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Home My WebLink About07-15-15 (2) perms 1505618403 DEVARTM.41vania OF RM,tx(03-14) REV-1500 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 14 1149 ENTER DECEDENT INFORMATION BELOW 11 21 2014 07 26 1931 Decedent's Last Name Suffix Decedent's First Name Ml ARMSTRONG JOAN 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 nx 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) nx 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 F1 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 0400 Second Line of Address 555 GETTYSBURG PIKE City or Post Office State ZIP Code ::0 rn MECHANICSBURG PA 17055 e, C-> C) ;;0 C__ co Correspondent's email address: epspjsde.com REGISCPE0EQ_F WILLS USE ON16 C_'> REGISTER OF WILLS USE ONLY 7 C7 _rl DATE FILED MMDDYYYY C_- C> cr) DATE FILED STAMP Side I 1 Illlil Illil VIII IIIA VIII lilll Illil VIII VIII VIII ILII 1111 1505618403 1505618403 1505618411 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule A).....___..................__...................__.........____...... 80 ,1100 - 00 2. Stocks and Bonds(Schedule B)............... ............................................................. 2. 39 ,429 - 82 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. 101586 - 46 6. Jointly Owned Property(Schedule F) [-] Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) [:] Separate Billing Requested............ 7. 59,000 - 87 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 189,017 - 15 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 25,082 - 81 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 5,896 -05 11, Total Deductions(total Lines 9 and 10)................................................................ 11. 30 ,978 - 86 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 1581038 - 29 13. Charitable and Governmental Bequests/See 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. 1581038 - 29 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. 11 - 00 16. Amount of Line 14 taxable at lineal rate X .045 158,038 - 29 16. 7 ,111 . 7 2 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 - 110 18. 0 - 00 19, TAX DUE................................................................................................................ 19. 7,111 - 72 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. S19VATURE 0 P SON RESPONSIBLE FOR FI RETURN Ann is le Dobb ZA S. JIKJU /-- 0.1, c S- ADDRESS 6350 Conc9rd)%oad, Mechanicsburg, PA 17050 SIGNATURE P THAN REPRESENTATIVE Edward P Seeber C)A;Ff_ ADDRESS4--' Suite C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 Side 2 15U5618411 1505618411 REV-1500 EX Page 3 File Number 21-14-1149 Decedent's Complete Address: DECEDENT'S NAME Armstrong,Joan M. STREET ADDRESS 621 Poplar Church Road Camp Hill STATE ZIP CITY C PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) 7,111.72 2. Credits/Payments A. Prior Payments 3,600.00 B. Discount 0.00 Total Credits(A +B) (2) 3,600.00 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 I +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 3,511.72 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;.........___................. ........... .... El 0b. retain the right to designate who shall use the property transferred or its income;................................. E Fx] c. retain a reversionary interest;or........ ...................................._.............................................................. F-1 Fix] d. receive the promise for life of either payments,benefits or care?............................................................ El nx 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........................____...................... ........................................__..... ❑ Fx� 3, Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... E 7X 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?........................................................................._..............._..................... Fx_1 El 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)j. 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 21years 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-1502 EX+(12-12) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 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 Include a copy of the deed showing decedent's Interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real estate located at 621 Poplar Church Road, East Pennsboro Township,Cumberland 80,000.00 County, PA-valued per sales price TOTAL(Also enter on Line 1, Recapitulation) 80,000.00 (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 A(Rev. 12-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 97.18 shares of Allianz Funds held in Edward Jones 17.55 1,705.51 Account No.*5035-valued per estate valuation dated 1/10115 2 252.495 shares of American Century Invt Tr held in Edward 10.85 2,739.57 Jones Account No.*5035-valued per estate valuation dated 1/10/15 3 460.213 shares of Bridge Bldr Tr held in Edward Jones 10.18 4,684.97 Account No.*5035-valued per estate valuation dated 1/10/15 4 281.206 shares of Dodge&Cox Income Fd held in Edward 13.9 3,908.76 Jones Account No.*5035-valued per estate valuation dated 1110/15 5 423.76 shares of Franklin Investor Services Tr held in 10.21 4,326.59 Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 6 73.201 shares of John Hancock Fds III Dspin Val Fund I held 19.84 1,452.31 in Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 7 187.457 shares of John Hancock Fds III Glblshldr YI I held in 12.27 2,300.10 Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 8 664.7 shares of JP Morgan Tr I Fed Money Market Instl held 1 664.70 in Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 Total of Continuation Schedules See attached pages TOTAL(Also enter on Line 2, Recapitulation) 39,429.82 (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 B(Rev.08-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 9 45.967 shares of JP Morgan Tr I Mid Cap Eqt held in Edward 46.47 2,136.09 Jones Account No.*6035-valued per estate valuation dated 1/10/15 10 176.474 shares of Lord Abbett Invt Tr held in Edward Jones 11.06 1,951.80 Account No.*5035-valued per estate valuation dated 1/10/15 11 43.486 shares of Massachusetts Invs Tr held in Edward 29.63 1,288.49 Jones Account No.*5035-valued per estate valuation dated 1/10115 12 68.813 shares of Scout Fds held in Edward Jones Account 36.18 2,489.65 No.*5035-valued per estate valuation dated 1/10/15 13 21.502 shares of T. Rowe Price Blue Chip Growth held in 70.96 1,525.78 Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 14 36.283 shares of T. Rowe Price Equity Income Fd held in 34.85 1,264.46 Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 15 280.53 shares of T.Rowe Price High Yield Fd held in Edward 7.03 1,972.13 Jones Account No.*5035-valued per estate valuation dated 1/10/15 16 207.343 shares of T.Rowe Price Intl Fds held in Edward 9.1 1,886.82 Jones Account No.*5035-valued per estate valuation dated 1/10/15 17 655.248 shares of T. Rowe Price Short Term Bd Fd held in 4.78 3,132.09 Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-9508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS,p& MISC. DEPARTMENT REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. ] 211-.11 4-1149 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 Accrued Dividends held in Edward Jones Account No.*5035-valued per estate valuation 27.37 dated 1/10115 2 Cash held in Edward Jones Account No.*5035-valued per estate valuation dated 1/10/15 200.12 3 M&T Bank Checking Account No.*697-valued per statement ending 11128/14 9,338.44 4 Miscellaneous personal property-valued per Executrix 900.00 5 Pentegra-final retirement benefit 99.00 6 Refund of 2014-15 school real estate taxes-valued per settelment sheet 21.53 TOTAL(Also enter on Line 5,Recapitulation) 10,586.46 (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+(o1-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT AXRET UE RN MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 This schedule must be completed and filed if the answer to any of questions 7 through 4 on page three of the REVA 500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DEWS EXCLUSION TAXABLE NUMBER THE DA E OF TRANSFERSAITAck THEIR PY OF TIHE DEIED FOR REAL ESTATE. VALUE OF ASSET INTEREST SIF APPLICABLE) VALUE 1 American General Life Insruance Company Annuity 15,420.44 100.000% 0.00 15,420.44 No.*722-beneficiary is Ann Dobb,daughter;valued per gross amount received 2 Genworth from Family Trust-Mlles C.Armstrong 43,042.40 100,000% 0.00 43,042.40 Trust dated 11/18/2005(not taxed at time of death& now subject to tax due to death of spouse)valued per amount received 3 Genworth Payment from Family Trust-Mlles C. 538.03 100.000% 0.00 538.03 Armstrong Trust dated 11/18/2005(not taxed at time o death&now subject to tax due to death of spouse) valued per amount received TOTAL(Also enter on Line 7, Recapitulation) 59,000.87 (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-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENTDECEDENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 12,032.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(s)Commission Paid 2. Attorney's Fees JSDC Law Offices 7,500.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 3,500.00 Claimant Micheal C.Armstrong Street Address 621 Poplar Church Road City Camp Hill State PA ZiD 17011 Relationship of Claimant to Decedent Son 4. Probate Fees 420.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,630.31 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 25,082.81 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 Armstrong,Joan M. 21-14-1149 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Good Shepherd-funeral luncheon 200.00 2 Musselman Funeral Home-funeral services 9,705.00 3 Patriot News-obituary notice 297.00 4 Rolling Green Cemetery-cemetery fees 1,830.00 H-A 12,032.00 Other Administrative Costs 5 Donegal Insurance-homeowners'insurance premium (less refund) 647.00 6 Edward Jones-date of death valuation fee 50.00 7 Recorder of Deeds,Cumberland County-realty transfer tax 800.00 8 The Sentinel -estate notice publication fee 126.82 9 USPS-certified mail charge 6.49 H-137 1,630.31 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-12) SCHEDULE I pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFMORTGAGE LIABILITIES AND LIENS RET INHERITANCE TAXAXRETURRNN RESIDENT DECEDENT ESTATE OF FILE NUMBER Armstrong,Joan M. 21-14-1149 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 Forest Park-unreimbursed nursing home bill 5,698.50 2 Graham Medical Clinic-unreimbursed medical bill 26.92 3 Graham Medical Clinic-unreimbursed medical bill 57.23 4 Guardian Drugs-unreimbursed prescription medication bill 113.40 TOTAL(Also enter on Line 10, Recapitulation) 5,896.05 (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 Armstrong,Joan M. 21-14-1149 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) 0 Not List ITAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Matthew Armstrong Son 1/3 of residue 47,539.28 38570 Knighten Lane Lebanon,OR 97355 2 Michael Armstrong Son 1/3 of residue 47,539.28 621 Poplar Church Road Camp Hill, PA 17011 3 Ann Michele Dobb Daughter Annuity&1/3 of 62,959.73 6350 Concord Road residue Mechanicsburg, PA 17050 Total 158,038.29 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)