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Home My WebLink About06-14-101505607120 --~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2sosol RESIDENT DECEDENT 2 1 0 8 1215 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 166 30 6073 11 27 2008 06 13 1916 Decedent's Last Name Suffix Decedent's First Name MI FALEY ALTHEA E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ 1. Original Return ^X 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required ^ g Decedent Died Testate (Attach Copy of will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 0 $. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received 10. Spousal Poverty Credit ((date of death ^ 11.Election to tax under Sec. 9113(A) ^ between 12-31-91 and f-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 WAYNE M PECHT ESQ 7176919808 r-.> ,./~ Firm Name (If Applicable) PECHT & ASSOCIATES, PC First line of address - 1205 MANOR DRIVE, SUITE 200 Second line of address City or Post Office MECHANICSBURG State ZIP Code PA 17055 Correspondent'se-mailaddress: H/peChtca pechtlBW.COm REGISTERrOFc®ILLS US~NLY ,~ ~ ~- :!~« ~= ~_'_ ~ n :~;-,;~ ,~-,;--;, ~D (~~ ~,.f j .. - DA~ FILED '~ ~y .`Y3 :~ Under penalti 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 tru orre and complete. Decla ion of parer other than the personal representative is based on all information of which preparer has any knowledge. SIGN RSON O E F FIL G ETURN DATE _ Thomas E Falev JR -~~=~-~\ w 6 Red Oa Drive, Boi 'ng Sys, PA 17007 SIGNAT RE O PREP ER OTH THAN PRE~S TIVE DATE A ~ ~ ~, ~./ Wayne M Pecht Esq ~;\ ~.\~~~, 1205 Manor Drive, Suite 200, Mechanicsburg, PA 17055 Side 1 1505607120 1505607120 J ~,~ ' PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF I FILE NUMBER I Faley, Althea E 21-08-1215 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. Signature #Z Name Address1 Address2 City, State, Zip Date John 18548 Sandpiper Place Leesburg, VA 20176 US~Z ~ /2 O - U 1505607220 REV-1500 EX Decedent's Social Security Number DecedenYsName Althea E Faley 166 30 6073 RECAPITULATION - - --- 1. Real Estate (Schedule A) ........................................................................................... 1. 2. Stocks and Bonds (Schedule B) ................................................................................ . 2. 6 9 2, 5 8 0. 2 7 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. 1 9 , 21 6 . 8 8 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .............. 7. 1 0 3, 1 9 9. 9 5 g. Total Gross Assets {total Lines 1-7) ........................................................................ g. 8 1 4 , 9 9 7.10 9. Funeral Expenses & Administrative Costs (Schedule H) ........................................... . 9. 1 7 , 4 13.3 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .................................. . 10. 8 , 0 0 0 . 1 8 11. Total Deductions (total Lines 9 & 10) ...................................................................... . 11. 2 5 , 4 13.5 0 12. Net Value of Estate (Line 8 minus Line 11) .............................................................. 12. 7 8 9 , 5 8 3 . 6 0 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. 7 8 9 , 5 8 3 . 6 0 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 .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 7 8 9, 5 8 3. 6 0 16. 3 5, 5 31.2 6 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due .................................................................................................................... . 19. 3 5 , 5 31.2 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505607220 150560722^ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-1215 DECEDENT'S NAME Althea E Faley STREET ADDRESS Bethany Village CITY Mechanicsburg STATE Zh PA II 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable p. Interest E. Penalty 34,485.12 Total Credits (A + B + C) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. q_ Enter the interest on the tax due. g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) 35,531.26 (2) 34,485.12 (3) (4) (s) 1,046.14 (5A) (5B) 1, 046.14 Make Check Payable to: REGISTER OF WILLS, AGENT fiF'iFiii::%i:%: ir:-::: i:54 i:4:% Fv:%:•:•:• ~4:•i::%:%:~ ?%r.•:.: %%i:•i:•i:•:•:•:i%:•:%:•:•:%:•:%{::•:•:%:•:•:%:•:%:%:%:%:%:%:%:-:%:%::5• ~fFiSf irFi ii+i: ~::: S:: S:!i: iii:::::::•:•:•:•i:•:::::•:::•: is i:>::>::::::::~::: xct ~srya.:.:.:.::::>: ii:::: »:':::::::> :.:.ia::::>:: a::::> :.:::?iii: :: fi:. ......: ,•: v :::::::::::::::::::: ?i•F.i!• :~ !~'i~ ~: :::: n: ui:iiiii:i::i:: %S<iiiii:•::•:•:•:•:~~::ii:::::::~ri::::::•:%.i4::i:::~:%:::j::::~:%::+ii+•:•j:i::%:i}q:::%:ti%:i%:%::$:::•}:•:%;::%:%::$:v:•::$~:~2%:'::•:%.•~•vvfi?:i55:•:::::•'r:::::::•::::::::ii::i~•:::::::i5•::nffif.%fiisF:~:~::::•.:::::!i::•,:•,:::~:::i•,:i>:ti::i•.:?%::%::}q~:•',s.:r::•'vt:::::::::::::i:::r{::ii:F% ~%j:::::::•i:::i::•:::%:•:•:•: i:•Y.•:>ii :.........................................:..................:...............................>...n....n:»:A....•....:............................1.....::.:::n:x::n:...:.n:n ....:n,... n:...::.,.:.,..v.::.:: ::::::::::::::::::::::v: ::v: :..:::: ::i::i::i::i ~:$::::::::ii:.. 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 :..................................................................................... ^ ~~ ~; b. retain the right to designate who shall use the property transferred or its income :......................................... ^'~ ~, c. retain a reversionary interest; or ..................................................................................................................... U 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 "in trust for" or payable upon death bank account or security at his or her death? ............... ~: u -- 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ i= IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. v:.•f.,ti:: f, ,:::..::.::r: w:::::::.::. v::::::::::::::::.:::::: .:.......,...... , .+ .ff.: t: . 4 f.<f' f .: : f. ~• .ff f f. .Yf .S :F iti v'.•: :SS .•..•.•.•.•.•:.v.•.........:. ~.4~:..n:~n~.•xn••.•.•.•.•.•.•.•.•...•.•.•.•.•.•.••.•.•.•::.• ................ . .. f...... •::::::..... ...r:., :f.::: f:: :~ •:: f ffr. ::f ..•.,'.•:• t,':. t+., • .t•:,••2: r :•.,:,tj . :.... F F . r::,:::...:..: f.: f•Fi: fif~:: ..f :err is ~'f +F':"f f 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-1503 EX+ (6-98) SCHEDULE B STOCKS ~ BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Faley, Althea E 21-08-1215 All properlyjointlyowned with right of survivorship must be tlisclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 AEGON NV 6.3750% Series (AEH) 1,961.25 2 American Balance Fund 49,820.26 3 American Funds 25,078.18 4 Bank Deposit Program -Money Market (BDPS) 39,506.96 5 Bank of America 6.375 NON Cum-3 (BML.I) 1,661.10 6 Barclays BK PLC 6.625 SER2 (BCS) 8,115.00 7 Blackrock GNMA Portfolio INSTL (BGNIX) 30,596.44 8 CORTS TR III AON CAP CL A 7.75 % 7,753.50 9 Ford Motor Credit Co. 7.8% 19,798.75 10 GENL Motors Acceptance Corp 6.75% 2,382.40 11 GMAC Bank Midvale UT CD 2.75% 45,000.00 12 Highland Credit Strategies FD (HCF) 12,710.00 13 ING Prime Rate Trust (PPR) 3,515.40 14 JP Morgan Chase Capital Trust 7% 8,778.00 15 Morgan Stanley Capital Trust VI 6.6% 5,785.65 16 MS Dividend Growth SECS B (DIVBX) 4,165.43 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 2, Recapitulation) 692,580.27 (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 B (Rev. 6-98) Rev-1503 EX+ (6-98y SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Faley, Althea E 21-08-1215 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 17 MS Global Div Growth SECS A (GLBAX) 18,522.21 18 NUVEEN PENN.PREMINC MUNI FND 2 (NPY) i 30,520.05 19 Prudential Alliance Account 1,310.82 20 United States Cellular 7.5% 2,755.00 21 Vanguard 500 Index Funde Investors Shares 4,009.38 22 Vanguard Growth and Income Fund 3,940.56 23 Verizon Global Funds Corp. 3,771.60 24 Wachovia Securities Account # 3070-4686 I 361,122.33 I I I i TOTAL (Also enter on Line 2, Recapitulation) 692,580.27 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK 17EPOSITS, 8t: MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Faley, Althea E 21-08-1215 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-1510 EX+ ~6-98) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Faley, Althea E 21-08-1215 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY 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 EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Allstate Life Insurance Company Contract 81,291.67 81,291.67 #484963 2 Members 1st Certificate of Deposit #32478-15 - 21,908.28 21,908.28 Katherine Faley-Wlech -Named Beneficiary TOTAL (Also enter on Line 7, Recapitulation) ~ 103,199.95 (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 G (Rev. 6-98) REV-1151 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Faley, Althea E 21-08-1215 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name(s) of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Pecht 8~ Associates, PC 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. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 10,385.10 6,000.00 1,028.22 TOTAL (Also enter on line 9, Recapitulation) I 17,413.32 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Faley, Althea E 21-08-1215 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses Neill Funeral Home, Inc. 10,385.10 H-A Subtotal 10,385.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 81: LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Faley, Althea E 21-08-1215 Report debts incurred by the tlecedent prior to death that remained unpaid at the date of tleath, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Bethany Village 121.00 2 Continuing Care -November Pharmacy Bill 518.00 3 Diocese of Harrisburg/Cemetaries -Grave Marker 850.00 4 Gift 8~ Associates -Tax Preparation 345.00 5 Internal Revenue Service 2009 Federal Income Tax 2,663.00 6 Internal Revenue Service -Personal Income Tax 2.389.00 7 Joseph Faley -reimbursement of costs advanced 150.10 8 Pennsylvania Department of Revenue 254.00 9 Pennsylvania Department of Revenue 59.08 10 Pennsylvania Department of Revenue 593.00 11 Register of Wills, Cumberland County -Filing Fee -Family Estate Settlement 20.00 Agreemenet 12 Register of Wills, Cumberland County, Filing Fees -Inheritance Tax Return and 30.00 Inventory 13 Register of Wills, Cumberland County -Short Certificates 8.00 TOTAL (Also enter on Line 10, Recapitulation) I 8,000.18 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08)