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Home My WebLink About01-16-14 `� 1505610105 REV-1500 EX(aa,1)(n)TV YT OFFICIAL USE ONLY Bu Department d al Revenue Taxes Pennsylvania County Code Year File Number PO BO 280601 INHERITANCE INHERITANCE TAX RETURN PO BOX rg,PA i } i Harrisburg,PA.t7u8-o6oi RESIDENT DECEDENT b� � 1 ENTER DECEDENT INFORMATION BELOW ' 01/07/2013 06/11/1929 Decedent's Last Name Suffix Decedent's First Name MI Fry Ann H (N Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number f --THIS RETURN MUST BE FILED IN DUPLICATE WITH THE.y - REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW - 00 1.Original Return MD 2.Supplemental Return - -- _ - ,C=D 3. Remainder Return(Date of Death Prior to 12-1382) Q 4.Limited Estate C:D 4a.Future Interest Compromise(date of C= 5. Federal Estate Tax Return Required death after 12-12-82) Cf 6.Decedent Died Testate C= 7.Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes (Attach Copy of Wilt) (Attach Copy of Taut) C=) 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death C7 11. Election to Tax under See.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 T0: Name Daytime Telephone Number Leslie M Dolan (717)761165 m c+- REGIS#t OP WILLS U gONLV71 Fn T n zr 0*1 "7 First Line of Address D M m ri 414 Blacklatch Lane �' a � -n Second Line of Address C7 Ca -n yc City or Post Office State ZIP Code ^,. DATE FILEDC.11 C!t Camp Hit) Pa 17011 Correspondent's ewnall address:dolansnpa @aol.com Under penalties of perjury,I declare that i he"exemh wd We return,including aocompanying schedules and statements,and to the best of my knoledge and belief, it Is titre,correct and complete.Declaration of preparer other than the personal represntative is based on ell Information of winch preparer has any knowledge. , SIGNATURE ERSON RESFONSIBLE FOR RETURN DATE ADDRESS ESS v N1q 6LAQtLR-7"CjH Lit!- LRA[P IWU , ;)A- 1-7011 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 1505610205 REV-1500 EX(Fl) RECAPITULATION 1. Real Estate(Schedule A)- .......... ...... ... . .............. 1, 0.00 2. Stocks and Bonds(Schedule B) . .. ...... .............................. 2. 0.00 3, Closely Held Corporation,Partnership or Sale-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. 0.00 6. Jointly Owned Properly(Schedule F) C'7 Separate Billing Requested ....... 6. 0.00 T, inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) CZ Separate Billing Requested,..... .. 7, 0.00 8. Total Gross Assets(total Lines 1 through 7). ....................... ... .. 8. 0.00 9. Funeral Expenses and Administrative Costs(Schedule H).. . .. . .. ... . . . . ... . 9. 46,90Z01 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)...... ......... 10. 0.00 11. Total Deductions(total Lines 9 and 10). .. ... . . . ... .. ...... .. ... .. . .. . .. 11. 46,$02.00 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12, . -46,902.01 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . .. . .. . . ..... ... ... . . . . 11 0.00 , 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 46,902.01 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 Lineal rate X.04-5 -2,110.59 16. -2,110.59 17. Amount of Line 14 taxable at sibling rate X.12 17. 184 Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ......................................................... 19. . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (0) Side 2 1505610205 1505610205 REV-1500 EX(FI) Pane 3 File Number Decedent's Complete Address: DECEDENT'S NAME Ann H. Fry STREET ADDRESS 785 Country Club Road CITY STATE ZIP Camp Hill Pa 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Una 19) (1) -2,110.59 2. Credits/Payments A.Prior Payments 0.00 B.Discount Total Credits(A+8) (2) 0.00 3. Interest (3) 0.00 4. If Una 2 is greater than Una 1+tine 3,enter the difference. This is the OVERPAYMENt Fill in oval on Page 2,Line 20 to request a refund. (4) 2,110.59 5. if Una 1+Line 3 is greater than U ne 2,enter the difference.This is the TAX DUE. (5) 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.......................................................................................... ❑ b. retain the right to designate who shalt use the property transferred or its income............................................ ❑ c. retain a reversionary interest..................................................................................................................-...... ❑ d. receive the promise for fife 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?................................._.................................-.......................--............ [] 3. Did decedent own an'in trust tor"or payable-upon-death bank account or security at his or her death?.............. Q 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ E 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)(1)1. 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 event 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 hom 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 RS.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12 percent F2 P.S.§9116(a)(13)].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. REV-1511 EX+ (10-09) pennsylvania SCHEDULE H •DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDSIDENT NTDECEDENT ADMINISTRATIVE COSTS ESTATE OF Ann H. Fry FILE NUMBER 2013-00131 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 2. 3. 4. 5. 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: 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: S. Accountant Fees: 6. Tax Return Preparer Fees: 7 Cost of Maintaining Property.(Insurance,Utilities and lawn care) 5,561.13 e. Realtor Commission 12,750.00 9 Repairs to prepare house for sale 24,467.68 10 Taxes (local and Real Esate Transfer) 4,123.20 tO 1O TOTAL(Also enter on Line 9, Recapitulation) $ 46,902.01 If more space is needed,use additional sheets of paper of the same size. C� r N 6 3 � m o a � m �+ V3 vi 3 cr�- c � aN CD0 N {� N 0 -,cC Ca .-r R �U