HomeMy WebLinkAbout10-14-111505610105
REV-1500°``°Z-11"~' ~
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes """"'«E«' «EYE«~E Counry Code Year file Number
PO BOX z8o6oa_ ~ INHERITANCE TAX RETURN ~/
Harrisburg, PA i'7128-o6oi RESIDENT DECEDENT ~ ~ ~i -I 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
200-240332 05/03/2009 12/05/1931
Decedent's Last Name Suffix Decedent's First Name MI
Fisher Elizabeth A
(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 Retum 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 l'ax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust B. 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 Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX fNFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Fiona K. Fadness, Esq. (717) 991-1382
First Line of Address
301 South Hanover St
Second Line of Address
City or Post Office
Carlisle
State ZIP Code
PA 17013
REGISTER OF WILLS USE,ONLY
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Correspondknt's e-mail address: flCIeSQUIre(a7aOI.C01'Yl
Under o perjury, I deGare that I have examined this return, inGuding accompanying schedules and statements, and to the Vest of rriy knowledge and belief,
it i co and complete. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUR O ERSO SPONSIBLE FOR FILING RETURN DATE
ADDRESS
1565 Longs Gap Road, Carlisle, PA 17013
SIGNA OF PREPARER OT Elj T~jAN PRESENTATIVE
Y DATE
~s.._....,~ _ //l /G/..//
301 South Hanover St., Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: Elizabeth Fisher 200-240332
RECAPITULATION
1. Real Estate (Schedule A) ......................................... .... 1. 82,000.00
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. 25,132.73
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested..... ... 7. 3,228.62
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 110,361.35
9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 27,316.06
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 80,036.92
11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 107,352.98
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 3,008.37
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. 3,008.37
TAX CALCULATION -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 .0_ 15.
16. Amount of Line 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 3,008.37
at collateral rate X .15
18.
451.26
19. TAX DUE ...................................................... ... 19. 451.26
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
DECEDENTS NAME
Elizabeth A Fisher
STREET ADDRESS
627 South West St
--- ---- ----- -- -- -- --- ---- STATE- ------- TZIP ---
CITY
Carlisle PA 17013
File Number
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19}
2. Credits/Payments
A. Prior Payments
B. Discount
(1)
45126
3. Interest
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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Total Credits (A + B) (2)
(3)
(4)
(5)
27.05
478.31
Make check payable to: REGISTER OF WILLS, AGENT.
PLFr4SE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRNATE 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 ...................................... ...... ^
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" orpayable-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)].
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 swviving 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(x)(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(x)(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(x)(1.3)]. Asibling 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-isoz Ex+ ~? z-os~
j ~ pennsytvania
~.~7 DEPARTMENT Or REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
ELIZABETH A FISHER 21-09-0686
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 properly that is jointly-owned with right of survivorship must be disclosed on Schedule F.
If more space is needed, insert additional sheets of the same size.
REV-i5o8 EX+ (u-io)
Pennsylvania SCI~IEDULE E
~i7 DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELIZABETH A FISHER 21-09-0686
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joinHy owned with right of survivorship must be disclosed on Schedule F.
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+ (OS-~,9;
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
ELIZABETH A FISHER 21-09-0686
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-150(1 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE DF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
E)(CLUSION
LIP APPUCaeLEI
TAXABLE
VALUE
i ~ Thrivent Financial Bank -IRA Acct # 7545851
3,228.62 100 3,228.6:
TOTAL (Also enter on Line 7, Recapitulation) $ I 3,228.62
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (.0-09)
~~i pennsytvania
DEPA RDEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
ELIZABETH A FISHER 21-09-0686
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Hoffman Roth Funeral Home -Funeral Expenses 10,267.69
2. Westminster Cemetary -Grave Opening 2,250.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address .____ ___
City _----- -----_--_- _ State ZIP
Year(s) Commission Paid:
~• Attorney fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address ___ _ -__
City _ -_ State __ ZIP __
3,500.00
Relationship of Claimant to Decedent
4• Probate Fees: 260.00
5• Accountant Fees:
5. Tax Return Preparer Fees:
~~ Citizens Bank -Interest Payment on Line of Credit 4,007.37
s. Legal Advertising -Cumberland County Law Journal 75.00
s. Real Estate Settlelment Costs -Transfer Tax, Settlement Costs and Realtor Fees 5,890.00
i o Pam Fisher -Reimbursement of Electric Bills 750.00
~ ~ Pam Fisher -Reimbursement of Lawn Maintenance 210.00
i2 Maintenance Fees for Estate Checking Acxount 106.00
TOTAL (Also enter on Line 9, Recapitulation) $~ 27,316.06
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ !12-OS)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
ELIZABETH A FISHER 21-09-0686
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 ~ Citizens Bank -Home Equity Loan 66,265.65
2. Carlisle Borough - Water Bill 297.72
3. Thomwald Home -Nursing Home Bill 6, 310.24
4. Cumberland County Tax Claim Bureau - 2008 Real Estate Taxes 2,308.00
5. Cumberland County Tax Claim Bureau - 2009 Real Estate Taxes 2,455.42
6. Cumberland County Tax Claim Bureau - 2010 Real Estate Taxes 2,399.89
TOTAL (Also enter on Line 10, Recapitulation) I $ 80,036.92
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
Pennsylvania
~.~7 DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDEiJT
SCHEDULE
BENEFICIARIES
ESTATE OF: FILE NUMBER:
ELIZABETH A FISHER 21-09-0686
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustees} OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1• Stephen G. Fisher, 1565 Longs Gap Rd., Carlisle, PA 17013 Brother 0
2. Caroline J. Jardine, 685 Barnstable Rd., Carlisle, PA 17015 Sister 0
3. Kevin Fisher, 2829 Regency Dr., Winston Salem, NC 27106 Nephew 0
4. Donna March 131 North East St., Carlisle, PA 17013 Niece 0
5. Karen Fisher Szweic, 102 Friar Tuck Dr., Niceville, FL 32578 Niece 0
6 Alison Krom, 10 Carter Place, Carlisle, PA 17013 Great Niece 0
7 Rebecca Greeger, 17 S Baltimore Ave., Mt Holly Springs, PA 17065 Great Niece 0
8 Patrick O.Donnell, 619 N West St., Carlisle, PA 17013 Great Nephew 0
9 Stephanie E. Fisher, 1565 Longs Gap Rd., Carlisle, PA 17013 Great Niece 1,504.19
10 Scott E. Fisher, 125 North Orange St., Carlisle, PA 17013 Great Nephew 1,504.19
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON L[NES 15 THROUGH 18 OF REV-1500 COVER SHEEP, A S APPROPRIATE.
II NON TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
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, use additional sheets of paper of the same size.