HomeMy WebLinkAbout03-28-08
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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
OFFICIAL USE ONLY
County Code Year
File Number
21 07
1047
Date of Birth
174-16-1434
02/27/2007
10/02/1920
Decedent's Last Name
Suffix
Decedent's First Name
MI
Fleagle
Kenneth
P
(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
. 1. Original Return
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-821
5. Federal Estate Tax Return Required
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)
8. Total Number of Safe Deposit Boxes
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
John R. Fenstermacher
717-691-5400
Firm Name (If Applicable)
Fenstermacher and Assoc
REGISTER OF WilLS USE ONLY
First line of address
5115 East Trindle Road
Second line of address
City or Post Office
State
ZIP Code
DATE FilED
v.
Mechanicsburg
PA
17050
Correspondent's e-mail address:john@fenstermacherandassociates.com
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules ,md 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.
'~~U~p.FF Pl€ ~.R R. S~. . .R.~~~SPO~I~LEF FOORR I FILING RETURN DO~~19/08
- ..... ~~ -<~~~~~
ADDRESS "<" --. --~ - ._--.._-~..- .-..~--
.?1 Linda[)rive,r>,I'-ech~icsbur~PA 170~__ __~_ _ _n___
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DP,TE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
L
15056051058
Side 1
15056051058
...J
~~-b
.-J
15056052059
REV-1500 EX
Decedent's Name:
Kenneth
P Fleagle
RECAPITULATION
1. Real estate (Schedule A).
2. Stocks and Bonds (Schedule B) . . . .
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) . .
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). . . . . . . . . . . . . . . .
9. Funeral Expenses & Administrative Costs (Schedule H). . .
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) ... ..... ... .
13. Charitable and Governmental Bequests/See 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) . .
.........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 45
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
L
15056052059
Side 2
Decedent's Social Security Number
174-16-1434
1.
45,000.00
2.
5.
100.00
8.
45,100.00
7,711.62
9.
37,388.38
37,388.38
1,682.48
1,682.48
15056052059
--I
REV-1500 EX Page 3
File Number
Decedent's Complete Address:
DECEDENT'S NAME
Kenneth P Fleagle
STREET ADDRESS
21
07
DECEDENT'S SOCIAL SECURITY NUMBER
174-16-1434
CITY
STATE
ZIP
i
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
1,682.48
3. Interest/Penalty if applicable
D. Interest
E.Penalty
Total Credits (A + B + C ) (2)
40.95
Total Interest/Penally ( 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)
40.95
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(5B)
A. Enter the interest on the tax due.
1,723.43
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;.......................................................................................... 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? ..............................................................................................................,......... D ~
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. 99116 (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. 99116 (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. 99116(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 PS. 99116(1.2) [72 P.S. 99116(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 PS. 99116(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
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kenneth P. Fleagle
FILE NUMBER
21-07 -1047
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
VALUE AT DATE
OF DEATH
Personalty
100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
100.00
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kenneth P Fleagle
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-07-1047
SURVIVING JOINT TENANT(S) NAME
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
RELATIONSHIP TO DECEDENT
A. Gwen Ann Fleagle, n/k/a Gwen Ann
Baitsell
B. Phyllis S. Miller
C.
JOINTLY-OWNED PROPERTY:
ADDRESS
1011 Franklin Street, Carlisle, PA 17013
81 Linda Drive, Mechanicsburg, PA 17050
Daughter
Daughter
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAl-JE OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DEe JS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET iNTEF EST DECEDENTS INTEREST
1. A 04/25/94 23 DeWalt Drive, Mechanicbsurg, PA 17050 180,000.00
2 B 11/17/98 23 DeWalt Drive, Mechanicsburg, PA 17050 180,000.00 25 45000.00
TOTAL (Also enter on line 6, Recapitulation) $ 45,000.00
(If more space is needed. insert additional sheets of the same size)
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~
TAX PARCEL No
I -;5" if'!
II lLE..EJ!
MADE the ~ day of ~in the year of our Lord, One Thousand
Nine Hundred and Ninety-Eight (1998).
BETWEEN
KENNETH P.l1LEAGLE:
GRANTOR
Alill
KENNETH P. FLEAGLE and
PH'M:.LlS MILLER, his daughter
as joint tenants with right orsurvivorship
hb'Fifty percent (50%) ownership in
subject real eastate:
GRANTEE
WITNESSETH THAT the said GRANTOR, for and in consideration of the sum of
ONE DOLLAR:
*if....*.w#t'lcw...Jdr.... 1600 ....",dllllifif*****.****if'
Lawful money of the United States, unto the GRANTOR. well and truly paid by the said
GRANTEES, the receipt whereof is hereby acknowledged, do hereby grant, bargain, sell,
alien, enfeoff, release, convey and confirm unto the said GRANTEES, their heirs and
assigns:
ALL THAT CERTAIN piece or parcel of land situate in the Township of Silver Spring,
County of Cumberland and Commonwealth of Pennsylvania, more particularly bounded
and described as follows, to wit:
BOOK 1lJ9 ;'1,Cl 426
r5;()
v'J/
BEING LOT NO.4 of Section A of MiIlbrooke Plan of Lots, which Plan is recorded in
the Cumberland County Recorder of Deeds Office in Plan Book 19, Page 70, having a
frontage along Township Road T-579 of one hundred five and zero hundredths (105.00)
feet and an even depth on the East and West of one hundred fifty-five and zero ~
hundredths (155.00) feet, and a width in the rear of one hundred six and eighteen 0
hundredths (106.18) feel.
HAVING THEREON ERECTED a brick and aluminum siding ranch dwelling known as
23 DeWalt Drive, Mechanicsburg, Pennsylvania 17055.
BEING the same premises which KelU1eth P. Fleagle and Pauline Fleagle, his wife, by
their deed dated the 25~ day of April, 1994, and recorded in the Office of the Recorder of
Deeds in and for Cumberland County, PelU1sylvania, in Deed Book / CJ"I ' Volume
,Page ~ ;J. () , granted and conveyed unto Kenrieth P. Fleagle and
Pauline Fleagle, his wife, and Gwen Ann Fleagle.
Whereas, the said Pauline Fleagle has departed this lifetime thereby vesting by
operation of law her interest in the tenancy by the entirety in Kenneth P. Fleagle.
Kenneth P. Fleagle is lawful grantor as to this undivided fifty percent (50%) interest that
he now conveys to himself and his daughter, Phyllis Miller, as joint tenants with right of
survivorship.
UNDER AND SUBJECT, NEVERTHELESS, to the conditions, restnctlons,
agreements, easements, rights of way, encumbrances, and all other matters of record.
TOGETHER with all and singular hereditaments and appurtenances thereunto belonging
or in anywise appertaining and the reversions and remainders, rents, issues and profits
thereof; and all the estate, right, title, interest, property claim and demand whatsoever of
the said GRANTOR, in law, equity or otherwise of, in and to the same and every part
thereof.
TO HAVE AND TO HOLD the above.described premises with the appurtenances unto
the GRANTEES, their heirs and assigns, forever.
AND THE GRANTOR does hereby covenant and agree with the GRANTEES, that the
GRANTOR, his Executors and Administrators, Shall and Will Warrant and Forever
Defend the herein above-described premises with the hereditaments and appurtenances,
unto the GRANTEES, their heirs and assigns, against the GRANTOR, and against every
other person lawfully claiming, or who shall hereafter claim, the same or any part thereof.
IN WITNESS THEREOF, the GRANTOR has hereunto set his hand and seal the day
and year first above written.
BOOK 189 PAGE 427
child.
This transfer is exempt from real estate transfer tax as a transfer from parent to
SIGNED, SEALED and DELIVERED in the presence of:
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BOOX 1139 P^GE 428
COMMONWEALTH OF PENNSYL VANIA:
COUNTY OF CUMBERLAND:
On this, the K day of
personally appeared:
~ ,1998, before me, the undersigned officers,
KENNETH P. FLEAGLE
known to me (or satisfactorily proven) 10 be the persons whose names are subscribed to
theii.viihill instrument, and acknowledge that they executed the same for the purposes
.:<~~s~~ii)0l}~ned.
i. ~:..:.,~;::_;:ti"': .:.1 tn~:":>ir, "/ .
. {;":J~, .W'W~S~,;;.YHEREOF I HEREUNTO SET MY HAND AND OFFICIAL SEAL:
;!~:;;~;l';~r:~,;:>' -/;;:~: ",~"
.:..'0.... fj s:J ,,' NOTARtALSEAL
~.'.i,~},;~~..~,;, ' ATTORi'4EY~~BA~~DtaI)'PUblID
My CommiHlon &pi,.. MIIy 13, t_
~ ~ 4--<-
rotary Public
hereby certify that the
/->
~~
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precise residence of the GRANTEES
~ (Ja /7&rcS'
I
is:
~~
orney for the Grantee
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND :
Recorded in the Office of the Recorder of Deeds, for said County, on the ~ day of
~~~J ,1998, inDeedBook~ Volume_Page=.ill..
WITNESS MY HAND AND SEAL OF SAID OFFICE, the day and year aforesaid.
_.:. .:" .... ~
[6ox 189 f.\Gf 429
1.G~~~;,2~:;;,.
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ORDER
DEE D
MADE the 25th day of April , in the year of
our Lord, One Thousand Nine Hundred and Ninety-four, 1994).
BETWEEN: KENNETH P. FLEAGLE and PAULINE FLEAGLE, his wife:
GRANTOR
AND
KENNETH P. FLEAGLE and PAULINE FLEAGLE his wife, and GWEN. ANN
FLEAGLE their daughter, as joint tenants with right of
survivorship:
GRANTEE
WITNESSETH THAT: The said GRANTOR, for and in consideration
of the sum of One Dollar:
*********************~****** $1.00 ***************************
Lawful money of the United States unto. the GRANTOR well and
truly paid by the said GRANTEE, the receipt whereof is hereby
acknowledged, does hereby grant, bargain, sell, alien, enfeoff,
release, convey and confirm unto the said GRANTEE, its Heirs
and Assigns.
ALL THAT CERTAIN piece or parcel of land situate in Silver Spring
Township, Cumberland County and state of Pennsylvania, more
particularly bounded and described as follows, to wit:
BEING LOT NO.4 of Section A, of Millbrooke Plan of Lots, which
Plan is recorded in the Cumberland County Recorder of Deeds
Office in Plan Book 19, Page 70, having a frontage along Township
Road T-579 of one hundred five and zero hundredths (105.00)
feet and an even depth on the East and West of one hundred fifty-
five and zero hundredths (155.00) feet, and a width in the rear
of one hundred six and eighteen hundredths (106.18) feet.
IIAVING THEREON ERECTED a brick and aluminum siding ranch dwelling
known as 23 DeWalt Drive, Mechanicsburg, Pennsylvania, 17055.
BEING the same premises which Robert L. Bernatos and Amy D.
Bernatos, his wife, by their Deed dated the 21st day of July,
1983, and recorded in the office of the Recorder of Deeds in
and for Cumberland County in Deed Book H, Volume 30, Page 502,
granted unto Kenneth P. Fleagle and Pauline Fleagle, his wife,
GRANTORS herein.
1.
800K 104 N.G( 820
..'--.
TIIIS PROPERTY IS EXEMPT FROM REALTY TRANSFER TAX AS A TRANSFER
BETWEEN PARENT AND CHILD.
SUBJECT to restrictions and conditions as contained in prior
deeds.
UNDER AND SUBJECT, NEVERTHELESS, to the conditions, restrictions,
agreements, easements, rights of way, encumbrances, and all
other matters of record.
TOGETHER with all and singular hereditaments and 'appurtenances
thereunto belonging or in anywise appertaining and the reversions
and remainders, rents, issues and profits thereof; and all the
estate, right, title, interest, property claim and demand
whatsoever of the said GRANTOR, in law, ,equity or otherwise
of, in, and to the same and every part thereof.
TO HAVE AND TO HOLD the above described premises with the
appurtenances unto the GRANTEE, their Heirs and Assigns, forever.
And the GRANTOR does hereby covenant and agree with the GRANTEE,
that the GRANTOR, his Executors and Administrators, Shall and
Will Warrant and Forever Defend the herein above described
premises with the hereditaments and appurtenances, unto the
GRANTEE, their Heirs and Assigns, against the GRANTOR, and
against every other person lawfully claiming, or who shall
hereafter claim, the same or any part thereof.
IN WITNESS THEREOF, the GRANTOR, has hereun~o set their hand
and seal the day and year first above w~itten.
SIGNED, SEALED and DELIVERED
in the presence of:
~~~
NESS .
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND:
On this, the ~ day of ft~ ' A.D., 1994,
before me, the undersigned officer, personally appeared
KENNETH P. FLEAGLE and PAULINE FLEAGLE
~ ..;... ~
Not Public
My Commission Expires ~//~~~5-
I hereby certify that the precise residence of the GRANTEE is
R~q:',~/ ">-> ~~, ~ f'q/7(}~5'
t~~~
Attorney for
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND:
Recorded in the Office of the Recorder of Deeds for said County
on the ~ day of
l~ , Page
.
Pw-'.\
%6 , Volume
, 1991{ in Deed Book
~~~
3.
Witness my hand and seal of said Office, the
aforesaid.
!'OllK 104 PAcr 822
ltY,IUUpJ,UI
<<fCOJrO('It'S USE ONLY
.9o,,'~'V_
~~
COMMONWfAlIH 01 ,.fHNlnV-'HLA
Df,....IUMfHT Of IllVlHUf
auuAU or W-lotvIOUAlc'A)US
DEn. ;U060)
HA.UIUU.G, ,.A l1)U.o002
s....1......,..,.
s.. Reven. for Inl.ructions
REALTY TRANSFER TAX
STATEMENT OF VALUE
Compl.l. .Dth I.dion and HI. In duplicale wllh Recold.r 01 D..d. when III th. (ull valuJcondd.rallon is not .el lorlh In Ill. d..d, t2) wh.l\.lhe d..
il. without conaid.rolion, or by gift, 01 PI o'lax exemption b dolmed. A Slol_me'" 01 Volue i.. nol required j,f Ih. Ira ruler II wholly aJUlmpl from 10
bOl..d on: p~ fomily't"QI~n"'ip at 12) pvLtic ulil;ey .011"".111. If n1o....spac. is neecMd, QUod. additional &he"~.j. '
. ., . .
Nom.
fta Nwnb.n
. . . .
.
717 1'737'-2033
Zip Cod.
17055
April 25. 1994
..~~~~.. M. BACH. ESQUIRE a" A~~,~.d.1
352 SOUTH SPORTING HILL ROAD, MECHANICSBURG, PA
I: ':'~'~~1;t~:..J.l" Oataolkc.p6mK.ofOOCllmd
G'~I.r(.ln.uo.tll
~3 DE WALT DRr~
01)" 5101.
MECHANICSBURG, PA
zijlCOa.
17055
& PAULINE FLEAGLE and GWEN 'I'
A. FLEAGLE
DR IVE
5101. Zip Cod.
PA 17055
KENNETH P. & PAULINE FLEAGLE
- Sl;;ii""ida;;;;--
Sir." Ad....
ell" 1o...tlMp..........
MECHANICS BURG
23 DE WALT DRIVE
~Coul'\ly
CUMBERLAND
....
... H
CUMBERLAND VALLEY
.
I. ....;11,01 Calk Con.ld.,oIlOll
2. 0&1.... Co"Nd.,atioll
3. ToIot CDANcMfOIJoel
ONE DOLLAR ($1.00)
.tl. Covnfy Au.....! Vol"l
+
5. ConmIOn ....vel ~olio fodDf
6. oilMelf"V U.
)(
. . .
10. Atnovnl ot E....mpllo... C1oHn.d
lb. '.,culoge GlInt.,.1I COIIW,..d
'-
2. Check Approprial. Ba. S.IDW lor E..mplion Claimed
o Will or inll"lalll succlnion _ .
- ----rN;;.;;-o11iM-;J;~T-----------ir.l....-ii1.Hw.a..)
o T.onll.r 10 IntJu,lliol Devolopmenl Agency.
o
o
o
Trolllfer 10 ogenl or It raW' poor. (AlIoch copy of agency/llraw pOlly oo,..monll.
Tronite, bl,wu"pllndpol and oS8nl. (Ailed. copy 01 agency/wrow Ir~H ogr..morn), TOJt paid prior d..d S ___ ;
Tranlof.n 10 Ih. Conunonwlal&h. the Uni.ed 5101.., and Inalrumanlolillu by gih, d.dicol;on. condemnalion or in Ii." 01 ,ond..nnalian.
(Alloch copy 0' r.,oluliont.
o Tron,'o" (rDIlI morlgagor )0 a holder of 0 morlg1lS. in d.Jauh. Morlgog_ Book Numb.r __. POQe Numb.r
o Corrective deed tAlIach copy 0' Ih. prior dudl.
D Slolulory corporale consolidalion, merger or diviloion. (AlIach copy 0' article,). .
Q Olher IPleose explain exemplion claimed, if olh.'lhon li,lld above.) TRANSFER BE~WEEN PARENTS AND CHILq
Under p.ngl.'lu ollu_. I dedur. thelll haye eJComlned ,hi. Slatem.nl, Including accompanying Inlo.matlon. and 10 Ih. be,1 of my knowl.d"
and b.lI.f, II 11 hu., corred and campl.t.. i
5Ig...... O;:;.~' ;;;;;::1i!:4 ~
t/ (SEE REVERSE)
REV-1511 EX+ (12-99).
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Kenneth P. Fleagle
FILE NUMBER
21-07-1047
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
1.
5,536.00
B.
1.
ADMINISTRATIVE COSTS:
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
2,175.62
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
7,711.62
(If more space is needed, insert additional sheets of the same size)