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HomeMy WebLinkAbout04-08-09 5056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Deparbnent of Revenue Bureau of Individual Taxes County Code Year File Number Po sox 280601 INHERITANCE TAX RETURN _ Harrisburg PA 17128-0601 RESIDENT DECEDENT ~ ~ ~ C~~.~C~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1. 7 0 2 4 5 1 2 4 0 2 0 4 2 0 0 9 1 1 1 4 1 9 2 9 Decedent's Last Name Suffix Decedents First Name MI F' E T Z E R D O N A L D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI F E T Z E R E L I Z A B E T H Spause's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL. IN APPROPRIATE OVALS BELOW a 1. Original Retum ~ 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) 0 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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number E L I Z A B E T H B F E T Z E R 7 1 7 7 7 6 ~,7 5 7 ~ -r~ i ---~ ~ r Firm Name If A livable) ( PP ,~ , ~ _ i ar=r.~crr~"OF7r111LLS US NLY - First dine of address 1 6 5 S P R I N G F I E L D Second line of address City or Post Office N 1~ W V I L L E Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying sclledules and statements, and to the hest of my knowledge and belief, 9t is true, correct and complete. Declaration of preparer other than the personal representhtive Is based on aN information of which preparer has any knowledge. SIGNA~~~~~T...rrvtF QF PERS N RES/PQNSIB R FILING RETURN C~,~/•/{/ D/A/TE ADDRESS / y SIGNATURE OF PR PARER R THAN REPRESENTATI DATE ADDRESS ZIP Code P A 1 7 2 4 1 _ ~ '" _-, p ' i i L7 J j r.,,.7 ~ t I ~~~~~ - _ { A~ tv i "~ - ~ ' r; ~.. ~;. a DATE FILED -..3 PLEASE USE ORIGINAL FORM ONLY 15056041125 Side 1 15055041125 J REV-1503 EX + (6-98) SCHEDt/LE B COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DONALD FETZER 0 0 All property jointly-owned wNh right of survnrorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 36 shares Prudential common stock a%?26.34/sh 948.24 TOTAL (Also enter on line 2, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) REV-1511 E;K + (12-99) SCHEDt~LiE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~i INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILf NUMBER DONALD FETZER 0 0 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EGGER FUNERAL HOME, INC. 10,328.28 2. RECEPTION -FIRST PRESBYT. CHURCH OF NEWViLLE 350.00 3. HEADSTONE - EBY GRANITE WORKS 2,603.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Sodal Security Number(suEiN Number of Personal Representative(s) Street Address City State Zip Year(s) Commissior+ Paid: 2 Attorney Fees 3, Family Exemption: (If decxdent's address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant 1o Decedent 4. Probate Fees REGISTER OF WILLS ~ ArxountanYs Fees 6. Tax Return Preparers Fees 7. REGISTER OF WILLS -FILING FEE 15.00 TOTAL (Also enter on line 9, Recapitulation} ~ S (If more space is needed, insert additional st+e~s of the same size) 1990 Ford F250 -Trade In Value, blue book value -Official Kelley Blue Book Site ,~ , _ ~ r: ~~. ~I~~~ ~~t~~ ~~~ :-' TNf TRU~TE© IRESOURCE Page 1 of 4 arivPrticr mant F~+rsrne tdew Cars Used Cars Research & ~xpiore News & Reviews Ready To Buy Classifseds L Used Car Prices ~ Search Used Car Listings ~ Certified Pre-Owned { Compare Vehicles ~ Perfect Car Finder ~ Most Rese• Welcome Back {Sign In {Create Account { My KBB ZIP Code: 17241 Home > Used Cars > 1990 > Ford > F250 > Long Bed 1990 Ford F250 Long Bed Trade-In Value Private Party Value BLUE $DaK" TRADEdt~ YALUE ,...- :Suggested Retail Vafue Photo Gallery Compare Vehicles NEw! E31ue Book Review Consumer Ratings Find Your Next Car Specifications More Photos Shopping Tools Free CARFAX Record Check Auto Loan from 5.39% APR Get a Free Insurance Quote Payment Calculator Find a Dealer t15~'IOUR CAR EAR SALE Special Package Offer! For one low price you can reach millions of used car shoppers. Learn more now 6'J'+` ~ I~SE C~ ~R on Blue Book Classifieds'" n s ,y:,, r`#ctt~sTr,~t~z~r' Ford Condition ",;.;, - ~, _ Value lEx+cellent $1,97'5 Good $1,825 Fair $1,55® 1" ~~ ~ ~ ~ ~ Price New Cars LocaF Listings: View Ford F250 Search all Classifieds in 17241 Average Consumer Rating (68 Reviews) Read Reviews http://vvww.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=1990&Mileage=415 79&... 3/30/2009 1990 Ford F250 -Trade In Value, blue book value -Official Kelley Blue Book Site :~~il~~~t ~. ~~ ~ ,s L oo4;s ne~.~, is in excellent mechanical condition and needs no reconditioning. s htever had any paint or body work ar;d is free of rust. • Clean title history and ~r~il! pass a smog and safety insper_tion, • Engine compartment is dean, vaith no fhaid Peaks and is free of any iriear or visible defects. • Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. Good .,_,~,_ ~. $1,825 • Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. • Little or no rust on this vehicle. • Tires match and have substantial tread wear left. • A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair . ,' $1,550 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional. • Tires may need to be replaced. • There may be some repairable rust damage. ~®or ~,~ a Severe mechanical and/or cosmetic defects and is in poor running condition. Ntay have problems that cannot be readily fixed such as a damaged frame or crusted-through body. • Oranded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Slue Book does not attempt to repart a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 3/30/2009 Accurate Condition Appraisal Change Condition Page 3 of 4 http://www.kbb.com/KBB/LTsedCars/PricingReport.aspx?Yearld=1990&Mileage=415 79&... 3/30/2009 P.O. Box 67013 (117) 234-8484 (Harrisburg) ~~ , _ Harrisburg, PA 17106-7013 (800} 237-7328 (Nationwide) ~,~ ~~ , ~ , website - http:// .ps~cu.c®m ~• -, . .~ METvfBEA NUMBER; 1 8101XXXXXX THE FAIR MARKET VALUE, CFMV) OF YOUR IRA WILL BE REPORTED TO THE INTERNAL REVENUE SERVICE DONALD C FETZER ANNUAL IRA-SUMMARY FOR CALENDAR YEAR 2008 PAGE 02 ~APYE = ANNUAL PERCENTAGE YIELD EARNED TRANS DBE EFFECT DN'~ SHARE ~ 7HANSACTKSM pESCKtIPT[oA!^ AMPUN7 ~ WITH+ HAL[3~JG ~~~~ IRA TYPE: TRADITIONAL CONTINUED 02/29 02/29 S53 DIVIDEND 4.410% 29.58 0.00 8,472.63 APYE~ 4.50% FROM 02/01/08 THROUGH 02/29/08 03/31 03!31 S53 DIVIDEND 4.4101 31.73 0.00 8,504.36 APYE~ 4.501 FROM 03/01/08 THROUGH 03/31/08 04/30 04/30 S53 DIVIDEND 4.4101 30.83 0.00 8,535.19 APYE* 4.501 FROM 04/01/08 THROUGH 04130/08 05/31 05/31 S53 DIVIDEND 4.~F10% 31,97 0.00 8,567.16 APYE~ 4.501 FROM 05/01/08 THROUGH 05/3I/08 Ob/30 Ob/30 553 DIVIDEND 4.4101 31.05 0.00 8,598.21 APYE~ 4.501 FROM Ob/01/08 THROUGH Ob/30/08 07/31 07/31 S53 DIVIDEND 4.4101 32.20 0.00 8,630.41 APYE~ 4.501 FROM 07/01/08 THROUGH 07/31/08 08/31 08/31 S53 DIVIDEND 4.4101 32.33 0.00 8,b62.7k APYE~ 4.501 FROM 08/01/08 THROUGH 08/31/08 09/30 09/30 S53 DIVIDEND 4.410% 31.40 0.00 8,694.14 APYE~ 4.501 FROM 09/01/08 THROUGH 09/30/08 10/31 10/31 S53 DIVIDEND 4.4101 32.56 I 0.00 8,726.70 APYE* 4.501 FROM 10/01/08 THROUGH 10/31/08 11/30 11/30 S53 DIVIDEND 4.410x. 31.63 0.00 8,758.33 APYE~ 4.501 FROM 11/01/08 THROUGH 11/30/08 12/31 12/31 '.S 53 DIVIDEND 4.4101 32.80 0.00 8,791.13 APYE~ 4.501 FROH 12/OI/08 THROUGH 12/31/08 12/31 S53 ENDING BALANCE 8,791.13 TRADITIONAL SUMMARY PREVIOUS YEAR CONTRIBUTIONS 0.00 CURRENT YEAR CONTRIBUTIONS 0.00 DISTRIBUTIONS 1,572.62 IRS WITHHOLDING 0.00 ROLLOVERS 0.00 NON TAXABLE DIVIDENDS 1,330.77 FAIR MARKET VALUE 30,424.48 ~ 2009 RMD 0.00 I Vanguard Fiduciary Tr Co. Cust 40387 A/C Donald C. Fetzer 165 Springfield Rd Newville, PA 17241-9456 ~`{ , ~: . ~. _ ,,.. .~..,,f..,,,,.,.~, "' Page > 1 of 2 ~~` Vanguard Report for 02%04/2009 r: Client Services: 800-662-2739 Name ~ Fund $~;Account ~~i~a~e " ~ °_~° ~ ` ~ Price~F'er ~ ~ ~-~ ' Number Opened Shares Share ~ Value` '4~~ued Dividends GNMA Fund Investor Shares 0036-09862719190 05/08/1990 S,a28.512 ~ $10.52 ------ ----- $57,107.95 $30.51 --- ~ _ _ _ _ tTotals $57;107.95 $30.5f ' Doesn't include accrued dividends. .~ ~ ~ - -_ ___,___ -_ 0157917497 03/23/2009 09:39:34 ®lamgu~ar~l® March 24, 2009 ELIZABETH B FETZER 165 SPRINGFIELD ROAD NEWVILLE, PA 17241-9456 Contract #: 700033215 Dear Mrs. Fetzer: P.O. Box 1105 Valley Forge, PA 19482-1105 www.vanguard.com Thank you for you continued interest in the Vanguard ®Variable Annuity. We received your request to confirm the Date of Death Value for the above contract. Our records indicate: Date of Death Value: $44,042.83 as of 2/4/2009 If you have any questions, please call Vanguard Annuity and Insurance Services at 800-522-5555. You can reach us on business days from 8 a.m. to 8 p.m., Eastern time. For complete information about any of our investment services, .please visit our website at www.vanguard.com to access and download information. You may also want to become a registered user of vanguard.com to manage your accounts, 24 hours a day. Sincerely, Rachel F Connors 30277449 ~omputershare Camputershare Investor Services 250 Royall Street Canton Massachusetts 02021 www.computershare.com ESTATE OF DONALD C FETZER 165 SPRINGFIELD RD NEWVILLE PA 17241-9456 March 23, 2009 Company: Registration: Holder Account Number: Our Reference: Dear Sir/Madam: PRUDENTIAL FINANCIAL, INC DONALD C FETZER 00005543258 PRU/0850180309/18031/77053 Thank you for contacting Computershare, Prudential's transfer agent. We appreciate the opportunity to be of service to you. On February 4, 2009, the closing price was $26.34 per share. Should you have other account related questions, please call us at 1-800-305-9404 between the hours of 8:30 AM and 6:00 PM Eastern US time, Monday through Friday. A telecommunications device for the hearing impaired (TTY/TDD) is also available at 1-800-619-2837. Sincerely, .. ' Service Representative Enclosure: None G~~ 15 Big Spring Avenue NEWVILLE, PENNSYLVANIA 17241 F. CHARLES EDGER, Supervisor 717-77b-3d1 d FRANK C. EDGER, Funeral Director Funeral Bill for Donald Fetzer Date of Service February 8, 2009 Professional Service $3,625.00 6 Death Certificates $6.00 a piece $36.00 Burial Vault $935.00 Vault Sunday Service Charge $195.00 Winfield Cherry Casket $3,995.00 Cemetery $500.00 Patriot News Obituary $292.92 Sentinel Obituary $155.74 Centre Dailey Times $260.98 Minister $100.00 Organist $40.00 Soloist $40.00 Flowers $152.64 Total $10,328.28 Eby Granite Works P. O. Box 187, Newville, Pa. 17241-01.87.. set- ~hone: 717/1 776-5118 "~ ,r{.g. ~...f ~~+- -aa:....: ~' 19 .~~.~ y"'. rte;... Y'. ~, Name ~ •° ~, _.. ~, Da#e~' ~ ~ Address ~ ~.. ;.~.-~ .~._ri~~~ ~~'~ ~ ~~ ..~,~~` .. Zi ~ d ~ ..,, ~r ,~ p Phone ~ ,~~,... ,.~;~ " ° ~.„ ,~ . ~-~. ~,, .~...~. Cornier Post ~ ,~ _~ ~~.~-~..~4„_ _ ... r Monument .- ~,; *,. ~ t .,. ~. i -~~.~ ~~ ~. a ~~ ~' over Vases Slant Base ~~.:; ~ti ~ t~ . ,w~ ~ a; ~ -,~~" `" ~ ~ ~' Kind of Granite/°~ :~ ~..~ ~ Bevel Cemete ~~w~-~ ry ,, ~ ~.....~ ~ ~~~ ~; ~ ~ .. . . Grass Marker Name on-back - FpUN`DATlON Design -~ ~~ ~_,~ Yes' No. ` WARRANTY ~ .. ~, _ ~~ s , _. _ ~ . ~„- 4~~.: ~ r ::'~ 3" 1......;........'.:......:........~:: ~:.: .... :.......... take full responsibility for the accuracy of the above spellings and dates. Chack How #o Letter Letter this way -opposite. ORD. P.O. POS GRA VAS POSTS GAR'S COM B&J Unit Price $ ~'. ~ ~~ ; ~'~~ Flower Vase $ Corner Post $..~'~ `~ Misc. $ - $_ Total ~~,~ ~., Deposit $ ~~ Balance $ ~ "~ ` s ,,, . 4~ `~. Vii. I agree that said. memorial, with title thereto and right of possession thereof; shall remain your personal property until. I have paid for it in full. In default of any payment hereunder, I license you to repossess andremove the said memorial, without guilt or trespass or other wrong, jand authorize and empower you, in my-:name and on my behalf; to apply to the management of said cemetery or other premises for a permit for its removal and to take any other steps you. may deem necessary or expedient and further agree to save you harmless from any entry, repossession and removal; you may retain said memorial or dispose of it at your own discretion without: being answerable to me for it or any proceeds therefrom. Orders subject to cancellation. Alt contractscontingent upon strikes, accidents, and othereauses beyond our control I understandthat 30 days afterplacement ofthe memorial a FINANCE CHARGE will be entered on the;biNing date. It is computed by a periodic rate of 1'/i'% per month which is an annual: percentage rate of t8 % applied to the previousbalance before deducting credits, payments or adding purchases appearing on this statement. To avoid FINANCE CHARGE pay the "New balance"before the billing date next month. 1 AGREE THAT ALL LETTERING AND DATES GIVEN ON ABOVE ORDER ARE CORRECT. ,.;-•- f ALSO HAVE BEEN INFORMED AND UNDERSTANDTHATTHEREwILLBE A CHARGE-:FOR ANY LETTERING DONE AFTERTHE MEMORIAL HAS BEEN' ERECTED IN THE CEMETERY. I ALSO ACKNOWLEDGE THATI HAVE BEEN GIVEN MY FOUNDATION GUARANTEE, IF APPLICABLE._ r ._ r r .,~. ~~ .._.- ~ ~.r _ ~......~:.w.* ~. ~ ./ ~... f.n ~ .........~ ,. . W ,..qL .,, .... :, ~ M... ~ ~ Per ..__.. ~.__ z _ ~-~ .. w ,~ ~ r,. .. .. ~: ~, ,~ .Customer's Signature Grave Marked ,;~, .. # of Grave ~ ~, Cremation _,, ~..w..:..