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HomeMy WebLinkAbout08-08-11 (2)-I Z5D561D7,D5 REV-15(30 =x~°~ :'"-~' ~~ OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes `"' ~ County Code Year File Number INHERITANCE TAX RETURN ,~ PO BOX z8D6oi t' f ~ ' Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT ~~ ~ t._ ~ r? (- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Iti1P~1DDYYYY Date of Birth 11MDDY','YY 148-18-7493 11 /11 /2010 10/06/1924 Decedents Last Name Suffix Decedent's First Name MI Fithian Bernice M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N/A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER 4F WILLS FILL 1N APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return {Date of Death Pror to 12-13-82) p 4. Limited Estate Q 4a. Future Interest Compron?ise (date of O 5. Federal Estate Tax Return Required death after 12-12-82j t=3 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of NJill) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 1i. Election to Tax under Sec. 9113(A} Between 12-31-91 and 1-1-95} (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephonetuber Jered L. Hock (717) 991-9889~~ -~- -1~ ~ ~~ --~-, ,- - REGISTER OFWIF~,~~ItSE ONW:' - _ > ~'T'1 t First Line of Address - - C ~ 1 1334 Kiner Blvd. ~ - ~77 . Second Line of Address _ - ~ ---i . . Y> City or Post Office State ZIP Code DATE FILED Carlisle PA 17015 Correspondent's a-mail address: jeredhock@gmall.com -~~ _ i=-~ ~; -'~ ~• ~ ~; ~.~ Under penalties of penury, I decare that I have examined this return, including accompanying schedules and statements; and to the best of my know--ledge and belief; it s true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. 5 RE OF P RSO RESP NS LE FOR FI G RETURN DATE ~ 08/11/2011 ~~~~ 1334 Kiner Blvd., Carlisle PA 17015-9769 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1,5D561,D1,D5 1,5D56ZD1~05 ~~~ r i J 1505610205 REV-1500 EX (FI} Decedent's Social Security Number Decedents N~~,P: Bernice M. Fithian 148-18-7493 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 1,681.43 3. Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Ntortgages and Notes Receivable (Schedule D) ......................... .. 4. 0.00 5. Cash. Sank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 3,127.20 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 4,808.63 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9: 2,378.99 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 663,207.31 11. Total Deductions {total Lines 9 and 10} .............................. ... 11. 665,586.30 12. Net Value of Estate (Line 8 minus Line 11 j ........................... ... 12. 0.00 13. Charitable and Governmental Bequests,-Sec 9113 Trusts for ~.vhich an election to tax has not been made {Schedule J) ..................... ... 13. 0.00 14. Net Value Subject to Tax {Line 12 minus Line 13) ..................... ... 14. 0.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATE5 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Une 14 taxable at lineal rate X .0 16. 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. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 15056],0205 150561,0205 J REV-1500 EX !Fi) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAA-0E Bernice Fithian, aka Bernice M. Fithian STREET ADDRESS Sarah A. Todd Memorial Home 1000 West South St. CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: t Tax Due (Page 2, Line 19) (1} 0.00 2. CreddsiPayments A. Priar Payments B. Discount Tatal Credits (A + B) (Z} 0.00 3. Interest ----_ ---- -- (3i _ 0.00 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. (~) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ 0.00 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 ...................................._ ~_...., ....., iJ c. retain a reversionary interest ........................................................................................................................ ...... J d. receive the promise for life of either payments, benefts or care? ............................................................... _. ....... 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... J 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ....... ....... '_J 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)]. 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. §9110 (a} (1.1) (ii)]. 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)]. 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. REV-15G3 EX+ ;;5-98j SCHEDULE B COMMONWEALTH OF PENNSY~V.4NIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bernice Fithian, aka Bernice M. Fithian 21-10-1141 All oroaertv jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets or the same size) REV-i5o8 EX+ (ir-so) ,~ SCHEDULE E • pennsylvania DEPAP,rMENT or aEVENUE CASH, BANK DEPOSITS & MISC. eNHERtraracE r~ax REruRN PERSONAL PROPERTY RESIDENT DECECEN- ESTATE OF: FILE NUMBER: Bernice Fithian, aka Bernice M. Fithian 21-10-1141 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. If more space is needed, use additional sheets of paper of the same s,ze. y ~~ perms lvania SCHEDULE G DE?An~MENT~F:'.EVENUE INTER-VIVOS TRANSFERS AND cr,r:ER:TANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESICENT DECEDENT ESTATE OF FILE NUMBER Bernice Fithian, aka Bernice M. Fithian 21-10-1141 This schedule must be completed and fired if the answer to ony cf c:uestions 1 through 4 on page three of the REU-].500 is yes. it more space is needed, use add`tior:al sheets cs paper or the same size. f2GV-_SI I E; _ ~i-0°; Pennsylvania : De~°ART: MENT OF REVENUE INHERITANCE TAX RETURN RESIDEPJT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Bernice Fithian, aka Bernice M. Fithian 21-10-1141 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTIOPd Ah'OUNT A. FUNERAL EXPENSES: 1 Hollinger Funeral Home, reserve for monument inscription 540.00 2. Giant, flowers for grave at burial 8.48 6. ADMINISTRATIVE COSTS: 1, Personal Represer:.tative Commissions: Name(s) of Persor:.a! Representatives; Jered L. Hock Street Address 1334 Kiner Blvd. city Carlisle state PA ZIP 17015 Years; commission Paid: 2011 -Please see explanation attached for fee calculation 2. Attorney fees ~. Family Exemption: (If cecedent's address is na: the same as claimant's, attach explar:.atien.',. Claimant Not applicable Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accounta~:t Fees: 6. Tax Return Preparer Fees; Reimbursibles pd to Jered L. Hock for parking, mileage, postage, photocopy, certified letters, etc.: these reimbursables are included here, as I didn't End another place for them. There are no separate tax preparer's fees. TOTAL (Also enter on Line 9, Recapitulation) $ if more space is needed, use add`tional sheets r` paper of the same size. 1.385.50 0.00 0.00 366.58 0.00 78.43 2,378.99 BERNICE FITHIAN, aka BERNICE M. FITHIAN DOD 11 11 10 File No. 21-10 -1141 Statement regarding executor's fee: I have kept contemporaneous records of time devoted to this matter, money advanced for mailings, mileage, photocopy, etc. I did not hire a lawyer, as I am a retired lawyer who settled many estates in Pennsylvania while engaged in private practice; accordingly, I thereby saved money for the estate by not hiring a lawyer. I charged $85 per hour, billed to the tenth of the hour. I know attorneys who are charging $200-$225 per hour for themselves and $95 and $100 per hour for their paralegals, in addition to what executors are paid. Accordingly, I feel that my $85 per hour, doing the work of both the executor and attorney, was very reasonable. This was a quite small estate. Nonetheless, performing all the tasks required took time which, in many instances, was essentially the same as the time that would be expended on comparable tasks with estates of considerable size. In addition, the decedent had no family, except some nieces in Texas, who did not maintain contact with her, who did not perform any services for their aunt, and who did not appear for the funeral or otherwise. In short, "it was all up to me." k CV -512. E) %-(>~.rj ~~ Pennsylvania SCHEDULE I 1~ ~=-ARri9ENT ~~ REvE^1~= DEBTS OF DECEDENT, rnr.ERrarucE rax REruRV MORTGAGE LIABILITIES & LIENS RESICENr DECEDENT ESTATE OF FILE NUMBER Bernice Fithian, aka Bernice M. Fithian 21-10-1141 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. iTEJ~1 I ! VALUE AT DATE ^JUM3ER ~ DESCRIPTIO~J i OF DEATH 1 ~ H. Romaine Sheaffer, POA, services provided, expenses reimbursed, for final six month's of decedent's life (note: decedent had no family to perform these obligations on her behalf from June-Nov 2010). 390.00 2. I Commonwealth of Pennsylvania, Dept. of Public Welfare, Lien for medical expenses + related expen- I ses for decedent in final six months of life. 32,367.15 3. I ' H. Romaine Sheaffer, POA, services provided, expenses reimbursed, on behalf of decedent, for the 12 months before the last six months of decedent's life (decedent had no family to perform these obli- i ! gations and attend to these matters on her behalf); this is for the period from July 2009 -June 2010). ! 500.00 4. ~ Commonwealth of Pennsylvania, Dept. of Public Welfare, Lien for medical expenses and related I expenses for decedent for period before the last six months of decedent's life). 629,950.16 TOTAL ;Also enter on Line 10, Recapitulation;; ~ 5 663.207.31 If more space is need?d, insert additiona sheets of the same size.