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Home My WebLink About05-23-08 ---I 15056041125 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 HarrisburQ, 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 8 RESIDENT DECEDENT File Number 022 3 Date of Birth 177506858 o 2 102 008 03161967 Decedent's Last Name Suffix Decedent's First Name BARGER B R I A N MI J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix N / A 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 Retum D 4. Limited Estate D D 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 D 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 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D D D D o 8. Total Number of Safe Deposit Boxes 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required THO MAS L WENGER E S Q 717 234 4 182 Firm Name (If Applicable) 5 0 8 NORTH SECOND STREET ~;^, W I X WENGER & WEIDNER First line of address Second line of address City or Post Office State ZIP Code ~' i:__) ,~.d -1-1 I ~ "'.._ "_J" r."O Plli~FILED Y? P 0 BOX 8 4 5 H A R R I S BUR G P A 171080845 c.n , ) (-) ~..~7 ~i Correspondent's e-mail address:TWENGER@WWWPALAW.COM 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, i is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. NATURE OF PERSON RESPONSI FOR FILING RETURN DATE ER RD, MECHANICSBURG,PA REPARER OTHER THAN REPRESENTATIVE 17055 PO BOX 845 HARRISBURG, PA 17108 PLEASE USE ORIGINAL FORM ONLY L 15056041125 15056041125 --.J~ Side 1 ---I 15056042126 REV-1500 EX 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. Decedent's Social Security Number 1 7 7 5 0 6 8 5 8 O. 0 0 O. 0 0 O. 0 0 O. 0 0 5 4 6 4 7 . 2 5 Decedent's Name: BRIAN J. BARGER 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. 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. 8. Total Gross Assets (total Lines 1-7) ........................... 8. o . 0 0 5 4 6 4 7 . 2 5 1 0 9 0 2. 0 0 8 3 3 3 4. 9 3 9 4 2 3 6. 9 3 - 3 9 5 8 9. 6 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. -39589.68 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 at lineal rate X .0_ o . 0 0 16. o . 0 0 17. Amount of Line 14 taxable o . 0 0 at sibling rate X .12 17. o . 0 0 18. Amount of Line 14 taxable o . 0 0 at collateral rate X .15 18. O. 0 0 19. Tax Due ................................................19. o . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT D Side 2 L 15056042126 15056042126 ---1 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME BRIAN J. BARGER STREET ADDRESS 11-C RICHMOND LANE File Number 21 08 0223 CITY CAMP HILL STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Cred~s/Payments A. Spousal Poverty Cred~ B. Prior Payments C. Discount (1 ) 0.00 3. InteresVPenatty if applicable D. Interest E. Penalty Total Cred~s (A + 8 + C) (2) 0.00 TotallnteresVPenalty ( 0 + 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 0.00 0.00 A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 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: Yes No a. retain the use or income of the property transferred; ...................................................................... D IXl b. retain the right to designate who shall use the property transferred or ~s income; ............................... D IXl c. retain a reversionary interest; or ................................................................................................ D 00 d. receive the promise for life of e~her payments, benefits or care? ....................................................... D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... D 00 3. Did decedent own an 'in trust for" or payable upon death bank account or secur~y at his or her death? ......... D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. D 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. 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 P.S. 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 P.S. 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-1502 EX + (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BRIAN J. BARGER 21 08 0223 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real Drooertv which is iointlv-owned with riaht of survivorshio must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1503 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF BRIAN J. BARGER FILE NUMBER 21 08 0223 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1504 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF BRIAN J. BARGER FILE NUMBER 21 08 0223 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1507 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF BRIAN J. BARGER FILE NUMBER 21 08 0223 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 4, RecapITulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1508 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BRIAN J. BARGER ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. FILE NUMBER 21 08 0223 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. DESCRIPTION AMERICHOICE FEDERAL CREDIT UNION, MECHANICSBURG, PA ACCOUNT NO. 34536-16 ($209.08) ACCOUNT NO. 41138-13 ($20.78) LIBERTY MUTUAL INSURANCE PREMIUM REFUND CHECK (VEHICLE) VALUE AT DATE OF DEATH 229.86 53.00 LIBERTY MUTUAL INSURANCE PREMIUM REFUND CHECK (TENANT INSURANCE) 23.00 CASH ON HAND 766.39 ORDINARY HOUSEHOLD GOODS AND FURNISHINGS 750.00 2008 DODGE RAM 2500 TRUCK (VALUE FULLY SUBJECT TO LIEN SET FORTH IN SCHEDULE I) 46,925.00 2005 JOHN DEERE MOWER 300.00 UTILITY TRAILER 5,000.00 MISCELLANEOUS TOOLS AND EQUIPMENT 600.00 TOTAL (Also enter on line 5, Recapnulation) $ (If more space is needed, insert additional sheets of the same size) 54.647.25 REV-1509 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BRIAN J. BARGER SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 08 0223 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. NONE B c JOINTL Y-OWNED PROPERTY: ADDRESS RELATIONSHIP TO DECEDENT LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-151O EX + (6-98) '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BRIAN J. BARGER FILE NUMBER 21 08 0223 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. NONE 0.00 0.00 TOTAL (Also enter on line 7 Recapitulation) $ 0.00 (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 ESTATE OF BRIAN J. BARGER SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 08 0223 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS FUNERAL HOME, MECHANICSBURG, PA 8,414.00 2. PASTOR STEVEN CREWS 100.00 3. MISCELLANEOUS ASSOCIATED EXPENSES 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) JAMES E. BARGER 0.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 128 CLOUSER ROAD City MECHANICSBURG State P A Zip 17055 Year(s) Commission Paid: N/A 2. AttomeyFees WIX, WENGER & WEIDNER (ESTIMATED) 2,200.00 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 CUMBERLAND COUNTY REGISTER OF WILLS 60.00 5. Accountant's Fees 6. Tax Return Prepare~s Fees 7. REGISTER OF WILLS - ADD'L SHORT CERTIFICATES 28.00 TOTAL (Also enter on line 9, Recapitulation) $ 10 902.00 (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 BRIAN J. BARGER FILE NUMBER 21 08 0223 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. AMERICAN GENERAL FINANCE XXXX-8424 VALUE AT DATE OF DEATH 4,815.00 2. CAPITAL ONE CREDIT CARD XXXX-771 0 258.36 3. CAPITAL ONE#6914 5,132.93 4. EQUITY ONE XXX-3758 136.94 5. CAPITAL ONE CREDIT CARD XXXX-6914 5,300.04 6. SPRINT WIRELESS 526.99 7. LOWES 965.61 8. CITI FINANCIAL XXXX-9552 496.86 9. GE CAPITAL CORPORATION c/o ESTATE RECOVERIES, INC. 923.51 10. GE MONEY XXXX-2046 5,104.55 11. HOME DEPOT CREDIT 1,834.18 12. PPL 43.4 7 13. UGI 174.19 14. VERIZON 19.49 15. FIRST EQUITY CREDIT CARD XXXX-6782 2,121.86 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 83 334.93 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 outritt spousal distributions, and transfers under Sec. 9116 (a (1.2)] 1. BRANDON J. BARGER Lineal 0.00 3781 SPRING ROAD SHERMANSDALE, PA 17090 2 TIMOTHY J. BARGER Lineal 0.00 3781 SPRING ROAD SHERMANSDALE, PA 17090 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PARTll - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ,,,,.,,h "'.''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BRIAN J BARGER SCHEDULE J BENEFICIARIES FILE NUMBER 21 08 0223 (If more space is needed, insert add~ional sheets of the same size) WIX, WENGER & WEIDNER RICHARD H. WIX DEAN A. WEIDNER STEVEN C. WILDS THERESA L. SHADE WIX" DAVID R. GETZ STEPHEN J. DZURANIN JEFFREY C. CLARK PETER G. HOWLAND A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 508 NORTH SECOND STREET POST OFFICE BOX 845 HARRISBURG, PENNSYLVANIA 17108-0845 THOMAS L. WENGER ROBERT C. SPITZER Of Counsel . Also Member MassachLJsens Bar (717) 234-4182 FAX (717) 234-4224 www.wwwpalaw.com Suburban Office: 4705 DUKE STREET HARRISBURG. PA 17109-3041 (717) 652-8455 May 22, 2008 o ~~ -:LJ :}i~ _.J ............ /'oJ c::;, ';-c:;) <=:0 :x > -< N W Ms. Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 ") '--. '..........! -n -0 :J!: ~ .0 .> Re: Estate of Brian J. Barger Estate File No. 21-08-0223 Our File No. 801-14865 UI Dear Ms. Strasbaugh: We enclose the following for filing on behalf of the above-captioned estate: 1. The original and one copy of the Inheritance Tax Return; 2. The original and one copy of the Inventory; and 3. Our check in the amount of $30.00, made payable to the "Register of Wills," representing your filing fees due. Please process these documents at your earliest convenience and return a time- stamped copy of the Inheritance Tax Return cover page (also enclosed) and Inventory to our office. A self-addressed, stamped envelope is enclosed for your convenience. Thank you for your assistance in this matter. If you have any questions regarding the above, please call me. Sincerely, WIX, WEN.GER & WEIDNER , ,';,/e>) .1, . ""t" " 1-' ,"" I " By:, t C" ~t.t .:..../; t- -i.t Denise B. Williamson Paralegal 1-_._- /dbw Enclosures 3DV1SOd sn o 01 ~ CO ~ CD L{) L{) ~ ~ ;::: ~ ~ o a) ;2 o I"- ~ E N 0 ('\1 U: ~ ] ;;; ::!: ~31SV'H '$." .. 't - - _. - == - - - - _. ~ - - ~ - - - - - ...::... -=- - - - - -- .......... ......a Hb. ',"lRL: rn-"'''l"' I'" j.:: IJ!,) r I .. i '., (I'!! I ( .1..1..,' 2008 HAY ~:,'. '.:,'1 - &. 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