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Home My WebLink About05-29-13 . J 15�56041125 REV-1500 �% (06-05) OfFICULLUSEONLY PA Department of Revenue Bureau M IiMrvidual Tanes County Code Year File Number Posoxzeo60� INHERfTANCE TAX RETURN 2 1 0 9 0 7 7 8 Hardsbu� PA nt28-0sot RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Sacurity Number Date of Death Date of Birth 0 8 1 0 2 0 0 9 0 3 2 6 1 9 9 4 DecedenPs Last Name Suffix DecedenPs First Name M� H O U G H R 0 D N E Y F( �{f Applicable)EMer Surviving Spouae's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Securiry Number THIS RETURN MUST BE F4LED IN DUPLICATE WVTH THE REGISTER OF WILLS FIIL IN APPROPRIATE OVALS BELOW � 1.Onginal Return � 2.Supplemental Return � 3. Remalnder fiatum(date of deeth priorto 12-13-82) � 4. limitetl Estate � 4a.Future Interest Compromise(date of � � 5. Federal Estate Tax Return Required death after 12-12-82) � 6. Decedent Died Testate � 7.Decedent Mainteined a Living Tmst _ 8.Total Numbar of Safe Deposit Boxes (Attach Copy of Wilp (Attach Copy of Trust) � 9. Litigation Proceeds Raceivad � 10.Spousal Poverty Credit(date of death � 11.Election to tau under Sac.9113(A) beiween 12-31-91 and 1-1-95) (Attach Sch.O) CORRE3PONDENT-TNIS SECTION MUST BE COMPLETED.ALL CORRESPONOENCE ANO CONFWENTIAL TAX INFOqMATiON SHf3ULD BE DII�CTED T0: Name Daylirt�Telephone I�jpiber �° r�� S U S A N J . H A R T M A N 7 1�7° 2 q �,' 7�7�g p Firm Name pf Applicable) � " c� � '"'�> - fi�Til�iER'�F WICl$USBEI ��' D U N C A N & H A R T M A N , P C y � `� C° '' - -, uT _ �, Hrst Ilne of address ��9 ,,,.,�, "� — 1 I R V I N E R 0 W �` r_� Second line oi address � � � �� f, ~' �� , �� City of Post Office State ZIP COda DATE FILEO C A R L I S L E P A 1 7 0 1 3 Correspondent�g e-ma�i adaregs:susanhartman�pa.net Untler penaltiee of perjury,I derJaie Uwt I h9ve ezefnk�ed tlti8 B1Urt,ImiuddM9 atcanPeMn9 sd�edWBS anO 9�BBmenb,2M b Me beat Of k(row d b 6ue,correct am!ownpleoe.Oedaratlon of peparer dhei'tl�Ihe Pe�one�represenlaeve is 6ased on aN inbrmetlon of which � �and belie(, �pp praparer has any knowledga � SIGNAT F P'�f.T NSIBLE FQR FILING RETURN D/ E I/ � ti�eZ�'1 ADO 1016 SHANNON LANE CARLISLE PA 17013 S{GNATUR OF PqEPARER OTHER��`N REPRESENTATNE DA7E �.��ms .flf' _�,_ - � S�AYI 3 A ESS �r'—f 1 S�QJiNE" Ytn� CA-kusL P/� !�D/3 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 � h� J 15056042126 � REV-1500 EX Decedent's Social Security Number oeceeenesName RODNEY K. HOUGH REGAPITULATION 1. Realestate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . 2. Stocksantl 8oads(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. 0 , � 0 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schetlule G) � Separate Billing Requested . . . . . . . 7. 1 � 5 9 8 3 , 2 5 8.ToWI Gross Assets(total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 7 5 9 8 3 � 2 5 9. funeral Expenses&Administretive Costs(Schedule H) . . . . . . . . . . . . . . . . 9. 3 0 3 0 , 0 0 10. Debts oi Decedent,Mortgage Liabilities, &Liens(Schedule q . . . . . . . . . . . . 10. � , 0 � 11. ToGI Deductions(total Lines 9&10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 0 3 0 , 0 0 72. Net Value of EsWte(�ine 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 7 Z 9 5 3 , 2 S 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . 73. , 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 1 7 2 9 5 3 , 2 5 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(12)X.o _ 0 , 0 0 tg. 0 , 0 0 76. Amount of Line 14 taxable ai lineal rate x.oae 1 7 2 9 5 3 , 2 5 16 7 7 8 2 , 9 0 17. Amount of Line 14 taxable at sibling rate X.12 � , � � �7 Q . Q Q 78. Amount of Line 14 taxable at collateral rate X.15 0 , � � �g 0 , 0 0 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 7 7 8 2 . 9 � 20. FILL IN THE OVAI IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 15056042126 15056042126 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 2� 09 0�78 DECEDENT'S NAME RODNEY K. HOUGH _ __ _ S7REETADDRESS 151 D STREET _ _ ___ — — ------ ----- — — — -- CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2 Line 19) (1) 7,782.90 2. CreditslPaymenis A.Spousal Povedy Credit � B.Prior Payments 8,497.70 C.Discount TotalCredits(A+B.C) (2) 8,497J0 3. InierestlPenalry if applicable D.in[erest E.Penalty Total Interest/Penalry(D+E) (3) 714.80 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. (4) 0.00 5. If Line 7 +Line 3 is greater than Line 2,enter Ihe difference.This is the TAX DUE. (5) 0.00 A,Enter the in�erest on�he tax due. (5A) B.Enter the total of Line 5+5A.This is the BALANCE DUE. (58) 0.00 Make Check Payable to: REG/STER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUES710NS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. relain the use or income ot the property transferred: ...................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its income; _.......... ❑ ❑x c. retain a reversionary interest;or ........................................----..._.._........................................ ❑ � d. receive the promise for life of either payments,benefits w care? ....................................................... ❑ � 2. If dealh occurred afler December 12,1982,did decedent hansfer propetly wiih'm one year of death without receiving adequate consideration? ....................................................................................... ❑ � 3. Did decedent own an"in irust 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-probale QmpeAy 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 i, 1994 and before January 1,1995,the taz rate imposed on the net value of trans(ers to or fa the use of the surviving spouse is three(3)percent[72 P.S.§9116(a)(1.1 J(iJ]. For dates of death on or after January 1, 1995,the tax rate Imposed on the net value o(iransfers to or for the use of the surviving spouse is zero(0)percent [72 P.S.§9116(a)(1.1)(ii)].The statute dces not exemot a transfer to a surviving spouse from tatt,and the statutory requirements for disclosure ot assets and tiling a tax relurn are siill 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 twenry-0ne years of age or younger at death to or for ihe use of a natural parent,an adoplive parent,or a stepparent of the child is zero(0)percent p2 P.S.§9116(a)�12)]. The tac rate imposed on the net value of transfers to or for the use of the decedenPs lineal beneficiaries is four and o�•half(4.5)percent,except as noted in 72 P.S.§9116(1.2)[/2 P.S.§9116(a�(i l�. The tax rate imposed on the net value of iransfers to or for the use of the decedenPS siblings is twelve(12)percent[72 P.S.§9116(a)(1.3J�.A sibling is defined,under Secfon 9102,as an individual who has at least one parent in crommon with ihe decedent,whether by blood or adoption. REV-1510 EX+(6-98) SCHEDULE G fNTER-VIVOS TRANSFERS 8 COMWHERITA CETAXRETURNAN�A MISC. NON-PROBATEPROPERTY RESIDENTDECEDENT ESTATE OF FILE NUMBER RODNEY K. HOUGH 21 09 0778 This schedule must be completed and fled if the answer to any of questions 1 ihrough 4 on fhe reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM wewoEmEHUnEOF.nEianHS�aee,n�EiRr+�uriorvswrrooECeoEx.rNO DATEOFDEATH °!OF�ECO'S EXClUSION TAXl18�E NUMBER �"canrc�rw.xr,�ea.anacxncowarr�oEeoFOa�uesrnre. VALUEOFASSET INTEREST prncRicnaie� VALUE �. JEFFERSON PILOT LIFE INSURANCE COMPANY 175,983.25 100. 175,983.25 CONTRACT NUMBER QP5101675 FLEXIBLE PREMIUM ANNUITY TOTAL (Also enter on line 7 Recapitulation ; 175 983.25 Qf more space is needed,insert adaitlonal sheeLS of Ne same size) REV-1511 EX+(12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENTDECEDENT ESTATE OF FILE NUMBER RODNEY K. HOUGH 21 09 0�78 Debls oi decetlent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNER4LEXPENSES: 1. 2. 3. 4. 5. B. ADMlNISTRATIUECOSTS'. q, Personal Representative's Commissions Name oi Personal Representa6ve(s) Social Secunry Numher(suEIN Number ot Personal Representative(s) SVeetAddress City State Zip Year(s)Commission Paid: 2, nttomeyFees DUNCAN & HARTMAN, PC 2,500.00 3. Family Exemption�.pt decedenPs address is rrot ihe same as daimaM's,atlach explanafion) Claimant Street Address City Shate Zip ReYatio�hip of Claimani to Decedent 4. ProbateFees REGISTER OF WILLS (ADDITIONAL) 215.00 5 AccountanCs Fees 6. Tax Return Preparefs Fees 7. REGISTER OF WILLS-FILING FEE 15.00 8. BOYER & RIT7ER-TAX PREPARATION 300.00 9. 10. 11. 12. TOTAL(Also enter on line 9,Recapitulation) S 3 030.00 (Ii more space is needed,insert additional SheeLS of ihe seme size) REV451'E%+(900) SCHEDULEJ COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE 7AX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RODNEY K. HOUGH 21 09 0778 REIA710NSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON�S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE � TAXABLE DISTRIBUTIONS [include ouhght spousal distnbu6ons,and transfers untler Sec.9116�a)(1.2)1 i. ADAM HOUGH Lineal 1016 SHANNON LANE 33 1/3 CARLISLE, PA 17013 2. ERIC HOUGH Lineal 300 S. BRADDOCK ST. APT 1 33 1J3 PITTSBURGH, PA 15221 3. MATTHEW HOUGH Lineai 4336 LERIDO DRIVE 33 1/3 SAN OIEGO, CA 92115 ENTER pOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROU�H 18,AS APPROPRIATE,ON REV-1500 COVER SHEET 11. NON-TAXABLE DIS7RIBU?IONS: A.SPOUSAL DISTRIBUTIONS UN�ER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 6.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. iOTAL OF PART If-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET E (If more space is needed,insert additional sheets of lhe same size) C� Lincoln Financial Group• March 15, 2013 Duncan & Hartman, P.C. Susan J. Hartman, Esquire One Irvine Row Carlisle, PA 17013 RE: Rodney K. Hough Jefferso� Pilot life Insurance Compnay ContracUPolicy Number QP5101675 Ciaim Number 896670 Dear Ms. Hartman: Thank you for your letter of March 11, 2013. I have reviewed the documents you furnished and will tre processing payment the first of the week. The following is the information you requested. The initial premium was $107,827.77 and the date of death value for Rodney K. Hough on 8/10/09 was$175,983.25. If you have any questions or I can be of further assistance, please contact me at 1-800-487-1485 ext. 4101, Monday through Friday 8:00 a.m. to 4:00 p.m. Eastern time. Sincerely, �Q�� ""`r_� Laurie Miller Associate Claims Examiner Life &Annuity Claims and Unclaimed Property Partner Solutions for Life, Claims & Distribution