HomeMy WebLinkAbout06-22-12--~ REV-1500 Ex (o1-10) 1505610143
PA De artment of Revenue ~' OFFICIAL USE ONLY
P pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
Po Box.zsoso~ INHERITANCE TAX RETURN 2 1 1 2 0 0 3 7 8
Harrisburg, PA 17128-OS01 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
192 62 9862 11 08 2011 02 24 1981
Decedent's Last Name Suffix Decedent's First Name MI
MARTIN MATTHEW D
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
MATTER-MARTIN ANDREA M
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ qa. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® g Decedent Died Testate ~ Decedent Maintained a Living Trust
(Attach Copy of Will) ^ (Attach Copy of Trust) __ 8. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 1 p. Spousal Poverty Credit (date of death 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
CRAIG A DIEHL ESQUIRE CPA 717 763 7613
First line of address
3464 TRINDLE ROAD
Second line of address
City or Post Office State ZIP Code
CAMP HILL PA 17011
Correspondent's a-mail address: C d l e h l@ C a d i e h I I a W. C O m
REGISTER ~~i LLS USEft`~NLY
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DATE FILED I'V ~`'~ _'S
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unaer penai[ies or peryury, I tleclare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, c ct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN J 6 F E E P NSIBUYIFO FILI RETURN DATE
"~~~~ ~ ~- -~'`'~~~ .~-~ Andrea M. Matter-Martin lr: ~ !5 - ~ ~_
ADDRESS
204 Center Street, Enola, PA 17025
ADDRESS //
3464 Trindle Road, Camp Hill, PA 17011
Side 1
L 1505610143
=rHrctrc I rttK I HA R RESENTATIVE DA
~, ,~~ Craig A Diehl Esquire CPA ~
``c~~
1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
oeoedent~sName: MARTIN, MATTHEW DAVID 1 9 2 6 2 9 8 6 2
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
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.
1,000.00
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .............
7, 1 0 0, 0 0 0 0 0
8. Total Gross Assets (total Lines 1-7) ....................................................................... g.
101,000.00
9.
Funeral Expenses & Administrative Costs (Schedule H) .........................................
9. 481.25
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
11. Total Deductions (total Lines 9& 10) ......................................................................
11. 4 8 1 2 5
12. Net Value of Estate (Line 8 minus Line 11)
............................................................. 12 1 0 0 , 5 1 8 7 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.
100,518.75
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 .o0 1 0 0, 5 1 8 7 5 15, 0 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 16.
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 ..................................................................................................................... 19. 0 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 12 - 00378
DECEDENT'S NAME
Martin, Matthew David
STREET ADDRESS -
204 Center Street
CITY
Enola STATE
PA ZIP
17025
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
(1) 0.00
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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.
Total Credits (A + B) (2) 0.00
(3) 0.00
(4)
(5) ~ . 0
' 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 :.................................................................................. ^ 0
b. retain the right to 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 occurred after December 12, 1982, did decedent transfer property within one year of death without I~ II~~~~
receiving ,adequate consideration? ....................................................................................................................... ^ ~I
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? ...................................................................................................................... x
^ ^
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 January 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)1. 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 E
- CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Martin, Matthew David 21 - 12 - 00378
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 OF
NUMBER DESCRIPTION
_ DEATH
Miscellaneous Personal Property
1.000.00
TOTAL (Also enter on Line 5, Recapitulation) I 1,000.00
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ~
ESTATE OF Martin, Matthew David FILE NUMBER
21 - 12 - 00378
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH ~ OF ~ EXCLUSION
NUMBER Include the name of the transferee, their relationship to decedent VALUE OF ASSET DECD'S TAXABLE VAGUE
and the date of transfer. Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE)
1 Met Life Annuity ~oo,ooo.oo 100% 100,000.00
Account#0000011405A
Transferred to surviving spouse i,
TOTAL (Also enter on line 7, Recapitulation) ~I 100,000.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Martin, Matthew David
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATNE COSTS
FILE NUMBER
21 - 12 - 00378
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
A.
B. ,ADMINISTRATIVE COSTS:
1. j Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
2.
3.
City State Zip
Year(s) Commission paid
Attorney's Fees Law Offices of Craig A. Diehl
!
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4
5.
6.
7.
Street Address
City State Zip
Relationship of Claimant to Decedent
I Probate Fees Cumberland County Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
PA Department of Public Welfare -Reimbursement of Certified Mail Costs
400.00
75.50
5.75
TOTAL (Also enter on line 9, Recapitulation) 481.25
MILITARY TESTAMENTARY PREAMBLE: This is a MILITARY TESTAMENTARY
INSTRUMENT prepared pursuant to Title 10 United States Code, Section 1044d, and executed
by a person authorized to receive legal assistance from the military services. Federal law
exempts this document from any requirement of form, formality, or recording that is prescribed
for testamentary instruments under the laws of a state, the District of Columbia, or a territory,
commonwealth or possession of the United States. Federal law specifies that this document
shall be given the same legal effect as a testamentary instrument prepared and executed in
accordance with the laws of the jurisdiction in which it is presented for probate. It shall remain
valid unless and until the Testator revokes it.
LAST WILL AND TESTAMENT
OF
MATTHEW D. MARTIN
I, Matthew D. Martin, a resident of the Commonwealth of Pennsylvania, make,
publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any
time heretofore made by me. I am in the military service of the United States, .currently
stationed at Fort Campbell, Kentucky.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of
the administration of my estate, and all estate, inheritance and similar taxes payable with respect
to property included in my estate, whether or not passing under this will, and any interest or
penalties thereon, shall be paid out of my residuary estate, without apportionment and with no
right of reimbursement from any recipient of any such property.
SECOND: It is my desire that, upon my death, be buried with full military
honors at Arlington National Cemetery, unless another place is determined by my wife, Andrea
M. Matter-Martin.
THIRD: I give all the rest, residue and remainder of my property and estate,
both real and personal, of whatever kind and wherever located, that I own or to which I shall be
in any manner entitled at the time of my death (collectively referred to as my "residu~y estate"):
as follows: ;.~, ~~
z~ ~ '.fir - ~~ ~ ~,~
D ~. J ~i '~
(a) If my wife Andrea M. Matter-Martin survives me, to my wife outright. r_ ~ ~ ~, _
C!. ~ ~J --
(b) If my wife does not. survive me, then to those of my children (wluei~~-~ ~;
hereafter may have) who survive me and to the issue who survive me of tho~'i~ ~, ;_=
my children who shall not survive me, per stirpes. n ' ~ ;~ o
G: __~
(c) If my wife does not survive me and there shall be no issue of mine then
living, my residuary estate shall be paid and distributed to my mother-in-law
Barbara Matter if she shall survive me.
(d) If none of the beneficiaries described above shall survive me, when I give my
residuary estate to those who would take from me as if I were then to die without
a will, unmarried and the absolute owner of my residuary estate, and a resident of
the Commonwealth of Pennsylvania.
FOURTH: If any property of my estate vests in absolute ownership in a minor
or incompetent, my Executor, at any time and without court authorization, may: distribute the
whole or any part of such property to the beneficiary; or use the whole or any part for the health,
education, maintenance and support of the beneficiary; or distribute the whole or any part to a
guardian, committee or other legal representative of the beneficiary, or to a custodian for the
beneficiary under any gifts to minors or transfers to minors act, or to the person or persons with
whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed
by the person to whom the distribution is made shall be a full discharge of my Executor from any
liability with respect thereto, even though my Executor maybe such person. If such beneficiary
is a minor, my Executor may defer the distribution of the whole or any part of such property until
the beneficiary attains the age of eighteen (18) years, and may hold the same as a separate fund
for the beneficiary with all of the powers described in Article SIXTH hereof. If the beneficiary
dies before attaining said age, any balance shall be paid and distributed to the estate of the
beneficiary.
FIFTH: I appoint my wife Andrea M. Matter-Martin to be my Executor. If my
wife does not survive me, or shall fail to qualify for any reason as my Executor, or having
qualified shall die, resign or cease to act for any reason as my Executor, I appoint my
mother-in-law Barbara Matter as my Executor. If my mother-in-law Barbara Matter shall fail to
qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for any
reason as my Executor, I appoint my aunt Dorothy Keebaugh as my Executor. I direct that no
Executor shall be required to file or furnish any bond, surety or other security in any jurisdiction.
SIXTH: I grant to my Executor all powers conferred on executors under the
Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and
all powers conferred upon executors wherever my Executor may act. I also grant to my
Executor power to retain, sell at public or private sale, exchange, grant options on, invest and
reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to
borrow money and encumber or pledge any property to secure loans; to exercise all powers of an
absolute owner of property; to compromise and release claims with or without consideration; and
to employ attorneys, accountants and other persons for services or advice. The term "Executor"
wherever used herein shall mean the executors, executor, executrix or administrator in office
from time to time.
SEVENTH: I direct that for purposes of this will a beneficiary shall be deemed
to predecease me unless such beneficiary survives me by more than thirty days. The terms
"child," "children" and "issue" as used in this will include children and issue hereafter born.
2
EIGHTH: I have served in the Armed Forces of the United States. I therefore
request that my Executor make appropriate inquiries to ascertain whether there are any benefits
to which I, my dependents or my heirs may be entitled by virtue of any military affiliation. I
specifically request that my Executor consult with a retired affairs officer at the nearest military
installation, the Department of Veterans Affairs, and the Social Security Administration.
IN WITNESS WHEREOF, I, Matthew D. Martin, sign my name and publish
and declare this instrument as my last will and testament this 3rd day of February, 2010.
Jp - ~ ,"
Matthew D. Martin
The foregoing instrument was signed, published and declared by Matthew D.
Martin, the above-named Testator, to be his last will and testament in our presence, all being
present at the same time, and we, at his request and in his presence and in the presence of each
other, have subscribed our names as witnesses on the date above written.
`'' ~~'` ~L' having an address at
~~ ~s~ ~r~ ~<<r
having an address at
3
MILITARY TESTAMENTARY INSTRUMENT SELF-PROVING AFFIDAVIT
WITH THE UNITED STATES ARMED FORCES
AT FORT CAMPBELL, KENTUCKY
'We, the Testator 'and the witnesses, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that
in the presence of the military legal counsel and the witnesses the Testator, Matthew D. Martin,
signed and executed the instrument as his military testamentary instrument, that he had signed
willingly, and that he executed it as his free and voluntary act and deed for the purposes therein
expressed. It is further declared that each of the witnesses, at the request of the Testator, in the
presence and hearing of the Testator, the military legal assistance counsel and each other, signed
the military testamentary instrument as witness, and that to the best of his or her knowledge the
Testator. was at the time at least eighteen years of age or emancipated, of sound mind, and under
no constraint, duress, fraud or undue influence.
C~z - ~,
Matte .Martin
Testator
~~~ .-~~
print: ~~3~w~ ~ - 1`/c~.~~i~S
Witne
rin : ~ ~ ,~~a 1_ ~~/
Witness
Subscribed, sworn to and acknowledged before me by the said Matthew D.
Martin, Testator, and subscribed and sworn to before me by the above-named witnesses, this 3rd
day of February, 2010.
I, the undersigned officer, do hereby certify that I am, on the date of this
certificate, a person with the power described in Title 10 U.S.C. 1044a of the grade, branch of
service, and organization stated below in the active service of the United States Armed Forces, or
an authorized civilian attorney under Title 10 U.S.C. 1044a, and that by statute no seal is
required on this certificate, under authority granted to me by Title 10 U.S.C. 104~~'~~`""~"®~'~~~
d y~~~~P~ Pue~~ ~ ~~
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Name of Officer and Position: ~~+~`fY~~kp'~.sot~-~-r~ ~~~~~ OR`ZEO=~mi
Grade and Branch of Service: It- pllSHgY = tn~
Command or Organization: '~
~ * SC r
Law Offices of
Craig A. Diehl
3464 Trindle Road
Camp Hill, Pennsylvania 17011
Craig A. Diehl, Esquire, CPA
Thomas L. McGlaughlin, Esquire
Ryan P. Mellinger, Esquire
Telephone (717) 763-7613
Fax (717)763-8293
www.cadiehllaw.com
June 18, 2012
In Spring Grove, Pennsylvania
119A West Hanover Street
Spring Grove, PA 17362
Telephone: (717)225-1929
Glenda Farner Strasbaugh
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Matthew D. Martin
Estate No. 21 12 00378
Dear Ms. Strasbaugh:
Enclosed for filing please find the following:
Original and two (2) copies of the Inheritance Tax Return REV-1500; and
2. Check in the amount of $15.00 for filing of the Inheritance Tax Return.
Please time-stamp and return the copies of the Inheritance Tax Return in the enclosed
self-addressed envelope. Should you have any questions, please feel free to contact me.
Sincerely,
CAD/daf
Enclosures
~~ ,.~~~
Craig A. iehl, Esquire, CPA
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