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Home My WebLink About05-04-091505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Coda Year File Number Bureau of individual Taxes INHERITANCE TAX RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 Lv, (;l-~`~Z ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 179 20 8516 11 19 2008 12 31 1927 Decedent's Last Name Suffix Decedent's First Name MI RISSER JEAN M (If Applicable) Enter Surviving Spouse's Information Betow Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW X j 1. Original Return r_-' ~_ _. -_i ', ~ 4. Limited Estate ~__ L ~ i g Decadent Died Testate ~ -' ---! (Attach Copy of Will) IJ MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return %~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future interest Compromise ~ ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) - 7 Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (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 WILLIAM J. HABERSTROH 814 944 9486 Firm Name (1f Applicable) LAW OFFICE WM J HABERSTROH First line of address 3615 BURGOON ROAD Second line of address City or Post Office State ZIP Code ALTOONA PA 16602 REGISTER OF WILLS USrc-0NLY <~ ~; -; , $:- - `. 7 ... "~` ~-, -, 1 't7 DATE ILED -`~ .- c.a~ Correspondent'se-mail address: haberlaW@Wlnbeam.COm Under 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. swrvv,i urct ur rcresvrv rccarvrvaro~t rvn riurv~ nt i unrv r AI t ~` ~~f ~- . Stanley S. Risser ,`'rf l' c~ ~' 528 Fairval William J. Haberstroh 16662 3615 Burgoon Road, Altoona, PA 16602 DATE i Side 1 150560712D 1505607120 J REV-1500 EX 1505607220 Decedent's rveme: Jean March R i s s e r __ 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. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............ .... 5. 6. Jointly Owned Property (Schedule F) 'iJ Separate Billing Requested ........... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) L ~ Separate Billing Requested ........... .. 7. 8. Total Gross Assets (total Lines 1-7) ................................................................. ...... 8. S3. Funeral Expenses & Administrative Gosts (Schedule ki) .................................... ..... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. 1'I. Total Deductions (total Lines 9 & 10) ............................................................... .......11. 1~'--• Net Value of Estate (Line 8 minus Line 11) .............................................................12. 1;{. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14'.. Net Value Subject to Tax (Line 12 minus Line 13) ..... ........................................ .... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLI CABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable 16 at lineal rate X .045 8 , 315.9 8 . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 19. Tax Due ...................................................................................................................19. 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 179 20 8516 12,918.54 1,008.03 13,926.57 1,040.00 4,570.59 5,610.59 8,315.98 8,315.98 0.00 374.22 0.00 0.00 374.22 Side 2 150560?220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 -- Jean March Risser STREET ADDRESS Messiah Village 606 West Keller Street _- __._ CITY i STATE ,ZIP Mechanicsburg ~ PA '~, 17055 Tax Payments and Credits: 1. Tax Gue (Page 1 Line 19) 2. Credits/Payments ,A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 -- --- ___ Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 374.22 (2) 0.00 Total Interest/Penalty (D + E) (3) 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 g. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 374.22 A. Enter the interest on the tax due. (5A) E3. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5S) 3 7 4.2 2 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 :................................................................................ ~ 'L x - -, b. retain the right to designate who shall use the property transferred or its income :.................................... ~ _~ ', x c. retain a reversionary interest; or ...............................................................................................................1_.._~! x -- : I- d. receive the promise for life of either a ments, benefits or care~ .............................................................:~~ x P Y ~~ ` 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .....................................................................................................................~ • -' I_X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ ~ ' x 4. Did decedent own arylndiv9 ual Retirement Account, annuity, or other non-probate property which I--1 contains a benefiGa desi nation ...................... `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 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. Rev-7508 E.X+(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Risser, Jean March I 21-- 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. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+t6-98) SCHEDULE F PROPERTY JOINTLY-OWNED COMMONWEALTH OF PENNSYLVANIA . INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Risser, Jean March 27-- If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. :iURVIVING JOINT TENANT(S) NAME A. Stanley S. Risser B. C. JOINTLY OWNED PROPERTY: ADDRESS 528 Fairvalley Road Martinsburg, PA 16662 RELATIONSHIP TO DECEDENT Son ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A Members 1st Federal Credit Union 2,016.05 50.000% 1,008.03 Savings Accts. #3262 -Date of Death Balance TOTAL (Also enter on Line 6, Recapitulation) 1,008.03 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Risser, Jean March 21-- Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2, f Attorney's Fees William J. Haberstroh 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 1,000.00 7. Other Administrative Costs 40.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 1,040.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Risser, Jean March 21-- AMOUNT ITEM DESCRIPTION NUMBER Other Administrative Costs 1 Administrative Postage 10.00 2 Cumberland Co. Clerk of Orphans' Court -File Petition for Small Estates 15.00 3 Register of Wills -Fee to File Inheritance Tax Return 15.00 H-B7 Subtotal 40.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 F.X+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Risser, Jean March 2~__ Include unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1573 EX+ (8-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Risser, Jean March 21__ NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee s I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116(a)(1.2)] Stanley S. Risser Son Residue of 528 Fairvalley Road Estate Martinsburg, PA 16662 Total Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE~ O.OO Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 1.7055 GEORGE M. HOUCK (1912-1991) May 4, 2009 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Jean M. Risser Dear Register of Wills: TELEPHONE (717) 766-0209 FAX (717) 795-7473 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Jean M. Risser Estate as well as Check No. 16167, in the amount of $15.00 for the filing fee and Check No. 16166 in the amount of $374.22 for the Inheritance Tax due. Thank you for your kind attention to this matter. Very truly yours, rv .. Charles E. Shields, III Attorney-At-Law CES/mjj