HomeMy WebLinkAbout03-16-15 (3) Q- pennsytvania 1505'614105
XPARTMENTOFMVFNUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURNFl:��
2
Harrisburg, PA 17128-0601 RESIDENT DECEDENT FJ S 7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
[01152013 7 [05271924
Decedent's Last Name Suffix Decedent's First NameMI
Kauffman Robert M
(If Applicable)Enter Surviving'Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Kauffman Gertrude I FH]
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(3g) 1. Original Return p 2.Supplemental Return p 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
O 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received C= 11. Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets 0 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name _ Daytime Telephone Number _
Fertrude H. Kauffman (717) 766-5348
First Line of Address
249 Rich Valley Road
Second Line of Address
City or Post Office State ZIP Code
Mechanicsburg PA 17050
Correspondent's email address: N/A cs y rT1
REGISTER OF WILLS 9SE ONLY
__
REGISTER OF_WILLS USE ONLY p ^ ' 1- r
DATE FILED MMDDYYYY i C7 CJ
DA7 4FILED S MP r"
PLEASE USE ORIGINAL FORM ONLY `
Side 1
150 14 5 1505614105
e.�
150.5614205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Robert M. Kauffman
RECAPITULATION
1. Real Estate(Schedule A). ... . .. . . ... . ... ..... .. . . ...... .... . .. .. ... . . 1. 0.00
2. Stocks and Bonds(Schedule B) . .. ... . ... . ... . ... . ... ... .... . ... . . .... 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. 0.00
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. ... :. 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. . ... . . 7. 0.00
8. Total Gross Assets(total Lines 1 through 7).. . .... . ... .. ... . . .... . ... . .. 8. 0.00
9. Funeral Expenses and Administrative Costs(Schedule H). . . ... ... .... .. . . .. 9. 10,054.00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. ... .... ... . .. 10. 0.00
11. Total Deductions(total Lines 9 and 10). ... .... ... . . ... . ...... .... . .. . .. 11. 10,054.00
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. 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_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE .... .. ... . .. .... . .. . . .. . .. . .... ... . . .. . .... .. . .... ... ... . 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,co ect and complete. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowle ge.
SIGNAT OF WRSON ESPONSIBL R FILINGRETURN DATE
ADDRESS
249 Rich Valley Road, MeQniZZrg, PA 17050
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADDRESS
Side 2
5 4�iiiii 05 1505614205 J
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Robert M. Kauffman
STREETADDRESS
249 Rich Valley Road
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments
B.Discount
(See instructions.) Total Credits(A+B) (2)
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 .............................................................................................................................. ❑
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? ........................................................................................................................ ❑ 0
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
172 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 step-parent 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(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-1511 EX+ (08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robert M. Kauffman 2013-0073
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Malpezzi Funeral Home 10,054.00
2. Trindle Spring Lutheran Church 950.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)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:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 10,054.00
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
'Robert M. Kauffman 2013-0073
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. Gertrude H.Kauffman Spouse 100%
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 the same size.
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND } SS File Number 2013-00073
Personal Representative(s)of the Estate of Robert Maurice Kauffman
deceased,depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memo ndum at the end of this inventory.
I verify that the statements made in this Inven- JU"t�J /V
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of �3 16/Z b/'/
18 Pa.C.S. §4904 relating to unsworn falsification to
authorities.
Attorney-- (Name) NSA (Supreme Court LD.No.)
(Address)
(Telephone)
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO.
January 15,2013 249 Rich Valley Road,Mechanicsburg,PA 17050
FIGURES MUST BE TOTALED
None. 0.00
(Attach additional sheets as needed)
TOTAL: 0.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may,at the election of the personal representative include the value of each
item,but such figures should not be extended into the total of the Inventory. (See 10 Pa.C.S.§3301(6))
Form RW-09 rev.10.13.06
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
No. 2013- 00073 PA No. 21- 13- 0073
Estate Of: ROBERT MAURICE KAUFFMAN
(First,Middle,Last]
Late Of: SILVER SPRING TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No:
WHEREAS, on the 18th day of. January 2013 an instrument dated
April 21st 1994 was admitted to probate as the last will of
ROBERT MAURICE KAUFFMAN
Mrst,Middle,Last]
late of SILVER SPRING TOWNSHIP, CUMBERLAND County,
who died on the 15th day of January 2013 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
GERTRUDE H KAUFFMAN
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, PENNSYL VA NIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 18th day of January 2013.
Register o Wills
` 7 L /J
j
/ Deputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
I, ROBERT M. KAUI'F1tAIT, of the Township of Silver Spring,
County of Cumberland and State of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and
making void any and all prior Wills by me at any time heretofore
Yaade
1.
I direct the payment of all my just debts and funeral
�y
expenses as soon after my decease as the sameaa beinvntly
� a
�, :,-jdone o = __y
r
CO
2.
I give, devise and bequeath all the rest,;!r4sidue�-aca C)
c� 1
remainder of my estate, real, personal and mixed, whatsoever and
wheresoever the same may be situate, to my wife, GE_RTRUDE H.
... .T.UF 'lAN, absolutely.and unconditionally.
3•
in the event that my wife, GERTRUDE H. K_AUFFMAN,' should
predecease me, or should she die within thirty (30) days from
the date of my death, then in either of such events, I give,
devise and bequeath my entire estate, of whatsoever nature and
wheresoever the same may be situate, to my two (2) children, to
wit, ROBERT B. KAUFF`MAN and BARBARA E. KAUFYMIAN, share and share
..1�
alike, per stirpes.
LASTLY, I nominate, constitute and appoint my wife.,
GERTRUDE H. KAUF.-RAIAN, Executrix of this my Last Will and
Testament, and in the event that my said. t-xife should predecease
me, or should she be unable or urruilling to serve in such
capacity for any reasons then in such event, I nominate; constitute
and appoint my son, ROBERT B. KAUFFMA.K. Executor of this my Last
Will and Testament, in her place and stead, and in either instance,.
I direct that 7n7 said personal representatives be excused from
posting bond or ocher security for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
�7 '
this. , I-day of April, A. D.s 1994-
(SEAL)
o er ie .Kauffman
-2-
Signed, sealed, published and declared by the above
named,, ROBERT M. KAUFM2AYi, as and for his Last Will and Testame
in the presence of us, who have subscribed our names hereto as
witnesses, at the request of said testator, in his presence and
in the presence of each other.
Ac ! �
1
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, - ROBERT M. nu5yiuv the testator
whose name is signed. to the. attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary act and'deed, for the purposes therein contained.
$Worri and affirmed to and acknowledged before me by
ROBERT*.. M-,,'. K-AUFTYPUN the.: testa= this
day of April A. D. i.9940
--------------
1-1
COMMONWEALTH OF PENNSYLVANIA 97
SS.
COUNTY OF CUMBERLAND
We, the undersigned, J. ROBERT STAUPIWIM
and ERIKA L, LEVEITHAGBN the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified
according to law, depose and. say that we were present and saw the
testator $ ROBERT- 14- _K'AT-iPPT4AW , sign and exe-
cute the instrument as his&mx Last Will and Testament; that the
said testatjLr ROBERT 17q. KAUFFU4AD executed it as
hi-030rr free and voluntary act for the purposes therein expressed;
that each of us,' in the hearing and sight of the t-estator signed
the Will as witnesses; and that to the best of our knowledge, the
testat Or was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
W--4 Ste;
wrdy 4
WCcnnis�n2karesNov
6,, 97
Sworn and subscribed to before Z'L'A
me' this I/ day of
April -19940
Mpn%.7i Kay Sft Waqt
mlis Nov 6