The URL can be used to link to this page

Home My WebLink About12-04-09 (3) 1505607120 REV-1500 ~ (06-05) OFFICIAL USE ONLY PA Depaftment of Revenue county code rear File Number Bureau of Individual Taxes Po Box.2soso~ INHERITANCE TAX RETURN Harrisburg, PA 1~~2s-oso~ 2 1 0 9 0 5 5 7 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 196 14 2554 03 15 2009 11 27 1924 Decedent's Last Name Suffix Decedent's First Name MI CREAMER MIRIAM E (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 1MITH THE REGISTER OF WILLS FILL IN APPROPRU\TE OVALS BELOW X^ 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (date of death after 72-12-82) 6. Decedent Died Testate ~ (Attach Copy of III) 7 Decedent Maintained a Living Trust (Attach Copy of Trust) O 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Poverty CredR (date or death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and T-1-95) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Nlamber GARY L. JAMES ESQ . 7 17 5 3 3~j3 2 8 0 ~,, ~[`` Firm Name (If Applicable) //~'' ~ ~'^~, JAMES, SMITH, DIETTERICR & CONNELLY, L REGISTER USE~YLY i.t / First line of address ~ ~ f ~` ~- 134 SIPS AVENIIE ~~ .~ ,~-,_ }~ ; Stacond line of address ..~ _ ~° City or Post Office HIIMMELSTOWN State ZIP Code PA 17036 ~~ wd~ ry' ~rvr~ W V/1 DATE FILED V ' Correspondent's a-mail address: 9 I1 ~1 S d C. C O m 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. M. Miller zo west PA 17055 -~-v SIGMA PREPARER O ER THAN REPRESENTATIVE DATE Gary L. James Esq. ~~~ _ 2"j .' A SS 134 Sipe A n H mmelstown, PA 17036 Side 1 1505607120 15056071210 1505607220 REV-1500 EX Decedent's Social Security Number o~a~,cSNa~: Miriam E. Creamer 19 6 14 2 5 54 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 8 5, 0 0 0. 0 0 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 De sits 8~ Miscellaneous Personal Pro e po p rty (Schedule E) ................ 5. 3 , 0 0 2 . 7 5 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 9 4 , 9 6 3 . 9 5 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8, 1 8 2, 9 6 6. 7 0 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 2 4, 9 5 5. 8 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 6 5 4 . 1 2 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11, 2 5 , 6 1 0 . 0 1 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 5 7 , 3 5 6 . 6 9 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. 1 5 7 , 3 5 6 . 6 9 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (ax1.2) x .o0 0. 0 0 15• 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 15 7, 3 5 6. 6 9 16• 7, 0 81.0 5 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18• 0. 0 0 19. Tax Due ..................................................................................................................... 19. 7 . 0 81.0 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 15056072210 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-0557 DECEDENT'S NAME Miriam E. Creamer STREET ADDRESS 20 West Factory Street CITY Mechanicsburg STATE PA ZIP 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 9,400.00 354.05 Total Credits (A + B + C) (1) 7,081.05 (2) 9,754.05 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. (3) (4) 2,673.00 (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 :.................................... ^x ^ c. retain a reversionary interest; or .................................................................................................................. ^x ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ~ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death withowt receiving adequate consideration? ....................................................................................................................... ^ 0 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? ...................................................................................................................... ^x ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R 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 p2 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 disGosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficary. 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 172 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. Rav-1502 EX+ (11.08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSriVANIA WNERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 All roal property owned solely or as a tenant in common must be reported ffi fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property whleh is jointly-owned with right of survNOrahip must be diadosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-150ti FJ(+ (6-g8) SCHEDULE E CASH, BANK DEPOSITS, 8l MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSVLVANN NHERRANCE TAX RETURN RE3NENT DECEDENT ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly Jointly-ovmsd with the right of survivorship must be dlsdosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Members 1st Savings Account # 266238-00 -valued per letter dated April 30, 2009 871.83 Accrued interest on Item 1 through date of death 0.25 2 Personal Property 1,500.00 3 PSERS -final pension payment 630.67 TOTAL (Also enter on Line 5, Recapitulation) I 3,002.75 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (688) SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY coMMOtawEA~TH of PENNSnvANw INHERRANCE TAX RETURN RESDENT DECEDENT ESTATE OF - (FILE NUMBER Creamer, Miriam E. 21-09-0557 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER I I F P P INCLUDE NAME OF 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 Pacific Life Insurance Company Annuity 28,014.10 28,014.10 Contract # VA99060380 -valued per statement dated March 31, 2009; beneficiary is the Miriam E. Creamer Living Trust dated 7-29-1994 2 1,168.307 units of Franklin Templeton Ltd. 10,012.39 10,012.39 Duration Income Trust -titled in the Miriam E. Creamer Rev Living Trust dtd 07127/1994; held in the Wachovia Securities brokerage account number 6851-8376; valued per public listing 3 2,479.784 units of Neuberger Berman Real Estate 2,628.57 2,628.57 Securities Income Fund -titled in the Miriam E. Creamer Rev Living Trust dtd 07/2711994; held in the Wachovia Securities brokerage account number 6851-8376; valued per public listing 4 1,281.294 units of PIMCO High Income Fund - 6,124.59 6,124.59 titled in the Miriam E. Creamer Rev Living Trust dtd 07/2711994; held in the Wachovia Securities brokerage account number 6851-8376; valued per public listing Accrued income on Item 4 through date of death 156.16 156.16 5 361.042 units of Pioneer Fund A -titled in the 8,744.44 8,744.44 Miriam .Creamer Rev Living Trust dtd 07/27/1994; held in the Wachovia Securities brokerage account number 6851-8376; valued per public listing Total of Continuation Schedules See attached es TOTAL (Also enter on Line 7, Recapitulation) I 94,963.95 (ff more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form P/1-15Q0 Schedule G (Rev. 6-98) Rw•1570 EX+ (686) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMNKNIYYEALTH OF PENNSYLVANIA } INHERRANCE TAX RETURN ~ COn `~ n Ue RESDENT DECEDENT ESTATE OF (FILE NUMBER Creamer, Miriam E. _ 21-09-0557 ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE NAME OF 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 6 1,009.818 units of PMA Capital Corp Notes 6,573.92 6,573.92 Senior Notes due 6/15/18 -titled in the Miriam E. Creamer Rev Living Trust dtd 07/27/1994; held in the Wachovia Securities brokerage account number 6851-8376; valued per public listing Accrued income on Item 6 through date of death 71.53 71.53 7 PSECU Checking account Shares number S04 - 6,460.62 6,460.62 titled in the Miriam E. Creamer Living Trust dated 07/22/1994; valued per letter dated April 28, 2009 Accrued interest on Item T through date of death 0.26 0.26 8 PSECU Christmas account Shares number S03 - 0.16 0.16 titled in the Miriam E. Creamer Living Trust dated 07/22/1994; valued per letter dated April 28, 2009 9 PSECU Regular shares account number S01 - 21,170.23 21,170.23 titled in the Miriam E. Creamer Living Trust dated 07122/1994; valued per letter dated April 28, 2009 6.09 6.09 10 4,990.73 units of Wachovia Bank Deposit Money 4,990.73 4,990.73 Market Fund -titled in the Miriam E. Creamer Rev Living Trust dtd 07/27/1994; held in the Wachovia Securities brokerage account number 6851-8376; valued per letter dated April 23, 2009 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1510 EX+ (6.98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COALIONWEALTH OF PENNSriVANIA INHERRANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE NAME OF 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 DECO~s INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE Accrued income on Item 10 through date of 10.16 10.16 death TOTAL (Also enter on Line 7, Recapitulation) I 94,963.95 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15Q0 Schedule G (Rev. 6-98) Rev-~is~ ex+~~o.os- SCHEDULE H COMMONWEALTH OFPENNSriVANIA FUNERAL EXPENSES ~ __ INRESIDE~NTDECEDEN RN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 8,078.53 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name(s) of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorneys Fees James, Smith, Dietterick ~ Connelly, LLP 5,000.00 3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation) 3,500.00 Claimant Carolyn M. Miller Street Address 20 West Factory Street -city Mechanicsburg state PA zip 17055 Relationship of Claimant to Decedent Daughter 4. Probate Fees 270.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 8,107.36 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 24,955.89 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-15Q0 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Hoss's -meal after funeral 118.53 2 Myers Funeral Home -funeral 7,960.00 H-A Subtotal 8,078.53 Other Administrative Costs 3 Diane Montgomery -notary fee per HUD 1 settlement sheet 10.00 4 James D. Bogar Law Offices -tax certification fee per HUD 1 settlement sheet 5.00 5 James Smith Dietterick 8- Connelly LLP -reserve for estate administration closing 500.00 costs 6 JL Ruth Electric -home improvement repairs prior to selling 4,982.00 7 John R. Zimmerman -messenger service to Cumberland County Register of Wills 22.57 Office 8 Lindy Kelsey -notary fee 20.00 9 Lowes -repairs for house 103.67 10 Mechanicsburg Borough -final refuse bill per HUD 1 settlement sheet $43.32 less 22.60 refund of $20.72 from 11/18/09 through 01/01/2010 11 Mechanicsburg Borough -final sewer bill per HUD 1 settlement sheet $70.00 less 36.52 refund of $33.48 from 11/18/09 through 01!0112010 Copyright (c) 2002 form software only The Lackner Group, Inc. Form P/~r1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Creamer, Miriam E. 21-09-0557 ITEM NUMBER DESCRIPTION AMOUNT 12 Recorder of Deeds Cumberland County -transfer taxes per HUD 1 settlement sheet 850.00 13 Register of Wills Cumberland County -short certificate per HUD 1 settlement sheet 5.00 14 Zimmerman Plumbing -home improvement repairs prior to selling 1,550.00 H-B~ subtotal 8,107.36 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 FJ(* (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANUI INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Creamer, Miriam E. 21-09-0557 Report debts incurred by the decedent prior to death that romained unpaid at fhe dabs of death, including unrsimbuned medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PM7500 Schedule I (Rev. 12-08) REV-1513 EX+ (11.08) SCHEDULE J LV ANIA COMMO gxER~Y TA BENEFICIARIES 1 ~ ERI NCE T RESIDENT DECEDENT ESTATE OF I FILE NUMBER Creamer, Miriam E. 21-09-0557 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 [nclude outright spousal distributions, and transfers under Sec. 9116(a)(1.2)I 1 Daniel P. Creamer Son 50% of residue 78,678.35 235 Scotch Pine Road Dillsburg, PA 17019 2 Carolyn M. Miller Daughter 50% of residue 78,678.35 20 West Factory Street Mechanicsburg, PA 17055 Total 157,356.70 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 150 0 ever sheet, as app priate, II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 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) 2009 form software only The Lackner Group, Inc. Form P/Ir150b Schedule J (Rev. 11-08}