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Home My WebLink About08-29-11 (3)1505610143 REV-1500 Ex(°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 11 0437 Harrisburg, PA 17128-OS01 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 169 44 2930 03 24 2011 12 04 1955 Decedent's Last Name Suffix Decedent's First Name MI FE LKER Jp,ME g R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Return 4. Limited Estate ~ qa, Future Interest Compromise (date of death after 12-12-82) g ~ ecedent P~ odf ~siate Attach Co ) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Povert Creditl(date of death between 12-31 X31 and -1-95) r 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required MI 8. Total Number of Safe Deposit Boxes C 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 TO: Name Daytime Telephone Number ROBERT G RADEBACH 717 896 2666 First line of address 912 NORTH RIVER ROAD Second line of address City or Post Office State ZIP Code HALIFAX PA 17032 Correspondent's a-mail address: mISSySWartz51 @aOI.COm REGISTER ~W~ ILLS USE.ONLY _t _--~~~~ ; r ~-i t , - ~;, .- ? \_i.y .) - DAIS FED under penalties of perjury, I declare that I 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. SIGNATURE OF PERSON RFSPnNSiRi F FnR Fu wr aFn ipu ADDRESS Ned D Felker -~dcl 451 B e tre t all x PA 17032 SIGNATUR PRE H H R RESENTATIVE DATE Robert G Radebach $ ~ a y_ o~ 6 ADDRESS 912 North River Road, Halifax, PA 17032 Side 1 15D5610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Felker, James R 169 44 2930 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 10 5, 5 7 7. 0 0 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... . 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. . 5. 25 , 94 9.99 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 43 , 957.72 7. Inter-Vivos Transfers & Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. 43 , 448.28 8. Total Gross Assets (total Lines 1-7) .................................................................... . 8. 218 , 932.99 9. Funeral Expenses & Administrative Costs (Schedule H) .............................. ......... 9. 5 , 93 6. 2 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..................... ......... 10. 80 6.71 11. Total Deductions (total Lines 9 & 10) .......................................................... ......... 11. 6 , 742.99 12• Net Value of Estate (Line 8 minus Line 11) .................................................. ........ 12. 212 , 190.00 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. 212 , 190.0 0 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 lineal rate X .045 190 211.14 r 16. 17. Amount of Line 14 taxable at sibling rate X .12 21 , 9 7 8 . 8 6 17. 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18. 19. Tax Due ................................................. ................................................................ . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 8,559.50 2,637.46 0.00 11,196.96 Side 2 ^ 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0437 DECEDENT'S NAME Felker, James R STREET ADDRESS - 205 Spring Lane CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.00 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 (1) 11,196.96 Total Credits (A + g) (2) 0.00 (3) (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 11,196.96 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 :.................................. ^ ^x c. retain a reversionary interest; or ............................................................................................................... ^ 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? .................................................................................................................... ^ ^x 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? .................................................................................................................. ^x ^ 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 January 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 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)]. . 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)]. 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-1502 EX+(~~-OSj SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Felker, James R 21-11-0437 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. t~~ nwia space Is neeaea, aoantonal pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-OS) Rev-1508 EX+~6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Felker, James R 21-11-0437 All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash Held at Home by Decedent 207.05 2 Funds from Gallagher Bassett 567.99 3 Money Received for 4 Guns 550.00 4 Refund from P.P.L. 54.64 5 Refund of Security Deposit 685.00 6 Refunds from Erie Insurance Group 203.00 7 Metro Bank -Checking Account 18,782.31 8 2000 Dodge Durango 3,200.00 9 Personal Property Sold within Decedent's Apartment (Utensils, Breakfast Set, Living Room 1,700.00 Set TOTAL (Also enter on Line 5, Recapitulation) I 25,949.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-7509 EX+(6.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Felker, James R 21-11-0437 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ned D. Felker B. Ronald N. Felker C. 451 Boyer Street Father Halifax, PA 17032 27 Galli Road Brother Halifax, PA 17032 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A PSECU - 12 Month Certificate -Ned Felker's 10,555.47 16.667% 1,759.28 Share-Father of Decedent 2 A PSECU - 12 Month Certificate -Ned Felker's 17,246.45 16.667% 2,874.47 Share-Father of Decedent 3 B PSECU -12 Month Certificate -Ronald 10,555.47 16.667% 1,759.28 Felker's Share-Brother of Decedent 4 B PSECU -12 Month Certificate -Ronald 17,246.45 16.667% 2.874.47 Felker's Share-Brother of Decedent 5 A PSECU - 24 Month Certificate -Ned Felker's 33,341.31 16.667% 5,557.00 Share-Father of Decedent 6 B PSECU - 24 Month Certificate -Ronald 33,341.31 16.667% 5,557.00 Felker's Share-Brother of Decedent 7 A PSECU - 48 Month Certificate -Ned Felker's 50,526.12 16.667% 8 421 19 Share-Father of Decedent , . 8 B PSECU - 48 Month Certificate -Ronald 50,526.12 16.667% 8,421.19 Felker's Share-Brother of Decedent Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 6, Recapitulation) I 43,957.72 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY continued ESTATE OF FILE NUMBER Felker, James R 21-11-0437 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 9 A PSECU Checking Account -Ned Felker's 9,970.99 16.667% 1,661.86 Share-Father of Decedent 10 B PSECU Checking Account -Ronald Felker's 9,970.99 16.667% 1,661.86 Share-Brother of Decedent 11 A PSECU Savings Account -Ned Felker's 10,230.13 16.667% 1,705.06 Share-Father of Decedent 12 B PSECU Savings Account -Ronald Felker's 10,230.13 16.667% 1,705.06 Share-Brother of Decedent TOTAL (Also enter on Line 6, Recapitulation) I 43,957.72 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Felker, James R This schedule must be wmpleted and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF R~ANSFERSATTACFi A COPYEOF T~E DEIED ~OREREAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Ingersoll-Rand 401(k) 43,448.28 43,448.28 TOTAL (Also enter on Line 7, Recapitulation) I 43,448.28 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) FILE NUMBER 21-11-0437 REV-1151 EX+(10-05) COMMONWEALTH OF PENNgYLVANIA INHERITANCE ~ RETURN RE IDEN DE EDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Felker, James R 21-11-0437 Debts of decedent must be reported on Schedule I. ITEM N MBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached I 3,475.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees 2,000.00 See continuation schedule(s) attached 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 175.50 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 285 78 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 5,936.28 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Felker, James R 21-11-0437 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral Ex enses Hetrick Boyer Funeral Home 3,475.00 Att F H-A 3,475.00 2 orney ees Robert G. Radebach, Esquire 2,000.00 P b t F H-B2 2,000.00 3 ro a e ees Fee to Open Estate - Register of Wills 175.50 Oth Ad i i H-64 175.50 4 er m n strative Costs Advertising Fee -Cumberland Law Journal 75.00 5 Advertising Fee -The Sentinel 210.78 H-B7 285.78 Copyright (c) 2002 form software only The Lackner Group Inc , . Form PA-1500 Sched ule H (Rev. 6-98) Rev-1512 EX+(12-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Felker, James R 21-11-0437 Report debts incurred by the decedent prior to death that remained unpaid at the date of daaeh ~~d~„~L,.. ~....e~...ti.,.--,, ..._,.:__~ ________ ..._. _ ..r...... ,.. ~ ~...,.. ~ ~+uiuvi iai payCS of uie same s¢e) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) COMINHRESIDE ITEDECEDEN~RNANIA SCHEDULE J BENEFICIARIES ESTATE OF Felker, James R NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 Ned D. Felker 451 Boyer Street Halifax, PA 17032 FILE NUMBER 21-11-0437 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) Father 1100% of the Residue ~ ~ Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet, as a ro I NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I OTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)