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Home My WebLink About05-22-12t 1505610140 REV 1500 ~` (°'-'°' - OFFICIAL USE ONLY PA Department of Revenue County Code Year File Numller Bureau of Individual Taxes INHERITANCE TAX RETURN Po sox z5D5ot 2 1 1 1 0 7 9 2 Hanisburo PA 1 7 7 20-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYri 82011 D310 19 44 Decedent's Last Name Suffix Decedent's First Name MI F I S H E R W I L L I A M L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 1. Original Return 4. Limded Estate Q 6. Decedent Died Testate (Attach Copy of Wilp 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a living Trust _ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Retum (date of death prior to 12-73.82) 5. Federal Estate Tax Return Required 0, Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTX)N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATN)N SHOULD BE DIRECTED TO: Name Daytime Telephone Number W I L L I A M A D U N C A N 7 1 7 2 coq 7 ~;' 8 D REGISTER 6~^i!gL~S?USE ~ .`~' C.'i ~ ` N First line of address U~- O N E I R V I N E R O W ~'=: `" Second line of address City Or POat Office State ZIP Code DATE FILED C A R L I S L E P A 1 7 0 1 3 ~ ~` c`~ . ~~~ .Z? ~_ i -~ i :5 r'rt (7 -.r~ correapondenrse-mauaddress: billaduncanhartmanlaw-com Under penelaes of perjury, I declare tnel l nave examined Ihia return, inducting aaomparrying sdbdulee arM statemenb, and to dre beat d my knowledge and Oeliel it is uue, coned antl cOmDlrrte. Dedaretlon d preperM o0ler tMn the personal representedve is based on ag intdrtnaddn d whkh preparer has any knoaledpa. 3 SMITH ROAD ~ ~ 6ARDNERS PA 17324 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505ks1O240 REV-1500 EX Decedent's Social Security Number Decedents Name: WILLIAM L• FISHER RECAPITUUTION 1. Real Estate (Schedub A) ........................................... 1. 2. Stocks and Bonds (Schedub B) ...................................... 2. 3. Closely Hekl Corporation, Partnership or Solo-Proprtetorship (Schedub C) ..... 3. 4. Mortgages and Notes Receivabb (Schedub D) .......................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 7. Inter-V'rvos Transfers RMiscellaneous N -Probate Property (Schedub G) ~ Separate Billing Requested ....... 7. 8. Total Gross Asssh (total Lines 1 through 7) ........................... 8. 9. Funeral Expenses and Administrative Coats (Schedule H) .................. 9. 10. Dabta of Decedent, Mortgage Liabilitles, and Liens (Schedule q ............. 10. 11. Total Daductlom (total Lines 9 and t0) ............................... 11. 12. Net Valw of Estats (Line 8 minus Line 11) ........ .......... ........ .. 12. 13. Charkable and Governmental Bequeats/Sec 9113 Trusts for which an ebction to tax has not been made (Schedule J) .. .......... ........ .. 13. 14. Net Valw Subject to Tax (Line 12 minus Line 13 .. .......... ........ .. 14. TAX CALCUUTION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxabb at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.0_ 0. 0 0 t5. 16. Amount of Line /4 taxable at lineal rata X .o _ 0 . 0 0 1 g, 17. Amount of Line 14 taxabb at sibling rate X .12 0 . D 0 17. 18. Amount of Line 14 taxable at collatersl rate x .15 4 1 5 9. 1 0 1 g, 19. TAX DUE ...................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1 6 0.0 0 7 3 7 5. 0 3 0. 0 0 7 5 3 5. 0 3 3 3 0 9. 5 2 6 6. 4 1 3 3 7 5. 9 3 4 1 5 9. 1 0 4 1 5 9. 1 0 0. 0 0 0. 0 0 0. 0 0 6 2 3. 8 6 6 2 3. 8 6 1505610240 J REV-15gg Ex Page 3 Decedent's Complete Address: Flk Numeer 21 11 0792 DECEDENTS NAME WILLIAM L• FISHER STREET ADDRESS 940 WALNUT 80TTOM ROAD aTv STA CARLISLE PA 17015 Tax Payments and Credits: t. Tax Due (Page 2, Line 19) 2. CreditslPayments 2 5 U• O U A. Price Payments 8. Discount (1) 623.86 TotalCredits(A+B) (2) 250.0(] 3. Interest 4. If Line 2 is greater than Line 1 +line 3, enter the diference. This is the OVERPAYMENT. FIII In oval on Page 2, Line 20 to request a refund. (3) 10.0 0 (4) 0 • D 0 5. If Line 1 +Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 38 3 • 8 6 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 : ................................................................. it i d i ..... ^ ^ ncome : ......................... eme or s b. retain the fight to designate who shall use the property trans ...... c. retain a reversionary interest, or .......................................................................................... ...... ^ ^ d. receive the promise for life of either payments, txxlefits or care? ................................................. ...... 2. If death ocrxlmed after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... ^ 3. Did decedent own an'in trust for' or payable-upon~eaN bank account or secudty at his or her death? ... ...... ^ 4. Did decedent own an individual retirement acount, annuity a other non-probate property, which contains a beneficiary designation7 ............................................................................................ ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTlON3 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 [I2 P.S. §9116 (a) (1.1) (i)]. For dates of deab on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to a 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 frD~t tax, and the statutory requirements for disclosure of assets and filing a tax velum are still applicable even if the surviving spouse is the only benefirary. Fw dates of death on or after July 1, 2000: • The tan 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 decedents lineal benefidaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [/2 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to w for the use of the decedent's siblings is 12 percent (72 P.S. §9116(a)(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-1503 EX+(8-99) scHEOV~e s COMMONWEALTH OF PENNSYLVANIA STOCKS 8t BONDS INHERRANCE TAX RETURN RESIDENT DECEDENT ;ATE OF nw numocn ~~LIAM L• FISHER 21 11 0792 Atl propeAy jotntlyowned whh right of survivorship must M dkcbwd on ScheduN F. ,TEM VALUE AT DATE ~'JMBER DESCRIPTION OF DEATH T. t_ cueRCC fTC fORPORATTON nl 9111.C1^ SHARE I 160.OG [SEE DOD CHART ATTACHED] TOTAL (Also enter on line 2, pi nary space fs needed, insert additlonal sheet d the same size) /-1508 EX+ (8-98) COMMONWEALTH OF PENNSYLVANUI INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY iATE of FILE NUMBER ~LLIAM L• FISHER 21 11 0792 Indude Me pprorocceeeetltlss M litigation aM the date the pn>~S wane receNed by the estate. AA jolmyovmed wNA ripM of aunNorahip must M distbsed on ScheduN F. ITEM VALUE AT DATE ~JMBER DESCRIPTION OF DEATH ,. CITIZENS BANK CHECKING ACCOUNTS 6100728145 2,668.16 CSEE DOD LETTER ATTACHED] 2• CITIZENS BANK SAVINGS ACCOUNT~6140272106 [SEE DOD LETTER ATTACHED] 3• CTS DIVIDEND 4• CARLISLE REGIONAL MEDICAL CENTER REFUND 5• ICTS DIVIDEND CHECK TOTAL (Also enter on line 5, Recapitulation) I = (K more space is needed, insert additlonal sheet d the same size) 4,590.64 0.56 115.11 0.56 V-7577 EX* (10-09) pennsyivania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ;'•. ~ E OF FILE NUMBER :~LIAM L• FISHER 21 11 0792 DecedanCs debts must ba reported on Schedule t. ~M ~.;:v~BER DESCRIPTION AMOUNT FUNERAL EXPENSES: t. NICKEL FUNERAL HOME 3. 4 ADMINISTRATIVE COSTS: Personal Representative Commissions: Names) of Personal Represemative(s) Street Address City Year(s) Commissbn Paid: Attorney Fees: DUNCAN & HARTMAN, PC Famiy Exemptlon: (K decedenYS address is not the same as daimant's, attach aXplanatlon.) CWirtlani Street Address City Spate ,_ Relatbnship of Claimant to Decedent _ Probate Fees: REGISTER OF WILLS 5_ I AaountantFees: v. v TaX Return Preparer Fees: REGISTER OF WILLS - SHORT CERTIFICATES REGISTER OF WILLS - FILING FEE HELD IN RESERVE 2,332.02 700.00 92.5C 20.00 15.00 15U•OC TOTAL (Also enter on Line 9, Recapitulation) I S 3 , 3 W 9 • 52 If more space b needed, use additional sheets of paper M the same size. State ZIP ZIP 1512 EX. (7208) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT .: E OF FILE NUMBER .SIAM L• FISHER 21 11 0792 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, Including unrelmbursed medkal expenses. ITEM VALUE AT DATE NUMBER DESCRIPTIQN OF DEATH NCO FINANCIAL SYSTEMS, INC• 26.41 2• BROKER FEE 40.00 TOTAL (Also enter on Line 10, Recapitulation) I S If more space is needed, ocean adoitbnet sMeeb of tl~e same sox.. v-1513 EX~ (01-10) pennsylvania DEPARTMENT Of REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ATE Of: FILE NUMBER: ' LIAM L FISHER 21 11 0792 _~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE .JMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llet Trustee(s) OF ESTATE . TAXABLE DISTRIBUTIONS pndudewtrght saldistributbnsanduansfersunder Sea 91 i6 (a) (~ •21.1 1. VICKEY L. SHIRLEY Collateral 3 SMITH ROAD 1UOi GARDNERS, PA 17324 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. ;, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS. i TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. f It Rwre space is needed, use additional sheets of paper of the same size. Lv'~.S'T'WILL,~TRD?~F,S7,,'~JK~,9VrI' <.. :-,~ r_ :,> '- /~. VT j~ ~ c. ; ; ;~{~ W ~' U tj .. .. . ~ ' i ~-, ~~ C7 _ - ~ T+ a ~,, ~~~ ~• I, William Fisher, a resident of the Commonwealth of Pennsylvania and County of Cumberland; and being of sound mind, do hereby make, publish and declaze this to be my Last Will and Testament, thereby, revoking and making null and void any and all other Last Wills and Testaments and/ or Codicils to Last Wills and Testaments heretofore made by me. All references herein to this Will shall be construed as referring to this Last Will and Testament only. FAMILY CLAUSE At the time of executing this Last Will and Testament, I am unmarried. I have no children. RESIDENCY CLAUSE 6i69959_DOC.Jac Having in mind the possibility that I may temporarily reside outside of, or simply be absent from the Commonwealth of Pennsylvania and County of Cumberland, at the time of my death, I elect and hereby declare that this Will and each and every disposition and provision contained herein shall be construed and regulated by and in accordance with the laws of said Commonwealth of Pennsylvania. It is my desire that this Will be probated in the Commonwealth of Pennsylvania, my place of domicile, and that the principal administration of my Estate be made in said Commonwealth of Pennsylvania and that none of the assets of my Estate which may be found in my place of domicile, be remitted to any other jurisdiction for administration or distribution. Page 1 of my Last Will and Testament (Signature) DEBT CLAUSE I direct that the executor named pursuant to this Last Will and Testament review (as soon after my death as practical) all of my just debts and obligations, including funeral expenses and the expenses incident to my last illness; excepting those longterm debts secured by real or personal property which may be assumed by the Heir of such property, unless such assumption is prohibited by taw or upon agreement by the Heir. The executor shall pay these just debts only after the creditor provides sufficient evidence to support their claim. My executor shall pay out of my gross Estate, as if they were my debts, and without proration or appointment, all estate and inheritance taxes, by whatever name called; (including any interest due thereon} becoming payable because of my death in respect to all property comprising my gross Estate for death tax purposes, whether or not such property passes under this Last Will and Testament. I further duect that if any Heir or Heirs named in this Last Will and Testament should be indebted to me at the time of my death, and evidence of such indebtedness is provided or made available to the Executor of my Estate, then that shaze of my Estate which I give, devise, and bequeath to any and each such Heir shall be reduced in value by an amount equal to the proven indebtedness of such Heir or Heirs, unless I have specifically provided in this Last Will and Testament for the forbeazance of such debt, or unless such Heir is the sole Principal Heir. Page 2 of my Last Will and Testament `IY,(~irr- ~.~s~ (Signature) PRINCIPAL DISTRIBUTION CLAUSE I give, devise, and bequeath to the persons named below (my "Principal Heirs"), if he or she, whichever the case maybe, shall survive me, all of the residue and remainder of my gross Estate after payment of all my just debts, expenses, taxes, administration and specific bequests, if any, in the percentages set forth below. 1. Name: Vickey Shirley Relation: Niece Percentage: 100% Incase such Principal Heir does not survive me, I direct that the share of my Estate which would have been given to such Principal Heir shall be distributed to: Dale Shirley. EXECUTOR APPOINTMENT CLAUSE (A) I nominate, constitute and appoint my niece, Vickey Shirley, to be the Executor of my Estate. (B) If, for any reason, my first nominee Executor should fail to qualify or be unable or unwilling to acceptor to continue as the Executor of my Estate, I nominate, constitute and appoint my nephew, Dale Shirley, to be the Executor of my Estate. (C) If for any reason, all of the nominees designated above in Paragraphs (A) and (B) should fail to qualify or be unable or unwilling to accept or to continue as Executor of my Estate, I nominate, constitute and appoint my niece by marriage, Gail Shirley, to be the Executor of my Estate. EXECUTOR POWER OF APPOINTMENT CLAUSE (A) All directives in this Will that use by reference the word Executor mean and include any person named herein as my Executor (or personal representative, as may be defined under state law) and any person who may be acting in either capacity, at any time. Such person shall have broad and reasonable discretion under the directives of this my Last Will and Testament with respect to any property, real or personal, left by or held by me, or acquired by my Executor on behalf of my Estate. Page 3 of my Last Will and Testament , '1/.l~irrt F~ (Signature) - (B) I wish my Executor to have broad and reasonable discretion in the administration of my Estate, to have all of the powers permitted to be exercised by an Executor under state law, and to be able to do everything he or she deems advisable for the best interest of my Estate and the Heirs thereof, all without the necessity of court approval or supervision. I direct that my Executor perform all acts, take all such proceedings, and exercise all such rights and privileges, although not specifically mentioned in this Will, with relation to any such property, as if the absolute owner thereof; and in connection therewith, to make, execute and deliver any instruments, and to enter into any covenants or agreements binding my Estate or any portion thereof. (C) No such person named in, o;appointed in connection with this Will in a fiduciary capacity shall be required to file any bond or other security for the faithful performance of his or her duties as such fiduciary in any jurisdiction; and if, despite this directive, a bond should be required, I request that it be accepted without sureties and in a nominal amount. NON-LIABILITY OF FIDUCIARIES Any fiduciary, including my Executor and any trustee, who in good faith endeavor to carry out the provisions of this Last Will and Testament, shall not be liable to me, my Estate, or my heirs, for any damages or claims arising because of their actions or inactions based on this Last Will and Testament. My Estate shall indemnify and hold them harmless. SAVING CLAUSE If a court of competent jurisdiction shall at any time invalidate or find unenforceable any provision of this Will, such invalidation shall not be construed as invalidating the whole of this Will. All of the remaining provisions shall be undisturbed as to their legal force and effect. If a court finds that an invalidated or unenforceable provision would become valid if it is limited, then such provision shall be deemed to be written, deemed, construed and enforced as so limited. Page 4 of my Last Will and Testament 'jf~i~:w~ C~ (Signature) IN WITNESS WHEREOF, I, the undersigned Testator, declare that I sign and execute this instrument on the date written below as my Last Will and Testament and further declare that I sign it willingly, that I execute it as my free and voluntary act for the purposes expressed in this document and that I am eighteen yeazs of age or older, of sound mind and under no constraint or undue influence. °I~/.rlk.,.t F.tif (Signature of William Fisher) SSN: ~q~-3y-98 ~o Date: l~ Y//~ r 2 ~~ 200`j Page 5 of my Last Will and Testament `l/,l~rA' f,~a (Signature) ATTESTATION CLAUSE This Last Will and Testament, which has been separately sued by William Fisher, the Testator, was signed, executed and declared by the above named Testator as his or her Last Will and Testament in the presence of each of us. We, in the presence of the Testator and each other, under penalty of perjury, hereby subscribe our names as witnesses to the declaration and execution of the Last Will and Testament by the Testator, and we declaze that, to the best of our knowledge, said Testator is eighteen yeazs of age or older, of sound mind and under no constraint or undue influence. (Si atu ~ of witness) Date: ~ a ? 0 J obv ~-~ . rPct~L (Print Na~e 9~~ C~- `~ _ S7~- (Addressj ~trl~`s!C ~ ~~4 ~ 70~ 3 (city, stare, zrnj ~gnature of witness Date: g~d~~v5 Page 6 of my Last Will and Testament (Print Name) ;~ ~y/3 W~bcs "P( (Address) ~l•sle 1~'(-~ d~o3 (city, smote, z~ °W.te4rw i.~.~.. (Signature) SELF-PROVING AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland I, William Fisher, the undersigned Testator, being first duly sworn, do declaze ro the undersigned authority that I signed and executed the attached or annexed instrument as my Last Will and Testament and that I signed it willingly, that i executed it as my hee and voluntary act for the purposes expressed in that document and that at the time I signed the document I was eighteen yeazs of age or older, of sound mind and under no constraint of undue influence. Date: /~ V'y17 Z 7 tOO9 ?/.K~tiet fi~~u. (Signature of William Fisher) We, the undersigned witnesses, being first duly sworn, do each declaze to the undersigned authority the following: (1) the Testator declared to each of us that the attached or annexed instrument is his or her Last Will and Testament; (2) the Testator executed the will in our presence; (3) each of us, in the presence of the Testator, signed the will as witness; and (4) to the best of our knowledge the Testator is eighteen yeazs of age or older, of sound mind and under no constraint or undue influence. /(St at of witness) (Print Name) of witness) (Print Name) Acknowled¢ement of Notary Public: Subscribed, sworn and acknowledged to me on this ,~Z day of !n (J . 20~ by William Fisher, as Testator, and ~t.e~~h (l and (' 1. r~,7, Piatr , as wttnesee . Witness my hand and seal. Signature of Notary Public ~ ~_, _ «,~iai s~ai Cathy E. Fry. Notary Public Cumberland County South btiddlcton 3'wp., My Comtnissinn Eipites July 30.2010 CTS Charts -Yahoo! 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' Uonl Gal tao Kbrsea Up Over CTS' Esrwgs N MNYy Feel ~iw .p ' C FS Elaovmxs MerwnsOUnq Shcawna Awsoea Nrw Cmvsd Iron a Map Mra.21 Orrtlopeclc Fam a..m.u wr. •.. >w !q ~; t5 E:ncua~ns Marwlaeruay Sownen3 AwsOeU Naw Cornea ham a .eaanyi nnhbc Fnn a...w.. w.. ~.. •.yy C f5 CuNV F es dEC mnn a-K Cnanye .n Onexlws ur Prvx.ya OH¢ss http://finance.yahoo.com/echatts?s=CTS&t= t d 10/5/201 I Citizens Bank' Account l~iumber b100728145 Account Title WILLIAM L FISHER Date ed 7/15/1974 Account T Checkin Princi al Balance as of DOD $2668.16 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $2668.16 YTD Interest to DOD $ .00 Citizens Bank• Account Number 6140272106 Account Title WILLIAM L FISHER Date ed 8/6/1999 Account T Savin Princi al Balance as of DOD $4590.64 Interest from Last Postin to DOD $ .04 Account Balance as of DOD $4590.68 YTD Interest to DOD $1.16