HomeMy WebLinkAbout06-29-101505607120
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
oun a ear ~ e um er
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO 60X.280601
Harrisburg, PA 17128-osol RESIDENT DECEDENT 2 1 0 9 0112 2
Social Security Number Date of Death Date of Birth
178222212 12012009 08021924
Decedents Last Name Suffix Decedent's First Name MI
GOODMAN BIIRTRAM P
(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
® 1. Original Return 0 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82}
0 4. Limited Estate 0 4a, Future Interest Compromise 0 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
0
® g, Decedent Died Testate ~ ~, Decedent Maintained a living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
~ 9. Litigation Proceeds Received ~ 1 p, 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)
ame Daytime Telephone Number
DALE F SHIIGHART,
F' N If A I' bl JR. HSQIIIR$ 7172414"31.1 "
rrm ame ( pp ica e)
First line of address
10 ~P$ST HIGH STR$$T
Second line of address
City or Post Office State ZIP Code
CARLISLE PA 17013
REGISTER O~.~VILLS USE ~l.Y
C~
Ti
~ ~ ~~ r
~ I
~
~
~ _
«~..
~
~
~ ..
:_
~^_
_' ~~~% t~ -~ c
_, 4- ~.
DATE E~ED F`J E-
,~ ~~>
~..
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statemerrts, 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.
.~,,.y~ ~-- Jeanne Goodman Ludt ~~/ ~~ ~ i7
3 School Street, Amherst, NH 03031
SIGNATURE O EPARER OTHER THAN REPRESENTATIVE DATE
Hamilton C. Davis, Esquire _ ~ f~~/j ~
20 East Burd Street, Shippensbsurg, PA 17257
Side 1
1505607120 1505607120 J
ADDITIONAL Personal Representatives
Goodman, Burtram P SS# 178-22-2212 12/1/2009
Under penalties of perjury, the undersigned declare that they have examined this return,
including accompanying schedules and statements, and to the best of their knowledge and
belief, it is true, correct and complete.
2 Signature
Name bert J. Goodman
Address 085 Guadeloupe Street
city, state, zip Boulder CO 80301
Date ~. Z ~ ~
3 Signature
Name
Address
City, State, Zip
Date
4 Signature
Name
Address:
City, State, Zip
Date
5 Signature
Name
Address:
City, State, Zip
Date
6 Signature
Name
Address:
City, State, Zip
Date
J 1505607220
REV-1500 EX
oecedent~s Name: GOODMAN , B U R T R A M P
Decedent's Social Security Number
178222212
RECAPITULATION
1.
( ) .........................................................................................
Real Estate Schedule A
1. 2 3 1, 5 0 0. 0 0
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sote-Proprietorship (Schedule C).......... 3.
4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 2 8 , 12 8 . 8 0
6. .faintly Owned Property (Schedule F) p ~ Separate Billing Requested ............. 6.
7. inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) p' Separate Billing Requested .............
7.
2 5 8, 6 2 7. 9 2
g, Total Gross Assets (total Lines 1-7) ....................................................................... 8. 5 1 8, 2 5 6. 7 2
9. Funeral Ex enses & Administrative Costs Schedule H g, 5 0 , 2 5 6 . 3 7
P ( ) ........................................
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 1 , 6 4 8 . 5 9
11. Total Deductions (total Lines 9 8 10) ..................................................................... 11. 5 1, 9 0 4. 9 6
12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 4 6 6 , 3 5 1 . 7 6
13.- .charitable and Govemrnental Bequests/Sec 9113 Trusts for which
...................... .................... 13.
' an election to tax has not been made (Schedule J)
466 351.76
14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14: ~
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 .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 4 6 6, 3 51.7 6 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxa e
at collateral rate X .15 18.
19. Tax Due ..................................................................................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
20,985.83.
20,985.83
Side 2
1505607220 1505607220
REV 1500 EX Page 3 File Number 21 - 09 - 01122
Decedent's Complete Address:
Goodman, Burtram P
1316 Georgetown Circle
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 20, 985.83
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments ~
C. Discount 1,049.29
Total Credits (A + B + C) (2) 20,999.29
3. Interest/Penalty ifapplicable
p. Interest
E. Penalty
Total InterestlPenalty (D + E) (3) 0.00
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 13.46
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. (5)
A. Enter the interest on the tax due. (5A)
g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 :...................................:..................................:...:........ x
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? .............................................................. 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? ...................................................................................................................... ~ ^
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 decedents 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.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
FILE NUMBER
ESTATE OF Goodman, Burtram P
21 -09-01122
rea property owned sole)yy or as a tenant n common must reppoorts at a r market value. air market va ue is a fined as the price
at which property would be excf~anged between a willing buyer and a wilfing 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.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Tract of land and townhouse located in the Borough of Carlisle, 1316 Georgetown Circle, 231,500.00
Carlisle, Cumberland County, PA, 17013, prior Deed reference Deed Book "K", Vol. 35, Page
186. Cumberland County Tax Parcel #50-21-0324-050. Value based upon actual sale price,
copies of Deed and HUD-1 attached.
TOTAL (Also enter on Line 1, Recapitulation) ~ 231,500.00
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
coM-~oNwEA~TH of PENNSn.vAN1A PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Goodman, Burtram P FILE NUMBER
21 -09-01122
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Household goods, furniture and furnishings, value based upon appraisal of IBIS Appraisals. 14,981.00
2 M ~ T Bank checking account #2672037351 10,557.51
Principal 10,557.51
Accrued interest 0
3 Social Security, final payment 849.00
4 MetLife, final annuity payment 1,000.00
5 USAA Federal Savings Bank 3.78
6 Centurytel, Inc. .. 4.64
7 Armed`Forces Insurance Exchange, refund homeowner's insurance .. 732:87
~ TOTAL (Also enter on Line 5, Recapitulation) ~ 28,128.80
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
IN RESIDENT DECED ~R" M1SCT ON~ PROBATE PROPERTY
ESTATE OF Goodman, Burtram P
FILE NUMBER
21 - 09 - 01122
This schedule must be completed and flied if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
Include the name of the 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 EXCt.usION
(IF APPLICABLE) TAXABLE VALUE
1 Merrill-Lynch Account #872-22248 transferred on 239,918.58 100% 239,918.58
death by beneficiary designation -value fetter
attached.
Jeanne Goodman Ludt, daughter, 1 /2 interest
Robert J. Goodman, son, 1/2 interest
2 Merrill-Lynch Account, Money Market #872-55793 6,541.96 100% 6,541.96
transferred on death by beneficiary designation -value
letter attached.
Jeanne Goodman Ludt, daughter, 1/2 interest
Robert J. Goodman, son, 1/2 interest
3 MetLife Annuity #072964207AB -value letter attached. 3,667.38 100% 3,667.38
Transferred on death by beneficiary designation.
Jeanne Goodman Ludt, daughter, 1/2 interest
Robert J. Goodman, son, 1 /2 interest
4 Romac Oil, rninera! and royalty lease, Kayser E.W. Jr. 500.00 . - 100% 500.00
#IU, valued based upon attached letter ,transferred on ~
death by beneficiary designation.
Jeanne Goodman Ludt, daughter, 1/2 interest
Robert J. Goodman, son, 1 /2 interest
5 Margaret Ludt, granddaughter, gifts made during 11,000.00 100% 3,000.00: 8,000.00
lifetime. Margaret received 11 gifts by checks:
01 /24/09, 02!24/09, 3/22/09, 4/17/09, 05/21 /09,
06/21 /09, 07/27/09, 08/24/09, 09/25/09, 10/29/09,
11 /23/09
TOTAL (Also enter on line 7, Recapitulation) f 258,627.92
S~h~llLE H
FUNERAL EXPENSES &
COMMONWEALTH of PENNSYLVANIA ~pwT
INHERITANCE TAX RETURN ~1~7 / R/'11 ~ ~~
RESIDENT DECEDENT
ESTATE OF Goodman, Burtram P
UMW
21 -09-01122
Debts of decedent must be reported on Schedule I.
T M
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Hoffman-Roth Funeral Home and Crematory, funeral 2,044.50
2 Jeanne Ludt, reimburse organist (200) Sexton (50) Caterer (389) 639.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Dale F. Shughart, Jr., Esquire (estimated)
3. Family Exempiaon: (If decedents address is not the same as claimant's, arch explanation).
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent ~ .
4. Probate Fees Register of Wills, probate fees paid (260 + 30) Owe (50)
5. Accountants Fees
6. Tax Return Preparer's Fees Smith Elliot & Kern
7. Other Administrative Costs
1 Register of Wills, Short Certificates
20, 000::00
340.00
395.00
20.00
TOTAL (Also enter on line 9, Recapitulation) 50,256.37
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sd~edWe H
Palatal Eames &
~~Q
ESTATE OF
Goodman, Burtram P FILE NUMBER
21 -09-01122
2 Cumberland Law Journal, advertise Letters 75.00
3 The Sentinel, advertise Letters 176.92
4 Postmaster, certified mail 12.00
5 Register of Wills, filing Income Tax Return and Inventory 30.00
6 Bonnie Coyle, notary fees 25.00
7 PP&L, electric 88.93
8 IBIS Appraisals, personal property appraisal 660.00
9 IBIS Appraisals, removing belongings from home 688.00
10 Recorder of Deeds, realty transfer tax on sale of home. 2,315.00
11 Jeanne Goodman Ludt, reimburse UGI bill 94.20
12 Jeanne Goodman Ludt, .reimburse miscellaneous expenses 1,586..77
13 Robert J. Goodman, reimburse~miscellaneous expenses ~ 2,349.77
14 June Baum, cleaning 687.00
15 Prudential Home Sales, realtor's commission 6,970.00
16 Carlisle Tax Account, 2010 county/borough real esate taxes 1,178.09
17 B-H Agency, realtor's commission 6,692.00
18 Prudential Home Sa{es, broker's fees 195.00
19 AHS, home warranty plan 455.00
20 UG! Utilities, gas 127.42
Page 2 of Schedule H
Sd~edule H
Fineral E~gper~ses &
COMMONWEALTH OF PENNSYLVANIA A ~y~„M•~~~ ~e ~OM~ ~~
INHERITANCE TAX RETURN /~~ ~ ~^ ~.~11 Ci~~l
RESIDENT DECEDENT
ESTATE OF Goodman, Burtram P L NU
21 -09-01122
21 ATT, phone 21.77
22 CenturyLink, cell phone 25.16
23 Register of Wills, filing Inheritance Tax Return and Inventory 130.00
24 Craig and Dolly Kern, credit on repairs to real property 2,000.00
25 Borough of Carlisle, sewer and water 101.84
26 Armed Foreces )nsurance Exchange, home owners insurance 133.00
Page 3 of Schedule H
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH of PENNSYLVANIA LIABILITIES, & LI ENS
INfiERtTANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Goodman, Burtram P 21 - 09 - 01122
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Checks written before death, clearing after death: 80.17
M & T Bank checking account #2672037351
#6880 Walnut Court Home Assoc. ,dues 60.00
AT&T, electric bill 20.17
2 Millenium Pharmacy System East, medicine
3 West Shore EMS -Carlisle, ambulance
4 Thornwaid Home Nursing Home, final bill
5 Discover Credit Card, balance due.
f USAA Credit Card Services, MasterCard
7 Borough of Carlisle, water and sewer
8 PPL Electric
9 UGI Utilities, Inc.
10 AT&T, phone bill
11 CenturyLink, phone
12 Walnut Court Assoc., condo fee January-March
13 June Baum, house cleaning
94.68
137.00
44.15
9.99
68.00
65.94
47.94
231.13
41.61
94.98
180.00
300.00
TOTAL (Also enter on Line 10, Recapitulation] ~ 1,648.59
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT continued
FILE NUMBER
ESTATE OF Goodman, Burtram P 21 - 09 - 01122
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
14 AFIE, homeowner's insurance 133.00
15 ~ PA Department of Revenue, estimated income tax ~ 120.00
Page 2 of Schedule I
REV-1513 EX+ (11-08)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Goodman, Burtram P
21 - 09 - 01122
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116 (a) (1.2)j
1 Jeanne Goodman Ludt Daughter one-half
3 School Street
Amherst, NJ 03031
2 Robert J. Goodman Son one-half
4085 Guadeloupe Street
Boulder, CO 80301
Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate.
~ NON-TAXABLE DISTRIBUTIONS: `
~ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX 1S NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 0.00