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Home My WebLink About05-25-1015056051058 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year Flle Number P080X280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 09 1190 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 182-46-3512 12/16/2009 09/14/1954 Decedent's Last Name Suffix Decedent's First Name MI HOFFMAN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Securty Number FILL IN APPROPRIATE OVALS BELOW 1 Original Return 4. Limited Estate i •' 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received JUDITH A Suffix Spouse's First Name __ _ _ MI THIS RET~1+?111 MUST 13iF. ~II.Fg IN [11JP1 IrATG 1/1lITI-I TI-IF REGISTER OF WILLS !"`° 2. Supplemental Return ';`:'~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise (date of ~,,,, 5. Federal Estate Tax Return Regwred death after 12-12-82) '"""° 7. Decedent Maintained a Livin Trust 0 ..._. 9 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) ~,,, 10. Spousal Poverty Credit (date of death ,;;;"~ 3 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Att h S CORRESPONDENT - THIS SECTION MUST BE COMPLET ac ch. O) ED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX I Name NFORMATION SHOULD BE D IRECTED TO: - -- THOMAS E. FLOWER Daytime Telephone Number __ (717) 737-3405 Firm Name (If Applicable) _ AIDIS, FLOWER & LINDSA __...__... _,,-., REGISTERY>F ~LLS US ~ _ E (~Y ~ First Ilne of address n ' _, _~ --.. _ ~ ' 2109 MARKET ST `7 _ __ r .~ -': - ? rz Second line of address - - -, t ~ .; -. City or Post Office ~i - - _ ---I State ZIP Code _ I3~E FILED -- ""' -, Cp,n~P HII I ..__ - ,~ . _ PA 17011-4723 n.a Correspondent's a-mail address: tflOWef~U Sfl-I8W.C0111 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, 't is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ''~ ~ I!t (~ JEFFREI~ ~ A R, 18 SY AN OAK WAY, NOTTINGHAM, MD 21236-4700 SI AT OF ~REPAR T EPRESENTATIVE -------__ a ADDRESS S/z~/~ ~ SAIDIS, FLOWER & LINDSAY, 2109 MARKET ST, CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 (~~ . `~ ti J REV-1500 EX 15056052059 Decedent's Social Security Number Decedents tvame JUDITH A HOFFMAN _. ~..... ' 182-46-3512 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 ... ..... . 2,196.30 6. Jointly Owned Property (Schedule F) `°';; Separate Billing Requested .. 6 . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property .... . °- {Schedule G) a°_::"> Separate Billing Requested.... .... 7. 8 Total Gross Assets (total Lines 1 7) . . _, ____ 2,196.30 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. . . 5,500.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ .... 1p. 11. Total Deductions (total Lines 9 & 10) ........ ....................... ... 11. 5,500.00 12. Net Value of Estate (Line 8 minus Line 11) ......... . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which - 0.00 an election to tax has not been made (Schedule J) . .................... .. . 13. 0.00 14 Net Value Subject to Tax (Line 12 minus Line 13) . _.... _. _...__ . TAX COMPUTATION -SEE INSTRUCTIONS FOR A " a 0.00 PPLICABLE RATES 15. Amount of Line 14 taxable _ .. rv V""~" " at the spousal tax rate, or transfers under Sec. 9116 - - - -- - - (a)(1.2) X .0_ 16. Amount of Line 14 taxable - - - 15. at lineal rate X .0 _ 17. Amount of Line 14 taxable 16 at sibling rate X .12 18. Amount of Line 14 taxable - 17. at collateral rate X .15 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 I_ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: 21 os 1i~19omber DECEDENT'S NAME - - _JUDITH A HOFFMAN DECEDENT'S SOCIAL SECURITY NUMBER STREET ADDRESS 182-46-3512 5 CAROL LANE clrY ENOLA srATE zIP PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments (1) 0.00 A. Spousal Poverty Credit B. Prior Payments C. Discount 1 interes~'Peralty if applicable Total Credits (A + g + C) (2) D. Interest - - E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.tal InteresUPenalty (D + E) (3) Fill in oval on Page 2, Line 20 to request a refund. (4) 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 Did deced t k en ma e a transfer and: a. retain the use or income of the property transferred :.................................................. Yes No ...................... b. retain the right to designate who shall use the property transferred or its income : ..................................... c t i .... ^ ^ . re a n a reversionary interest; or ...................................................... ... d. receive the promise for life of either payments, benefits or care? ......................................................... 2 If d C; ...... eath 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 d ...... x ^ ^ ^ x .... . ecedent 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 no__ t e_ xemDt 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)]. 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY REV-1508 EX+ (6-98) - !' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JUDITH A. HOFFMAN ._. _..-..... ..~ .~~., .aolllc ~ILC~ FILE NUMBER 21-09-1190 Include the proceeds of litigation and the date the proceeds were received by the estate. All nrooerty ininliv_nw.. n.l ,.,:aG _:_~. _~ ___ . . REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT CJIHIt Uh JUDITH A. HOFFMAN ITEM NUMBEf A. 1 B. 1 SCHEDULE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-09-1190 Debts of decedent must be reported on Schedule I. FUNERAL EXPENSES: SULLIVAN FUNERAL HOME, ENOLA, PA THIS AMOUNT WAS INITIALLY PAID BY THE EXECUTOR (DECEDENT'S SON) FROM HIS OWN ACCOUNT BY CHECK DELIVERED PRIOR TO DEATH AND NEGOTIATED AFTER DEATH - IT WAS INADVERTENTLY OMITTED FROM THE ORIGINAL RETURN, WHICH ONLY CLAIMED THE BALANCE OF FUNERAL COSTS IN EXCESS OF THE INITIAL $5,500. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Prcbate Fees Accountant's Fees Tax Return Preparer's Fees Zip Zip TOTAL (Also enter on line 9 Recapitulation) I $ (If more space Is needed, insert addltlonal sheets of the same size) 5,500.00 5,500.00 LAW OFFICES SAIDIS, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 CARLISLE OFFICE: JOHN E. SLIKE TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 26 WEST HIGH STREET ROBERT C. SAIDIS EMAIL: attorney@sfl-Iaw.com CARLISLE, PA 17013 JAMES D. FLOWER, JR wwwsfl-law.com TELEPHONE: (717)243-6222 CAROLJ.LINDSAY FACSIMILE: (?17)243-6486 iOHN B. LAMPI DANIEL L. SULLIVAN ALBERT H. M ASLAND DEAN E. REYNOSA REPLY TO CAMP HILL THOMAS E. FLOWER MARYLOU IvtATAS JASON E. KELSO May 24.2010 ~~~ Cumberland County Register of Wills - `~-' 1st floor, Suite 102 ~~~:`_~ - 1 Courthouse Square `- r? --~ r ~ } ~ ,:; Carlisle, PA 17013 ~ . `~~-~ u~: ~~ - =:; _.. ..:::.. Re: Estate of Judith Hoffman _'_ -: File No. 21-09-1190 ~ ~=' c.~ Dear Sir or Madam: Enclosed are the original and one copy of the Inheritance Tax Return for the above- referenced decedent along with a check for the filing fee of $15.00. Please contact our office if you have any questions regarding this matter. Very truly yours, SAIDIS, FLOWER & LINDSAY ~~ , ~ ~~ ~,~~ o e Sersch, Assistant to ~ as E. Flower, Esquire /yms enclosures ~~~ ~;~ ~-.~~ ~. ~: LL -" i c~ c~ ~. .:= ~- ,_ ~ J s.a. f~ ~ ~= rte.-..-. U N ~ 4--~ O z r~ " ~/ ¢ ~ o `' ~ ~ N p~ '¢ cn ~ a ~ , W ~= ~ - ~ (B 3~ ~x ~ o ~~ 0~ ~ ~ 0 o~~o U~ w N~ o~ A ~~ od ` ~ o ~ aS a~ ~o~ ~ ~, ~ ~ O ~L ~ NU ~ Ur-~U O H