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Home My WebLink About01-20-12 (3)J 1505610143 REV-1:00 °``°'~'°' OFFICIAL USE ONLY PA Departrrant d Revenue Pennsylvania County Cods Y.v Flb Number Bureau of Individual Taws o.~..rra~.+~e Po Box28oeo1 INHERITANCE TAX RETURN 21 (`~j g$a- Hartlsbtxp, PA 17128-0801 RESIDENT DECEDENT ENTER DECEDENT MFORMATiON BELOW Social Setxail)r Number Date of Death Date of Birth 180 03 9368 07 25 2005 02 10 1915 De~dertt'e last ~~ Suffa Decedent's First Name MI RUSSELL ~Ry A (ff APPS) Ert~sr Surviving Spouse's Information Belotiv Spouse's Last Name SufFoc Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS F~L NV APPROPRIATE OVALS BELOW Q 1. Original Relum ^ 2. Suppbnardal Return ^ 3. RertalrKbr Rehrm (date of death priorto 12-13-62) ^ ~. Utnked Est ^ ~. ~~ a ~ ~ ~ ^ 5. Federal Estate Tax Return RegWrod ^ 8. ~~ ~a~~ ^ 7, ~ a LiNrq Truce ~ 8. Total Number of Sal'•s Dsposk t3cores ^ 9. Liliyalian Proceeds Received ^ 10. °W' ~~~~ ^ 11.E Soh. O)undsr Sec. 9113(/y - Tlbs >IECTION MUST SE COMPLETED. ALL AND CONRDENTIAL TAX INFORMATION sIlOULD t~ DNS TO: ~~ Dayttrrte Telephone Number JESSICA L FISHER 717 697 3223 First Nne of address 555 GETTYSBURG PIKE Second line of address STE C100 City or Post OfM:e r~cHANlcssvRG State Z~ Code PA 17055 x^ ~~-. . ~-'i cornsportdeftrs a-rrtaN adanss: J~icaQksystot»slderiaw.com thMsr peralMss oI perjray, I declare tlat I haw srramkad itds ratum, a~o~aryinp soladrdss and staternsrhs, and ~ the beat oI N to hw, correct and oanpisb. Dsolaratlon or proparor alhsr flan Ua persortai repreesrHsave b tweed on aN krforrrpitfon of v+Ftloh ~ and ' preparer has arty bavrladae. • /.~'"~.~ss~L Terry Russell 1 ~ ~o ~ ~..o l Z-- 3100 Mominpside Drive, Ca~tip Hill, PA 17011 310NATl1rtE OF PREPAttER OTHER THAN R~RESENTATNE DATE o`~. ~Q^ Jessica L. Fisher (~a~ ~a.~1~.- ADorctrA 565 Gettysburg Pike, Mechanicsburg, PA Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedents Sodal Security Number ~^~'_ ~»~ Russell, Mary Arlene 18 0 .0 3 93 68 RECAPITtKATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stodca and Bonds (Sc~e~le B) ................................................:............................ 2. 3. Ckxiey Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ......... 3. 4. MortBepss & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits 8 Mitcelieneotrs Personal Property (Schedule E) ............... 5. 6. Jokdly Owned Property (Schedule F) ^ Separate Billing Requested ............ 6. 51, 605.00 7. Inter-Viws Transfers 8 MfsosNaneous Nq~robate P~pe~y (Schedule G) Se arate BIAi R t d LJ p r~ eques e ............ 7. 8. Total Dross Assets (total Lines 1-7) ..................................................................... 8. 51, 605.00 9. Funeral Expenses 8 Ave Costs (Schedule H) ....................................... 9. 10. Debts a Decedent, Mortgage Li~ilitles, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 810) ................................................................... 11. 12. Net value of Estate (Una 8 minus Line 11) .......................................................... 12. 51, 60 5 . 0 0 13. Charitable and Goerorrnnsrrtal Bequssb/Sec 9113 Trusts for which an election to-tax has not been made (Sc~redule J) ............................................... 13. 14. Net Value Sutrjed to Tax (Line 12 mMus Line 13) ............................................... 14. 51 , 60 5 . 0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount a Line 14 taxable ~ the spousal tax rate, or trarrafers under Sec. 9116 (aX1.2) X .00 15. 0 . 0 0 1s. ~ gAmo~ r ~ 1 0 51, 605.00 1s. 2 , 322.23 17. Amount a Line 14 taoaible at sibNrrp rate x .12 0.0 0 17. 0.0 0 18. Amount a Line 14 taxable at oogetsral rate X .15 0 . 0 0 18. 0.0 0 19. Tax Due .................................................................................................................. 1s. 2 , 322.23 20. FILL IN TFIE OPAL IF YOU ARE REGUESTINO A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 REV 1500 EX Pape 3 Decedent's Complete Address: File Number 21 DECEDENTS NAME Russell. (Nary Arisns STREET ADDRESS 3100 MominBsidlt DHw CITY STATE ZIP Carnp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payrrrents A. Prior Paynrerrts 0.00 B. Discount 0.00 Totai Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greeter than Line 1 + Una 3, enter the differerx;e. This is the OVERPAYMENT. (4) Chedr box on Pape 2 Une ZO to roquest a refund 0.00 742.86 5. If Line 1 + Line 3 is greeter then Une 2, enter the dN'ference. This is the TAX DUE . (5) 3,066. ~ 8 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Dkl decedent melee a transfer and: Yes No a. retain the use or kxxxne d the property transferred : ............................................................................... x b. retakr the right to desigttete who shall use the property transferred or tta income : .................................. c. retain a roversiorrsry interest; or ............................................................................................................... x d. receive the prorrdte for life d either peyrrrents, bertsflts or cero~ ............................................................ x 2. If death occxxred after December 12, 1982, dkl decedent transfer property within one year d death without roeivinp adequste coraideration? .................................................................................................................... ^ a 3. DkJ decedent own an `In trust for' or payable upon death bank account or security at his or her death? ....... ^ 4. Did decedent own ~ Ir~vidusl Retirement Ac~unt, annuity, or other non-probate property which contains a bsnefidary deei~fon? .................................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABOVE t3~ST10NS IS YES, YOU MUST COMPLETE SCHEDULE O AND FILE R AS PART OF THE RETURN. For dates d death on or alter Juy 1,191#4 and bsforo Jan. 1, 1995, the tax rate knposed on the nd valeta d transfers to or for the use d the surviving spouse is 3 psrcerrt (!2 P.S. §9118 (a) (1.1)(9]. For dates d death on or after January 1, 1965, the tart vale knpossd on the net value d transfers to or br the use d the survivkrp spouse is 0 percent (72 P.S. §9118 (a) (1.1)(191. The statute does not eoaempt a transfer to a surviving spouse from tax, and the statutory ~ for discloeuro d asset and flNng a tax return aro atlN appNrx~ble even if the surviving spouse fs the ony benetldary. For dales d death on or attar July 1,2000: • The tax rats krrposed on the net valve d transfero from a deceased chik121 yeero d age or younger at death to or for the use d a r>aturol parent, an adoptive paront, or a stepparent d the c~rlld is 0 percent [72 P.S. §9118 (a) (1.2)]. . The tax rats imposed on the net wilds d trarafars to or for the use d the decedent's grbal benstlciaries is 4.5 percent, except as nded in 72 P.S. X118 1.2) [72 P.S. §9118 (a) (1)j. • The tax rats hnPosed on the net value d bansfsrs to or for the use d the decedent's sibNrps is 12 percent (72 P.S. §9118 (a) 1.3) . A srdirp is defkrsd under Section 9102, as an individual who has at least one parent in common with the decedent, whether by or adoption. 2,322.23 Rw-1009 EXr (g.9e) SCHEDULE F OOtaAOMNEALTMOFPBfISriVAfAA JOINTLY-OWNED PROPERTY elEItRMK;E TAX RETUIN RE&DBtT OtX~tl@R ESTATE OF FILE NUMBER Russell Ma Arlene 21 K an aee~t v~ evade ~Mrt witldn one ywr d the decedent's date d death, R mint be sported on schW Wt O. SURVIVING JOINT TENANT(S) NAME I ADDRESS I RELATIONSHIP TO DECEDENT A. B. C. JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOIN TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSTnLT1pN AND BANK ACCOUNT NUMBER OR SIMILAR IDENTiFYMKi NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE DATE OF DEATH BLUE OF ASSE % OF DECD'S INTEREST DATE ~ DEATH vALUE OF ~p,R.s 9~(TERESi 1 3100 MorninOside Drive, Camp Hill, Pa 17011 103.210.00 50. 51,805,00 TOTAL (Also enter on Line 6. Recaaitulation) ~ 51.605.00 (ff more space is needed. additiorrel pages o(the same size) Copyright (c) 2002 form soRrvare ony The Laclater Group Inc. Form PA-1500 Schedule F (Rev. 8-98) -~a--~-- Penalty and Interest Calculations CALCULATION DATES- 4/25/2006 TO 1/20/2012 TAX DEFICIENCY $ 2,322.23 CALCULATED INTEREST $ 742.95 BALANCE AS OF 1/20/2012 $ 3,065.18 j ~rt over. j ._ https://www.doreservices.state.pa.us/pitservices/Default.aspx 1/9/2012