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Home My WebLink About03-17-14 ......��...,,,, 1505610105 REV-1500 EX(02-11)(R) OFFICIAL USE ONLY PA Department of Revenue pennsyLvania County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 28o6oi ^� Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 09/21/2011 ! 03/05/1991 Decedent's Last Name Suffix Decedent's First Name MI Haulman Natasha ; R (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI n/a I L Spouse's Social Security Number ___ r__.____— THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1.Original Return C=:) 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) C=:) 4. Limited Estate C ) 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 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 O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Richard W. Stewart, Esq. 1(717) 761-4540 ! _ REGISILa OF WILLS USf ONLY .r- First Line of Address f L; 301 Market Street _ r _._. __... - ...-.__ _._ C7 C- , Second Line of Address City or Post Office State ZIP Code 'DATE FILED f�T 'Lemoyne � ' � j PA �17043 Correspondent's e-mail address: RWS @JDSW.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. SIGNATURE 0 PSRSON RESP BL, FOR FILING RETURN DATE ADDRESS 61 NueKet- 15+ L--cvno�h{ ? A l70Y� SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: NATASHA R. HAULMAN j RECAPITULATION 1. Real Estate(Schedule A). . .............. ... . . . . ... ...... ...... ....... 1. 0.00 2. Stocks and Bonds(Schedule B) ....... . .. . .. . . .. .. . ............... .... 2. 1 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .... . 3. i 0.00 4. Mortgages and Notes Receivable(Schedule D). ..... ..... .. ........... ... 4. I 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5. I 0.00 I 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... .. . . 7. 8. Total Gross Assets(total Lines 1 through 7).. .............. ............. 8. 0.00 I 9. Funeral Expenses and Administrative Costs(Schedule H).................. . 9. r 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 11. Total Deductions(total Lines 9 and 10). .......... .. ... ...... . ........ .. 11. 0.00 12. Net Value of Estate(Line 8 minus Line 11) . .. .... . ... ..... .............. 12. 0.00 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. 0.00 I 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_ 15. 0.00 16. Amount of Line 14 taxable at lineal rate X.0_ I 16. 0.00 17. Amount of Line 14 taxable at sibling rate X.12 17. 0.00 18. Amount of Line 14 taxable _ ti at collateral rate X.15 18, 0.00 I 19. TAX DUE .............. ............ ... ......... ................... 19. 0.00...... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME NATASHA R. HAULMAN STREETADDRESS 102 SEVERS ROAD CITY STATE ZIP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.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 1 +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 .......................................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0 c. retain a reversionary interest .............................................................................................................................. ❑ 0 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?.............. ❑ 0 4, Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ E 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)(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 p2 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. r REV-1508 EX+(o8-i2) U pennsytvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: NATASHA R. HAULMAN 2013-00731 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. This estate was opened for litigation purposes. There were no proceeds of litigation payable to this estate. 0.00 Also,the decedent was not yet 21 years old at the time of her death. TOTAL(Also enter on Line 5, Recapitulation) ; 0.00. If more space is needed,use additional sheets of paper of the same size. COS'T0P UL®Sp,F' S,,TER & 'FIELDS ATTTORNEYS.AND COUNSELORS ATL'AW 1331`1 A1k1a T STREET P.O.BOX2,22 WILLIAM C.COSTOPOULOS L`EMOYNE,PENNSYLVANIA 17043-0222 TELEPHONE(717)761-2121 DAVID J.:FOSTER '*AX(717)761-4031 LESLIE M.FIELDS WNWV.COSTOPOULOS.COM GEORGE`H.MATANGOS HEIDI F.EAKIN March 12, 2014 Lisa M. Grayson, Esquire Register of Wills Cumberland County Courthouse One;Cour'thouse'Square Carlisle, PA 1701: Re: ]Estate of Natasha Haulman File Number: 2013-00731 Dear Ms. Grayson: . .. Enclosed for filing please find two original duplicates of the Inheritance Tax.Return •Resident Decedent pertaining to the above-referenced estate. Thank you fop your attention:to-this filing. -Should you have any questions, please do not hesitate to contact our office. Very truly yours, COSTOPOULOS, FOSTER& FIELDS Lesiie Iv r ields -_ ... LMF:jmk Enclosures . 0 no 1 r �Q t , C r t RECEIPT FOR PAYMENT ------------------- LISA M. GRAYSON, ESQ. Receipt Date: 3/17/2014 Cumberland County - Register Of Wills Receipt Time : 15 : 12 : 24 One Courthouse Square Receipt No. : 1077332 Carlisle, PA 17613 HAULMAN NATASHA R Estate File No. : 2013-00731 Paid By Remarks : COSTOPOULOS FOSTER & FIELDS DB1 ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 4233 $15 . 00 Total Received. . . . . . . . . $15 . 00 Oy z� O y CD `Q5C HIO m N x CL rr P m In C7 O CD 0 CA `�. m in F o �o n o `° m r v Fl y P- w M (D rnrn� N CD 'V Vt v i � � a z y x � CD a 'j W > C*) w o N o N Ul �_ O C) N W W r 3 o b O m O n y C+ , m � 3 > � 7 D� p C O , z � N Z a m r Cllr m 0 S 0 oilJ D l�J r v CA =t 11) PD fr 4 3 to Y N } O 'P w Q -69 - -•N A C) 0 0) -4 D W O U t A O (J D (O 1 O