HomeMy WebLinkAbout04-20-15 ' .J
REV-1500 EX(02-11) 1505610143
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
07 28 2014 01 13 1932
Decedent's Last Name Suffix Decedent's First Name MI
BRUMAGIM ROBERT T
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
BRUMAGIM ELSIE E
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ❑ 2. Supplemental Return1:13. Remainder Return(Date of Death
Prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
6 Decedent Died TestateDecedent Maintained a Living Trust 8. Total Number of Safe De
(Attach Copy of Will) (Attach Copy of Trust) posit Boxes
9. Litigation Proceeds Received 10.Spousal Povert Creditl(Date of Death 11.Election to tax under Sec.9113 A
between 12-31-J1 and ( )
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Nu�r
GARY L JAMES ESQ 717 53,3 3 2 8 rn n
c->
REGISTEWOFW14S USV ONL 1
r 1 r— cv IrTI
First Line of Address r�
M G> a
134 S I PE AVENUE
Second Line of Addressc ► -` f=- M
(�
City or Post Office State ZIP Code DA-M FILED
HUMbELSTOWN PA 17036
Correspondent's e-mail address: glj@jsdc.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.Declara on of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT OF PERSON RES ONSIBL R FILING RETURN DATE
G F Elsie E. Brumagim
ADDRESS
1403 Mountain Road, Newburg, PA 17240
SIGNAT E OF PREPARER HER THAN REPRESENTATIVE DATE
Gary L.James Esq. /49 -- 2C
ADDRESS
134 Sip v n , Hummelstown, PA
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Brumagim, Robert T.
RECAPITULATION
1. Real Estate(Schedule A)...... ......................... ....................... ........... I
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5.
6. Jointly Owned Property(Schedule F) 0 Separate Billing Requested............ 6.
7. inter-Vivos Transfers&Miscellaneous Non Probate Property
(Schedule G) El Separate Billing Requested............ 7. 77, 928 . 00
8. Total Gross Assets(total Lines I through 7)........................................................ 8, 77, 928 . 00
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 7 , 188 . 29
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)............................................................... 11. 7 , 188 .29
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 70, 739. 71
11 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. 70 ,739. 71
TAX COMPUTATION-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 17 , 684 . 92 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 53, 054 . 79 16. 2 ,387 . 47
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. 2 , 387 . 47
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. F]
Side 2
15056111243 1505610243
REV-1500 EX Page 3 File Number 21
Decedent's Complete Address:
DECEDENT'S NAME
Brumagim, Robert T.
STREET ADDRESS
1403 Mountain Road
CITY STATE ZIP
Newburg PA 17240
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 2,387.47
2. Credits/Payments
A. Prior Payments 2,268.10
B. Discount 119.37
Total Credits(A +B) (2) 2,387.47
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 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;............................................................................... ❑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?............................................................ ❑ ❑
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate 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
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 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 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.
f
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
Bruma im, Robert T. 21
This schedule must be completed and filed N the answer to any of questions 1 through 4 on page three of the REVA500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER
INCLUDE
HE DATE OF TRANSFER SATTACH THEIR OPY OF THE DEED FOR REAL EST AND
VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Personal Property 1,500.00 1,500.00
2 Real Estate located at 1403 Mountain Road, Newburg, 76,428.00 76,428.00
Cumberland County, Pennsylvania-titled in the
Robert T.Brumagim Living Trust dated'December 11,
2009;valued per tax assessed value common level
ratio$77,200.00*.99=$76,428.00
TOTAL(Also enter on Line 7.Recapitulation) 77,928.00
(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-15111EX+00-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX R
RESIDENT DEC ENT
URN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Brumagim, Robert T. 21
Decedent's debts must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
- NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 2,173.29
B. ADMINISTRATIVE COSTS:
I Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees James, Smith, Dietterick&Connelly, LLP 1,500.00
3. Family Exemption: (if decedent's address is not the same as claimant's,attach explanation) 3,500.00
Claimant Elsie E. Brumagim
Street Address 1403 Mountain Road
City Newburg State PA ZiD 17240
Relationship of Claimant to Decedent Spouse
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 15.00
See continuation schedule(s)attached
I
TOTAL(Also enter on line 9,Recapitulation) 7,188.29
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Brumagim,Robert T. 21
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral ral Exe�, nses
1 Egger Funeral Home-funeral 2,173.29
H-A 2,173.29
Other Administrative Costs
2 Register of Wills Cumberland County -filing fee inheritance tax 15.00
H-B7 15.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-'613 EX+(01-10)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Brurnagim, Robert T. 21
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
DP Not List Trustee(s),
TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
I Alan L. Brumagml Son 25%of residue 17,684.93
1658 The Hideout
3462 Chestnut Hill Drive
Lake Ariel,PA 18436
2 Elsie E.Brumaginn Spouse 25%of residue 17,684.93
1403 Mountain Road
Newburg, PA 17240
3 Matthew P.Brumagirn Son 25% of residue 17,684.93
19 Yale Drive
Hampton Bays, NY 11946
4 Thomas D.Brumagim Son 25% of residue 17;684.93
In den Bruehlwiesen 7C
D-61352 Bad Homburg
Germany
Total 70,739.72
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1560 cover sheet,as appiopriate.
NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART it-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
JSDC LAW OFFICE;
April 16, 2015
THE
Lisa M. Grayson, Esq. r
Register of Wills & ' ` ESTATE '`
Clerk of Orphans' Court SECjTY.
1 Courthouse Square FORMULA.,
Carlisle, PA 11013
RE: TRUST ESTATE OF ROBERT T. BRUMAGM, DECEASED
FILE NO. 21-14-1011
Denise M.Long
dml@jsdo.com
Dear Ms. Grayson:
Enclosed are the following documents to be filed in the above-referenced Estate:
1. An original and two (2) copies of the Pennsylvania Inheritance Tax
Return.
2. A check made payable to the "Register of Wills" in the amount of Thirty
Dollars ($15.00) representing the filing fee.
Please time-stamp the additional copies of the Return and return to me in the enclosed
self-addressed, stamped envelope.
If you have any questions, please feel free to give me a call.
Sincerely,
JSDC LAW OFFICES
:tecis,
Denise M. Long ac� rn
cn
7 'P' p
`kl
N
134 SIPE AVENUE
HUMMELSTOWN,PA 17036
MAILING ADDRESS
P.O.BOX 650
HERSHEY,PA 17033
TOLL FREE 1.600. 60
eo
TEL.717.533.32803280 FAX 717533.7771
www.jsdc.com
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