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Home My WebLink About04-09-13 1505611185 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po eox 26oso1 21 12 0833 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 07062012 02261925 Decedent's Last Name Suffix Decedent's First Name M I FLEMING THOMAS J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I FLEMING VIRGINIA H Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) F-1 6. Decedent Died Testate F-1 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 ❑ 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number PETER J - RESSLER, ESQUIRE 71 232-501111 77 ri1 3331E�TER OF VItICES USE)O",Y CIO `Ci f rr —� First Line of Address =;° I- C0 3401 NORTH FRONT STREET Second Line of Address PO BOX 5950 = City or Post Office State ZIP Code DAT %ED "r1 HARRISBURG PA 17110 Correspondent's e-mail address: P J R E S S L E R a0 M E T T E - C O M 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN � DATE ADD SS 605 HILLTOP DRIVE NEW CUMBERLAND, PA 17070 SIGNATURE OF RREPARER OTHER THAN REPRESENTATIVE DATE L-t& Ll(- �e, _ !id-/ ADDRESS /1-0 T PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 OM46473.000 1505611185 1505611285 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name F L E M I N 6 THOMAS J RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 . 00 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . 2. 587-1333 - 53 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C). . , , . 3. 0 - 00 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . 4. 0 - 00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . . 5. 241091 - 76 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested , . . . 6. 0 - 00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . 7. 1351725 . 81 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8 747,151 - 10 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9. 31-.347 - 59 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) , . . . . . . . . 10. 0 - 00 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. 31,347 - 59 12, Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . 12. 715,803- 51 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . 13. 0 - 00 14. Net Value Subject to Tax(Line 12 minus Line 13) . . , . . , , . 14. 715-.803 - 51 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers un�er Sec.9116 (a)(1.2)x.0- 7151803 . 51 15, 0 . 00 16. Amount of Line 14 taxable at lineal rate X.0 4 b 0 . 00 16. 0 . 00 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0 . 00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 12 0833 DECEDENTS NAME FLEMING THOMAS STREET ADDRESS 605 HILLTOP DRIVE CUMBERLAND CITY STATE zip NEW CUMBERLAND PA 17070- Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0 . 00 2. Credits/Payments A. Prior Payments 0 . 00 B. Discount 0 • 0 0 Total Credits(A+B) (2) 0 . 00 3. Interest (3) 0 . 00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0 . 00 5. If Line 1 + Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0 . 00 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 . . . . . . . . . . . . . . . . . . . . . . . . �� 0 b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments,benefits or care? . . . . . . . . . . . . . . . . . . 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ 0 3. Did decedent own an"in trust for"or payable-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,which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FKI ❑ 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 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(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. OM4671 2.000 REV-1503 EX-(8-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Thomas J Fleming 21 12 0833 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 912.987599 Shares Nuveen Municipal Value Fund 9,485.94 2 1,837 .761 Shares Fidelity PA Municipal Income 20,858.59 3 302.931 Shares Windsor II Fund Inv 8,373.01 4 39.124 Shares 500 Index Fund Inv 4,887.76 5 723.558 Shares Oppenheimer Funds 40,323.89 6 1,478.201 Par Dreyfus Municipal Bond Fund, Inc. 17,394.47 7 4,865.83 Shares Invesco Tax-Exempt Cash Fund 4,865.83 8 1,109.549892 Shares Northeast Utilities 42,928.48 9 260.9432 Shares Dow Chemical 8,222.32 10 100 Shares Covidien 5,322.00 11 994.943164 Shares Carlisle Companies 54,015.46 12 2 Units PA Insured Municipals Income Trust Series 183 560.28 13 300 Shares Plum Creek Timber Company 12,000.00 14 87.083 Shares Duke Energy 5,833.69 Total from continuation schedules . . . . . . . . . 352,261.81 TOTAL (Also enter on Line 2,Recapitulation) $ 587,333.53 2w4696 2.000 If more space is needed,insert additional sheets of the same size Estate of: Thomas J. Fleming 21 12 0833 Schedule B (Page 2) Item Value at Date No. Description of Death 15 855.636 Shares The Hershey Company 62,042.16 16 1,775.0837 Shares Southern Company 82,399.38 17 1,920.238 Shares PPL Corporation 53,459.43 18 658.3603 Shares Exelon Corporation 24,491.02 19 115 Shares TE Connectivity LTD 3,729.45 20 115 Shares Tyco International LTD 6,096.15 21 253.4121 Shares Praxair, Inc. 27,533.22 22 4,275 Shares Mylan Laboratories, Inc. 92,511.00 Total (Carry forward to main schedule) 352,261.81 REV-1508 EX-(08-12) pennsylvania SCHEDULE E DEPARThAENTOF REVENUE CASH, BANK DEPOSITS &MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Thomas J Fleming 21 12 0833 Include the proceeds of litigation and the date the proceeds were received by the estate. All propert y jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Dreyfus Liquid Assets, Inc. , Class 1 Shares 5,617.98 2 Tyco International LTD (unclaimed property) 5.78 Dividend recovered from unclaimed Property. 3 2011 Ford Fusion 18,468.00 TOTAL(Also enter on line 5,Recapitulation) $ 24,091.76 2w48AD 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) SCHEDULE G pennsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC.NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Thomas J Fleming 21 12 0833 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 INMUDETFENWEOFTHETRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBE THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST IF APPLICABLE VALUE 1 UBS Financial account 85,092.93 100.0000 3,000.00 82,092.93 Account was held in the sole name of Decedent until February 2012 when the assets were transferred into the existing account owned by the Decedent and his wife. 2 4,836.148 Shares GNMA Fund Admiral Shares 53,632.88 100.0000 0.00 53,632.88 Traditional IRA with sole primary beneficiary being his wife, Virginia H. Fleming. 3 GNMA Fund Investor Shares 0.00 100.0000 0.00 0.00 Traditional IRA with sole primary beneficiary being his wife, Virginia H. Fleming. TOTAL(Also enter on line 7, Recapitulation)$ 135,725.81 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2.000 REV-1511 EX.t10-09' SCHEDULE H pennsylvania DEPARTMENTOF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Thomas J Fleming 21 12 0833 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Parthemore Funeral Home 6,289.81 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 25,000.00 3. 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 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 US Treasury 57,78 TOTAL(Also enter on Line 9,Recapitulation) $ 31,347.59_ 9w46AC 2.000 If more space is needed,use additional sheets of paper of the same size. R'EV-15T3 EX+(01-10) SCHEDULE J pennsylvania DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Thomas J. Fleming 21 12 0833 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Virginia H. Fleming 605 Hilltop Drive New Cumberland, PA 17070 4,836.15 Shares GNMA Fund Admiral Shares Inventory Value: 53,632.88 GNMA Fund Investor Shares UBS Financial account Inventory Value: 82,092.93 All of Residue to Virginia H. Fleming: 580,077.70 Surviving Spouse 715,803.51 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00 9 W46A 1 2.000 If more space is needed,use additional sheets of paper of the same size. METTE, EVANS &WOODSIDE A PROFESSIONAL CORPORATION ATTORN"S AT LAW 3401 NORTH FRONT STREET P.O.BOX 5950 HARRISBURG,PA 17110-0950 E-MAIL ADDRESS PETER J.RESSLER IRS NO. pjressler @mette.com 23-1985005 TELEPHONE FAX (717)232-5000 (717)236-1816 HTTP;//W W W.METTE.COM April 8, 2013 Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square, Room 102 Carlisle, PA 17013 Re: Estate of Thomas J. Fleming File No.: 2012-00833 Dear Sir/Madam: Enclosed for filing are the following: 1. Original and one copy of an Inventory; 2. Original and one copy of a Pennsylvania Inheritance Tax Return, plus a copy of the cover page of the tax return; 3. Check made payable to "Register of Wills" in the amount of$30.00 for filing; and 4. A self-addressed, postage prepaid envelope for return mail. Please file the original Inventory and Inheritance Tax Return. Please forward a copy of the Inheritance Tax Return to the Pennsylvania Department of Revenue. Please return a date- stamped copy of the Inventory and the cover page of the tax return, along with a receipt for the Inheritance Tax payment, to my attention in the enclosed envelope. Please do not hesitate to call with any questions. Thank you for your assistance. Very truly yours, Jessica R. Porter Paralegal to Peter J. Ressler JRP/xx Enc. 634111v1 > 2 > 01 Z 0 0 j ) ( 0 En r- T -j > 0 6 m :E ;a m > m 0 z M C.) o o rn M ;v CD Oq. 0 A tr mz t1i (D -n 7D � \(� \ fiq � \� /§