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Home My WebLink About12-24-081505607121 '-' REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 1 0 7 6 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 0 0 8 2 0 0 8 0 8 0 4 1 9 3 2 Decedent's Last Name Suffix Decedent's Firs t Name MI F O S T E R L E R O Y J (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 ^X 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of-death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E '7 1 7 2 4 9 2 3 5 3 Firm Name (If Applicable) I R W I N 8 M c K N I G H T First line of address 6 0 W E S T P O M F R E T S T R E E T Second line of address City or Post Office C A R L I S L E Correspondent's a-mail address: State ZIP Code P A REGISTER OF WILLS USE ONLY r.:, :. ; ;_:~ ~.,, - 7 _, _ ~ -? `~ i r~,_~ - - .~- ,. ~,, DAME FILED _ ~ i , ~ ~ ~ _ ~ y .. ~ . , : -7 1 7 0 1 3 c~ , Under penalties of perjlyry, 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 cfimplete. Declaration o~repare~~the~an the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF SON RESPON F FILI RETURN n f, .DATE ~ ADDRESS / / / / 172 BIG SPRING TERRACE NEWVILLE PA 17241 Sl MATURE OF P ARE OT R *HAN REPRESENTATIVE DATE A SS 6 WEST POMFRET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J 1505607221 REV-1500 EX Decedent's Social Security Number decedent's Name: L E R O Y J F O S T E R RECAPITULATION 0 0 0 1. ........................ Real estate (Schedule A) .......... ..... . 1. 0 . 0 0 2. ........................ Stocks and Boncis (Schedule B) .... ..... . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages 8 Notes Receivable (Schedule D) .................. .... .. 4. 1 4 9 7 1 . 3 8 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . .... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . .... .. 6• • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 0 0 0 (Schedule G) ^ Separate Billing Requested . .... .. 7. 8 1 4 9 7 1. 3 8 8. Total Gross Assets (total Lines 1-7) ......... .... .. . 9 5 3 0 ' 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) . .......... .... • .. 0 ' 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...... .... .. 10. 11. Total Deductions (total Lines 9 & 10) ..................... .... .. 11. 5 3 0 • 0 0 12. Net Value of Estate (Line 8 minus Line 11) ................... .... .. 12• 1 4 4 4 1 . 3 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............ .... .. 13. 1 4 4 4 1 3 8 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 0 0 0 15 Q. 0 0 (a)(1.2) x.o ~ . 16. Amount of Line 14 taxable 1 4 4 4 1 3 8 6 4 9. 8 6 at lineal rate X .045 16. 17. Amount of Line 14 taxable 0 0 0 17 0 • 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 0 • 0 0 at collateral rate X .15 18. 1s. Tax Due 6 4 9. 8 6 ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505607221 1505607221 ADDITIONAL Personal Representatives Estate of Leroy J. Foster - SS# 208-24-4029 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. ~~. ~ Signature `~k~~ ~ .~"~. Name Deborah L. Fetter Address Line 1 2718 Ritner Highway Address Line 2 City, State, 'Lip Carlisle, PA 17015 Date REV-1500 EX 'Page 3 n,:,...,i...,~~~ !'r,rv,r,ln4n ArlrlrncC• File Number 21 08 01076 ................~ ~. ...-•r---- - ----- - DECEDENT'S NAME LEROY J. FOSTER __ _ ___ ----- - STREET ADDRESS 714 GRAHAMS WOODS ROAD -- CITY I STATE -- - --- ZIP -- NEWVILLE ! PA ' 17241 Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) (1) 649.86 2. CreditslPayments A. Spousal Poverty Credit: B. Prior Payments C. Discount 32.49 Total Credits (A + B + C) (2) 32.49 3. Interest/Penalty if applicable D. Interest E. Penalty Total InteresUPenalty (G + E) (3) 0.00 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 617.37 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (58) 617.37 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 : ................................................................. ..... ^ ^ ^ b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ ................................................ c. retain a reversionary interest; or ••••••••••••••••••••••••••••••••••••••••••• ••••• ^ d. receive the promise for life of either payments, benefits or care? ................................................... ..... 2. If death occurred after December 12,1982, did decedent transfer property within one year of death ^ 0 without. receiving adequate consideration? ................................................................................. ? " ...... ^ ... or payable upon death bank account or security at his or her death 3. Did decedent own an "intrust for ...... Did decedent own an Individual Retirement Account, annuity, or other non-probate property which 4 . contains a beneficiary designation? ............................................................................................ ...... ^X ^ 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)]. 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 they surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt 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 10 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 r~et 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 riet value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling 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) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER LEROY J. FOSTER e:1 08 01076 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T INVESTMENT GROUP 14,971.38 MTB MONEY MARKET 14,971.38 X $1.00 TOTAL (Also enter ors line 5, Recapitulation) I $ 14,971.38 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER LEROY J. FOSTER 11 08 01076 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commission Paid: State Zip 2. Attorney Fees IRWIN & McKNIGHT 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. I Probate Fees 5 Accountant's Fees 6. Tax Return Preparer's Fees 7. I REGISTER OF WILLS -FILING FEE TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 500.00 30.00 00 REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LEROY J. FOSTER 21 08 01076 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustees} OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. DEBORAH L. FETTER Lineal 7,220.69 2718 RITNER HIGHWAY 1!2 REMAINDER CARLISLE, PA 17015 2. JESSICA A. SALISBURY Lineal 7,220.69 172 BIG SPRING TERRACE 1l2 REMAINDER NEWVILLE, PA 17241 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 PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) ~/I&T Investment Group &T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1885 November 17, 2008 Date of Death Valuation For the account of Leroy Foster Date of Death 10/8/08 AZC035567 Description of Security Quantity in Valuation Price per share Shares Date 10/8/2008 MTB Money Market 14,971.38 .$1.00 We have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share on valuation date is the closing price on that date. Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #l. Thank you. Sincerely, /~ L ,/ %~ ~ /~ /~ i Robin Brown Brokerage Operations Specialist M&T Securities, Inc. i Investment and Insurance Products: • Are N~T Deposits • Are NOT FDIC-Ins~d • Are NOT Insured By Any Federal Government Agency ave NO Bank Guarantee • May Go Down In Value M&T Investment Group"' is a service mark of M&T Bank Corporation and consists of M&T Securities, Inc., the investment-related areas of M&T Bank and investment advisory firms MTB Investment Advisors, Inc., and Zirkin-Cutler Investments, Inc. Brokerage services and insurance products are offered by M&T Securities, Inc. (member FINRA/SIPCj, not by M&T Bank. M&T Securities, Inc. is licensed as an insurance agent and acts as agent for insurers. 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