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Home My WebLink About01-13-101505607120 -~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2sosol 2 1 0 9 10 8 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 493 50 2922 10 28 2009 11 03 1946 Decedent's Last Name Suffix Decedent's First Name MI PALMER SCOTT D (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 X^ 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a, Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) X g Decedent Died Testate 7, Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty CredR (date of death between 1231-91 and I-1-95) ~ 11, Election to tax under Sec. 9113(A) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. BOGAR 717 737 8761 Firm Name (If Applicable) REGISTE~F WILLS U' I ONLY ~ BOGAR & HIPP LAW OFFICES c> ---~. ~ First line of address ~ ~ . ~ ~ 5 t ~ ~ . ONE WEST MAIN STREET ~"~-~ ~ w -'. '-' rr1 r; Second line of address = ; ~„_-,, p, r-. ~ - O~ ~ r .-- _~ ~ _ ~ .._< DAT~ILED ; , ..r 1 - t Offi Ci P t , , `, ~ or ce os N State ZIP Code ~_ +~~. SHIREMANSTOWN PA 17011 Correspondent'se-mail address: Jbogar@bogarlaw.COm 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. SIGdATURE OF PERSON RESPONSIBLE FOR~ILING RETURN ~ DATE Bernadette M. Palmer ADDRESS 514 James D. Bogar 1 One West Main Street, Shiremanstown, PA 17011 1505607120 Side 1 1505607120 Road, Camp Hill, PA 17011 PAREl~THER THAN REPRESENTATIVE DATE J~ REV-1500 EX Decedents Name: Scott D. P a l m e r Decedent's Social Security Number 493 50 2922 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 8~ Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1 1 , 7 8 5 . 7 3 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 1, 7 8 5. 7 3 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11 • 0 . 0 0 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 1 , 7 8 5 . 7 3 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 1 , 7 8 5 . 7 3 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 11 , 7 8 5. 7 3 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16• 0. 0 0 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. 0 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 150560722D 15056D7220 J 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-1083 DECEDENT'S NAME Scott D. Palmer STREET ADDRESS 514 Susan Road CITY Camp Hill STATE PA ZIP 17011 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 0.00 Total Credits (A + B + C) (1) 0.00 (2) 0.00 (3) 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 (4) (5) 0.00 (5A) (5B) ~ . 0 Q 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 .................................................................................................................. ^ 0 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? ...................................................................................................................... ^ ^x 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 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 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 p2 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. Rev-1508 EX+ (698) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Palmer, Scott D. 21-09-1083 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with fhe right of survivorship must be disclosed on schedule F. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) (If more space is needed, additional pages of the same size) COMMONWEALTH OF PENNSYLVANIA OFFICE OF THE BUDGET COMPTROLLER OPERATIONS Bernadette M. Palmer 514 Susan Road Camp Hill, PA 17011 Dear Ms. Palmer: December 16, 2009 BUREAU OF COMMONWEALTH PAYROLL OPERATIONS P.O. BOX 8006 HARRISBURG, PA 17105-8006 FAX: (717) 772-3104 The enclosed check represents payment to you on behalf of Scott Douglas Palmer as the executrix of his estate. Please note that you as the executrix will receive a "Form 1099-Misc." in the amount of $13,290.81 at year's end. The form will be in the name of the ESTATE OF SCOTT DOUGLAS PALMER and the TIN#27-6320277 and should be kept along with this letter for tax filing purposes. PAYMENTS (PAY DATE AFTER DATE OF DEATHI PPE DATE PAY DATE TYPE PAY HOURS GROSS DEDUCTION AMOUNT* NET 10/30/09 Sala 52.50 $1,498.88 Annual 346.17 $9,883.15 12/16/09 Sick 67.50 $1,927.13 $1,523.43 $11,785.73 LESS NON-TAXABLE GROSS DEDUCTIONS: AMOUNT EXPLANATION OF NON-TAXABLE DEDUCTION $18.35 Pre Tax Medical Deceased Employee Estate Payment December 16, 2009 Page 2 *EXPLANATION OF DEDUCTIONS TAKEN FROM PAYMENTS: AMOUNT EXPLANATION OF DEDUCTIONS TAKEN $284.60 Lon Term Care $1,016.75 Social Securit 1Medicare $69.90 SERS Bu back $133.83 Retirement Should you have any questions regarding this letter, please contact Mr. Edmund Brenner, at telephone number (717) 772-5368. Sincerely, Sharon Wentling, Chief Special Pay Processing Enclosure REV-1513 EX+ (11-08) SCHEDULE J ANIA COM~ TA BENEFICIARIES NCE TAX RETURN ERI RESIDENT DECEDENT ESTATE OF FILE NUMBER Palmer, Scott D. 21-09-10 83 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Truste s I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116(a)(1.2)] Bernadette M. Palmer Spouse Rest, residue 514 Susan Road and remainder Camp H[II, PA 17011 of Estate Total Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 150 0 cover sheet, as appr opriate, 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 GUVER SHEET ~ u.uU Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAMENT OF SCOTT D . PALMER I, SCOTT D. PALMER, of Camp Hill, Cumberland, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my wife, BERNADETTE M. PALMER, provided she survives me by sixty (60) days. SECOND: Should my wife, BERNADETTE M. PALMER, prede- cease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate, includ- ing any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, KAREN P. WOODRING and BRYAN S. PALMER, provided that should either of my children predecease me, I give and bequeath such child's share unto his or her issue per stirpes by representation, and if there be a failure of same, then I give and bequeath such deceased child's share to my surviving child as provided herein. THIRD: Should any of my grandchildren not have at- tained the age of twenty-two (22) years at the time for dis- tribution to him or her, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said grandchild's education (including college, trade school or other similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their discretionary authority with respect to the payment of income or principal of the within Trust to my grand- children, shall take into consideration any income or other resources available to my grandchildren from sources outside this Trust. Any income or principal not so applied shall be dis- tributed to each grandchild when he or she attains the age of twenty-two (22) years. In the event any of my grandchildren die prior to the termination of this Trust established herein for their benefit, the interest of said grandchild in said Trust shall cease with any income and principal being divided evenly between or among that deceased grandchild's brothers or sisters or the separate Trusts established hereunder for their benefit and, in the absence of any brothers or sisters, or any Trusts established hereunder for their benefit, to my other grandchil- dren, or the Trusts established hereunder for their benefit, in equal shares. FOURTH: In addition to all powers granted to them by law and by other provisions of-this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give 2 legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administratior~ expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. 3 FIFTH: I nominate and appoint JOHN A. WOODRING, husband of my daughter, KAREN P. WOODRING, as Trustee of the hereinabove described Trusts. I direct that my Trustee shall serve without bond and shall receive fair and reasonable compen- sation. SIXTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. SEVENTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. EIGHTH: I nominate and appoint my wife, BERNADETTE M. PALMER, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said BERNADETTE M. PALMER, I nominate and appoint my children, KAREN P. WOODRING and BRYAN S. PALMER, Co-Executors of this, my Last Will and Testament. I direct that my Executrix or Co-Executors, and Trustee, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~ day of ~~~~~-- 2 0 0 9 . ~'~~ (SEAL) SCOTT D. PALMER 4 Signed, sealed, published and declared by the above- named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address 5