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Home My WebLink About01-30-13 (3)J 1,50561,01,40 REV-1500 EX ~°'-,°> PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number Harrisbur , PA 17128-0601 RESIDENT DECEDENT 2 1, 1 2 1 2 9 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 1 3 0 2 0 1, 2 0 8 1, 5 1, 9 2 9 Decedent's Last Name Suffix Decedent's First Name A L B E R T MI ~1 A R I O N N (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUP FILL IN REGISTER LICATE WITH THE OF WILLS APPROPRIATE OVALS BELOW 1. Original Return 2. Supplemental Return 3 R i 4. Limited Estate ~ 4a F t . ema nder Return (date of death prior to 12-13-82) ^X 6 D . u ure Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required . ecedent Died Testate (Attach Copy of Will) ~ ~• Decedent Maintained a Living Trust ~ 8 9. Litigation Proceeds Received (Attach Copy of Trust) 10 S l . Total Number of Safe Deposit Boxes . pousa 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 B E COM PLETED ALL C O) t Name . ORRESPONDENCE AND CONFIDENTIAL TAX INF ORMATIO N SHOULD BE DIRECTED T0: J O H N C Daytime Telephone Number Z E P P I I I 7 1, 5 ~, 2 8~. ~8 9 0 0 Rf~f3~S ; , OF WILLS USE b9VL~ ~ ~ First line of address f ~ ~ ~`R' ~ "' +;~ B O X ~ 4,~ 2 0 4 ~ Second line of address t, ~ - ~~ ~ , ---;5 City or Post Office a - }'~~' ° ~~ Y O R K S P R State ZIP Code ~ ~ ''"' 2 r.°I DATE ED ~ , r;,, ~- I N G S P A 1 7 3 4' `=~r 7 2 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of m kn it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has an SIGN a URE OF P~RSON~$PO~,gIBL~FOR F ING RETURN Y owledge and belief, y knowledge. '~DDRES 6 I LCRE-s SIGNA E O AD ESS P BO 204 RIVE ~~ OT .THAN REPRESENTATIVE SILVER SPRINGS TI,IP Pd l_7n~n YORK. SPRINGS rLC/~Jt USE ORIGINAL FORM ONLY Side 1 L 150561,01,40 DATE ~ u v U DATE PQ 17372 150561014 J h~ 1,50561,D24D Decedent's Social Security Number REV-1500 EX ... ~T~~~ ni el RFRT Decedents Name. ~ ~ • • • • - - - RECAPITULATION 1. ............. ...................... 1. Real Estate (Schedule A) .. • • • • • 2. 2. Stocks and Bonds (Schedule B) ..••••••••~~•-•~~~"""'•~~~~ 3. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . • • • ................... 4. 4. Mortgages and Notes Receivable (Schedule D) . • • • • • Schedule E). • • • • • • 5• 5. Cash, Bank Deposits and Miscellaneous Personal Property 6. Schedule F) ^ Separate Billing Requested ...... . 6. Jointly Owned Property 7. Inter-Vivos Transfers & Miscellaneous No^n-PrSo paraterBilling Requested ....... 7• (Schedule G) .......... 8. - - - ---~,. ~+„+~i i inac 1 through 7) ........... . 8. ~ Oial urt.raa .~,~~...., ~.___ g. Funeral Expenses and Administrative Costs (Schedule H) .. • • Mortgage Liabilities, and Liens (Schedule I) .. f Decedent •,... 10. 10. , Debts o ... 11. .. 11. .............. Total Deductions (total Lines 9 and 10) . . 12. 12. Net Value of Esta ts/Sec 9113 Trusts for which n ln 13. Beques a vernme ...... Charitable and Go t been made (Schedule • • • .... 13. .. an election to tax has no ........ _~ ~_ T..., n ono ~ ~ minus Line 13) • • • • • • • .......14. 14. Net value ~uu~~~< <~ • ~•- ~-~~ ~- TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 D D D 15. (a)(1.2) X •0 16. Amount of Line 14 taxable D D D 16. at lineal rate X •0 17. Amount of Line 14 taxable D D D 17. at sibling rate X .12 18. Amount of Line 14 taxable 3 8 8 5 5 3 3 18. at collateral rate X .15 19. ................ 19. TAX DUE " " ~ " " 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 J 8 6 0 8, 3 6 3 1 8 7 1. 6 3 4 0 4 7 9, 9 9 1 6 2 4. 6 6 1 6 2 4. 6 6 3 8 8 5 5. 3 3 3 8 8 5 5. 0 3 0. D D D. D 0 0. D 0 5 8 2 8. 2 9 5 8 2 8. 2 9 1 1505610240 1.. REV-1500 EX' Page 3 Decedent's Complete Address: File Number 21 12 1292 DECEDENT'S NAME MARION N. ALBERT STREET ADDRESS 1 LONGDORFF WAY CITY CARLISLE STATE PA ZIP 17015 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. Credits/Payments 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. (1) 5,828.29 Total Credits (A + B) (2) (3) (4) 291.41 (5) 5, 536.88 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 property transferred or its income; ......................... ...... ^ c. retain a reversionary interest; or .......................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................. ...... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. h? " " ...... ^ ^ ... or payable-upon-death bank account or security at his or her deat in trust for 3. Did decedent own an ...... 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. 291.41 RSV-1508 EX+ (11-10) Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARION N. ALBERT 21 12 1292 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 on Schedule F. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH ~, SOVEREIGN CHECKING ACCOUNT #1681736764 8,317.39 2. personal property was liquidated when moving into Cumberland Crossing, clothing was 0.00 donated to the home 4. Comcast Refund 8.96 5. Cumberland Crossing Refund 71.42 6. Bethany Towers Refund 210.59 TOTAL (Also enter on Line 5, Recapitulation) I $ 8,608.36 If more space is needed, insert additional sheets of paper of the same size REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER nn,4RinN N ALBERT _ 21 12 1292 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. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATEOFTRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUE OF ASSET INTEREST (IFAPPLICABLE) VALUE 1. Fidelity Brokerage Account 2,948.42 100.00 2,948.42 2. American Funds: 3 Investments accounts P.O. Box 2560 Norfolk Virginia, VA 23501-2560 28,923.21 ~ 100.00 28,923.21 TOTAL (Also enter on Line 7, Recapitulation) ~ $ 31, 871.63 If more space is needed, use additional sheets of paper of the same size. R!~V-1511 E)~+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF nnnRlnN N AI RFRT ITEM NUMBER A. 1, B. 2 3 4 5. 6. 7. 8. 9. 10 Decedent's debts must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: City State PA Z-P 17372 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Atldress Year(s) Commission Paid: Attorney Fees: JOHN C. ZEPP, III Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 119.50 Accountant Fees: Tax Return Preparer Fees: CUMBERLAND COUNTY LEGAL JOURNAL 75.00 THE SENTINEL 200.16 INVENTORY: CUMBERLAND COUNTY REGISTER OF WILLS 15.00 CUMBERLAND COUNTY REGISTER OF WILLS 9filing of return) 15.00 FILE NUMBER 21 12 1292 AMOUNT 1,200.00 TOTAL (Also enter on Line 9, Recapitulation) I $ 1 624.66 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (a1-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARION N. ALBERT 21 12 1292 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE j TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. LARRY C. FERTENBAUGH Collateral 1.00 6 HILL CREST DRIVE SILVER SPRINGS, PA 17050 I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. jj. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 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, LAST WILL AND TESTAMENT OF MARION N. ALBERT ... I MARION N. ALBERT, of Cumberland County, Pennsylvania, being of sound and dis osin mind, memory, and understanding, do hereby publish and declare the following as and for p g m Last Will and Testament, hereby revolting any and all Wills by me at any time heretofore made. y ITEM I `'~ I direct that all of my legal debts, the expenses of my last illness, and my funeral expenses e S aid from m residuary estate, as soon as practicable after my decease, as part of the expenses of the p y s`` administration of my estate. ~.: ~~~ ITEM II ~. J I give and bequeath all of my jewelry, automobiles, clothing and other personal effects, as t which I ma own, including any insurance thereon to my well as all household goods and equrprnen y nephew, Larry C. Fertenbaugh. In the event that my nephew, Larry C. Fertenbaugh should predecease me, then the share to which that he would have been entitled I hereby give, devise, and bequeath to his wife, Jan M. Fertenbaugh. ITEM III I give, devise, and bequeath all the rest, residue and remainder of my estate, real, personal or mixed of whatsoever bind and nature and wheresoever situate at the time of my decease, I give, devise, and bequeath to my nephew, Larry C. Fertenbaugh. In the event that my nephew, Larry C. Fei-tenbaugh should predecease me, then the share to which that he would have been entitled I hereby give, devise, and bequeath to his wife, Jan M. Fertenbaugh. ITEM IV I nominate, constitute and appoint my nephew, Larry C. Fertenbaugh, to be the Executor of 1 j this my Last Will and Testament. In the event my nephew, Larry C. Fertenbaugh, should predecease r unce or be Inca able of acting as the Executor of this my Last Will and Testament, me, resign, reno p then I nominate, constitute and appoint Jan M. Fertenbaugh, to be the Executor of this my Last Will and Testament. ~. ITEM V .% `' I direct that no bond shall be required of any fiduciary, trustee, executor or guardian, hereunder in any jurisdiction. 2 IN WITNESS WHEREOF, I, MARION N. ALBERT, named herein, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, on this the 12th day of August, 2010. MARION N. ALBERT Si ned, sealed, published, and declared by the above-named Testatrix as and for her Last Will and g Testament, and we, in her presence and in the presence of each other, and at her request, ave subscribed our names as witnesses hereto. ~?~ -- r ~ ~~~~~ ~,~~~ .~/ 3 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ADAMS ) I, MARION N. ALBERT, Testatrix whose naive is signed to the attached or foned and instrument having been duly qualified according to law, do hereby acknowledge the that Igsi ned it executed the instrument as my Last Will and Testament, that I signed it willingly, an g as my free and voluntary act for the purposes therein expressed. ~. MARION N. ALBERT Sworn or affirmed to and acl~lowledged before me, by MARION N. ALBERT, this 12t~' day of August, 201fl. lic COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JOHN C. ZEPP, III, Notary Publ'~c Huntington Twp:, Adams County Commission Ex its April 16, 2014 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ) We, `,~~J~~, r-, ~ - (rl2t2r`- and ~: ~~ ~~~~ 1~ ~,'%s~he 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 and Testament; that MARION N. ALBERT signed 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 influence. (SEAL) (SEAL) Sworn and affirmed to and acknowledged before me by ~ ~~~~~~ ~ .~~-~,~ and -~-~: ~=r-~?C ~ , ~~~~~.=,,~f' ,witnesses, this the 12t~' day of August, ZO10. otary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JOHN C. ZEPP, III, Notary Public Huntington Twp., Adams County My Commission Ex Ires April 16, 2014 5