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Home My WebLink About04-23-09-~ REV-1500 15056U7120 - EX (0&05) OFFICL4L USE ONLY PA Department oT Revenue cauMy cow Ymr Flb Numwr Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX.200801 21 O H 0 8 1 1 HaMsburg, PA 17128.0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal 07272008 09301921 Decedent's Last Name Suffu Decedents Firat Neme MI FRITZ BETTY C (If Applleable) Enter SurvWina Spouse's IMormatlon Below Spouse's Last Name Suffer Spouse's First Neme MI Spouse's Sodal Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ® 1. Onpinal Relum ^ 2. Suppbmenfal Retum ^ 3. Remalntler Retum (date of deaN pnor OO 12-13-52) ^ 4. Limited Estate ^ 4a. Future trwie.t Campiomse ^ 5. Federal Estate Tax Retum Required (wb of wsN Mar 12-12A2) 0 ^ g. Dscetlenl Dbe TsNele Alb h C r vA ^ ~, Derwwrn MNrHWrxA a LIWIp Tnat 5. Total NOmhx d Sete Depoeh Boxes (AtbM Copy of Trueq ( c opy o q ^ 9. Litlpetlon Praceede Received ^ 10. eii231A~a~re i-i~atleeth ^ 11.Electlon to tax untler Sec. 9113(A) (Attach Sen. O) C mRE8PONDEM - TN18 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX INFORMATION SHOULD BE DIRECTED TO: N Daytime Telephone NumMr HAMILTON C DAVI3 7175325713 Firm Name (If Applluble) ZVLLINGER DAMS, PC First Ilne of address 20 EAST SURD STREET, SUITE 6 second Ilne of address Clly or Post OTflce Stab ZIP Code SHIPPENSBURG PA 17257 CorrespondsM'se-malladdras: hamlltondavislaw~comcast.net GEORGE M. FRITZ 175 CHAMBERLIN ROAD, SHIPPENSBURG, PA 17257 Hamilton C Davis DATE ::-> t =`i ri ~7 r ~-, '~=J -i; _, iri 20 East Burl Street, Suite B, Shippeneburg, PA 77257 L aide 1 1505607120 1505607120 ~ ~(1~,~. REGI8TER OF~ILLS USE ~.Y .o ~ a _' ' ~ U~r ~ i~~rn to " ~O~ t ~. = ~ . , _ D FILED i - ,~ fV o~ ~~o 17" ~r'" q ~~1~ ~ ~ ~,~~,~ ~. r ~, . ~ u~ .t.~ .... ~ ~:_~~ 1505607220 REV-1500 EX Decedent's Social Securiy Number D'.~.m.: FRITZ, BETTY C. RECAPITULATION 1. Real Estate (Schedub A) ...................................................................................... .... 1. 2. Stodca and Bonds (Schedule B) ............................................................................ ... 2. 3. Closety Held Corporetlon, Partnership or Sole-Proprletorehip (Schedule C)....... ... 3. 4. Morlgagea 8 Notes ReceNable (Schedule D) ....................................................... ... 4. 5. Cash, Bank Deposits & Miscellaneous Pareonal Properly (Schedub E) ............. ... 5. 4 , 0 41.2 3 6. Jolntty Owned Property (Schedub F) ^ Separete Billing Requested ........... .. 8. 7 , 9 5 9 . 0 4 7. Inter-VNos Trenafers 8 Miscellaneous Non-Probate Property (Schedule G) ^ Saperete Billing Requested ........... .. 7. 8. Total Gross Assets (total Linos 1-7) ..................................................................... .. 8. 12 , 0 0 0 . 2 7 9. Funerel Expenses & AdminiatretNe Costs (Schedule H) ....................................... .. 9. 11 , 2 8 8 . 0 6 10. Debts of Decedent, Mortgage Liabilitba, 8 Liens (Schedule I) ............................. ... 10. 9 3 2 . 4 5 11. Total Deductions (total Linea 9 & 10) ................................................................... ... 11. 12 , 2 2 0.51 12. Net Valus of Estate (Line 8 minus Lfne 11) .......................................................... ... 12. - 2 2 0 . 2 4 13. Charitabb and Govammental Bequeats/Sec 9113 Trusts for which an ebcllon to tax has not been made (Schedule J) ............................................... .. 13. 14. Net Valw Subject to Tax (Line 12 minus Line 13) ............................................... .. 14. - 2 2 0 . 2 4 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. 18. Amount of Line 14 taxable at lineal refs X .045 16. 17. Amount of Line 14 taxable at sibling rete X ,1p 17. 18. Amount of Line 14 taxable at collalerel rete X .15 18. 19. Tax Dua ................................................................................................................... .. 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 31de 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: FIIs Number 21 - 08 - 0817 FRITZ, BETTY C. STREET ADDRESS 742 COTTAGE ROAD CITY SHIPPENSBURG STATE pA ZIP 17YS7 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. CreditslPayments A. Spouses Poverty Credit B. PNOr Payments C. Discount 3. TotalCrodita(A+B+C) IntereatlPenehy Bapplicable (2) 0.00 D. Interest E. Penalty Total lnterostlPenalty (D+E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the dfference. This is the OVERPAYMENT. (q] Check box on Page 2 Llne 20 to rogues[ a refund 5. Ii Line 1 + Line 3 is greater than Line 2, enter the difference. Thla b the TAX DUE. (5) 0.00 A. Enter the interost on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Q , Q Q 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 trenafer and: Yes No a. retain the use or Income of the properly Vansierred :.................................................................................. x b. retain the right to designate who shell use the property trenaferrod or ka Income :.................................... g c. retain a roverelonary interest; or .................................................................................................................. x d. receive the promisefor Ilfe of ehher payments, benefits or cero9 .............................................................. ~ x 2. If death occurred after December 12, 1982, did decedent trenafer property wkhin one year of death without receHing adequate conaideratlon7 ....................................................................................................................... ^ ^x 3. Did decedent own an "intrust for or payable upon death bank axount or security at hie or her death?......... ^ Q 4. Did decedent own an Indhrkluel Retirement Account, annuity, or other non-probate property which contains a beneficiary deslgnation9 ...................................................................................................................... ^ ^x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN. For dates of death on or aflar Juty 1, 1994 and before January 1, 1995, the tax rete Imposed on the net value of trensfere to or for the use of the aurvMng spouse Is three (3) percent p2 P.S. §9118 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rata Imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent p2 P.S. §9118 (e) (1.1) (ii)]. The statute dose not exempt a transfer to a survWing spouse from tax, and the statutory requirements for dlaGosure of assets and filing a tax return are still applicable even H the surviving spouse Is the onty beneficiary. For dates of death on or after July 1, 2000: The tax rote imposed on the net value of trenafere from a deceased chlkl twenty-one years of age or younger et death to or for the use of a nature) parent, en adoptNe parent, or a stepparent of the child is zero (0) percent [72 P.S. §9118 (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-haH (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax reta imposed on the net value of trensfere 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 bast one parent in common with the decedent, whether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. °°"""°"`"~"~TM°~"~''~°^"" PERSONAL PROPERTY RINERTrNlCETAC RETURN REBE)EM DECEDENT FILE NUMBER ESTATE OF FRITZ, BETTY C. 21 - 08 - 0811 Include the DDroceeds of IRlgation 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 CITIZENS BANK CHECKING ACCOUNT, ACCOUNT NO. 6100798526 (SEE ATTACHED 1,562.03 VALUATION) 2 COMCAST CABLE REFUND 42.80 3 PERSONAL PROPERTY AND PERSONAL EFFECTS -AUCTION PROCEEDS 413.40 4 COTTAGES OF SHIPPENSBURG -RENT REFUND 267.00 5 ERIE INSURANCE -PREMIUM REFUND 375.00 B CAPITAL BLUECROSS -REFUND 312.99 7 MET LIFE -PREMIUM REFUND 21,48 8 PATRIOT NEWS REFUND 46.55 9 ALLSTATE MEDICAL LOSS CLAIM CHECK 1,000.00 TOTAL (Also enter on Llne 5, Recapitulation) I 4,041.23 SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FRITZ, BETTY C. FILE NUMBER 21-08-0811 If an asset was made )olnt within one year of the decedent's date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME I ADDRESS I RELATIONSHIP TO DECEDENT A 175 CHAMBERLIN ROAD SHIPPENSBURG, PA 17257 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT Include name nan el In on an ban account number or similar identifying number. Attach deed for Jolnty-held real estate. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST DATE of DEATH VALUE OF DECEDENTS INTEREST 1 A 11/05/2001 CITIZENS BANK SAVINGS ACCOUNT, 10,074.44 50% 5,037.22 ACCOUNT N0.6140234735 (SEE ATTACHED VALUATION) 2 A 01/22/2002 CITIZENS BANK CERTIFICATE OF DEPOSIT, 5,843.64 50% 2,921.62 ACCOUNT NO. 6140853621 (SEE ATTACHED I VALUATION) TOTAL (Also enter on line 6, Reeapitulation) 7,959.04 .E H CMI.EINWFJ,LTN aF rreNNanvANU ~~~ WNERRANCE TAIL RETURN AE'1a~a@T~•T11IC /V1C1r REa'AEM DECEDENT /~L~A~~~7 r rW r rrG \/W r ~7 FILE NUMBER ESTATE OF FRITZ, BETTY C. 21 - 08 - 0811 DetKe of decedent must be reported on Schedule i. ITEM DESCRIPTION AMOUNT NUMBER FUNERALEXPENSE3: A. 1 FOGELSANGER - BRICKER FUNERAL HOME 9,213.18 2 FUNERAL RECEPTION 328.38 B. ADMINISTRATIVE COSTS: t. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): 0.00 Street Address Cly State Zip Year(s) Commission paid 2. Attomey'sFeea HAMILTON C. DAVIS, ESQUIRE 1,500.00 3. Femiy Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decadent 4. Probate Faes CUMBERLAND COUNTY REGISTER OF WILLS 75.00 5. ~ Accountant's Fees 6. Tax Retum Preparor's Fees 7. Other Administrative Coate 1 LEGAL ADVERTISING -THE NEWS CHRONICLE 96.50 TOTAL (Also enter on line 9, Recapitulation) q q,ygg,Og COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN Sd~edule H Funeral E/~~q~~ermes& l+~J~ ESTATE OF FRITZ, BETTY C. FILE NUMBER 21-08-0811 LEGAL ADVERTISING -CUMBERLAND COUNTY LEGAL JOURNAL 75.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE `°""'°"R'~"`TM°R'~""'Y`°"`"` LIABILITIES INNERRONCC TIVIRETURN , & LIENS RE910EM oeceoaNr ESTATE OF FRITZ, BETTY C. FILE NUMBER 21 -OB-0811 Include unreimbureed medical expanses. ITEM NUMBER DESCRIPTION AMOUNT 1 PPL UTILITIES 72 67 2 EMBARO 76.60 3 BON -TON CREDIT SERVICES 154.54 4 WALMART CREDIT CARD 42.31 5 COMCAST CABLE CO. 5766 6 CHAMBER58URG IMAGING 22 20 7 SHIPPENSBURG FAMILY PRACTICE 11.47 8 RENT -COTTAGES OF SHIPPENSBURG 495.00 _ I TOTAL (Also enter on Llne 10, Recapitulatlon) I 932.45 REV.tets Ez.laml COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE6IDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF FRITZ, BETTY C. FILE NUMBER 21 -08-0811 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE RECEIVING PROPERTY Do Not Up Trwbyq ($$$) I, TAXABLE DISTRIBUTIONS [nGude outright s usal diatHbutlons and transfers under Sec. !)118 (a) (1.2)] 1 GEORGE M. FRITZ Son 175 CHAMBERLIN ROAD SHIPPENSBURG, PA 17257 2 SCOTT M. FRITZ San 1226 PEGGY DRIVE HUMMELSTOWN, PA 17036 3 TERRY D. FRITZ 440 NORTH HANOVER STREET CARLISLE, PA 17013 Son Enter dollar amounts for distributions shown above on Ilnes 151hrough 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 CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 ao gy ~NA •N ~8~~ NO ~~ ~qq o a~2 soy .~ t~ N N V ~.+ L .~ ~.~. i ~~ r `,I< ~~. ~i''v 1Q04 AFR c3 f'N 12: 20 CLERK;;; QAPtt.F'V~5 cou+;r (XJlNBE- ~~ PA N n n ~n og < > ~ r ZZ z ~~y ~ a a o O J~a~ ~' <a ~ ~ ~~ N = Z2 W a_ x N 1 LAW OFFICES OF ZULLINGER -DAVIS PROFESSIONAL CORPORATION JOEL R ZULLINGER 14 North Main Street Dale F. Shughart, Jr. Suite 200 of counsel Chambersburg, PA 17201 717-264-6029 Fax:717-264-1884 zuingrlaw ,earthlink.net Register of Wills Cumberland Courthouse Room No. 102 One Courthouse Square Carlisle, PA 17013 Apri122, 2009 RE: Estate of Betty C. Fritz Est. No. 21-08-0811 Dear Sir or Madam: HANIILTON C. DAVIS 20 East Burd Street, Suite 6 P.O. Box 40 Shippensburg, PA 17257 717-532-5713 Fax:717-530-5222 hamiltondavislaw(c>7comcast.net N n O O ~h ~~, ~ ~:~ W : t t:J ~ _ . c.3 n ~ s. C;, r-r7 SOT 37 = ,_. ".Y1 ~ '~ r'r 1 W -, N Enclosed herewith please find an inheritance tax return, filed in duplicate. As you can see from the return, there is no tax liability due. A check for filing fee in the amount of $15.00 is also enclosed. Please send a bill to our office for any additional costs due. If there are any questions or concerns, please contact me at the Shippensburg office. Tbank you. HCD/ams Enclosures Sincerely yours, ~~ Hamilton C. Davis for Zullinger -Davis Professional Corporation Reply to: Hamilton C. Davis P.O. Box 40 Shippensburg, PA 17257