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Home My WebLink About11-16-10J REV-1500 15056071,20 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 2 1 0 7 -~ 0 6 5 7 Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 169442562 07032007 Decedent's Last Name HAMMACHER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number Date of Birth 09251957 Suffix Decedent's First Name MI ARCHIE F Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ 1. Original Return ® 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of death after 12-12-82) ® 6 Decedent Died Testate ^ ~ Decedent Maintained a Living Trust (Attach Copy of WiII) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit ((date of death between 12-31-91 and i-1-95) ZIP Code 17112-0216 CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number NORA F. BLAIR 71754114,28 r,, c~ Firm Name (If Applicable) First line of address 5440 JONESTOWN ROAD Second line of address PO BOX 6216 City or Post Office State HARRISBURG PA Correspondent's a-maul address: N F B L A W@ C O m C a S t. n e t 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. S URE OF PERSON R71~+c~LPONSIBLE FOtR~FILING RETURN DATE ADDRESS 2160 Sand Beach Road, Hummelstown, PA 17036 SIGNATURE OF PREPARER OTHE THAN REPRES ~ DATE. _ j~',. ' ` Nora F. Blair ~, _~ ~ ~ a Ess 5440 Jonestown Road, Harrisburg, PA 17112-0216 Side 1 ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 0 __ ___ 8. Total Number of Safe Deposit Boxes (~ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) ~~ - REGISTER ~LS USNLY ~~- - \~ ~~ ~ ~ ' t1 ;) ~ ~~ --; t .., :_.. `T~ DATE~FILED ~ C..'"'"s ;; ~F "t _,. ::1 _. 3 _ ~:.,:,~ ._, '> ~:_., 1505607120 155607120 i J 15056D7220 REV-1500 EX Decedent's Social Security Number Decedents Name: H A M M A C H E R, A R C H I E F. 1 6 9 4 4 2 5 6 2 RECAPITULATION 6 5, 0 0 0 0 0 1. _ ...........................__....................... Real Estate (Schedule A) ............................._ . . 1. 2. .. ............... Stocks and Bonds (Schedule B) .............................__......................... 2. 5, 2 3 1 6 3 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. 1 6 , 7 7 8 8 1 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7 2 , 9 0 9 0 7 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ..............................._............................_...... 8. 1 5 9 , 9 19.5 1 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... g. 1 9 , 4 9 3.11 i 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. . 10. 6 6 , 19 9 . 8 5 11. Total Deductions (total Lines 9 & 10) ................'::.........__.......:.....,..............__.... 11. 8 5 , 6 9 2 . 9 6 12. Net Value of Estate (Line 8 minus Line 11).~ ..........:.................._.........:.::............. . 12. '7 4 , 2 2 6 . 5 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...............:...........:...,,............. 13, 14. Net Value Subject to Tax(Line 12 minus Line 13) ..............................__............... 14. 7 4 , 2 2 6 . 5 5 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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 9, 4 0 0 5 3 16. 1, 3 2 3 0 2 17. Amount of Line 14 taxable at sibling rate X .12 4 4, 8 2 6 0 2 17. 5, 3 7 9.12 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ............................. ._............................__............................__.................. . 19. 6 , 7 0 2.14 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15D560722D 1505607220 J r REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 07 - 0657 DECEDENT'S NAME Hammacher, Archie F. STREET ADDRESS 1800 Sheepford Road CITY Mechanicsburg ,STATE ZIP ~' PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 6 , 7 0 2.14 2. Credits/Payments A. Spousal Poverty Credit _ __ __ _ ___ _ _ B. Prior Payments 7, 0 9 0.2 2 C. Discount 3. - --------- Total Credits (A + B + C) Interest/Penalty if applicable (2) ____ 7,090.22 _ ___ __ -__ p. Interest 3 8 8.0 7 E. Penalty Total Interest/Penalty (D + E) (3) 3 8 8.0 7 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) 0.01 Check box on Page 2 Line 20 to request arefund - --- ---- -- - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) -- _ __ _ _- o . ~ 0 Make Check Payable to: REGISTER OF WILLS, AGLNT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No --- ~ ;--; a. retain t e use or income of the property transferred :............................._.............................__................ ; xj -- ;-- 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 premise 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 a equate consideration? ..........................................................................................__.................... x --- __ 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? ....................... ' .....__ ............................__............................__.................... x . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR 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 statutedoes not exempts 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)]. 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. ' ~, SCHEDULE F COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF Hammacher Archie F FILE NUMBER , . 21 - 07 - 0657 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Donna J. Berkhimer 2160 Sand Beach Road Sister A Hummelstown, PA 17036 Archie Hammacher 5933 Linglestown Road Father B Harrisburg, Pa 17112 JOINTLY OWNED PROPERTY: ITEM I LETTER ; DATE L~F{.SCRIPTION OF PRO~ERTY ~ - - ~ .Include name o manclal instltutlon an bank account number DATE OF DEATH '~ ° OF ! ~° DATE of DEATH NUMBER i FOR JOINT] MADE TENANT JOINT ',or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET ~ ;I DECD'S NTEREST VALUE OF DECEDENT'S INTEREST __ __ _____ -- -- testate. --___ --- -- - - 1 03/08/1994 - --- --_ --- -- _ ' Fulton Chechin Account 9 ; - - - _- -- - _ - - _ ~ 34,485.94 ~-- - ~ 50% - - --- -- _ - 17,242.97 2 B '; 10/01/2006 1986 Ford Dump Truck 1,000.00 ~ 50% 50 . 0 00 3 A, B 09/19/2001 5933 Linglestown Road 119,282.00 ' 33% 39,363.06 Harrisburg, PA 17112 Assessed at $81,700 x CLR 1.46 4 A, B 09/19/2001 5928 Avis Lane 46,428.00 33% 15,321.24 Harrisburg, PA 17112 Assessed at $31,800 x CLR 1.46 5 A, B ! 09/19/2001 5929 Rear Linglestown Road ~ 1,460.00 33% 481.80 Harrisburg, PA 17112 Assessed at 1,000 x CLR 1.46 TOTAL (Also enter on line 6, Recapitulation) 72,909,07