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Home My WebLink About12-19-06 (2) -.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth 186-26-9152 09/30/2006 01/01/1934 Decedent's Last Name Suffix OFFICIAL USE ONLY County Code Year a " b\J File Number \ D<-1\ Hoffman Phyllis Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Hoffman Leigh Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW . 1. Original Return 2. Supplemental Return 4. Limited Estate 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 between 12-31-91 and 1-1-95) . 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) MI E MI P CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Norman M. Yaffe, Esq. Firm Name (If Applicable) Yaffe & Yaffe, P.C. First line of address 214 Senate Ave., Ste 404 Second line of address City or Post Office State ZIP Code Camp Hill PA 17011 Correspondent's e-mail address: (717) 975-1838 REGISTER OF WILLS USE ONLY Q ~...., '1~:~.:l (:~J C;""'\ .---, ~ CJ r"l I.J ,.. .,,--; .::-.~ DATE:FIt1f:l \.D :Do ~r ....1:~ '.0 <::"I N Under penalties of pe~ury, I declare that I have examined this return. including accompanying schedules and statement he best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN .~~#~ ~RES~~-" 4720 Breezy Vista Lane, York, PA 17406 -SIG~AI~ PREPAR~OTHE:'t R~ENTATiVE--- . .L_. L-/~.. .'1-7:.+- r ADDRESS 214 Senate Ave., Suite 404, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 DATE 12/28/06 DATE 12/28/06 15056051058 --.J J -.J 15056052059 REV-1500 EX Decedent's Name: Phyllis E Hoffman 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 Personai Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 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 .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L Decedent's Social Security Number 186-26-9152 2,293.87 2,293.87 5,774.20 5,774.20 -3,480.33 0.00 0.00 15056052059 -.J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME .~~~Iis STREET ADDRESS 512 Joyce Road E Hoffman DECEDENT'S SOCIAL SECURITY NUMBER 186-26-9152 CITY Camp Hill --'STATE : PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 0.00 0.00 0.00 0.00 0.00 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. 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 [KJ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [KJ c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. 0 [KJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................... .................................................................... ...... ........................ 0 [KJ 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 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 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 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) SCHEDULE E CASH, BANK DEPOSITS, & MISe. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phyllis E, Hoffman FILE NUMBER 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 DESCRIPTION Refund of unearned premium on long term care Prudential Insurance Company owned by Decedent VALUE AT DATE OF DEATH 2,293.87 TOTAL (Also enter on line 5, Recapitulation) $ 2,293.87 (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 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Phyllis E. Hoffman FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Hoffman-Roth Funeral Home, Inc. 1,814.20 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 425.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Leigh P. Hoffman Street Address 512 Joyce Road City Camp Hill State PA ,Zip 17011 Relationship of Claimant to Decedent Spouse 4. Probate Fees 35.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,774.20 REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phyllis E. Hoffman FILE NUMBER 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 [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Leigh P. Hoffman Spouse 0 . surviving spouse, Leigh P. Hoffman, will deplete the estate value, and cause it to be an insolvent estate, when he takes the family exemption. 0 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 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) LA W OFFICES YOFFE & YOFFE, P.c. SUITE 203 · 214 SENA TE A VENUE CAMP HILL, P A 17011 (717) 975-1838 ~~._"-~ LAST WILL AND TESTAMENT OF PHYLLIS E. HOFFMAN I, Phyllis E. Hoffman, presently residing at 512 Joyce Road, Camp Hill, cumberland County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last will and TestameI1t, hereby revoking any and all wills by me heretofore made. FIRST: I direct that my funeral be conducted in a manner corresponding with my estate and situation in life, and that all my just debts and funeral expenses be paid and satisfied by my Executrix hereinafter named, as soon as conveniently may be after my decease. It is my wish that my children be given sufficient time to SECOND: remove items that may belong to them, or articles they personally desire before residue is inventoried for sale. This privilege is to be extended to my grandchildren if their mother is deceased. Any such article chosen by an issue as aforesaid (not being an article already belonging to such issue), shall not diminish such issue's share of my residuary estate as hereinafter devised. THIRD: I give, devise and bequeath all of the rest, residue and remainder of my estate, both real, personal and mixed, of whatsoever kind and wheresoever situate, to my husband, Leigh P. Hoffman; providing however, that he survives me for at least 30 days. In case my husband shall fail to survive me for a period of 30 days, then the gift to my husband shall be and become null and void and, in lieu thereof, I provided as follows: All the rest, residue and remainder of my estate, real and personal property, of whatever nature and wheresoever situate, I give, devise and bequeath unto my 3 children, share and share alike. In case a child shall fail to survive me for a period of 30 days, then the issue (surviving me for a period of 30 days) of such deceased child shall take, per stirpes, the share of the deceased child. In default of such issue, the share of such deceased child shall lapse. PAGE 1 OF 2 PAGES ~, f,N I P.E.H. FOURTH : I hereby nominate, constitute and appoint my daughter, Bethley Nauman of York, Pennslyvania, to be the Executrix of this my Last will and Testament. If the said Bethley Nauman is unable or unwilling to serve as such, I then appoint my daughter, Jo Dowell of Boiling Springs, Pennsylvania to serve in such capacity. If the said Jo Dowell is unable or unwilling to serve as such, I then appoint my daughter, Sandra Yalich of Kingsville, Maryland to serve in such capacity. I direct that my personal representative be excused from entering and/or filing any bond to assure the proper performance of her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of November, 2002. TESTATRIX re .fl.Ai fu i r ~~-rV (SEAL) PHYLL~i. ~OFFMAN ADDRESS c2lcfJblPb ~<('Sul-k ~3 {tc::rj(.(tJ/PJI ;:Ih701/ , , ADDRESS c;}1t(..u~_~k(-I<c)ds C?Vvp If/I P.A /70// COMMONWEALTH OF PENNSYLVANIA: !is! COUNTY OF Cumberland Phyllis E. Hoffman, the Testatrix, and the above witnesses, whose names are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament in the presence of the witnesses 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 witness and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, 1~n to and acknowledged before me by the witn....., thi, day of NOV'mb~r,~'1 'v-tY4 Notarial Seal NO ARY PUBLIC Norman M. YolTe. NOIUy PubUc: My Commission Expires: Camp Hill BOlO, Cumberland County My Commission Expires Allg. 26, 2006 the Testator and PAGE 2 OF 2 PAGES @,f.A! ; P.E.H. hoffman, leigh\will.ph