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Home My WebLink About08-25-10J 1505610101 REV-1500 Extol_,o, ~; PA Department of Revenue enns lvania OFFICIAL USE ONLY P Y Bureau of Individual Taxes _,~., y ~ ~ County Code Year File Number r INHERITANCE TAX RETURN PO BOX 280601 2 1 0 5 0 4 8 5 Harrisburg, PA i~iz8-o6oi RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date __ of Death MMDDYYYY Date of Birth MMDDYYYY _ 202-24-5893 ' 05/13/2005 06/20/1933 Decedent's Last Name Suffix Decedent's First Name MI Hoffman Gloria J (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 O 1. Original Return (~ 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust} O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 TO: Name Daytime Telephone Number Richard C. Snelbaker First line of address 44 West Main Street Second line of address City or Post Office Mechanicsburg Correspondent's a-mail address: State ZIP Code PA 17055 REGISTER D~ WILLS USE 6NLY t_._ Q r~ ''~ ~7 7A' G ' ~ ~ G ~ - - ;:~ u't _ Ll~~ ~ r-iC7~l ~. r-) Q -~ f ..k. DATE~.ED `a C>> -; ., .-_` -r, '.~'~ ~) --; 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. SIG~tJUf~E/OF P~jRS PONSIBLE FOR FILING RETURN ~ ~TE (( ADDRESS Ronal Hoffman, Administrator C.T.A. 233 Siddonsburg Road, Dillsburg, PA 17019 SIGN U O _ REP R OTHER THAN REPRESENTATIVE _ BATE ~ 7flot~l (~~ ADDRESS 44 West Main Street, Mechanicsburg, PA 17055 Richard C. Snelbaker, Esquire PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 7,505610101 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: 202-24-5893 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 2,479.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. 9 9 ( ) ......................... Mort a es and Notes Receivable Schedule D 4. .. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 139.84 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. ' 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 2,618.84 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 766.27 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. 0.00 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 766.27 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 1,852.57 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... ... 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 1,852.57 --- - TAX CALCULATION -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 .0_ 15. 1G. Amount of Line 14 taxable at lineal rate X .0 45 1,852.57 '' 1g, 83.37 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. ...................................... TAX DUE ................. 83.37 ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J _. __- _ _ __ ____ __ REV-15Q0 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Gloria J. Hoffman STREET ADDRESS 61 Honeysuckle Drive, Silver Spring Township Cumberland County CITY STATE ZIP Mechanicsburg PA ~ 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest (1} 83.37 Total Credits (A + B) (2} 0.00 (3) 23.93 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 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. (5) 10 7.30 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Dld decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ 0 b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ x^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ CI 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 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 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 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. REV-1503 EX + (8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS 8~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTA' FILE NUMBER Gloria J. Hoffman 21 05 0485 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1.Ralston-Purina Company 2,479.00 74 shares of common stock valued at $33.50 per share TOTAL (Also enter on line 2, Recapitulation) I $ 2 , 47 9.00 3wasss i o00 (If more space is needed; inserCadditional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Gloria J. Hoffman 21 05 0485 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 VALUE AT DATE NUMBER r~croioTinni OF DEATH 1 2 Citigroup Global Ivlarkets, Inc. cash due the decedent from a class action settlement Commonwealth of Pennsylvania unclaimed property held by the state 100.00 39.84 TOTAL (Also enter on line 5, Recapitulation) _$ _~ 139.84 _ awaBADt.oo0 (If mdrespace is needed,irisert additional sheets of the same size) REV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Gloria J Hoffman 21 05 0485 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ None B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) - - Straat Address 2 3 City State Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Straat Address 4. 5. 6. 7, 1 City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees 475.00 Register of Wills filing fee for Supplemental Inheritance Tax Return 15.00 Total from continuation schedules I 276.27 TOTAL (Also enter on line 9, Recapitulation) ~ $ 7 6 6.27 swasac 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: Gloria J. Hoffman Schedule H Part 7 (Page 2) 2 Ronald B. Hoffman reimbursement for following: 1. Fee to ComputerShare for stock reissue $262.78 2. Postage $5.49 3 Snelbaker & Brenneman, P.C. short certificates ......_...... . __ _._ _ _ __ __ _ . __ __ -- __. _ __ __ Total (Carry forward to main schedule) 202-24-5893 268.27 8.00 276.27 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Jeffrey S. Hoffman 9 East Willow Terrace Drive Mechanicsburg, PA 17050 33.333333 of Residue: 617.52 FILE NUMBER 21 05 0485 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Son 617.52 2 Ronald B. Hoffman 233 West Siddonsburg Road Dillsburg, PA 17019 33.333333 of Residue: 617.52 Son 617.52 3 Steven P. Hoffman 61 Honeysuckle Drive Mechanicsburg, PA 17055 33.333333 of Residue: 617.52 Son 617.52 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET I I NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I_~ o . oo __ TOTAL OF PART II ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET - (If more space is needed, insert adddional sheets of the same s¢e) 3W46AI 1.000