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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 C7 n~ _..-. = _ _ _,~ -. _~~ _~ ,~ -,~ TSq'F~i FILED Z ~ .:,~ ~ C -. --Fi ., i' .-r:. 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.