HomeMy WebLinkAbout12-04-09 (2)
1505607121
REV-1500 EX (0605)
PA Department Of Revenue OFFICUIL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po sox 280601 INHERITANCE TAX RETURN
NanbbLM-' PA 1712&4601 RESIDENT DECEDENT 2 1 0 9 0 0 4 1
ENTER DECEDENT INFORMATION BELOW
Social Secudty Number Date of Death Date of Birth
1 8 2 6 8 6 7 0 6 1 0 3 0 2 0 0 8 0 5 0 8 1 9 7 5
Decedent's Last Name Suffix Decedent's First Name MI
L E H M E R R O B E R T E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Soaal Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® i. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death
4. Limited Estate
~
4a. Future Interest Compromise (date of pdorto 12-13-82)
~ 5. Federal Estate Tax Retum Required
^
6. Decedent Died Testate
(Attach Copy of Will)
~ death after 12-12-82)
7. Decedent Maintained a Living Trust
8. Total Number of Safe Deposit Boxes
9. Llfigatlon Proceeds Received
~ (Attach Copy of Trust)
10. 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 T0:
Name
Daytime Telephone Number
M A R C U S A M c K N I G H T I I I 7 1 7 2 4 9 2 3 5 3
Firm Name (If Applicable)
I R W I N RE019TER ILLS USE i I Y
& M c K N I G H T P C.
First line of address ~ ;
6 0 W E S T
Second line of address
City or Post Office
C A R L I S L E
State ZIP Code
P A 1 7 0 1 3
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this relum, including accompanying schedules and statements, and m the best of m kr
d Is true, wnect and complete. Dedaretion of preparer other than the personal representatlve b based on all information of wh~h preparer has ar
SIGNATURE OF PERSAN RESPr1NSrRi c tno rni iun_ ernrn ~e.,
ADDRESS
Side 1
L 1505607121
P O M F R E T S T R E E T
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'C22L09SOS'L
REV-1500 EX Page 3 Flle Number
Decedent's Complete Address• 21 os ooal
~T E. L
ADDRESS
clrY
Tax Payments and Credits:
1 Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
STATE ZIP
Pi4 17013
11) 20 17
Total Credits (A + g + C) (2) 0 00
3. InteresUPenalty if applicable
D. Interest
E. Penalty 5 04
Total Interest/Penalty (D + E) (3) 5.04
4. If Line 2 Is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Llne 20 to request a refund. (4) 0.00
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 lane 5 +5A. This is the BALANCE DUE.
(5) 25.21
(5A)
(5B) 25.21
Make Check Payable to REGISTER OF WILLS, AGENT
„~~
.,(,~R ~v ~iN~E.4-sAP<"~.'ti~'.'~ ~.. .~.~`'~i., ,., ~~I`9~~tk' '~~'ht-~i~~~l..#..~ ~'"i ~ ~Ca~I.~AS ~..~"~~~~k'~_ ai ~~:.'. ~"~t7€~'~~.~~.. =a~3~ ~ r~r(l~&?t~r 'P~, si6 t f"~i~'LCC .4"k, '
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 transferced : .......................
b. retain the right to designate who shall use the property transferced or its income : ............................... ^
c. retain a reversionary interest: or ................................................................................................
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
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? ......... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. ^
„„ IF THE ANSWER TO ANY OFT"~HtE ,A),80VE QUESTIONSp ISM{ YES, Y,O~U; M~gUST ~Cx"OMPLET;E~§~S(¢CHEDULE G AN&~D§~¢FIL~`E I{T~ ASpPAr~'RT OF THE RETUyRN}
&Fi~n ~ ~ Ir~r~~~~9 v~~b,~g~~$~£~`~~Sidi.i, ~... ~4~E~~~~KI~~~W~~w-..~.a lfie.~~4-~-,k~~0t~~~pT~u.. s. ?~~^~~~~€i{~€",(~~.+ .. 17'S~~~i'n ii:~~'~P`M„A:M~:'~rA~~~~.~~., .i. s~5~$e1~. r~~+l.:fi~r ~~?
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)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure 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 childtwenty-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 benefidaries 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)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
~;~a~~Yf~t ~;Y;.i w.bkdk,f t;t°L7 j~. C ~~.' t7r.e
REV-1508 EX + (6-98)
SCHEDULE E
COMMONV/EA~Tri pF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
IN RESIDENTDECEDENT~ PERSONAL PROPERTY
ESTATE OF FILE NUMBER
ROBERT E. LEHMER 21 09 0041
All propel intly.owo d~witl~i rlgl t of to Norshi~m u~st be~dis bled on Scl~u~le F.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
t. MEMBERS 1ST FEDERAL CREDIT UNION -CHECKING ACCOUNT #173458-11 103.14
2. MEMBERS 1ST FEDERAL CREDIT UNION -SAVINGS ACCOUNT #173458-00 9,153.87
3. REFUND FROM COLE'S BICYCLES, INC. 1,000.00
4• REFUND FROM IRS 992.00
TOTAL (Also enter on line 5, Recapitulation) ~ ;
(If more space is needed, insert additional sheets of the same size)
- _. ~ w ~'.
REV-1511 EX+(10-01i)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ESTATE
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ROBERT E. LEHMER 21 09 0041
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A• FUNERAL EXPENSES:
1. EWING BROTHERS FUNERAL HOME 5,044.67
2. SHAD BAKER -FUNERAL SERVICE 100.00
B. ~ ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) KITZIE E. GALBRAITH
street Address 837 NEWVILLE ROAD
City CARLISLE state PA zip 17013
Year(s) Commission Paid:
p, AttomeyFees IRWIN & MCKNIGHT, P.C.
3. Famiy Exemptron: (If deosdenfs address is not the same as daimanfs, attach explanatan)
Claimant KITZIE E. GALBRAITH
StreelAddress 837 NEWVILLE ROAD
City CARLISLE Sfape PA zip 17013
Relationship of Claimant to Decedent MOTHER
4• PrebeteFees REGISTER OF WILLS
5• I Awountanfs Fees
6. I Tax Retum Preparers Fees PATRICIA A. ROSENDALE, CPA
7. ~ REGISTER OF WILLS -FILING FEE
TOTAL Also enter on Ilne 9, Recapitulation) 19
600.00
800.00
3, 500.00
68.00
350.00
30.00
(If more space is needed, Insert additional streets of the same size)
r v. N'm t
~ T::k`.~.dv'F.3fsx.. n n Ta
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ESTATE
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8 LIENS
ROBERT E. LEHMER 21 09 0041
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmburaed medical expenses.
ITEM I
NUMBER DESCRIPTION
PENN CREDIT CORPORATION -COUNTY AND TOWNSHIP PER CAPITA TAX
2. ~AMAZON.COM -OUTSTANDING DEBT
3. ~RN RHAPSODY MUSIC -OUTSTANDING DEBT
4• YMCA -OUTSTANDING DEBT
VALUE AT DATE
OF DEATH
180.00
61.19
14.99
52.00
TOTAL (Also enter on line 10, Recapitulation) I S
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-00)
' SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT E. LEHMER 21 09 0041
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [ndude ou ht sppoousal distributions, and transfers under
Sec. 9116 (~a (1.2)]
1. KITZIE E. GALBRAITH Lineal 448.16
837 NEVWILLE ROAD
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 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 NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S
(If more space Is needed, Insert additional sheets of the same size)
Ewing B 3o~th u~ Hu~oera Home, In
c.
Carlisle, PA 17013-
(717)243-2421
November 5, 2008
Kitzie E. (Marquiss) Galbraith
837 Newville Rd.
Carlisle, PA 17013
The Funeral Service for Robert E. Lehmer
We sincerely appreciate the confidence you have placed in us and will continue to assist you in
feel free to contact us if you ha
ve any questions in regard to this statement. every way we can. Please
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT
AND MERCHANDISE THAT YOU SELECTED
,
WHEN MAKING THE FUNERAL ARRANGEMENTS.
I. PROFESSIONAL SERVICES
Services of Funeral Director/Staff •
Embalming, ~ $1495.00
Dressing,Casketing Etc. $695.00
•
2. FACILITIES AND SERVICES $265.00
Funeral Ceremony, •
3. AUTOMOTIVE EQUIPMENT $475.00
Vehicle to transfer remains to Funeral Home
,
Hearse (Casket Coach)
$265.00
Service Car $295.00
FUNERAL HOME SERVICE CHARGES $145.00
SELECTED MERCHANDISE: ~ $3635.00
Rental Casket
Acknowledgement cards, $540.00
Register Book(s) $10.00
Memorial folders , ~ $25.00
THE COST OF OUR SERVICES, EQUIPMENT
AND MERCHAN
T $50.00
,
DISE
HAT YOU HAVE SELECTED
,
C h A ~ ~
54260.00
as dvances
Certified Copies of the Death Certificate
Crematorium fee
Cremation Permit Cumberland County, '
The Sentinel Obit with photo
The Patriot Obit with photo •
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
Total
Total Cost , •
$18.00
$295.00
$25.00
$160.60
$286.07
$784.67
. . . . . C. $5044.6
<~ C J C
• PO BOX 988 J ~L~~~G~~C~
HARRISBURG, PA 17108-0988 Motrcd
800 900-1372
2009ro2~7 Hours: Mon-Thur Sam-10pm,
Fri Sam-Spm, Sat 8am.12pm
(Eastern Standard Time)
#BWNMZSX NOTICE OF COLLECTION ~ A C rA at
#800828430007#
ROBERT LEHMER ~ w ..
837 NEWVILLE RD ~•
CARLISLE, PA 17013
CLIENT: Cumber land County
TOTAL BALANCE DUE: $98.00
Our clierrt has ~ ------•-- ._ -~.._____._
referred your deli vent acx;ount s -- `---~`W- -.-
all monks owed them and I am sure your inter4ipns are ~~~ for collection. Our client is earls s about collecting
or you may go onYne to malae payment or contact our office to pay ~. Send payment ~~ the enclosed envelope
to pay the amount due. Phone. Contact'our offk;e tf you are unable
Unless you ~y q~ offirx within 30 days after naxh4ng thk notkx that
thereof this offle will assume this debt ie valid. ff you notify this office in wrki the valktity of thk debt or any portion
that you dkpube the vaNdRy or this debt or a n8 within 30 days from receiving this notk;e
of a Judgment snd rrraH nY Peron thereof, this offkx3 wNl obtain vertfkx~tlcn of the debt or obtain a copy
receiving this notice thk offk;e wHl of such Judgment or verification. ff you request this office in writing wlhin 30 days after
currerrt credkor. pr~ovlte ~ wRh the name and address of the original creditor, K different from the
This k an attempt to collect a debt by a debt cblkctor and any intomration obtained wiN be used for that u
important rights inckrded above appy to each aarourtt indlvid p rPose. The
~~ Irx;lt~ in ~ notice. In the event you choose to ~ have the right to dispute any or all of the
~ mss) You are disputing. ~ ~~~~ rights included above pl~ae irMk~te
R~~--n e~
c4 Py
002
36.00+
144.00+
180.OOx~
PoI cK* aZ o6
`t-t 6_o 4
2009ro2~27
ROBERT LEHMER
837 NEWVILLE RD
CARLISLE, PA 17013
ID NUMBER: 80082643
r with your payrcerg for aocoutk identification. - - - - - - - - - - - - - - - - -
Weaccept Visa, MasterCard and check by Phone
Phase include a check or till out the information below
ff you wish to pay by credit card.
BALANCE: $38.00 Check one: ^ Visa ^ MasterCard
Card #: _
Expiratbn Date: ~ j -""--------
• PO BOX 988
HARRISBURG, PA 17108-0988
2008/072
#BWNMZSX
#800828430007#
ROBERT LEHMER
837 NEWVILLE RD
CARLISLE, PA 17013-0000
Failure to contact our office Inds us b believe that
ff you are unable to pay in full, settlements a~lor F
work with you.
Please contact our office today or set Payment in
2004 CNTY & TWp PER CAPITA; >fiAX NORTH
M~
2005
2006 CNTY & TWP
CNTY & TWP ::
PER CAPITATAX NORTH#1NI
2007
CNTY & TWP PER CAPITA `TAX,,NtJRTH MI
PER CAPITA TIIX'WORTH MI
of resolving your just debt.
may be available. We will do our best b
2004/00/0O
2005 $36.00
2006 $36.00
2007 536.00
$36.00
Thy letter is from a debt collection agency. This is an attempt to cWlect a dml~t. Any information obtained will be used for that
purposef I~ u have filed bankruptcy, pl~se furnish us with your banivuptcy case number. If you wish to have us communk:ate
WKh r-tey regarding this debt, please furnish us with their name and address so that we
Detach and return with ~Y C~ntaLk them.
payment to expedite credit to your account
2oo8ro7ro2
ROBERT LEHMER
837 NEWVILLE RD
CARLISLE, PA 17013-0000
ID NUMBER: 80082643
BALANCE DUE: $144.00
800826430007
Call our toll free number and ~y using check by phone.
If you wish to pay by credit card, p~ enter the requested
information in the spaces provided
Check one: ^ Visa
^ Mastercard
Card #: _
Expiration Date: _% % --
Signature:
PENN CREDIT CORPORATION
~~rrirz ~red~ ~iox~uaxa~,ca~r~
800 900-1372
Hours: Mon-Fri Sam-10pm, Sat Sam-2pm
(Eastern Standard Time)
apT0111,t
~ d,Y~ `O
w ~~ _
., ~~~~ ,~
pMATMM'
CLIENT: Cumberland County
TOTAL BALANCE DUE: $144.00
REQUEST FOR PAYMENT
AD2PC
MEMBERS 1rt
FEDERAL CaEDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
CHECKING ACCOUNT•
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
LOAN ACCOUNT:
Account Number/Suffix
Date Loan Established
Loan Type
Principal Balance at Date of Death
Name of Co-Borrower
Estate of: ROBERT E. LEHMER
Date of Death: 10/30/2008
Social Security Number: 182-68-6708
173458-00
01/26/1998
$9,146.35
$7.52
$9,153.87
None
173458-11
01/26/1998
$103.14
$.00
$103.14
None
173458-01
03/17/2005
Personal Service Loan
$.00
None
M BERS 1ST FEDERALyC~~DIT UNION
Danielle A. Kline ~~
Insurance Services Specialist
November 27, 2009
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 800 283-2328
~ ) wwwmemberslst.org
~ ~i~~
~~~~~~
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