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Home My WebLink About12-12-06 R.EV-1500 fJ 0-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 20~ _012L__ YEI>R NUMBER COUNTY CODE UJ ~ ~~cn (.)O:~ UJ 0.(.) :J:OO (.) O:..J Q.[lJ 0. <( SOCIAL SECURITY NUMBER 261-56-8692 I- Z W C W U w C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Nichols, William N. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 12/11/2003 12/01/1938 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Nichols, Georgia D 1 Original Return D 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received 3. Remainder Return (date of death pnor to 12.13-82) 5. Federal Estate Tax Retum Required THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 161-32-7397 D [Xl [Xl 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) _ 8. Total Number of Safe Deposit Boxes 10. Spousal Poverty Credit (dale of death between 12.31.91 and 1.1.95) [ZJ 11 Election to tax under Sec. 9113(A) (Allach Sch 0) .... z w c z o c- UI W !l: !l: o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Elyse E. Rogers, Esquire FIRM NAME (If Applicable) Keefer Wood Allen & Rahal, LLP TELEPHONE NUMBER 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011 717-612-5801 Real Estate (Schedule A) (1) 0.00 OFFICIAL USE ONLY r....:> <= <= CJ''',\ 2. Stocks and Bonds (Schedule B) (2) 0.00 0.00 0.00 N : 'I o r~~O - =8 r::J r-fl C') 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) N 0.00 0.00 -0 z o i= :s :::l !::: c.. <{ U w e::: 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) (6) 0.00 (.n 0.00 (8) 8. Total Gross Assets (total Lines 1-7) 0.00 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 88,839.10 11. Total Deductions (total Lines 9 & 10) (11) 88,839.10 (88,839.10) 0.00 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amou nt of Line 14 taxable at the spousal tax 21,457.89 Z rate, or transfers under Sec. 9116 (a)(1.2) 0 i= 16. Amount of Line 14 taxable at lineal rate 26.411.41 <( ~ ::::l 0. 17 Amount of Line 14 taxable at sibling rate :;: 0 (.) 18. Amount of Line 14 taxable at collateral rate >< <( Tax Due ~ 19. (14) (88,839.10) x .0 _(15) x .0 _(16) (1,188.52) x .12 (17) x .15 (18) (19) 20. [Z] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2W4645 1000 Decedent's Complete Address: S"TREET ADDRESS 38J.6 Conestoga Road CllY I STATE I ZIP Camo Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 54,125.97 0.00 52,630.28 2,684.21 Total Credits (A + B + C) (2) 55,314.49 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) 1,188.52 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Pa able 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: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . D c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . " D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " [Z] 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No [X] [X] [X] [X] [X] [X] ADDRESS ICh preparer has any knowledge. ADDRESS DATE 10....) -C~ 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. S 9916 (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. 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 im posed 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. 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%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 9 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% (72 P.S. S 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individ ual who has at least one parent in common with the decedent, whether by blood or adoption. 2W4646 1.000 REV.1512 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Nichols, William N. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER :21.-2005-0125 Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 88,839.10 1. Debt owed to One Fourteen Bridge Street, Inc. 2W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 88,839.10 ~ SELIGMAN, FRIEDMAN & COMPANY, P.C. . CERTIFIED PUBLIC ACCOUNTANTS & CONSULTANTS www.seligmancpa.com Harrisburg' 1027 Mumma Road' Wormleysburg. PA 17043 . (717) 761-0211 . Fax (717) 975-9750 State College' 1423 North Atherton Street. State College, PA 16803' (814) 238-8474' Fax (814) 234-3523 York' 96 South George Street, Suite 350' York. PA 17401 . (717) 843-0040' Fax (717) 843-0075 September 13, 2006 Elyse Rogers Keefer Wood Allen & Rahal, LLP 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011-4906 RE: William N. Nichols Dear Elyse: You have requested that we provide you with information concerning the debt owed to One Fourteen Bridge Street, Inc. by William N. Nichols. This debt consists of excess distributions taken by William N. Nichols over the years. The total amount owed to One Fourteen Bridge Street, Inc. by William N. Nichols at date of death, December 10, 2004, totaled $88,839.10. If you need additional information I may be reached at 717-761-0211. Sincerely, ~:3~~~ Mark D. Tomeo Seligman, Friedman & Co., P.C. Robert N. Levy, CPA, CSEP James A. Smeltzer, CPA, ABV Robert S. Freed, CPA, CFA, CFE David G. Phillips, CPA John J. Cardello, CPA Calvin J. Wagner, CPA Jodi L. Green, CPA Michael S. Signor, CPA, ABV James J. Karchner, CPAlPFS, CFP Arthur J. Full, CPA, CFA Edward E. Wagoner, CPA Claire S. Weaver, CPA, CSEP Founding Partner Murray D. Friedman, CPA KEV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Nichols William N NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Nichols, Georgia 3816 Conestoga Road Camp Hill, PA 17011 1. 2 Nichols, Nick 318 Lamp Post Lane Camp Hill, PA 17011 3 Nichols Trust A c/o Nick Nichols, Trustee 318 Lamp Post Lane Camp Hill, PA 17011 FILE NUMBER 21-2005-0125 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Spouse Son AMOUNT OR SHARE OF ESTATE 410,248.68 850,250.00 352,549.43 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 2W46A11.000 TOTAL OF PART 11- 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 REV-1649 EX' (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Nichols, William N. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) P U AL DISTRIBUTI N FILE NUMBER 21-2005-0125 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Nichols Trus t A Trust (marital, residual, A, B, By-pass, Unified Credit, etc.) If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed in Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the ejection to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Scheduie 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivin souse under a Section 9113 A trust or similar arran ement. DESCRlPllON 1 Nichols Trust A Total value of Trust is calculated to be $638,977.47 An election to Pennsylvania Inheritance Tax is made for this trust; the taxable portion is $352,549.43. See attachment VALUE 352,549.43 Part A Total $ 352,549.43 PART B: Enter the descri tion and value of all interests included in Part A for which the Section 9113 A election to tax is bein made. DESCRlPTlON VALUE Nichols Trust A Total value of Trust is calculated to be $638,977.47 An election to Pennsylvania Inheritance Tax is made for this trust; the taxable portion is $352,549.43. See attachment Total from continuation pages.... 2W46E21 000 Part B Total $ (If more space is needed, insert additional sheets of the same size) 352,549.43 Estate of William Nichols Date of Death: December 11,2004 Funding Calculations Nichols Trust A for Pa Inheritance Tax Purposes Residue before Death Taxes Residue After Death Taxes $ Nichols Trust A Funding Maximum Amount sheltered by Applicable Credit Plus: State Death Tax Credit Shelter Less: Taxable Gifts Less: Pennsylvania Inheritance Tax Amount 638,977.47 $ 1,500,000.00 $ 37,096.78 $ Maximum Credit Shelter Amount $ 1,537,096.78 Less: Joint Property to Nick Nichols $ (850,250.00) Subtotal $ 686,846.78 Pa Purposes Only: Nichols Trust A $ 638,977.47 Balance of Residue $ For Pennsylvania Inheritance Tax: Life Estate Portion Remainder Portion $ $ Inheritance Tax on Non-Probate Inheritance Tax on Trust A Total Inheritance Tax Less Discount Net Inheritance Tax Paid 286,428.04 352,549.43 $ 38,261.25 $ 15,864.72 $ 54,125.97 $ (2,684.21) $ 51 ,441.76 Fractional Share 100.000% Disregard for Pa 44.826% 55.174% Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 CHARLES W. RUBENDALL II ROBERT L. WELDON EUGENE E. PEPINSKY. JR. JOHN H. ENOS m GARY E. FRENCH DONNA S. WELDON BRADFORD DORRANCE JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER ELYSE E. ROGERS CRAIG A. LONG YEAR JOHN A. FEICHTEL DONALD M. LEWIS]II STEPHANIE KLEINFELTER ERIC R. AUGUSTINE TODD F. TRUNTZ CAROL L. VERISH KEEFER WOOD ALLEN & RAHAL, LLP ATTORNEYS AT LAW 635 NORTH 12TH STREET, 4TH FLOOR LEMOYNE, PA 17043 ESTABLISHED IN 1878 OF COUNSEL: HEATH L. ALLEN N. DAVID RAHAL SAMUEL C. HARRY PHONE 717-612-5800 FAX 717-612-5805 EIN No. 23-0716135 www.keeferwood.com HARRISBURG OFFICE: 210 WALNUT STREET HARRISBURG. PA 17101 December 11, 2006 PHONE 717-255-8000 717 -612-5801 erogers@keeferwood.cOill f",.;I = (.::::;) Cj.... CJ ,'''[1 (J "'-) v -..:;...... r-~ (J) 0"1 Re: Estate of William N. Nichols File #21-2005-0125 Dear Sir/Madam: Enclosed herewith for filing please find the following: 1. Supplemental Pennsylvania Inheritance Tax Return (filed in duplicate); 2. Supplemental Federal Estate Tax Return (Form 706); and 3. Check in the amount of $15 in payment of your filing fee. Kindly acknowledge receipt of these documents by time-stamping the enclosed copy of this letter and returning it to our office. Thank you. cJr Enclosure Sincerely yours, ~ /) C~~ [~i Elyse Ej Rogers (::~