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REV.15llO EX + (&.00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
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DECEDENTS NAME (LAST, ARST. AND MIDDlE INITIAL)
THOMAS SR
DATE OF DEATH (MM-DO-Year)
ROBERT L.
DATE OF BIRTH (MM-DD-Year)
09/03/2006 06/16/1935
(IF APPUCABLE) Sl!RVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDlE INITIAL)
00 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (AIIach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of death after 12.12-82)
o 7. Decedent Maintained a Living Trust (AIlech copy of Trust)
o 10. Spousal Poverty Credit (date 01 death between 12-31.91l11d 1.1.95)
OFFICIAL USE ONLY
FILE NUMBER
R..L-~fL -LQfL.1z_
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
1 9 8 - 2 8 - 1 876
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURI'Ff NUMBER
o 3. Remainder Return (dele 01 death priorto 12.13-82)
o 5. Federal Estate Tax Retum Required
_ B. Totall':lumber of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AIlech Sch 0)
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NAME COMPLETE MAILING ADDRESS
ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
0.00 X _(15) 0.00
4,627.72 X ~(16) 208.25
0.00 X .12 (17) 0.00
881.47 X .15 (18) 132.22
(19) 340.47
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership 'Or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L) .
8. Total Gross Assets (total Lines 1-7)
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)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(B)
(11)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
15. Amount of Line 14 taxable atlhe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14laxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
t~;%';;f;}?'\p~;*;t~stt~1f~;~t~~~t;t*t~~~#I~}ftlt:
20. D
CHECK HERE IF YOU t.RE REQUESTnJG A REFUND OF AN O\'ERPAYrlnn
OFFICI4I. USE ONLY
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9,731.37
1,893.01
11.624.38
5,509.19
5,509.19
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ece en s ample e ress:
STREET ADDRESS 1480 GOODYEAR ROAD
CITY GARDNERS I STATE I ZIP
PA 17324
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
340.47
17.02
Total Credits (A + 8 + C)
(2)
17.02
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty (D + E) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
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; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ................................................................~..................................... 0 00
d. r~eive the promise for life of eith~r payments, benefits or care? .......................................:..................... 0 00
2. If death occurred after December 12,1982, did decedent transfer property within one year of deatn
withoufreceivi,ng adequate consideration?........................................................:............::....................... 0 00
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .......................................................................:............................... 0 00
0.00
0.00
323.45
323.45
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DAiJ-/-dCp
60 WEST POMFRET STREET
CARLISLE. PA 17013
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. ~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% [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 disclosure 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 a stepparent of the child is 0% [72 P.S. ~9116(a){1.2)].
The tax rat~ 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. ~9116(1.2) [72 P.S. ~9116(a)(1)J.
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. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has 1M least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX + (6-,98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
THOMAS. SR
FILE NUMBER
ROBERT
L.
All property jointly~wned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
SERIES EE SAVINGS BONDS -INVENTORY ATTACHED
VALUE AT DATE
OF DEATH
243.28
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert addiUonal sheets of the same size)
243.28
REV-1508 EX + (~.98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THOMAS. SR
FILE NUMBER
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PERSONAL PROPERTY 13,736.50
2. COINS - APPRAISAL ATTACHED 129.92
3. PNC BANK - CHECKING ACCOUNT #5080574997 2,988.82
4. PNC BANK - SAVINGS ACCOUNT #5000807042 35.05
ROBERT L.
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.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16.890.29
REV-1511 EX + (1,.2-99)
*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE caSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THOMAS. SR ROBERT
FILE NUMBER
L.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hollinger Funeral Home 5,702.62
B. ADMINISTRATIVE COSTS: ..
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Irwin & McKnight 1,200.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Return Preparers Fees Patricia A. Rosendale, CPA 350.00
7. Register of Wills 30.00
8. Notary Fees 25.00
9. Redding Auction Service, Public Sale 2,213.75
10. Donald C. Thomas, Reimbursement of Trash Hauling 210.00
TOTAL (Also enter on line 9, Recapitulation) $ 9 731.37
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (8-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THOMAS. SR ROBERT
FILE NUMBER
L.
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Comcast Cable, Utility
VALUE AT DATE
OF DEATH
64.82
2. Embarq, Telephone
61 .48
3. Met-Ed, Electric
139.46
4. Mitch Gelbaugh, Rent
450.00
5. West Shore EMS, Ambulance
716.17
6. York Hospital, Medical .
36.75
7. Wellspan Medical Group, Medical
25.66
8. Carlisle Regional Medical Center. Medical
. 398.67
TOTAL (Also enteron line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 893.01
'<V.""~'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
~;..._. a ~R I
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 pnclude outr~ht spousal distributions, and transfers under
Sec. 9116 (a (1.2)]
1. Donald C. Thomas Lineal 3,525.88
180 Peach Glen Road
Gardners, PA 17324
2. Alice Nailor Lineal
26 Old Stonehouse Road
Carlisle, PA 17015
3. Rosemary Sweitzer Lineal
309 Starner Station Road
Gardners, PA 17324
4. Agnes Thomas Lineal
120 Peach Glen Road
Gardners, PA 17324
5. Dianne C. Swetizer Collateral 881.47
309 Starner Station Road
Gardners, PA 17324
6. Stephanie Kibler Lineal 550.92
181/2 W. King Street
Littlestown, P A 17340
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS 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 $
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
THOMAS, SR
Decedent's Name
ROBERT
L.
Page 1
File Number
Schedule J - Beneficiaries - 1
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONtS) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (include outright spousal distributions)
7. Brandon Smith, Sr. Lineal 550.92
575 Clearview Road
Aspers, PA 17304
..
;
LAST WILL AND TESTAMENT
I, ROBERT L. THOMAS, 'Of Dickins'On T'Ownship, Cumberland C'Ounty, Pennsylvania,
declare this t'O be my Last Will and Testament, hereby expressly rev'Oking all Wills and C'Odicils
heret'Of'Ore made by me.
1. I direct my Execut'Ors t'O pay all of my debts, funeral and administrative expenses as
s'O'On as may be d'One conveniently after my decease.
2. I devise and bequeath all 'Of my estate 'Of every nature and wherever situate as f'Oll'Ows:
a. Ten Percent (10%) t'O each 'Of my grandchildren; and
b. Eighty Percent (80%) to be divided in five (5) shares between my
br'Other, three (3) sisters and IUY niece, DIANNE C. SWEITZER,
share and share alike.
3. I n'Ominate and appoint DONALD C. THOMAS and DIANNE C. SWEITZER t'O be
the Execut'Ors 'Of this my Last Will and Testament; they are t'O serve as such with'Out b'Ond.
4. I hereby suggest that my pers'Onal representatives retain the services 'Of Irwin &
McKnight as att'Orneys in the settlement 'Of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 12th day of May,
2006.
~r~
ROBERT L. THOMAS
(SEAL)
Signed, sealed, published and declared by ROBERT L. THOMAS, the Testator above-
named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his
presence and in the presence of each ()ther have subscribed our names as witnesses hereto.
~~~~ft(/
.J2I]aJ.V'Y<- Of' 'dJLAd'~
,
2
ACKNOWLEDGMENT AND AFFIDA VIT
WE, ROBERT L. THOMAS, MARTHA L. NOEL and SHARON L. SCHWALM,
the Testator and witnesses respectively, whose names are signed to the foregoing instrument,
being first duly sworn, do hereby declare to the undersigned authority that the Testator signed
and executed the instrument as his Last Will and Testament, that he had signed willingly, that he
executed it as his free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the
best of their knowledge the Testator was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
'-
\...~UjAt)eL d ,0JLUZfL~
. /' SHARON L. SCHWALM
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by ROBERT L. THOMAS, the
Testator herein, and subscribed and sworn to before me by MARTHA L. NOEL and SHARON
L. SCHWALM, witnesses, this 12th day of May, 2006.
Notary Public
3
OCT-12-20B6 21:45
PNCERNK
412 768 3458
::>.01/01
o PNCBAN<
October 13,2006
ROler B. Irwin
60 West Pomfret Sn-eet
Carlisle, PA 17013-3222
RE: Estate of Robert L. Thomas, (Deceased)
SSN: 198-28-1876
DOD: 09/03/2006
Dear: Mr. Irwin
In response to your request for Date of Death balances for the customer noted above, our
records show the following: .
Checking Account
Established 06123/1997
SaviDas Account
Account # 5000807042
Established 07/0111999
ROBERT L THOMAS
DOD balance: $35.05 + SOO.OO accrued interest
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do Dot process any ftnuclal
traasactioDS or provide statements. If you need assistance with any of these items,
please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
r\~~A9JJt--
~::;;cr
1-800-762-1775
P7-PFSC-04-F
SOO First Avenue
Pittsburgh PA 152]9
Member FDIC
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ROBERT L. THOMAS, SR. ESTATE
d/o/d - September 3, 2006
Appraisal by:
Harry E. Donson
CARLISLE COIN SHOP
25 Circle Drive
Carlisle, PA 17013
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243-8943
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Offjce 717-334-6941
~
REDDING AUCTION SERVICE
c. DAVID REDDING, Auctioneer
1085 TABLE ROCK ROAD
GETTYSBURG, PENNSYLVANIA 17325
PA #AU-742-L
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