Loading...
HomeMy WebLinkAbout11-29-10~ 1505610101 REV-1500 Ex `01.1°' '~ lvania OFFICIAL USE ONLY PA Department of Revenue p~+~Y County Code Year File Number DEPRRTNENT Oi REVENUE Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 28o6os Harrisbur PA s sz8-o6os RESIDENT DECEDENT ~ ! 21 0 9 0 5 5 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY __ 191- 2 6- 3 3 4 2 04/14/2009 02/08/1936 _ _ _ _ _. Decedent's Last Name Suffix Decedent's First Name MI ____ __ _ __ __ ':Fitzgerald 'Esther M (1f 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 O 1. Original Return ~ 2. Supplemental Return O 3. Remainder Return (date of death p 4. Limited Estate O 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Andrew C. Sheely, Esquire :717-697-7050 REGISTE~F WILLS U ~~NLY j -~ ~ ~ ~ - ~ """C ; ~ - -y ~~ r-; ~ rra r ; i~ ~ J ~-~ / '. C..~ , ,,. . ~~ ~~ . _~ _,~.~ --i .. - -~'ATE FILED G? !Mechanicsburg PA :17055 _ _ __ __ Correspondent's a-mail address:andrewc.sheely@verizon.net '7 i } .~.. ~ ~__ .. _..: Under penalties 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT E OF PERSON RESPO SIBLE FOR FILING RETURN t'"T~ ~~ ~~~~ ~ pnnaF~~ Richard D. Fitzgerald, Ex., 48 Palmer Drive, Camp Hill, PA 17011 _ SIGN RE OF PREP H HAN REPRESENTATIVE ATF !l 2 l ~ pn a cc Andrew C. Sheely, Esquir , 127 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1,50561,010], J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: Fitzgerald, Esther M. 191- 2 6- 3 3 4 2 RECAPITULATION 14. Net Vafue Subject to Tax (Line 12 minus Line 13) ........................ 14. ! $686.101: TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unc+~~ c~c. 9116 (a)(1.2) X .0. 15. 16. Amount of Line 14 +~~~ble at lineal rate X .045 $686.10 1g 30.87 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 30.87 19. TAX DUE ......................................................... 19, 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610105 1505610105 , REV-1500 EX Page 3 File Number 2 1_ 0 9_ 0 5 5 2 Decedent's Complete Address: pFf:~nFNT'C NGAAF Esther M. Fitzgerald STpG~renncccc 48 Palmer Drive . CIT./ Camp Hit{ STAT~A zl 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. CreditslPayments A. Prior Payments - B. Discount Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 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) 30.87 1.08 $31.95 Make check payable to: REGISTER OF WILLS, AGENT, ,~ M _.. s w .. ~~ . .. :, ~~~. . ~ ~~ ,: 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 :................................................................................... ....... ^ 0 b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ 0 c. retain a reversionary interest; or ................................................................................................................... ....... ^ ^ 0 0 d. receive the promise for life of either payments, benefits or care? ............................................................... ....... 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ 0 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ....... ....... ^ 0 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. ,..., ............ ...,.<. .. a 6 ~:. ro.. ~q v: 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 for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 fvr disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. Far 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)]. • 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, 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 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-1503 EX+ (6-98) r COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Esther M. Fitzgerald 21-09-0552 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. ' REV-1.5:l1 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FART` ESTATE OF ,~ Esther M. Fitzgerald FILE NUMBER 212-09-0552 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: $ 0.00 Name(s) of Personal Representative(s) Richard D. Fitzgerald street Address 48 Palmer Drive city _Camp Hill -state PA ZIP 17011 Year(s) Commission Paid: $125.00 i. Attorney Fees: Andrew C. ~heely, Esquire, per agreement 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 _ $67.50 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Misc. postage $4.40 $~ Filing fee $15.00 TOTAL (Also enter on Line 9, Recapitulation) $ 211.90 I If more space is needed, use additional sheets of paper of the same size. ~~ Return to top. ' ~ e • REV 35~: Ex+ c9-oa> CdMMdNWEALTN OF PENNSYLVANIA INHERITANCE TAX RETURN RE5iDENT DECEDENT ESTATE OF FART Esther M. Fitzgerald SCHEDI~ILE J BENEFICIARIES FILE NUMBER 21-09-0552 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Richard D. Fitzgerald, 48 Palmer Drive, Camp HI{I, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son AMOUNT OR SHARE OF ESTATE 100°/a Rest, Residue of F~tatP ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON 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 I $ (If more space is needed, insert additional sheets of the same size) . _ - _ ~ .Return to top Qf pa LAST WILL AND TESTAMENT +~i~~~ ~ s ~~~~~~~~~ ,~ E~~'"ER FSTZ~RA:~-D i C~1` Li33~'E.'~' ,~..~I'2 T~~wt~1~h1~ ~ Cu~erland ~t~~n~~ r F~tnns~~.v`an3.1, ~~+~, per. ah and. decl a~a ~ a~ and fC3~" ~y IAa~3t ~.~.~.. a~I'lC~, ~'+~t~t~+~n~, he~reb~r ~evc+king exll c~~~a 'i~.l~ and ~c~d.~.cils~ h~r~ttaf~re made by ~, ~~: Z d1X~'+~C~ '~.~'1a~ a~.l ln~'£'~'~.'~~nGE~:, ~~t~.~~ r ~,~'c'~!~'1'~"`°° ~~t'Y',, ~3t~CC~.'~S~.C~-2"3 and death ~a3C~i~~ C?~ and' ~Clt1~. ~rha~sae~aa~~ ~~x.~°i ~ ~- pa~abl~ b~ ~ese~n ~~ ~ deat~-, whether ar nc~~ with ~~ ~~~~ert~ pae~ng Winder this Will ~ s~hal~. €~ paid ~?~~ ~~ ~~ ~°~~~ipa1. ~-` any re~idua~ ~~~~~~. d+evi~e ~.~~: he~r~a~h a~.l ~ rest, re~:~d~e end ~e~ainder ~~ m~ estate ref whatever nature and wherever ~~~~,~ including any prc~~rt~r csver w~i~ch Z ~tt~ld p~~wer a~~c~intx~ent and tagethex~ with an~r in~uranc+~ ~+~~.c.~~~ ~.he~ra~~n ~ ~.~- ut~r scan, R~~~~~ ~~ FITZGE~LD. ~C~,[„~„~R ~hcauld RI~'~I.A~~,3 3. F~T~GE~~I~ pr+~de~ea~e tee, ~~:~`'~„~ and ~+~Ct1E3~lt~ alb "~~.' rest.., ac'esdu+~ and re~tainde~r a ~'' estate ~ whatever xaat~tre and where~~r situate, .ncudnr~ ~ p~r~p+~rty ~~~~ which ~ hold p~+~~r cif apc~int~+~nt and tc~s~ethe~ Frith any insurance p+~l~.c+ea tha~reon, ~ my i~t3n, 13,~,~'~~L J ~ ~'1T~G~~A~,~. .~ ,. ~ ~hvu.d L~i'I~~ ~'. 1~~T~~E.-1-D predecease me, .'~ deer i,~e and b+~gx~eat~ al ~. the r~a~, gyres .due and re~a inde~c ~ :. ~„f~~`~,.~restate cf wha°~ever ~-~~~~+~ and wherever si.tuat.e, .including an~r '~,~~~+~rt~ paver w~i~.ch I hcald peer ~~ a~apr~~.nt~+~nt and t~~agethe~ with EF~ and insua~anc+~ palicies thereon, in ec~~atal shares, tca ~ grand-~ ~hildaren, ~,~:NSE~, JUfi~PH F~T~GE1~.I~t3, ~'R.. , I~1'A ~M[ARI~ ~'~TZG~'.-~I,~ ~:~ and. S~~-.N~~~ R~NE~ ~`I~`ZGE~L£~. ~, ~, In ,addt:ic~n to all p~aw+era~ granted tc~ ~~ h~ ;~ law and ~ ether pravisiv~-s cf this ~1ill, ~ g~.ve the fid~c~.aries actznc~ h+~r+~under the ~ca~.lr~w-ing powers, a~~al.i~cable to all prca~er~ `. ~ ~ ea~eresabl~e withr~ut +~t~t~~rt approval and. effective ~nt~.l actual ~Y dis~.ri~~x~.ic~n c~~ all p~~~ert~y {~i} '~+~ a+~3.1 at public ~~ pr~ra~a agile, or ~a ~~~ fray ~~~ pew ~~ ~$~te, any ~~~~. car pe~,~~na.l prc~p+~r~y ax~r~ ~ ~i~ ~p~.~n~ ~~~ Sale, e~~han~+~ t3Y" 158 ~ ~~~ ~ut~h pz~ea ~~ ~ such ~er~s ~ inclu~ilang +~rer~it, with nr wthau~ s~cu~ri~Y` gar ~~nd~.lc~ns a~ are dee~+d prc~pe~. '~~i~.s includ+~s ~~.~ p+~we~° ~~ c~. lc~~a~..y ~uf~'cien~ inet~en~e fay ~z~at~e~e~ ~~ ~~e prc~p~~y re~+~e ~~e p~~acee~~ cif ~~~ c~~posa.~iQn cif ~.~. ~~ Tc~ par~i~~.r~n. s~at.i.Yfd+B, a-r ~p~ov+~ real. e~~a~e ~.~~ ~~ ender ~.nt~ agxeeen~s cQn~erninc~ +~ p~.r~itic~r~, ~udivi~ ~ic~x~, ~tt~arc~~rement, ~c~ning or ~ana~e~~n~ c~~ ~~~. esi~a~e anc~ ~~- .~~~aaae car extn~s~ r+~a~rc~ic~ns +~~ real eata~e ~~) '~o cc~mprr~~ise ax~y ~claa.~ car ontrcavex~~-y anr~ ~.~ ab~nd~n ar~y property w~i+~h is cif l i~~le car n~ valu~* { T~~ Tc~ invest in all ~c~S c~~ praperty x in~~.uc~.nc~ sucks ~ ~ca~on t~s~ ~~:~ and aa~rtgag+~ in~rest~e»t ~un~, ~it~ut a~e~trictic~n fic~ nvea~~~en~s autbr~r~~*d ~t~r :~ennsylvania ~~c~uc- ares, as are deemed prt~per, without re~g~rc~ tc~ any pa~inc~p:e of da.~re~~sif~~ation, risk or proc~u+ct~.~rity. (~ Tca +~xerc.~.se ~~~ ~3ption, rl~ght ~~ pri~rleg+~ x`a~at+ in ~.nsuran~+~ p~-~. ides +~z in ~~,~~ in~estx~~x~ts . ~~'~ ~o exercise any el€*.c~on gar prltril+~ge given bar ~.~ Federal a~xd ether ~ IaWS, .nclt~ding, but nQt n~ceasarily ~+~~ i~tit+~d ~ T peraona~. ~.nCt~~E~,~ gift and ~~~~~~ cx inheritance ~ . aws i ~:.. ~f ,L~ ~.tf..~r ir1[~~4.i.~i 7/~~~i~ LLJ ~K~ ~G.~~~ tl[.i iil~x.1[ .~b'G ~.~ti.r~~". F „ . V £ ~':. -y^t~.i.,~~a'~ J.il L-~31 ~4.iL .i aii ~~li~. V~ ~~A. LA~ .iil +~»~~r~• ~~ iQ ~~3. i. ~7~ iil~il~~ ~Aw~~ Lr~~~~~i7 f".r~M~~ ~~i. 47 L.3 x.L ~~A QA~."~e.6i. ~ ~ ., ~~ .~ ~.~ pay dsb°~a, '~a1!~E~t'S, ~r estate or trtls'~ a~~mini~~ra~~c~~ ~~a~, ~~ protect t~z i~nprc~v+~ any prcap+~r~.y h~*ld unr~'er my w ~. l , at~~ fc~~° ~,~~~ ~.nves~t~+~n.~. urp-c~ae~ . I } Tc~ select a mode of pay~-ent xxnder ar~y cal i~.ed t reti~°e~er~t plan ~p+~nsir~n plan, profit ahar~nc~ plan, employee ~~~ suck t~wr~ersh.iP plan, or any +ath~er ~~~ of qual.f+~ct pla~~ ~c ~x~en~ th+~ p~~n car ~h+~ ~ p~1~s t~i~am ~c~ d+~ eta, ~~+~. t~ ~;e~~. ~ c~~~~r ~~.+~~~~ wxlch ~h+~y 1~a~y ha~r+~ u11~+~r tote ~~.a11, ,in w~h~~~~~~° m~~l~~~ .hey cc~n~~~r ~ct~vi~~ble. Exe~~.i~r~r ~ ~h~.~, ~~ ~~~ i~~.l~. algid T~~tal~~nt. ~n ~~+~ ~~~~~ ~~ the c~+~~t~, re~igna~tic~n ore in~bl icy ~ a~~rv~ ~+~~ ~~ r~asn wha~~r~~v~z` ~f ~h~ said I+~~~tD- i9. FI'Z~F~L~!~ I na~n~~ ~~~~ ~n~ ~3~IE~ ~' . ~'I'~ZG~~€ALT~ x ~~~~ut~a~r ~-~' ~~1~ ~ zany Lr~.~~ ~.I.1 ~'~;~t~m+~»t . ~ d~.~rect ~.~a~ ~~ E~ecut~a~`, ~xic~ his su~~~~~xca~r~ ~ ~~ ~~~ ~ ~+~q~.r~~ try ~c~~t ~ec~rlty ar ~ bt~11d ~c~r the p+~~fca~~~ ~~~i~ dut~.~~ in ~:n~ ~u~~.sdlction. ~~' [~'I'~~`E~S "W~IE~i~~, I ~~+~ ~.~~euntc~ ~s~~ my h~-r~+~ ~.~ ,° ~: ,,` ~, ,. ~ ~ L ~~gn~d, seslec~, publ.i.~~a~~d ~d d+~clarec~ her ~h~ ~.~c~v-~ n~mec~ T~~~.tlw~.~ as sand ~a~ her Est W~.~. end '~~~~a.~n~. ~~ ~~° pl»"E*S'-~1'I~~' ~ W~2t'~ t ~"~. ~~1~ ~Qtl~l~~ ~ 1.11 ~~~ ~x'e3~"s'.1'1~+~ ~1'lt~ In '~.~'2~ p~~~~~c~ ~~ ~~ch Qt~lelr', h~tv~ h~r+~untr~ ~ub~~r~e~ cur n~m~:~ .Ads ~`+~:~5 ~,c~d~e~ k Y ~( }Y :. ~~ s. r ~~",~`d:?"". mow. ,~`,~~- <• a~vvKrw c. sHrrL~- 717.697.7050 Attorney at Law 127 S. Market Street P.O. Box 95 Mechanicsburg, PA 17055 Register of Wills Glenda Farner Strasbaugh Cumberland County Courthouse Carlisle, PA 17013 Dear Register of Wills Strasbaugh: 71.7.697.7065 (fax} andrewc.sheelyC~verizo n. net November 24, 2010 ~~ -; K~ M ~ / , T ~ ~ rt , ~ .1- , f - i ..~ l ''T 7 ~ ~ ~ ,- ., .~~,;~ ~.. ._ ~.~ =°~t ~ ~ _ _; c ~ -~-; --- _ ~ ~ ~ `~, - z~ w N RE: Estate of Esther M. FitzQ~,erald Estate No. 21-09-0552 Enclosed please find four (4) supplemental inheritance tax returns associated with the above-referenced Estate. Also, enclosed please find check number 5863 in the amount of $31.95 for additional inheritance tax and interest, along with check number 5864 in the amount of $15.00 for the filing fee. Should you have any questions, please call. ACS/bmk Enclosure c: Richard D. Fitzgerald, Executor ~,~ ~/~ ~~~~ ~~ t l ~- Ve t ly yOUr~ (: ~1,~ N REW C. SHEELY ,, ~. ~~ {~ ~. b ~~ p c, ;. ~.