HomeMy WebLinkAbout12-19-08J 15056051047
REV 1500 EX (O6-OS)
OFFICIAL USE ON V
PA Deperimentot Revenue County Code Year
Bureau otlndividualTaxes File Number
INHERITANCE TAX RETURN
PO BOX 28(1601 ~J I
Hanisburg, PA 17128-0601 RESIDENT DECEDENT J(
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
19 / ~ Y ov~~ /~ Z~ Zooms i ZI s/ 9~z
Decedent's Last Name Suffix Decedent's First Name MI
FAR~EK .12.~s ~
(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 WI THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
! 1. Original Retum O 2. Supplemental Retum O 3. Remainder alum (date of death
prior [0 12- 3-62)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Es to Tax Retum Required
death aRer 12-12-82)
O 6. Decedent Dietl Testate O 7. Decedent Maintained a Living Trust 6. Total Numb r of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to untler Sea 9113(A)
between 12-31-91 antl 1-1-95) (Attach Sch O)
CORRESPONDENT - THIS SECTION MUST SE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION HOULD BE DIRECTED T0:
Name Daytime Telephon Number
~ 613~R ~ F,g ~ /S~2 `7i~ 7 ~~ Ysyy
Firm Name (If Applicable)
REGISTER WILLS USE~LY
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First line of address ~ I'-~~
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City or Post Office State ZIP Code ~iLED I
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Correspondent's e-mail address:
Under penalties d perjury, I tledare Mat 1 have examined Mis realm, indutlirg accompanying schetlWes and statements, and to the bas W my knowledge and belief,
it is tme, mmecl and complete. Declaration of Paperer other Man the personal representative is based on all information of which pre arer has any Imowle0ge.
SIG E OF PERSON RESP SIBLE FOR FILING RETURN ATE
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SIGNATURE OF PR PARER dfHER
AN REPRE
ATIVE
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ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051047 1505605 047
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15056052048
REV-1500 EX
Decedent's St
Decetlent's Name: J
RECAPITULATION
1. Real estate (Schedule A) ............................................. 1.
2. Stocks and Bonds (Schedule B) ....................................... 2. Y
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
:ial Security Number
iyoy~~
~,-~_
r~y~.~~
4. Mortgages 8 Notes Receivable (Schedule D) ......................... .... 4. ,
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .... .... 5. JS a 7-. ®`v
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. ..
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.... .... 7. ,
8. Total Gross Assets (total Lines 1-7) ................................ .... 8. ~ b (~ 3 (~• ~. y.
9. Funeral Expenses 8 Administrative Costs (Schedule H) ................. .... 9. (~ '7 l] , Q
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............ ... 10. / Z Y
7
.
y
3'
11. Total Deductions (total Lines 9 & 10) ............................... .... 11. I [
/
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7
3 ~ / , / Y
12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. ~ 3 / Z , ~ ('.
13. CharRable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) .................... .... 13. ,
14. Net Value Subjeet to Tax (Line 12 minus Line 13) ..................... ... 14. S Z 3 I Z, 7 Q
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
16. Amount of Line 14 taxable
at lineal rate X .0 _ S 2, 3 I Z • 7.Q 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17,
18. Amount of Line 14 taxable
at collateral rate X .15 . 18.
19. TAX DUE ....................................................... .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
3 ~y.D7
3Sy.D7
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Side 2
15056052048 1505605 048
REV-75nn EX Page 3
Decedent's Complete Address:
Flle Number
ZOO -UI/6~
DECEDENTS NAME ,~
STREET ADDRESS ~
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Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payrrcents
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
TotalCredits(A+g+C) (2)
3. Interest/Penalty if applipble
D. Interest ~, Z O __
E. Penalty ,~-Z
~~-- Total InteresVPenalty (D + E) (3)
4. ff 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)
Z3sy,~~
t/ Ys- ~ z
5. If line 1 + Line 3 is greater than Line 2, enter the di0erence. This is the TAX DUE. (5)
Z ~1 -~
A Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPR PRIATE BLOCKS
1. Did decedent make a transfer and: N
o
a. retain the use or income of the property transferred :.......................................................................................... ~~
v
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,Ly.
b. retain the dght 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. ff death occurred after December 12, 1982, did decedent transfer property within one year of death ,
without receiving adequate consideration? ..................................................._..._.................................................... ~.
3. Did decedent own an "in Wst tar" or payable upon death bank account or security at his or her death? .............. ~'
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficary designa6on? ........................................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE ~ AND FILE 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)].
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 s rviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse tram lax, and the statutory require ents 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, 20D0:
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)J.
The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is four and one-ha (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. §911 (a)(1.3)]. A sibling is defined, under
Sermon 9102, as an individual who has at least one parent in common wflh the decedent, whether by blood or adoption.
REV-1503 EX+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
,Ti~~ s ~a.~e. ZDa~ -
U//~6
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
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FEVd508 EX~(M19]1
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHRESIDENTD EDENTRN PERSONAL PROPERTY
ESTATE OFD, FILE NUMBER
~i'~s G'a,d~l~ vrJ~-
//6~
Include the proceeds of litigation and the date the proceeds wem receNed by the estate. All property jointlyowned with the right of survivo hip must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
,. ~NL 6.~-rk /~ccf #s/-yvys-~y5~ ~Z
Z~1~6~
;
Po box 6o y
®/ {~S~v~~~ ~~ /S 230- 973Y
2, ~nTP~~i1J' ~a"'~ /~'cc~ #ZOGOUOS&y ~~~.57~ 3!
33 y5 ~''~a-key S t.
C a-„-# 1~~ J / ~~` l ~O 11
3, ~~~P ,~
y ~ ~~ ~CGf~ZUbOGUS7~ g3g;~
33 ~~ ~a-kef s~
cum, ~~,~~ P~ ~~~~~
TOTAL (Also enter on line 5, Recapitul lion) a Z U flay,
(If more space is needed, insert additional sheets of the same size)
Interest ~Checkin~.~i~;collnt Statement
PNC Yank
For the period 10/26/2007 to 7 7/28/2007
IRIS FARBER
RICHARD E FARBER
54 BAYBERRY DR
MECHANICSBURfi PA 17050-3188
PNCBANK
Primary account nu~ber. 51-4043-1497
Page 1 of 2
Number of enclosur s:0
f}~~ For 24-hour ba king, and transaction or
° Interest rate inf rmation, sign on to
'rl' PNC Bank Onli a Banking at pnc.com.
For customers rvice call l-888-PNC-BANK
between the h trs of 6 AM and Midnight ET.
Para servicio a espzliol, 1-866-HOLA-PNC
Motringt Please c ntact us at 1-886-PNC-BANK
® Write to: Custo er Service
PO Box 609
Pittsburgh PA 1 230-9738
Visit us at pnc. to
TDD terminal:l 800-531-1648
For hearnrg'vnP a' d dientx only
Give the gift of PNC Bank Visa®Gift Canis this holiday season. Petfect for everyone and available in whole do tar amomits up to $500. Stop
b a artici atin PNC Batik branch for store details.
Interest Checking Account Summary Iris Farber
Richard E Fat ber
Account number: 51-4043-1497
Balance Summary Please see tit Activity Detail section fol
additional in rmation.
Beginning Deposits and Checks and other Ending
balance other additions deductions balance
1,629.46 781.09 138.85 2,271.64
Average monthly Charges
balance and fees
2,116.00 2.00
Interest Summary As of 11/26, total of $3.35 in interest was
paid this yea .
Annual Percentage Number of days Average collected Interest Paid
Yield Earned (APYE) in interest period balance for APYE this period
0_]07. 32 2,116.00 .18
Aativ€ty Detail
Deposits and Other Additions There were Deposits and Otlter Additions
Date Amount Description totaling $78 .03.
I1/Ol 18.75 Direct Deposit - Fi/Hh [ntst
Bur Ot Pub Debt XXXXXXXXX5010
11/02 762.10 Direct Deposit - Soc Sec
US Treasury 303 XXXXX0485A
11/26 .18 Interest Payment
Online and EleotroniC Banking Deductions There was 1 nline or Electronic Banking
Date Amount Description Deduction to sling $136.85.
10/29 136.85 Direct Payment -CPA EFT Highmark XXXXX6265
Othel Deductions There was 1 ther Deduction totaling
Date Amount Description $2.00.
11/26 2.00 Check Images In Statement Fee
RORM953R-1005
Reviewing Your Statement
~ ~PNCBANK
Ptease review this slalemenl carefidly andreooncile it with your records. Call dte telephone number on the app r tight side of the first page
ofthis statement if:
• you have any questions regarding your accounts(s);
• your name or address is incorrect;
• you have a business account and your tax identification number is missing or incorrect;
• you. have arty questions regarding interest paid to an interest-bearing account.
Balancing Your Account
Update Your Account Register
Compare: The activity detail section of your statement to your account register.
Check O(f: All items in your aooowrt register that also appear on your statement. emend}er to begin
with the ending date of your last statement (An asterisk {* } wilt apps r in the Checks
section if there is a gap in the listing of consecutive check nwnbers.)
Add to Your Account Register Any deposits or additions including interest payments and ATM or ele tronic deposits
Balance: listed on the statement that are not already entered in your register.
Subtract From Your Account Any account deductions including Cees and ATM or electronic deducti ns listed on the
Register Balance: statement that are not already entered ht your register.
Update Your Statement Information
Step 1:
Add together
de
osits and
Date of Depoak
Amount Step 2:
Add together
h
k
th
d check xa
Dsdaetbw De r ar
crirytion
Amount
p
other additions c
ec
s an
o
er
deductions listed
listed hr
our in
our accowrt
y
account register y
ister but not on
re
but not on your g
our statement
statement y
.
.
7ota1 A
Step 3:
Enter the ending balance recorded on your statemeut $
Add deposits and other additions not recorded Total A + $
Subtotal= $
Subtfact checks and other deductions not recotdedTotal B - $
77te result should equal your account register balance = $
Total 6
Verification of Direct Deposits
To verify whether a direct deposit or other transfer to your account has occttined, cal I us 7 da}+s a week finm 6:00 A. ~d. to 1\~[idnight (E'1~ at
the customer setx~ice number listed on the upper right side of the first page ofthis statement.
Electronic Funds Transfers
In case oC en'ors or gnesfione shout yonr elechnnic tlunsfera or if yon need mote htfotmafion about a hmisfer, call ns 7 days a week finm 6:00 .h1. to >\IirLrighr (P,9) at the
onstmuer service number listed ou the upper right side of the fast page of tlds statement Or, if yon prefer, please write as at Customer Servic . LO. }3 ox (r09. Piitsbnrgly PA
15 23 0-0 6 0 9. If you believe there is n emblem, yonr mast contact us no later than 60 days ader the ending date of the nrst sGntement nn wldch he error or prdilnn appeared.
Yon will need to provide the fo0owhrg inComrafinu:
' Your uame and account mmrbegs);
• A Aesciipfion of dw ennr or the finnsFer yon are gnesfiouing. Please explain as clearly as yon can why }'on need more infonnafiou ttt wLy on believe au anor rrns made;
' 7Le do0u-amam[ of the suspected error.
R'e will invenfigafe yore complaint and will arnect any error promptly. If the invesfigafion takes longer than 10 business days, we wi0 credit ~,
ammnd yon [Link is in ennr, so [hat yon will have use of the fimds dining the fine it ekes us to complete our invealigafion.
acconm (or the
,~!~ FORM953R-1005
Member FDIC I_:.,J Equal Housing Lender
. ~ .. yp.we... n ~ a . , ~ hatt1L'er ..
^~
Integrity
B A N K
3345 Market Stree{ Camp Hi[[, PA 17077
~~~~~ vzo-avoo
.*Ff•el :'i ~.(~ .ail'{;..{f .w.aNMrs:.,gt9'~`A~~'. :rSAFAMilban t.
IRIS E FARBER
54 BAYBERRY DRNE
MECHANICSBURG PA 17050-3188
Checking
MONEYMARKET CHECK Beginning Rate 2.96000
ACCOUNT NUMBER 0206000589
PREVIOUS STATEMENT BALANCE AS OF 10/31/07 ........................
PLUS 1 DEPOSITS AND OTHER CREDITS ...................
LESS 0 CHECKS AND OTHER DEBITS ......................
CURRENT STATEMENT BALANCE AS OF 11/30/07 ............. ... ..........
NUMBER OF DAYS IN THIS STATEMENT PERIOD 30
• Account Transaction
DATE DESCRIPTION DEBITS
11/30 INTEREST PAYMENT
• Balance By Date
10/31 16,529.23 11/30 1H, 579.31
PAYER FEDERAL ID NUMBER ................. 52-2369022
INTEREST PAID YEAR TO DATE .............. 220.35
Page: 1
Enclosures: 0
nt Date: 11/30/2007
Number: 206000589
MBINED-031
',529.23
95.08
.00
,579.31
4$.08
*** INTEREST EARNED THIS STATEMENT PERIOD ***
DAYS IN PERIOD ......................... 30
INTEREST EARNED ........................ 95.08
ANNUAL PERCENTAGE YIELD EARNED (APY).... 3.008
~w _.. ~,;µy.. . ,,..ax..= ~ .M .. e+~+mtMr~ .-~kte~.,~. .^.tiy. ~as:a..., nr +.
Page: 2
Enclosures: 2
IRIS E FARBER
54 BAYBERRY DRIVE
MECHANICSBURG PA 17050-3188
Checking
PRIVILEGED CHECKING Beginning Rate l.ooooo
ACCOUNT NUMBER 0206000571
ACCOUNT TITLE IRIS E FARBER
PREVIOUS STAmxrwvfam BALANCE AS O& 10/31/07 ........................
PLUS 1 DEPOSITS AND OTHER CREDITS ...................
LESS 2 CHECKS AND OTHER DEBITS ......................
CURRENT STATEMENT BALANCE AS OF 11/30/07 .........................
NUMBER OF DAYS IN THIS STATEMENT PERIOD 30.
• Account Transactions
DATE DESCRIPTION DEBITS
11/10 INTEREST PAYMENT
• Check Transactions
SERIAL DATE AMOUNT SERIAL DATE
1029 11/20 7,050.00 1030 11/20
• Balance By Date
10/31 9,776.01 11/10 9,785.11 11/20 36.11
PAYER FEDERAL ZD NUMBER ................. 52-2389022
INTEREST PAID YEAR TO DATE .............. 78.18
nt Date: 11/30/2007
Number: 206000571
,776.01
9.10
,797.00
38.11
10
21697.00
*** INTEREST EARNED THIS STATEMENT PERIOD ***
DAYS IN PERIOD ......................... 30
INTEREST EARNED ........................ 5.10
ANNUAL PERCENTAGE YIELD EARNED (APY).... 1.009
IPIB FM0B1 IIFLU
RO6FI1f LFM061 M FOh
]2~~~~1
~iEgMViRF~iN» ~p,If:Pit~v' / ~~~ ~.u~n
~ ~ ' n ~ re in ~ ~ E 7, GSa W
J _ 4 1 p
~4`~ ' ~ gllli e 6.•
u•~_M~
~ ~~~
00313387871: Ot060005P it 3029
PO FM091 1YJV
M6 ~LFMBFA JRPM;
F/. 1R0 !R' C tl:> d4.-! /~/ ~~ ..e..w
[
0 q
/1~~/~
nnximn
rc
F'n Jiit•. ~ t~/7~
~
-/
~
3
~
~j
~
j~
~~
_~
pt _ .~I
~
%
~
I:p 313187871: 0206000573 03~7~
0 ~pOpO !$q 700/
11/20/2007 1030 $2,697.00
........._...
Account Number:
Page: 3
os~l .,..1
REV-151t EX+(1J-0ej
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
_
.l/iS f' r~71~ wU7-U/ ~6
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t. /( //,y~
/103 Fd/{Lf~ / /UH'i' ~ ~GU ~~
EW I n ~/
FY ~
~ /
~/
~, ~ 7
~
f~UWt-~ ~I~z) ~~~7, U>=
/'~ow/mss ~/UG~~ Z72~ yZ
e. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City Stale Zip
_
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (Ii decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City Stale Zip - _. _
Relationship of Claimant to Decedent
4.
Probate Fees js ~ UU
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitul ion) $ SV ~~ OI
(It more space is needed, insert additional sheets of the same size)
REV~7512 EX+(12-03)
SCHEDULE.1
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAx RETURN DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF
~~i 5 ~a/hri ZGO FILE NUMBER
-UI/66
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbu ed medical expenses.
ITEM
NUMBER
DE
SCR
IPTION VALUE AT DATE
OF DEATH
t L p
/
/
/
~/a~'emon/ /Uu~'s/ng C~~~h~(j C/C3G3~ S7GZ,
Cu- ~IS ~e ~/t j 7U I3
la,.,.7oH /'L 336/y
%~-~ ~L 336%y
f}cvr.5
6v
~ Q/¢
~~ n
/
C PiYG+~~G sCrvi~cf;, (uJ(/~TGC~Gea) C/D/U~
/ /
~ n~Prra/ y~y3 Gi
//
//
~~ /~AO(taQ~i/ a D~
® l>` ~~~~ ~ ~2e vie 5~~~~« ~iol/) Y9 3z
Oh,luJ.~l~~,u /~~
TOTAL (Also enter on line 10, Recapitulation) b / Z 7 /~ ~ 3
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+(9-00) -
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
.Lr~~s Ya hri Za~-7-
//66
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDEN
Do Not Llst Trustee(s) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers under
Sec. 9116 (a) (12)]
1 Kuho~~ L, /-a.yei Son 57~
lay ,vo.~ Rrbr. i2~
Uahs ~~ l 9 ys6
f'L~a ~,~ E Vi=a,-~~ Su.. .Sv~
~o iti~~N1. C~/lc~~. s~
Cum/isle %/t 17~I3
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 16, AS APPROPRIATE, N REV-1500 COVER SHEET
tI NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert atlditional sheets of the same size)
Department of the Treawry -Internal Revenue Service 2~U7
Form ~ ~4~ U.S. Individual Income Tax Return
IRS I/se Only-
DO not write or staple in Nis space.
For the r tan 1 -Dec 31, 2007, or other tax year beginnin , 2007, ending , 20 oMe rvo. i sas~oma
Label
($ee instructions.) Your first name MI Last name
Iris E Farber Your social sxurily number
191-14-0485
Use the
IRS label. Ii a joint return, spouse's first name MI Last name Spouse's social sseuria numbx
OtherWlSe,
please print
or type. Home adtlress (number and street). If you have a P.O. box, see instructions. Apartment no.
54 Ba berr Drive You must entef your
social security
~ number(s) above.
te ZIP cotle
tr
ti
St
i
d
i
Presidential uc
ons.
a
gn ad
ress, see
ns
City, lawn or post office. If you have a lore
Mechanicsbur PA 17050 chageyour~taxolr~efifod.n~
Election
Campaign ' Check here if you, or your spouse if filing joilRly, ward $3 to go to this fund? (see instruc0ons) ................
^ You ^ Spouse
Filin $tatUS 1
9 2
3 X Single 4 Head of household (with qu
Married filing jointly (even if only one had income) instructions.) If the qualifyin
but not your dependent, ent
Marded filing separately. Enter spouse's SSN above & full name here . ~ lifying person). (See
person Is a child
r this child's
Check only
one box. name here . ~ 5 Quali in widower wdh depende t child (see insVUCgons)
EXempt1On5 6a
b X Yourself. If someone can claim you as a dependent, do not check box 6a .......
S ouse .........................................................................
- L o~"r,~a`„d fiy°d 1
ao.m cnitdf.n
c Dependerds:
First name Last name (2) Dependent's
social security
number (3) Dependent's
relationship
to ou
y (4
na
oh~i d
tax
(see if ~ ~""r1O1
iNing Iwad
r miid wHh you -
redll • did trot
InsVSJ Iivs with you
dYa t0 d1VOfOe
Or SB~iraL011
If more than (ace lllall5)
UBpendeMs
on ec not
entered above .
four dependents,
see instructions. aad^amb.r:
...................................... .....
d Total number of exem lions claimed ...... on tirros
...... above..... ~
1
7 Wages, salaries, tips, etc. Attach Form(s) W-2 ....................................... 7
Income Sa Taxable interest. Attach Schedule B if required ...... . .............................. 8a 100 267.
b Taxcxempt interest. Do not include on line Sa ............. ~ 8b
Attach Form(s) 9a Ordinary dividends. Attach Schedule B if required ..................................... '
9a
W-2 here. Also b Qualified dividends (see insVS) .......................... _ ...... 9b
attach Forms 70 Taxable refunds, credits, or offsets of state and local income taxes (see instructions) .................
" ~ ~ " ~. `. ;,.2~.-
10
W-2G and 1099-R
if tax was withheld. 11 Alimony received ................................................................... 11
12 Business income or (loss). Attach Schedule C or C-F2 ................................ 12
If you did not
2 13 Capital gain or (loss). Att Sch D if regd. If not read, ck here ......................... ~ ^
t
W 13
ge
a
-
see illstru~ons. 14 Other gains or (losses). Attach Form 4797 ............................................ 14
15a IRA distributions ............ 15a bTazable amount (see instrs) . 15b
l6a Pensions and annuities ...... l6a b Taxable amount (see instrs) . l6b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . 17
but do 18 Farm income or (loss). Attach Schedule F ............................................
Enclose 18
,
rwt attach, any 19 Unemployment compensation ....................................................... 19
paymerd. Also, 20a Social security beneFgs ........... ~ 20a~ 9, 961 . ~ b Taxable amount (see instrs) .
lease
se ZOb 8, 9 67 .
p
u
Form 1040-V. 21 Other income 21
______________ ______ ___ _ ___
22 Add the amounts in the far ri ht column for lines 7 throw h 21. This is our total income 22 108 739 .
23 Educator expenses (see instructions) ...... ........ 23
Adjusted 24 Certain business ezpenses of reservists, performing artists, and fee-basis
Gross governfnent officals. Attach form 2106 or 2106-EZ .......... . ......
24
~
IrICOme 25 Health savings account deduction. Attach Form 8889 ........ 25 a ,
>
~
'
i'
26 Moving expenses. Attach Form 3903 ....................... 26 ,
.
,
~
"`
27 One-half of self-employment tax. Attach Schedule SE ....... 27 ~-..
28 Self-employed SEP, SIMPLE, and qualified plans ........... 28 ~~;
29 Self-employed fwalth insurance deduction (see instrudions) ............. 29 ""'
h
30 Penalty on early withdrawal of savings ....................
30 .,;
'"s
-
31 a Alimony paid b Recipient's SSN .... ~
31a ~
'
32 IRA deduction (see instructions) ..... ......... 32 '~`
33 Student loan interest deduction (see instructions) ........... 33 =~~r,.
34 Tuition and fees deduction. Attach Form 8917 ........ . ...... 34 x
35 Domestic produdion activities deduction. Attach Form 8903
.. .......
35 f
~
36 Add lines 23-31a and 32.35 ...................... _ .......... ...... .................... 36
37 Subtract line 36 from line 22. This is our ad'usted toss inco me .. ................... 37 108 734.
BAA For Disclosure, Privacy Act, and Paperwork Reduction Ad Notice, see instructions. FDIAOt tt laoa~m Form 1040 (2007)
corm 1040 7 Iris E Farber
91-14-0985 Pa e 2
d 38 Amount from line 37 (adjusted gross income) ....
T 38 108 734.
ax an
Credits 39a Check r XB You were born before January 2, 1943, 8 Blind. Total boxes
rf
-
39a
: l Spouse was born before January 2, 1943, Bhnd. checked
Standard _ b Ii your spouse itemizes on a separate return, or you were actual-status alien, see instrs and ck here - 39 b
Deduction 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ................... 40 7 6, 328 .
for - q1 Subtract line 40 from line 38 . ............................................
~~~~~~~~~~ 41 32 406.
•People who
checked any box 42 If line 38 is $117,300 or less, multiply $3,400 by the total number of exemptions
on line 39a or claimed on line 6d. If line 38 is over $717,300, see the instructions ..................... 42 3 400.
396 or who can 43 Taxable income. Subfrad line 42 from line 41.
be claimed as a If line 42 is more than line 41
emer -0 . ...................................................... 43 2 9 006 .
dependent, see ,
qq Tax (see instrs). Check if any tax is from: a Form(s) 8814 b ^ Form 4972
instructions.
c 8
Form(s) 8889 .......................
44
3, 963.
• All others: 45 Alternative minimum tax (see instructions). Attach Form 6251 ......................... 45
i
d ~ Add lines 44 and 45 .... .......... ......... .... .......... ......... 46 3, 963.
Single or Marr
e
filing separately, 47 Credg far child and dependem care expenses. Attach form 2441 ..... 47
$5,350 qg Credit for the elderly or the disabled. Attach Schedule R ..... 48
Married filing 49 Education credits. Attach Form 8863 ......... ......... 49
jointly or 50 Residential energy credits. Attach Form 5695 .... 50
~dow erg
( ) 51 Foreign tax credit. Attach Form 1116 if required .. ... 51
,
$10,700 52 Child tax credit (see instructions). Attach Form 8901 if required .......... 52
Head of 53 Retirement savings contributions credit. Attach Form 8880 ... 53
household, 54 Credits from: a ^ Form 83% b ^ Form 8859 c ^ Form 8839 .. 54
$7,850 rm
55 Other aedits: a ^ seb
b ^ eeom c ^ F 55
o
o
56 Add lines 47 through 55. These are your total credits ........ ...... .................... 56
57 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0 . ................. 57 3 963.
58 Sdf-employmerd taz. Attach Sdtedule SE ..................................................... 58
OtheY 59 Unreported social security and Medicare taz from: a ^ Form 4131 b ^ Form 8919 ...... .......... 59
Taxes 60 Additional taz on IRAs, other qualified retiremem plans, etc- Attach Form 5329 if required .................. 60
61 Advance earned income credit payments from Form(s) W-2, box 9 ..................... 61
62 Household employment taxes. Attach Schedule H ..................................... 62
63 Add lines 51.62. This is Your total tax ..................................................... 63 3, 9 63 .
Payments 64 Federal income tax withheld from Forms W-2 and 1099 ...... 64
65 2001 estimated fax paymems and amoum applied from 2006 return ..... 65
If you have a
66a Earned income cedk (EIC) ... ........ ...
quahfymg 66a
child, attach ~ b Nontaxable combat pay election .. -~ 66b~
h
d
l
EIC ,
`.^
Sc
e
u
e
. 67 Excess social security and tier 1 RRTA tax withheld (see instructions) 67
68 Additional child tax credit. Attach Form 8812 ................ 66 ~...,...
69 Amount paid with request for extension to file (see instructions) .......... 69 :--..
70 Paymems from: a ^ Form 2439 b ^ Form 4136 c ^ Form 8885 70
71 Refundable credit for prior year minimum tax from Form 8801, line 21 ... 71
72 Add lines 64, 65, 66x, and 6] through 71.
7L
These are your total paYmsnts ................................... ...... ...................
Refund 73 If line 72 is more than line 63, subnact line 63 from line 72. This is the amount you overpaid .............. 73
Direct deposit? 74a Amount of line 73 you want refunded to ou. If Form 8888 is attached, check here .. - 74a
See instructions - b Routing number ........ XXXXXXXXX ~ c T e: Checking ^ Savings
and fill in 746, . d Account number ....... XXXXXXXXXXXXXXXXX ~
74c, and 74d or '
Form 8888. 75 Amount of line 73 ou want a lied to our 2008 estimated taz ....... - 75
A1110Unt 76 Amount you owe. Subtract line 72 from line 63. For details on taw to pay, sce instructions ............... 76 9 143 .
You Owe 77 Estimated tax enal see instructions ........ 177 180 ' ' ~'
Third Party Do you warn to allow another person to discuss this return with the IRS (see insWCtions)? ...... Yes. Co
' plete the following. X No
Designee
s Phone
Desi nee name ~ no. ~ Personal Identinwlion
number (PIN) ~
$1 n Under penalties of perjury, I declare that I have examined this return and accomparrying schedules and statements, and to the esl of my krwwiedge and
9 belief, they are true, correct, and complete. Declaration of praparer (other than taxpayer) is based on all inbrmation of which eparer has any knowledge.
Here
Vo igna r Date Vour occupation
Joint return? `-~
~
~ Daytime phone number
See instructions. - f`
~. fU 5~ etired
~"
Keep a copy pouse s signature. It a lolnt return, both must sign. Date Spcuse's occupation viyt ;ye
for your records. ~ ''`
Date Preparer's SSN or PTIN
Preparer's
~
Paid signature Check ii selr-emptoyetl
Preparer's Firm's name Self-Prepared
Use Only (°r y°ars it
self-employed),
EIN
address, and
ZIP code Phone
Form 1040 (2007)
FDIAON2 12/06/07
J 0700113172
PA-40 - 2007
Pennsylvania Income Tax Return
ENTER ONE LETTER OR NUMBER IN EACH BOX.
Do Not Use Your Preprinted Label
191140485
FARBER
IRIS
54 BAYBERRY DRIVE
MECHANICSBURG
E Oaupation RETIRED
Occupation
N
N
R
Extension.
Amended Return.
Residency Status.
PA ResidenUNonr sidenUPart-Year Resident
from to
Single/Married, Fil ng Jointly/Married,
Filing Separately! final RetumlDeceased
Date of Death 12607
Farmers.
School District Name CARLISLE AREA
PA 17050
21110
1 a Gross Compensation. Do not include exempt income, such as combat
zone pay and qualifying retirement benefits. See the instructions.
7 b Unreimbursed Employee Business Expenses.
1 c Net Compensation. Subtract Line 1 b from Line 1 a.
2 Interest Income. Complete PA Schedule A if required.
3 Dividend and Capital Gains Distributions Income. Complete PA Schedule B if required.
4 Net Income or Loss from the Operation of a Business, Profession, or Farm.
5 Net Gain or Loss from the Sale, Exchange, or Disposition of Property.
6 Net Income or Loss from Rents, Royalties, Patents, or Copyrights.
7 Estate or Trust Income. Complete and submit PA Schedule J.
8 Gambling and Lottery Winnings. Complete and submit PA Schedule T.
9 Total PA Taxable Income. Add only the positive income amounts from Lines 1 c,
2, 3, 4, 5, 6, 7, and 8. DO NOT ADD any losses reported on Lines 4, 5, or 6.
70 Other Deductions. Enter the appropriate code for the type of deduction. N
See the instructions for additional information.
17 Adjusted PA Taxable Income. Subtract Line 10 from Line 9.
PAIA0412 11/13/0]
D
N
EC Page 1 of 2 FC
^700113172 m m
1a ~ 0
1b 0
1c 0
2 344
3 0
4 0
5 0
6 0
7 0
8 0
9 344
10 0
11 344
0700113172 J
PA-40 - 2007
Social Security Number
0700213186
191140485 Name(s)Ir1S E Farber
12 PA Tax Liability. Mukiply Line 11 by 3.07 percerd (0.0307).
13 Total PA Tax Withheld. See the instructions.
14 Credit from your 2006 PA Income Tax return.
15 2007 Estimated Installment Payments.
16 2007 Extension Payment.
17 Nonresident Tax Withheld from your PA Schedule(s) NRK-1. (Nonresidents only)
18 Total Estimated PaymeMS and Credits. Add Lines 14, 15, 16, and 17.
Tax Forgiveness Credk.
19a filing Status: 01 Unmarried or Separated 02 Married 03 Deceased
19b Dependents, Part B, Line 2, PA Schedule SP
20 Total Eligibility Income from Part C, Line 11, PA Schedule SP.
21 Tax Forgiveness Credit from Part D, Line 16, PA Schedule SP.
22 Resident Credit. Submit your PA Schedule(s) G-R with your
PA Schedule(s) G-S, G-Land/or RK-1.
23 Total Other Credits. Submit your PA Schedule OC.
24 TOTAL PAYMENTS and CREDITS. Add Lines 13, 18, 21,22, and 23.
25 TAX DUE. If Line 12 is more than Line 24, enter the difference here.
26 Penalties and Interest. See the instructions. Enter code:
If including form REV-1630, mark the box. N
27 TOTAL PAYMENT. Add Lines 25 and 26.
28 OVERPAYMENT. If Line 24 is more than the total of Line 12 and Line 26, enter
the difference here.
The total of Lines 29 through 35 must equal Line 28.
29 Refund -Amount of Line 28 you want as a check mailed to you. Retund
30 Credit -Amount of Line 28 you want as a credit to your 2008 estimated account.
31 Amount of Line 28 you want to donate to the ~Id Resource Conservation Fund.
32 Amoufd of Line 28 you ward fo donate to the Military Family Relief Assistance Program.
33 Amount of Line 28 you want to donate to the Governor Robert P. Casey Memorial
Organ and Tissue Donation Awareness Trust Furut.
34 Amount of Line 28 you want to donate to the Juvenile (Type 1) Diabetes Cure
Research Fund.
35 Amount of Line 28 you want to donate to the Breast and Cervical Cancer
Research Fund.
SigrxWre(s). UrMer penalties of penury, I (we) tledare that 1 (we) have ezamined this return, indudirg all
accomparying schedules and statements, and to the best of my (our) belieL Ney are true, correct, and complete.
Yoy(Signature Spouse i Signature, it filing joirNy
~reparer's ame antl Telephone Number Date
7v ~ Gam
Self-Prepared
Pa e2of2
PAIA ®2 11/13/07
0700213186
12 11
13 0
14 0
15 0
16 0
17 0
18 0
19a 00
19b 00
20 0
21 0
22 0
23 0
2y 0
25 11
26 0
27 11
28 0
29 0
30 0
31 0
32 0
33 0
34 0
35 0
Firm EIN Preparer's 5$N/PTIN
0700 13186
A
F.IF'ILES'~DATAFN.E\WILLSV]iT.ril OR GINAI RETAINED Ry;.
d~~athon, ~ uw oEFICER
tc~otff il/YiCCiants $ l!~tM
A PRO SSIONAL CORPORAT70N
EAST NIGH STREET'
ARLI$LE. PA 1]013
LAST WILL AND TESTAMENT 1]I]I y0-3311
I, IRIS E. FARBER, of 127 West Ridge Street, Cazlisle, Cumberland Cou ty, Pennsylvania,
being of sound and disposing mind and memory, do hereby make, publish and de laze this to be my
Last Will and Testament, hereby revoking any and all former Wills or Codicils y me made.
1.
I direct that all my legally enforceable debts, funeral expenses, testamen ary expenses and
all inheritance taxes (whether such taxes may be payable by my estate or by an recipient of any
property) shall be paid from my residuary estate as soon as practicable after my d ease and as part
of the administration of my estate. My Executor shall have no duty or obl gation to obtain
reimbursement for any such tax so paid, even though on proceeds of insurance or they property not
passing under this Will.
2.
I give, devise and bequeath all of my estate, both real and personal prope , in equal shares,
unto my sons, ROBERT L. FARBER and RICHARD E. FARBER, absolutely.
3.
I nominate, constitute and appoint my son, ROBERT L. FARBER, as Exe utor of my estate.
In the event he is unwilling or unable to so act, then I appoint my grandson, ROB RT L. FARBER,
7R., as Executor of my estate.
4.
I direct that my Executor shall not be required !'o file a bond to se ure the faithful
performance of his duties in any jurisdiction.
5.
I authorize and empower my Executor, in his sole and absolute discreti , to purchase or
otherwise acquire and retain any investments of which I die seized or any real or ersonal property
of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of o grant options in
regazd to any or all property of any kind forming a part of my estate for such to and such prices
as * may deem advisable; to borrow money for any purposes connected with
protection and
I.E.F.
Page 1 of 3 Pages
preservation of my estate; to mortgage or pledge any real or personal property f
estate or to join in or secure the partition of same; to compromise any claims
estate against others or of others against my estate; to make distribution in kin
shaze to be composed of cash, property or undivided fractional shares in propel
from any other share; to employ agents, attomeys and proxies and to delegate 1
as my Executor considers desirable and to pay reasonable compensation for sc
be rendered by such agents, attomeys and proxies; and to execute and deliver
may be necessary to carry out any of these powers. In addition, I direct that my
the power to conduct an inventory of any safe deposit box necessary to the ad
estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this
~-- ,~ .
Iris E. Farber
SIGNED, SEALED, PUBLISHED AND DECLARED by the
for her Last Will and Testament, in the presence of us, who at her request, have
our names as wit1~esses thereto, in the presence of the said Testatrix and of each
ping a part of my
r demands of my
and to cause any
different in kind
them such power
i services as may
;h instruments as
ecutor shall have
inistration of my
~3~' day of
Testatrix, as and
subscribed
Page 2 of 3 Pages
e
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, Iris E. Fazber, IVc~ ~f ~ ~'TO "~~1 _ ,and ~~Au'L' i A \
the Testatrix and the witnesses, respectively, whose names aze signed to the fore
being first duly sworn, do hereby declaze to the undersigned authority that the Te
executed the instrument as her last Will and that the Testatrix has signed Willi
Testatrix executed it as her free and voluntary act for the purposes therein expres
of the witnesses, in the presence and hearing of the Testatrix, signed the Will as
to the best of his/her knowledge the Testatrix was at that time eighteen yeazs c
sound mind and under no constraint or undue influence.
Witness
Subscribed, sworn to and acknowledged before me by Iris E. Fazber,
subscribed Vand /sworn to before me by ~ Vey y , ITT
~ARC.i ~ !. CLmPTO ti > the witnesses, this ~3`~`day of
L. MYERS,
omg instrument,
tatrix signed and
gly, and that the
~d, and that each
witness and that
' age or older, of
Testatrix, and
2000.
and
Public
Page 3 of 3 Pages
LOCAL REGISTRAR'S CERTIFICATION OF D
WARNING: It is illegal to duplicate this copy by photostat or photoc
Fee for this certiticate, $6.00
P 13~33~;3~~
Certification Number
f his is to certi Fy
correctly copied f
Luly filed with n
:ertificate will I
tecords Office fi
p. f~~
~ocal Registrar
9znsslu rIEV nrzma COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEgLTH • VRAL RECORDS
svrErmNxxs lx
P~E+^ CERTIFICATE OF DEATH
m"OI lNn (See Inetruollorxa entl ezemPles on reversal
5FAiE FllF
k
TH
iat the information here given
m an original Certificate of Deg
us Locnl Registrar. The origir
forwarded to the Sate Vi
permanent filing.
N~2
Date Issued
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7
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I,
S
CERTIFICATE
Register for the Probate of Will and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby cer ify that on
the 27th day of December, Two Th usand and
Seven,
Letters TESTAMENTARY
in common form were granted by t e Register of
said County, on the
estate of lRIS E FARBER 1 ate of MIDDLESEX TO
(First, Middle. Lasp
in said county, deceased, to ROBERTLFARBER
!First, Middle, Last
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and
seal of said office at CARLISLE, PENNSYLVANIA, this 27th da:
Two Thousand and Seven.
File No. 2007-01166
PA File No. 21- 07- 1166
Date of Death 11/26/2007
S.S. # 191-14-0485
affixed the
of December
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED