HomeMy WebLinkAbout11-28-06
REV-1500 EX (6-00)
.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
-1L
COl.MY CODE
~L 0534 ___
YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAL)
Diehl Jac eline
DAle OF DEATH (MM-DD-YEAR) DAle OF BIRTH (MM-DD-YEAR)
6/8/2006 6/18/1931
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
L
SOC~LSECURITYNUMBER
207-22-2316
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
soc~ SECURI"TY NUMBER
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[Xl 1. Original Retum
D 4. Limited Estate
00 6. Decedent Died Testate (Attach copy of \Mil)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum D 3. Remainder Retum (date of death prior to 12-13-82)
D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under See. 9113(A)(AttachSchO)
44 West Main Street
THIS SECTION. MUSTBECOMPL.ETED. ALL CORRESPONDENCE AND CONFIOENTIALT AX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLElE MAILING ADDRESS
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Richard C. Snelbaker
FIRM NAME (If Applicable)
Snelbaker & Brenneman, P. C .
TELEPHOf\E NUMBER
717-697-8528
Mechanicsburg, PA 17055
1. Real Estate (Schedule A)
(1)
2. Stocks and Bonds (Schedule B)
(2)
0.00
29,075.31
0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
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4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
0.00
8,154.08
0.00
8,307.86
8. Total Gross Assets (total Lines 1-7)
(8)
4,449.09
1,296.95
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)
13. Charitable and Governmental Bequests/See 9113 Trusts for Votlich an election to tax has not been
made (Schedule J)
(12)
(13)
qrFflAL USE ONLY ~
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45,537.25
5,746.04
39,791. 21
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14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 1.4 taxable at the spousal tax
z rate. or transfers under See. 9116 (a)(1.2)
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~ 16. Amount of Line 14 taxable at lineal rate
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~ 17. Amount of Line 14 taxable at sibling rate
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~ 19. Tax Due
20. ~
0.00
39,791. 20
0.00
0.00
X.O L- (15)
X.O 45 (16)
x .12 (17)
39,791. 21
0.00
1,790.60
0.00
x.15 (18)
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPA YMENT
0.00
1,790.60
> > BE SURE TO ANSWER AU QUESTIONS ON REVERse SIDE AND RECHECK MATH <<
3W4645 1.000
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Decedent's Complete Address:
, STREET ADDRESS
1471 'Hillcrest Court #706
Lower Allen T , Cumberland Count
CITY
Cam: Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
STATE
PA
ZIP
17011-
(1)
1,790.60
0.00
1,500.00
75.00
Total Credits (A + B + C) (2)
1,575.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty (D + E) (3)
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
215.60
A. Enter the interest on the tax due.
(5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGIS1ER OF WILLS, AGENT
(58)
215.60
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
Dog
Dog
Dug
Dug
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [Jg
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D []g.
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. liJ D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I haw 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 infonnation of which preparer has any knowledge.
:TI.RE PERSON R PONSI LE FOR FILING
';>>.
1. Did decedent make a transfer and:
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; .
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments. benefits or care? . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
Stephen H. Diehl, Executor
S_TIJ<E{FP~~='_
ADDRESS ~
Richard C. Snelbaker
1117 App1Q Drive, Mechanicsburg. PA 17055
If;;;;"
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 3%
[72 P.S. 99916 (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% [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 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-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or 8 stepparent of the child is 0% [72 P.S. ~ 9116(8)(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%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. 9 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. '
3W4646 1.000
REV-1503 EX + (6-98)
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Jacqueline L. Diehl
21 06 0534
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESC~PTION
1. Wilmington Trust Corp
683 shares of commom stock valued
at $42.57 per share
. VALUE AT DATE
OF DEATH
29,075.31
3W4696 1.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, Insert additional sheets of the same size)
29,075.31
REV-1508 EX + lli-98)
COMMONWEALTH OF PENNSYLVANIA
INl-ERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Jacqueline L. Diehl
FILE NUMBER
21 06 0534
Include the proceeds of litigation and th~ date the proceeds were received by the estate.
All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
EESCRIPTION
VALUE AT DATE
OF DEATH
.'
1
Citizens Bank
savings account #6243925426
7,316.26
2
Citizens Bank
checking account # 6100705358
344.99
3
Comcast
refund on cable TV service
11. 21
4
Household goods
retained by family
310.00
5
Patriot-News
refund on subscription service
17.10
6
State Farm
refund unused premium
154.52
3W46AD 1.000
TOTAL {Also enter on line 5 Recaoitulationl $
(If more space is needed, insert additional sheets cI the same size)
8,154.08
REV-1510 EX + (6.98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jacqueline L. Diehl
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21 06 0534
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM H:I.1.Ce TIE IWAE OF TI-E lRANSFEREE. TlEIR RELATIONSHP TO DECEDENT NoD DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER TI-E DAle OF lRA/IIlFER. ATT I'CHA COPY OF THO DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF N'PUCABLE) VALUE
1. Allstate 301.48 100.0000 0.00 301.48
annuity
2 Amisys Synertech, Inc. , 5,835.11 100.0000 0.00 5,835.11
401K account #48825
3 Home Depot, Inc. 2,171.27 100.0000 0.00 2,171. 27
401K account
TOTAL (Also enter on line 7, Recapitulation) $ 8,307.86
(If more space is needed. insert additional sheets of the same size)
3W46AF 1.000
REV-1511 EX + (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONVVEAL TH OF PENNSYLVANIA
INH:RITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jac~eline L. Diehl
ITEM
NUMBER
A.
B.
3W46AG 1.000
FILE NUMBER
21 06 0534
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
1.
Hollinger Funeral Home
funeral expenses
Total from continuation schedules
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representatlve(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Snelbaker & Brenneman, P.C.
Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4.
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Cumberland Law Journal
advertising Executor's notice
Total from continuation schedules
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
1,472.20
590.00
1,450.00
136.00
75.00
725.89
4.449.09
Estate of: Jacqueline L. Diehl
Item
No.
2
207-22-2316
Schedule H Part 1 (Page 2)
Description
.Am6unt
Michael Diehl
reimburse for funeral flowers,
luncheon and organist
590.00
Total (Carry forward to main schedule)
590.00
Estate of: Jacqueline L. Diehl
207-22-2316
Schedule H Part 7 (Page 2)
2
Expenses associated with
the disposal of household goods
not retained by family
50.00
3
Patriot News
advertising Executor's notice
129.69
4
Register of Wills
filing fee for Inheritance Tax
Return
15.00
5
u.S. Postal Service
postage expense
31.20
6
Reserve
for filing fees, accounting fees
and other costs associated with
the administration of Decedent's
estate
500.00
Total (Carry forward to main schedule)
725.89
REV..1512 EX + (\2-03)
COMMONVVEAL TH OF PENNSYLVANIA
IIII-ERITANCE TAX REl1JRN
RESIDENT DECEDENT
ESTATE OF
Jacaueline L. Diehl
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 0534
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses.
ITEM
NlNBER
1.
t:ESCRIPTlON
VALUE AT DATE
OF DEATH
Bon-Ton
credit card balance
155.01
2 Country Walk Apartments
rent
785.00
3 Emerge Visa
credit card balance
166.30
4 PPL Electric
electric service
99.29
5 Vasculer Associates
medical expenses
47.63
6 Verizon
phone service ($50.28 less $6.56
refund)
43.72
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same sile)
1,296.95
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
II'IiERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jac~leline L. Diehl
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Michael S. Diehl
863 McAllister Street
Hanover, PA 17331
1
50% of Residue: 19,895.60
2 Stephen H. Diehl
1117 Apple Drive
Mechanicsburg, PA 17055
50% of Residue: 19,895.60
FILE NUMBER
21 06 0534
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Son
Son
19,895.60
19,895.60
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI 1.000
TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets of the same size)
$
0.00
AW OFFICES
;NELBAKER.
:RENNEMAN
Be SPARE
LAST W~L AND TESTAMENT
I, JACQUELlNE L. DIEHL, of the Township of Lower Allen, County of Cumberland,
and Commonwealth of Pennsylvania, being of sound and disposing'mind, memory and
understanding, do make, publish and declare this as and for my Last Will and Testament, hereby
revoking and making void all former wills and codicils by me at anytime heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be paid by my
Executor, hereinafter name<L as soon as conveniently may be done after my decease.
SECOND. I order and direct that all the rest, residue and remainder of my Estate, real,
personal and mixed, whatsoever and wheresoever situated, be divided into two (2) equal parts,
~hich parts shall be distributed as follows:
~
A. I give, devise and bequeath one (1) such part of my residuary estate unto
my son, namely, STEPHEN H. DIEHL, absolutely and in fee simple, ifhe survives me.
lfmy said son, STEPHEN, should not survive me, then and in that event, I give,
devise and bequeath said one (1) part of my residuary estate in the fractional amounts as
follows:
(1) Fifty per centum (50%) of said part unto my daughter-in-law,
namely, LV ANN DIEHL, provided that she survives me and is unmarried at the
time of my death.
If my said daughter-in-law should not survive me or if she has remarried
at the time of my death, I order and direct that the foregoing provisions for her
shall lapse and the subject matter thereof shall be added to and distributed as part
of the dispositive provisions of subparagraph (2) immediately following.
(2) All the rest, residue and remainder of said part in equal shares unto
my two (2) grandchildren, namely, RACHEL E. DIEHL and RYAN H. DIEHL,
share and share alike.
B. I give, devise and bequeath one (1) such part of my residuary estate unto
LAW OFFICES
SNElBAKER.
BRENNEMAN
a SPARE
:,._-.,.",,~
my son, namely, MICHAEL S. DIEHL, absolutely and in fee simple, ifhe survives me.
lfmy said son, MICHAEL, should not survive me, then and in that event, I give,
devise and bequeath said one (1) part of my residuary estate in the fractional amounts as
follows:
(1) Fifty per centum (50%) of said part unto my daughter-in-law,
namely, DAWN M. DIEHL, provided that she survives me and is unmarried at
the time of my death.
If my said daughter-in-law should not survive me or if she has remarried
at the time of my death, I order and direct that the foregoing provisions for her
shall lapse and the subject matter thereof shall be added to and distributed as part
of the dispositive provisions of subparagraph (2) immediately following.
(2) All the rest, residue and remainder of said part shall be added to
~
and distributed as part of the dispositive provisions of paragraph A of this Item
Second.
LASTL Y. I nominate, constitute and appoint my son, namely, STEPHEN H. DIEHL, to
be the Executor of this, my Last Will and Testament, but if for any reason he should fail to
qualify as such Executor or cease so to serve, then and in that event, I nominate, constitute and
appoint my son, namely, MICHAEL S. DIEHL, to be the Executor hereof, each and both to
serve without bond or other security as a condition of qualification hereunder.
IN WITNESS WHEREOF, I, JACQUELINE L. DIEHL, have hereunto set my hand and
seal to this my Last Will and Testament, which consists oftbree (3) typewritten pages to each of
which I have affixed my signature this "~~y of March, A.D., Two Thousand Four (2004)
~,..~:. ..}"'d2_:'" ,
JACQUELINE L. DIEHL .
(SEAL)
-2-
".-.."",,,,,...,...~
, ..
The preceding instrument, consisting of this and one (1) other typewritten page, each
identified by the signature of-the Testatrix, was on the date thereof signed, sealed, published and
declared by JACQUELINE L. DIEHL, the Testatrix therein named, as and for her Last Will and
Testament, in the presence ofns, who, at her request' her presence and in the presence of each
other, have. subscribed our names as witnesses he to.
ct- 6 8~
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND
)
We, JACQUELINE L. DIEHL, RICHARD C. SNELBAKER and JANE J. COONEY,
the Testatrix and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that
the Testatrix signed and executed the instrument as her Last Will and Testament and that she had
signed willingly, and that she executed it as her free and voluntary act for the purposes therein
~ expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the
Will as a witness and that to the best of his or her knowledge, the Testatrix was at that time
eighteen years of age or older, of sOWld mind and under no constraint or undue influence.
~ .~~
Witness
~~h'
Subscribed, sworn to and acknowledged before me by JACQUELINE L. DIEHL, the
Testatrix, and subscribed and swom.to before me by RICHARD C. SNELBAKER and JANE J.
COONEY, the witnesses, this;J!l-fl1 day of March, 2004.
~;;( r~
/" Notary Public . f
LAW OFFICES
SNELBAKER.
BRENNEMAN
Be SPARE
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Susan L Mab'azi, Nofary Public
Medlanicsburg Bora, Cumber1and County
My Commission Expires Nov. 24, 2007 .
Member. Pennsylvania Association Of Notaries
-3-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DIEHL STEPHEN H
1117 APPLE DRIVE
MECHANICSBURG, PA 17055
__nnn fold
ESTATE INFORMATION: SSN: 207-22-2316
FILE NUMBER: 2106-0534
DECEDENT NAME: DIEHL JACQUELINE L
DA TE OF PAYMENT: 11/28/2006
POSTMARK DATE: 11 /28/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/08/2006
NO. CD 007484
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $215.60
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$215.60
REMARKS:
CHECK#139
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS