HomeMy WebLinkAbout05-28-15 (2) � 1505614134
EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 2soso� INHERITANCE TAX RETURN 2 1 1 5 0 1 2 0
Harrisbur , PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDWYY Date of Birth MMD�YYYY
1 0 1 1 0 2 0 1 5 1 0 2 5 1 9 1 9
DecedenYs Last Name Suffix DecedenYs First Name MI
MI L L ER PAUL �1
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name M�
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
a 1.Original Return � 2.Supplemental Return � 3. Remainder Return(date of death
Priorto 12-13-82)
� 4.Agriculture Exemption � 5. Future Interest Compromise(date of � 6.Federal Estate Tax Return Required
(date of death on or after 7-1-2012) death after 12-12-82)
Q 7.Decedent Died Testate � 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 � 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 T0:
Name Daytime Telephone Number
MURREL R . WALTERS , I I 1 71 7 697 4700
First Line of Address
WALTERS & GALLOWAY , PLLC
Second Line of Address
54 E . MAI N ST .
City or Post Office State ZIP Code
;..�
MECHANI CS BURG PA 1 7 0 5 5 c�
�
c� �; :� �
c C..� r�� �
- "� �-� c�
CorrespondenYs e-mail address: 1'11U1'1'el waltersqallowav.com �7 '� �> -,�,�
,_.., '� r J -G , .....,
REGIST�R pF NJILLS US�ONLY 4'�
� _,
REGISTER OF WILLS USE ONLY 7
DATE FILED MMDDYYYY -`} ' �
_:1 _'.�
` : r,�
Ct� _ C`+1
CC�.� '`;,� �I
DATE FILED STANf�
PLEASE USE ORIGINAL FORM ONLY
Side 1
I IIIIII II�II�IIII(IIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
� 1505614134 1505614134 J �
� 1505614234
REV-1500 EX(FI) DecedenYs Social Security Number
DecedenYsName: PAUL A. MILLER
RECAPITULATION
1. Real Estate(Schedule A) �• �
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2•
4 9 6 2 0 1 . 9 5
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. '
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. � 4 9 5 1 � � � 6
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. � 5 6 5 r'J . 6 9
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 5 6 4 6 6 . 3 $
7. Inter-Vivos Transfers&Miscellaneous Ng�Probate Property 2 Q 1 3 3 6 , 5 2
(Schedule G) U Separate Billing Requested . . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 9 � 9 1 7 0 , 6 0
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9� 3 2 3 $ 9 . $ 2
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. � 9 4 4 � . � 2
11. Total Deductions(total Lines 9 and 10) �1. 5 1 8 3 � . 9 4
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 $ 6 7 3 3 9 . 6 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . �3 •
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. $ 6 7 3 3 9 . 6 6
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 g 6 7 3 3 9 . 6 6 3 9 0 3 0 . 2 8
at lineal rate X.045 16.
17. Amount of Line 14 taxable � . � �
at sibling rate X.12 0 . � � 17.
18. Amount of Line 14 taxable � . � �
at collateral rate X.15 � • � � �g.
19. TAX DUE 3 9 � 3 � . 2 8
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
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.
SIGNATURE OF PERSON RESPONSIBLE�-FOR FILING RETURN DATE
ADDRESS / � (�` / �� - / S
d t, 'J
SIGNATURE Ff P R � R THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADDRESS
MURREL R. VVALTERS III 54 E. MAIN ST MECHANICSBURG PA 17055
I IIIIII IIIII IIIII IIIII IIIII III�I IIIII IIIII IIIII IIIII IIII IIII Side 2
� 1505614234 1505614234 J
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PAUL A. MILLER 21 15 0120
DecedenYs Name Page 2 File Number
Correspondents
Name Daytime Telephone Number
J O H N R . M I L L E R 8 0 4 3 3 7 5 3 6
First line of address
1 5 0 0 E A S T R I D G E R D .
Second line of address
# 2 0 8
City or Post Office State ZIP Code
H E N R I C O V A 2 3 2 2 9
Correspondent's e-mail address:
Under penalties of perjury,i declare that I have examined this retum,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 personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN �M .�_1,/�, DATE�',e�0�
.� Yw1Fw(
Name Daytime Telephone Number
P A U L A E . L O G A N 7 1 7 8 0 5 4 1 5 5
First line of address
5 0 9 C A S C A D E R D .
Second line of address
City or Post Office State ZIP Code
M E C H A N I C S BU R G P A 1 7 0 5 5
CorrespondenYs e-mail address:
Under penalties of perjury,I declare that I have examined this retum,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 personal representative is based on all infortnation of which preparer has any knowledge.
SIGN RE OF P RSON ESPO IBLE FOR FILING RETURN DATE
/ z /�
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PAUL A. MILLER 21 15 0120
DecedenYs Name Page 3 File Number
Correspondents
Name Daytime relephone Number
S U S A N E . M I L L E R
First line of address
9 3 4 E . L 1 S B U R N R 0
Second line of address
City or Post Office State ZIP Code
M E C H A N I C S BU R G P A 1 7 0 5 5
CorrespondenYs e-mail address:
Under penalties of perjury,I deciare 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 personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN�A��n�� � �Gr' �// DATE � !/� ,�D/��
v �
�
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address: 2� 15 0120
DECEDENT'S NAME
PAUL A. MILLER —_
STREET ADDRESS
1001 E. LISBURN RD _____
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 39,030.28
2. Credits/Payments
A.Prior Payments 36,000.00
B.Discount 1,800.00
(See instructions.) Total Credits(A+B) (2) 37,800.00
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) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,230.28
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 ............................... X
c. retain a reversionary interest ..........................................'......................................................... � 0
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? ......... ❑ ❑X
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
atloptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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 decedenYs 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-1503 EX+(8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PAUL A. MILLER 21 15 0120
Ail property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, AMERIPRISE FINANCIAL SERVICES, INC. 29,741.76
AMERIPRISE ONE FINANCIAL ACCOUNT
2. AMERIPRISE FINANCIAL SERVICES, INC. 466,460.19
RIVERSOURCE FIXED ANNUITY RATE
TOTAL(Also enter on Line 2,Recapitulation) $ 496 201.95
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
PAUL A. MILLER 21 15 0120
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. MORTGAGE OF ERIN &BENJAMIN MOLL 149,510.06
1001 E. LISBURN RD.
MECHANICSBURG, PA 17055
TOTAL(Also enter on Line 4,Recapitulation) $ 149 510.06
(If more space is needed,insert additional sheets of the same size)
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
PAUL A. MILLER 21 15 0120
Include the proceeds of litigation and the date the proceeds were received by the estate.
Ali property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ZIEGLER AUCTION CO. 74.40
PERSONA� POSSESSIONS
2. STATE FARM FIRE AND CASUALTY COMPANY 322•29
REFUND-PREMIUM
3. RIVERSOURCE INSURANCE 3,264.00
LONG-TERM INSURANCE
4. INTERNAL REVENUE SERVICE 11,995.00
2014 PERSONAL INCOME TAX
REFUN�
TOTAL(Also enter on Line 5,Recapitulation) $ 15 655.69
If more space is needed,use additional sheets of paper of the same size.
REV-1509 EX+(Ot-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE ,101NTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
PAUL A. MILLER 21 15 0120
If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. PAULA E. LOGAN 509 CASCADE RD DAUGHTER
MECHANICSBURG, PA 17055
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 7/21/91 PNC BANK 112,932.75 50. 56,466.38
CHECKING ACCOUNT-x3481
TOTAL(Also enter on Line 6,Recapitulation) S 56 466.38
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PAUL A. MILLER 21 15 0120
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 DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
�TEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DATE OF TRANSFER.ATfACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST pFnvaucne�e) VALUE
1. ALLIANT CREDIT UNION 100,760.69 100.00 100,760.69
SAVINGS ACCOUNT-x3601
PAYABLE AT DATE OF DEATH
JOHN R. MILLER-SON-1/3 SHARE
PAULA E. LOGAN-DAUGHTER-1/3 SHARE
SUSAN E. MIILER-DAUGHTER-1/3 SHARE
2. AIR LINE PILOTS ASSOCIATION FCU 100,575.83 100.00 100,575.83
CHECKING ACCOUNT-x633
PAYABLE AT DATE OF DEATH
JOHN R. MILLER-SON-1/3 SHARE
PAULA E. LOGAN - DAUGHTER- 1/3 SHARE
SUSAN E. MILLER-DAUGHTER- 113 SHARE
TOTAL (Also enter on Line 7,Recapitulation) $ 201 336.52
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PAUL A. MILLER 21 15 0120
DecedenYs debts must be reported on Schedule[.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MALPEZZI FUNERAL HOME 1,396.07
2. MINISTER-MECHANICSBURG PRESBYTERIAN CHURCH 400.00
3. ORGANIST 150.00
4. MECHANICSBURG PRESBYTERIAN CHURCH WOMEN-MEAL 1,000.00
5. CUMBERLAND VALLEY HONOR GUARD 100.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representa6ve(s) JOHN R. MILLER (waived) 0.00
StreetAddress 1500 E. RIDGE RD. #208
City HENRICO State VA Z`p 23229
Year(s)Commission Paid:
Z Attomey Fees: WALTERS&GALLOWAY, PLLC 27,200.00
3. Family Exemption:(If decedenYs address is not the same as claimanPs,attach explanation.)
Claimant RENOUNCED
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. ProbateFees: REGISTER OF WILLS OF CUMBERLAND COUNTY 720.50
5 Accountant Fees:
6. Tax Retum Preparer Fees: WHITCOMB TAX SERVICE 940.00
7. ESTATE NOTICE-THE PATRIOT NEWS 162.26
8. ESTATE NOTICE-CUMBERLAND COUNTY LAW JOURNAL 75.00
9. US POSTAL SERVICE-CERTIFIED MAIL 6.49
10. REGISTER OF WILLS OF CUMBERLAND COUNTY-Short Certificates 20.00
11. MORTGAGE SATISFACTION,PREPARATION,RECORDING 159.50
12. FEDERA�EXPRESS-Distribution to Beneficiaries 60.00
TOTAL(Also enter on Line 9,Recapitulation) $ 32 389.82
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PAUL A. MILLER 21 15 0120
DecedenYs Name Page 1 File Number
Schedule H - Funeral Expenses �Administrative Costs - 61
ITEM
NUMBER DESCRIPTION AMOUNT
B. ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2- Name(s)of Personal Representative(s) PAULA E. LOGAN (waived) 0.00
StreetAddress 509 CASCADE RD
City MECHANICSBURG State PA zIF 17055
Year(s)Commission Paid:
3. Name(s)of Personal Representative(s) SUSAN E. MILLER (waived) 0.00
StreetAddress 934 E. LISBURN RD.
City MECHANICSBURG State PA ZNP 17055
Year(s)Commission Paid:
SUBTOTAL SCHEDULE H-61
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PAUL A. MILLER 21 15 0120
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. LIFEWAYS AT MESSIAH VILLAGE 13,582.69
RESIDENTIAL CARE
2. UNCLE BOB'S SELF STORAGE 693.24
PERSONAL POSSESSIONS
3. MECHANICSBURG PRESBYTERIAN CHURCH 2,880.00
2015 CONTRIBUTION AS PART OF ONGOING ANNUAL OBLIGATION
4. CAPITAL AREA HEALTH ASSOCIATES 42.66
MEDICAL
5. PA DEPARTMENT OF REVENUE 1,194.00
2014 PERSONAL INCOME TAX
6. RIVERSOURCE INSURANCE 1,048.53
RETURN OF EXCESS PAYMENT
TOTAL(Also enter on Line 10,Recapitulation) $ 19 441.12
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
PAUL A. MILLER 21 15 0120
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. JOHN R. MILLER Lineai 33.00
1500 E. RIDGE RD.,#208
HENRICO,VA 23229
2. PAULA E. LOGAN Lineal 33.00
509 CASCADE RD
MECHANICSBURG, PA 17055
3. SUSAN E. MILLER Lineal 33.00
934 E. LISBURN RD
MECHANICSBURG, PA 17055
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.