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Home My WebLink About12-10-11~-1~~~ro',o) 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsy sofa county code re Fue Numb Bureau of ind'rviduai Taxes uEVwxTM~rov~~ " Po Box.2sosol INHERITANCE TAX RETURN 21 10 0 4 7 5 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 210 30 1583 04 24 2010 it 26 1926 Decedent's Last Name Suffix Decedent's First Name MI CARD FRANCES M (If Applicable) Enter Surviving Spouse's Information Betow Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE VMTH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder R~tum (date of death prior to 12.13-~2'~ ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal fistat8 Tax Return Required (dale of death after 12-12.82) ® g. DeoedeM Died Testate (Attacfi copy or wlq ^ 7 Decedent Maintained a LNinp Trust (Attach copy or rn,et) 8. Total Number, of! Safe Deposit Boxes ^ 9. Litigation Proceeds Received [] 10. Spousal PovertysCredit{date or death between 121- 1 end -1-95) ^ 11, Election tC under Sec. 9113(A) Att h S$h~ ( ac ) ; CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTL4L TAX INFOR TI SHOULD BE DIRECTED TO: Name Daytime Telepha ~n$ Number FRANCIS A ZULLI 717 23!2' 1488 Francis A Zulli rV REGISTER IO ~~ S USE ~.Y First line of address r-r C~~ ~ ,,, ~~ ~ 109 LOCUST STREET Second line of address ~ _~ - " ~7'I f V r_ DAT LED ~ ~ City or Post Office St t a e ZIP Code HARRISBURG PA 17101 ..~_.. con-esponderrt'se-maitaddress: wzs@mindspring.com Under pemafties of perjury, l declare that 1 have examined this return, inGuding accompanying schedules and statements, and to the bas o my knowledge and belief, it is true, correct and complete. Dedaratlon of preparer other than the personal representative is based on all information of which preps as any knowledge. SIGNATURE OF PERSON RE NSIBLE FOR FILING RETURN ~ ~ ~ ~-' ,~~ ~~ w,.,,..., Mary Jo Garrety McGowan iI, DATE/ j 2i- ,I' "~ /! a 18 109 ~2i, Camp HNI, P 7011 :PARER OTHER THAN R ^ENT IVE Street, Harrisburg, A 17101 150561D143 l Z~~ ~ ~~ Side 1 1505610,14 J --~ i..i _ _ __ _ _ ___ REV-1500 EX oeos~M'sName: CARD, FRANCES M 1505610243 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 9 0 2. 6 4 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 3 , 3 2 5 . 8 2 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) ....................................................................... g, 4 , 2 2 8 . 4 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 , 13 2 . 5 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 9 2 ' 2 0 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 2 , 2 2 4 . 7 5 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 , 0 0 3.71 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. 2 , 0 0 3 . 7 1 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 .00 15. 16. Amount of Line 14 taxable at -ineal rate x .045 2 , 0 0 3.71 1 s. 9 0.17 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18• 19. Tax Due ..................................................................................................................... 19. 9 0.17 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 1505610243 Side 2 Decedent's Sofial Security Number 210 30 1583 150561g2Mi~ __ .__. i REV-1500 EX Page 3 File Number 21 - 10 - 0475 Decedent's Complete Address: Card, Frances M STREET ADDRESS 18 Sussex Road CITY Camp Hill STATE pA ZIP 17011 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 Ltne 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 90.17 Total Credits (A + B) (2) 0.00 (3) 0.00 (4) (5> 90.17 Make Check Payabie to: REGISTER OF WILLS, AGENr1T. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE aPp!F~OPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .....................................................................................................:............ x d. receive the promise for life of either payments, benefits or care? .............................................................. x 2. If death occurred after December 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 d~atft?......... ^ ^x 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 pIL~ It AS 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 transfer$ to'or for the use of the surviving spouse is 3 percent p2 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 ~yrviving spouse is 0 percent p2 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory) u rements for disGosure of assets and filing a tax re um are still applicable even if the surviving spouse is the ony 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 (or 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 perc&nt, 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 p2 P.S. §91116 (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 __ _. ~ i . ~ COMdONWEAITIi of vo~MSYLVANw WFERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS .& BONDS FILE NI~MSI?R ESTATE OF Card, Frances M 21 -10'-01475 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VAILUE VALUE AT DATE OF DEATH 1 MetLife Stock I 902.64 TOTAL (Also enter on line 2, Recapltulatio~) I 902.64 SCHEDULE E CASH, BANK DEPOSITS, & MISC. °O"'''ON"~'''TMOF~"~"-~A"'A PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE Nl)M~ER ESTATE OF Card, Frances M 21 -10'- 81475 Include the pproceeds of litigation and the date the proceeds were received by the estate. All property jolntly±ov~tned with the right of survlvorshlp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Members 1st FCU Checking Account No. 207761 2,400.47 2 Members 1st FCU Savings Account 631.75 3 MetLife Unclaimed dividend check 11.96 4 MetLlfe Unclaimed dividend check 17.02 5 Highmark -premium refund 224,28 6 PA Treasury Escheat Department 40.34 TOTAL (Also enter on Line 5, Recapltulatloh) ~ 3,325.82 con~oNwEarN of rErwsnvANw MFERITANCE TAX RETURN RESIDENT DECEDENT E H FI~ERAL. D~1SES 8~ ADNNSTRATNEC06T5 ESTATE OF Card, Frances M I FILE NUlIAB~R 21 - 'I 0 - 0475 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Koch Funeral Home -Funeral Service 116.61 2 Ronald Miller, Pastor 100.00 3 Michael Price, Assistant Pastor 100.00 4 James Bearick, Organist 100.00 5 Wegeman's -After funeral reception 105.00 B. ADMINISTRATIVE COSTS: ~. 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 750.00 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 Register of Wills 77.50 Register of Wills -filing fee 30.00 Register of Wills -short certificates 16.00 5. Accountant's Fees 6. Tax Return Preparers Fees 7. Other Administrative Costs 1 Debra K. Wallet -Attorney fees 737.44 TOTAL (Also enter on Ilne 8, Recapitulation) I 2,132.55 iT - - -. 1_ ~ ~___ _ __ __ -_ ca,~,~oNaueuni of rEw~sr~www ua~wrnricE r~x ~ruRN r~sio~rr oec~Nr SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NWM~ER ESTATE OF Card, Frances M 21 -101,- 4475 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unr$im~wrsed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Mobile X-Ray Imaging Inc. 21,54 2 Green Ridge Village 51.56 3 Millennium Pharmacy 19.10 TOTAL (Also enter on Llne 70, Recapitulattpn)I ~ 92.20 REV-1619L3X+(11-08! _ ~ _ SCHEDULE) COM NHOENRIT~ANCETAXRETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF Card, Frances M I FILE NWM$ER 2!1 -10 - 0475 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE O E TATE (Wo~rds~ AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not Ust Trusteels) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X116 (a) (1.2)) 1 Mary Jo Garrety McGowan Daughter 1/3 of Estate', 18 Sussex Road Camp Hill, PA 17011 2 Raymond Card Son 1/3 of Est~lte 91 West Chestnut Street Dallastown, PA 17313 3 Angelo Leonard Card Grandson 1/6th of E~tatje 81 Galli Road Halifax, PA 17032 Enter doNar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as apprgpri~te. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART It -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SF~EE 0.00 _ _ - _ _ __ _ _ _ - _ - __ i i_ RN1r•1613 t37tr (8A0) SCHEDULE J COMMONWEALTIIOFPENNSYLVANIA BENEFICIARIES continued MHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE Nl1M~ER Card, Frances M I 21 -10 - 0475 RELATIONSHIP TO SHARE Ott E~TATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Wotds) ($$$) RECEIVING PROPERTY Do Not ust Tntstes(s) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X116 (a) (1.2)] 4 Leonard Card Grandson 1/6th of E~ta~e 783 Ertord Road Camp Hill, PA 17011 Page ~'~of Schedule J ;~