HomeMy WebLinkAbout04-28-111505610105
REV-1500 Ex ~°2-11' ~~~ ~
PA Department of Revenue pennSylvaMa OFFICIAL USE ONLY
-----_
Bureau of Individual Taxes DEMRTNENrOFREVENUE County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN ~ ~
_ Harrisburg, PA 1'7128-o6oi RESIDENT DECEDENT ~ ~ ~ ~- ~'' `~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
192-14-5008 02-18-2011 06-16-1922
Decedent's Last Name Suffix Decedent's First Name MI
Fackler Robert B
(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 O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-8:?)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
m &. Decedent Died Testate O 7. Decedent Maintained a Living Trust _jl 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedules O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Stephen R. Fackler 717-514-7288
~.....,
First Line of Address
1301 Swatara Park Rd
Second Line of Address
Apt 4
City or Post Office
Middletown
State ZIP Code
PA 17055
._s? ; : -;
REGISTER OF WIti~01SE ONLY °--
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DATE FILED
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Correspondent's e-mail address: ~~,,,,~,~,,,~,,,,,__ __~ sfac{~E~^ ~~ ~~,C r L4 vrl
Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my kno tw ed eg and
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer hias any knowledge.
SIGN E O ES ~ FOR FILING RETURN DATE
ADDRESS
/ .3 ~ it 5 w a-~ra~r~q ~~+~2t~ n ~ ~} ~'T ~- r"r ~ D J ut=r-~ ~-~' ~-' P~+ I "1 ~ 5 '7
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056101D5 1505610105 J
J
REV-1500 EX (FI)
Decedent's Sociall Security Number
Decedent's Name:
192-14-5008
RECAPITULATION
1. Real Estate (Schedule A) ............................................ . 1.
2. Stocks and Bonds (Schedule B) ...................................... . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3.
4. Mortgages and Notes Receivable (Schedule D) .......................... . 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
110,032.35
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ...... .
......................
8.
110,032.35
Y
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9.
11,484.31
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............... 10.
14,501.58
11. Total Deductions (total Lines 9 and 10) ................... 11
.............. .
25,985.89
12. Net Value of Estate (Line 8 minus Line 11) ...... .................... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 84, 046.46
an election to tax has not been made (Schedule J) ........................ 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14.
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES __ 84.046.46
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0____
15.
16. Amount of Line 14 taxable
at lineal rate X .Oq,~ 84
046
46 16.
17. ,
.
Amount of Line 14 taxable 3782.09
at sibling rate X .12 17
18. Amount of Line 14 taxable
at collateral rate X .15 . „
19. TAX DUE .........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 1505610205
1505610205
Side 2
3782.09
O
1505610205 J
REV 1500 EX (Ff) Page 3
Decedent's Complete Address:
STREET ADDRESS
CITY
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 QVERPAYMENT.
Fill in oval 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.
File Number
2l i l c~ZS 9
STATE ~( Zlp
(1) - ~~st~ na
Total Credits (A + 8) (2) - ~ na ~ n
(3)
(4)
Make check payable to: REGISTER OF WILLS, AGENT.
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 ............................................ ^ 0
c. retain a reversionary interest .............
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? ..........
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 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 transfers to or for 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 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)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.
• 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(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)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common wi#h the decedent, whether by blood or adoption.
REV-i5o8 EX+ (ii-io)
~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCMEDt~LE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
ESTATE OF:
FILE NUMBER:
Robert B_ Fa kler
~1-11-(l 5A
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.
ITEM
NUMBER
1 ~ Wachovia Bank Checking Account 1000663146261
2 Wachovia Bank Savings Account 1010208656148
3 Wachovia/Wells Fargo IRA 257400051070161
4 IRS refund
TOTAL (Also enter on Line 5, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
VALUE AT DATE
OF DEATH
899.55
91,887.09
16,845.71
400.00
110.032
REV-1511 EX+ (10-06}
P SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF -
Ro,~,~2T FILE NUMBER
i= f~L i~ L~ (Z ',~ i - I i - Cry 'Z Yj
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES: AMOUNT
1. j A~1<L~:f;--~~~Ofu~s~ Fi~LN?RL iHGr'1~ ^i..'2"3°-il Fu-.N ,
~. F1~-E2~tL Lunlt~~c~v ? - Z~ -~ J j 3 ~~s ; ~~
3. Pi3~~TANC:Y C~-tf"itr''l'w~ij ~"a.~vwTl~~/~,JaTA~.A1'i~=J 4'6r6i=AN r1A~kF-~ , ~ f ~ ~~~"~
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City __ State __ Zip
Year(s) Commission Paid:
2~ Attorney Fees
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±~~~.T Cf~`Ti~icaT'~= + ~ ~ ~ ~c7
5• Accountant's Fees
6. Tax Return Preparer's Fees
~. r~x F~ W NL F~~ 15 : ~
TOTAL (Also enter on line 9, Recapitulation) I $ j ~ 4. ~ t~. , ~ 1
(If more space is needed, insert additional sheets of the same size) -
REV-1512 EX+ (12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT ~
ESTATE OF =
~~i3t~~T 6, i=a~Kc-E~ FILE NUMBER
Z..I-i~ -o~25y
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, includin g unreimburseci medical ex
ense
ITEM p
s.
_ _
_
NUMBER DESCRIPTION VALUE AT DATE
1. We ccs" Ft~ ~~. C ~c D ~T ~ A ~=~ __ OF DEATH
' >~ I t C~ `t-
.~ No,~
ll~ t ~v~~7~.=~ ~ S~li~'~'~ off' C:i~-C`'t~ ~~q
4., Ccr-~r't~.anr~Tlj L-1 FF_ TrRr'l +~~':CAL
~ ~ ~ ~ ~~~
~. V SY~~' 46~ ~ ~ ~ c.~9
'7. F'~r_ss~A~~ v~~~~~-~
~. 2Gc~ . ~1-C+
g, C~ u~ N Tu r1 I ~`~A~~ NL- ~ T-wr ~=a ~ ~ K~r ~c -~
5G'tS~¢
~ w = s T 5 ~-~~ ~. ~ r~7 ~. 3 ~ .:~ ~
TOTAL (Also enter on line 10, Recapitulation) $ f ~ ~- 5 vl _ ~
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
~.
~. SCHEDt~LE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~~ phi ~ yr
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
i3ar S~~>~~[ PACK ~a ~Pr~
k r,.Nr~rrr-~ ~ Ir~ALk ~% ~
rGjrv I~rC~~li_L~ ~r
c~ ~-~ rs~ ~ ~er_- , ~ r ca ~. ~- j o
3 ~a~~ ~_r ~ . rµ~~~~ ~
1'75 Sti~4~6N lJ~.
FILE NUMBER
2 j - - i - c~ t~. ~ ~
RELATIONSHIP TO DECEDENT ~ AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
sc~ I /~3
~~,~! %~i
Se ~ ~ 0~,
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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)
PIGIS~~~~.~~ a~ ~~~~IL.L.S
c~ ~J M B E I~ L. A N A ~'::; Q IJ N ~" Y
PE=NNSYI_'VAI'~ll,~,
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CERTIFICATE OF
GRANT OF LETTERS
No . 201 ~ - 00259 PA No . 21- 1 ~ - 0259
Es to to Of : ROBERT B FA (':K/ FR
(First, Middle, Lastl
Late Of : UPPER ALLEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : 192-14-5008
w7-IEREAS, on the 25th day of February 2 011 an instrument dated
December 9th 2004 was admitted to probate as the last will ~of
ROBER T B FA CKL ER
(First, Midd/e, Last1
late of UPPER ALLEN TOWNSH/P, CUMBERLAND County,
who died on the 18th day of February 2011 and
WHEREAS, a true copy of the wi 11 as probated i s annexed r~ereto .
THEREFORE, I, GLENDA EARNER STRASBAUGH Register o~F Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to.'
S TEPHEN R FA CKL ER
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to 1 aw, a1' 1 of which
fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE,
CA RL lSL E, PENNS YL VA NlA ,
IN TESTIMONY WHEREOF, I have hereunto set my hand and af~f.ixed the seal
of my office on the 25th day of February 20 ~ ~.
,.
~M
eglster of Wills
~, ~ ~~~~
epu y
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* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST')
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ROBERT B . FACKLER =
~ ~' '-!
C~ ..~.~ ... _~,.-,
I , RQBERT B . FACKLER, of Lower Allen Township, ~"'-u"1~nber,],;.~nd ~~' G
County, Pennsylvania, being of sound mind, memory and
understanding, do hereby make, publish and declare this; to be my
Last Will and Testament. ; hereby revoking anYT and all fo~~mer Wills
and Codicils by me at any time heretofore made.
ITEM I: I give all my tangible personal property, together
with all policies of insurance thereon, including but not limited
to, any and all automobiles, furniture, furnishing;, china,
silverware, j ewelry, ornaments, works of art, books, pictures and
wearing apparel, but excluding cash on hand and tangible evidences
of intangible personal property, to my sons who survive mE~, to be
divided among them as they shall agree. In case of disagz'eement,
or if any child of mine is a minor, my Executor is authorized to
make the division, having due regard for the personal preferences
of my children, but making such division in as nearly equ<~1 shares
as my Executor deems advisable.
ITEM II: I give, devise and bequeath all the rest, re;~idue and
remainder of my estate, both real and personal, wherever situate,
in equal shares to my children. If any of my children predecease
me, I give that child's share to his or her issue, per stirpes.
Provided, however, that if at the time of my death an.y of my
property should pass, either under this Will or otherwi:;e, to a
beneficiary who has not attained the age of twenty-one C~~ years,
I give, devise and bequeath the share of such beneficiary to the
uardian of such beneficiary as Custodian for him or her under the
g
Pennsylvania Uniform Transfers to Minors Act.
ITEM III • I appoint my son, STEPHEN R . FACKLER, Executor of
this, my Last Will and Testament. If he is unable or unwi:ling to
ualify as Executor, or, having qualified, is unable or unwilling
q
to continue to act, I then appoint my son, KENNETH S. FP~C:KLER, as
Executor of my Will.
ITEM IV : I direct that no custodian or personal reprE~sentat1ve
hereunder shall be required to provide security, surety or- bond in
an jurisdiction for the faithful performance of any duty under
Y
this Will. This clause is applicable only to such custodians and
ersonal representatives as are specifically named in tlZi.s Will.
P
IN WITNESS WHEREOF, I , ROBERT B . FACKLER, have set may hand and
Last Will and Testament, this __~_ day of
seal to this, my
;~ ~ - 2004.
r~ ~~ ` ,
~ ~ ~r° ~'` t~ %` ~ ~ ;
. ~ r ( SEAT }
ROBERT B. FACKLER
2
Signed, sealed, published and declared by ROBERT B. E'ACKLER,
the Testator, as and for his Will, in the presence of us, who, at
his request, in his presence, and in the presence of each other, we
believing him to be of sound mind, memory and understanding, have
hereunto subscribed our names as witnesses.
~:
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C0~0~~~~4~:: ~__ ~2F PE'~+IB"~L''A~A
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. SS.
COUNTY O F f~~°'~~AT ~~ ~.r.-~ ,~cf^:~!~ .~'~ _..__.;~
~_~ ~
We, ROBERT B . FACKLER, Testator, ~ ~~-. - ~ - ~~. ,~ ,~~~_~,,„-t ,~'~~ and
~;,~ ~~ '~ -~~~~`.~ witnesses, respectively, whose names are
signed to the attached or foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the
Testator signed and executed the instrument as his La:~t Will and
Testament and that he had signed willingly, and that he executed it
as his free ar~d vel;~nt?ry act fcr the purposes thereirl elLpressad, .
and that each of the witnesses, in the presence and hea:ri.ng of the
Testator, signed the Will as witnesses and that to the best of
their knowledge, the Testator was at that time eighteen (18) years
of age or older, of sound mind and under no constraint or undue
influence.
~,
_ F
ROBERT B. FACKLER - Testator
_.~, y
Subscribed, sworn to and acknowledged before me by ROBERT B.
FACKLER, Testator, and subscribed and sworn to before me by
/fi1r7 ~.. /~~/ %'-'~'~`cC'~5 and l",s,~ iG;t~;: ~r''-~ 1~".-'~ .
~. ~..~ ,
witnesses, this `~?f day of ,,~'.~~-~r,°,~s~~..-~~~ 2004.
~, j
No ary Public
t--~O~~'1~'~'IUlWI_:r'~L:ift l7t~ i~`ENNSYL~'Ai'~ll~
Notarial Seal
i Jenny A. "Tobias. Notary Public
City of Harrisfxlr~. i~auphin County
~ ~y Con~missiiu~ }~xni~~~~~ ~eh_ t 7. 2.005
of 1'?F'+@c
-~~~ Consolidated Statement
i 01 1000663146261 752 30 0 110 3,506
v~ACHOVIA
000005G8
I~~~Iil~~~lll~„~I~I~~I~I~I~~I~~II~~II~~~I~I~~~~~il~~~lll~~~li
~~ ROBERT B FACKLER
`~'~~' 111 MESSIAH CIR PB
MECHANICSBURG PA 17055-8609
1 /20/2011 thru 2/15/2011
Summary of Accounts
Checking & Savings
Account number Account Balance As of Interest Maturity
rate date
1000663146261 CROWN CLASSIC BKG 18,183.68 2/15
257400051070161 IRA 25 MONTHS 16,845.71 2/15 2.,08 % 10/11/2011
1 01 02086561 48 HIGH PERFORMANCE MMI 91,881.65 2/15
Total $126,911.04
"~ ~~ bl`T- 2.5 C. heck ~ rCQ`t'
l~ ~ ~?c~ ..~~
WACNOVIA BANK , HARRISBURG CAPITOL page 1 of 5
~'~ Consolidated Statement
~i 02 1000663146261 752 30
1TACHOVIA
0 110
3,507
1/20/2011 thru 2/15/2011
Crown Classic Banking
Account number: 1000663146261
Account owner(s): ROBERT B FACKLER
Accou>rlit Summar
Opening balance 1/20 $2,214.81
Deposits and other credits 23,300.00 +
Interest paid 0.15 +
Checks 6,730.92 -
Other withdrawals and service fees 600.36 -
Closing balance 2/15 $18,183.68
!~ c~, 6 ~ `11'. ~'~' ~ i«~k ~3t~~4
_- {G;~ (p;jr.~. ~~ t. /~r~-~.. 31.0:7
_. _. _ _
Deposits and Other Credits ~~'9;~'-~
Date Amount Description
1/25 6,000.00 TRNSFR 1010208656148 01/24
PHONE XFERS CONFIRMATION # V1012423055020
2/15 0.15 INTEREST FROM 01/20/2011 THROUGH 02/15/2011
2/15 17,300.00 TRNSFR 1010208656148 02/15
PHONE XFERS CONFIRMATION # V1 02 1 52049 1 040
Total $23,300.15
Interest
Number of days this statement period
Annual percentage yield earned
Interest earned this statement period
Interest paid this statement period
Interest paid this year
Checks
Number Amount Date
3602 6,690.92 2/02
Other Withdrawals and Service
27
0.05%
$0.15
$0.15
$0.37
Number Amount Date
3603 40.00 2/07
3604 ~xlts N~':~t,Rk ~~~~~
Fees -3~s 2/ ~~ ,~~~.~~ ~ ~~~~ ~
Date Amount Description
2/02 600.36 AUTOMATED DEBIT WELLS FARGO CARD PHONE PYMT
CO. ID. 2420921 140 1 1 0202 TEL
MISC 500002
Total $600.36
Number _ Amount Date
Total -X6,730.92
~, ~ ~s.
i
WACHOVIA BANK , HARRISBURG CAPITOL page 2 of 5