HomeMy WebLinkAbout11-01-06
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue..
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128.{)601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 6
File Number
00252
Date of Birth
168244777
0314200 6
06271929
HIPPMAN
o AWN
MI
S
Decedent's Last Name
Suffix
Decedent's First Name
(If Applicable) Enter Surviving Spouse's Infonnatlon Below
Spouse's Last Name Suffix
HIP P MAN
ROBERT
MI
S
Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
00 1. Original Return 0
o 4. Limited Estate 0
00 6. Decedent Died Testate 0
(Attach Copy of Will)
D 9. Litigation Proceeds Received 0
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
8. Total Number of Safe Deposit Boxes
D A V I D H R A 0 eLl F F E S Q
Firm Name (If Applicable)
71723 6 9 3 1 8
2 0 E R FOR D R 0 A 0
REGISTER OF WILLS ~ ONLY
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R A 0 eLl F F LAW 0 F FIe E P C
SUI T E 200
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First line of address
Second line of address
City or Post Office
State
ZIP Code
.:...~fDATE FI
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L E M 0 Y N E
P A
1 7 0 4 3
re that I have examined this retum, induding accompanying schedules and statements, and to the best of my knowledge and belief,
tion f preparer other than the personal representative is based on all information of which preparer has any knowledge.
G RETURN DATE
(f)- ^,-O~
ENOLA
PA 17025
N REPRESENTATIVE
LEMOYNE
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041125
15056041125
.-J
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15056042126
REV-1500 EX
Decedenfs Name: DAWN S. HIP PMAN
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 & 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 N,2D;Probate Property
(Schedule G) U Separate Billing Requested. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7)
........................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H)
................ 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
. . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
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.
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.O _
16. Amount of Line 14 taxable
at lineal rate X .0
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
5 1 3 3 5
5 6
15.
o
o 0
16.
o
o 0
17.
o
o 0
18.
19. Tax Due
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042126
Decedent's Social Security Number
168244777
5308456
5308456
1 7 4 9 0 0
1 7 4 9 0 0
5133556
5133556
o 0 0
o 0 0
o 0 0
o 0 0
o 0 0
o
15056042126
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
00252
DECEDENrs NAME
DAWN S. HIPPMAN
STREET ADDRESS
14 RANDI ROAD
CITY I STATE I ZIP
ENOLA PA 17025
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19) (1)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
Total Credits (A + B + C) (2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
0.00
T otallnterestlPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Line 20 to request a refund. (4)
5. If Une 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
0.00
A. Enter the interest on the tax due.
B. Enter the total of Une 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
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 ofthe property transferred; ...................................................................... D 00
b. retain the right to designate who shall use the property transferred or its income; ............................... D 00
c. retain a reversionary interest; or ............... .... .. .. .. ..................... . ..... ....... ..................................... D 00
d. receive the promise for life of either payments, benefits or care? ....................................................... D 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequ ate consideration? . .. .. .. .. .. . .. . .. .. .. . .. .. . .. . .... . . . . .. .. . .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. . .. .. .. . .. . D 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... D 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. D 00
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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (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 zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure of assets and
filing a tax retum 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 twenty~ne years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (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 four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [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 twelve (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-1508 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DAWN S. HIPPMAN
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
00252
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
25,039.34
SOVEREIGN BANK
CD #0925160038
2.
SOVEREIGN BANK
CD #0925479271
28,045.22
TOTAL (Also enteron line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
53.084.56
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
DAWN S. HIPPMAN
FILE NUMBER
00252
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. ROBERT S. HIPPMAN
14 RANDI ROAD
ENOLA, PA 17025
SPOUSE
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 DECD'S VAlUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER A IT ACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrSINTEREST
1. A. ALL OTHER PROPERTY WAS JOINT WITH
SURVIVING SPOUSE
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV.1511 EX + (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DAWN S. HIPPMAN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
00252
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s}IEIN Number of Personal Representative(s}
Street Address
City State Zip
Year(s} Commission Paid:
2. Attorney Fees RADCLIFF LAW OFFICE, P.C. 1,550.00
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 169.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7. Filing fee - Inventory & PA Inheritance Return 30.00
TOTAL (Also enter on line 9, Recapitulation) $ 1.749.00
(If more space is needed, insert additional sheets of the same size)
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 pndude o~ht spousal distributions, and transfers under
Sec. 9116 (a (1.2))
1. ROBERT S. HIPPMAN Spousal 51,335.56
14 RANDI ROAD
ENOLA, PA 17025
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIA TE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
~-1513~+I*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DAWN S HIPPMAN
SCHEDULE J
BENEFICIARIES
FILE NUMBER
00252
(If more space is needed, insert additional sheets of the same size)
'.bonalJ !E. Dw!:n
COUNSELOR.AT.LAW
10S MT. VIEW DR.
ENOLA. PA. 170211
PHONE (717) 732-31182
LAST WILL AND TESTAMENT
OF
DA WN S. HIPPMAN
I, DAWN S. HIPPMAN, of Enola, East Pennsboro Township,
Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understandingl do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking any and all Wills,and Codicils previously
made by me at any time heretofore.
FIRST: I hereby direct that my personal representative, hereinafter named, to
pay all of my just debts, funeral and testamentary expenses, including Pennsylvania
Inheritance Taxes, as soon after my demise as may be practicable.
SECOND: All the rest, residue and remainder of. my estate, I hereby give, devise
and bequeath to my beloved husband, ROBERT S. HIPPMAN, should he survive
me by thirty (30) days.
THIRD: In the event that my husband, ROBERT S. HIPPMAN predeceases me,
dies on or before the thirtieth (30th) day following my death, or should we die
simultaneously in a common disaster, I hereby give, devise and bequeath all the rest,
residue and remainder of my estate to my two sons, ROBERT EDWARD HIPPMAN
and BRIAN PATRICK HIPPMAN, equally and per stirpes,
FOURTH: Should either or both of my sons, ROBERT E. or BRIAN P.
HIPPMAN, predecease me and my spouse, I hereby declare that their one-half (1/2)
share pass to their children with all assets to be converted to cash and placed in
trust accounts .
FIFTH: I hereby direct the Trustee named herein:
A. Not to be able to expend any money held in trust until said
child(ren) is/are twenty-five (25) years of age, except as provided in Paragraph
FIFTH B. below.
B. Be authorized to expend money from each child's trust fund
between the ages of eighteen (18) and twenty-five (25), -as may be appropriate for:
1. Health and Dental Insurance premiums and/or bills.
2. Post-high school educational training, including but not
limited to application fees, books, tuition, computer and lab fees, room and board,
transportation and living expenses.
SIXTH: Upon attaining the age of twenty-five (25), each trust shall be
dissolved and the balance of the funds, if any, shall be distributed outright to said
child(ren).
"*
(I)
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SEVENTH: I hereby nominate Fulton Bank and Trust Company as
"Trustee" of said accounts for my grandchildren, should either or both of my children
predecease me and my spouse, thereby necessitating implementation of Paragraph
FOURTH and FIFTH above.
EIGHTH: I hereby nominate, constitute and appoint my beloved
. .
husband, ROBERT S. HIPPMAN, as Executor of this my, Last Will and Testament.
In the event that my husband, ROBERT, should predecease me, fail to qualify, cease to
act, or for some reason is incapable of performing such task, I then nominate,
constitute and appoint my two sons, ROBERT E. HIPPMAN and BRIAN P. HIPPMAN,
as alternate Executors of this my Last Will and Testament.
NINTH: None of the above named persons sh~1I be required to post bond
or surety in this or any other jurisdiction for faithful compliance of the office of Executor.
IN WITNESS WHEREOF, I hereby set my hand and seal and declare this to be
my, LAST WILL AND TESTAMENT, consisting of this and two (2) other typewritten
pages, identified by my signature,
dated on this, the ..-)
dayof ~.19ti
t!w~p~t!~
(Testatrix)
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The preceding instrument, consisting of this and three (3) other typewritten pages,
identified by the signature of the Testatrix, DAWN S. HIPPMAN, as and for her Last
Will; who at her request, in her presence and in the presence of each other
have subscribed our names as WITNESSES hereto.
<~~.~l
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Residing At
Residing At
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COMMONWEALTH OF PENNSYLVANIA)
)
COUNTY OF CUMBERLAND )
WE, ~J t ~~""~. Q~ S \~~ ,AND
~ )(~ , the Testatrix, and the witness s, respectively,
whose names are signed to the attached and foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testatrix, DAWN S.
HIPPMAN, signed and executed the instrument as her Last Will, and that she signed
and executed it willingly, and that she executed it as her free and voluntary act for the
purposes therein expressed, that each of the Witnesses, in the presence and hearing
of the Testatrix, DAWN S. HIPPMAN, signed the Will as witnesses, and 'that to the best
of our knowledge and sight, was at the time eighteen (18) or more years of age, of
sound and disposing mind, memory and under no c nstraint or undue influence.
~~~ ~~'
WITNESS
CZt(~ tL~
WITNESS . -
Subscribed, sworn to and acknowledged before me by DAWN S. HIPPMAN. the
Testatrix, who personally appeared before me, the undersigned officer,and
s~ri~ to Nld swor{l to by the Wr{N~SES,
~.. :"S It'cYe ~~ ~nd ~c:W ~ , on thiOl
the ~~ay of ~ I 19f'
~ ~S)~/5~(L
My Commission Expires:
Netarial Seal
... Donald B. Owen, Notary "ubllc
t:ist PennSboro Twp., Cumb8rtand County
,Iv Commlssien Expires Nov. 24, 1 Iii
M.iN,., ....-,twria .. .. '''~
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of DAWN S. HIPPMAN
, Deceased
No. 21 06 00252
Date of Death 3/14/2006
Social Security No. 168-244777
also known as
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent. that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INIe
verify that the statements made in this inventory are true and correct. INIe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Name of
Attomey: David H. Radcliff. ESQ.
1.0. No.: 25483
Address: 20 Erford Road. Ste 200
Lemoyne
Telephone: 717236-9318
Personal Representative: ~~
'K~ ~ "QL~
Dated
/O-21'Ob
PA 17043
Description
Sovereign Bank CD #0925160038
Value
25,039.34
Sovereign Bank CD #0925479271
C)
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Total
(Attach Additional Sheets if necessary)
53,084.56
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4