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Home My WebLink About06-11-12 (3)_J 15056101D5 REV-150 ex (nz-~~, (FD'i+! OFFICIAL DSE ONLY PA De artment of Revenue Pennrylvania -- P ,.,..„ „..,„~, Coun:y Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX z8o6ot RESIDENT DECEDENT p?I. Harrisburg. PA 17128-o6ot ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY Decedent's Last Name Suffix Decedent's First Narhe MI Fralish Jean L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name: MI Fralish James Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 175406187 REGISTER OF WNLLS FILL IN APPROPRIATE OVALS BELOW OD 1. Original Return O 2. Supplemental Return O 3. Remainder Retum (Date of Death Prior to 12-73-82) O 4. limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Refurn Required death after 12-12-82) O 6. Decedent Dietl Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ~ 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-97 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFCIRMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number James Fralish (7'17) 343-9122 First Line of Address 75 John King Lane Second Line of Address City or Post Office Mechanicsburg State ZIP Code PA 17050 REGISTEF WILLS US~NLY N L Z , C r'r1 !l+..J ~ r-, >C7 8~ ^'r -p ~ ~~rr..y JDATE FILED N .~. CO nn~ p -"r-f -ri t~'t Correspondent's a-mail address: CBI[07COryIBShheLCOm Under penalties of perjury I tledare that I have examined this return, including acwmpanying 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 informedion of which preparer has any knowledge. SIGt1AT~URE OF PER~~RESrpNS1eLE FOR FILING RETURN DATE ~ „ ~ I ~ „L 75 H~sburg, PA 17050 THAN REPRESENTATIVE X1023 N. 2nd street, Suite 201 Harrisburg, PA 17102 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 REV-1500 EX (FI) Decedent's Name: Decedent's Social Security Number RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. t. 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. 71340 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 71340 9. Funeral Expenses and Administrative Cosis (Schedule H) ............. ...... 9. 7129 t0. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 7675.76 11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 14804.76 12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 56535.24 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. 55535.24 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.OQ 28267.62 t5. 16. Amount of Line 14 taxable at lineal rate X .04~ 28267.62 t6. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 :1505610205 1505610205 0 1272.04 1272.04 O REV-1500 E% iFp Page 3 Decedent's Complete Address: File Numb[:r Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments _ B. Discount 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. (i) 1272.04 Total Credits (A+ B) (2) (3) (4) (5) 1272.04 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 .................................................................................... ...... ^ b. retain the right to designate who shall use the properly transferred or its income ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ I• d. receive the promise for life of either payments, benefts 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 "intrust 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, whic~ contains a beneficiary designation? .................................................................................................................. ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE O 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 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 benefciary. 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(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, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. PEV-i5o8 EX+(1i-1o) ;; Pennsylvania SCHEDULE E i~? DEVApTMENTOFFEVENIIE CASH, BANK DEPOSITS 8r MISC. `""EaITANCE TaX afro"" PERSONAL PROPERTY aESIDENT DECEDENT ESTATE OF: FILE NUMBER: Jean Fralish 21-06-0355 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed an Schedule F. If more space is needed, use additional sheets of paper of the same size. REV-15ll EA+ (10-09) Pennsylvania ^EPARTMENT OF flEVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H PUNERALEXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Jean Fralish 21-06-0355 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. 1. z. 3. 4. 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) _ _..... Street Address City __._,.. ._ State ZIP Year(s) Commission Paid: +~ Attorney Fees: 50.~k ~ Add ~ ~- e~e- Family Exemption: ([f decedent's address is not the same as claimant's, attach explanatlon.)~~ C^y`A~~ claimant _J_ames Fralish ~~k 5 Street Address 75 John King Lane _.__ city Mechanicsburg __ _____ State PA . uP 17050 Relationship of Claimant to Decedent SpOUSe Probate Fees: Accountant Fees: Tax Return Preparer Fees: 3500 3500 129 TOTAL (Also enter on Line 9, Recapitulation) I $ 7129 If more space is needed, use additional sheets of paper of the same sizE. REV-1.51'_ EX+ (1~-087 ~ Pennsylvania SCHEDULE I '! DEPARTMENT OE REVENUE DEBTS OF DECEDENT, I"r1ERIT"NCE T"x RETUR" MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Jean Fralish 21-06-0355 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert adGitional sheets of the same size.