @ 0.275 55.00 300 shs. Macquarie Infrastructure Co. @ 10.395 3,118.50 900 shs. Alpine Total Dynamic Dividend Fund @ 8.05 7,245.00 Dividend of $.18 per shaze declazed 9/2/08, payable 10/31/08 to holders of record on 10/27/08 162.00 300 shs. Blackrock Debt Strategies Fund Inc. @ 3.455 1,036.50 Dividend of $.053 per share declazed 10/1/08, payable 10/31/08 to holders of record on 10/15/08 14.40 325 shs. U S Shipping Partners LP @ 0.71 230.75 Cash 897.91 $2,000. Bazclays Bank 14.125% due 2/25/09 @ 27.87 557.40 TOTAL: $139,588.85 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVPNW PERSONAL PROPERTY INHERRANCE TAX RETURN RESEIENT OEGEOENT FILE NUMBER ESTATE OF Lemke, ROSe A. 21 - 08 - 1117 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 VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Checking acct#0231129351 at Sovereign Bank, 107.22 P.O. Box 841005, Boston, MA 02284 2 ~ Coins, sale price ~ 900.00 3 ~ Cash on hand ~ 85.93 4 ~ Highmark Blue Shield, refund ~ 510.93 5 ~ The Patriot -News, refund ~ 31.50 6 ~ Personal property per appraisal ~ 8,311.00 7 ~ U.S. Treasury, 2008 income tax refund ~ 52.00 TOTAL (Also enter on Llne 5, Recapltulatlon) ~ 9,998.58 ' SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLYAWNED PROPERTY INHERITANCE TA%RETURN ESTATE OF FILE NUMBER Lemke, Rose A. 21 - 08 - 1117 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 Lavelle Henry Arnold 286 Walter Road Son-in-Law A Cochranville, PA 19330 John D. Lemke P.O. Box 802771 Son B Dallas, TX 75380 Margaret H. Cole 2495 Upper Brush Valley Road Sister C Centre Hall, PA 16828 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT InGude name of i~nanalal in~idulon a pd bank 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 oecE ENTS NTEREST 1 A 10/30/2006 Checking acct#1051068169 at Sovereign Bank, 9,097.61 50% 4,548.81 P.O. Box 841005, Boston, MA 02284 Accrued interest to date of death 0.12 50% 0.06 2 A 10/30/2006 Savings acct#1054019169 at Sovereign Bank, 535.06 50% 267.53 P.O. Box 841005, Boston, MA 02284 Accrued interest to date of death 0.27 50% 0.14 3 B Demand Notes #90009011262241 at Demand 3,935.76 50% 1,967.88 Notes by GMAC, P.O. Box 535006, Pittsburgh, PA 15253-5006 4 C One-half Cottage situate in Cook Township, Cumberland 45,000.00 50% 22,500.00 interest County, PA (known as 741 Pine Grove Road). (per appraisal) TOTAL (Also enter on line 6, Recapitulation) 29,284.42 SCHEDULER COMMONWEALTX OF PENNSYLVANN ~~~~ INNERRANCE TA%nETURN ~1~11LT~AT111C /YY"TG~ RESIDENT DECEDENT I~'~J1~~1I1I~~NN ~~ ff VV 11 ~~ ~~YY GG ~W ~ ~7 FILE NUMBER ESTATE OF Lemke, Rose A. 21 - OS - 1117 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Musselman Funeral Home Cremation Services, Inc. 7,436.67 2 Rolling Green Cemetery Co. 1,345.00 3 Funeral luncheon 223.69 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions John D. Lemke Social Security Number(s) / EIN Number of Personal Street address P.O. Box 802771 City Dallas State TX Zip 75380 Year(s) Commission paid z. Anomeys Fees Larmore Scarlett LLP -- L. Peter Temple, Esquire 3. Family Exemption: (If decedent's address is not fhe same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Letters Testamentary Register of Wills, Short Certificates Register of Wills, Commission 5. Accountant's Fees 6. Tax Retum Preparer's Fees Fenstermacher 8 Co., preparation fee for 2008 income tax 7. Other Administratlve Costs 1 U.S. Postal Service, certified letter 15,000.00 17,000.00 414.00 24.00 25.00 530.00 33.23 TOTAL (Also enter on Tine 9, Recapitulation) 50,481.48 C. ~ScFtedtrie H COMMONWEALTH OF PENNSYLVANIA ru ~o INHERITANCE TAX RETURN ~~`~ RESIDENT DECEDENT ESTATE OF Lemke, Rose A. FILE NUMBER 21 - OB - 1117 2 Cumberland County Law Journal, advertising Letters Testamentary 75.00 3 Fidelity Title Co., copy of the deed 7.50 4 The Sentinel, advertising Letters Testamentary 190.54 5 Collectors' Rowe, personal property appraisal 1,163.00 6 Summit Locksmith, changed locks 222.60 7 Fed Ex charge 20.65 8 Beiler-Campbell Realtors & Appraisers, real estate appraisals 700.00 9 Lavelle H. Arnold, security for house 300.00 10 Constance Arnold, security for house 700.00 11 Margaret Bower, security for house 640.00 12 SCCAC, title search 325.00 13 Constance Arnold, cleaning and disposal of personal property 945.00 14 Disposal of personal property 2,880.00 15 Auction fee for sale of personal property 280.60 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LD^MNR~R?N1LE~A%RET1RNµw LIABILITIES, & LIENS RESOENT DECEDENT FILE NUMBER ESTATE OF Lemke, Rose A. 21 - 06.1117 Include unreimburaed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 PPL Electric Utilities Corp., balance 166.08 2 Borough of Lemoyne, balance 357.00 3 Country Meadows At Home, balance 883.57 4 Pennsylvania American Water, balance 149.17 5 Bookwalter Painting, balance 4,780.00 6 Sovereign Bank, overdraft fees 120.62 7 Verizon, balance 12.79 8 Eshenaurs Fuels, Inc., balance 958.58 9 Elwood G. Kline, lawn service 180.00 10 McNelis Gutter Cleaning Inc., balance 100.00 11 Pennsylvania Department of Revenue, 2008 income tax 97.00 12 Allstate Insurance, premium balance 564.78 13 Steven Brink Construction, balance 879.00 14 Know Swett, balance 50.00 15 Expenses of sale of real estate 13,524.81 TOTAL (Also enter on Line 10, Recapitulation) I 22,823.40 REVd310 EXr (y-001r ~ ~ - • SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES I NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lemke, Rose A. 21 - 08 - 1117 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do xotun Trun«p1 I, TAXABLE DISTRIBUTIONS[inGude outright spousal disVibu6ons, and transfers under Sec. 9116 (a) (1.2)] 1 John D. Lemke Son 1/5 tangible personal P.O. Box 802771 property; 1/5 residue Dallas, TX 75380 2 Constance Arnold Daughter 1/5 tangible personal 286 Walter Road property; 1/5 residue Cochranville, PA 19330 3 Timothy A. Lemke Son 1/5 tangible personal 130 Spring Drive property; 1/5 residue Dillsburg, PA 17019 Enler dollar amounts for distributions shown above on lines 1 5 through 18, as appropdate, on Rev 1500 cover sheet II NON-TAXABLE DISTRIBUTIONS: . A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ 0.00 REV•iSiJ EXi13-001, ~ ~ • SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lemke, Rose A. FILE NUMBER 21 - 08 - 1117 NUMBER NAME AND ADDRESS OF PERSONS () RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not LIH Trusbepl I~ TAXABLE DISTRIBUTIONS[InGude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 4 Philip C. Lemke Son 1/5 tangible personal 4290 Sunshine Blvd. property; 1/5 residue St. James City, FL 33956 5 Christopher T. Lemke Son 1/5 tangible personal 20 Rymen Lane property; 1l5 residue Palm Coast, FL 32164 6 John S. Lemke Grandson 2,500.00 802 Cresside Richardson, TX 75081 7 Kristin A. Shelby Granddaughter 2,500.00 1049 Cochran Drive Mesquite, TX 75149 8 Andrew L. Arnold Grandson 2,500.00 710 Saginaw Road Oxford, PA 19363 9 Todd W. Arnold Grandson 2,500.00 43 Berkshire Road Landenberg, PA 19350 10 Amy A. Hunt Granddaughter 2,500.00 18536 Kent Ave. Hagerstown, MD 21748 11 Peter Lemke Grandson 2,500.00 130 Spring Drive Dillsburg, PA 17019 12 Molly Lemke Granddaughter 2,500.00 130 Spring Drive Dillsburg, PA 17019 13 Hans D. Lemke Grandson 2,500.00 6454 Anderson Ave. Hanover, MD 21076 Page 2 of Schedule J REV-1811 EY+9-081. _ ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lemke, Rose A. FILE NUMBER 21 - 08 - 1117 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY oo NOe Lbt rrumel.) I, TAXABLE DISTRIBUTIONS[include outright spousal dlstnbuhons, and transfers under Sec. 9116 (a) (1.2)] 14 Nichole V. Campbell Granddaughter 2,500.00 4290 Sunshine Blvd. Saint James City, FL 33956 15 Timothy Ian Lemke Grandson 2,500.00 1508 Echo Road Durham, NC 27707 Page 3 of Schedule J fa eJ 1 CYS ~~. {} ~'Y~ ~J U~ ~'L G p - ~" N 11', ~„ N (: SJ5 U.. 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