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Home My WebLink About12-10-10 (3)J ~,, gOO ~ (D1-10) 15 0 5 61014 3 PA Department of Revenue pennsy ania OFFICIAL US~ ONLY Bureau of Individual Taxes o~~~Ea*oFa~NUe County Code Yea Fde Number Po Box.2sosol Harrisburg, PA 17128-0601 INHERITANCE TAX RETURN 21 '1 ~ 0 4 7 5 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Soaai Security Number Date of Death Date of Birth 210 30 1583 04 24 2010 it 26 1926 II Decedent's Last Name Suffix Decedent's First Name II MI CARD FRANCES ! M (If Applicable) Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's First Name ~ MI Spouse's Social Security Number I THIS RETURN MUST BE FILED IN DUPLIC/ T~ N REGISTER OF WILLS ~ V ITH THE FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainde' Re Y/1 (date of death prior to 12 13 2) ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death aRer 12-12.82) , 5. Federal E ^ ~ } t r~a Tax Return R cared eQ ® g, Decedent Died Testate (Attach Copy or can) ^ ], Decedent Maintahed a LINng Trust (Attach Copy or trust) S. Total Num I ber pf'Safe Deposft Boxes ^ 9. Litigation Proceeds Received ^ 1 p. spousal Poverty Credit (date of death between 1231 D1 and 'f-1-ti5) 11, Election t ^ (Attach Sc~ tax . udder Sec. 9113 A ( ) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTU-L TAX INFORM Name Daytime Telex FRANCIS A ZULLI 717 23 First line of address 109 LOCUST STREET Second line of address City or Post Office State 1~.~ D' 21P Code BARRISBURG PA 17101 comesponderrt'se-mauaddress: wzs~mindspring.com ', Under penal5es of perjury, I deGare that I have examined this return, InGuding accompanying schedules and statements, and to the It iS true, correct and complete. Dedaratkxr of preparer other than the personal representative is based on all information of which pre SIGNATURE OF PERSON RE NSIBLE FOR FILING RETURN 1 ~D'7vro o,,..,,..-., Mary Jo Garrett' McGowan ADDRESS 18 Suss'IZr 13,da8, Camp Hill, P~A~•-7011 SIGNATURE F EPARER OTHER THAN R ENT nrF ~ SHOULD BE DIRECTED TO: EM Number X488 S USE ~LY ,> ~ ~ C ij C ~~ ~ r I ED ~ ~ ~.~ REGISTER 4 knowledge and belief, arty knowledge. ''? ~/ a Francis A Zulli ~ 2' ADDRESS 109 t Str9eet, Harrisburg, A 17101 Side 1 '~ L 1505610143 1505610~L43'~ -- . ~I J REV-1500 EX 1505610243 oecedenrsName: CARD, FRANCES M RECAPITULanoN 1. Real Estate (Schedule A) .................................................................... ......... 1. 2. Stocks and Bonds (Schedule B) ................................. ................................ 2. .............. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8, 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 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. ~ wx cvmPUTATION -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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 , 0 0 3.71 16. 17. Amount of Line 14 taxable at sibling rate X ,1Y 17 18. Amount of Line 14 taxable at collateral rate X .15 1 g, 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 Decedent's,So ial Security Number 210 ~ 1583 902.64 150561024 3,325.82 4,228.46 2,132.55 92.20 2,224.75 2,003.71 2,003.71 90.17 90.17 REV-1500 EX Page 3 Decedent's Complete Address: Card, Frances M 18 Sussex Road Camp Hill Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A• Prior Payments B. Discount 3. Interest 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. A ZIP 17011 (1) 90.17 Total Credits (A + ~) I Make Check Payable to: REGISTER OF WILLS, AG 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 transfeprrepde,,~ transferred or its income :................... b. retain the right to designate who shall use the ro f ~~~ ~.... 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 de~th receiving adequate consideration? .......................................................................................................~r.... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her de~th 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 FI E For dates of death on or after Ju 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers spouse is 3 percent (72 P.S. §916 (a) (1.1) (i)]. For dates of death on or after Janua-y 1, 1995, the tax rate imposed on the net value of transfers to or for the use of tl p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory assets and filing a tax re um 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 ye ~~ of age or younger at death to or f~ 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 perce 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 deoedent's siblings is 12 percent p2 P.S. sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w~ File Number 21 - 10 - 0475 (2) 0.00 (3) 0.00 (4) (5) 90.17 TE BLOCKS Yes No x iithout ........ ^ ^x ~'AS PART OF THE RETURN. the use of the surviving spouse is 0 percent s for disclosure of use of a natural parent, an as noted in ~a) (1.3)]. A y blootld or adoption. COI.MONWEALTIi of PENNSYLVANIA NliERRANCE TAX RETURN REB®ENT DECEDENT ESTATE OF Card, Frances M SCHEDULE B STOCKS ~ BONDS All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1 MetLife Stock FILE N<,IIM~LR 21 -10 I,- 0475 I UNir V i '~ I I~ I ~~ i i '~ I VALUE AT DATE OF DEATH 902.64 TOTAL (Also enter on Ilne 2, Recapltulatio~') ~- 902.64 SCHEDULE E CASH, BANK DEPOSITS, & MISC. M111ERtTANCE TAX RETURN ~`TM°~~`''"s''"'"~" PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Card, Frances M FILE NUM ER 21 - 10 i- 075 Indude the pproceeds of litigation and the date the proceeds were received by the estate. All property jointly-~w ed survlvorshtp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Members 1st FCU Checking Account No. 207761 2 Members 1st FCU Savings Account 3 MetLife Unclaimed dividend check 4 MetLlfe Unclaimed dividend check 5 Highmark -premium refund 6 PA Treasury Escheat Department TOTAL (Also enter on Line 5, Recapltulatlor~) I i I with the right of VALUE AT DATE OF DEATH 2,400.47 631.75 11.96 17.02 224.28 40.34 3,325.82 ca.MONweanioFPENNSnvaNu INFiERRANCE TAX RETURN RESX)ENl'DECEDENT ESTATE OF Card, Frances M SG~U,.E H eFnU~ER~ALp/D~~~E~N/S- ESQ&~ ^+•~°~+~ ~v'~~ ~VG Vih71~7 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION A. 1 Koch Funeral Home -Funeral Service 2 Ronald Miller, Pastor 3 Michael Price, Assistant Pastor ~~, 4 James Bearick, Organist 5 Wegeman's -After funeral rece ' tlon p B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid '~ 2. Attorney's Fees Wion, Zulli and Seibert -- Francis A Zulli 3. Family F-xemption: (If decedent's address is not the same as cl aimant's, attach explanation) Claimant III Street Address City State Zip Relationship of Claimant to Decedent ~'~ 4. Probate Fees Register of Wills Register of Wills -filing fee Register of Wills -short certificates 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Debra K. Wallet -Attorney fees II TOTAL (Also enter on Ilne 9, Recapitulation) iR 0 - 0475 AMOUNT 116.61 100.00 100.00 100.00 105.00 750.00 77.50 30.00 16.00 737.44 2,132.55 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE 6~MERRANCE TAX RETURN °°"`TM°~~"'"~"`""""'"" LIABILITIES, 8~ LIENS RESIDENT DECEDENT ESTATE OF Card, Frances M FILE NUM ER 21-100 75 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unr~im urs ITEM NUMBER DESCRIPTION 1 Mobile X-Ray Imaging Inc 2 Green Ridge Village 3 Millennium Pharmacy TOTAL (Also enter on Llne 10, medical expenses. AMOUNT 21.54 51.56 19.10 92.20 REV-1613 t7(+ (11.08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE N M$ER Card, Frances M 211 -'',10 - 0475 NUMBER NAME AND ADDRESS OF PERSON(S) RE DECEDENT TO SHARE O E~T~1TE AMOUNT OF ESTATE RECEIVING PROPERTY Do Not ust Trusta~(s) (WD s' I ($$$) I~ TAXABLE DISTRIBUTIONS[includenutright spousal ' distributions and transfers under Sec. X116 (a) (1.2)] 1 Mary Jo Garrety McGowan Daughter 1/3 of Estate ~I 18 Sussex Road Camp Hill, PA 17011 2 Raymond Card Son 91 West Chestnut Street Dallastown, PA 17313 3 Angelo Leonard Card Grandson 81 Galli Road Halifax, PA 17032 ~. Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 coverlsheet, as NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT T, B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER 1/3 of Estate I'~ i i 1/6th of Es~at~ ~ET 0.00 I ~ L. REV-1ti1~ EX+ (9.00) COMMONWEALTH OF PENNSVLVANw SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES continued RESIDENT DECE DENT ESTATE OF Card, Frances M NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS(nclude outright spousal distributions and transfers under Sec. X116 (a) (1.2)] 4 Leonard Card 783 Ertord Road Camp Hill, PA 17011 FILE NU~IA~ER 2'~ - tl 0 - 0475 RELATIONSHIP TO SHARE OF ES ATE AMOUNT OF ESTATE DECEDENT (Wor s) Do Not List Trusteetsl ($$$) Grandson ~ 1/6th of of Schedule J