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HomeMy WebLinkAbout04-29-15 pennsylvania 1505618627 3M464710.000 OEPARMENT OF REVENUE Ix(03-14)(TP) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 10032014 06271917 Decedent's Last Name Suffix Decedent's First Name MI TILLMAN ERMA M (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 X❑ 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(date of death ❑ prior to 12-13-82) 4. Agriculture Exemption(date of El 5. Future Interest Compromise(date of ❑ 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 7. Decedent Died Testate X❑ 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) ❑ 10. Litigation Proceeds Received 0 11. Non-Probate Transferee Return F 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) El13. 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 JEFFREY P . OUELLET, ESQ 717-2a"C>7254 M' First Line of Address =X) HARTMAN UNDERHILL rn r-r M w cp ' Second Line of Address _ C 221 E . CHESTNUT ST . City or Post Office State ZIP Code LANCASTER PA 17602 r� Correspondent's email address: J E F F O a@ H U 8 L A W - C 0 M REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 1111111111111111111 IN 1505618627 1505618627 1505618635 REV-1500 EX(TP) 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. $291493 . 74 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested. . . . . 6. $0 - 00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested. . . . . 7. $0 - 00 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8. *29-1493 - 74 9, Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. $31074 - 50 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). . . . . . . . . . 10. *199 - 25 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. $3,273 - 75 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . 12. $26,219 - 99 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . 13. $1,582 - 00 14. Net Value Subject to Tax(Line 12 minus Line 13). . . . . . . . . . . . . . . 14. $241637 -99 TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers urltier Sec.9116 (a)(1.2)X.01_ $0 . 00 15. $0 . 00 16. Amount of Line l4�xable at lineal rate X.044- $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 *241637 - 99 18. *31695- 70 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. $31695- 70 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ 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 person responsible for filling the return is based on all information of which preparer has any knowledge. SIGNATURE OF P RSON R SPONSIBLE FOR FILING RETURN DATE " K F64I vdw 2 AD RESS C/0 221 E - CHESTNUT STREET LANCASTER, PA 17602 SIGNATOE O REPARER PHE20HAN PEFSON RESPONSIBLE FOR FILING THE RETURN ATE _ ADDRE 221 UCZEJNUT STREET LANCASTER, PA 17602 111111111111111111111tippi11t1ll161�1�111111111111111111 Side 2 1505618635 3M464810.000 REV-1500 EX(TP) Page 3 • File Number Decedent's Complete Address: DECEDENTS NAME TILLMAN E M STREET ADDRESS 221 EAST CHESTNUT STREET LANCASTER CITY STATE ZIP LANCASTER PA 17601 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) *3,695- 70 2. Credits/Payments A. Prior Payments *0 . 00 B.Discount *0 . 00 (See instructions.) Total Credits(A+B) (2) *0 . 00 3. Interest (3) *0 - 00 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) $0 . 00 5. If Line 1 + Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $31695- 70 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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? . . . . . ❑ 4. Did decedent own an individual retirement account, annuity, or other non-probate property,which contains a beneficiary 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 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 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. 3M4671 4.000 REV-1502 EX+(12.12) SCHEDULE A pennsylvania DEPARTMENT OF REVENUE /� cT/�TC INHERITANCE TAX RETURN - REAL ES 1 A 1 E RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Erma M. Tillman All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None TOTAL (Also enter on Line 1,Recapitulation.) $ $0.00 2w4695 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Erma M. Tillman All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, None TOTAL (Also enter on Line 2,Recapitulation) $ $0.00 2w4696 2.000 If more space is needed, insert additional sheets of the same size REV-1504 EX+(9-12) SCHEDULE C pennsylvania DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATION, INHERITANCE TAX RETURN PARTNERSHIP OR RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Erma M. Tillman Schedule C-1 or C-2(including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH None TOTAL(Also enter on line 3,Recapitulation) $ $0.00 2w4697 2.000 (If more space is needed,insert additional sheets of the same size) REV-1507 EX+ (04-13) pennsylvania SCHEDULE D DEPARTMENT OF REVENUE MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Erma M. Tillman All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH None TOTAL(Also enter on Line 4,Recapitulation) $ $0.00 2w46AC 2.000 (If more space is needed,insert additional sheets of the same size.) REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.INHERITANCE TAX _ RESIDENT DEC ENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Erma M. Tillman Include the proceeds of litigation and the date the proceeds were received by the estate. All pr=jointly'ointl owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Armstrong World Industries - Lump sum payout of pension, payout initiated prior to death $16,689.74 2 Citizens Bank - Green Checking account registered to Erma M. Tillman, account number 6100645428 $4,741.00 3 Claremont Nursing & Rehabilitation Center - Refund of unused monthly deposit $7,728.00 4 Myers - Buhrig Funeral Home and Crematory, Ltd. - Refund of overpayment $335.00 TOTAL(Also enter on line 5,Recapitulation) $ $29,493.74 2w48AD 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1509 B(+,(0 1-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE • INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Erma M. Tillman If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule a SURVMINGJOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH TT� FOR JOINT MADE INCLUDE NAM_OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMLAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JCINTLYHELD REAL ESTATE. VALUEOFASSET INTEREST DECEDENTS INTEREST None TOTAL (Also enter on Line 6, Recapitulation) $ $0.00 9w46AE 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) SCHEDULE G pennsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC.NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Erma M. Tillman This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLLOETHENAME OFTHE TRANSFEREE,THEIR RELATIONSHIP TOOECEDENTAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OFTRANSFER.ATTACH ACOPY OFTHE OEEDFOR REAL ESTATE, VALUEOFASSET INTEREST IFAPPLICABLE VALUE 1• None TOTAL(Also enter on line 7,Recapitulation)$ 0.00 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2.000 REV•1511EX+(08-13) SCHEDULE H Pennsylvania DEPARTMENTOF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Erma M. Tillman Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Myers Buhrig Funeral Home and Crematory, Ltd. - Funeral $222.50 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: $2,500.00 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. 1 Hartman Underhill & Brubaker, LLC - Administrative costs $50.00 2 Richard K. Eckman, Trustee - Trustee's commission $300.00 Total from continuation schedules . . . . . . . . . $2.00 TOTAL(Also enter on Line 9,Recapitulation) $ $3,074.50 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 RESIDENT DECEDENT ESTATE OF FILE NUMBER Erma M. Tillman 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 United HealthCare - Health insurance premium, debt due at death $199.25 TOTAL(Also enter on Line 10,Recapitulation) $ $199.25 2W46AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) SCHEDULE J pennsylvania DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Erma M. Tillman 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. Revocable Living Trust of Erma M. Tillman dated June 18, 2002 c/o Richard K. Eckman, Successor Trustee 911 Herman Drive Mechanicsburg, PA 17055 Sole beneficiary of Estate. Trust $0.00 2 Bessie L. Caldwell 567 West Lemon Street Lancaster, PA 17603 Beneficiary under Revocable Living Trust of Erma M. Tillman of 23.5% of Trust principal Sister-in-law $6,161.70 ENTER DOLLARAMOUNTS 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 See Attached 1 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ $1,582.00 9W46AI 2.000 If more space is needed,use additional sheets of paper of the same size. Estate of: Erma M. Tillman Schedule J Part 1 (Page 2) Item No. Description Relation Amount 3 Anna Mae Myers 38 South Penn Street Manheim, PA 17545 Beneficiary under Revocable Living Trust of Erma M. Tillman of 23.5% of Trust principal Sister-in-law $6,161.70 4 Jean S. Eckman 1938 Krestrel Court Lancaster, PA 17603 Beneficiary under Revocable Living Trust of Erma M. Tillman of one-half residue of Trust after compliance with charitable bequests and certain individual bequests Niece $6,157.30 5 Richard K. Eckman 911 Herman Drive Mechanicsburg, PA 17055 Beneficiary under Revocable Living Trust of Erma M. Tillman of one-half residue of Trust after compliance with charitable bequests and certain individual bequests Nephew $6,157.29 Estate of: Erma M. Tillman Schedule J Part 2B (Page 1) Item No. Description Amount 1 Green Hill United Methodist Church 5801 River Road Conestoga, PA 17516 Beneficiary under Revocable Living Trust of Erma M. Tillman of 2% of Trust principal $533.20 2 Green Hill United Methodist Cemetery 5801 River Road Conestoga, PA 17516 Beneficiary under Revocable Living Trust of Erma M. Tillman of 3% of Trust principal $786. 60 3 The Billy Graham Evangelistic Association 1 Billy Graham Parkway Charlotte, NC 28201 Beneficiary under Revocable Living Trust of Erma M. Tillman of 1% of Trust principal $262.20