HomeMy WebLinkAbout02-11-05
REV-1500EX+ (6.00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
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-05 0 14
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DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
Frances M. Britcher
JATE OF D:::ATH (MM-DD-Year)
99- 1 4 - 1 239
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
DATE OF BIRTH (MM-DD-Year)
03/01/2004
02/14/1926
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
w [Xl 1 Original Return D 2. Supplemental Return D 3. Remainder Return (date of deafhpriorfo12 i3-82)
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~~<.n D 4. limited Estate D 4a, Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required
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:1:",-, 6. Decedent Died Testate (Attach copy of Will) 7. Decedent Maintained a Living Trust (Attach copy oITrust) 8. Total Number of Safe Deposit Boxes
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<( D 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1-95) 0 11 Election to tax under Sec. 9113(A) [Attach Set" :J:.
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Rob A Kru , Es uire 53 East Canal Street
FIRM NAME (If Applicable)
PO Box 155
TELEPHONE NUMBER
717-292-5615
Dover
RA 17315
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
OFFICIAl,. USE ONLY
(1)
(2)
(3)
(4)
(5)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4, Mortgages & Notes Receivable (Schedule D)
2,215.57
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(6)
L
(7)
2,215.57
(8)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
2,620.70
0.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
'11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
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2,620.70
-405.13
(11)
(12)
(13)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14 Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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-405.13
(14)
15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
x 0.00 (15)
X 045 (16)
X 12 (17)
X 15 (18)
(19)
0.00
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable al sibling rate
18. Amount of Line 14 taxable al collateral rate
000
19. Tax Due
20 D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
46 Erford Road
CITy I STATE I ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1 Tax Due (Page 1 Une 19)
2 Credits/Payments
A. Spousal Poverty Credil
B. Prior Payments
C, Discount
(1)
0.00
T alai Credils ( A + B + C ) (2)
3 Inlerest/Penally if applicable
D. Interest
E. Penalty
Tolallnterest/Penalty ( D + E)
4 If Une 2 IS grealer than Une 1 + Une 3, enler the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5 If Une 1 + Une 3 is grealer than Une 2. enter Ihe difference. This IS Ihe TAX DUE.
(3)
(4)
(5)
0.00
A. Enler the Interesl on the tax due. (5A)
B. Enler the lolal of Une 5 + 5A. ThIS IS Ihe BALANCE DUE. (5B) (:J:",~()'-" <N ,-) 000
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:
a. retain the use or income of the property transferred;
b. refain the flghl to designate who shall use the property fransferred or its Income; .
c, retain a reversionary interest; or .
d, receive the promise for life of either payments, benefits or care? .
2. If deafh occurred after December 12,1982, did decedenl transfer property Wllhln one year of death
without receiving adequate consideration?.
3. Did decedenl own an "in trusf for" or payable upon death bank account or securily at his or her death?
4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .
Yes
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o
o
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, includin~ 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 pre parer has allY knowledge
SIGNATURE OF PERSON RESPONSIB E FOR FILING RETURN DATE
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ADDRESS 1 Essex Road
Camp Hill
SIGNATURE ~~ER OTHER T AN REPRESENTATIVE
ADDRESS 53 East Can treet
Dover
PA 17011
DATE
PA 17315
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 99116 (a) (11) (i)].
For dates of death on or after January 1, 1995, the lax rale imposed on Ihe nel value of fransfers 10 or for fhe use of Ihe survlvln9 spouse is 0% [72 PS 99116 (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 dales of dealh on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent
or a slepparenl of the child is 0% [72 PS 99116(a)(1.2)].
The lax rate Imposed on the net value of transfers to or for the use of the decedenl's lineal beneficianes IS 4.5%, excepl as noted in 72 PS 99116(1.2) [72 P.S. 99116(a)(1)]
The lax rate Imposed on the net value of transfers to or for the use of the decedenl's siblings IS 12% [72 PS. 99116(a)(1.3)]. A sibling IS defined, under Secllon 9102. as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX + (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Frances M. Britcher
FILE NUMBER
05
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 PNC Bank account #7276 1,60076
2. Beverly Health Care credit 593.34
3. Verizon refund 747
4 Senior Blue refund 14.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2.215.57
REV.1511 EX+(12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Frances M. Britcher
FILE NUMBER
05
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1 Cremation Society of Pa 1,14000
B ADMINISTRATIVE COSTS
1 Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)JEIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid'
2 Attorney Fees Rob A. Krug, Esquire 350.00
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's Fees
6 Tax Return Preparer's Fees
7 Pinnacle Health-last illness 1,040.70
8 VA benefits return 90.00
TOTAL (Also enter on line 9, Recapitulation) $ 2.620.70
(If more space is needed, insert additional sheets of the same size)
REV~1513EX.(.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Frances M Britcher
FILE NUMBER
05
RELATIONSHIP 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
See 9116 lal (1.2)J
1. John Matthew Britcher, II grandson $500
2. Sarah Abigail Britcher granddaughter $500
3. Elizabeth A Rehm daughter remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV~ 1500 COVER SHEET
II. NON~TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
la!if~eJ unit ~Jfoment.
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01
FRANCES M. BRITCHER
I. FRANCES M. BRITCHER, of Mechanicsburg, Cumberland
County. Pennsylvania, being of sound mind, memory and
understanding, do make, publish and declare this as and for my Last
Hill and Testament, hereby revoking and making null and void any
and all Wills and Testaments and writings in the nature thereof by
me at any time heretofore made.
ITEM 1: I direct that all my just debts and funeral expenses be
paid as soon after my demise as may be convenient.
ITEM 2, I give and bequeath the sum of five hundred ($500.00)
dollars to my grandson, John Matthew Britcher, II.
ITEM), I give and bequeath the sum of five hundred ($500.00)
dollars to my granddaughter, Sarah Abigail Britcher.
ITEM 4: All All the rest, residue and remainder of my estate, of
whatsoever nature and wheresoever situated, whether it be real,
personal or mixed, including property over which I have a power of
appointment, I give, devise and bequeath unto my daughter,
Elizabeth A. Rehm. Should Elizabeth A. Rehm fail to survive me for
a period of thirty (30) days, I then give, devise and bequeath my
entire residuary estate unto my son, John Matthew Britcher, per
stirpes.
ITEM 5: I direct my Executor to pay all inheritance, estate,
succession and legacy taxes of whatsoever nature and kind, to Ivhich
my Estate or the transfer of any property passing hereunder or
otherwise pClssine by reason of my demise, may be subject und to
charge such taxes against my residuary estate, it being my
intention that none of the aforesaid taxes, either federal or
state, on any property required to be included in my gross estate,
under the provisions of any state or federal law now in force or
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FRANCES M.
A-u.~-<--( SEAL)
BRITCHER
intention that none of the aforesaid taxes, either federal or
state, on any property required to be included in my gross estate,
under the provisions of any state or federal law now in force or
hereafter enacted, shall be prorated among the persons interested
in my Estate to whom such property is or may be transferred or to
whom any benefit accrues.
ITEM 6: I appoint my daughter, Elizabeth A. Rehm as Executor of
this my Last Will and Testament. Should Elizabeth A. Rehm fail to
act as Executor for any reason, I then appoint John Matthew
Britcher as Executor hereunder.
ITEM 7: I hereby direct that upon my death I shall be cremated and
my ashes and urn buried at the Mount Olivet Cemetery in Hanover,
Pennsylvania.
ITEM 8: I direct that my Executor or her successor shall not be
required to give bond for the faithful performance of their duties
in any jurisdiction.
this
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WITNESS WHERE~ I have hereunto set my hand and seal
day of 1/. . 1994.
P.A1'"4CU l)l &.L~Ac/
FRANCES M. BRITCHER
The preceding instrument, consisting of this and one other
typewritten page was on the day and date thereof signed, sealed,
published and declared by FRANCES M. BRITCHER the Testatrix herein
named as and for her Last Will and Testament, in the presence of
us, who as her request, in her presence and in the presence of each
other, have subscribed our names as witnesses hereto.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF YORK
\-Je, FRANCES M. BRITCHER, Rob A. Krug and Vickie A.
Reinecker, the Testatrix and the witnesses respectively, whose
names are signed to the foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will and
Testament, and that she signed willingly, and that she executed
as her free and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of
the Testatrix signed the Will as witnesses, and that to the best
of their knowledge, the Testatrix was at the time eighteen years
of age or older, of sound mind, and under no constraint or undue
influence.
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'FRANCES M. BRITCHER
SWORN TO AND SUBSCRIBED
BEFORE ME THIS "II-/.. DAY
OF ~v(<Ul~' 1993.
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NOTARY PUBLIC
(SEAL)
My Commission Expires:
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