HomeMy WebLinkAbout08-13-09 (2)1505607120
~ REV-1 SOO EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue county code veer Flb Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po sox.zaosot 2 1 0 8 114 2
Harrisburg, PA 1712&0801 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
310 40 6142 11 15 2008 07 30 1940
Decedent's Last Name Suffix Decedent's First Name MI
FISHER NANCY C
(If Applicable) Eller Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's Firet Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
X^ t. Original Retum
4. Limped Estate
S Decetlent Dletl Testate
(Attach Copy of Will)
MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return ~ 3. Remainder Retum (date of death
pnor to 12-13A2)
qa, Future Interest Compromise ~ 5. Federel Estate Tex Retum Required
(date N tleeth aNer 12.12A2)
T oecetle~~yl~ irnvee )a Living Trust 1 a. Total Number of Sete Deposit Soxes
9. Litigation Proceeds Received ^ tg'be ween Pi3lMgcre tlH{rice lof tlenn ~ tt,Election to tax under Sec. g113(A)
(Attach Sch. O)
CORRESPONDENT -7X18 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDWARD P. SEEBER 717 533 3280
Firm Name (If Applicable) o
REGISTE~F WILLS ~ ONLY
L
JAMES, SMITH, DIETTERICIF & CONNELLY, L _
>OO ~, =.,,.
f
;
First Ilne of address ?
~.' ~ ~ ~~ ~ t "
-
-~7y n -~
-.:
SUITE C-400, 555 GETTYSHURG PIRS r
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-~
,
t . ,,
Second Ilne of address .
Cn ,-, :
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N ,
ILED -'
City Or Post Otfice State LP Code - O
MBCHANIC3BURG PA 17055
Correspondent's a-mall address: epsQjsd c.COm
Under penalties of perjury, I deUarc that I have examined this realm, including accompanying schedubs and statements, end to Me hest of my knowledge and belle(,
It is true, wrroct and complete. Deelaroaon of p parer other than the personal roprosentaNve Is based on all information of which prepercr has any knowledge.
SIG E F P R ON R SP FOR RETURN DAT
(;,~ Scott H. Fisher ~ f t(
~~Qj
ADDRESS ~
206 F~erlrview Road, New Cumberland, PA 17070 _
Edward P. Seeber ~,( )
DATE
Suite C-400, 555 Gettysburg Plke, Mechanicsburg, PA 17055
Side 1
1505607120 1505607120 J
PA Inheritance Tax Return
Signature of Additional Fiduciaries
~EFisherE,NancyC. 12108N1 2BER
Under penakies of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, cortect and corn .Declaration of preparer other than the personal representative is based on all informellon
of which preparer has any knowledge. ~
Signature #2
Name
Addressl
Addressl.
City, State, Zip
Date
Richmond, VA 23223
1505607220
REV-1500 EX
Decedent's Social Security Number
oeueem•s Nerve: Nancy C. Fisher 310 40 6142
RECAPITULATION
2 1 6. 5 9 4. 0 0
1. Real Estate (Schedule A) .......................................................................................... 1.
2 2 7 3, 4 8 3, 8 3
2. Stocks and Bonds (Schedule B) ............................................................................... .
3. Closely Haltl Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4.
5. Cash, Bank Deposits & MlsceNaneous Personal Property (Schedule E) ................ 5. 1 4 , 9 2 8 . 8 8
8. Jofndy Owned Property (Schedule F) ~ Separete Billing Requested ............. 8.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested .............
7.
3 8 0, 0 5 5. 5 9
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 8 8 5, 0 6 2. 3 0
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 1 , 3 0 5.19
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................... . 10. 8 5 5 ' 6 8
11. Total Deductions (total Lines 9 & 10) ..................................................................... . 11, 2 2 , 1 6 0 . 8 7
12. Net Value of Estate (Line 8 minus Llna 11) ............................................................ . 12. 8 6 2 , 9 01.4 3
1 g, Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................. 13.
14. Net Value 8ubjactto Tax (Line 12 minus Line 13) ................................................ . 14. 86 2 , 9 0 1 . 4 3
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Une 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0
0 0
15.
0. 0 0
.
(a)(1.z) X .o0 .
16. Amount of Line 14 taxable
atiinealrateX .045 862, 901.43
16.
38, 830.56
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 1 g, 0 . 0 0
at collateral rete X .15
19. Tax Due .................................................................................................................... . t9. 38,830.56
20. FILL IN THE OVAL IF YOU ARE REpUESTING A REFUND OF AN OVERPAYMENT.
S[de 2
L 1505607220 15~56a722U J
REV-1500 EX Page 3
Decedent's Complete Address:
FIIe Number 21-08-1142
DECEDENT'S NAME
Nancy C. Fisher
STREET ADDRESS
520 St. Johns Drive
q7Y
Camp Hill STATE
PA 21P
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 38,830.56
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 38,000.00
C. Discount 1,894.74
Total Credits (A + B + c) (2) 37,894.74
3. InteresUPenalty K applicable
p. Interest
E. Penalty
Total InteresUPenaky (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Chock box on Page 2 Llne 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) 935.82
A, Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 93 5.82
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 properly trans(erred :.................................................................................. ^ x
b. retain the right to designate who shall use the property transferretl or its income :.................................... ^
c. retain a reversionary interest: or .................................................................................................................
d. receive the promise for life of either payments, benefits or pre? ................:............................................. ^x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideretlon? ....................................................................................................................... ^
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
0
^
contains a beneficiary designatlon? ......................................................................................................................
IF THE ANSWER TO ANY OF THE A80YE 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 not value of transfers to or for the use
surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of tleath 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) (11)]. The statute does not exempt a transfer to asurviving spouse from tax, and the statutory requirements
for disGosure of assets artd filing a taz return are s011 appiicable 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 twentyone 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. §9118 (a) (1.2)J.
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 p2 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.
Rw•leeg EX* (8-ae)
SCHEDULE A
REAL ESTATE
GOMIAONW EALTH OF PENNBYLVPNN
INNERe/JlCE T~% RETURN
RE810ENT DECEDENT
ESTATE OF (FILE NUMBER
Fisher, Nancy C. 21-08-1142
All real property ovmM uley or u a N„ant m common moat lr npoMtl afalr eunua valve. Feb market vaWe k defined u the prke at whkh property wcuq be
exchanged between a willing buyer antl a wIINnB eellm, neimer being cempNlM to buy or sell, both having reuoneDb knowbdge of me relevant hcle.
Rwl Pfops,y v,Aleh b lolntlyownsd edN rlpM of aurvlvorehiP must De dlaeloaad on uhstlub F.
{It more space is needed, additional pages of iha same size)
Copy>ight (c) 2002 form software only The Lackner Group, Inc. Forth PA-1500 Schedule A (Rev. 6-98)
Rwde07 EX+(a-88)
DOMAgNWEAITN OF PENNSYIVANW
INHERITANCE TAX RETURN
REeIDENT DECEDENT
ESTATE OF
Fisher, Nancy C.
scHe~u~e s
STOCKS & BONDS
LE NUMBER
21-08.1142
NI property Jointlyawnad vAth Nght of survWOnhlp mugee WedoeW on 9eheeule F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 102.887 shares of Dryden Global Total Return Fd CIA 5.76 592.63
held in Prudential Account No. 0272-0011200314 -
valued per letter dated 1/28/09
2 Morgan Stanley Brokerage Account No. 102,382.87
410-055499-140 -valued per account statement 8
public listing
3 Morgan Stanley Brokerage Account No. 80,336.90
410-056498-140 -valued per account statement &
public listing
4 Wachovia Securities Brokerage Account No. 90,171.43
2767-8550 -valued per account statement & public
listing
TOTAL (Also enter on Line 2, Recapitulation) 273,483.83
(It more space Is needed, additional pages of the same size}
Copyright (c) 2002 form software only The Lackner Group, Ina Form PA-7500 Schedule B (Rev. 6-98)
Rav1tWa FJN (B•ae)
1 SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
GOMMONWFALTN OF PENNBYLVFNN
NHEPITANCE TA%gETURN
gEeIDENT DECEDENT
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-08-1142
Inclutle die praua'da A Iltlaatlan end the tlate the procaetla were reulvetl by the enlete.
All propsrry lolntly.ownad with tl,e daht of suMVOnhip must M dleolpesd on echsdula F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 American Century Investments Money Market Account No. 921.051730078 -valued 5.265.25
per letter dated 12/18/08
2 American Century Investments Money Market Account No. 821.051730078, accrued 5.59
Interest -valued per letter dated 12/18/08
3 Capital One -refund of account 63.09
4 Commerce Bank Checking Account No. 32079535 -valued per bank letter dated 4.20
12/16/08
5 Commerce Bank Savings Account No. 430055357 -valued per bank letter dated 3,135.08
12/16108
6 Commerce Bank Savings Account No. 430055357, accrued interest -valued per 1.01
bank letter dated 12/18!08
7 Dreyfus Worldwide Money Market Account No. 0762-0300099520 -valued per letter 759.70
dated 1/14/09
8 Dreyfus Worldwide Money Market Account No. 0762-0300099520, accrued interest - 0.59
valued per)etter dated 1/14/09
9 Highmark Blue Shield -refund of insurance premium 16.40
10 MB:T Bank Checking Account No. 33235554 -valued per bank letter dated 1218/08 279.96
11 MB,T Bank Checking Account No. 33235554, accrued Interest -valued per bank 0.07
letter dated 12/8!08
Total of Continuation Schedule
See attached page
TOTAL (Also enter on Line 5, Recapitulation) I 14.828.88
(If more space Is needed, atldltbnal pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule E (Rev. B-98)
Rw-1508 EX+(B-88)
COMMONWEALTH OF PENNeYLVANN
INXERRANCE TAX RET-RN
RESIDENT OECEOENT
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
continued
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-08-1142
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
12 1896 Ford Taurus Wagon -valued per Kelley Blue Book 850.00
13 1998 Pontiac Bonneville -valued per Kelley Blue Book 1,350.00
14 Miscellaneous personal property -valued per Executors 500.00
15 PA Department of Revenue - 2008 Income tax refund 179.00
16 United States Treasury - 2008 Income tax refund 2.519.00
TOTAL (Also enter on Llne 5, Recapltulatlon) I 14,928.88
Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA~1500 Schedule E (Rev. 8-98)
Rav-1510 EXi (&88)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF (FILE NUMBER
Fisher, Nancy C. 21-OB-1142
Thls schedule must be completed erW OfeO 0 the ansvm b fnq rR pu~tbne 1 though 4 on the ravens eke al eie REV-1500 COVER SHEET le yes.
ITEM
NUMBER
INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET %OF DECD'S
INTEREST Excl.uswN
(IFAPPLICASLE) TAXABLE
VALUE
1 Morgan Stanley IRA No. 410-027735-140 - 352,727.77 100.000 0.00 352,727.77
beneficiaries are children; valued per account
statement & public listing
2 Morgan Stanley IRA No. 410-051547-140 - 27,327.82 100.000 0.00 27,327.82
beneficiaries are children; valued per account
statement
TOTAL (Also enter on Line 7, Recapitulation) I 380,055.59
(If more space is needed, eddldonal pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98)
REV-N 51 Ex+(1RAB)
COMMNHERITALNCE TAX HETUVRN~IA
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21.08-1142
Dabta of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. ~ FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representa0ve(s):
Street Address
City State Zip
Year(s) Commission paid
2. Anomeys Fees James, Smith, Dietterick & Connelly, LLP
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City Siate Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
8. Tax Retum Preparers Fees
7. Other Administretive Costs
See continuation schedule(s) attached
7,336.12
10,000.00
495.00
3,474.07
TOTAL (Also enter on line 9, Recapitulation) I 21,305.19
Copyright (c) 2002 form software only The Lackner Group, Inc.
Fonn PA-1500 Schedule H (Rev. 8-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-OB-1142
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Neill Funeral Home -funeral services 7,336.12
H-A subtotal 7.336.12
Other Administrative Costs
2 ABC Fuel Oil -fuel delivery for residence 238.00
3 Allstate Insurance Co. -automobile insurance premium 350.35
4 Allstate Insurance Co. -homeowners insurance premium 528.23
5 Comcast -cable service for residence 52.25
6 Comcast -cable service for residence 57.25
7 Comcast -cable service for residence 57.26
8 Comcast -cable service for residence 114.53
9 Hampden Township -sewer & trash services for residence 138.65
10 Hampden Township -sewer & trash services for residence 138.65
11 James, Smith, Dietterick 8 Connelly, LLP -reservation for estate administration 200.00
closing expenses
12 MBrT Bank -safe deposit box key replacement fee 10.00
13 PAWC -water service for residence 15.06
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule H (Rev. 8-98)
8CHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-OB-1142
ITEM
NUMBER DESCRIPTION AMOUNT
14 PAWC -water service for residence 14,44
15 PAWL -water service for residence 13.15
16 PAWC -water service for residence 13.15
17 PAWC -water service for residence 25.73
18 PAWC -water service for residence 13.41
19 PPL -electric service for residence 116.00
20 PPL -electric service for residence 117.45
21 PPL -electric service for residence 103.92
22 PPL -electric service for residence 103.88
23 PPL -electric service for residence 103.84
24 PPL -electric service for residence 76,30
25 PPL -electric service for residence 74.74
26 Register of Wills, Cumberland County -filing fee for Return 8 Inventory 30.00
27 Register of Wills, Cumberland County -short certificates fee 16.00
28 Scott Fisher - lawncare for residence 600.00
29 Verizon -telephone service for residence 72.50
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 8-98)
8CHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-08.1142
ITEM
NUMBER DESCRIPTION AMOUNT
30 Verizon -telephone service for residence 39.95
31 Verizon -telephone service for residence 20.13
32 Verizon -telephone service for residence 21,25
H-87 subtotal 3,474.07
Copydght (c) 2002 form software only The Lackner Group, Inc. Form PA-1300 Schedule H (Rev. 6-98)
8CHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
GOMMONYEALTH OF PENNBYLVFNW
INHERRANCE TAX RETURN
REBIOENT pECEOENT
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21-08-1142
Include uRntlmburaed medial sxpenea
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Associated Otolaryngology - unrelmbursed medical bill 23.21
2 Comcast -cable service for residence 57.25
3 Hampden Township -sewer 8r trash services for residence 124.78
4 Matthew Swomley • leaf removal at residence 140.00
5 PA Department of Revenue - 2008 individual income tax 205.00
8 PAWC -water service for residence 15.78
7 PPL -electric service for residence 87.87
8 Verizon -telephone service for residence 36.34
9 West Shore EMS - unrelmbursed ambulance bill 185.45
TOTAL (Also enter on Line 10, Reoapitulatlon) I 855.68
(H moro space Is needed, addttlonel papas of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-7500 Schedule I (Rev. 6-98)
REV-1717 EX~ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
BENEFICIARIES
RESIDENr DECEDENT
ESTATE OF FILE NUMBER
Fisher, Nancy C. 21.08-1142
NUMBER
NAME AND ADDRESS OF RELATIONSHIP TO
DECEDENT
SHARE OF ESTATE
AMOUNT OF ESTATE
PERSON(S) RECEIVING PROPERTY (Words) ($$$)
Do xo1 u•e rm• •
I TAXABLE DISTRIBUTIONS pndude outright spousal
distribu0ons and transfers
under Sec. £;118(a)(1.2)]
1 Nancy J. Fisher Daughter 50% of residue 431,450.72
867 N. 22nd Street & IRAs
Richmond, VA 23223
2 Scott Fisher Son 50°h of residue 431,450.71
206 Fairview Road g, IRAs
New Cumberland, PA 17070
Total 862,901.43
Enter dollar amounts for distributions shown above an lines 5 throw h 18, as appropr ate, an Rev 1500 cover 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 SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)