HomeMy WebLinkAbout07-15-14 REV-1500 Ex(02-11)(FI) 1505611186
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes oep'd.0 or R. County Code Year File Number
PO Box 280601 INHERITANCE TAX RETURN
Harrisburg,PA 17126-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
10162013 12041916
Decedent's Last Name Suffix Decedent's First Name MI
LEHMAN WALTER S
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix 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 BOXES BELOW
1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate ❑ 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 13E COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
WANDA L HEISE
REGISTER OF WILLS USE ONLY
ry
no
First Line of Address 0 C_ n
2 SOUTH 21ST STREET m Off. r
� h — im
Second Line of Address Ln '-0Q�
C}C")
City or Post Office State ZIP Code 8�AT E i>{SLED %D `= r n
C3 c�O
HARRISBURG PA 17404 0
Correspondent's e-mail address:
Under penalties of perjury,i declare that I have examined this return,including ecwmpanytng schedules and statements,and to the beat 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 knovAedge.
SIGNATURE OF PERS N RE ON5ISLE FOR FILING RETURN DATE
ADDRESS
2 SOUTH 21ST STREET HARRISBURG PA 1744
SIGNATUR PREPARER OTHE`RRAN REPRESENTATIVE DATE
GM's! . e 7- /J r ?o19,
ADDRESS
5006 E TRINDLE RD SUITE 200 MECHANICSBURG PA 17050
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505611186 3W46475.000 1505611186 ❑
J 1505611286
REV-1500 EX(FI)
Decedent's Social Security Number
-Decedent's Name:WALTER S LEHMAN
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 00
2. Stocks and Bonds(Schedule 8). . . . . . . . . . . . . . . . . . . . . . . . . 2 0 00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , 3. 0 00
4. Mortgages and Notes Receivable(Schedule D) . . , 4 0 00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . , , , , 5. 8770 52
6. Jointly Owned Property(Schedule F) Separate Billing Requested , , , . 6 0 00
7. Inter Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested . . . . 7. 0 00
8. Total Gross Assets(total Lines 1 through 7) , , , , . , , , , . 8 8770 52
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9, 6063 15
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , . 70 2824 39
11. Total Deductions(total Lines 9 and 10), , , , , , . . . 11 888754
12. Net Value of Estate(Line 8 minus Line 11) . . . 12 -117 02
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J), , , , , . . . . . 13 0 00
14. Net Value Subject to Tax(Line 12 minus Line 13) . 14. 0 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- O OO 15. 0 00
16. Amount of Line 14 taxable
at lineal rate X.0- 0 00 16 0 00
17. Amount of Line 14 taxable
at sibling rate X.12 0 00 17. 0 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 00 18. 0 00
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0 00
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505611286 1505611286 J
3w4646 5.000
REV-150D EX(FO Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
WALTER S LEHMAN
STREETADDRESS
MESSIAH VILLAGE
100 MT ALLEN DRIVE
CITY STATE ZIP
MECHANICSBURG PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (q} 0
2. Credits/Payments
A. Prior Payments 0
8, Discount 0
Total Credits(A+8) (2) 0
3. Interest
(3) 0
4. if 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, (4) 0
5. If Line 1 + Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. {5} 0
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . .
2. If death occurred after Dec. 12, 1962,did decedent transfer property within one year of death H 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.
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 172 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
172 P.&§91 16 (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 lax 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 172 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 172 P.S. $116(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. V 16(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.
3W4e71 3.000
REII45M E%-(M-12)
pennsylvania SCHEDULE E
DEPARTVENT OF REVENUE CASH, BANK DEPOSITS & MISC.
[WERRANCE TAX RE
RESIDENTOECEDENrNRN PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
WALTER S LEHMAN 2013-01126
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property olnit owned with right of survivonshlip must be disclosed on Schedule F.
ITEM
NUMBER VALUE DATE
DESCRIPTION OF DEATH
1. M & T BANK CHECKING ACCOUNT # 9842636301 3, 317.34
2 CASH
5, 000.00
3 RETIREMENT CHECK 49. 13
4 REFUND MEDICAL INSURANCE PREMIUM 404 .05
TOTAL(Also enter on line S.Recapitulation) $ 8, 770.52
3w46AD 1.000 If more space is needed,use additional sheets of paper of the same size.
REV.1511 Ex.108-13)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
WERF'ANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEOENT
ESTATE OF FILE NUMBER
WALTER S LEHNAN 2013-01126
Decedent's debts must be reported an Schedule I.
ITEM
NUMBER DESCRIPTION _ AMOUNT
A. FUNERALEXPENSES:
1. COCKLIN FUNERAL HOME 1, 217 . 40
2 BRETHREN IN CHRIST CHURCH KITCHEN FUND FOR RECEPTION 600.00
3 GIFTS AND SNACKS FOR MESSIAH CILLAGE STAFF 74 .97
4 TRAVEL 3, 309.08
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Names)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees:
3. Family Exemption:(if decedent's address is not the same as claimant's,attach explanation,)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 211. 70
S. Accountant Fees:
S, Tax Return Preparer Fees: 300. 00,
7. EXECUTRIX ADMINISTRATIVE EXPENSES 350.00
TOTAL(Also enter an Line 9,Recapitulation) $ 6,063.15
3W46AG 2.000 If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX-(12.12)
pennsylvania SCHEDULE I
DEPARTMENTOF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RES®ENi DECEDENT
ESTATE OF FILE NUMBER
WALTER S LEHMAN
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,Including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. MESSIAH VILLAGE — NURSING CARE 2, 829 . 39
TOTAL(Also enter on Line 10,Recapitulation) $ 2, 829. 39
SwaeAH 1.000 If more space is needed, insert additional sheets of the same size.
REV=1513EX+1 SCHEDULE J
Pennnsns ylvania
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
WALTER S LEHMAN 2013-01126
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
1.
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. $
3w46Al 1.000
If more space is needed, use additional sheets of paper of the same size.
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
c�
No. 2013- 01126 PA No. 21- 13- 1126
Estate Of: WALTER S LEHMAN
tF7st Middle,Lan;
Late Of: UPPER ALLEN TOWNSHIP
CUMBERLAND COUNTY
0 Deceased
Social Security No:
WHEREAS, on the 24th day of October 2013 an instrument dated
May 10th 1991 was admitted to probate as the last will of
WALTER S LEHMAN
(road,Meddle tes4
late of UPPER ALLEN TOWNSHIP, CUMBERLAND County,
who died on the 16th day of October 2013 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBA UGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARYto:
WANDA L HEISE
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 24th day of October 2013.
a. ; 11 A
c eg;ster V, is
i <
eP Y
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
WILL `. .:..
OF
WALTER S. LEHMAN
I, WALTER S. LEHMAN, currently of Upper Allen Township,
Cumberland County, Pennsylvania, realizing the uncertainty of
this life, but with confidence in God and trust in His Son, my
Lord and Savior, Jesus Christ, who died for my sins upon the
cross and rose again to redeem me and give me eternal life, do
hereby make, publish and declare this to by my Last Will and
Testament, hereby revoking any and all prior Wills and Codicils
made by me.
I. I direct that all my just debts and funeral expenses be
paid from the assets of my estate as soon as practicable after my
demise.
II. I direct that all estate and inheritance taxes that may
be assessed in consequence of my death, shall be paid out of the
principal of my general estate to the same effect as if said
taxes were expenses of administration and all property
includable in my taxable estate whether or not passing under
this Will shall be free and clear thereof.
III. I bequeath unto my wife, Mildred W. Lehman, all tangible
personal property which I own at my death.
IV. All the rest, residue and remainder of my estate, of
whatever nature and wherever situate, including property over
which I hold a power of appointment, I devise and bequeath unto
my wife, Mildred W. Lehman.
V. In the event that my wife, Mildred W. Lehman, does not
survive me, I devise and bequeath my entire estate that would
have otherwise passed under Paragraphs III and IV above as
follows:
A. I direct that my three daughters, Wanda K.
Heise, Winifred J. Hock and Gwendolyn J. Lehman, may
choose whatever personal effects of mine that they
desire. Those items not chosen shall pass as part of
my residuary estate below.
B. The residue of my estate shall be divided as
follows:
(1) Twenty percent (20%) unto The Jacob
Engle Foundation, Inc. , Mechanicsburg,
Pennsylvania, to be divided among charities
according to the instructions I intend to
keep with this my Will.
(2) Eighty percent (80%) equally unto
my three (3) daughters, namely Wanda K.
Heise, Winifred J. Hock, and Gwendolyn J.
Lehman, or their issue per stirpes.
VI. I appoint my wife, Mildred W. Lehman, Executrix of this
my Will„ In the event that she fails to qualify or ceases to
act as Executrix, I appoint my daughter, Wanda K. Heise,
Executrix of this my Will. In the event that she fails to
qualify or ceases to act as Executrix, I appoint Roy E. Lehman
Executor of this my Will.
VII. I direct that no bond be required by my fiduciary for the
faithful performance of her duties in any jurisdiction.
I
IN WITNESS WHEREOF, I, WALTER S. LEHMAN, herewith set my
hand to this my Last Will, typewritten on two (2) sheets of
paper including the attestation clause and signatures of
witnesses, this ;c day of May„ 1991.
(SEAL3
WALTER S. LEHMAN '
Signed by WALTER S. LEHMAN, by him declared to be his Will
in our presence, who have hereunto subscribed our names as
witnesses in his presence and at his request, this c = day of
May, 1991.
residing at—,
f � yh � C r`GG residing at e-
-2-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
WE, WALTER S. LEHMAN, :1 t• �. S �• and
the testator and the witnesses, respectively,
whose names are signed to the attached or foregoing instrument,
being first duly affirmed, do hereby declare to the undersigned
authority that the testator signed and executed the instrument as
his Last Will and that he signed willingly (or willingly
directed another to sign for him) , and that he executed it as
his free and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of
the testator, signed the Will as witnesses and that to the best
of our knowledge the testator was at that time eighteen years of
age or older, of sound mind and under no constraint or undue
influence.
WALTER S. LEHMAN
WITNESS. !
����
WITNESS
Subscribed, sworn or affirmed and acknowledged before me by
WALTER S. LEHMAN, the testator, ":I 4, : . rA. S-, -4; 1� and
L.,.-5-1 , Witnesses, this lo ', day of May, 1991.
(SEAL) NOTARY PUBIJIC
Notarial Sea'
'' RoboA L.Fry,Notary Public
' uppx to T .Cumb"Land County
�Mycommission Expires Aug.19,1991
Membe;,Parmsydvanla,4:sada+icn c.l No+�tio5
-3-
M M&T Bank
499 Mitchell Road,Millsboro,DE 19966 Adjustment services
Phone 888-5024349
Fax (302)934-2955
Wanda Heise October 25,2013
2 South 2151 Street
Harrisburg, PA 17104
Re: Estate of Walter S. Lehman
Social Security:
Date of Death: October 16, 2013
Dear Sir or Madam:
Per your inquiry on October 22, 2013, please be advised that at the time of death, the above-named decedent
had on deposit with this bank the following:
1. 7}pe ojAccount Checking Account
Account Number 9842636301
Ownership(Names oJ) Wanda L Heise(Rep Payee)
Walters Lehmon(Principal)
Opening Date 0310612006
Balance on Date ojDeath S3,31733
Accrued Interest S .01
Total ..-._---- ---------------- -----------
S 3,317.34
2. Type ojAccount Checking Account
Account Number 602426(closed 0710912013)
Ownership(Names off Wanda L. Heise(POA)
Walter S. Lehman
Opening Date 1211911980
Balance on Date ojDeath $ 0.00
Accrued Interest $ .00
Total
-Y0.00 ---------