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HomeMy WebLinkAbout08-01-13 J 1505610140 REV-1500 EX (02-11)(FI) OFFICIAL USE ONLV PA Department of Revenue Bureau of Individual Taxes Counry Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 � 3 2 2 Harrisburq, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDVYVY Date of Birth MMDOYYYY 0 2 2 8 2 0 1 3 0 1 1 6 1 9 2 5 DecedenYs Last Name ' Suffix DecedenPS First Name MI H A M M A K E R A L V I N E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffx 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 � 1.Original Return � 2.Supplemental Retum � 3.Remainder Return(Date of Death Priorto 12-13-82) � 4.Limited Estate � 4a. Future Interest Compromise(date of � 5.Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust _ 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 M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 3 4 6�5 0 c' ��, � rn REG(STER OF Wi665 US I�i�Y �' -� CJ Cf> +� f.rl =L n -.{ Z,y First Line of Address � �� �- �T� rn ry :z' � �--+ :;� Ci 5 4 E • M A I N S T R E E T M "-' ;�c o � ci �, � -v -,� -�� Second Line of Address �-� � .,� � _ '*� ,� c� = C� .. ]Lr i—• Y"_ R7 Ciry or Post Offce State ZIP Code �'a ,� DnTE�FJi,EO � o 1-� M E C H A N I C S B U R G P A 1 7 � 5 5 correspondent•s e•maii address: murrel@waltersgallowaY.com . Under penaities of perjury,I declare ihat I have examined Ihis reNm,including awompanying schedules and statements,and to the hest ot my knowledge and bellef, it is true,cortect and compiete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON R E SI E FOR FILING RETURN DATE �'��6�-' /� /� 7�d v��� ADORESS GREGORY L • HA f7'AK , 545 MOUNTAIN RD DILLSBURG PA 17019 SIGNATURE OF PFt AR E HAN REPRESENTATIVE DATE . z� • � 3 ADDRESS MURREL R - L ERS, III, 54 E • MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 � 150561�140 150561014U J � Continuation of REV-1500 Inheritance Tax Return Resident Decedent ALVIN E. HAMMAKER 21 13 0322 DecedenPs Name Page 2 File Number Correspondents Name Daytime Telephone Number M U R R E L W A L T E R S , I I I E S Q 7 1 7 6 9 7 4 6 5 0 First line of address 5 4 E . M A I N S T R E E T Second line of address City or Post Office State ZIP Code M E C H A N I C S B U R G P A 1 7 0 5 5 correspondenrs e-maii address:murrel(�ilwaltersaallowav.com Under penalUes of pe�ury,I declare that I have examined this retum,induding accompanying schedules and statemenLS,and lo Ne best of my knowledge and 6elief, it is We,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA7 RE RSON RESPONS�OR�IN'OII�C'dRPi� DATE/ �i�.e/UG<, L� � "�=1� � o�(�/�� ADDRE 5 LYNETTE F. POTTEIGER, 76 SILVER CROWN DR MECHANICSBURG PA 17050 J 1505610240 REV-1500 EX(FI) � Decedenfs Social Security Number oecedenrsName: ALVIN E . HAMMAKER 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 and Notes Receivable(SChedule D) . . . . . . .. . .. . .. . .. . . . . . . . . . 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . . . . 5. 4 2 4 � , 3 6 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .. . . . . 6. 7. Inter-Vivos Transfers 8 Miscellaneous�N n-Probate Property • (Schedule G) � Separate Billing Requested .. . .. . . 7. , 8. Total Gross Assets(total Lines 7 through 7) . . . . . .. . . . . . .. . . .. . .. .. . . . . 8. 4 2 4 0 . 3 6 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . .. . . . . . .. . . . . . 9� 2 4 9 5 . 0 7 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . .. . . . . . .. .. 10. 3 3 2 6 2 . 3 4 ��. 7otal Deductions(total Lines 9 and 10) . .. . . .. . .. . . . . . . .. . .. . .. . .. . .. . 11. 3 5 7 5 7 . 4 1 t2. Net Va�ue of Estate(�ine 8 minus Line t�) . . . . .. . . . .. . . . . . . . . . . . . . . . . . t2. - 3 1 5 1 7 . 0 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 Ta�c(Line 12 minus Line t3) .. . . . . . .. . . . . . . . .. . . . . 14. - 3 1 5 1 7 . 0 5 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or trensfers under Sec. 9116 (a)(1.2)X.0 _ 0 . 0 0 15. 0 . � � 16. Amount of Line 14 taxable atlinealrate X.0_ 0 . 0 0 �6. 0 . 0 0 17. Amount of Line'14 taxable at sibling rate X.72 0 . � � 17. � . 0 Q 18. Amount of Line 14 taxable , at collateral rete X.15 � . � 0 �g, � . � Q 19. TAX DUE .. . . .. . . . . . . . .. . . .. . . . .. . . . . .. . .. . . . . . . . . . .. . . . . .. . . . . '19. O . O O 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 1505610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Deceden£s Complete Address: 21 13 0322 DECEDENT'S NAME ALVIN E. HAMMAKER STREETADDRESS 9 S. GEORGE STREET CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Paymenis A.Pnor Payments B.Discount Total Credits(A+g) (p) 0.00 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. (3) Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is lhe TAX DUE. (5) 0.00 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. relain the use or income of the property transferred ...................................................................... ❑ ❑X b. retain the right to designate who shall use the propedy iransferred or ils income ............................... ❑ QX c. retain a reversionary interest ..................................................................................................... ❑ ❑X d. receive the promise for life of either payments,benefts or care? ....................................................... ❑ Q 2. If death occurred after December 12, 1982,did decedent transfer property wilhin one year of death without receiving adequale consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an"in trust for"or payable-upon-death bank account or searity at his or her death? ......... ❑ QX 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a benefciary designalion?.................................................................................................. ❑ ❑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 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 benefciary. 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 decedenfs lineal beneficiaries is 4.5 percent,except as noted in nz P.s.§s�ts�a��i��. • The tax rate imposed on the net value of transfers to or for the use of the decedenPs 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-1508 EX*(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN ResioeNroeceoENr PERSONAL PROPERTY ESTATE OF: FILE NUMBER: ALVIN E. HAMMAKER 21 13 0322 Include the proceeds of litigation and the date the proceeds were received by the estate. All propertyjointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC BANK 4,103.66 CHECKING 2. CLAREMONT NURSING HOME 136.70 REFUND-PERSONALACCOUNT r - TOTAL(Also enter on Line 5,Recapitulation) $ q Q40.36 If more space is needed,use additional sheets of paper of the same size. REV4511EX+(�0-09) pennsylvania SCHEDULE H °EP"RT""E"T oF RE�E""E FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESI�ENT OECEDENT ESTATE OF FILE NUMBER ALVIN E. HAMMAKER 21 13 0322 Decedenl's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A. FUNER4LEXPENSES: 1. COCKLIN FUNERAL HOME, DILLSBURG, PA 327.00 2. ENGRAVE HEADSTONE& NEWSPAPER NOTICE pg�,g7 3. FUNERAL FLOWERS 312.70 4. FUNERAL LUNCHEON-IMMANUEL CHURCH;MECHANICSBURG 200.00 B. ADMINISTRQTIVE COSTS: i. Personal Representative Commissions: Name(s)ofPersonalRepresenWtive(s) GREGORYL. HAMMAKER 105.00 StreetAddress 545 MOUNTAIN ROAD City DILLSBURG State PA Z�p 17019 Year(s)Commission Paid: 2013 2, AttomeyFees: MURREL R. WALTERS, III 1,000.00 3, Famity Exemption:(If decedenPs address is not the same as claimanPs,attach explanation.) Claimant Street Adtlress City Stale ZIP Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 113.50 5 AccountantFees: 6. iaxRetum PreparerFees: PBS/CAREY- PREPARATION OF INCOME TAXES 50.00 7. TOTAL(Atso enter on Line 9,Recapitulation) $ 2 495.07 If more space is needed,use additional sheets of paperof the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ALVIN E. HA64FMAKER 21 13 0322 De�edenPS Narme pa9e� File Number Schedule H — Funeral Expenses &Administrative Costs- 81 ITEM rA1MBER DESCRIPTION AMOUNT g, ADMINISTR4TIVE COSTS: Personal Representative Commissions: 2 • Name(s)ofPersonalRepresentative(s) LYNETTE F. POTTEIGER 105. 00 Sveetnddress 7 SILVER CROWN DRIVE Ciry MECHANICSBURG Stare PA Z�P 17050 Year(s)Commission Paid: 2�13 SUBTOTAL SCHEDULE H-61 105.00 REV-1512 EX+(ip.�p) pennsylvania SCHEDULE I DEPARiMENTOFREVENLIE DEBTS OF DECEDENT� iNHeRirnNCernxReruaN MORTGAGE LIABILITIES 8 LIENS RESIDENT DECE�ENT ESTATE OF FILE NUMBER ALVIN E. HAMMAKER 21 13 0322 RepoR debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PA DEPARTMENT OF PUBLIC WELFARE 33,262.34 CLAIM FOR MEDICAL ASSISTANCE � TOTAL(Also enter on Line 10,Recapitulalion) S 33 262.34 If more space is needed,insert additional sheets of the same size. REVd573 EXt(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ALVIN E. HAMMAKER 21 13 0322 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee�s) OF ESTATE � TAXABLEDISTRIBUTIONS pncludeoutrightspousaldistributionsandtransfersuntler Sec.9116(a)(12).] 1. GREGORY L. HAMMAKER Lineal 545 MOUNTAIN ROAD DILLSBURG, PA 17019 2. LYNETTE F. POTTEIGER Lineal 76 SILVER CROWN DRIVE MECHANICSBURG, PA 17050 3. KENNETH L. HAMMAKER,JR. Lineal 11725 NORTHGATE TRAIL ROSWELL, GA 30075 4. JEREMY L. HAMMAKER Lineal 700 WILLOW DALE LANE KENNETH SQUARE, PA 19348 5. STEVEN A. HAMMAKER Lineal 136 COLD SPRINGS LANE CARLISLE, PA 17013 6. WENDY J. HAMMAKER Lineal 10 HILLTOP ROAD ETTERS, PA 17319 7. KARAN L. HAMMAKER Lineal 11 S. GEORGE STREET MECHANICSBURG, PA 17055 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 ihe same size.