HomeMy WebLinkAbout09-14-1215D561D143
REV-1500 Ex(D,_,o,
PA De artment of Revenue OFFICIAL USE ONLY
p Pennsylvania County Code Year File Number
Bureau of Individual Taxes CEVARTMEM Of REVENUE
Po Box.2soso~ INHERITANCE TAX RETURN 21 12 ~ !\~~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT lJ
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
07 28 2012 10 25 1947
Decedent's Last Name
WALTMAN
Suffix
Decedent's First Name MI
KARL ~ E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
WALTMAN
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
Spouse's First Name MI
KATHY E
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
X^ 1. Original Return ^ 2. Supplemental Return
^ 4. Limited Estate ^ ~ Future Interest Compromise
(date of death after 12-12-82)
6 Decedent Died Testate
(Attach Copy of Will)
^ ~ ecede44t Maintained a Living Trust
~A
ttach Gopy of Trust)
^ g, Litigation Proceeds Received ^ p
10. b8tweeriP2~31 ~Ji a dt (1a95)f death
^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
^ 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
cUKReSPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
LINDA J OLSEN ESQ 717 540 4332
First line of address
2000 LINGLESTOWN RD
Second line of address
SUITE 202
City or Post Office
HARRISBURG
State ZIP Code
PA 17110
Correspondent's a-mail address: IOISent~haZenelderlaW.COm
REGISTER QLS USEfO-ILY ~
~'7 ~.: ,'--'- 17 ''
~
G
Cr. _ ~_
L7 C. J ' ~ -" 7
~J ~ ..a
- r t .V _
DATE FILED -~
-~-.
."l_.
_~~
i _.3
I
i )
:~>
-r'
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.
SIGN~,A,T.U.-R}E~OF.P'ERSON RESPONShBL~FOR FILING RETURN DATE
~A. ~ ~~~~.~V'"- -'~'VL-~ Kathy E. Waltman ~ -(3 ~ /~
ADDRESS
2 G~,fview Dr., Mechanicsburg, PA 1
2000 Linglestown Rd. ,Harrisburg, PA 17110
Linda J. Olsen, Esq.
DATE
_ ~~ _
Side 1
15D561D143 15D561D143 J
1505610243
REV-1500 EX
Decedent's Social Security Number
°eceaent~sName: Waltman, Karl E.
RE CAPITULATION
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 8 Notes Receivable (Schedule D) ...................................................... .. 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............. .. 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6.
7. Inter-Vivos Transfers & Miscellaneous lyoq Probate Property
(Schedule G) u Separate Billing Requested........... . 7. 947 , 642.91
8. Total Gross Assets (total Lines 1-7) ................................................................... .. g, 94 7 , 642.91
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 3 , 500 . OO
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10.
11. Total Deductions (total Lines 9 8~ 10) .................................................................. . 11. 3 , 5 O O . O 0
12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12, 944 , 142.91
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. 944 , 142.91
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 944 , 142.91 15. O . 00
16. Amount of Line 14 taxable
at lineal rate X .045 0 . OO 16. Q , OQ
17. Amount of Line 14 taxable
at sibling rate X .12 0.00 17. 0.00
18. Amount of Line 14 taxable
at collateral rate X .15 O . OO 18. Q , 00
19. Tax Due ................................................................................................................. . 19. 0 . 0 O
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
L 1505610243 1505610243
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-12
DECEDENT'S NAME
Waltman, Karl E.
STREET ADDRESS
3612 Golfview Dr.
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
0.00
(1)
Total Credits (A + B) (2)
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.
Make Check Payable to: REGISTER OF
(3)
(4)
(5)
AGENT.
0.00
0.00
~.~0
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 :.................................. ~ 0
c. retain a reversionary interest; or ............................................................................................................... ^ 0
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? ....................................................................................................................
x
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? ............................................. O ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
.' - .. „~ , ,, ~:~~l.,.
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)j.
. 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)]. 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.
Rev-1510 EX+(8.98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Waltman, Karl E. ~,,_,,,
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.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S
NUMBER THE DATE OF TEROANSER.SATfACNTA CO YEOF THE DEED FOOREREA°l ESTATE. VALUE OF ASSET INTEREST (IF APPLICABNE) TAXABLE
VALUE
1 Fidelity Management Trust Co. -IRA, Act. #Y93-43975 947,642.91 100.000% 947,642.91
- Decedent's spouse is beneficiary of this IRA
TOTAL (Also enter on Line 7, Recapitulation) 947,642.91
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule G (Rev. 6-98)
REV-1151 EX+ (10-06)
COMM~EAI.7j~D pENNN~YLVANIA
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Waltman, Karl E.
Debts of decedent must be reported on Schedule I.
ITEM
DESCRIPTION
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
FILE NUMBER
21-12
AMOUNT
Street Address
City State Zip
Year(sl Commission paid
2. Attorney's Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Kathy E. Waltman
Street Address 3612 GOlfview Dr.
city Mechanicsburg state PA zip 17050
Relationship of Claimant to Decedent SpOUSe
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
3,500.00
TOTAL (Also enter on line 9, Recapitulation) I 3 500 00
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 10-06)
REV-1513 EX+~t1-08)
COMM.QF~q~TH DF,~jNg RLVANIA
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Waltman_ Karl F .,. .
NUMBER
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT i -
SHARE OF ESTATE
AMOUNT OF ESTATE
(Words) ($$$)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116 a 1.2
1 Kathy E. Waltman Spouse Residue of the
3612 Golfview Dr. estate
Mechanicsburg, PA 17050
Total
Enter dollar amounts for distributions shown above on lines 1 5 throu h 18 on Rev 150 0 cover sheet, as a r o riate.
II NON-TAXABLE DISTRIBUTIONS:
. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
~ y?~(ntntnV~U~tnmvi
o mo-I-a-~-r-a~-i ~ ro ~~m~' `0
O~A]Pbbnabo °~ a~~,A ~
~ ^~C ~ G1 L7 ~ ~ ~ m ~ 3 5 rp Oy 3 O ~ m O ~ o C7 "TI
C ~ ~~~ ~
"~ Cn C7 G7 C7 C1nC7 C~1Ca ~ sb 3.m ~ w T~~ - t~~
~ r D b b D A D b 4- C~ b m ~ o ~ ~.
OmQOl7oQQO~ ~s ~ ~ ~ ~ ~ O ~~C'-'
~~C~$CCG 3 w m w m= CjrL~ - a MM
~QzUOCmCL7 ~ ~ e ~`01 ~~~ =a H
'n~-1~tA~>~O ~ m sv cy~ M L~~b .~ ai H
p~g4 ~~O]] .~ c w~ .~ ~ bD~ _ ~
_ _o
v
m ~ 4 ~ c'n =n ~i+ -~ N ~- lam' r. ~ ~'
~ C ~ it m N ~~
z~c NS~cG~x yr fn Id ~ u ~ 'Z7C
T
w M '~
X ~ V Gl N I7'I ~
~ V ... O ~ N SD ~ ~T ~ Vj
NA ~ ~~ a0
~ ~ ~ ~ .~
W
r ,.~ c17 W A N lQ Q .. • ~ ~ ~ ~
y (~ N co jV IN cp to A o ~ m = C
m V Gs A ~l m cn ~ ~~ a
m of of ok o4 ;e ;2 ;~ ok ~ ~ ~ ~ ~
3 r
o m ~m
W N W N rn v O ~ ~ ~ ~
CQ yyWs~.. O~ Q~ C~ A 1 tD 'N ~ ~
m W 0 A m .r W .OA N ~~ W G S-,.
oe in N IN V A O~ it ... N p b Z
n°Ow'~awAwo s5 z
w++aocnmrncncnp N~ N8
O
r
r
_ ~° ~ C
w -. ~ ~ ~~ is 171
!J7 P CD 4 o Cb i~ Np+y ~ ~ ~ ~ ~
~ A ppOpp ~~ 4Wi o N A ~ ~ O v ~
0 0 t7 O 4 O O o 0 w ~. ODD ~ b
"r1
fa _
? V _~ ONO N fNil 00 N ~ CD~p~j ~j m ~ tiC
W W N (W O i~ `+ V dD Al O .. "'1 ^~ ..-
oD N m r. m
0 o V ,OOO ,iVD O~Oc i pf pAj c~ ~ ~ b ss.~ ~ e o I~
O O iao c~J1 m~~ rn 'V ~ n b g 5~ ~ C N M
~ o G7 o m C
m = ~ ~ w m ~ ~,
c~ ~ ~ m b m ~ w
AwwN coo m ~2 Q' ~ ~ ~ ,•-,
W ~~ iyo, iv V+ ./ ~! ~: ~ ~ Tf y ~ ~ ro '~
W W W CVii o cio ~ A o N ~<
m ~ W o OW7 cQn ~ N A eND ~ : C ~ ~
O ~ ~p
Q
d! ~ flD ~ an m pp
O O G 6
? N Q O cn (.Nh• fa Oo Oo C O O AO~7 m C? ..
coo O] ~ Q OoO A N V ~~ wY A~A~ ~ ,gyp .
~ -• N rn 00o O W °c ~V~cA A W
LA !D N p N •
4Wn ~ (~7t Uwi ~ A
Q
ZT 3~JCd ~t1I~NGNIdf1 ~ TZ6Li9LLIL +EZ ~9T ZTOZ/0Tj80 ~~
4
~ ~
j a a°, • rn
A
~S
g W
m Or v
~ <;
`D C m m
a a
~ ~ m
° .mom. m n
.~ m
_~ ~ m•
~ ~, Q
7
ryC7
R
^
V
m
A
0
m O
N O
• T N -0~.
N i ...
tQ'arn~
~ ~ ~
D ~ ~_ ~
~ ~ y
n p
v ~
m ~
N
n
m
c
c p
~ a
~ ~
~.
3'
S ~
9
q a
a
a
a o'
v
w
s
a
s
~ » ~ N.~ ~ G~ ll =.
Om ~
_
O ~~'
O
S,r~AOO~pAm~ ~ tL
~
a ~
~
~ ~ m
m ~ = 4 ~ G~ GJ ~ ~ c _
°' ~
w~~
o ooA ~' R
m o ~~ ~z
~ C r
a' ~m
o
A
a
~ n ~~~ mmm
m
°rtncc '
''~ L
ec
$ 4
a T ~ -WI jj
~~
~ r D Z -I N O N _~
m~
~ G:
~ w
G
~ ~
4 J
~ -fY r
; Z= ?~
~ p O
O ~
~ ~7 ~ C) W
T ~ t
~
~'$ ~ .
~
a ~ a
.
n~~Q~m~x
~ '1
rC
po- fc A'~ ~([~~~ 0 cV ~ v
o' A m~ O m 0~
5 ~z
~~myc -~iQ
~~"~'~n
Y
~ m
~
~ ~ ~ ao
x
~
~
~
~~ ~
° c 'A'
~
i
h
a
~ O
O
r-
°
W W
i.+ is
~itvcnyaocnrar~
i-~ 'v, i :~ io i~ a, A 'v, e
03~
~ 0 2 ~
h
OE -p+
~ e~ yw N .a .i cn ~mg o~, .i rn
O ~ ~ ~ oC e\ o o aE ,vp, ~ ~ C
yr n ~ CIS ~S
"
`.'~ !
O m
a Q~
~~ w - D
A ~ N A N V [h W Q1
~a p y .~. W W N F. ~ D
~
~
~
P 11 1~ CMT7 W o w
w ~+
~ Q
o uNl O t~71 V ~ ... N f,A ~ S ~
d N ~D cD Vf N OD (O w.~
O
o r-
5 ~
~, ~ ~ C
w
b
r
r ~. ... ...
W t0 1 QO o t0 0 ~ ~~
+
~ b m
YI
J!
O GO .P ~ t0 CO Q fV
o 0 4 Q p O D O
~~
N O ~
m
'~
`TG N
~ O 09 W ~ ~ y N M(i1
fdT1 m
O
~ A N N IV V 'J V 11 Ut
~
a
~ VV
A a v V~ O cn 4 0
O
~ o N tNP W N ODD d o cn q~ Z
W
oD
A
A
v V ~ li
m ~ A A
N N A n
i i ~ O
~ i add ~di~N~i.~n
b
m
z
~ N rJ Cn W ~!
Q ~
W ~ ~ ~ ~
C
O C ~
V
yp
V Of !b ~ OD V
~ ~ ~ ~
V
V oD tT A !p W t?7
O
A m p V
w
A ~
• r
i
O
W
c
0 ~+ ~
CA
Q
1
~ ~} R7
h
A
~ trl I'rl
zr
r y
H
LJ l
f ~ ~
~ -~ 4~
~
r., ..~ ~ ~
`1"1 ~ N
~
7 y
y
H ~
M
~ y~
N
e
C ~
I~
~M
N
C ~
`~C ~
w
o ~
N ~
~_
~~ O A ao o N N N
~ ~
~ _`
"~
A IV
wv+wn~irnvq~1.CDi~
O cn N W Q~ Oi W [v o o ~s
Vi A N qS _ _
eri ~ N ~„~ V ~ Obi OoD A ~ t
j~
TZ6LL9LLZL ~Z~Si ZTOZ/0T(80
£ i OL I ~v'd `alsii i~~
a.~~nbs asnou~no~ aup
scald uou~uzo~ ~o ~no~ ~~uno~ pu~I.zaqu~n~
silit~cl ~o .~a~si~a~
o.l.
O I I L i ~'d `~.zngst.ur.H
£0£ a~rns
p~o~ unno~sal~ul7 OOOZ
z~_.
~: ~~, ;~
~,;~ CtJ
G/1 i1
is lL
L~C_' RE
_ _.: ~
~
t."„r'
hJ U
..~ ~ ~ I 1 I
Q t t L t 300:? dlZ tN023d tl3lidW
ZIOZ £t d3S 06£699Z000
o0Z'100~ dt zo
33Mp9 A3Nlfd `~
~~ r
y
~d ~~'
n~e~ aaPi~ uaz~g
2=~9 =E,e .oao o.ez „o.
~~~R~N~~~~~~I~~~~~I~~~~~~~