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HomeMy WebLinkAbout04-24-15 7 p?nnsrlvania 1505618403 ARTME OF REVEN` X(03-14) REV-15010 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 15 0127 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 01 24 2015 08 03 1926 Decedent's Last Name Suffix Decedent's First Name MI MARTIN JOHN L (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW RX 1. Original Return 2. Supplemental Return ❑ 3. Remainder Return(date of death prior to 12-13-82) 4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) a7. Decedent Died Testate RX 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 10. Litigation Proceeds Received ❑ 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) 13. Business Assets 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 EDWARD P SEEBER 717 533 3280 First Line of Address SUITE C400 Second Line of Address 555 GETTYSBURG PIKE City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's email address: eps isdc.com REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY rV C DATE P4ED STARig C7 7D. Side 1 M 3W r` .. . o IIIIIIIIIIIIILIII1I5I0II5I6IIII8I4II0 �IIIII�IIIIIIIIIIIIIII 1505618403 J 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Martin, John L. 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. 14 ,065 - 01 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 445 ,517 - 91 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 459,582 . 9 2 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 33,642 - 23 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 5 ,042 • 64 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 38-,684 - 87 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 420,898 • a5 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. 4211,898 - 05 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.00 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 420,898 - 05 16. 18 ,940 - 41 17. Amount of Line 14 taxable at sibling rate X.12 0 . 011 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 18-,940 - 41 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ 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,correct and complete.Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has any knowledge. S GNATURE OF PERSON RESPO�SIBLING RE rianne Shaffer ADDRESt 156 Madel le, Dillsbur , PA 17019 SIGN RE OFJPR A OT R THAN REPRESENTATIVE Edward P Seeber DATE AD ESS Suite C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 L 111111111111111111111111111111111111111111111111111111111111 Side 2 1505618411 ' REV-1500 EX Page 3 File Number 21-15-0127 Decedent's Complete Address: DECEDENT'S NAME Martin,John L. STREET ADDRESS 2624 North Rosegarden Boulevard CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 18,940.41 2. Credits/Payments A. Prior Payments 17,993.39 B. Discount 947.02 Total Credits(A +B) (2) 18,940.41 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0,00 Make Check Pa able 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;............................................................................... ❑x ❑ b. retain the right to designate who shall use the property transferred or its income;.................................. x c. retain a reversionary interest;or............................................................................................................... x d. receive the promise for life of either payments,benefits or care?............................................................ x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receivingadequate consideration?.................................................................................................................... ❑ ❑x 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which El abeneficiary designation?.................................................................................................................. 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 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 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 21ears 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-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Martin,John L. 21-15-0127 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Members 1st Federal Credit Union Savings Account No.40674-04-valued per letter dated 4,000.25 2/27/15 2 Members 1st Federal Credit Union Savings Account No.40674-00-valued per letter dated 7,400.02 2/27/15 3 1993 Toyota Corolla-valued per sales price 2,100.00 4 Genworth Financial-insurance premium refund 527.70 5 Magazine subscription refunds 32.04 6 PA Department of Revenue-2014 income tax refund 5.00 TOTAL(Also enter on Line 5, Recapitulation) 14,065.01 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Martin,John L. 21-15-0127 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF NAME OF ATTACTHEIR COPY OF THE DEIED FOR REAL ESTATE. VALUE OF ASSET NT AND INTEREST (IF APPLICABLE) VALUE 1 AXA Equitable Annuity No.*33-beneficiaries are 47,201.22 100.000% 0.00 47,201.22 children;valued per statement dated 1/26/15 2 Prudential Annuity No.*94-beneficiaries are children; 20,685.93 100.000% 0.00 20,685.93 valued per statement dated 1126/15 3 TD Ameritrade IRA No.*02-beneficiaries are children; 55,773.93 100.000% 0.00 55,773.93 valued per statement dated 1/26/15 4 216.656 shares of AMG Yacktman Focused Service 5,588.64 100.000% 0.00 5,588.64 held in TD Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 5 56 shares of Apple Inc held in TD Ameritrade Account 6,334.16 100.000% 0.00 6,334.16 No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 6 440 shares of Ball Corp held in TD Ameritrade 28,328.30 100.000% 0.00 28,328.30 Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 7 758.956 shares of Berwyn Income held in TD 10,405.29 100.000% 0.00 10,405.29 Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 8 Cash held in TD Ameritrade Account No.*82-titled in 10,628.80 100.000% 0.00 10,628.80 the John L.Martin Living Trust dated 11/27/1996- valued per statement&public listing Total of Continuation Schedules See attached pages TOTAL(Also enter on Line 7, Recapitulation) 445,517.91 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE �+/► INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Martin,John L. 1 21-15-0127 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE INCLNUMBER THE DATE ODE F TRANSOF FER.SFEREE THEIR ATTACH A COPY OF THE DEIED FFOREREAL ESTATE. VALUE OF ASSET ENT AND INTEREST (IF APPLICABLE) VALUE 9 1,452.893 shares of Eaton Vance Floating Rate 15,676.72 100.000% 0.00 15,676.72 Advantage Adv held in TD Ameritrade Account No.*8 -titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 10 315 shares of FirstEnergy Corp held in TD Ameritrade 12,973.28 100.000% 0.00 12,973.28 Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 11 5,261.309 shares of Franklin Income Advisor held in 12,495.61 100.000% 0.00 12,495.61 TD Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 12 318.395 shares of Hennessy Gas Utility Investor held 9,841.59 100.000% 0.00 9,841.59 in TD Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 13 170 shares of Lockheed Martin Corp held in TD 33,395.65 100.000% 0.00 33,395.65 Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 14 Members 1st Federal Credit Union CD Account No. 26,232.11 100.000% 0.00 26,232.11 474474-40-titled in the John L. Martin Living Trust dated 11/27/1996-valued per letter dated 2/27/15 15 Members 1st Federal Credit Union Savings Account 84.81 100.000% 0.00 84.81 No.474474-00-titled in the John L.Martin Living Trust dated 11/27/1996-valued per letter dated 2/27/1 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) Rev1610 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE �■ INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Martin,John L. 1 21-15-0127 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE INCLNUMBER THE DATE OF TROANSERSATTACFI A COPTHEIR Y OF THE RELATIONSHIP OR REAL ESTATE. VALUE OF ASSET EDENT AND INTEREST (IF APPLICABLE) VALUE 16 Members 1st Federal Credit Union Savings Account 10,900.35 100.000% 0.00 10,900.35 No.474474-05-titled in the John L. Martin Living Trust dated 11/27/1996-valued per letter dated 2127/1 17 375 shares of Merit Medical Systems Inc held in TD 5,955.00 100.000% 0.00 5,955.00 Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 18 125 shares of Mobileye NV held in TD Ameritrade 5,100.00 100.000% 0.00 5,100.00 Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 19 1,762.63 shares of Oppenheimer Capital Income A 17,388.34 100.000% 0.00 17,388.34 held in TD Ameritrade Account No.*82-titled in the John L.Martin Living Trust dated 11/27/1996-valued per statement&public listing 20 525.089 shares of Oppenheimer Global A held in TD 40,581.50 100.000% 0.00 40,581.50 Ameritrade Account No.*82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 21 230.6 shares of Oppenheimer Global Allocation A held 4,002.06 100.000% 0.00 4,002.06 in TD Ameritrade Account No.*82-titled in the John L.Martin Living Trust dated 11/27/1996-valued per statement&public listing 22 Orrstown Bank Checking Account No. 111001239- 27,943.44 100.000% 0.00 27,943.44 titled in the John L. Martin Living Trust dated 11/27/1996-valued per letter dated 3/16/15 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE �+ INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Martin,John L. 1 21-15-0127 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF EROANSFERSATTACH A CIOPY of THE DEED FFOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 23 Orrstown Bank Checking Account No. 111001239, 0.78 100.000% 0.00 0.78 accrued interest-titled in the John L.Martin Living Trust dated 11/27/1996-valued per letter dated 3/16/1 24 524.398 shares of Permanent Portfolio held in TD 21,686.48 100.000% 0.00 21,686.48 Ameritrade Account No.`82-titled in the John L. Martin Living Trust dated 11/27/1996-valued per statement&public listing 25 224 shares of W.P.Carey Inc.common stock-titled in 16,313.92 100.000% 0.00 16,313.92 the John L.Martin Living Trust dated 11/27/1996- valued per public listing TOTAL(Also enter on Line 7, Recapitulation) 445,517.91 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Martin,John L. 21-15-0127 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 14,748.73 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Marianne Shaffer Street Address 156 Martel Circle City Dillsburg State PA ZiD 17019 Year(s)Commission Paid 5,200.00 2, Attorney's Fees JSDC Law Offices 13,400.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip RelationshiD of Claimant to Decedent 4. Probate Fees 155.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 138.00 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 33,642.23 Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Martin, John L. 21-15-0127 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Gingrich Memorials-engraving services 175.00 2 Malpezzi Funeral Home-funeral services 14,573.73 H-A 14,748.73 Other Administrative Costs 3 Vehicle transfer fees 138.00 H-67 138.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-12) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFMORTGAGE LIABILITIES AND LIENS RET INHERITANCE TAXAXRETURRNN RESIDENT DECEDENT ESTATE OF FILE NUMBER Martin,John L. 21-15-0127 Report 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 Dental Health of Silver Spring-unreimbursed dental bill 59.95 2 Holy Spirit Hospital-unreimbursed medical bill 22.50 3 Homelnstead-unreimbursed homecare 3,062.91 4 Homelnstead-unreimbursed homecare-check written prior to death&cashed in after death 757.28 5 United States Treasury-2014 income tax 1,140.00 TOTAL(Also enter on Line 10, Recapitulation) 5,042.64 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Martin,John L. 21-15-0127 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) ITAXABLE DISTRIBUTIONS (include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Susan DiPaula Daughter 1/3 of residue 140,299.35 6346 Rone Stallion Lane Columbia,MD 21045 2 Christine Metcalfe Daughter 1/3 of residue 140,299.35 2622 North Rosegarden Boulevard Mechanicsburg, PA 17055 3 Marianne Shaffer Daughter 1/3 of residue 140,299.35 156 Martel Circle Dillsburg, PA 17019 Total 420,898.05 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)