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Home My WebLink About03-09-09-~ REV-1500 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 8 0 1 17 2 PO 60X.280601 Harrisburg, PA 17128-0601 i RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 200325758 12162007 Decedent's Last Name BARRIS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number Date of Birth 05261913 Suffix Decedent's First Name MI THERESA Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE W{TH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 0 ® 8 Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 8. Total Number of Safe De osit Boxes (Attach Copy of Will) (Attach Copy of Trust) p ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death. 1 ~ .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 CRAIG A. DIEHL, ESQUIRE, CPA 7177637613 Firm Name (If Applicable) LAW OFFICES OF CRAIG A. DIEHL REGISTER OF WILLS USE ONLY r-.~ First line of address i;l` ~ ~i ~ - ~ +_;a 3464 TRINDLE ROAD _n ._.. r,} ;-. <-~ ^-o Second line of address = `?~ I - LO = ... _., - ~_ , DAT~$IL~D _D ' City or Post Office State ZIP Code ~ ~ ` CAMP HILL PA 17 0 11 :,~_~ f:'? r - t f l '' tU _ ~.D Correspondent'se-mail address: Cdiehl@Cad1eh118W.COm Undeir penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DAT ~~'-~t~ yu~,. ~~(jc~f,;,~a~ Arthur R. Barris, Jr. ~f~ ~? ~l ADDRESS -~ 312 S. Fifth Street, Indiana, PA 15701-3009 SIGNATURE O PREPARER OTHER THAN REPRESENTATIVE DATE r - Craig A. Diehl, Esquire, CPA ~tl ADDRESS 3464 Trindle Road, Camp Hill, PA 17011 Side 1 15D56D712D 15056D7120 ~ :~ 1505607220 REV-1500 EX Decedent's Social Security Number oecedenYs Name: B A R R I S, THERESA 2 0 0 3 2 5 7 5 8 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. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ .. 4. 5,997.61 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 (Schedule G) ^ Separate Billing Requested ........... .. 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... .. g. 5, 9 9 7 6 1 1,653.80 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... .. 9. 323,341.52 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. ... 10. 3 2 4, 9 9 5 3 2 11. Total Deductions (total Lines 9& 10) ................................................................... ... 11. 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. -318,997.71 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. ... 13. -318,997.71 114. 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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 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. ?0. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 0.00 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 08 - 01172 DECEDENT'S NAME Barris, Theresa STREET ADDRESS 100 Mt. Allen Drive P.O. Box 2015 CITE' STATE ZIP Mechanicsburg PA 17055-2015 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Ilnterest/Penalty if applicable p. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.0 0 q, Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g) ~ . ~ 0 Make Check Payable to: REGISTER OF WILLS, AGENT - ~~~~~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRI ATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :........................................................................ .......... ^ ^x b. retain the right to designate who shall use the property transferred or its income :.......................... .......... ^ ^x c. retain a reversionary interest; or ........................................................................................................ .......... ^ ^x 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 without receiving adequate consideration? .............................................................................................................. ......... ^ 3. Did decedent own an "in trust for" 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 beneficiary designation? ...................................................................................................................... ^ 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 the 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 to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Barris, Theresa 21 -08-01172 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Messiah Village -Trust Fund Account 22.21 2 ~ Commerce Bank -Checking Account No. 0536277205 ~ 5,975.40 TOTAL (Also enter on Line 5, Recapitulation) ~ 5,997.61 CHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN Ar111A'NIC~TL]ATI~/L 1~~1QT~` RESIDENT DECEDENT /'~LJI~~ 1~7 ~ rW ~ ~Y C LIW ~ ~7 FILE NUMBER ESTATE OF Barris, Theresa 21 - 08 - 01172 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. B. 1. ADMINISTRATIVE COSTS: !, Personal Representative's Commissions Arthur R. Barris, Jr. ~, 299.88 Security Number(s) / EIN Number of Personal Representative(s): Street Address 312 S. Fifth Street City Indiana state PA zip 15701-300 Year(s) Commission paid 2009 2. Attorney's Fees Law Offices of Craig A. Diehl 1,000.00 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 Register of Wills -Probate fee 87.00 Register of Wills -Commission to Take Oath i 20.00 5. Accountant's Fees ~I 6. ~ I Tax Return Preparer's Fees I 7. Other Administrative Costs ~, 1 j The Sentinel -Estate Advertisement ~, 166.60 TOTAL (Also enter on line 9, Recapitulation) 1,653.80 Schedule H Funeral Expenses & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN l4dminlstr'atiVe Costs continued RESIDENT DECEDENT ESTATE OF Barris, Theresa FILE NUMBER 21 -08-01172 2 5.32 3 Law Offices of Craig A. Diehl -Reimbursement of certified mail fee for DPW letter Cumberland Law Journal -Estate Advertisement 75.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMWHERITANCE TAX RETURLN ANIA LIABILITIES, & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF Barris, Theresa 21 - 08 - 01172 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Commonwealth of Pennsylvania 323,341.52 Department of Public Welfare Bureau of Financial Operations Estate Recovery Program TOTAL (Also enter on Line 10, Recapitulation) I 323,341.52 REV-157J EX+(9-q0) ,~ SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Barris, Theresa FILE NUMBER 21 -08-01172 NUMBER ~I NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY I Do Not List Trustee(s) I, ITAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Arthur R. Barris, Jr. Son 25 Percent 312 South Fifth Street ~ I Indiana, PA 15701-3009 I 2 Dennis R. Barris Son 25 Percent 528 Fishing Creek Road Lewisberry, PA 17339 3 !Ruth Marie Day ~ Daughter 25 Percent ' 892 Cedar Road Lewisberry, PA 17339 I i i Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on i Rev 1500 cover sheet II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS li NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV-1513 EX+ (g-00) COINMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Barris, Theresa SCHEDULE J BENEFICIARIES continued NUMBER ' NAME AND ADDRESS OF PERSON(S) ' RECEIVING PROPERTY I, TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 4 ,Betty Lou Crumrine 468 E. Baltimore Street Greencastle, PA 17225 FILE NUMBER 21 -08-01172 RELATIONSHIP TO SHARE OF ESTATE ;AMOUNT OF ESTATE DECEDENT (Words) ($$$) Do Not List Trustees) I Daughter 25 Percent '~ Page 2 of Schedule J Law Offices of Craig A. Diehl 3464 Trindle Road Camp Hill, Pennsylvania 17011 Telephone (717) 763-7613 Fax (717)763-8293 www.cadiehllaw.com Craig A. Diehl, Esquire, CPA Thomas L. McGlaughlin, Esquire March 4, 2009 Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court One Courthouse Square Carlisle, PA 17013 Re: Theresa Barris 21-08-1172 Dear Ms. Strasbaugh: In Spring Grove, Pennsylvania 119 West Hanover Street Spring Grove, PA 17362 Telephone: (717) 225-1929 ~~ c~ .-, a o ~' _~ ~s~. _ .~ ~ t-t I ; , !;~ - -.; ~ - _, :~ - ra ;__ ;, v N w Enclosed for filing please find the original and two (2) copies of Inheritance Tax Return, as well as our check in the amount of $15.00 which represents the filing fee. Please time-stamp and return a copy of the Inheritance Tax Return to me in the enclosed self-addressed, stamped envelope. Thank you very much. Sincerely, "` ~~,~ Craig A. Diehl, Esquire, CPA CAD/dz Enclosure ~~ s 1Rt J !` r.~ ~ ..~~• $%~ ~ ~ ~f # ~ Y H. , ~~ ,, ~ _ ~~ ~~ !, r ~ ~ ~..`~~ Y ~ sr t , }~~~ tt, ~F~ f. p k.., N . gV ~ ~ f~, d ~ ,~ ~~. j V~ Z,.I j i `. .4i, ~ 1. c; . 'c,,, ~' H 0 . ~~> %. F. 4~ m o r* ~ ~x,~t, fD ri rh n ~7 r ~ ~ C'1 ~' ' ~' O O ri ~ w ~--i ~ti~ °', ~U O ri rn ~ ~ n aGb ~ b z ~~~~ ~~ ,~ ~D ~ ~ cn ~ ~ vi T W~ C") W can a~ n Cr1 ~,: N ~ PJ ~ o O ~a ~ ~ ~~. YY`,' FMM~I F~ °T'~.i ~.; ~ ~f' ~ ~~ Y..~. ~; ~, ~_~. '~ - .f ,ti ~' r ~ a; , ~' 1.. rt` ~: 4 `Ccs~ti ~~~ ~L.' ~ •~: ~ ~ w ~~.~ . ~, ' y.. ~< ~ '~ 4 ~~ ~ ~_ ~ f.~.:~ i f , _:f.,i. Y ~'~`,yF ,`h ~~~: ,~ ~~: ~,.~ ~:' ~,:r ~y i ~~ , ~~.. .~~~ ± ~~ , ' . „• ~. ~' p~. ~4. r I~Te! ..:~.f~l~ ~~: `" ~ ,,,~ . 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