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Home My WebLink About06-04-15 pennsylvania 1505618403 OE.,,,., NTOFREVE1X(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 0350 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 01 02 2015 11 18 1938 Decedent's Last Name Suffix Decedent's First Name MI MARTHINSEN MARGARET K (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 n1. 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) n7. Decedent Died Testate ❑ 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 HUBERT X GILROY 717 243 3341 First Line of Address 10 EAST HIGH STREET Second Line of Address City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent's email address: hgilroy(aD_martsonlaw.com v REGISTERMF81LLS USE NLY REGISTER OF WILLS USE ONLY C r� DATE FILED MMDDYYYY r,1 « G 9 1 r DATE FILED STAMP - r C> cn Side 1 IIIIIIIVIIIVIIIIIIIIIIIDIIIIIIIIIIVIIIVIIIVIIIIIIIIII 1505618403 1505618403 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Marthinsen, Margaret Kate 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. 11,800 -10 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 16,643 - 91 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 28,444 - 01 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 21033 -85 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 2,033 -85 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 26,410 -16 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. 2 6,410 - 16 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 26, 410 -16 16. 1,188 - 46 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 11 -011 18. 0 .00 19. TAX DUE................................................................................................................ 19. 1,188 - 46 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. SIGNAT E OF PE ON RES ONSIBLE FOR FILING RETURN Guy H. Marthinsen � DATE_, ADDRESS ✓[ 60 t LputA Street, Carlisle, PA 17013 SI V:ZR OTHER THAN REPRESENTATIVE HubertX. Gilroy ATE aD ADDRESS 10 East High treet, Carlisle, PA (111111111111111111111111111111111111111111111111111111111111 Side 2 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-15-0350 Decedent's Complete Address: DECEDENT'S NAME Marthinsen, Margaret Kate STREET ADDRESS 210 Todd Circle CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 1,188.46 2. Credits/Payments A. Prior Payments 1,000.00 B. Discount 52.63 Total Credits(A +B) (2) 1,052.63 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) 135.83 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?............................................................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receivingadequate 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 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. Rev1508 EX+(08.12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Marthinsen, Margaret Kate 21-15-0350 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 Wells Fargo Savings-Account#152032812,date of death value 6,875.63 Accrued interest on Item 1 through date of death 0.01 2 Centurytel, Inc. -Refund,Centuryl-ink 63.83 3 Fresenius Medical Care-Refund 30.71 4 United Church of Christ Homes-Refund 428.94 5 United Church of Christ Homes-Refund 2,108.87 6 US Department of Treasury-Refund from 2014 1040 return 2,288.00 7 USAA-Refund 4.11 TOTAL(Also enter on Line 5, Recapitulation) 11,800.10 (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-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marthinsen, Margaret Kate 21-15-0350 If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Guy H. Marthinsen 604 West Louther Street Son Carlisle, PA 17013 B. Hugh H. Marthinsen 3103 West Euclid Ave Son Tampa, FL 33629 C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'SVALUE OF NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE DECEDENT'S INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. INTEREST 1 A&B prior to Wells Fargo Certificate of Deposit-Account 22,154.64 33.333% 7,384.81 Wachovia/ #247402084027981 ($22,154.64),jointly held Wells with sons,Guy H.Marthinsen and Hugh H. Fargo Marthinsen. See attached Merger in 2008 2 A&B prior to Wells Fargo Certificate of Deposit-Account 21,637.80 33.333% 7,212.53 Wachovia/ #247402084027982($21,637.80),jointly held Wells with sons,Guy H. Marthinsen and Hugh H. Fargo Marthinsen. See attached Merger in 2008 3 A&B prior to Wells Fargo Checking-Account 6,139.76 33.333% 2,046.57 Wachovia/ #1010141501473($6,139.75+$.01 interest), Wells jointly held with sons,Guy H. Marthinsen and Fargo Hugh H. Marthinsen. See attached Merger in 2008 TOTAL(Also enter on Line 6, Recapitulation) 16,643.91 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10) REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENTDECED NTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Marthinsen, Margaret Kate 21-15-0350 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 467.30 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attorney's Fees Martson Law Offices 1,408.55 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 143.00 7. Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 2,033.85 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 Marthinsen, Margaret Kate 21-15-0350 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Cremation Society of Pennsylvania, Inc. 467.30 H-A 467.30 Other Administrative Costs 2 Register of Wills-Filing fee 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-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Marthinsen, Margaret Kate 21-15-0350 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY (Words) ($$$) 0 Not Loste I TAXABLE DISTRIBUTIONS [include outright spousal • distributions,and transfers under Sec.9116(a)(1.2)] Guy H. Marthinsen Son 13,205.08 604 West Louther Street Carlisle, PA 17013 Hugh H.Marthinsen Son 13,205.08 3103 West Euclid Ave Tampa, FL 33629 Total 26,410.16 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) 2015-05-28 13:54 Welts Fargo Bank, NA 7172499341 >> 717 243 1850 P 2/2 Josoph Millor Wolls Fargo Bank Personal Banker Boo B High St Carlisle,Pa 17013 Tel;717 249 7478 Fax:717 249 9031 1. Checking Account#1010141501473 a. Jointly held by Kate Marthinsen,Guy Marthinsen and Hugh Marthinsen b, Date made joint- Unknown C. Date of death balance(01/02/2015)- $6,139.75 d. Was there any accrued interest on her date of death?$.01 2. Savings Account#1512032812 a. Was this account held solely by Kate? i. Sole owned account. b. Date of death balance(01/02/20I5)-$6.875.63 C. Was there any accrued interest on her date of death?$0.06 3. CD#247402084027981 a. Jointly held by Kate Marthinsen,Guy Marthinsen and Hugh Marthinsen b. Date made joint- unknown C. Date of death balance(01/02/2015) $22 , 154.64 4. CD#247402084027982 a. Jointly held by Kate Marthinsen. Guy Marthinsen and Hugh Marthinsen b. Date made joint- unknown C. Date of death balance (01/02/2015) $21 ,637. 80