HomeMy WebLinkAbout11-02-07 (2)
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
~~~~:2=ual Taxes INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Gode Year
2 1 0 7
File Number
o 2 6 8
Date of Birth
179302565
o 307 2 0 0 7
090 6 1 9 3 9
BAR R I C K
A N J A
MI
L
Decedent's Last Name
Suffix
Decedent's First Name
(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
00 1. Original Retum
o 4. Limited Estate
00
o
o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of
death after 12-12-82)
D 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
D 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
D
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
W ILL I A M
A.
DUN CAN
71724 9 7 7 8 0
Firm Name (If Applicable)
DUNCAN
&
HARTMAN,
P C
REGIS~OF WILLS U~,ONL Y
::.:~)
First line of address
1 IRVINE
ROW
;.'....:
I
I
I
I
~
Second line of address
City or Post Office
State
ZIP Code
"_, -'-'1
OA TE FILED r-;
I..I::'
CAR LIS L E
P A
17013
Correspondent's e-mail address:billduncan@planetcable.net
Under penalties of pe~ury, I declare that I have examined this return, 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.
SI NATURE F PERSON RESP SIB FOR FILING RET RN DATE
.
/()
AVENUE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
CARLISLE
PA 17013
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
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15056041125
15056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
DecedenfsName: ANJA L. BARRICK
RECAPITULATION
179302565
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) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. . . . . .. 7.
46317.92
8. Total Gross Assets (total Lines 1-7) 8. 4 6 3 1 7 . 9 2
.......................... .
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 8 2 4 1. 5 0
. . . . . . . . . . . . . . . .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . ... .. 10. 1 6 2. 5 7
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 8 4 0 4 . 0 7
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 3 7 9 1 3. 8 5
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.
37913.85
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.O _ o . 0 0 15. o . 0 0
16. Amount of Line 14 taxable 3 7 9 1 3 . 8 5
at lineal rate X .00L 16. 1 7 0 6. 1 2
17. Amount of Line 14 taxable o . 0 0 O. 0 0
at sibling rate X .12 17.
18. Amount of Line 14 taxable o . 0 0 o . 0 0
at collateral rate X .15 18.
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1 7 0 6. 1 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
D
Side 2
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15056042126
15056042126
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 07 0268
DECEDENTS NAME
ANJA L. BARRICK
STREET ADDRESS
45 SPRING ROAD
~ ~.-
-- I STATE --
CITY I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
1,706.12
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)
0.00
0.00
1,706.12
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
1,706.12
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. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving 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
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)l.
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 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. ~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, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ANJA L. BARRICK
FILE NUMBER
21 07 0268
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joinUy-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
PROCEEDS OF M& T BANK ACCOUNT
VALUE AT DATE
OF DEATH
3,993.04
2.
COMMONWEALTH OF PA TAX REFUND
500.00
3.
U.S. TREASURY REFUND CHECK
30.00
4.
PROCEEDS AS DISTRIBUTION FROM ESTATE OF ROBERT A. DAVIS
38,894.88
5.
DIAMOND RING FROM ROBERT L. DAVIS ESTATE
[SEE ATTACHED APPRAISAL]
2,900.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
46317.92
REV-1511 EX + (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ANJA L. BARRICK
FILE NUMBER
21 07 0268
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME & CREMATORY, INC. 5,383.60
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
S1reetAddress
City State Zip
Year(s) Commission Paid:
2. Attomey Fees DUNCAN & HARTMAN, PC 2,315.90
3. Family Exemption: (If decedenfs address is not the same as daimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. ProbateFees REGISTER OF WILLS FILING FEE 92.00
5. Accountanfs Fees
6. Tax Retum Prepare~s Fees GROUPS TAX. AND PAYROLL SERVICE 50.00
7. RESERVED FUTURE FILING FEES 400.00
TOTAL (Also enter on line 9, Recapitulation) $ 8241.50
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ANJA L. BARRICK
FILE NUMBER
21 07 0268
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. EMBARQ PHONE BILL
VALUE AT DATE
OF DEATH
43.73
2. PPL ELECTRIC BILL
93.17
3. MISC. POSTAGE & FED EX CHARGES
25.67
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
162.57
""""""...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ANJA L. BARRICK
SCHEDULE J
BENEFICIARIES
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 ~ndude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. CYNTHIA L. LINDENMUTH lineal
1037 WAYNE AVENUE 25%
CARLISLE, PA 17013
2. CHRISTINE SCHWANGER lineal
207 CHESTNUT STREET 25%
MT. HOLLY SPRINGS, PA 17065
3. MERL Q. BARRICK lineal
45 SPRING ROAD 25%
CARLISLE, PA 17013
4. VINCENT BARRICK lineal
12752 BUFFALO TRACE 25%
NEWPORT, PA 17074
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 $
FILE NUMBER
21 07 0268
(If more space is needed, insert additional sheets of the same size)
LAST WILL
&
TESTAMENT OF
I, ANJA L. BARRICK, of 45 Spring Road, Carlisle, Cumberland County, Commonwealth
of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking any and all other
wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot in accord
with my expressed wishes.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath all of my estate of whatever nature, be it real,
personal or mixed, and wherever situate unto my children in this manner: one-fourth unto
CYNTHIA L. LINDENMUTH, one-fourth unto VINCENT E. BARRICK, one-fourth unto
CHRISTINE A. SCHW ANGER, and one-fourth unto MERL Q. BARRICK, JR., in equal
shares, per stirpes.
FIFTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my
estate Passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
SIXTH I hereby nominate, constitute and appoint CYNTHIA L. LINDENMUTH as
Executor ofthis my Last Will and Testament. In the event of renunciation, death, resignation or
inability to act for any reason whatsoever of CYNTHIA L. LINDENMUTH, I nominate,
constitute and appoint CHRISTINE A. SCHWANGER as Executor of this my Last Will and
Testament. I hereby relieve my Executor from the necessity of posting security in connection
with his duties, as such, in any jurisdiction in which he may be called upon to act insofar as I am
able by law to do so. In addition to the powers conferred by law, I authorize my Executor, in his
absolute discretion, to retain in the form received, and to sell either at public or private sale any
real or personal property owned by me at the time of my death.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of one typewritten page this t ~ ~y of ~1 ,2005.
cZrLkt.-- cI /3~L
ANJA WBARRICK
Signed, sealed published and declared by the above named Testatrix ANJA L. BARRICK as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
uA~L
~
rP' ~
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, ANJA L. BARRICK, Testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
t2?~ ~ /!J~d
ANJA L. ARRICK
Sworn or affirmed to and
acknowledged before me, by
ANJA L. BARRICK this ilo
of S~bQ,\.
L~~ nfWV~~J
ot P b IC ,
day
,2005.
NOTARIAL SEAL
K.athy L. Muromert, Notary Public
Borough of Carlisle, Cumberland Co., PA
My Commission Expires Aug. 11, 2007
COMMONWEALTH OF PENNSYLVANIA
:SS.
COUNTY OF CUMBERLAND
We, Wd liom. A DUVl.(Qf\ and ~c:aJ\ b Adams
the witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw ANJA L. BARRICK
sign and execute the instrument as her Last Will; that she signed willingly and that she executed
as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the
Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
UJ@i .
. / l) / ~c C C..1._________
~tJ, ~
(;
Sworn or affirmed to and
subscribed before me b:y
\JJ; \ t( ~VY\ A ()0y'\.(a(\
S c)QX\.D A doVyts
this L 0 day of S e.p ieNh 'v I..:>V
cli ~ cJ VVfI~>( {--
Notary ub IC
NOTARIAL SEAL
Kathy L. Mummert, Notary Public
Borough of Carlisle, Cumberland Co., PA
My Commission Expires Aug. 11, 2007
and
, witnesses,
,2005.
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RALPH PIERRO
Certified Gemologist
RONALD PIERRO
Registered Jeweler
ACCREDITED GEM LABORATORY
BRADENTON. FLORIDA
Jewelry
Appraisal
Insurance
Property of
R. A. Davis
907 Fruitland Avenue
Address
Bradenton, Florida
DateJanuary 18, 1989
DESCRIPTION OF ARTICLE
ESTIMATED REPLACEMENT
COST
1
One ladies yellow gold 18-k solitaire ring. Six prong white
gold head contains a round brilliant diamond, 6.10 X
6.18 MM, of exactly .82 carat, cutting average, color K,
clarity SI-l. $2,900.00
F.Yrlll~ivp of all taxes.
These estimated replacement costs are
ba..d only on estimates of the quality
of the stones (unless specifically stated
that the stones were removed and
graded). We assume no liability with
respect to any acholl that may be taken
r" \on the basis of ~pprals~J
',.~ C;.. \
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