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HomeMy WebLinkAbout01-16-13 (2)1505611180 -~ REV-1500 Extp2_",l1=1) Pennsylvania OFFICIAL USE ONLY PA Department of Revenue oevner~nlornevenoe County Code Year file Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 ~, I ~ I j Harrisburg, PA 17126-0601 RESIDENT DECEDENT 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 171-28-2998 09272011 07061935 Decedent's Last Name Suffix Decedent's First Name MI DYARMAN ESTHER ARLENE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M1 Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW © 1. Original Return Q 2. Supplemental Return 0 3. Remainder Retum (Date of Death Prior to 12-13-82) Q 4. Limited Estate 0 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12.82) © 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (Date of Death [~ 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 ROBERT G. FREY 7172435838 First Line of Address 5 S. HANOVER Second Line of Address City or Post Office CARLISLE State ZIP Code PA 1707,3 R£G1ST£R OF1a1LL$1~ LY n G ~-' rn c7 G~ ' c ~ o ~ ::Ci ~'l7 - Tr _.._ :T.7 ~ r,: e- R ...} t rt ~J.. ~ ,, , {- rrt q dJ :. , .. ~.... ~ .i'C .~ -: , _ . : ,_.. - , ~ . : .... .. , ....:.: C DATBf,ILED : ~~ S ~1 ., ~7 Correspondent's a-mail address: R F R E Y a~ F R E Y T I L E Y. C O M 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. ADDRESS - / f 5 SOUTH HANOVER STREET_ C LISLE_ PA 1701,3 PLEASE Side 1 1505611180 1505611180 SIGNATU~REO RE REI-TH{N~EP TATIVE ~~~v~p~ATiE ~/ z ~/ ~ 1505611280 REV-1500 EX (FI) Decedent's Social Security Number oecedent'sName: ESTHER ARLENE DYARMAN 171-28-2998 RECAPITULATION 1. Real Estate(ScheduleA) ........................................ . 1. 62000.00 2. Stocks and Bonds (Schedule B) ............................. ..... . 2. N 0 N E 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . 3. N 0 N E 4 Mortgages and Notes Receivable (Schedule D) ........ 4. N 0 N E 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ... . 5. 2 8 4 4 . 0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ..... .. 6. N 0 N E 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ..... .. 7_ N 0 NE 8. Total Gross Assets (total Lines 1 through 7) ........................ .. 8. 6 4 8 4 4 . 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ............ . .. . 9. 2 3 4 9 2 . 0 0 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule q . ......... . 10. 4020. ^0 11. Total Deductions (total Lines 9 and 10) ............................ . 11. 27512.00 12. Net Value of Estate (Line 8 minus Line 11) .......................... . 12. 3 7 3 3 2 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0 . 0 ^ _14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 37332.00 TAX 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 0 15. O .O O 16. Amount of Line 14 taxable at linealratex.o 45 37332.00 16. 1679.94 17. Amount of Line 14 taxable at sibling rate X . 12 17. 0 . O 0 18. Amount of Line 14 taxable at collateral rate X . 15 t 8. 0 . 0 0 19. TAX DUE.. ... ....... ................................... .19. 1679.94 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 L 1505611280 1505611280 J REV-7500 EX (FI) Page 3 Decedent's Complete Address: File Number 21-11-1094 171-28-2998 DECEDENT'S NAME ESTHER ARLENE DYARMAN STREET ADDRESS 171 LIMEKILN ROAD CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + B ) 4. It Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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. (1) 1679.94 (2) 0c,00 (3) ~~ . I ~c (4) 0.00 (5) ~iE79'94 lr '7v'Z'. `f ~ Make check payable to: REGISTER OF WILLS, AGENT ,° ~ s, ~ i° ~ ~ ' , 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 occurred 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" 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. ,r 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-7502 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: .Esther Arlene Dyarman 21-11-1094 All real property owned solely or as 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. If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+(„-,o' SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, ~ MISC. NHERRTANCE oAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Esther Arlene Dvarman 21-11-1094 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE 1 Members First Savings Account No. 197079-00 187 2 Members First Checking Account No. 197079-11 213 3 Personal property sold at auction, 4/11/12 449 4 Sewing machine sold 20 5 Guns sold 900 6 Personal property sold at auction, 11/19/12 242 7 Automobile sold 250 8 Personal property Bald at auction, 6/15!12 459 9 Cash on hand 4 10 Miscellaneous personal property 120 TOTAL (Also enter on line 5, Recapitulation) $ I 2,844 It more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) pennsylvania DEPARTMEN70F REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant ESTATE OF FILE NUMBER Esther Arlene Dearman 21-11-1094 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Eby Granite Works 119 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Joyce ShUghart Street Address city Carlisle state PA zIP 17015 near(s) Commission Paid: 2012 2. 3. 4. 5. 6. 7. 8 9 Street Address City State Relationship of Claimant to Decedent SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ZIP Probate Fees: Accountant Fees: Tax Return Preparer Fees. Inses in connection with real estate sold !oneer commission for sale of personal property utor's mileage (44 trips of 14 miles to residence) 3,000 3,000 209 16, 790 32 342 TOTAL (Also enter on Line 9, Reca If more space is needed, use additional sheets of paper of the same size. REV-1512 Ex+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Esther Arlene Dearman 21-11-1094 Report debts incurced by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1 Members First Loan No. 197079-07 545 2. Members First Loan No. 197079-08 1,557 3. Members First Loan No. 370421-01 78 Medical Bills: 4. Holy Spirit Hospital 43 5. Allied Interstate 205 6. Allied Interstate 50 7. Allied Interstate 250 8. Allied Interstate 15 9. Allied Interstate 50 10. Allied Interstate 250 11. Carlisle Regional Medical Center 50 12. Carlisle Regional Medical Center 14g 13. Masland and Associates 33 14. J.L. Hrdesty 180 15. Quest Diagnostics 15 16. National Rehab 67 17. National Rehab 13 18. Cardiology Diagnostic 35 19. CBCS 191 20. Bureau of Account Management 250 TOTAL (Also enter on Line 10, Recapitulation), $ 4 020 if more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF: FILE NUMBER: Esther ArlPnct Ilvarman NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE TAXABLE DISTRIBUTIONS [Inclutle outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] ~ Tara Palm granddaughter Net proceeds of real estate after payment of bal. of estate debts & expenses ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, 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. 0.00 ~~ rnvie space is neecea, use aanmonal sheets of paper of the same size. Real Estate Expenses Public sale advertisement 303 Auctioneer fee 620 Redevelopment Authority of Cumberland County, rehaq loan 13,225 Satisfaction recording cost 51 2012-2013 school tax 1,212 Less, proration from settlement statement -685 2012 county and township tax 249 Less, proration -31 D&D Septic, pumping septic systement 195 RIP Pest Control 239 Interstate Waste gg Millville Mutual Insurance Co. 388 Gagster, trash removal 1qq Joyce Shughart, hauling trash 100 Elwood Shughart, mileage for trash hauling 91 Realty transfer tax 62D Total real estate expenses 16.790 Personal Income Tax e-Services Center Penalty and Interest Calculations CALCULATION DATES- 6/27/12 TO 1/16/2013 TAX DEFICIENCY $ 1,679.94 CALCULATED INTEREST $ 27.96 BALANCE AS OF 1/16/2013 $ 1,707.90 ................._........_...... Start Over hops://www.doreservices.state.pa.us/pitservices/Defau ILaspx 1/16/13 2:26 PM Page 1 of 2 c `~ _c. ~-, ,,T, W{LL OF =-=arm-, _._ ESTHER A. DYARMAN = ~=~ ~' ALSO KNOWN AS __ `~'=J - -, . :, ARLENE DYARMAN ~-'~ ~- ,, --, .. n - I, Esther Arlene Dyarman also known as Arlene Dyarman, of "~ Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke alt prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: A. I leave everything to my husband, Junior H. Dyarman. Should he predecease me I then leave everything to be distributed as follows: B. I leave the guns, the vehicle(s) and Arlene's gold wedding band to Seth H. Dyarman; C. I leave the house, the porcelain doll and wedding rings to Tara R. Palm. D. i leave the sevring machines to be divided equaiiy to Joyce Shughart and Marie Dyarman. E. I leave everything else to be divided equally between Marie Dyarman, Joann Sanderson, Carol Jean Reed, Judy McNew and Joyce Shughart. F. Should Marie Dyarman, Joann Sanderson, Carol Jean Reed, Judy McNew or Joyce Shughart predecease me, their share shall go to Tara R. Palm or her heirs. LAW OFFICES OF TEPHEN J. HOGG .9 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 / J -, - -, _..,. _ -; c_: 4. I appoint Junior H. Dyarman as Executor of this my last Will. If she should predecease me or cease to act in such capacity, I appoint Joyce Shughart as alternate. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. I direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. fN WITNESS EREOF, I have hereunto set my hand this day of /'~=~t.r~' > 2004. Esther Arlene Dyarman also known as Arlene Dyarman LAW OFFICES OF CEPHEN J. HOGG 9 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by Esther Arlene Dyarman also known as Arlene Dyarman, as and for his {ast Will in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. ITNESS ESS tAW OFFICES OF ~PHENJ.xoGG 3 S. HANOVER STREET SUITE 105 CARLISLE, PA 17053 ACKNOWLEDGMENT State of Pennsylvania County of Cumberland ss I, Esther Arlene Dyarman also known as Arlene Dyarman, 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; that I signed, it willingly and as my free and voluntary act for the purposes therein expressed. Esther Arlene Dyarman also known as Arlene Dyarman Sworn to or affirmed anCd cknowledg before me by Junior H. Dyarman, the testator, this day of ~~ , 2004. ~~j NOTARIAL SEAL ~f STEPHEN J. NOGG, NOTAIvY PUiaLik' f ' L' G CARLISLE BORa, CUMBERLAND Ca.. ~t Public/Attorney i MY COMMISSION EXPIRES SEPTEwSBER 3, $ State of Pennsylvania County of Cumberland AFFIDAVIT ss We, i Prrr (11~n,• /~ I"~fli~rand (.fs ~- ~~ ~ ~F l.- ,the LAW OFFICES OF iTEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 witnesses whose names are signed to the attached or foregoing 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 act 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 so d mind and under no constraint or ndue influence. / ;~ 7 `~ ~ `. 4 Sworn to or affirmed this -f-day of NOTARIAL SEAL STEPHEN J. NOGG, NOTARY PUELk:: CARLISLE BORO, CUMBERLAtdi~ CC.. >rA MY COMMISSION EXPIRES SEP7ENR8ER 3, 2PR5 subscribed to before me by witnesses, 9z-tee >?9,04. Lf / ~ (~ St MEMBERS 1St FEDERAL CREDIT ANION REGULAR SAVINGS ACCOUNT: Account NumbeNSuffix 197079-00 Date Account Established 09/21!2000 Principal Balance at Date of Death $186.73 Accrued Interest to Date of Death $.07 Total Principal and Accrued Interest $186.80 Name of Joint Owner None CHECKING ACCOUNT Account NumbeNSuffix 197079-11 Date Account Established 09/21!2000 Principal Balance at Date of Death $212.61 Accrued Interest to Date of Death $.00 Total Principal and Accrued Interest $212.61 Name of Joint Owner None LOAN ACCOUNT: Account Number/Suffix 197079-07' Date Opened 09!24/2009 Principal Balance at Date of Death $545.09 Loan Type Unsecured Contractual Pledge of Shares Interest Rate 8.40°l0 Name of Co-Borrower None *Loan does not have life coverage. **Loan does not have life coverage. PRIMARY OWNER: Shawna Werner LOAN ACCOUNT: Account NumberlSuffix 370421-01' Date Opened 1 0/2 612 0 0 9 Principal Balance at Date of Death $77.85 Loan Type Unsecured Contractual Pledge of Shares Interest Rate 12.89% Name of Co-Borrower E. Arlene Dyarman *Loan has life coverage on primary, Shawna Werner. 197079-08*" 08/16/2010 $1, 556.79 Unsecured Contractual Pledge of Shares 13,24% None M BERS~ST F DERAL~ED~~-~CJ\N 1 ~ ~. Danielle A. Kline Lending Insurance Support Specialist November 8, 2011 Estate of: E. ARLENE DYARMAN Date of Death: 09!27/2011 Social Security Number: 171-28-2998 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org