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Home My WebLink About07-10-07 " ~ 15056041147 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 County Code Year INHERITANCE TAX RETURN 2 1 0 6 RESIDENT DECEDENT File Number 01074 Date of Birth 199348067 11252006 10121912 Decedent's Last Name Suffix Decedent's First Name RITA MI N FOX (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW II 1. Original Retum 0 2. Supplemental Retum 0 4. Limited Estate 0 48. Future Interest Compromise (date of death after 12-12~2) II 6. Oecedant Diad Testate 0 7. Oecedant Maintained a Living Trust (Allach Copy of Will) (Allach Copy of Trust) 0 9. Litigation Proceeds Received 0 10. =:, ~~~~f~dtt 1(~1a_~5)f death o o 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number ROBERT P. KLINE 7177702540 Firm Name (If Applicable) KLINE LAW OFFICE REGISTER OF WILLS USE ONLY First line of address 714 BRIDGE STREET o So .~>. :0 .) ...,::, ":iID ~~= ~; gj (f) ::.." ,...., <::;:) c::::::> '""-J c.... C r- t-R 10 _ 0 c':;. ::0 ...tCJ r ,., :-10 50.,0 ,., ;.~~ /._ fTl ,~,? C) --Cl Second line of address P.O. BOX 461 o City or Post Office NEW CUMBERLAND State PA ZIP Code 17070 00. DA~~Q ::0 -l ::Do U1 CO Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this retum, 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 information of which preparer has any knowledge. ' SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE James N. Novinger .., Robert P. Kline DATE ~ ::r ~ UJo1 714 Bridge Street, New Cumberland, PA 17070 Side 1 L 15056041147 15056041147 ~ ~M .' .' --.J 15056042148 REV-1500 EX Decedent's Name: FOX, RITA N Decedent's Social Security Number 199348067 RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 2. 417,840.00 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. 338,325.71 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. 756,165.71 36,686.10 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 3,210.30 11. Total Deductions (total Lines 9 & 10)...................................................................... 11. 39,896.40 716,269.31 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, 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 .15 716,269.31 71,626.93 15. 16. 3,223.21 17. 73,059.47 18. 5,372.02 19. 81,654.70 608,828.92 35,813.46 19. Tax Due..................... ........ .................... ............. ....................................................... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. [!J Side 2 L 15056042148 15056042148 --.J " REV-1500 EX Page 3 Decedent's Complete Address: .~ NAME Fox, Rita N STREET ADDRESS 325 Wesley Drive, Apartment 3218 File Number 21 - 06 - 01074 Mechanicsburg I STATE PA lZIP 17055 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 81,654.70 79,000.00 4,082.74 3. InterestlPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 83,082.74 TotallnterestlPenalty (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 + SA. This is the BALANCE DUE. (3) (4) (5) (SA) (58) 0.00 1,428.04 0.00 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: 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 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 [!J 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 B ~ B [!J [!J [!J 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 exemDt 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. " . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N FILE NUMBER 21 - 06 - 01074 All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH 1 PPL Corp 34.82 417,840.00 TOTAL (Also enter on line 2, Recapitulation) 417,840.00 .' . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAl. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N FILE NUMBER 21 - 06 - 01074 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 OF NUMBER DEATH 1 Ameriprise Financial #05120578742-0-002 96,805.39 2 Ameriprise Financial #08140578742-5-002 198.728.14 3 IDS Life Insurance Company #9100-4954156 2.722.80 4 M & T Bank 26,584.89 5 PNC Bank, NA #50-8003-3875 4,982.49 6 Multi Diamond Fashion Ring 750.00 7 Misc. Jewelry 3.740.00 8 Misc. Furniture & personal property 4.012.00 TOTAL (Also enter on Line 5, Recapitulation) 338,325.71 " . SCI-EDlI.E H FlJeW.. EXPENSES & AI:l\tWSTRATIVE COSTS COMMONWEAl. TH OF PENNSYLVANIA INHERITANCE T-'\X RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: A, 1 Parthemore Funeral Home & Cremation Services, Inc., New Cumberland, PA DESCRIPTION 2 Susquehanna Club, New Cumberland, PA (reception) 3 Giant Foods, New Cumberland, PA (reception cake) 4 Oak Hill Cemetery, Millersburg, PA 5 Elizabethville Monument Co., Elizabethville, PA B. ADMINISTRATIVE COSTS: Personal Representative's Commissions James N. Novinger Social Security Number(s) I EIN Number of Personal Representative(s): 1. Street Address 45 Sam Snead Circle 2. 3. City Etters Year(s) Commission paid 2007 Attorney's Fees Kline Law Office Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant State PA Zip 17319 4. Street Address City Relationship of Claimant to Decedent Probate Fees Register of Wills Zip State 5. Accountant's Fees Carey Associates 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal TOTAL (Also enter on line 9, Recapitulation) FILE NUMBER 21-06-01074 AMOUNT 4,209.20 366.30 17.99 300.00 98.00 25,000.00 5,000.00 670.00 500.00 75.00 36,686.10 " . SchedUeH RnnI Expenses & Aa1WM.:6IeCostsCCll'dium COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N FILE NUMBER 21 - 06 - 01074 2 The Sentinel 86.21 3 Henderson & Co. Jewelers, Inc., Mechanicsburg, PA (appraisal) 76.00 4 Fitch's Trading Post, Camp Hill, PA (appraisal) 37.40 5 Claude C. Wolfe & Associates, Camp Hill, PA (appraisal) 250.00 Page 2 of Schedule H f " . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA WHERrrANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N FILE NUMBER 21-06-01074. Include un reimbursed medical expenses, ITEM DESCRIPTION AMOUNT NUMBER 1 Verizon 71.66 2 Alert Pharmacy 99.65 3 PSERS 791.26 4 Bethany Court Apartments 2,227.79 5 Guideposts 19.94 TOTAL (Also enter on Line 10, Recapitulation) 3,210.30 " , , REV-U13 EX+ (9.(10) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fox, Rita N I FILE NUMBER 21-06-01074 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not Uat Truatee(s) I. TAXABLE DISTRIBUTIONS [include outright sr,ousal aistributionsg and ransfers under Sec. 116 (a) (1.2)] 1 Sandra Itterly Stepchild 10 1050 Old Forge Road, Lewisberry, PA 17339 2 Rita Sue Fultz, 7939 Clinton Rd, PO Box 667, Niece 5 Stedeman, NC 28391-0667 3 Quentin DeWalt Novinger Brother 85 1632 Grampian Blvd, Williamsport, PA 17701 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 TAXIS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART" - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 ~ ~ LAST WILL AND TESTAMENT OF RITAN.FOX I, RITA N. FOX, of Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Wil~ and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my personal representative hereinafter named to pay all of my just debts, funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my personal representative need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. If! do not own a burial plot or a grave marker at the time of my death, I authorize my personal representative, in his, her, or its sole discretion, to purchase a burial plot and to erect a suitable marker at my grave, and to expend sums from my estate for this purpose. Page 1 of 6 Pages ~ . ~ .~ ~ SECOND I give, devise, and bequeath the sum equaling ten percent (10%) of my net estate after payment of my just debts and taxes to my stepdaughter, SANDRA ITTERL Y, provided that she survives me by sixty (60) days. Should SANDRA ITTERL Y predecease me or die on or before the sixtieth day following my death, then I give, devise and bequeath her share to her son, SCOTT ITTERL Y, provided that he survive me by sixty (60) days. THlI:ID I give, devise, and bequeath the sum equaling five percent (5%) of my net estate after payment of my just debts and taxes to my niece, RITA SUE FULTZ, provided that she survives me by sixty (60) days. Should RITA SUE FULTZ predecease me or die on or before the sixtieth day following my death, then I give, devise and bequeath her share, in equal shares, to her children, MATTHEW FULTZ and ANITA FULTZ, provided that they survive me by sixty (60) days, per stirpes. FOURTH I give, devise, and bequeath the rest and remainder of my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate to my brother, QUENTIN deW ALT NOVINGER, providing that he survives me by sixty (60) days. FIFTH Should QUENTIN deW AL T NOVINGER predecease me or die on or before the sixtieth (60th) day following my death, then I give, devise, and bequeath the entire rest and remainder of my Page 2 of 6 Pages ~ K .~ ~ estate together with all insurance proceeds thereon of whatever nature and wheresoever situate in equal shares to JAMES M. NOVINGER, Q. THOMAS NOVINGER, PETER NOVINGER, and DIANE LEAHEY, who survive me by sixty (60) days, per stirpes. SIXTH My Executor is authorized and empowered to exercise from time to time in his, her or its sole discretion and without prior authority from any Court, in respect of any property forming any part of my estate or otherwise in its possession hereunder all powers conferred by law upon executors and I intend that such powers be construed in the broadest possible manner. SEVENTH I nominate, constitute and appoint my brother, QUENTIN deW AL T NOVINGER, Executor of this my Last Will and Testament. In the event QUENTIN deW AL T NOVINGER is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my nephew, JAMES M. NOVINGER, to serve instead. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. EIGHTH I hereby declare it to be my expressed desire that my personal representative employ Kline Law Office of New Cumberland, Pennsylvania, for legal advice and assistance regarding this my Last Will and Testament, said attorneys having considerable knowledge of my affairs, views Page 3 of 6 Pages and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and 7 -tIr. dayof $"~,2006. QyVy- Testament this Witness ~' /J/1~ ~ rl'~~ RIT N. FOX ~.r\~.. Witness Page 4 of 6 Pages ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND I, RITA N. FOX, the Testatrix whose name is signed to the attached or foregoing instrument, having been du1y qualified according to the law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~11. RITA N. FOX t?{' ~or Sworn or affirmed and acknowledged before me by RITA N. FOX, the Testatrix, this 7ftdayof t~ , 2006. /Lsf'~ /NOTARY PUBLIC t. OJ; ;V.ANU NCICIriII .. R. P...... ~ Pubtic rw <>4....~ Boro,' Cllnlbe.1aud ~ My Oa- ..Iou Expinls Apr. IS, 2007 Page 5 of 6 Pages I , ., AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND We'~A=l7 f'. /)Z<LJF- and 4.t14.r-P ~;dG ,the witnesses whose names are attached to the foregoing document, being duly qualified according to the law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ~?~ ~~p t~. Sworn or affirmed and subscribed beforee; by;#' 4=1-,: j7 ~/" ~. -!/.w/~ ;:J J.y::P5 this;1 dayof ~~~7 ,2006. L~~ //NOTARY PUBLIC and Page 6 of 6 Pages OIl NOIIriIl Sell .... R. FeiItIr. ~ NIIic ~~. I d~_c.l"'~ My O>-Wtlo8 ExpiNs Apr. 15, 2007