HomeMy WebLinkAbout07-26-11J 1505610105
REV-1500 EX (oz-ii) (FIB ~,
PA Department of Revenue pennsytvania OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX z8o6oi °`°""~"`"'°`"`"`""` County Code Year File Number
INHERITANCE TAX RETURN -
Harrisbur PA 1128-0601 RESIDENT DECEDENT ~ ~ ~~ ~U ` f
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0922-2260 01 /07/2011 03/13/1930
Decedent's Last Name Suffix Decedent's First Name
_. MI
KILLIAN___ ROBERT D
(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
Olp 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
O 4. Limited Estate O Prior to 12-13-82)
4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O
(Attach Copy of Will) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
A
(
ttach 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 Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0
Name :
_ Daytime Telephone Number
JOHN D. KILLIAN
(717) 232-1851
rrttswrEle.,Q~ILLS USE~~ILY ~~
a. ~ r-_ i .'T't
First Line of Address t-~+ ~--- f ~~ ~7
-T
218 Pine Street - _ ~ ~ ~ ~ ~ r ~,
- f -,
~ -1' ~- C-, i ' ;
Second Line of Address C'-)
_ -
CJ =~ --~ -!-~;
~ - - i
"p---~1 ~~ f`r`i
City or Post Office State ZIP Code ATE FILED ,r
Harrisburg __ _ _ _ _ _ _ ~_ -~-~
PA 17055
Correspondent's a-mail address:~kllllan@kllllangephart.COm
Under p ies of perj eclare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true cor and plate. ecl ation a er other than the personal representative is based on all infonnation of w h reparer has any knowledge.
SIGNAT E F PE S RES L F ILIN>; RETURN
ATE
ADDRESS (~ -~ / )L'L~^J-, 1
~~~ Ir/r')`E' ~~~~''~ /~f~t'k'I~ibr:A/~C"i Pa ~?'~al
JIC~IVAI URE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
1505610105
Side 1
1505610105 J
k
J
1505610205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: 090-22_2260
RECAPITULATION
1. Real Estate (Schedule A) .......................................... ... 1. 0.00
2. Stocks and Bonds (Schedule B) .................................... ... 2. 250,126.53
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. '' 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 135,530.09
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. 385,656.62
9. Funeral Expenses and Administrative Costs (Schedule H) ......
..........
... s.l
i 3,165.59
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10.
..~ 11,909.23
11. Total Deductions (total Lines 9 and 10) ............................... .. 11. ' 15,074.82
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ' 370
581.80
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. ' 370,581.80
~P-x 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.
16. Amount of Line 14 taxable
at lineal rate X .0 _ ' 16.
17. Amount of Line 14 taxable __ __
at sibling rate X .12 17. ' 44
469
82
18. Amount of Line 14 taxable ,
.
- - -
at collateral rate X .15 18
19. TAX DUE .................................................... .....19.I 44,469.82
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
Flle Number
DECEDENT'S NAME
ROBERT D. KILLIAN
STREET ADDRESS
5225 WILSON LANE
CITY
MECHANICSBURG STATE
PA ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 43,500.00
B. Discount 2,223.49
3. Interest
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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 44,469.82
Total Credits (A+ B) (2) _ 45,723.49
(3)
(4) 1,253.67
(5)
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 .......................................................................................... ^ ^
b. retain the right to designate who shall use the property transferred or its income ............................................ ^
c. retain a reversionary interest .....................................................................................
d. receive the promise for life of either payments, benefits or care? ....................................... .
2. If death occun'ed after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an "in trust for" orpayable-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(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+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT D. KILLIAN 2011-00047
All property jointlyowned with right of survivorship must np dla~hava ,,., s,.tiea.,re e
to wvra space is neeaeo, mser[ aaamonai sneers or the same size)
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THE GABELLI FIINDS
PO BOX 8308
BOSTON MA 02266-8308
864416 F001 335 10Z 1/1 - 335 GB
JOHN D KILLIAN EXEC
ESTATE OF ROBERT D KILLIAN
5225 WILSON LN APT 3144
MECHANICSBURG PA 17055-6670
GABELLI VALUE FUND- CL A
Gabelli
REc~ Funds
Confirmation of Redemption: 0 3/ 0 4/ 2 011
Representative:
Dealef: GABELLI & COMPANY INC
ONE CORPORATE CENTER
RYE NY 10580-1436
For Customer Service: 1- 8 0 0- 4 2 2- 3 5 5 4
Fund No: 409
Account No: 3239341-3
Trade Transaction Dollar Share Shares This Total
L Date Description Amount Price Transaction Shares
03/04/2011 SI-TARES REDEEMED $43,546.21 $16.52 2,635.969 0.000
REV-i5o8 EX+ (> i-io)
~~i , Pennsylvania SCHEDULE E
~ DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC~
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ROBERT D. KILLIAN 2011-00047
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorshia must be disclosed en schpd~~Ip F
~~ niu~e ~ycce is neeaea, use aamaonai sheets of paper of the same size.
REV-1511 EX+ {10-09)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT D. KILLIAN 2011-00047
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A• FUNERAL EXPENSES:
I' Paxton Presbyterian Church
250.00
2. W. Orville Kimmel Funeral Home 1,832.09
3. Town of Hempstead 300.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) John D. Killian
Street Address 5225 Wilson Lane Apt. #3144
city Mechanicsburg state PA zIP 17055
Year(s) Commission Paid;
2• Attorney Fees: 0.00
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 0.00
Claimant
Street Address
City State
Relationship of Claimant to Decedent
4.
5.
6.
7.
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
ZIP
TOTAL (Also enter on Line 9, Recapitulation) I ~
If more space is needed, use additional sheets of paper of the same size.
443.50
340.00
3,165.59
REV-1512 EX+ (12-08)
Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT D. KILLIAN 2011-00047
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1• Bethany Skilled Nursing 10,593.85
2. HSBC Card Services 76.95
3. Jeffrey's Flowers 172.73
4. J.J. Stanis & Company 13.05
5. McKesson Medisurg 5.83
6. Check Printing Fee 17 gg
7. Camp Hill Emergency Physicians 34.89
8. Kanter & Trach Associates 68.04
9. McKesson Medisurg 29 Og
10. CCRX 484.25
11. PNC Bank Fee 10.00
12. PA Department of Revenue 320.00
13. Smith Radiology, INC 1.75
14. Mobil Xray Imaging 80.81
TOTAL (Also enter on Line 10, Recapitulation) I # 11,909.23
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ {01-10)
J i~ Pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ROBERT D. KILLIAN 2011-00047
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1~ John D. Killian, 5225 Wilson Lane, Apt. 3144, Mechanicsburg, PA 1055 Brother 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, use additional sheets of paper of the same size.
1
LAST WILL p,ND TESTAMENT
OF
ROBERT D. KILLI.AN
I, ROBERT D. KILLIAN, declare this to be my Last
Will and Testament and hereby revoke all prior wills and
codicils made by me.
FIRST: My Executor shall pay from the residue of
my estate all my debts, funeral and administration
expenses and all estate, inheritance, succession and
transfer taxes imposed by the United States or any
state, territory or possession which shall become
payable by reason of my death. It shall not be
necessary to file any claims therefor, nor to have them
allowed by any court.
SECOND: I give and devise the residue of my estate,
real, personal and mixed, of whatever kind and nat~ire,
and wherever situate at the time of my death, including
any property over which I now have or hereafter acquire
a power of appointment, to my brother, JOHN D. KILLIAN,
his heirs and assigns forever. If my brother
predeceases me, I give and devise the residue of my
LAST WILL AND TESTAMENT
OF
ROBERT D. KILLIAN
estate, real, personal and mixed,. of whatever kind and
nature, and wherever situate at the time of my death, to
my sister-in-law, SALLY G. KILLIAN, her heirs and
assigns forever. If both my bro'cher and sister-in-law
predecease me, I give and devise the residue of my
estate, real, personal and mixed, of whatever kind and
nature, and wherever situate at the time of my death, to
my nephew and niece, DAVID B. KILLIAN and JOAN E. ROOF,
their heirs and assigns forever, per stirpes.
THIRD: I nominate, constitute and appoint my
brother, JOHN D. KILLIAN, Executor of this my Last Will
and Testament, to serve without bond or security, ar.d to
make distribution of my estate in cash or in kind, or
partly in cash and partly in kind, and. in such manner as
he may determine . I authorize, e~- power and. dir_er_.t h1.m
to sell and convey, by good and sufficient deed, in fee
simple estate, any and all of my real estate, at public
or private sale, for such price or prices, upon such
terms and conditions, as in his judgment is best for my
2
LAST WILL AND TESTAMENT
OF
ROBERT D. KILLIAN
estate, and to that end to sign, seal, execute,
acknowledge and deliver all deeds or other instruments
necessary therefor, as effectively as I could do if I
were personally present.
In the event that my brother, JOHN D. KILLIAN, does
not survive me, or refuses to act as Executor or does
not complete the duties of Executor, then I nominate,
constitute and appoint my sister-in-law, SALLY G.
KILLIAN, as alternate Executrix, to serve without bond
or security. My alternate Executrix shall have all of
the powers, privileges, duties and immunities as
provided herein.
IN WITNESS WHEREOF, I, ROBERT D. KILLIAN, the
Testator, have to this my Last Will and Testament, set
-}~-
my hand and seal this ? g~ day of June, ?005.
_ _
~y ..~_ / AL )
RO D. KILLIAN
3
LAST WILL AND TESTAMENT
OF
ROBERT D. KILLIAN
Signed, sealed, published and declared by the above
named Testator, as and for his Last Will and Testament,
in the presence of us, who have hereunto subscribed our
names at his request, as witnesses hereto, in the
presence of the said Testator, and of each other. The
preceding document consists of this and three (3) other
consecutively numbered typewritten pages.
esiding at
esiding at ~ ,~(~ I'
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.:
COUNTY OF ~ ~~'~ ~ ~ )
I, ROBERT D. KILLIAN, the Testator whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; and that I signed it willingly and
as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by ROBERT D..
KILLIAN, the Testator, this ~~ day / Juna-, 2005.
---- - ~ ; r
Test for
Notfary Public
(SEAL )
Notarial Seal
4 Rhonda L. Lang, Notary Public
Ci of Harrisburg. Dauphin County
My~ommission Expires Aug. 9.2008
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
ss.:
COUNTY OF ~~}~{.~ r ~ )
- / r '
We, F~~ ~h~~4 ~ ~ and //~ ~ , 6~?
the witnesses whose names are signed to the at ached or oregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw the Testator sign and execute the
instrument as his Last Will; that the Testator signed willingly and
executed it as his free and voluntary ar_t for the purposes therein
expressed; that each subscribing witness in the hearing and sight
of the Testator signed the Will as a witness; and that to the best
of our knowledge the Testator was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn )to o affirmed and s s ribed before me by
/ ~ ~ and
ytn sses, this 29 ,~ ay of June, 005.
~./'ft(.E/.( - % LL~/Lt-~ ~ SEAL)
Notary Public
Notarial Seal
Rhonda L. Lang, Notary Public
Ci of Harrisburg, Dauphin County
My~ornmission Expires Aug. 9, 2008