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Home My WebLink About05-08-07 " , -.J 1505bOlf11lf7 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 OFFICIAL USE ONLY CountyCode Year INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 6 File Number 1100 Date of Birth 563324014 11232006 12131909 Decedent's Last Name Suffix Decedent's First Name FENTON HELEN MI R (If Applicable) Enter Surviving Spouse's Infonnation Below Spouse's Last Name FENTON SuffIX Spouse's First Name JR. HORACE MI R Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW DI 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (dale of deeth prior to 12-13-82) 0 4. Limited Estete 0 4a. Future Interest Compromise 0 5. Federal Estete Tax Return Required (date of death after 12-12-82) 0 6. Decedent Died Testate 0 7. Decedent Mainteined a Living Trust 0 8. Tolal Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigetion Proceeds Received 0 10 Spcusal Pove~ Cred~ idate of death 0 11.Election 10 tax under Sec. 9113(A) . b8lween 12-31'91 and -1-95) (Attach Soh. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFQRMATION SHOULD BE DIRECTED TO: Name -, Daytime Telephone Number ...'~ .~ GERALD J. BRINSER 71783~~348 ~ c .." Finn Name (If Applicable) BRINSER, WAGNER & ZIMMERMAN .- -.'J - , ,. REGISTER ~~~ USe::QNL Y J.,:-;':: I . co First line of address 6 E. MAIN STREET -v Second line of address P.O. BOX 323 1'''-' \ I c:: r.,) City or Post Office PALMYRA State PA ZIP Code 17078 DATE FILED Correspondent's e-mail address: w. crawford@ choiceonemail .com John W. Fenton 2831 Carie Hill Circle, N.W., Massillon, OH 44646 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE .f!t ~d--l ~-.... _ Gerald J. Brinser ADDR~ / 6 E. Main Street, Palmyra, PA 17078 DATE ,>/$>/#/ 7 . L Side 1 1505bOlf11lf7 1505bOlf1:J.lf7 -I~ --' 15056042148 REV-1500 EX Decedenfs Name: FENTON, HELEN R Decedent's Social Security Number 563324014 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 Non-Probate Property (Schedule G) 0 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/Sec 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, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 30,059.12 15. 16. 17. 18. 19. Tax Due............................................ ...................................... ............................. ...... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 30,859.12 30,859.12 800.00 800.00 30,059.12 30,059.12 0.00 0.00 D 15056042148 --' REV-1500 EX Page 3 Decedent's Complete Address: CON Fenton, Helen R STREET ADDRESS 214 Messiah Circle File Number 21 - 06 - 1100 CITY Mechanicsburg STATE ZIP PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 TotallnteresUPenalty (0 + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 0.00 (5A) (58) 0.00 1m Make Check Payable to: REGISTER OF WILLS, AGENT iii i I [~mJliH I 1m II iI. UI 1Ii!H[ if" 11m 'HII' W if [[II m !mlilllJilll~ if PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS I 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;..................................................................................... 0 [!] ~: ~::~ ~h=i~~~i~t:~~:.~~~.I~.~~.~~~.~~~~~.~~~~~~.~.~~.~~.i.~.~~:::::::::::::::::::::::::::::::::::::::::: B ~x d. receive the promise for life of either payments, benefits or care?.................................................................. 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............ .................................. .............. .............................................. ................ 0 [!] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?............... 0 [!] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?...................... ................................................... .............................................. 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. mllll For dates of de8th 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. 59116 (a) (1.1) (i)]. For dates of de8th 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. 59116 (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 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 zero (0) percent [72 P.S. 59116 (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. 59116 1.2) [72 P.S. 59116 (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. 59116 (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. . SCHEDULE E CASH, BANK DEPOSitS, & MISC. PERSONAL PROPERTY COMMOIWVEAl. TH OF PENNSYlVANIA IMlERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Fenton, Helen R FILE NUMBER 21 - 06 - 1100 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 PNC Bank - Certificate of Deposit #31800288403 30.859.12 (Includes accrued interest of $74.44) TOTAL (Also enter on Line 5, Recapitulation) 30,859.12 . SCHEDUlE H RJNERAL EXPENSES & ADNNSTRAllVECOSTS COMMONWEAllH OF PENNSYlVANIA I~ERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fenton, Helen R Debts of decedent must be reported on Schedule I. FILE NUMBER 21 - 06 - 1100 ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. I I I B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): ! Street Address City State Zip - Year(s) Commission paid I 2. Attorney's Fees Brinser, Wagner & Zimmerman 650.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address I City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills (no additional letters due) 133.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. other Administrative Costs 1 Register of Wills - Filing Fee for Inventory 15.00 TOTAL (Also enter on line 9, Recapitulation) 800.00 . SchecUe H Fu1eraI Exper ISOO & M,'..dlNeCostsCOlllirud COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fenton, Helen R FILE NUMBER 21 - 06 - 1100 2 Notary Fee for Renunciation 2.00 Page 2 of Schedule H REV-11113 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fenton, Helen R I FILE NUMBER 21 - 06 - 1100 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(S) I. TAXABLE DISTRIBUTIONS[include outright s~usal Clistributions and nsfers under Sec. 9116 (a) (1.2)) 1 Horace R. Fenton, Jr. Spouse Entire Residue 30,059.12 214 Messiah Circle Mechanicsburg, PA 17055 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 0.00 WILL OF HELEN R. FENTON I, HELEN R. FENTON, currently of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. I bequeath unto my husband, Horace, all tangible personal property which I own at my death. IV. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath unto my husband, Horace. V. In the event that my husband, Horace does not survive me, I devise and bequeath my entire estate that would have otherwise passed under Paragraphs III and IV above as follows: A. I bequeath unto our two (2) sons, John and George, all tangible personal property which I own at the time of my death. B. The residue of my estate shall be distributed as follows: 1. Fifteen percent (15%) unto the Latin American Mission, Miami, Florida, to be used as it sees best. ~ -1- JL;~ ~ +~14 2. Five percent (5%) unto the Grantham Brethren in Christ Church, Grantham, Pennsylvania, to be used as it sees best; 3. Ten percent (10%) unto Messiah Village, Mechanicsburg, Pennsylvania, to be used in its Endowment Fund. 4. Ten percent (10%) unto Paxton Street Ministries, Harrisburg, Pennsylvania, to be used as it sees best. 5. Ten percent (10%) unto Seneca Hills Bible Conference, Franklin, Pennsylvania, to be used as it sees best. 6. Ten percent (10%) unto my sister-in-law, Eleanore Dixon. If she predeceases me, this share shall be added proportionately to the shares passing under sub-Paragraph Seven (7) , Eighty (8), and Nine (9) below. 7. Ten percent (10%) unto my brother-in-law, John S. Fenton. Ifhe predeceases me, this share shall be added proportionately to the shares passing under sub-Paragraph Six (6), Eight (8), and Nine (9). 8. Fifteen percent (15%) unto my son, John, or his issue per stirpes. 9. Fifteen percent (15%) unto my son, George, or his issue per stirpes. VI. I appoint my husband, Horace L. Fenton, Jr., Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my son, John W. Fenton, Executor of this my Will. VII. I direct that no bond be required of my fiduciary for the faithful performance of his duties in any jurisdiction. ~ -2- 1 Lt.-, 12 J-- ~ IN WITNESS WHEREOF, I, HELEN R. FENTON, herewith set my hand to this my Last Will, typewritten on three (3) sheets of paper including the attestation clause and signatures of witnesses, this ;2 /) f1.r day of :r t.I L Y , 1999. j~~ &'2'~(SEAL) HELEN R. FENTON Signed by HELEN R. FENTON, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this .;2c.? f-tday of ...;T4/L.)I , 1999. ,~~ ~l /tj:l~ '?f-~ J B~ residing at /~...._(f'411? residing at !/,J-Ut ~j", ,,-/2. -3- . COMMONWEALTH OF PENNSYL VANIA kliR.. Y L PRO~~;e COUNTY OF CUMBERLAND WE, HELEN R. FENTON, GERALD J. BRINSER and KAt<.YL I_ P,fo!>'sE.L., the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), and that she executed it as his 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 witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ;;~ R. j~ HELEN R. FENTON L;~ ~_.~~ wrfNESS / ~~~.vY~ WI SSl Subscribed, sworn or affirmed and acknowledged before me by HELEN R. FENTON, the testatrix, GERALD J. BRINSER and }(Il~ L Peos5e ~ , witnesses, this vUadayof Jc.c..ly , 1999. ~~ ~ C-',.tk i~(SEAL) , . Public Notarial Seal Lona Sue ClmenhaQa. Notary Public Upper Allen Twp., Cumberland County My Commission Expires Aprif 28, 2001 Member, Pennsylvania AssocIalfon of Hotarles -4-