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Home My WebLink About12-18-0915D5607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Cade Year Fite Number BureauothdividualTaxes INHERITANCE TAX RETURN Po sox zfiosol 2 1 0 9 (] 3 1 0 tianisb~~ PA 17128-0fi01 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW c....~s~ ce,~,.a.. Nti~miwr Dafe nE Death Date of Birth 4 5 4 6 0 3 6 7 9 D 3 2 1 2 D D 9 D 3 1 9 1 9 4 1 Decedent's Last Name Suffa Decedent's First Name MI F R I Z Z E L L T E R R A L ~, I J if Applicable) Errter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social 5ecuriry Number THIS RETURN MUST 8E FILED IN DUPLICATE WITH ~ WE REGISTER OF W(LLS =ELL INAPPROPRIATE OVALS BELOW ~ O 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 T Return Required death after 12-12-82) ^X 6. Decedent Died Testate [] 7. Decedent Maintained a Living Trust ~ 8. Total Number of S f+i3 Deposit Boxes (Attach Copy of Wili) (Attach Copy of Trust) 9, litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax un Sec. 9113(A) betureen 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST f3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHO t3E DIRECTED T0: Name Daytime Telephone Num er L I N U S E- F E N I C L E 7 1? 7 6 3 1 3 $~ ° Fimt Name (If Applicable) REGISTER OF E ONLY ~ R E A G E R & A D L E R, P C { First line of address ~ frn'1 --~ ' - ~ OOy 2 3 3 1 M A R K E T t S T R E E T ~ `~ Second line of address ( ,' ~ -~~~....' C7 }'} ~ City or Post Office State ZiP Code ~ ~~ Ft C A M P H I L L P A 1 7 D 1 1 Correspondent'se~naifaddress:LINUS E• i=ENICLE Under of pe~luy,1 dedare ve turn, inducting accompanyv~g schedules and statements, and fo the t-ast of my a and tie6ef, ft b We, and comple ration pn3perer thaA gfe personal lepceserl~five is based on aU ~Ifolmatjon of which prepaler t-as any U OF PERSON E NSI$ R FI G RN f DA ~ \~ ~ ADD S 8136 H7:LLCREEK DRIVE MIDLOTHIAN VA 2 !112 SIGNATURE 0 PARER OT~R REP AF ENTATIVE ~ % ADDRESS 2331 MARKET STREET CA11P HILL PA 7, 011 PLEASE USE ORfGINAI FORM ONLY Side 1 ~ 15D56D7121 15056077,21 ~~ ~I i ~:~ ~'-~ `~ 7 ~`~'j C:,' ' ") _t:; E_7 `~ ~ _,-_~ -} ~.'~ ~~ -~ J 1505607221 REV-1500 EX Decedent's Name: T E R R A L J• F R I Z Z E L L Decedent's Soci~l 4 5 4 Security Number 0 3 6 7 9 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. ' 3 5 0 0 . 0 0 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6• 1 2 5 . 1 1 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. .............. 8. Total Gross Assets (total Lines 1-7) . ............ 8. 4 6 2 5 . 1 1 ................ 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 3 8. 8 ? 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule 1) ............ 10. 2 5 9 4 . 1 7 ...................... 11. Total Deductions (total Lines 9 & 10) ....: 11. 2 7 3 3 . 0 4 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12• 1 8 9 2 • D 7 13. 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. 1 8 9 2 . 0 7 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 D D D 15 (a)(1.2) X •0 ~ . . 16. Amount of Line 14 taxable 0 0 0 at lineal rate X .0 ,_ . 16. 17. Amount of Line 14 taxable D . D 0 17 at sibling rate X .12 . 18. Amount of Line 14 taxable ] 0 3 8 9 2 7 at collateral rate X .15 , . 18. 19. Tax Due .............. ........................... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15D5607221 0. 0 0 0. D D 0. D 0 0 8 3. 8 1 0 8 3. 8 1 15056072 ], REV-1500 EX Page 3 Decedent`s Complete Address: File Number 21 09 0310 DECEDENTS NAME TERRAL J• FRIZZELL STREET ADDRESS 950 WALNUT BOTTOM ROAD, SUITE 15-121 CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: ~~ Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. Interest/Penafty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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) Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPF 1. Did decedent make a transfer and: a. retain the use or income of the property transferred : ...................................................................... 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 I'rfe 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'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 contains a beneficiary designation? .................................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT 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 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 p2 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 disc filing a tax return are still applicable even ff 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 ; 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, 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 (/2 P.S. §9116(a)(1.3) Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, ,TE BLOCKS No 0 0 0 0 ^X $ PART OF THE RETURN. i tlhe surviving spouse i zero (0) percent sure of assets and atural parent, an xcept as noted in A sibling is defined, under -~ I rccv-i aves cn + ~o-aa~ SCHEDULE E CASH BANK DEPOSITS & MISC COMMONWEALTH OF PENNSYLVANIA , , . IN RN PERSONAL PROPERTY RES DENT DECEDENT ESTATE OF FILE NUMBER TERRAL J• FRIZZELL 21 09 0 10 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. BELONGINGS/JEWERLY 500.00 2• 2004 SATURN SW 3,000.00 3• 2001 NATIONAL RECREATIONAL VEHICLE 30,000.00 TOTAL (Also enter on line 5, Recapitulatio ) S 33 , 500.00 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) SCHEDULE F ~! JOINTLY-OWNED PROPERTY ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER TERRAL J• FRIZZELL 21 09 310 ff an asset vras made joint within one year of the decedent's date of death, it must be reported on Schedule SURVMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. HOWARD F. PRITZ 8136 HILLCREEK DRIVE BROTHER-IN-LAW MIDLOTHIAN, VA 23112 B C JOINTLY-OWNED PROPERTY: ITEM LETTER FOR JOINT DATE MADE DESCRIPTIDN OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH % OF DECD'S DATE OF DEATH VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 11/07 COMMERCE BANK -CHECKING ACCOUNT 16,250.21 50• 8,125.11 TOTAL (Also enter on line 6, Recapitulation) 3 8 ,12 5.11 (ff mon3 space Ls needed, insert additlonal sheets of the same size) REV-1511 EX + M n-061 SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER TERRAL J- FRIZZELL 21 09 0 31D Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 1,935.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address Cily State Zip Year(s) Commission Paid: 2, AttomeyFees REALER & ADLER, PC 3,500.00 3. Family Exemption: (If deoadenCs address is not the same as daimant's, attach explanation) Claimant Street Address ChY State Zip Relationship of Claimant to Decedent 4• Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 132.00 5 Aocountanfs Fees 6. Tax Retum Preparers Fees 7. LEGAL ADVERTISEMENT - CENTRAL PENN BUSINESS JOURNAL 79.00 8• LEGAL ADVERIITEMENT - CUMBERLAND LAW JOURNAL 75.00 9. EXECUTOR EXPENSES FOR TRANSPORT OF ASHES OUT OF STATE 937.87 (INCLUDES AIRFARE, LODGING, CAR RENTAL, FOOD) 10. EXECUTOR EXPENSE - CLEANING OUT RV 480.00 TOTAL (Also enter on line 9, Recapitulation S 7 ,13 8.8 7 (It more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE 1 DEBTS OF DECEDENT COMMONWEALTH OF PENNSYLVANIA , INHERITANCETAxRETURN MORTGAGE LIABILITIES, ~ LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER TERRAL J• FRIZZELL 21 09 310 Report debts incurred by the deceder{t prior to death which remained unpaid as of the date of death, including unreim reed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CAR LOAN - GMAC 1,211.84 2• RV LOAN - BELCO 11,615.49 3• CAR REPAIRS - FOR SALE OF CAR 806.00 4• CAR INSURANCE - PROGRESSIVE 74.98 5• RV STORAGE - CLOVER HILL STORAGE 775.00 6• RV REPAIR - GRUMBINES - PA 485.00 7• RV REPAIR 8 SERVICE - SOUTHERN RV-VA 490.33 8• RV FUEL, NEW BATTERY 8 PARTS 238.63 9• RV REPAIR & SERVICE - COLONIAL FORD - VA 1,492.26 10• RV REPAIR & SERVICE - MCGEORGE'S ROLLING HILLS RV-VA 211.29 11• RV INSURANCE 423.00 12• RV REGISTRATION RENEWAL - PENNDOT 81.0 13• WEST SHORE EMA 211.80 14• HOLY SPIRIT HOSPITAL 100.00 15• PA UMEMPLOYMENT COMPENSATION FUND 1,441.46 TOTAL (Also enter on line 10, Recapitulation S 20 , 59 4.17 (If more space 's needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent TERRAL J. FRIZZELL 21 09 0310 Decedent's Name Page 1 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, 8 Liens ITEM NUMBER DESCRIPTION AMOUNT 16• 17• 18• 19• COMCAST PA DEPARTMENT OF REVENUE CUMBERLAND COUNTY PER CAP• TAX CLEANING OF RV - JANE PRITZ 62•bb 357.48 36.00 480.00 SUBTOTAL SCHEDULEI 936.09 GRAND TOTAL SCHEDULEI S 20,594.17 REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERrrANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER TERRAL J• FRIZZELL 21 09 310 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 pndude outrightssppoousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. HOWARD F• PRITZ Collateral 13,892.07 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, N REV-1500 COVER SHEET n, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 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)