HomeMy WebLinkAbout08-29-13 (2) � 1505610105
REV-150tJ°`{�_`�'«,
PA(7epartment of Revenue P���n��^� OFFlCIAI.USE ONLY
8ureauofIrMiNduatTaxes �NHERITANCETAXRETURN �� Y� ��� ����� '
�eox��� �I 13 4�3
t�arrfs�xc,aa z�uso5oi RES@ENT dECEDENT
ENTER pECEDENT INPORMATION BELOW
Sociei 3ea��rity Number Date�Osath MA�6YYYY DBte at'Bieth Mh�YYYY
03l27l2Q13 04l2(N1822
_ __ _. _ __ _
DecedenPs Laat Name SuHiac pecedenPs First Name MI
Fry _ Ruth _ R
{NAppiicabto)EMar Survivinp Spousa's tnfortnadon Oelow ...... . .... ..._ .. .. .... . .... .. . .. ..
Spouse's Last Name Sutflx Spouse's Khst Name MI
Spquse's Sodai 5ecurity Number ...... . .-__ .._... .. .
THIS RETURN MUST 9E fILED IN DUPLICATE WITH TNE
__ _ _ _ _ REGISTER OF WILLS
Fii.l MI APPROPRiATE 6YAL$BElt7W
�! 7.Original Retum O 2.Supplemental Retum p 3. RemairWer Retum(Dete ot Death
Priw#o t2-13�82}
p 4.Limited Esteta O 4a.FuWre InWrest Compramise(date of O 5. Fetleral Eslate 7ax Retum Required
deaih after 12-'l2-82}
�1 8.Decedant Dietl Testate C� 7. Decadent MaiMainetl a Living Trust � 6. Tqtal Numbar qf Safe Depueit Boxes
{Ai3ech Copy of tY�i} (Atfach CoRY flf Tn�st}
C? B.l'Ngatlon Pmceetle Received q 70.Spousal Pwerty Credil(Dffie of Death O 11. ElaGion to 7�under Sec.9113(A)
eetween 12-3t-91 aral 1-t-&'i) {A#�Schsdule 0�-_: _ �
CORRESPONDENT- TId3 SECTION MU9T BE COIAPLETED.ALL QORRE8PONDENCE AND C4NFlDEN7IAL TA7(INPORNA�8E � D n
Nama Daytime Numbp�' '^� c^a
'.T' r:,'Y.; > .:,.°I..
Law Otfice of John C Oszug�aw�cZ {717)Z�- �` "• !
_ _ _ _ _ � n��i r�� �i_ ;
c�_
RE ER(�W�-SUSE#i.Y�..
C t � � i
Rt&ttirSBMAddress `} •:. ., --� ��°
o ..:. �;�.�
104 S Hanvoer 5t. _ . .__ _ ti ;.;y �v
;� ` w� .. �.��
S8Wf7d L,I1180f AddfB@S _ . .. . . __. .. . ..... .. ..... . ..... . ..... jco r :�:' ry 1
City or Post Oflice_ . _ . .... _. . . ._ _.... .. . .SWte ZIP Cafe DATE PI�P
Carlisle . _ PA 17013 _
carr.apooa.nYs wnan addr.sr:johno�carlislepalaw.com
I iiMer Pxielfies W PerWry,i Ceciere tlwt I heve exeminetl tltls r�um,pidudin8 ecoompenylrq adiedulee entl aWta�n�Na�and to Ma hast of mY k�tm'�ed8e antl deliet,
n a we.wrrect w�a complete.tlemra�wn of preparer omer man u»varaonet rea�eaenlative is eaeed on eu Inrormana�aa wn�a,preparer nes any kno�x�acge.
i SIGp�u�6F PER80N RESPONSI�,LFOR FlL�NG REiURN DATE /
�' :71.J.[�vt.n,N+ L .��„ _���y��i/j� .
ADORE33 (i
1809 erretta Gap Ave,Carlisle, PA 77073
SIGNANR �pTHER TiiAN REPRESENTATIVE OPi� I f�
r z4
aoors�s
104 S Nanover St.,Carlisle, PA 77013
PLEAS@ USE ORIqpINAL FORM ONLY
Side 1
� 150561U105 1505610105 �
�
� b5�561�2�5
REV-7500 EX{FI)
DecedeM's Sociai Seqt�ity Number
oeoaaem�s Nema:
neca�ru�a,naH
_ _
t. Resl Estata�Schedule R}. ............................................ 1. ' .__._..�����.
_....__ ._.,._ . . __,. .. ....J
2. sso�e�d eo�ag�sdr0duie s� ....................................... a.
__ , . ..___. . .
3. Ctosaty H�d Corpowtion.Partnetship ar Soie-Rroprietorship{Schedule Cj ... 3. � .._... , , .,
..__.._. ... . ......_... ._. .......,_.. � ...
4. Mortgages gnd Notes Receivable(Schadule D)........................_. 4. � ���.��.
.._�__ ._� _._�._ . , �.. ,„ _
5. Cash,Bank Deposfts end M�scenaneous Personai Pfoperty(Scheduie Ej..... . b. 81,328.47 ��-
.......... . .. ......... . . _........_. . .. _..
6. JWMty Ownqd Propedy(Schedule F) O Separate Biliing Requested ....... 8. ��
7. IMer-VivoS Transfers&Misceilarte0u6 Non-PNbate Prapetty _..... ... . . . _ ..... ..
{Scheduie G) O Separate BiNi�Fiequested........ 7. �:. ..
._,.__ �.... ._... _...._,.,, ..., . _.....
8. Total Oross Auats(total Lines 1 throu9h 7)............................. 8. 81�828.4T .
9. Furreral Expenses and Actministrative Costs{Sebedule H}................... 9. ' 2,91$.08 !��,
._..... . . ., ........, ... , ......... . .,... .
10. Debts of Decedant,Mortgage Liabilities and Liens(Schedule I).._........... 10. 58.99 �'�..
.__� ....._._._ . . .__ . .
tt. Totai DeductFoos(totai�ines 8 ancf t0)................................. i1. 2,ST$.07 '..
....... ..... ........ .. . ..___,.. ___ ..
12. Net Velue af Estate(Lino 8 minus Line 11) .............................. 12. 78,35Q.40 '.
13_ Ctmritsb�and Govemmentat Bequests7Sec 9ii3 Ru�s iw which -_ .�_�..__ ___._ _ .
an electlon to tax has not been made{Schedule J} ........................ t3. ... '
.. ....._. . .... .. .. ...._.,.. ... _ .
14. Nbt Valuo SubJect to Taac(Line 12 minua Line 13) ............._......... 14. 7$,350.40 -.
TAX CpLCU1AT10N-SEE INSTRUCTION5 FOR AppLICAg�E Rp7'Eg
t5. Amount af tine 14 taxabie
et the epousal tax rete,or
NansfeiaunderSec.9ri8 ..._. "�_. __. ; .._. _._ _....
{axt 2}X.0� f3.;
16. Amount W Une 14 fexabid . ...__.....w,... . .�....�_...� .. .__..,_._ . ,...:, . ...__._...� . �_.___._. - ---°-° i
et��neai rete X.0 4�` i 78�350.40 ' �6. '', 3,525.77 ',
17. AmouMOfUoel4taxable ..__....._., ....w,.,_... , .. ..,.._,.,. � _ ..,.; _,.,...__ . _...__ .. ,._ .. �
.._,. _. ... ,... . _.
at e�CMg rate X.'12 . 1Z !
. ._...._.. .__.... ......... ...... .......__._ . . . .._
i8. Mnpunt of Lina t4 taxabie -...-- . .._..._...._ ._:
et collateral rete X.15 ,'�. � 18. �. ..''..
_..... . . ..... . . ....m..... .. , _ .
ts. Tl�t oue...._................................................... �9. 3,525.77 '
2Q. FLLt,IN THE OVAL iF YOU ARE REqUE$TINO A REFUND t7F AN OVERpAYMENT C}
5ide 2
�„� �50561tI205 1505bZ�205 �
REV-1506 EX{FI) Page 3 File tiumWr
Decedertt's Gomplete Address:
E
Ruth R Fry
STREETADDRESS ------..__..—..-------�----"-------�._.----------._..� .—
7705HanovsrStreet ---------------------------
c�n—.————.__—..————--------------_—— sinh—...-------- aP—.---_
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,525.77
2. CreditslPeyments
A.PriaPaymems ___ 3�200.80
B.6iscount 177.Op
.----...�.—.T_— To1alCredRS{A+8} (2} 3,377.00
3. loterest
(�)
4. if line 2 is greatar than l'me i+Lirre 3,amer the difierence. This is the 6VERPAYMENi:
Fia in oval an Page 2,u,»�o�re�t a r�na. t�i
5. if Line t+�ne 3 is greater N�an Line 2,enter the difierence.This is the TAX DUE. {5) 148.77
Make check payabie to: REGISTER OF WiLi.S, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a Vanster and: Yes No
a. �elain tha use a income M the ProPedy transferred................................................................................._...... ❑ �
b. refain the rigM lo designate who shali use ihe propeAy transferted or its income ............................................ ❑ �
c. retain a reversionary iMaesi.............................................................................................................................. ❑ �
d. receive Mre pmrttise tor Nfe of eilMer payrnenis,benefits or careT...................................................................... ❑ �
2. If KIe�A occurred after Dac.12,1962,did decedant tr9�fer praperty wiihin arre year of deeth
withoul rece�ade9ua�twnsidera6an?.............................................................................................................. ❑ �
3. !Hd decedent am an'in Uus!far'ar psYable�uPon-death bank acmunt ar secunty st Ms a her de�h?.._.......... ❑ �
4. Did decedent mm an individual retirement acwunt,annuity or athar nun�probate property,which
containsa beneficiary designation7 ........................................................................................................................ ❑ �
1F THE AtiSWER TO ANY t3f TNE ABQVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEdULE G AND FILE IT AS PART OF TNE REtURN.
For dates of deatlr on a aft�July 1,1994,a�d befae Jan.1,1995,the�x rate imposed on the net vaiue�Vansters to a for ihe use of the surmnng spouse
is 3 percent j72 P.S.§9116(a){1.1?(i)1.
For dakes of death an a att�Jan. 3, 1995, the tax tate imposed a7 the r�et va(Ue of Uansfers to w for the use of ihe s�vivirag spouse is 0 percent
[72 P.S.§9116(a�{1.1)(ii)].The staWte dces noC exempt a Vanster to a surviving spouse from tax,and the statutay reqUirements fa d�ure af asse#s and
fiiing a tax reium are s�il applicaWe even if the surviving sppuse is the only beneficiary.
Fa da0as of death o�a aftar July 1,2W0:
• The tax rate imposed an the net value at iranslers from a deceased chfld 21 years of age or you�ger at death t�w tar tha use at a narival parent,an
edoptive parent or a stepparent of the chld is 0 percent(72 p.S.§9116(aj(1.2)].
. The tax rate imposed an ihe net value af irensfers fo or fa Ihe use of fhe decedem's lineal beneficiaries is 4.5 percznt,except as noted in p2 P.S.Q9N8(a)(7)].
. The tax rate imposed on the net value of transfers Ro or for the use ot the decedenks sihlings is 12 percartt(72 P.S.§9116{a){1.3)].A s�ng is da8ned,
under Sec�an 9102,as an iodividuai whp has at�east one perent in common with the decedent,whether by blood or adoption.
REV-L508 EX+(o8-f2)
�pennsylvania �MEDULE E
�t'ARTM�e+TO��`�+t� CASH, BANK DEPOSIT5&MISC.
INHERRANCETA%RETURN PERSONAL PROPERTY
RESI�EHT OECFOENT
ESTATE OF: fILE NUMBER:
��n a F�y 21-13-6453
Include the AroceeGs�IiGgaUat and the date the P��ds were received bY the estate.
All property jolntly ownod with ripAt oi wrvivaahip must be disdosed on Schadula F.
R� VAL{1E AT DA'fE
NUMBEtt DESCWPfION Of DEATH
1. A�ambers 1st Federai Credit Uniai kcrAUrt�102793 _ 68,$OO.pB
y hlBT Bank Checking Accaunt#23517891 5,019.93
3 Pnntemiat Cife lnsurance Froceeds Contract#D50 382126 _ 5,910.18 ;
q The Sentinei-Unused nevr3paper refund 110.55 '
g Chapet Point Tmst Accqunt refund _ 60.00
_g Ci�apet PoiM Nursing Cere retund' _ _ _ . _ 1,427.73
TOTAL{Alsa enter a�Line 5,Recapitulakion} ; &1,328.47
if more space Is needed,use addltlqnal sheets oP paper of the ume size.
REV-2511 EX+(p8-i3}
�pennsylvania SCHEDULE H
°E""k'"F"T°��vE"�E FUNERAL EXPENSES ANd
`""�^"�T"""�" ADMINISTRATIVE CdSTS
RESIDENT DECEDENT
ESYATE OP PILE NUMBER
Ruth R Fry 21_�S.pq53
Decedent's debts must be reported on Schedule I.
T(EM
NUMSER pE�p�jpN ���
A. 1 Fl1NERAt EXPENSES;
B. ADMMISTRATIVE COSTS.
1. Perwr�ai Reprrsentadve Commis5ions: . . � _.... .._..
Name(s)of Personal RepresentatNe(s) � � � �� �� �
StreM AdGress�
�ty ._. , ._ _State._,�ZIP_,..,--_,—
Year(s)Commission Paid:
2, Attomey Fees; 2,d10.00
�. Fartriiy Fa�emptkn: (if decedent's address is oot tt�e same as claimaM`s,attach e�anadoo.) .
Claimant
Street Address
�b _ .,._SWte�ZIP �
RelaSionshiR of CfBkmank to Decedent
4, probate Fees: 328.50 '
5. AaouMant Fees: _ . . . ,
6. Taz Return preparer Fees: � �� �
7. The Sentinel-legal advertising _ 104.58
e Cumberland County Law Joumal-Legal advertisin9 75.00
�
TOTAL(Also enter pn Line 9, Recapitulatlon) ¢ 2�9�8��8
If more space is needed,use�ditia�a!sheets ef paper af the satne size. .�.,... .
REV-]512 EX+(12-12)
�pennsylvania SCHEDULE I
UEPANIMENTOFpEyENUE DEBTS OF DECEDENT,
[NHERITpNCETpXqE7URN MORTGAGE LIABILITIES& LIENS
ItESIDENTDECEDENT
ESTATE OF
Ruth R F FILE NUMBER
Report dabta incurred by tfie decedent prior to death that remained unpald at Me date of derih Includin wrcimbuned medical
ITEM � 9 expensea.
NUMBER DESCRIPTION VALUE AT DATE
1. . . . . ... .. ... ... .. . . .. .. .. . . . . . . OF DEATN
Millennium Pharmacy
59.99
iOTAL(Also enter on Line 10, RewpitulaGOn) ;, 59.99
If more space is needed,(nsert addkional sheets of the same size.
�
;`': , _ _ : ..; , , . , ��.,..,
I.9!>T Wl'LL AND TESTAMII3T
� I;, RU7H" R. ��'�`t cE i;arl.zsle, Cumberlaad Gaunty, Pennsylvania,
beitig of sctxmd 7air{ct, m�ynerq and understanding, do make, publish and
declare this a:; �c:c�. f, - Ty last wi11 and testament, herebp revoking
and making ✓aic' a 1 1 ;oi_ i.y by me at anp time heretofore made.
�
FIRST. i; �_, =�t; : -e �±� my persanal re�reeenta*_ive T^ere;r.�F�eY
... . ..
_ .... ,.
named to pap r�Zl. ny � t,r lebts and fuaeral e�eases as saaQ a€ter �e}r
deaeaae as r�xp 1,.> i'��•zr�c� ����nvenisnt to da sa.
SECOrID, I �,: fe , c±et 7 se and bequeath ai1 my estate, real aad
persanal, t[ flly ha�>b.tc<C:y E:dg�3x' C. Fry.
TSZRD. �n t:t,<� 4,ue�t my said husband should predecesse me, th�n
I give, devi:�e .�r�d b.c�u<a�:th a1Z mp estaCe, real and persranal, to mp
8ozi� Detuiis C. 3�*,� . : r 'ti:3 isSUe.
IASTLY, I iznmizyri° � .o�stitute and apgoint mys�id i�usbamd, Edgar
C. Frq, Exec,xt�r:� , � -': ti~.'ing> otherwise mp said son, Densxis C. '�rc,
.w.�iy.x�' . .�RM1y�.°�'y,i�R ��••a t#ty s..<�f:� i1.rl.�.w �t� 4E''J�ir�k�.•
IN WITN]:SS t?iiE2E�F , ': have hereunto set my haad and sea2 this
� ��,..:��_:�' __� 4.. _
'� ` �3' o� _._ ._ ___, i97s.
��� 11 �,�,. � {SE'1�Z.1
a
Signed, �eaX.etd ���bl:ished a�,d declerec� by R�thR Frv, the
above named Tr.sta�t r; r:, a ; ae�d �ar har last will aa3 testasent , .ss
the pr�sence :,#' e�; , w�°_: , .+� �et- rem.�est anc� in her aresersce a�rc �
the presen+�e �:+:f e:�cr �-;,_=.-� , �+�+e '�,eretmte� salsscri'bed �z �raieies� a�
vitaesses Lhe t��tc� .
r ,
.,..�+.;,� �aa.���,: ,i ; � ; � �'t.t:;wn��
� f ,
�"�lt,'�:-s,_ . !'. t:'d1.t.�ta.�'�t