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Home My WebLink About02-27-13__ _ _ _ I 1505610140 REV-1500 ~` ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox zaosol INHERITANCE TAX RETURN ~ Harrisburg, PA 17128-0601 RESIDENT nFr_FnFNT 2 1 1 2 0 6 3 0 ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death MMDDYYYY 2 3 5 4 0 3 6 2 2 0 5 1 7 2 0 1 2 Decedent's Last Name Suffix M O R R I S O N (H Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth MMDDYYYY 0 8 2 6 1 9 2 7 Decedent's First Name P H Y L L I S Spouse's First Name MI J MI THIS RETURN MUST BE FILED IN DUPLICATE WIT THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retu (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of prior to 12-13-82 ~ 5. Federal Estate T x Retum Required death after 12-12-82) ® 6. Decedent Dfed Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of afe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Electlon to tax u er Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SH LD BE DIRECTED T0: Name Daytime Telephone Nu bar M U R R E L W A L T E R S I I I E S Q 7 1 7~ 6 9 x 6 5 0 ~ j r-r-i ~ O x ~ v First line of address .r ~A N - -t ~' ~ 5 4 E A S T M A I N S T R E E T ~ =~ o~ Second line of address ~ en ~ -n ~'1 ,~ ,a ~- -,~,: c'~ ... r'^ City or Post Office State ZIP Code 0 DATE FI ..] 'rl M E C H A N I C S B U R G P A 1 7 0 5 5 under p h Is true, ident's e-mail address: es of penury, I declare that I have examined this return, pct and wmplet DeGaredon of preparer other than the OF PERSO E$PON318LE FOR FILING RETURN z-...~~"" "j'~ men 4--~ SIGNATURE OF PR R FH ADDRESS / MURREL LT RS, 1505610140 __ _ -- CAMS ST. REPRESENTATNE accompanying schedules and statements, and to the best of m knowledge and belief, representative is based on all information of which preparer ha any krx>wledge. DA E ~- - ~-/~ ENOLA pe i~n~s 54 E• MAIN ST MECHANICSB PLEASE USE ORIGINAL FORM ONLY Side 1 DA 1 ~ ~-~i IRG PA 7055 1505610140 J Continuation of REV-1500 Inheritance Tax Return Resident Decedent PHYLLIS J. MORRISON 21 12 0630 Decedent's Name Page 3 File Number Correspondents Name Daytime Telephone Number First line of address Second line of address City or Post Office State ZIP Code Correspondent's e-mail address: Under penaltles of perjury, I dedere that I have examined this return, including aceompanying schedules and statements, and to the best of my knowledge and be f, ft is true, carecd and complete. Dedaratio/np~LOf~preparer other than the perwnal representative is based on aN mfomiation of whk;h preparer has any knowledge. SI RE O~PQ~!f /FOR FILING RETjURN DATE ADDRESS __ __ J 1505610240 REV-1500 EX Decedent's Social Security Num ber t>ecedern'sNama: PHYLLIS J• MORRISON 2 3 5 4 D 3 6 2 2 RECAPITULATION 1. Real Estate (Schedule A) ......................................... .. 1. 1 6 7 0 0 0. 0 0 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. 1 2 9 9 8 4 . 3 1 8. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 6 6 0 6 2. 4 8 7. Inter-vvos Transfers 8 Miscellaneous Iy~Probate Properly (Schedule G) u S eparate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 3 6 3 0 4 6 , 7 9 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .... 9. 4 4 8 D . 8 8 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... .... 10. 3 5 9 1 . 1 2 11. Total Deductions (total Lines 9 and 10) ........................... .... 11. 8 D 7 2 . D D 12. Net Value of Estate (Line 8 minus Line 11) ........................ .... 12. 3 5 4 9 7 4 . 7 9 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. 3 5 4 9 7 4 . 7 9 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (ax1.2)X.0 _ 0 . 0 D 15. 16. Amount of Line 14 taxable at lineal rate X .045 3 5 4 9 7 4. 7 9 16. 17. Amount of Line 14 taxable at sibling rate X .12 D . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0. D D 1 g, 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1 5 9 1 5 9 1505610240 0. 0 0 7 3. 8 7 0. 0 0 0. 0 0 7 3. 8 7 REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21 12 0630 DECEDENTS NAME PHYLLIS J. MORRISON STREET ADDRESS 47 BURWICK DRIVE CITY MECHANICSBURG STATE PA ZIP 17050 Tax Payments and Credits: ~. Tax Due (Page 2, line 19) 2. Credits/Payments A. Prior Payments 15.175.18 B. Diswunt 758.59 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. (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE 1. Did decedent make a transfer and: Total Credits (A +B) (2) Yes a. retain the use w income of the property transferced : ...................................................................... ^ 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 fw 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? ....................................................................................... ^ 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 w other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ BLOCKS No IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PA 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 3 percent [72 P.S. §9116 (a) (1.1) (i)]. OF THE RETURN. of the surviving spouse is 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 spou a 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 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 c 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 z 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. Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. a natural parent, an noted in A sibling is defined, under - - _ i _ _.. REV-1502 EX+(01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE "' "" ` "' ' FILE NUMBER: PHYLLIS J. MORRISON 21 12 0630 All real properly owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pri a at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable know) ge of the relevant facts. Real property that is jointlyowned rNth right of survivorship must be disclosed on Schaduk F. Attach a copy of the settlement sheet'rf the property has been sold. ITEM Include a wpy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 47 BURWICK DRIVE MECHANICSBURG, PA 17050 COUNTY ASSESSED VALUE 167,000.00 TOTAL (Also enter on Line 1 Recapitulation) I S If more space is needed, use additional sheets of paper of the game size, _ _ _ - I RC V' 1.7V0 CAr (I 1' I U) Pennsylvania SCHEDULE E I DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: PHYLLIS J. MORRISON 21 12 0630 Include the roceeds of litigatlon and the date the pproceeds were received by the estate. All property ~Ointy owned with M of survlvonhip must be discbsed on Schedub F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. MEMBERS 1ST FEDERAL CREDIT UNION 5,072.00 CERTIFICATE 2. PNC 104,912.31 SAVINGS 3. SOVEREIGN BANK 20,000.00 ANNUITY TOTAL (Also enter on Line 5, Recapitulation) S 129 984.31 ii ~~rv~c ayaw IJ I ICCUCY, matlrl GaaNOI181 SfleelS OT papef OT QIe Same SIZe Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: PHYLLIS J. MORRISON 21 12 0630 Nan asset was made Jolnty owned within one year of the decedent's date of death, it muat be reported on Sch ule G . SURVIVING JOINT TENANT(S) NAME(S) ADDRESS ELATIONSHIP TO DECEDENT A. DONALD F MORRISON 47 BURWICK DRIVE ON MECHANICSBURG, PA 17050 B. C. JOINTLY-OWNED PROPERTY: ITEM LETTER FOR JOINT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH % DECE OF NTS DATE OF DEATH VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INT REST DECEDENTS INTEREST 1. A. 6/23/11 MEMBERS 1ST FCU 6,014.84 100. 6,014.84 SAVINGS 2 A 6/23/11 MEMBERS 1ST FCU 21,847.44 100. 21,847.44 CERTIFICATE 3 A 6/23/11 MEMBERS 1ST FCU 17,691.71 100. 17,691.71 CERTIFICATE 4 A 3/22/11 MEMBERS 1ST FCU 6,713.49 50. 3,356.75 CERTIFICATE 5 A 4/06/11 MEMBERS 1ST FCU 34,303.48 50. 17,151.74 CERTIFECATE TOTAL (Also enter on Line 6, Recapitulation) S 66,062.48 ~~ ~„~,a aNaw u i ieeuw, uwt aaalaOnai sm3eis Or papef Or Vle Same SIZE. REV-1511 EX+(10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ESTATE OF FILE NUMBER PHYLLISJ_MARRISAN _. ._ ____ DecedenPs debts must be repoRed on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME, MECHANICSBURG, PA B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) DIANE SHEARER Street Address 31 ADAMS STREET City ENOLA State PA Zlp 17025 Year(s) Commission Paid: (RENOUNCED) p, Attorney Fees: MURREL R. WALTERS,111, ESQ. 3. Famiy Exemption: (If decedenCs address is not the same as claimanCs, attach explanation.) Claimant Street Address CtiY State ZIP Relationship of Claimant to Decedent 4• Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) ~ S AMOUNT 96.38 3,900.00 484.50 If more space is needed, use additional sheem of paper of the same size. _ _ _ _ _. - , Continuation of REV-1500 Inheritance Tax Return Resident Decederht PHYILIS J. MORRISON X21 12 0630 Decedent's Name Page 1 ', File Number Schedule H -Funeral Expenses $ Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative Commissions: 2• Name(s) of Personal Representative(s) DONALD F. MORR130N Street Address 47 BURWICK DRIVE City MECHANICSBURG State PA ZIP 17050 Year(s) Commission Paid: (RENOUNCED) SUBTOTAL SCHEDULE H-B1 __ _ _ __ ..~~-w ~c ten- ~ icvo/ '.. Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, ~, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ~ ESTATE OF FILE NUMBER PHYLLIS J. MORRISON 21 12 0630 Repoli debts Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed m ical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. LAB CORP 435.21 MEDICAL 2 LCA 17.93 MEDICAL 3 MOFFIT 3.56 MEDICAL 4 SPS INC 9 59 MEDICAL 5 MOBILEX 6.96 MEDICAL 6 HOLY SPIRIT HOSPITAL 472.33 MEDICAL 7 PRISM 40.83 MEDICAL 8 MASLAND ASSOC 25 28 MEDICAL 9 WBR LLC 25.35 MEDICAL 10 CHEP 29.57 MEDICAL 11 O I OF PA 26.41 MEDICAL 12 ANDREWS AND PATEL 10.02 MEDICAL 13 CRMC 97.53 MEDICAL 14 EVERGREEN HOMEOWNERS ASSOC 120.00 DUES 15 GOLDEN LIVING 16.00 MEDICAL TOTAL (Also enter on Line 10, Recapitulation) 3 591.12 ... ~...~....y.......a ~ i~....v~, n wc~ i wulwn lal JI IC06S UI V Itl JAII W SIZ@. __ _ ,_. Continuation of REV-1500 Inheritance Tax Return Resident Decede~tt PHYLLIS J. MORRISON 21 12 0630 VCIitlYC1ItJ 1`I21111C ~ aa~- •• •• •- Schedule I -Debts of Decedent, Mortgage Liabilities, 8~ Liens ITEM NUMBER DESCRIPTION AMOUNT 16 STATE FARM 77.79 CREDIT CARD 17 HARTZELL 22.00 MEDICAL 18 DEBRA BASESHORE WEIST, TAX COLLECTOR 1,892.62 COUNTYITOWNSHIPTRX SCHOOL TAX 19 AP ASSOC 9.92 MEDICAL 20 PCIINC 4.61 MEDICAL 21 PA CARE 120.50 MEDICAL 22 HOMESERVE 107.88 HOUSE SERVICE CONTRACT 23 PINNACLE HEALTH 19.25 MEDICAL ~, SUBTOTAL SCHEDULE I 2,25q,57 GRAND TOTAL SCHEDULE I i , 3,591.12 _ __ __ REV-1513 EX+ (01-10) Pennsylvania SCHEDULE J '' DEPARTMENT OF REVENUE BENEFICI A oleo INHERITANCE TAX RETURN G G y MR Ga RESIDENT DECEDENT ESTATE OF: FILE NUMBER: PHYLLIS J. MORRISON 21 12 0630 RELATIONSHIP TO DECEDENT AM( NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee~a) I TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).J 1. DIANE SHEARER Lineal 31 ADAMS STREET ENOlJ1, PA 17025 2. DONALD F. MORRISON Lineal 47 BURWICK DRIVE MECHANICSBURG, PA 17050 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS 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. j If more space is needed, use additional sheets of paper of the same size. AS iUNT OR SHARE OF ESTATE 50.00 50.00