The URL can be used to link to this page

Home My WebLink About11-12-09 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau oflndividualTaxes INHERITANCE TAX RETURN Z' ~ ~ Q~~ PO Box 280601 ~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202-20-1367 04102009 03231925 Decedent's Last Name Suffix Decedent's First Name MI BARRICK EFFIE M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 15056041169 Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE BOXES 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 (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 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. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ALF RED L WHITCOMB EA 717-766-9477 Firm Name (If Applicable) WHITCOMB TAX SERVICE First line of address 43 WEST MAIN STREET Second line of address City or Post Office MECHANICSBURG State ZIP Code PA 17055 REGISTEF~ WILLS US ILY ~ ~ i`~ _ ~ 9^ a ~~rn- "~ ~~ _ C, } ,~ ~ -~ ~ ~~ I C7 ~-, ~ "L~ ~ ~ 9 c.~~ `= ~TE FILED ~~ i ; . "~ ~~ ~_ T °y 1 K~7 t'"~ ~-'r-I _?J r`z°~ ~' Correspondent's a-mail address: AL@WHI TCOMBTAX . COM Under penalties o rjury, 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, Corr d wmplete. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT E ERSON BESP IBLE R FILING RETURN DATE] /! //o/O S BARRICK, 5009 FIRETHORN LN, MECHANICSBURG, PA 17055 ~a/e 9 ALFRL~ L WHITCOMB, EA, 43 WEST MAIN ST, MECHANICSBURG, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041169 15056041169 ~~ 15056042160 REV-1500 EX Decedent's Social Secuiity' Number ~ecedent'sName: EFFIE M BARRICK 202-20-1367 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 8~ Notes Receivable (Schedule D) ........................ ..... 4. 10 , 3 7 6 . 6 7 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... ..... 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .. ..... 6. 7. Inter-~lvos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .. ..... 7. 8. .............................. Total Gross Assets (total Lines 1 - 7) g. ..... 10 , 3 7 6 . 6 7 9. Funeral Ex enses &Administrative Costs Schedule H g_ 7 , 6 9 8.31 10. Debts of Decedent, Mort a e Liabilities, 8~ Liens (Schedule I 9 9 ) ........... 10. .... 2 5 7 .4 0 11. .............................. Total Deductions (total Lines 9 8~ 10) 11. .... 7 , 9 5 5.71 12. .......................... Net Value of Estate (line 8 minus Line 11) 12. .... 2 , 4 2 0 . 9 6 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .... 13. 14. Net Value Sub'ect to Tax Line 12 minus Line 13 1 ( ) .................... 14. .... 2 , 4 2 0 . 9 6 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 .0 15. 16. Amount of Line 14 taxable 2 4 2 0. 9 6 10 8. 9 4 at lineal rate x .04 5 ' 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. 108.94 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042160 15056042160 J REV•1500 EX Page 3 Decedent's Complete Address: FIIeNumber 21-09-0355 DECEDENT'S NAME EFFIE M BARRICK STREETADDRESS SPRING GARDEN ESTATES, LOT 55 CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 108.94 0.00 0.00 108.94 108.94 Make Check Payable fo: REGISTER OF VN/LLS, 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 : ..................................... ..... ^ X^ b. retain the right to designate who shall use the property transferred or its income : ............... ..... ^ c. retain a reversionary interest; or .................................................... ..... ^ 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 "intrust 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 exemot 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)]. Asibling 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-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER EFFIE M BARRICK ESTATE 21-09-0355 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUEAT DATE NUMBER DESCRIPTION OF DEATH 1 M & T BANK, CHECKING ACCOUNT #2672034069 1,192.44 2 MONUMENTAL LIFE INS POLICY MM5085877 2,000.00 3 MONUMENTAL LIFE INS POLICY I010220660 1,000.00 4 MONUMENTAL LIFE INS POLICY MM3011486 1,013.22 5 MONUMENTAL LIFE INS POLICY MM3191219 1,013.74 6 MONUMENTAL LIFE INS POLICY MM1703116 2,016.92 7 1985 SKYLINE HOUSE TRAILER 500.00 8 PERSONAL HOUSEHOLD ITEMS SOLD AT AUCTION 1,640.35 TOTAL (Also enter on line 5, Recapitulation) I $ 10 , 3 7 6 . 6 7 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER EFFIE M BARRICK ESTATE 21-09-0355 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~~ HOFFMAN-ROTH FUNERAL HOME 7,001.31 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) DENN I S BARB I C K StreetAddress5009 FIRETHORN LANE CityMECHANICSBURG State PA ZIP17055 Year(s)CommissionPaid: RENOUNCED 2. Attorney Fees 3. Famiy Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant StreetAddress 4. 5. 6. 7. City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees _ZIP_ RENOUNCED 102.00 595.00 TOTAL (Also enter on line 9, Recapitulation) I E (If more space is needed, insert additional sheets of the same sae) 7,698.31 REV-1512 EX+ (12-08) i pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERRANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER EFFIE M BARRICK ESTATE 21-09-0355 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (11-08) Pennsylvania SCHEDULE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER EFFIE M BARRICK ESTATE 21-09-0355 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] i. DENNIS BARRICK SON 20% 5009 FIRETHORN LANE MECHANICSBURG, PA 17055 2 SHIRLEY BARRICK DAUGHTER 20% 75 SPRING GARDEN EST LOT 75 CARLISLE, PA 17013 3 MICHAEL BARRICK SON 20% 55 SPRING GARDEN EST LOT 55 CARLISLE, PA 17013 4 GARY BARRICK SON 20% 730 SKYLINE DRIVE JUNCTION CITY, KS 66441 5 GEORGE BARRICK SON 20% 28 KOUGH ROAD NEWVILLE, PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1, TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, insert additional sheets of the same size. wl~~ of EFFIE BARRICK I, Effie Garrick, of Cumberland County, Carlisle, ~sylvania, declare this to be my last Will and hereby revoke all prior and codicils. 1. I direct that all my just debts and funeral expenses, marker and administrative expenses shall be paid from my ary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, ~sion and death taxes of any kind whatsoever which may be e by reason of my death shall be paid out of my residuary estate. 3. I direct that my estate be distributed as follows: A. I direct my entire estate be sold and the proceeds be divided equally between my children Shirley M. Sheriff, Gary D. Barrick, Dennis A. Barrick, George . A. Barrick, and Michael L. Barrick. Should any of my children predecease me, their share shall lapse and go to the surviving children. 4. I appoint Shirley M. Sheriff and Dennis A. Barrick as joint Executors. Should either Shirley M. Sheriff or Dennis A. Barrick be unable or unwilling to serve as the Executor, the other shall be the sole Executor. 5. The Executors of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. 1 direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN WITNESS WH EOF, 1, Effie Barrick, have hereunto set my hand #his ~~ day of ~ , 2002. i EFFIE RICK uw o~~s of s~~v J. HocG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and one other page was on the and date hereof signed, published and declared by Effie Barrick, as and for her Will in the presence of us, who at her request, in her presence and in the pence of each other have subscribed our names as witnesses hereto. ..:.- Witness ~~ LAW OFFICES OF s~~v J. Hoc,G 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 ACKNOWLEDGEMENT ommonwealth of Pennsylvania of Cumberland ss 1, Effie Barrick, the testatrix, whose name is signed to the attached or foregoing ~trument, having been duly qualified according to law, do hereby acknowledge Ilt I signed and executed the instrument as my last Will; that I signed it wil{ingly d as my free and voluntary act for the purposes therein expressed. EFFIQ.~ ~ RRICK ~- Sworn to or affirm nd acknowledged before me by Effie Garrick, the testatrix, day of r~~ ~ ~~, 2002. }i' . ~~ NCTAAIALSEAL. wvw~ y STli;PF1EN J. FIOQ0. NOTARY PUBRIC A CAAL161.E BORO, CUYB~~, MY CORN EXP~ES of Pennsylvania of Cumberland ss We, ~r/~~~c:~'~~t~~`I' and ~~.~~'r ,~v S ~:r'~/ ,the witnesses whose mes are signed to the attached or foregoing instrument, being duly qualified girding to law, do depose and say that we were present and saw the testatrix in and execute the instrument as her last Will; that the testatrix signed willingly d executed it as her free and voluntary act for the purposes therein expressed; it each subscribing witness in the hearing and sight of the testatrix signed the Will a witness; and that to the best of our knowledge the testatrix was at the time 18 more years of ag(e, of sound mind and under no constraint or undue influenozr. ~ f:,-~ Sworn to affirmed and subscribed to before me b~witnesses, this ~ day of . -G'~ ~_, , 2002. ~ ~ ,'''~~~~~ L/` _ uwo~~s°F Notary Putilic/Attom s~r>~av J. xoc~ 19 S. HANOVER STREET ~,~>sEEAL SUITE 101 S7R.PF~N d ~~ ~~ ~ CARLISLE, PA 17013 CARLISLE BOAC, C1IMBERLAirD CO.. pA AAY COBION EXPIIN;S SEPTre418ER 8, 2003