HomeMy WebLinkAbout03-0079OFFIClN_ USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
RLENUMBER
COUNTY CODE YEN{ NUMBER
DECEDEI~PS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
T"~,,,,,,,,~, 1{.:i.~','d J :1.82-22-8749
THIS RETURN MUST BE RI. ED IN DUPUCATE WITH THE
REGISTER OF WILLS
z
o
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
07/10/2002 04,/10/1921
(iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND M~DDLE INmAL)
Z
O
SOCIAL SECURITY NUMBER
r~ 1. Original Return I I 2. Supplemental Return L__J 3. Remainder Return (date of death pdor to 12-13-82)
[] 4. Limited Estate r'~ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required
[--~ 6. Decedent Died Testate (Attsof~ copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes
[~ 9. Litigation Proceeds Received ~ 10. Sp_~,,~! Poverty Credit (date of death between 12-31-91 and 1-1-95) [~ 11. Election to tax under Sec. 9113(A) (Attach SCh O)
NAME
T.este: R ~mnma
:IRM NAME (If Applicable)
TELEPHONE NUMBER
COMPLET~ MAILING ADDRESS
[207 St. John's Church Road
tCam~ Hill, PA 17011-4049
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
6. J~n,..~.~' Owned Property (Schedule F) (6)
I I
~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate ProperbJ (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedulel) (10)
1. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net V,,h,~ Subject to Tax (Line 12 minus Line 13)
0.00
1~313.76.
0.00
0.00
6,981.60
0.00
32,000.00
OFFICIAL USE ONLY
(8)
40,295.36
3,765.70
16,001.42
(11)
(12)
(13)
(14)
19,767.12
20,528.24
0.00
20,52g.24
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
t 5. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at co~lateral rate
0 · 00 x .00 (15)
20,528.24 x .o45 (16)
0.00 x.12 (17)
0.00
x .15 (18)
(19)
19. Tax Due
20.
0.00
923.77
0.00
0.00
923.77
2W4645 1 .o0o
Dec~lent's Complete Address:
S3REE'I' ADD RESS
Seidle Nursing Facility
CITY
Mechanic s]:m. rg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable D. Interest
E. Penalty
JSTATE
0.00
0.00
0.00
0.00
0.00
Total Credits (A + B + C)
(1)
(2)
Total Interest/Penalty (D + E) (3)
17011
923.77
0.00
0.00
923~77
If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(4)
(5)
A. Enter the interest on the tax due.
(5A), 0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 923.77
Make Check Pa able to: REGISTER OF WILL.% 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 properly transferred; .......................
b. retain the right to designate who shall use the property transferred or its income; ......... [~ r~
c. retain a reversionary interest; or ................................
d. receive the promise for life of either payments, benefits or care? .................
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?
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.
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, con'ecl and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
S~GN~tl~IRE OF PERSON RESPxON/~IBLE FOR FILING RETURN DATE
ADDRESS207 S~.. Jo~'8 CZtttrc~ Road
Cam~ Hill, PA 17011-4049
S,7~F ~~N RE PRESENTATIVE DATE
ADORE~013 ~= ROa~, Suite 100
L~e, PA 17043
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 3%
[72 P.S. § 9916 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of trsnsfers to or for the use of the surviving spouse is 0% [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 retum 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 0% [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%, 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% (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.
2W4646 1,000
REV-1502EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Thmmm, Richard J -2002-
All real property owned solely or es a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which le Jointly-owned with
right of eurvlvorehlp must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1. 0.00
TOTAL (Also enter on line 1, Recapitulation) $ 0 o 00
2w,~69s 2.000 (If more space is needed, insert additional sheets of the same size}
REV-1503 EX + (1-97)
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
'~t-~', R:i. ch~=c~ J -2002-
All property jointly-owned with right of survivorship must be diecloaed on Schedule F.
ITEM
NUMBER
1. 42
DESCRIP'I3ON
VALUE AT DATE
Shares Prudenti&l Financi&l Inc. C~maon
OF DEATH
1,313.76
TOTAL (Also enter on line 2, Recapitulation) $ 1,313 o 76
2W4696 3.000 (If more space is needed, insert additional sheets of the same size)
REV-150~ EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
T'ntumaa, ~R~ob~=cl ~ -2002-
Include the ~roceeds of litigation and the date the proceeds were receNed by the estate. NI properly jointly-owned wilh the right of survivorship must be dteclo~ed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. MaT Bank Account #442062 6,981.60
2W46AD 2.000
TOTAL (Also enter on line 5, R~_,_~;Jl~ion) $
(If more space is needed, insert additional sheets of the same size)
6,981.60
REV-1510 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOSTRANSFERS &
MISC. NON-PROBATE PROPERTY
E~I'ATE OF FILE NUMBER
Th,,,,~, Richard ,.T -2002-
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
~SCRIPTION OF PROPERTY % OF
I~M INCLUDE THE NNVlE ~'IHE ~FEREE, ~BR RE~TIONSHIP TO DATE OF DEATH DECD'S EXCLUSION
DECEDENT ~D 1HE ~ OF TRANSFER. A~ACH A COPY ~ THE TAXABLE VALUE
NUMBEF DEED FOR REN. E~A~. VALUE OF ASSET INTEREST (F ~=PUC~)
1. Cash gi£t to son, Lester R. 30,000.00 100,00 3,000.00 27,000.0C
Thmmaa, £rceaproceeds o£ sale
o£ residence c~leted on
04/01/2002
2 Cash gi£t to Trust account 8,000.00 100.00 3,000.00' 5,000.00
£/b/o Shirle~ ~. Thuwmna and
Wanda H. Thumzna, £ro;np;oceeds
o£ sale o£ residence coa~leted
on 04/01/2002
3 0.00 100.00 0.00 0.00
TOTAL(Also ~tero~li~e7, Reca~itul~ion) $
32,000.00
(If more space is needed, insert additional sheets of same size.)
2W46AF 2.000
REV-1511 EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Th~maa, Richard J -2002-
ITEM
NUMBER
Debts of decedent must be relxxtsd o~t Schedule I.
DESCRIP'RON
5.
6.
7.
FUNER,N_EXPENSES:
Hoffman Roth Funeral Home
Westminster Cemetery
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Lester R Tht~mta,
Social Security Number(s) / EIN Number of Personal Representative(s)
StreetAddress 207 St. John's Church Road
City Ca.a~ Hill State PA Zip 17011-4,049
Year(s) Commission Paid:
AttorneyFeesNa.ate.' Gates, Halbruner & Hatch, P.C.
Family Exemption: (If decedent's address is not the same es claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Retum Preparer's Fees
Filing Fees for Small
Estate Petition
TOTAL (Also enter on line 9, Recapitulmion)
2W46AG 2.000 (If more space is needed, insert additional sheets of same size)
AMOUNT
185.70
565.00
1,500.00
1,500.00
0.00
0.00
0.00
0.00
15.00
3,765.70
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABILITIES, & LIENS
ATE OF FILE NUMBER
Th-~,n,,, Richard J -2002-
Include unreimbursed medical expenses.
ITEM
NUMBER
2
3
4
5
6
7
8
9
10
2W46AH 2.000
DESCRIPTION
Sus~ueb=~-& Surgeons Ltd.
West Shore Anesthesia
~m~erland County Goodwi11 EMS
Pinnacle Health Hospital
Quantum Imaging & Therapy
Gates, Halbruner & Hatch
Moffitt Heart & Vascular
Physicians of Rehabilitation
Vascular Associates
American Income Life
Three Springs Family Practice
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
15.80
19.15
53.58
15,486.05
10.78
262.50
59.57
11.80
2.51
34.50
45.18
16,001.42
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RE'FJRN
F~SIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
r.~ATE OF
NUMBER
II,
FILE NUMBER
· Richard. O' -2002-
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
'~b-~Ym',,,, T.eBt:er R
207 st:. John,s Chu=ch Ro&cl.
Cam~ H~11, PA 17011
20,528.24
ENTER DOLLAR AMOUNTS FOR DISTRIBUTioNS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBLmONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II I ENTER TOTAL NON-TAXABLE DISTRIBLmONS ON UNE 13 OF REV-1500 COVER SHEET $ 0.0 0
2w4s^~ 1.ooo (If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA '~ 7128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 002094
GATES LOWELL R ESQ
1013 MUMMA RD
SUITE 100
LEMOYNE, PA 17043-1144
........ fold
ESTATE INFORMATION: SSN: 1 82-22-8749
FILE NUMBER: 2103-0079
DECEDENT NAME: THUMMA RICHARD J
DATE OF PAYMENT: 01/27/2003
POSTMARK DATE: 01/24/2003
COUNTY: CUM BERLAN D
DATE OF DEATH: 07/10/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $923.77
TOTAL AMOUNT PAID:
$923.77
REMARKS: GATES ETAL
SEAL
CHECK# 756
INITIALS: VZ
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
'ql 1140 0000 4007 8634
i_O. -ooq 9
LAW OFFICES OF
~JA~ HA. LBRUNER &-HATCH, P.C~
1013 MUMMA ROAD, SUITE 100
LEMOYNE, PENNSYLVANIA 17043
Certified Mail - Return Receipt
Mary C~ Lewis, Register of Wills
CUmberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
IN THE MATTER
OF THE ESTATE OF
RICHARD J. THUMMA
Deceased.
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND
COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No.
PETITION FOR SETTLEMENT OF SMALL ESTATE
TO THE HONORABLE, THE JUDGE OF SAID COURT:
The Petition of the undersigned respectfully represents:
1. The name, address and relationship of your petitioner to the above decedent are:
Name:
Address:
Relationship:
Lester R. Thumma
207 Saint John's Church Road, Camp Hill, PA 17011
Son
2. The above decedent died on July 10, 2002 at Seidle Nursing Facility,
Mechanicsburg, Cumberland County, Pennsylvania 17013.
3. Said decedent died Intestate.
estate are:
The names, relationships and interests of all parties beneficially interested in the
NalTle
Relationship Interest Sui Juris
Lester R. Thumma
207 St. John's Church Rd
Camp Hill, PA
17011-4049
Son 25% Residuary Yes
Beneficiary
Joyce A. Staver
518 Oak Creek Drive
Brandon, FL 33511-7511
Daughter 25% Residuary Yes
Shirley J. Thumma
207 St. John's Church Rd
Camp Hill, PA
17011-4049
Daughter 25% Residuary Yes
Beneficiary
Wanda M. Thumma
207 St. John's Church Rd
Camp Hill, PA
17011-4049
Daughter 25% Residuary Yes
Beneficiary
5. No person is entitled to or claims the family exemption of $3,500.00 by virtue of
being a member of the same household as the decedent.
6. Said decedent died owning property (exclusive of real estate and of wages, salary,
pension or vacation benefits) of a gross value not exceeding $25,000.00, which is itemized as
follows:
Item Amount
M&T Bank Account #442062
6,981.60
42 Share Prudential Financial Inc. ~ 31.28/share
1,313.76
Total $8,295.36
7. An itemized statement of all claims against the estate is as follows:
(a) Claims heretofore paid by Lester R. Thumma to the following:
Claimant Nature Amount
Hoffman Roth Funeral Home
Susquehanna Surgeons Ltd.
West Shore Anesthesia
Cumberland Goodwill EMS
Pinnacle Health Hospital
Pinnacle Health Hospital
Pinnacle Health Hospital
Quantum Imaging and Therapy
Pinnacle Health Hospital
Gates, Halbruner & Hatch, P.C.
Moffitt Heart & Vascular
Physicians of Rehabilitation
Vascular Associates
Gates, Halbruner & Hatch
American Home Life
Funeral Services 185.70
Medical Services 15.80
Medical Services 19.15
Emergency Services 53.58
Medical Services 913.50
Medical Services 6,965.53
Medical Services 4,906.20
Medical Services 10.78
Medical Services 2,355.64
Legal Services 120.50
Medical Services 59.57
Medical Services 11.80
Medical Services 2.51
Legal Services 142.00
34.50
Claimant
Nature
Amount
Three Springs Family Practice
Pinnacle Health Hospital
Westminster Cemetery
Medical Services
Medical Services
Burial Services
45.18
345.18
565.00
Total
$16,752.12
(b) Claims remaining unpaid:
Claimant
Nature
Amount
Commonwealth ofPenns~vania
DepartmentofPublicWdfare
P.O. Box 8486
Harrisburg, PA 17105-8486
Claim for
restitution of
medical
assistance
18,818.27
Total
$18,818.27
7. Petitioner will cause to be paid all Pennsylvania inheritance taxes due on all
property to be awarded. The Pennsylvania Inheritance Tax Return was filed simultaneously
herewith in the Register of Wills Office.
8. All parties beneficially interested in the estate other than the petitioner have
signed the joinder in this petition which is hereto attached.
WHEREFORE, your Petitioner prays that the above property of the decedent be
distributed under Section 3102 of the PEF Code as follows:
(a)
possible
In reimbursement of claims against the estate heretofore paid, to the extent
Name Amount
Lester R. Thumma
8,295.36
Tot~: $8,295.36
(b)
Commonwealth of Pennsylvania
Department of Public Welfare
(c)
the estate.
For payment of claims against the estate remaining unpaid:
Amount
0.00
There are no funds remaining for distribution in accordance with the interests in
GATES, HALBRUNER & HATCH, P.C.
DATED: ~ ~,~.~ V~ , 2002
BY:
Ct, a~ A. Hatch, Esq.
1013 Mumma Road, Suite 100
Lemoyne, PA 17043
(717)_731-9600
Lester R. Thumma
VERIFICATION
This i '~ day of -'~ e ¢-s:-cx~r ~ ,2002, the foregoing Petitioner hereby verifies,
subject to the penalties of 18 Pa.C.S. 4904 (relating to unswom falsification to authorities), that
the facts set forth in the foregoing Petition which are within his knowledge are true, and as to the
facts based on information received, after diligent inquiry, he believes them to be true.
Lester R. Thumma, Petitioner
JOINDER
We, the undersigned, being all the parties, other than the Petitioner, beneficially
interested in the estate of the foregoing decedent, do hereby certify that we have read the forgoing
Petition and join in the prayer thereof.
Dated - ' Lester R. Thumma
January ;~ 2003
Dated ·
January [~t 2003
Dated
Shirley' J. Thumma
Wanda M. Thumma
JOINDER
We, the undersigned, being one of the parties, other than the Petitioner, beneficially
interested in the estate of the foregoing decedent, do hereby certify that I have read the foregoing
Petition and join in the prayer thereof.
January I,~ 2003
Dated
t.~/oyce A. Staver
518 Oak Creek Drive
Brandon, FL 33511-7511
dAN 2 8 2003
IN THE MATTER
OF THE ESTATE OF
RICHARD J. THUMMA
Deceased.
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
AND NOW, TO WIT: This_.,_,~'~ day of 2003, upon consideration
of the foregoing Petition and on motion of the attorney for the Petitioner, it is ordered that the
property of the decedent be distributed under Section 3102 of the PEF Code as follows:
The assets remaining on hand after the payment of the cost of these proceedings be
distributed to Lestcr R. Thumma as reimbursement of expenses paid on behalf of the decedent;
and it appearing that there are no funds remaining for distribution in accordance with the interests
in the estate, it is further
Ordered that this decree of distribution shall constitute sufficient authority to all transfer
agents, registrars and others dealing with the property of the estate to recognize the persons
named herein as entitled to receive such property without administration, and shall in all respects
have the same effect as a decree of distribution after an accounting by a personal representative.
BY THE COURT,
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0~01
CRAIG L HATCH
GATES ETAL
1015 MUMMA RD STE 100
LEMOYNE PA 17045
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 E~ AFP
DATE 05-24-2005
ESTATE OF THUMMA RICHARD
DATE OF DEATH 07-10-2002
FILE NUMBER 21 05-0079
COUNTY CUMBERLAND
ACN 101
I Amount Remitted I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~* RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-Z547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF THUMMA RICHARD J FILE NO. 21 05-0079 ACN lO1 DATE 05-24-2005
TAX RETURN WAS: C X} ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. ReaZ Estate CSchedule A}
2. Stocks and Bonds CSchedule B}
5. Closely Held Stock/Partnership Interest CSchedule C}
4. Mortgages/Notes Receivable CSchedule D}
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E}
&. Jointly Owned Property CSchedule F} C6)
7. Transfers CSchedule G}
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/M/sc. Expenses CSchedule H} C9}
10. Debts/Mortgage Liabilities/Liens CSchedule I} ClO>
11. Total Deductions
12. Net Value of Tax Return
.00
lt515.76
.00
.00
6~981.60
.00
NOTE: To insure proper
credit to your account,
submit the upper port/on
of this form with your
tax payment.
5,765.70
16,001.42
(~1) ]9.7~7.1~
(12) 20,528.24
19. Princi
TAX CREDITS
PAYMENT
DATE
15.
1~.
NOTE:
ASSESSMENT OF TAX=
15. Amount of Line 14 at Spousal rate ClS)
16. Amount of L/ne 14 taxable at Lineal/Class A rate (16}
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate C18~
~al Tax Due
RECEIPT DISCOUNT (+}
NUMBER INTEREST/PEN PAID (-~
01-24-2005 CD002094 .00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
reflect figures that include the total of ALL returns assessed to date.
· O0 x O0 = . O0
20,528.24 x 045 = 925.77
.00 x 12 = .00
· O0 x 15 = . O0
¢19)= 925.77
AMOUNT PAID
925.77
Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J} C15) .00
Net Value of Estate Subject to Tax C14) 20,528.24
If an assessment uas issued previously, lines 14, 15 and/or 16, 17, 18 and 19
TOTAL TAX CREDIT
925.77
.00
.00
.00
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
C IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY SE DUE
A REFUND. SEE REVERSE SZDE OF THIS FORM FOR INSTRUCTIONS.}
52~000.00
ca) 40,295.56
RESEEVATION=
Estates of decedents dying on or before December I2, I982 -- if any future interest in the estate is transferred
in possession or enSoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby exgressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE=
PAYMENT=
REFUND (CR)=
OBJECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALTY=
INTEREST~
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to= REGISTER OF N[LLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an °~pplication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office
of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering= 1-800-$62-2050; services for taxpayers with special hearing and / or
speaking needs= 1-800-447-5020 (TT
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax Cincluding discount or interest) as shown on this Notice must object within sixty (&O) days of receipt of
this Notice by=
--written pretest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to= PA Department of RevQnue,
Bureau of IndividuaI Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0&0I
Phone (717) 787-&505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" CREV-150I) for an expianation of administrativeiy correctabie errors.
If any tax due is paid within three C3I calendar months after the decedent's death, a five percent CSX) discount of
the tax paid is aliowed.
The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before Januar~ 18, I996, the first day after the end of the tax amnesty period. This non-participation
penalty is appeaiabIe in the same manner and in the the same time period as you wouid appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of deiinquency, or nine C9) months and one C1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six C&%) percent per annum caiculated at a daiiy rate of .000164. All taxes which became delinquent on and after
JanuarY 1, I982 will bear interest at a rate which wiii vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are=
Interest Daiiy Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Yea.~r Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .000192
1983 16% .000438 1988-1991 11% .000301 2000 8% .000219
1984 11% .000501 1992 9% .0002~7 2001 9% .000247
1985 13% .00035& 1993-1994 7% .000192 2002 6% .000164
1986 10% .000274 1995-1998 9% .000247 2003 5% .000157
--Interest is calculated as follows=
I'NTEREST = BALANCE OF TAX UN'PA/D X NUNBER OF DAYS DELXNI~UENT X DAXLY XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation date sho~n on the
Not/ce, additional interest must be calculated.
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY
UNTIL COMPLETION.
Name of Decedent:
Date of Death:
File No.:
STATUS REPORT UNDER RU£E 6.12
Richard J. Thumma
07/10/2002
2103-0079
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: Yes
Date:
If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a £mal account with the court? No
Bo
The separate Orphans' Court No. (if any) for the personal representative's
account is:
Co
Did the personal representative state an account informally to the parties in
interest? Yes
Do
June 9, 2004
Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of Orphans' Court and may be attached to
this report.
~r~ i .gDE. '~H4a~ ~h7¢E s quire
GATES, HALBRUNER & HATCH, P.C.
1013 Mumma Road, Suite 100
Lemoyne, PA 17043
(717) 731-9600
Capacity: Counsel for Personal Representative