HomeMy WebLinkAbout11-03-11J 1505610140
REV-1500 EX ~°'-'°~
PA Depart~hent of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes Coun Code Year
Po Box 280601 INHERITANCE TAX RETURN ty File Number
Harrisbur , PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 3 1 7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
2 1 9 1 8 4 1 5 3 0 2 2 3 2 0 1 1 0 5 2 0 1 9 2 1
Decedent's Last Name Suffix
Decedent's First Name MI
F I S H E R M A E
(If Applicable) Enter Surviving Spouse's Information Below O
Spouse's Last Name Suffix
Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS
0 1. Original Return ~ 2. Supplemental Return
3. Remainder Return (date of death
4. Limited Estate ~ prior to 12-13-82)
4a. Future interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Livin Trust
(Attach Copy of Will) (Attach Copy of Trust) g ~ 8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95 11 • Election to tax under Sec. 9113(A)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX NFtORMATION SHOULD BE DIRECTED TO:
Name
Daytime Telep~tgne Number
D A V I D H S T O N E E S Q U I R E 7 1 7 `-~~ y ~~"4 ~~ ~_
_`
REGISTF,.l~16Py~g USEiONLY
First line of address ~ 's ~~
_, ~' >
4 1 4 B R I D G E S T R E E T ~ ~ ^~~
_' ~ ~:~:;
Second line of address j --, ---~ ..
,-~
is .
City or Post Office
State ZIP Code~______ DATE FILED ;
___
N E W C U M B E R L A N D P A 1 7 0 7 0
Correspondent's a-mail address: D S T O N E a7 S T O N E L A W• N E T
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.
SI NATURE OF PERSON RESPONSIBLE FOR FILING RETU N
_~ ._ ~ n ,~ TE
RESS -~ ,~ ~ l/
95 WI K R, MECHANIC BURG .._
S NATU OF PA HER THAN REPRESENTATIVE P A 17 0 5 0
'\ DATE
A ESS C.1- Z -!
414 BRIDGE BEET NEW CUMBERLAND
PLEASE USE ORIGINAL FORM ONLY P A 17 0 7 0
Side 1
L 1505610140 1505610140 ~`
~... ~
REV-1500 EX
1505610240
Decedent's Social Security Number
Decedent's Name: M A E 0• FISHER 2 1 9 1 8 4 1 5 3
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.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested
7. ....
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ... 6.
.... ... 7.
8. Total Gross Assets (total Lines 1 through 7) .
....................... .. .
8.
9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9.
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10.
11. Total Deductions (total Lines 9 and 10) ...
......................... .. .
11.
12. Net Value of Estate (Line 8 minus Line 11)
13. ..........................
Charitable and Governmental Bequests/Sec 9113 Trusts for which
12.
. .
an election to tax has not been made (Schedule J) ..... , .... 13
14. Net Value Subject to Tax (Line 12 minus Line 13)
....................
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES .. 14.
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x• 0 0 0 0 15
16.
Amount of Line 14 taxable .
at lineal rate x• 0 4 5 1 6 7 5 2 5. 6 5
17.
Amount of Line 14 taxable 1 s.
at sibling rate X .12 0 . 0 0 17
18.
Amount of Line 14 taxable .
at collateral rate X .15 fl n n
19. TAX DUE ......................................................19.
20. FILL IN THE OVAL If~ YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505610240
8 2 3. 5 9
9 1 5 3 3. 7 6
9 1 3 6 0, 4 6
1 8 3 7 1 7, 8 1
1 4 9 3 4. 5 8
1 2 5 7. 5 8
1 6 1 9 2. 1 6
1 6 7 5 2 5. 6 5
1 6 7 5 2 5. 6 5
0. 0 0
7 5 3 8. 6 5
0. 0 0
0. 0 0
7 5 3 8. 6 5
0
1505610240
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
MAE 0• FISHER _ _
STREET ADDRESS --
407 FIFTH STREET
- --- - -------- ------- - -- ----
CITY
NEW CUMBERLAND
Tax Payments and Credits:
~ • Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments 7, 2 0 0• D O
B. Discount 3 7 6. 9 3
3. Interest
File Number
21 11 0317
__ __ --
'STATE ZIP
IPA 17070-
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.
(1) 7, 538 •65
Total Credits (A + g) (2) 7 , 5 7 6 • 9 3
(3> 0.00
(4> 3 8 •2 8
(5) 0.0 0
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:
a. retain the use or income of the ro ert transferred;
P P Y ................................................................ Yes
...... ^ No
0
b. retain the right to designate who shall use the property transferred or its income;
.........................
.
.... ^
X^
c. retain a reversionary interest; or
.......................................................................................... :
..... ^
a
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? ................................................................................ ..... ^
3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? .... ..... ^ X^
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
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. §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)]. Asibling is defined, undE
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MAE 0• FISHER 21 11 0317
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
1 18 shares MetLife Inc stock a $45.755 each OF DEATH
823.59
TOTAL (Also enter on line 2, Recapitulation) I $ 8 2 3 5 9
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ M~S~r.
IN REST DENTED ~ DENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
MAE 0• FISHER 21 11 0317
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointty-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1• Inter County Supplemental Ins-premium refund 429.70
2 (Miscellaneous deposit I 417.57
3 Sovereign Bank-Checking Acct #0771102542 6,468.28
Princ• $6,468.38, Int• $05
4 Sovereign Bank-Checking Acct #0771102542 - Accrued 0.05
Interest
5 Sovereign Bank-Money Market Acct #0774101636 8,266.31
Princ• $8,266.31, Int• $1.69
6 Sovereign Bank-Money Market Acct #0774101636 - 1.69
Accrued Interest
7 Sovereign Bank-Time Deposit #0775545650 14,552.37
Princ• $14,552.37, Int• $2.79
8 Sovereign Bank-Time Deposit #0775545650 - Accrued 2.79
Interest
9 Sovereign Bank-Time Deposit #0775545668 14,398.84
Princ• $14,398.84, Int• $1.30
10 Sovereign Bank-Time Deposit #0775545668 - Accrued 1.30
Interest
11 Wachovia Bank nka Wells Fargo Savings Acct 46,989.97
#1010245308527 Princ• $46,989.97, Int• $4.89
12 Wachovia Bank nka Wells Fargo Savings Acct - Accrued 4.89
Interest
TOTAL (Also enter on line 5, Recapitulation) ~ $ q i_ _ ~ > > -,
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX+ (OS-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ca i r-i t yr FILE NUMBER
MAE 0• FISHER 21 11 0317
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACHACDPYOFTHEDEEDFORREALESTATE. VALUE OF ASSET INTEREST (IFAPPLICABLE) VALUE
1• Fulton Financial Advisors-Annuity 91,360.46 100.00 91,360.46
#21545339 beneficiaries Judith A•
Marpoe and Charlotte S• Lively
TOTAL (Also enter on Line 7 Recapitulation) ~ $ 91 , 3 6 0 4 6
If more space Is needed, use addltlonal sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
MAE 0• FISHER 21 11 0317
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
Stone & Murray Funeral Home-funeral expenses
Judith Margpoe-Reimb on funeral luncheon
Judith Marpoe-Reimb for church organist
B• ~ ADMINISTRATIVE COSTS:
AMOUNT
6,974.00
197.23
125.00
1. Personai Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2. AttomeyFees: David H • Stone, Esquire 2, 500 • 00
3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation.) 3 , 5 D D • D D
Claimant Judith A Marpoe
Street Address 9 5 Keswick D r i v e
city Mechanicsburg state FA zIP 17050
Relationship of Claimant to Decedent D a u g h t e r
4• Probate Fees: Register of Wills Cumberland County 153.50
5 , Accountant Fees:
6 • Tax Return Preparer Fees:
7• Sovereign Bank-fee for value of accounts 20.00
2 Chandelle Spayd-notary fee on probate papers 5.00
3 Social Security Adm-return of March payment 1,294.00
4 Judith A Marpoe-Reimb for mailing & cell phone bill 35.85
5 Register of Wills-filing Inh Tax Return & Inv 30.00
6 Reserve for closing expenses 100.OD
TOTAL (Also enter on Line 9, Recapitulation) $ y 4 , 9 3 4 • 5 8
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
FILE NUMBER
MAE 0• FISHER 21 11 0317
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VAOF DEADHTE
1 West Shore EMS-ambulance services 1,121.98
2 Moffit Heart Assoc-services rendered 67.80
3 New Cumberland Family Practice-services rendered 67.80
TOTAL (Also enter on Line 10, Recapitulation) I $ 1, 2 5 7 5 8
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF:
MAE 0• FISHER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1• JUDITH A MARPOE
95 KESWICK DRIVE
MECHANICSBURG PA 17050-
2 CHARLOTTE S LIVELY
3236 ELMAE DRIVE
LANCASTER PA 17601-
FILE NUMBER:
21 11 0317
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Lineal I 83,762.83
Lineal ~ 83,762.82
~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER SHEET AS 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.
ESTATE OF MAE O FISHER
REV-1500 Inheritance Tax Return Resident Decedent
Additional address from Co-Executrice on Front Page
3236 ELMAE DRIVE, LANCASTER, PA 17601
Schedule H
#3. Family Exemption
File No. 21-11-0317
Explanation of different address: Judith A. Marpoe's residence was 407 Fifth Street, New
Cumberland, PA 17070 at the time of Mae O. Fisher's death. Judith has since moved and now
lives at 95 Keswick Drive, Mechanicsburg, PA 17050.
,i
' ~'
LAST WILL AND TESTAMENT
OF
MAE O. FISHER
I, MAE O. FISHER, of the Borough of Columbia, Lancaster
County, Pennsylvania, hereby revoke all Wills and Codicils, as
~~
well as all other instruments of a testamentary nature, hereto- ~
fore made by me, and do hereby make, publish and declare this to
be my Last Will and Testament.
FIRST: I direct that my hereinafter named Executrices
pay all my just debts and funeral expenses as soon after my
decease as may be practicable.
SECOND: I give, devise and bequeath all of my estate,
both real and personal property, to which I may be entitled, or
over which I may have any disposing power at the time of my death,
in equal shares, to my daughters, CHARLOTTE M. LIVELY and JUDITH
it ANN MARPOE, or to their issue per stirpes.
!~
!i
~~ THIRD: I nominate, constitute and appoint my daughters,
CHARLOTTE M. LIVELY and JUDITH ANN MARPOE, or the survivor of them,
to be the Executrices or Executrix of this my Last Will and
Testament.
IN [VITNESS WHE F, I, MAE O. FISHER, the Testatrix,
have to this my Lash Wil ld Testament set my hand and seal
-~ ,~ ,~~
this ~~' day of 1992.
.`
~ ~ ~
l ~' ~~ .~~T-~-~~~'~t~ ~ SEAL )
Mae 0. Fisher
p i:.' 1.:.. .. .. -.. .. ..
.1
I
!i Signed, sealed, published and declared by the within
named MAE O. FISHER as and for her Last Will and Testament in
,;
'; our presence and we, at her request and in her presence, and
in the presence of each other, have hereunto subscribed our
names as witnesses.
:,~
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Sovereign
~~u~~~u r~vccssmg ~ veceaents - MAI-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284
April 22, 2011
David H. Stone
Stone LaFaver & Shekletski
414 Bridge St
P.O. Box E
New Cumberland, PA 17070
RE: Estate of Mae O. Fisher
Date of Death: 02/23/2011
Dear Sir or Madam:
Per your request, enclosed please find the account information as of the date of death
for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
Please feel free to contact me if I can be of any further assistance.
Very truly yours,
~-~t. ~ ~~1 ~~~
Donna M. Long
Lead Specialist
Phone:617-514-5189
Fax: 617-533-1931
Sovereign Bank
ESTATE OF Mae O. Fisher
SOCIAL SECURITY #: 219-18-4153
DATE OF DEATH: February 23, 2011
Account #: 077 1 1 02542 Type: Checking Open date: 3/6/2008
In the name of: Mae O. Fisher
Date of Death Balance: $6,468.28
Int.(YTD) from 1/1/2011 to 1/24/2011 $0.05
Accrued interest to date of death: $0.05
Otherlnfo:
Account #: 0774101636 Type: _ Money Market Open date: 7/20/2009
In the name of: Mae O. Fisher
Date of Death Balance:
Int.(YTD) from 1/1/2011 to
Accrued interest to date of death: _
Other Info: Account Closed 03/10/2011
Account #: 0775543705 Type: _ Time Deposit Open date: 10/20/2008
In the name of: Mae O. Fisher
Date of Death Balance: Closed Prior to Death
Int.(YTD) from to
Accrued interest to date of death:
Other Info: Account Closed 04/21/2010 $2,075.32
Account #: 0775544646 Type: Time Deposit Open date: 2/3/2009
In the name of: Mae O. Fisher
Date of Death Balance: Closed Prior to Death
Int.(YTD) from to
Accrued interest to date of death:
Other Info: Account Closed 02/04/2010 $28,769.58
Account #: 0775544869 Type: Time Deposit Open date: 3/27/2009
In the name of: Mae O. Fisher
Date of Death Balance: Closed Prior to Death
Int.(YTD) from to
Accrued interest to date of death:
Other Info: Account Closed 03/29/2010 $2,050.07
$8,266.31
$1.69
$1.64
1 /24/2011
Page 1 of 2
Sovereign Bank
ESTATE OF Mae O. Fisher
SOCIAL SECURITY #: 219-18-4153
DATE OF DEATH: February 23, 2011
Account #: 0775545650 Type: Time Deposit Open date: 2/4/2010
In the name of: Mae O. Fisher
Date of Death Balance: $14,552.37
Int.(YTD) from 1/1/2011 to 2/4/2011 $25.65
Accrued interest to date of death: $2,79
Otherlnfo:
Account Closed 03/10/2011
Account #: 0775545668 Type: Time Deposit Open date: 2/4/2010
In the name of: Mae O. Fisher
Date of Death Balance: $14,398.84
Int.(YTD) from 1/1/2011 to 2/22/2011 $417.57
Accrued interest to date of death: $1.30
Other Info: Account Closed 03/10/2011
Page 2 of 2
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FuLroty FINANCIAL ADVISORS`
Ma~tdng Success Persona!'
V~
December 31, 2010 to March 31, 2011
Account # 21545339
GREGORY MALIN
Raymond James Financial Services, Inc.
RAYMOND JAMES FINANCIAL, SVCS ~ ONE PENN SQUARE LANCASTER, PA 17602
~ (717) 763-2098
Greg.Malin~RaymondJames.com
Ilrllllll~'11111'III~~~~III'I'~Illl~lll~lr~ll~ll~l'll'I'~111~'~'I
MAE FISHER
407 5TH ST
NEW CUMBERLAND PA 1 7070-1 81 5073
449
Value This Statement
$91,360.46
Last Statement
$90,661.23
Raymond James Client Services
800-647-BERN (7378)
Monday -Friday 8 a.m. to 6 p.m. ET
Online Account Access
raymondjames.com/investoraccess
This Statement Year to Date
Prior Year-End
$90, 661.23
Beginning Balance $90,661.23 $90,661.23
Deposits $0.00 $0.00
Income $0. GO $0.00
Withdrawals $0.00 $0.00
Expenses $0.00 $0.00
Change in Market Value $699.23 $699.23
Ending Balance $91,360.46 591,360.46
• Your primary objective is Capital Preservation, with a low risk tolerance and a 5 to 10 year time horizon.
s~ Account carried by Raymond James 8 Associates, Inc ~ Member New York Stock ExchangelSlPC
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