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Home My WebLink About10-22-12 (2)15D561D143 REV-1500 Ex (o,-,o) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 Harrisburg, PA 17128-0601 RESIDENT DECEDENT Year File Number 12 0926 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 178 16 6469 07 28 2012 Decedent's Last Name Suffix FORTNEY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth 07 18 1921 Decedent's First Name MI MARY R Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 4 Limited Estate 4a. Future Interest Compromise ~I . (date of death after 12-12-82) ^ S to 6~ d e ~ ~ At a dh Copy Hof Tned)a Living Trust J Copy of W I) Attac h ~~ g, Litigation Proceeds Received ~ 1~ betweenP2v3rtyCre~dditl(datge5~fdeath g Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required g. Total Number of Safe Deposit Boxes ^ 11 Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L BANGS 717 730 7310 First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office CAMP HILL State ZIP Code PA 17011 i~ ;-_, c;-`3 ~~:1 x-:11; _.:.~ N ~~ Q Correspondent's a-mail address: mlkebangS@VerIZOn.net 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. SIGNA RE,lJF PERSON RESPONSIBLE FOR FILING URN UA I t ~~A~~ /~ j~,;~~~~' Daniel V. Bonawitz ,~`~~.~~ ~~~~°~~'~~ ADDRESS 12 Oatfield Lane, Palmyra, PA 17078 SIGNATURE OF P,~REP ER OTHER N REPRESENTATIVE DATE V ~. ' ~ ~ Michael L. Bangs ~a " l ~ - ~~- ADDRESS 429 South 18th Street, Camp Hill, PA Side 1 1505610143 REGISTER OF WILLS USE ONLY ~ .--- r..s r...:.•a ~ J7 Q . _ d V' C ~ ,_ "7 C.::~ ` "~ _ ` QA~~:f I LE D ~~~' 1505610143 ~~1 J REV-1500 EX Decedent's Name: FOrtrley, Mary R. Decedent's Social Security Number 178 16 6469 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 8 7, 7 0 0. 0 0 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 9 8 7. 6 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 252 , 028.11 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 3 4 O , 715.8 0 9. Funeral Expenses & Administrative Costs (Schedule H) ........................ ............... 9. 18 , 223.18 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... ............... 10. 4 81.92 11. Total Deductions (total Lines 9 & 10) .................................................... ............... 11. 18 , 7 0 5.10 12. Net Value of Estate (Line 8 minus Line 11) ........................................... ............... 12. 322 , 010.70 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. 322 , 010.70 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15. (a)(1.2) X .00 16. Amount of Line 14 taxable 3 2 2 , 010.7 0 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 • 0 0 17. at sibling rate X .12 18. Amount of Line 14 taxable 0 • 0 0 18. at collateral rate X .15 19. Tax Due ................................................. ............................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15D561D243 0.00 14,490.48 0.00 0.00 14,490.48 Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-12-0926 DECEDENT'S NAME Fortney, Mary R. ___ STREET ADDRESS 11 East Locust Street r_ -- - - ---- CITY STATE I ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 13,765.96 724.52 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. Make Check Payable to: REGISTER OF WILLS, AGENT. (1) 14,490.48 14,490.48 ~.0~ Total Credits (A + B) (2) (3) (4) (5) 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 property transferred or its income :.................................. ~~ LX c. retain a reversionary interest; or ............................................................................................................... ~~ d. receive the promise for life of either payments, benefits or care? ............................................................ U 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ~, x] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ~L_~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ~ ~_~ contains a beneficiary designation? .................................................................................................................. ~I 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 January 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)]. A sibling 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-1502 EX+ (~ ~ -08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Fortnev, Marv R. 21-12-0926 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 property which is jointly-owned with right of survivorship must be disclosed on schedule F. Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) (If more space is needed, additional pages of the same size) Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Fortney, Mary R. _ 21-12-0926 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 33 shares of MetLife, Inc. 29.93 987.69 TOTAL (Also enter on Line 2, Recapitulation) 987.69 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) SCHEDULE E iv CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Fortnev. Marv R. 21-12-0926 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) (If more space is needed, additional pages of the same size) REV-1151 EX+ (10-06) ,., COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Fortney, Mary R. 21-12-0926 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N M ER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(sl Commission paid 2. Attorney's Fees Michael L. Bangs 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 11,571.00 6,000.00 4. Probate Fees 419.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 232.68 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 18,223.18 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Fortney, Mary R. 21-12-0926 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex ep nses 1 Buse Funeral Home 8,381.00 2 Gingrich Memorials 3,190.00 H-A 11,571.00 Other Administrative Costs 3 Cumberland Law Journal -estate advertising 75.00 4 The Sentinel -estate advertising 157.68 H-B7 232.68 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 s DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Fortney, Mary R. 21-12-0926 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) (If more space is needed, additional pages of the same size) REV-1513 EX+ (11-08) ,, COMMNHERITANCE TAX RETURNANIA RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Fortne , Ma R. ~ 21-12-09 26 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 Daniel V. Bonawitz Grandson One-half of 161,005.35 12 Oatfield Lane estate Palmyra, PA 17078 Joan A. Bonawitz Daughter One-half of 161,005.35 157 Santo Drive estate Grantville, PA 17028 Total 322,010.70 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) METRO BANK September 8, 2012 Bangs Law Office, LLC 49 South 18~' Street Camp Hill PA 17011 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.com RE: Estate of: Mary R. Fortney Tax Identification Number: 178-16-6469 Date of Death: July 28, 2012 To Whom It May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Savings Account Number: 626190714 Date Opened: 1 /14/2004 Primary Owner: Mary R. Fortney Date of Death Balance: $107,690.13 Account Type: Checking Account Number: 32039968 Date Opened: 12/8/1993 Primary Owner: Mary R. Fortney Date of Death Balance: $88,878.28 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, -~~- Jennifer Jacobs Research Associate Metro Bank ~P`N~ ,August 3 I , 2012 Michael L Bangs ,A.tCOZxae~ at l,,aw 429 South 18~ S~ Camp Till PA 17011 R~: Mary R Fortney SSN- 178-1 b-b469 DOZ?: fl7,/28/2012 Dear 5ir/Madam: In response to your request for Date of Death (DAD) balances for the customer Hated above, our recazds show ~e following: Savings Aceaubt Account # 5I 11999219 established: 11/24/20x6 Mr~1tY R FOR`~'~~ DAD ballazzee: $55,3 1.5.78 + l .36 ~cnted intorest Please note t~ this ofFce provides date of dead balances for deposit accounts (ZR~As, CI?s, Checking sad Savings). Vt~e da not process ~y financial tr$assctio~ or pirov~ s#~t+e~oae~uts. if you n~xd. assista~acc with any of these items, please call I-888-~'NC-BA-I~ {I-888-7b2-~~5} ar stop by your tool. pNC Bank branch of~"zce. Sincerel~~, National Financlai Services Center PN~C Bank, N.~~.. Member I/DrC '`his mcssabQe is rnteicd.ed for the rase of the r~rdividual or entity to which it i~ addressed' rrnd may eohtwin inforrrratiori that xs privileged; cvxfrde~~ and exer,~t frvrM d~scrosure c~tder a,~,~~'cable taw If tie reader o,~'thxs message is xot the intended recipient yr the employee or agent responsible, for delivering tb;s message trr flte tided recipient, you acre lzerelry nnti f led tleut arty duseminaturn, at~stribution or copying of this cox~~rcations is str~tty prohib~ed ~f yvu Dave received thu eom~r~enicatior~ in error, dense n ~ ~dirrtelY by reply or by t~~ne act ADO 762-~ ?75 snit ~imrRedxately destroy t1i~s, frr~ced docent Page l of I ~'~ I, MARY R. FORTNEY, of Enola, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ''~1 ebts and ~ neral ex enses, including my gravemarker ITEM I. I direct that all my ~ ust d f~ P 0 0~ and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether pn property passing under this will or .~ otherwise, shall be paid from my residuary estate as ;soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all ~ insurance thereon and relating thereto, in equal shams to my daughter JOAN A. BONAWITZ or to the survivor of them, who survives my death and my grandson, DANIEL V. BONAWITZ, by thirty (30) days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate , in equal shares to my daughter JOAN A. BONAWITZ and my grandson, DANIEL V. BONAWITZ, or to the survivor of them, who survives my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my grandson DANIEL ~'. BONAWITZ executor of this my last will. Should my grandson predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my daughter JOAN A. BONAWITZ executrix of this my last will. ITEM VI. In addition to the other powers ar~d authorities granted to my personal representatives by Pennsylvania law and by the othet~ terms and provisions of this will, I hereby ~~ give to my personal representatives the following powers and authorities effective without court p ~ approval and until actual distribution of all property:: to compromise any claim or controversy; Q~ ly to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as ~ my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock qr other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my ersonal representatives deem proper, without regard to any principle of risk or diversification; P to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, . any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 2 ~ _ ~HEREUF, I have hereunto, set my hand this ,~ `~ day of -~,~-ot~-e.~,~~- , 2005 . ~~ ~ MARY R. FORTA~EY 11~e insirument, consisting of this end THREE other typewritten pages, each idet~tif~d b`- the signature of the testatrix was on thy, date thereof signed, published, and declared by MARY R. FORTNEY, the testatrix therein name, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. ," ~ ;, 4 col~o~vv~.TN a~ xsn.~~~ ss_ couxTY of CuMBERI~Ar~ ) The undersigned, being the testatrix whose name' is signed to the attached or foregoing instrument, having been duly qualified according to law, idoes hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. MARY ~2. F THEY -~-~- sworn or affirmed to and acknowledged - ..`_~~;" y the s ed above ~~~ .- = ,~.,,~~ ay f ~, 2005. .. ~_ , ..~ =_ _ i ~. ~G ~ ~ ~ ~~ - -, Nc~~,~ii ~ 5~1~1. - ,y - - _ _ _.. - ~ ~- - yy~+~Y S. CFiESSRO, Pt~ic lamer Alen TwP-• ~ ~ ~'D ~Y Camn Ex~e~ COMMO H OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) !j ~o ti' ~? icy ~ ~?~ ,the VIE, _ /~. ~ .lt~ L ~ L ,~ ~ and ~ ~ G ic1 witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue in - ~. `-` --fti~r~,~Tn 4~affi d acknowledged -- ~~ ~~ day of `" - . ~" ~ _ , 2005. -, . - - - - - ~ ~ ~~ 11~~~~~~ ;~,~ ~ ~~ ~~ ~ Notary Publi ARlAI. SEAL Public YVENDY S. C;HES8R0, Lower Allen Twp., My Commission Expires Nlay 10, 5