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Home My WebLink About05-24-13 _ _ - — _ — .��,�„ � 1505610140 REV-1500 EXt°'-,°, PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 0 3 8 5 HarrisburQ, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT 1NFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDOYYW 0 3 2 0 2 � 1, 3 1 2 3 1 1 9 2 5 DecedenPs Last Name Suffix Decedent's First Name MI F I S H E R E V A R (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 DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW a 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) Q 6.Decedent Died Testate � 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 Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9� 4 6 5 0 _�, :� _ . � :�a '� <.-, REGISTER OF 1KtpL5;�1SE ONLY`�::� ` � ::.3 I i _,, ,�'� —r� 4,7 :;3 First line of address ' r' r.,., �` , , . . ..s , . ., .. 5 4 E - M A I N S T R E E T i —4 � ` � —`' � 6 - _, . Second line of address ` � = � - ° , ... ..A ._.. , � � � � 1 V S I��,I City or Post Office State ZIP Code �_ DA'I'E�ILED "�- �xi-� M E C H A N 2 C S B U R G P A 1 7 0 5 5 CorrespondenYs e-maii address: m u r r e 1 a w a 1 t e r s q a 11 o w a y • C 0 RI Under penalties of pery'ury,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. SI ATUR P SO S O IBLE FOR FILING RETURN 1�� S" z 3 2,�/ ADDRESS RONALD L • FISHER 1 NESTSIDE CT HARRISBURG PA 17110 SIGNATURE OF P. P ER TH TH REPRESENTATIVE DATE 5 "� � t � ADDRESS MURREL R W LTERS, III, 54 E• MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 � 15�561014� 1505610140 � _ _ . _ f n n� Continuation of REV-1500 Inheritance Tax Return Resident Decedent EVA R. FISHER 21 13 0385 DecedenYs Name Page 2 File Number Correspondents Name Daytime Telephone Number M U R R E L W A L T E R S , I I I E S Q 7 7, 7 6 9 7 4 6 5 0 First line of address 5 4 E • M A I N S T R E E T Second line of address City or Post O�ce State ZIP Code M E C H A N I C S BU R G P A 1 7 0 5 5 CorrespondenYs e-mail address:m U►^r e 1 a�W a 1 t e r S q a 1 1 O W c3 y •C O RI Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief, it's true,correct and complet Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S ATURE OF PERSO R S BLE FOR FILING RETURN ADDRESS /� KERRI L • FAREY, 3601 A NY DR MECHANICSBURG PA 17050 _ _ . _ •��, � 15�5610240 REV-1500 EX Decede�Ys Social Security Number oecedent's Name: E V A R • F I$H E R RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �• ' 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 3 4 1 3 1 . 5 8 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 5 4 � 6 9 . 8 4 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) � Separate Billing Requested . . . . . .. 7. • 8. Total Gross Assets(total Lines 1 through 7) .. . . . .. . . . .. ... ... . ... . . ... 8. 1 8 8 2 � 1 . 4 2 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 3 9 � 3 . 5 0 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 9 9 � 2 . 2 � ��. Total Deductions(total Lines 9 and 10) . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . 11. 1 3 8 0 5 . 7 0 12. Net Vatue of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . �2• 1 7 4 3 9 5 . 7 2 13. Charitable and Governmenta!BequestslSec 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. 1 7 4 3 9 5 . � 2 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.0 _ � . � � 15. � . � � 16. Amount of Line 14 taxable at�inea�rate X.045 1 7 4 3 9 5 . 7 2 �g, ? 8 4 7 . 8 1 17. Amount of Line 14 taxable at sibling rate X.12 � • � � 17. 0 . � a 18. Amount of Line 14 taxable at collateral rate X.15 0 • � � 1 g, 0 • � � 19. TAX DUE . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . ... 19. 7 8 4 � • 8 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 1505610240 1505610240 � _ _ ,�� REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 13 0385 DECEDENT'S NAME EVA R • FISHER STREETADDRESS i 1D0 MT • ALLEN DRIVE __— _ — --- CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: �� Tax Due(Page 2,Line 19) (1} 7,8 4 7 • 81 2. Credits/Payments A.Prior Payments B.Discount 3 9 2 • 3 9 Tota�Credits(A+B) i2) 3 9 2 .3 9 3. Interest (3) 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. (4) 0 • 0 0 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 7,4 5 5 . 4 2 Make check payabie 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: ...................................................................... ❑ �X b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ OX c. retain a reversionary interest;or ................................................................................................ ❑ 0 d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ OX 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ QX 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ QX 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?................................... ❑ QX ............................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTfONS 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 noied 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. _ .. . _ .. - — _ _ _ . ._ . _ . . - — •�ow _ REV-1508 EX+(OS-12) pennsytvania SCHEDULE E UEPARTMENTOFREVENUE CASH, BANK DEPOSITS � MISC. IPdHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: F{LE NUMBER: EVA R . FISHER 21 13 �385 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. METRO BANK 49,187. 46 SAVINGS 2 • MEMBERS 1ST FEDERAL CREDIT UNION 1,693 • 06 REGULAR SAVINGS ACCOUNT #1 3 • MEMBERS 1ST FEDERAL CREDIT UNION 14,762 . 75 CHECKING ACCOUNT 4 . MEMBERS 1ST FEDERAL CREDIT UNION 60,254 .24 INVESTMENT ACCOUNT 5 • MEMBERS 1ST FEDERAL CREDIT UNION 4 ,00� � 42 LIFE SAVINGS ACCOUNT 6 • MEMBERS 1ST FEDERAL CREDIT UNION 276 • 65 REGULAR SAVINGS ACCOUNT #2 7 • INTERNAL REVENUE SERVICE 3,957 .�0 2012 INCOME TAX REFUND TOTAL(Also enter on Line 5,Recapitulation) S 13 4 ,131 • 5 8 if more space is needed,use additional sheets of paper of the same size. _ _ �,��.. REV-1509 EX+(�t-1a) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: EVA R • FISHER 21 13 0385 If an asset was made jointly owned within one year of the decedenfs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. RONALD L • FISHER 111 NESTSIDE COURT SON HARRISBURG, PA 17110 B. KERRI L • FAREY 3601 ANTHONY DRIVE GRANDDAUGHTER MECHANICSBURG, PA 17050 c. JOINTLY•OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY °!o OF DATE OF DF..ATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMIIAR DATE OF DEATH DECEDENT'S VALUE OF NUM6ER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTERES7 DECEDENT'S INTEREST 1. A. 6ni2oio METRO BANK 50,522 • 99 50• 25,261 • 50 CD � , g ainizoo9 MEMBERS 1ST FEDERAL CREDIT UNION 28,808 - 34 50• 14 ,404 �],7 CD -44 3 . B 4"72009 MEMBERS 1ST FEDERAL CREDIT UNION 28,808 • 34 50 • 14,404 � �7 CD -45 TOTAL(Also enter on Line 6,Recapitulation) $ 5 4 ,0 6 9 • 8 4 If more space is needed,use additional sheets oi paper oi the same size. _ _ __ _ _ _ _ _ _ _ _ �� ___ REV-1511 EX+(10-09) pennsytvania SCHEDULE H DEPARTMENT OF REVENUF_ FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FftE NUMBER EVA R • FISHER 2], 13 D385 DecedenPs debts must be reported on Schedule t. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS BUHRIG FUNERAL HOME, MECHANICSBURG PREPAID B. ADM{NISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s}of Personal Representative(s) R 0 N A L D L • F I S H E R streetAddress 111 NESTSIDE COURT City HARRISBURG State PA Z�p 17110 Year(s)Commission Paid; �R E N 0 U N C E D) 2. AttomeyFees: MURREL R• WALTERS, III 3,5�0 �00 3, Family Exemption.(If decedenYs address is not the same as ciaimanYs,attach expianation.) Claimanf Street Address City State ZiP Relationship of Claimant to Decedent 4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 403 . 50 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9,Recapitulation) S 3,9 0 3 • 5� If more space is needed,use additional sheets of paper of the same size. _ . ... . . . . . _ . . . _ _ _ . _ . . . . _T,.� _ Continuation of REV-1500 Inheritance Tax Return Resident Decedent EVA R. FISHER 21 13 0385 DecedenYs Name Page 1 File Number Schedule H - Funeral Expenses 8�Administrative Costs- B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMWISTRATIVE CQSTS: Personal Representative Commissions: 2 • Name(s)of Personal Representative(s) K E R R I L • F A R E Y streetqddress 3601 ANTHONY DRIVE �iry MECHANICSBURG State PA z�p 1705Q Year(s)Commission Paid: �R E N 0 U N C E D) SUBTOTAL SCHEDULE H-61 . . _ _._ .. . _ . ._ .. - - .. .. .. . ��. . REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT� INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER EVA R • FISHER 21 13 0385 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. MESSIAH VILLAGE 9,68� • 00 RESIDENTIAL CARE 2 • ALERT PHARMACY 98 • 20 MEDICAL 3 • PA DEPT OF REVENUE 119 • 00 2012 INCOME TAX TOTAL(Also enter on Line 10,Recapitulation) $ 9,9 0 2 . 2 0 If more space is needed,insert additional sheets of the same size. - _ _ _ ��. REV-1513 EX+(Oi-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: EVA R . FISHER 21 13 0385 RELATIONSHfP TO DECEDENT AMOUNT OR SHARE= NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1,2).] 1. RONALD L • FISHER Lineal 111 NESTSIDE COURT HARRISBURG, PA 17110 2 • KERRI L • FAREY Lineal 3601 ANTHONY DRIVE MECHANICSBURG, PA 17�50 3 • KATHIE J - DIEMLER Lineal 128 SALEM CHURCH ROAD MECHANICSBUR6, PA 17050 4 • SCOTT L - FISHER Lineal 126 CATALPA STREET MIDDLETOlilN, PA 17057 ENTER DOLLAR AMOUNT5 FOR DISTRIBUTIONS SHOWN ABOVE QN 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 QISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. � _ ____ _ - --__-- _ � LAST WILL AND TESTAMENT ` BE IT REMEMBERED THAT I, EVA R. FISHER, a resident of Cumberland County, Pennsyl��ania, being of sound mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that my son, MERIL DEAN FISHER, predeceased me, leaving three (3) children, KERRI L. FAREY, KATHIE J. POTTEIGER, and SCOTT L. FISHER, and I have a son, RONALD L. FISHER, who has two (2) children, CHRISTINA M. FISHER and BRYAN L. FISHER. II I direct that all my just deUts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III T C.�.:;..C� ±hYt yll t�.v_P� .7-?� mocr hP • � acePS�e� �n �nncan��pprP �f my death; of ��hatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all of my property, whether real or personal, wherever situate, inciuding any property over which I may have a power of appointment, as follows: ONE-SIXTH (1/6) to my granddaughter, KERRI L. FAREY, per stirpes; ONE-SIXTH (1/6) to my granddaughter, KATHIE J. POTTEIGER, per StZrpeS; O'�TE SIXTH (1/61 to my grandson, SCOTT L. FISHER, per stirpes; ONE-HALF (1/2) to my son, RONALD L. FISHER, per stirpes. - A � 1 � '3 � =.�7 � �; v, __. � m `' c-> -- c'_ " � � r- - - r � r - . A �n : "" '. - � -- �. . `. �� _' _. C ' — � ��j � . ..,�g'�e'g'* � . -� - �. �t �- � . . � . . . .�. �. . � . . . . .. ... . �� a � ��r��:r �.. .. � � �� _ _ ,�,� v . I nominate, constitute and appoint my son, RONALD L. FISHER, and my granddaughter, KERRI L. FAREY, as Co-Executors of this LAST WILL, to serve without bond. If either is unable or unwilling to act in that capacity, then the other may act alone as Executor of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, EVA R. FISHER, have set my hand to this LAST .,�.T T fi.,;� , - - t/ t�ay of - c%i-" , 2008. —�.�� r._ -� _/ EVA R. FISHER Signed, sealed, published and declared by the above-named EVA R. FISHER, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. % / /,,% ,/f ! , _ �,�•' ��`" J l� , , u 'I {u _ _ M�.�,-� �� .�, ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND . I, EVA R. FISHER, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknow�ledge that I signed and executed the instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. !��/ �, ��:�>_-�/� EVA R. FISHER Sworn or affirmed to and acknowledged before me by EVA R. FISHER, Testatrix, this �!`��i� day of �' ; ,, , 2008. �,c,✓.� �rs� � � . � � � � , x.: _ .i��..�_ � l� `-=*i�:::�� ` „w � _ ; Notary blic -�.�_ � --°"°---• \_T `u `"� r�'� !, NOT.",R;A! 5_AL .��or vT� � DL4F c vi SM:?4 `��.:�' '` •° � V.:ta� -::bliC �� ,+ ,� = ' LOV�:R AI.LE�.1-,NF CUMBERUWD COUNTY " ��s�'��„ �';��mmi:;ion Expires Jun 22,2008 Yy �� AFFIDAVIT COi��?!v?ON�x�EAi..TN OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND . We, ! �(i; ��f� � L-i.1��c=t J�`,� and�/I�2C t1� � ��yL'i2� the w�itnesses 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 Testatrix sign and execute the instrument as her LAST WILL, that EVA R. FISHER 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 the time 18 years of age or more, of sound mind and under no constraint or undue influence. ! ,�; ,,% i ��` l{ ��- _ �I �J 7 �� ' /�7ru� ,y , S�a�orn or affirmed to and acknowledged fore me " - this '"� day of _ ��. , 2008. _i -�'`"" 1 '� :�..�5� _ _� Yi ` • � � ,\ i .-. _.-�y � '.� .� �_� / t �� \ �I� � � ...�� ( .'. \ ,� y . _ ��...(�..�„ ^� ( �%%��L� �"` � #� ° Nota �" �z� ��. d „,� NOTARIAI SEAL '�� v DIANE M SMITH Nofory public LOWER ALLEA TV✓P CUMBERLMp COUN7Y My Commlcsion Expires Jun 22,200d �