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Home My WebLink About08-26-10 (2)15056bOb43 RED-1 X00 Ex(o,_,o, OFFICIAL USE ONI~.Y PA Department of Revenue Pennsylvania county code Year File Number Bureau of Individual Taxes oE.neTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 10 i 0105 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW ', Social Security Number Date of Death Date of Birth 162 36 8470 10 O1 2009 O1 17 1947 Decedent's Last Name Suffix Decedent's First Name ~ MI E'RARER ~faIZSrENE (If Applicable) Enter Surviving Spouse's Information Below ~I Spouse's Last Name Suffix Spouse's First Name I MI FRARER WILLIAM I L Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE {INI~H THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW I' 1. Original Return ~ 2. Supplemental Retum ~ 3. Remainder Re rn (date of death prior to 12-13-8 ) 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate ax Return Required (date of death after 12-,2.82) g Decedent Oied Testate ~ T, (Att~achd Copy ionft Trust)a Living Trust 0 8. Total Number f Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ~ 1 p, Spousal P4vP tfL Credit (date of death 11. Election to tax nder Sec. 9113(A) between,2-31 9, and i-,-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO SHOULD BE DIRECTED T0: Name Daytime Telepho a Number PATRICIA R BROWN ESQ 717.249 6333 REGISTER O~ ' S USE ~L.Y -'_ . ~~ First line of address ~'n C. ~ r =tr-: 3 5 4 AI.E1i.ANDER SPRING RO ~, `._ c;, ~ rn x , Second line of address r- t~ ~ "~ 'i' i -,•~ ~C -- ~„1 DA FILED ` ~ :~-rt City or Post Office State ZIP Code ~ `~ ~ CARLISLE PA Correa ondent's a-mail address: PbrOWn(~sslZl'1'tat117hugh@S.CG117 ~I' P Under penalties of perjury, I deGare that 1 have examined this return, including accompanying schedules and statements, and to the best of mry knowledge and belief, k is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preps r has any knowledge. Salisbu 4029 Carlisle Rd. Gardners, PA 17324 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ~~ _, ~ ~ -~/~~ J Patricia R. Brown Esq. ~~~; ~ ~" ao ~a ADDRESS ~/ ' 354 Alexander Spring Road, Suite 1, Carlisle, PA Side 1 b5056bOb43 15056bOb43 J 1505610243 REV-1500 EX Decedent's Social Security Number oe~eder~'g Nye: Fraker, Arlene i 62 3 6 !8 4 7 0 RECAPITULATION I 1. Real Estate (Schedule A) ....................................................................................... 1. I i 2. Stocks and Bonds (Schedule B) ............................................................................. 2. I 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. ~~ 5'S, 078.66 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous than; Probate Property arate Billin Requested Se 7 '7 ~$ ~ 7 91.13 ............ g p (Schedule G) ~J . 8. Total Gross Assets (total Lines 1-7) ..................................................................... g, 33 , 869.79 9. 10. Funeral Expenses ii Administrative Costs (Schedule H) ....................................... Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 9. 10. 110,498.78 19, 151.00 11. ......................... Total Deductions (total Lines 9 8 10 .......................................... 11. 2 9 , 64 9 ' 7 8 12• ............................:.......................... Net Value of Estate (Line 8 minus Line 11). .. 12 ~04 , 220 . O1 13. Chartable 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, ~.04 , 220 . O1 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 505.57 91 15. (a>(1.2) x .o0 , 16. Amount of Line 14 taxable 714.44 12 16. at lineal rate x .045 , 17. Amount of Line 14 taxable 0 0 0 17 at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 00 18 at collateral rate X .15 . . 19. Tax Due ................................................... .............................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 ~ L 1505610243 150561D2 3 __ __ __ 0.00 572.15 a.oo o.oo 572.15 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0105 DECEDENTS NAME Fraker, Arlene STREET ADDRESS 4029 Carllale Rd I CITY Gardners STATE PA IP 17324 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0.00 B. Discount 0.00 3. Interest 572.15 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. Total Credits (A + B) Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE 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 life of either payments, benefits or care? ......................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death withc 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 A 0.00 572.15 ;IATE BLOCKS Yes No ^ x x x x t ^ a ^ 0 0 ^ PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or foF the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)j. 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 surviMing,spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)J. 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 21 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 0 percent [72 P.S. §9116 (a) (1.2)J. i . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, ex~ept as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)j. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 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. .._ _ r SCHEDULE E CASH, BANKDEPOSITS, 8~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMB Fraker, Arlene 21-10-0105 Include the proceeds of litigation and the date the proceeds were received by the estate. ~~ All property )oindy-owned with the fight of survivorahlp must be dlscloeed on schedule F. ',I I ITEM VALUE AT DATE NUMBER DESCRIPTION I OF DEATH 1 Estate of Dallas J. Paxton -1/3rd residual distribution 53,228.66 2 2002 Dodge Intrepid -VIN 2B3HD46R72H101296 1,800.00 3 HMA -Physician Management -refund ~i I i it I I ; I I ~I I 50.00 TOTAL Also enter on Line 5, Recapitulation) I 55,078.66 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 S edule E (Rev. 6-98) _. ~- r --- _ „~ -. Rev1510 Ex~ (6.98) COMMONVYEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scH~ou~~ G INTER-VIVOS TRANSFERS & MISC. NON=PROBATE PROPERTY ESTATE OF (FILE NUM~ER Fraker, Arlene 21-10-01 5 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 RROPERTY THE DATE OAF TRANSFERSATTACIi ACOPY OF THE DEED ~OREREAL EST TE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST excwsl (IF APPLIC LE) TAXABLE VALUE 1 Fidelity, Sprint Nextel 401(k) Plan -Beneficiary: 78,791.13 100.000°~ ~, 78,791.13 William L. Fraker -spouse !i ~~ i, j I I I ~I i i I i I ~i I II TOTAL (Also enter on Line 7, Recapitulation) ', 78,791.13 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. I~ Form PA-15Qp Schedule G (Rev. 6-98) II --~ ~~-~-~- ~ ---~ SCHE-DUL-S M FUNERAL EXPENSES ~ COMM NEEWRR7~~gNTC~~{EE Fqq~~PEErR~NNEENSUVLVAN~A '~ R" ' O N IOENT T ES ECEDE ADMINISTRATIVE COSTS ESTATE OF FILE NUM ER Fraker, Arlene 21-10-01 5 Debts of decedent must be reported on Schedule L ITEM DESCRIPTION AMOUNT N R q, FUNERAL EXPENSES: See continuation schedule(s) attached 3,435.77 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s) Commission paid 2. Attomev's Fees Salzmann Hughes, P.C. I 2,700.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) I 3,500.00 Claimant Deanna Salisbury Street Address 4029 Carlisle Rd. city Gardners state PA zip 17324 Relationship of Claimant to Decedent Daughter ~ 4. Probate Fees i I 205.85 5. Accountant's Fees II I I . - 6. Tax Return Preparer's Fees I 350.00 7. Other Administrative Costs 307.16 See continuation schedule(s) attached I~ TOTAL (Also enter on line 9, Recapitulation) 10,498.78 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-150 Schedule H (Rev. 10-06) s~c~wEOU~e H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBE~2 Fraker, AHene 21-10-0105', ITEM NUMBER DESCRIPTION AMOUNT Funeral ExRenses i 1 George's Flowers -funeral flowers 243.80 2 Hollinger Funeral Home -funeral services 3,191.97 ~, H-A !~ 3,435.77 Other Administrative Costs ~I 3 Register of Wills -filing fees II 30.00 I 4 Register of Wills -short certificate ~ 4.00 5 Salzmann Hughes, P.C. -reimbursement for legal advertising in the Cumberland Law Journal I 75.00 I 6 Salzmann Hughes, P.C. -reimbursement for legal advertising in The Sentinel ', 198.16 I H-B7 307.16 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 S~hedule H (Rev. 6-98) I Rev-1512 EX+ (12A8) ~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBE Fraker, Arlene 21-10-01051 Report debts incurred by the decedent prior to death that remained unpaid at the date or death, including unreimbureed medical expena ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Capital One -balance due on account i 6,983.02 2 Capital One -112 balance due on account, this was joint with ~Iliam Fraker, spouse I 1,003.98 3 Chase -balance due on account Ili i 3,865.00 4 Deanna Salisbury -reimbursement for 2009 mileage expense for medical transportation for ~I 252.40 Mrs. Fraker I I 5 Deanna Salisbury -reimbursement for 2009 gas expense for medical transportation for Mrs. ~ 670.00 Fraker 'I 6 QVC -balance due on account Iii 301.82 7 Select Specialty Hospital-Harrisburg -balance due on account !, 250.00 8 VISA -Cornerstone FCU -balance due on account 5,824.78 TOTAL (Also enter on Line 10, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. r 19,151.00 ~_ Form PA-1500 Schedule I (Rev. 12-08) scH~DU~f ~ COMINO, I~o~c oENTLN~IA ~ BENEFICIARIES ESTATE OF FILE NU BER Fraker, Arlene 21-10-0 05 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE MOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • dlstnbutlons, and transfers under Sec. 9116 a 1.2 1 William L. Fraker (d.o.d. 512 512 0 1 0) Spouse 112 residue 91,505.57 1861 Walnut Bottom Road Newville, PA 17241 2 Curtis E. Bear Son 116th Residue 4,238.15 1131 Mt. Road Newburg, PA 17240 3 Deanna Salisbury Daughter 116th Residue 4,238.14 4029 Carlisle Rd. Gardners, PA 17324 4 Jenni R. Fraker Daughter 1/6th Residue 4,238.15 6 Fox Hollow Lane Carlisle, PA 17015 Total 104,220.01 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet as a r riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAK N B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ~I I I ~~ I~ TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1l30~ Schedule J (Rev. 11-08) _. __.. _ r.__ __ __ _ ,- I _-1_.__. I. _ _ _- _- _ N V F S T M F N T May 6, 2010 SALZMANN HUGHES, PC 354 ALEXANDER SPRING ROAD SUITE 1 CARLISLE, PA 17015 Key Reference Information Plan Sponsor: Sprint Nextel Corporation Reference Number: W008814-02MAY10 Re: Document production pursuant to Authorization for Arlene Fraker To Whom It May Concern: On behalf of Sprint Nextel Corporation, this letter is in response to the Authorization receiv Employer Services Company LLC, on May 2, 2010 requesting information concerning Arle Fidelity Employer Services Company LLC ("FESCo") provides certain administrative rep services for the plans} within the explicit provisions of the plan(s) or a framework of the guidelines, and interpretations conveyed to FESCo by Sprint Nextel Corporation. by Fidelity Fraker. ions, Enclosed, please find the following information requested in the Authorization: ', • A copy of Ms. Franker's account statements in the Sprint Nextel 401(k) Plan on Oc~ober 1, 2009 • Beneficiary: William L. Fraker This is the only information requested by the Authorization for Arlene Fraker that FESCo h s in its records and is being provided in lieu of a personal appearance. If further assistance is requi ed in this matter, please submit your request in writing to the following address: Fidelity Employer Services Company LLC '~ PO Box 770003 ~ Cincinnati, OH 45277-0070 Sinc el Sea cDonnell Fidelity Employer Services Company Qualification & Compulsory Processing ', I - - _ - Page 1 of 5 Print Thi~_Page Sprint! Sprint Nextel 401(k) Plan ARLENEFRAKER 1861 WALNUT BOTTOM ROAD NEWVILLE, PA 17241-9515 Retirement Savings Statement 'Q' Customer Service: (800) 877-4015 Fidelity Investments Institutional Operations Company, Inc. 82 Devonshire Street Boston, MA 02109 Your Account Summary Beginning Balance Change in Market Value Ending Balance Additional Information Vested Balance Statement Period: 10/01/2009 to 10/1/2009 $80,>~26.60 $1, 35.47 91.13 $78,h91.13 _. __._ Your Personal Rate of Return ~~ This Period -1.7% Your Personal Rate of Return is calculated with atime-weighted formula, widely used by flna cial analysts to calculate investment earnings. It reflects the results of your investment selection as well as any activity in the plan account(s) shown. There are other Personal Rate of Return formulas used that may yield different results. Remember that past performance is no guarantee of future results. ~~ Your Asset Allocation Statement Period: 10/01/2009 to 10/V71/2009 I i ~,+~..~. ii„i.,.,~.,,,.,~„r~Ar.,;,.P~ann f;~iai;rv ~~m/nlanennnsnr/sponsor/online statement det it 05/06/2010