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HomeMy WebLinkAbout09-13-10 (2)1505607121 REV-1500 EX (06-05) OFFICUIL USE ONLY PA DeperbnenfofRevenue County Code Yeer File Number BureauoflndPoidualTaxes INHERITANCE TAX RETURN Po sox 2tJ0801 2 1 0 9 0 9 8 9 Hamsbum. PA 17128-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death Date of Birth 1 6 5 2 6 5 3 5 8 1 0 1 3 2 0 0 9 1 1 2 1 1 9 3 3 Decedent's Last Name Suffix Decedent's First Name MI M I L L E R M A R I A N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 1. Original Retum ^ 4. Limited Estate ^ 6. Decedent Died Testate (Attach Copy of wllq ^ 9. Litigation Proceeds Received Q ^ ^ ^ 2. Supplemental Retum 4a. Future Interest Compromise (date of death after 12-12-62) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-3f-91 and 1-1-95) ^ ^ ~ ^ 3. Remainder Retum (date of death pnarto 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE CONPL.EIED. ALL CORRESPONDENCE AND CONRDENTIAL TAx INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number 7 1 7 2 4 3 N 3 4 1 Finn Name (If Applicable) - --- o REGIS WILLS U![ ONLY ~~ M A R T S O N L A W O F F I C E S ', w ~ '-'~`~ , First line of address v , , ~~~ ... ~~ j T ~ ~ Cn;~. 1 0 E A S T H I G H S T R E E T . ,~~~ c t.; Second line of address i ro ~ ~ ~''~ _ -~ ~ v~ r (= r-n '~-'DATEFILEDp ~~~ ~ ' ~`' City or Post Office State ZIP Code ~p C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address: I O T T O a M A R T S O N L A W• C O M Under penal8es o-perprry, l declare that 1 halm examined this return, irldudklg aCCOmpatrying schedules and statements, and to the hest of my knowledge and belief, ft is hue, correct and complete. Dedare8on ofpreparer other then the personal represent~ve k based on ell information of which preparer has any knowledge. SI ~,URFjOF~RSOI~S'P~Jr~ILE~~ILINGRETURN ~~~ /~ RIT OTHER THAN REPRESENTATIVE ARLISLE 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY L 1505607121 Slde 1 1505607121 J~ 1505607221 REV-1500 EX Decedent's Social Security Number oe~nYsName: MARIAN E• MILLER 1 6 5 2 6 5 3 5 8 RECAPITULATION 1. Real estate (Schedule A) .................................... .... 1. 2. .............................. Stocks and Bonds (Schedule e) .... 2. 5 2 7 0 3. 4 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. 4. Mortgages & Notes Receivable (Schedule D) .................... .... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... .... 5. 7 7 6 1 . 7 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ... .... 6. 1 0 6 0 0 • 8 0 7. Inter-Vivos Transfers & Miscellaneous Probate Property ~ 4 3 4 4 2 7 8 (Schedule G) Separate Billing Requested ... .... 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 1 4 5 0 8. 8 4 9. Funeral Expenses 8 Administrative Costs (Schedule H) ............ .... 9. 1 0 8 7 8 • 4 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........ .... 10. 9 3 , 6 6 11. Total Deductions (total Lines 9& 10) ....................... 11. .... 1 0 9 7 2. 1 1 12. Net Value of Estate (Line 8 minus Line 11) ..................... .... 12. 1 0 3 5 3 6 . 7 3 13. Charitable and GovemmenffiI BequeatslSec 9113 Trusffi for which an electlon to tax has not been made (Schedule J) .............. .... 13. 14. Nst Valus SubJect to Tsx (Line 12 minus Line 13) .............. 14. .... 1 0 3 5 3 6 , 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.0 _ 0 . 0 0 15. 16. Amount of Line 14 taxable 0 0 0 at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable 8 7 0 3 9 0 2 at sibling rate X .12 . 1 ~. 18. Amount of Line 14 taxable 1 6 4 9 7 7 1 at collateral rate X .15 . 16. 19. Tax Due .............. ........................... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 0. 0 0 1 0 4 4 4. 6 8 2 4 7 4. 6 6 1 2 9 1 9. 3 4 Side 2 1505607221 1505607221 J REV-1500 FaC page 3 Decedent's Complete Address: DECEDENTS NAME MARIAN_E. MILLER STREETADDRESS 210 BIG SPRING ROAD CITY Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credft File Number 21 09 0989 _.. _ . ----__ - STATE ZIP PA 17241 B. Prior Payments C Discount 3. Interest/Penalty if applicable Toth Credits (A + B + C ) D. Interest 129.32 E, Penalty 4. If line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPA YMFNT.Total InteresfiPenalty (D + E ) Ffll In oval on i~ 2, Una 20 ro 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. 8. Enter the total of Line 5 + 5A. This is the &4LANCE DUE. (1) l2 919.34 (2) 0.00 13) - 1 9 2 (4) 0 00 (5) 13,048.66 (5A) (5B) 13,048.66 Make Check Payable to: REGISTER OF WILLS, AGENT ~~~~i~ - _ ~ , ~_ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Dfd decedent make a transfer and.• Yes No a. retain the use or Income of the property transferred : ............ b. retain the right b designate who shall use the property transferred or its income; ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ^ c. retain a reversionary interest; or .......................... ......................................................... ^ ............. d. receive the promise for life of either payments, benefits or care? ...................................... 2. If death oxurred after December 12, 1982, did decedent transfer property within one year of death wffhout receiving adequate conslde-8tiort? ....................... 3 Did decedenrt own an "in host for' or payable upon death bank aaount or security at his or her death? ......... ^ 4. Did decedent own an Individual Retirement Account, annuity, orothernon-probate property which contains a beneficiary designatiat? .................................................................................................. a ^ IF THE ANSWER TO ANY OF THE~yABOVE QUESTIONS /S YES, YOU MUST COMPLETE SCHEDUULE G AND FILE IT AS PART OF THE RETURN. 3.. } ~ rrP f?r!,%~~i" .~e~n~iP~~. ~.4~Se+~`dwh~~~aSH a ~~i6~ t i~~:f~n amp 5~~'d~±•u :k:: iR. ~ ~+::. , . For dates of death on or alter July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers b or for the use of the surviving spouse is three (3) percent (72 P.S. §9116 (e) (1.1) (i)/, For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers b or for the use of the surviving spouse is zero (OJ percent (72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer b a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applcable even if the suMving spouse is the only beneficiary. For dates of death on or after July 1, 2000; The tax rate imposed on the net v~ue 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)J. The tax rate imposed on the net v~ue of transfers to or for the use of the decedent's tines/ beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9118(1.2) (72 P.S. §9116(8)(1)). The tax rate Imposed on the net value of transfers to or for the use of the decedents sibiings is M~elve (f2) percent (72 P.S. §9116(a)11.3)l. Asibling is defined, under Section 9102, as an individual who has at feast one parent In common with the decedent, whether by blood w adoption. REV-1503 EX + (g-Bg) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS 8j BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF rat numertK MARIAN E. MILLER 21 09 0989 All pmpsrlyJolntly-owned edtlr right oisuMvorshlp moat 6e dlacbsad on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Edward Jones Account # 377-10278-1-4 52,703.49 TOTAL (Also enter on line 2, Recapdulation) ~ S (Hmore space is needed, insert additbnal sheets of fhe same size) REV-1508 EX + (e-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER MARIAN E. MILLER 21 09 0989 Include the s o(IlHgation and Me dabs fhe proceeds xere recehred by fhe estate. All props Intly~oemed xdNi f of survlvonhlp moat be dhchaed on Scheduh F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH i. Crozer-Keystone Health System, pension benefit paid after date of death 2,252.49 2. 2 Series E. $50 Savings Bonds 77.50 (See attached) 3. Green Ridge Village, refund 5,141.02 4. Banker's Life, refund of health care premium 201.76 5. US Treasury, 2009 1040 income tax refund 89.00 TOTAL (Also enter online 5, Recapitulation) S 7 761 77 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (8-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF RLE NUf/8ER MARIAN E. MILLER 21 09 0989 Han asset was med~ joint w7tldn one year o/the decedents date o/deeth, h must be reported on Scheduh G. SURVIVING JOINT TENANT(S) NAME A. JOINTLY•OWNED PROPERTY.• ADDRESS TIONSHIP TO DECEDENT ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIALINSTITUiIONANDBANKACCOUNTNUMBERORSIMILAR IDENTIFYING NUMBER. ATTACH DEED FORJOINTLY~FIELDREALESTATE. DATEOFOEATH VALUE OF ASSET %OF DECD'S INTEREST DATE OF DEA TH VALUE OF DECEDENT'SINTERESI 1. A. 04/04 M&T checking account # 9835623944 21,201.59 50. 10,600.80 2830 Ritnet Highway Carlisle, PA 17015 TOTAL (Also enter on line 6, Recapitulation) I S 10,600.80 (1/more space is needed, insert edddlonel streets o/the same sae) REV-1510 EX + (g-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER MARIAN E. MILLER 21 09 0989 This schedule must ba completed and filed if the answer to any of questions 1 through 4 on fhe reverse side orfhe REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY uewoEn~Ew~oFn~Ernu+sFEaE{TMEwneurroNSHmroar.E°EHruro TXEM7E°FTRWSFER.ATfAC11ACOPYOFiHEOEF.OFORFFALESTA7E DATE OFOEATH VALUE OF ASSET 960FDECD'S INTEREST EXCLUSION (IFAPFLILABLE) TAXABLE VALUE 1. Midland National Annuity 8500208979 (See Attached) 24,659.13 100. 24,659.13 Beneficiaries: Paul E. Miller, brother, 50.5%; James E. Miller, brother, 49.5% 2. North American Company Annuity 8000028347 (See Attached) 18,783.65 100. 18,783.65 Beneficiaries: Paul E. Miller, brother, 50.5%; James E. Miller, brother, 49.5% TOTAL(Alsoenteronline7Recapifulafion) ~ S 43,442,78 (Hmore apace fs needed, (naerf eddlNonal sheets o/the same size) REV-1511 EX + (10.08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARIAN E. MILLER 21 09 0989 Debte o/decedent must be reported on ScbeduN I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. Hoffman-Roth Funeral Home, Carlisle, PA 17013 2,772.37 2. Cazlisle Memorial Service, grave marker 185.00 3. Green Ridge Village, funeral reception 200.00 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) SbeetAddress Gty State Zip Year(s) Commission Paid: Z, AttomeyFees MARTSON LAW OFFICES (estimated) 6,900.00 g, Fatuity Exemption: (Ifdecedent's address b not the same as daimant's, alteCh explanatron) Galmant Street Address City State Zip Reletionshlp of Gaimant to !)eCedent 4. Probate Fees Cumberland County Register of Wills t 32.00 5 Accountant's Fees 6. Tax Return Preparer's Fees H&R Block, preparation of 2009 personal income tax returns 332.00 7. Filing Fee, Inheritance Tax return 15.00 8. Edward Jones, estate services 100.00 9. Death Certificates 52.00 10. Certified mailings, Department of Public Welfaze & US Treasury 11.08 11. Short Certificate 4.00 12. Homestead Title Company, search to determine if NJ property and mortgage were in the name 175.00 of the Decedent TOTAL (Also enter on line 9, Recapitulation) S 10.878.45 (Il more space is needed, insert additiond sheets of the same size) REV-1512 EX + (12-03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ~ flLE NUMBER MARIAN E. MILLER 21 09 0989 Report debts Incurred by the decedent prior to death whkh remaMed unpaid as of the dah of death, Including unrelmbureed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEA 7H Millennium Pharmacy Systems East, account payable 93.66 TOTAL (Also enter on line 10, Recapitulation) 13 93 (If mae space is needed, insert addMbnal sheets otthe same size) REV-1513 EX ~ (9-001 SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT MARTAN R MTT.L.FR 21 09 0989 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lfst 7rustae(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS pndude outright spousal dishibutions, and transfers under Sec. 9116 (e) (1.2)1 1. Paul E. Miller Sibling 49,037.13 2830 Ritner Highway Sch F + 50.5% Sch G + Carlisle, PA 17015 1/3rd of estate residue 2. James E. Miller Sibling 38,001.89 59 Meade Drive 49.5% Sch G + Carlisle, PA 17013 1/3rd of estate residue 3. Hope Miller Collateral 5,499.24 308 Stonehedge Drive 1/6th of estate residue Carlisle, PA 17015 4. Glenn E. Miller, Jr. Collateral 5,499.24 622 Opossum Lake Road 1/6th of estate residue Carlisle, PA 17015 5. Robin Omer Collateral 5,499.23 805 North West Street 1/6th of estate residue Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET li, 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 OFPART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size)