HomeMy WebLinkAbout09-20-13 J
REV-1500 1505610101
EX tat-iar
enn5 lvania OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes = INHERITANCE TAX RETURN tJ
PO BOX 290601 RESIDENT DECEDENT
Harrisburg PA 1')128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08127/2013 01121/1924
Decedent's Last Name Suffix Decedent's First Name MI
HARTMAN SUSAN W
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
HARTMAN FRANK R
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
206-24-5560 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CID 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
p 4.Limited Estate O 4a"Future Interest Compromise(date of C= 5, Federal Estate Tax Return Required
death after 12-12.82)
OID 6,Decedent Died Testate C=) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9.Litigation Proceeds Received C=) 10. Spousal Poverty Credit(date of death O Tt. 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
THOMAS E. FLOWER (717) 243-5513
REQISTEL,,OF WILLS-USE ONLY '
First line of address
FLOWER LAW, LLC
Second line of address
�l
10 W. HIGH ST (_
City Or Post Office State ZIP Code 'BATE FILED' f+
CARLISLE PA 17013
Correspondent's e•maii address:TOM@FLOWER-LAW.COM
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.
SIONA F PERSON ES�,o�t Fi NG RETURN fir- C9 D0 ATE
ADDRESS
C y 1/j�j l
FRANK R. HARTMAN, EXECUTOR; 1233 N. WEST STREET, CARLISLE, PA 17013
SI TU F P THAN REPRESENTATIVE
ADDRESS fJ
FLOWER LAW, LLC; 10 W. HIGH STREET, CARLISLE, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 J
1505610105
REV-1500 EX Decedent's Social Security Number
Deaadanfa Name: SUSAN W. HARTMAN
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, 31,951.00
& Jointly Owned Property(Schedule F) C=) Separate Billing Requested 6,
T. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) C=) Separate Billing Requested.. ... ... 7. 2,131.00
8. Total Gross Assets(total Lines I through 7).............. ......... ..... . 34,082.00
9, Funeral Expenses and Administrative Costs(Schedule H)... .. . ... . ..
10, Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ...... 10,
11, Total Deductions(total Lines 9 and 10)... . .. .. . ... . .. .— . .. . ... . .. .... 11.
12, Net Value of Estate(Line 8 minus Line 11) .... ....... 12. 34,082.00
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made(Schedule J) . .. . . .. . ... . .. . .. .. . ... . 13,
14. Not Value Subject to Tax(Line 12 minus Line 13) ........ 14. 34,082.00
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.O.L 34,082.00 15. 0.00
16. Amount of Line 14 taxable
at lineal rate X.0 16.
17, Amount of Line 14 taxable
at sibling rate X.12 IT
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19, TAX DUE.......... ......... ........ ......... ......... 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=)
Side 2
L 1505610105 1505610105
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
SUSAN W. HARTMAN
STREET ADDRESS
1233 N. WEST STREET
f STATE�A - zip17013
CITY RLISLE
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments
R Discount Total Credits(A+B) (2) 0.00
3. Interest
(3)
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)
5. If Line f +Line 3 is greater than Line 2,enter the difference.This is the 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. 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;m...............................__.........................................._.........................,,..........._...
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ 0
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?.....__..... ❑i 1K
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa 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 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)(11)(i)].
For dates of death on or after Jan. 1, 1995, the lax 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)].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+(11-10)
pennsytvania SCHEDULE E
OEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL. PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
SUSAN W. HARTMAN 21-13-0949
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
NUMBER DESCRIPTION OF DEATH
1. M&T BANK CHECKING ACCT.N0.1227351 1,640.05
2. M&T BANK MONEY MARKET ACCT.NO.15004200933974 30,310.66
TOTAL(Also enter on Line 5, Recapitulation) $ 31,950.73
If more space is needed,use additional sheets of paper of the same size.
: c
..STATEMENT:PER100 PAGE
JUL.27-AUG.26,2013 1 OF 4
00 0 04319H NM I17
000002296 FIDS1541G70108261308 01 000000 2296
SUSAN W HARTMAN
1233 N WEST ST
CARLISLE PA 17013-1443
ff
SELEGTE,D< ACCOUNT. SUMMARY
ACCOUNT ACCOUNT INTEREST EARNED MATURITY ENDING
TYPE NUMBER YEAR-TO-DATE DATE BALANCE
POWER CHECKING 000000001227351 0.11 1,640.05
POWER MONEY MARKET 015004200933974 16.15 30,310.68
TOTAL DEPOSITS 31,950.73
S
- ;tACCOUNT:<::i: SUSAN W HARTMAN
POWER CHECKING T:IEi s#
E ACCOUNT N0. .1227351 - - HIGH STREET-CARLISLE '
n INTEREST EARNED FOR STATEMENT PERIOD 0.01 •
ACCOUNT SUMMARY
-
v ...............R?i?;;: [G;`.;>i�'d?i�i?i:;:CURREN. ...... ... ..... ...::..::. ::,.
-
8� �oiN€R�:AtibftioNS. . :C: �cHEOKS:.PAiD::"` sB7RactiONS'; INtERE5tP0
8 I NO. I AMOUNT I NO. AMOUNT NO. AMOUNT
1,957.57 1 ol 0.00 1 31 120.00 1 3 1 197.55 1 0.01 - 1,640.05
8
} ACCOUNT ACTIVITY
......:......a;:,;: ;::o:::a:c;:o:;:::;;::o» »:�.�:;;.:R%2;::ri;:ii. :..
:..ROSTING. :::::.�::::::::::::::::.:::.::::.::::::.:.:..:.............DEPOSITS,INTERES.:i _.
.
TRANS bESCRIP.TION. . . .�::. �:: �: ::' &'OTNEk�.AbDTT10NS :.. ..aSUBT�ACYZONB J[ BAE:ANCE2:'C:'::"'
07-27-13 BEGINNING BALANCE 61,957.57
07-29-13 ATG MONTHLY ODA TO SAV 100.00 1,857.57
08-01-13 BARCLAY CARD US CREDITCARD 000000000002869 44.95 1,812.62
08-06-13 CHECK NUMBER 2870 40.00 1,772.62
08-07-13 CHECK NUMBER 2864 _ 40.00
08-07-13 AT&T SERVICES CHECKPAYMT 000000000002871 52.58 1,680.04
08-09-13 CHECK NUMBER 2872 40.00 1,640.04
08-26-13 INTEREST PAYMENT 0.01 1,640.05
ENDING BALANCE 01 640.05
.. .. . .. .
ECKS
2864 08-07-13 40.00 2870* 08-06-13 40.00 2872* 08-09-13 40.00
LOOa>rsTna
REV-7510 E%+(6-98)
SCHEDULE G
COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS &
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SUSAN W. HARTMAN 21-13-0949
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.
DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE
ITEM RCLNDE THE NUAE of M nWSfEREE.PIER KE TIONWPTODECEDEMUA
NUMBER TIEDAMOFTIWISFER ATTAGIA COT'a PHE OEEn roR RFM ESTATE. VALUE OF ASSET INTEREST IF VALUE
I DWS TRUST COMPANY IRA ACCOUNT 1189265033 PAYABLE TO 2,131.00 100 2,131.00
SPOUSE,FRANK R.HARTMAN C
TOTAL(Also enter on line 7 Recapitulation) $ 2,131.00
(If more space is needed,insert additional sheets of the same size)
Transaction Confirmation Deutsche Asset Ll
July 25, 2013 & Wealth Management
Page 1 of 2
IIII1.111-11Ill. 1"III.1IllluI'l Ill oil 1111 Ill 1llllll1111111Ilp (� Investment Professional: RYAN AWEIGLE
DWS TRUST COMPANY CUST CETERA ADVISOR NETWORKS LLC
FOR THE IRA OF 000917 5-KACEY CTSTE 101
SUSAN HARTMAN MECHANICSBURG PA 17055-9220
1233 N WEST ST (717)766.4551
CARLISLE PA 17013-1443 R, Shareholder services: (800)728-3337
7 a.m.to 7 p.m.(CT)Monday through Friday
Automated Assistance 24 hours a day
International: Call collect(816)435-7177
7 a.m.to 7 p.m.(CT)Monday through Friday
Web Site: www,dm-investments.com
Account Activity
■ Account Number 89265033
Fund Name DWS Global Income Builder Fund-A DWS TRUST COMPANY CUST
Fund Number 2 FOR THE IRA OF
NASDAQ KTRAX SUSAN HARTMAN
Trade Share Shares Total Shores
Date Traniattion Description Dollarknount . price This Transaction Owned
Beginning Balance 212.355
07/25/2013 Reinvest From Stratgov A $5.08 $10.010 0.507 212.862
07/2512013 Sales Charge%=0.00 $0.00 $0.000 0.000 212.862
Ending Balance as of 07125 $2,130.75 $70.010 212.862
II II IIII VIII III I I II II
OEU_•11 110'.OSI82/300A.0'N09.ON119XUDEURSHP.IOEUMMIU7 .P10.3897MM5251I9
REV-1513 EX+(01-30)
pennsylvania SCHEDULE ]
DEPARTMENT or REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
SUSAN W. HARTMAN 21-13-0949
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustees) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
I. FRANK R.HARTMAN,1233 N WEST ST,CARLISLE,PA 17013 SPOUSE 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 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 TAXIS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART n-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
/ L�
i
LAST WILL AND TESTAMENT
OF
�Jm"M C0.$1($AN WINFIELD HARTMAN
T
I, SUSAN WINFIELD HARTMAN, of the Borough of Carlisle, Cumberland
County, Pennsylvania, do hereby make this my Last Will and Testament,
hereby revoking any and all previous Wills and Codicils made by me. I .am
married to FRANK RITTENHOUSE HARTMAN, and all references to my husband are
to him. He is the father of my children, SUSAN TRYON HARTMAN, CHRISTINA S
LEETE HARTMAN, FRANK WINFIELD' HARTMAN, and JEAN STEWART HARTMAN..
FIRST
.. I direct that all my just debts ; expenses of my illness and funeral
expenses be paid as soon as may be convenient after my death, _
..f� .. _ SECOND .,
I direct my personal representative to purchase a grave marker and
cemetary lot if necessary. I authorize my personal representative to cause
title to or ownership of any cemetary lot to be vested in such person:.as my
personal representative shall designate.
THIRD
A. I give, devise, and bequeath all the balance of my Estate of
whatsoever nature, real or personal, and wheresoever situate, to which I may
be legally or equitably entitled, to my husband, FRANK RITTENHOUSE HARTMAN,
should he survive me by thirty (30) days.
B. In the event he predeceases me, I give, devise, and bequeath all
the balance of my Estate of whatsoever nature, and wheresoever situate, to
Page 1 of 4
which I may be legally or equitably entitled, to my children in equal
1
shares : SUSAN TRYON HARTMAN, CHRISTINA LEETE HARTMAN, FRANK WINFIELD
HARTMAN, and JEAN STEWART HA4TMAN. In the event any of my children
predecease me, then the share of my deceaed child shall go to the issue per
stirpes of my deceased child.
FOURTH
I hereby nominate, constitute, and appoint my husband, FRANK
RITTENHOUSE HARTMAN, Executor of this my Last Will and Testament . In the
' event of, the. renunciation, death, resignation, or inability to .act for any -
..reason whatsoever of the aforementioned, I nominate, constitute and appoint
my daughter, SUSAN TRYON HARTMAN, of Carlisle, Pennsylvania, as Executrix
of this my Last Will and Testanent. I hereby relieve my. Executor from the
necessity of posting security in connection with such duties in any
. jurisdiction in which he may be called upon to act insofar as I am able by
law to do so.
FIFTH
I authorize my Executor to sell, with or without notice, at either
public or private sale, and to lease any .property belonging to my Estate,
subject only to such confirmation of Court as may be required by law, and
to compromise claims.
SIXTH
I authorize and empower my Executor to sell, convey, pledge, or
mortgage by proper instrument therefore, for such prices and on such terms
and conditions as said Executor may deem best, any and all real and
Page 2 of 4
personal property which I may leave, without any judic M decree or other
enabling authority.
r
I hereby subscribe my name to this Will this '54h day of
1987, at Carlisle, Cumberland County, Pennsylvania.
zc�GMnv,,, (SEAL) _
SUSAN WINFIELD WTMAN
Testatrix
COMMONWEALTH OF PENNSYLVANIA .
. ss
COUNTY OF CUMBERLAND
We, SUSAN WINFIELD HARTMAN, RUBY D. WEEKS, SHIRLEY P. CLEVENGER,
and ^ .-� `A }_iii_.:- Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument , being first duly
sworn, do hereby declare to the undersigned authority that the Testatrix
signed and executed the instrument as her Last Will and she had signed
willingly and that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence
and hearing of the Testatrix, signed the Will as witness and that to the -
best of their knowledge, the Testatrix was at that time eighteen years of
age or older, of sound mind, and under no constraint or undue influence.
( O•t w % ��! / a y>iCt�SEAL)
SUSAN WINFIELDH ARTMAN
Testatrix
Page 3 of 4
residing at
Witness
" r -r
i J,y'., residing at
Witness j, I
residing at
�- - Witness
Sub'scrib'ed, sworn 'to�and acknowledged before me by SUSAN WINFIELD, ,
HARTMAN; the Testatrix; and subscribed and sworn to before me by RUBY D,
WEEKS, SHIRLEY P. GLEVENGER, and _. .. witnesses, this
day of _J'iu.- , 1987..
Notary Public
SHARM A. Mlfl, No4irY Public
Cariiys, PA, Cu;ni�,r,anci CMMY
My Commission Expi'cs Jan. 16, 1989
Page 4 of 4