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HomeMy WebLinkAbout02-20-14 (4) 1505610105 REV-1500 EX(02-11)(FI) Pennsylvania Bu OFFICIAL USE ONLY Department Revenue P enn SY Bureau of Individual. ­­­­­­E= . County Code Year File Number Po BOX 28o6o1 INHERITANCE TAX RETURN QI n Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 11/03/2010 01/03/1925 Decedent's Last Name Suffix Decedent's First Name MI Flasher Clarice E (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 OD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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 John F Lyons,Attorney (717) 238-4777 REGISTER OF WILLS USE.ONLY -in First ..1 . . rte First Line of Address 112 Walnut Street Second Line ofAddress _ City or Post Office _ State _ ZIP Code - DATE FILED Harrisburg Pa 17101 DUI T Correspondent's e-mail address:jflyonslaW @msn.Com 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 a complete.Declaratio f preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE RS E L FI RETURN DAT ,� ADDRES 31 E. WEindinq Hil chanicsburg, Pa. 17055 SIGNATUR F PR ER OTHER ESENTATIVE DATE ADDRESS 112 Wal t treet, Harrisbur , Pa. 101 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 1505610205 REV-1500 EX(FI) Decedent's Social Security Number ..... ....................... . -._...... . Decedent's Name: RECAPITULATION __. ..... ... 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, . 100.00 6. Jointly Owned Property ty(Schedule F) Separate Billing Requested _ . .. ,.., g, 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. .... . . 7, 8. Total Gross Assets(total Lines 1 through 7). .., . ,,, e. : 1,000.00 9. Funeral Expenses and Administrative Costs(Schedule H)., ,,,, ,, ,_. 9. 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. ... . ........ . 10. 11. Total Deductions(total Lines 9 and 10)..... ... . .. .. 11 12. Net Value of Estate(Line 8 minus Line 11) .. . .... ,,. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. 1,000.00 an election to tax has not been made(Schedule J) ...... .... ... .. . ....... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) .. ... ...... ....... . ... .... 1,000.00 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_ - .. 16. Amount of Line 14 taxable - 15. at lineal rate X.0 45 - - - 1,000.00 15. _ 17. Amount of Line 14 taxable �� -- - - - - ' 45.00 at sibling rate X.12 18. Amount of Line 14 taxable _. 17. at collateral rate X.15 18. 19. TAX DUE .. ... . .. ... .... .. . . . . ... ... ... . ....... . ........ .. .... . . . 19.. 45.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O 1505610205 Side 2 1505610205 J REVA500 Ex(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Clarice E. Flasher STREET ADDRESS _ 517 E.Winding Hill Road CITY STATE ZIP Mechanicsburg Pa 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 45.00 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+6) (2) 0.00 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) 5. If line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 45.00 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 .........__....___.................... ❑ N c. retain a reversionary interest-..................-...................................................._................._.._.._......................1 © N d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 2, If death occurred after Dec. 12,1982,did decedent transfer property within one year of death without receiving adequate consideration?......___................................................................................................ ❑ N 3. Did decedent own an"in trust fob'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? ......................................_................_.............-.................-...._............-..... El 0 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.1,11995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent 172 P.S.§9116(a)(1.1)O), 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 [12 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 172 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. • 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.§91116(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. REV-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Clarice E. Flasher 21-12-1033 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's Interest if owned as tenant In common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1 517 E.Winding Hill Road,Mechanicsburg,Upper Allen Township Cumberland County,PA 17055(property is under contract of sale. Closing is scheduled on or before December 13,2014.Suspension of assessment of tax is requested until closing and determination of all expenses of sale and estate administration) TOTAL(Also enter on Line 1, Recapitulation.) $ 0.00 If more space is needed,use additional sheets of paper of the same size. REV-z5o8 EX+(o8-u) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TM RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Clarice E. Flesher 21-12-1033 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly awned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIFTION OF DEATH 1. Misc.Personal property. Decedent was advanced in years and lived a frugal lifestyle. Property consists of 1,000.00 old wom household furniture and house wares. TOTAL(Also enter on Line 5, Recapitulation) $ 1,000.00 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) j7pennsylvania SCHEDULE H �-� DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Clarice E. Flesher 21-12-1033 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Expenses and costs to be deducted on Supplemental tax return when real estate is sold. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: Z. 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: 5. Accountant Fees: 6. Tax Return Preparer Fees: ). TOTAL (Also enter on Line 9, Recapitulation) $ if more space is needed,use additional sheets of paper of the same size. REV-1512 Ex+ (12-12) pennsylvania SCHEDULE I �? DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Clarice E. Flesher 21-12-1033 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 2' Debts and liabilities to be deducted on Supplemental tax return when real estate sold. TOTAL(Also enter on Line 10, Recapitulation) $ 0.00 If more space is needed,insert additional sheets of the same size. REV-1513--EEX+(01-10) pennsytvania SCHEDULE J REVENUE INHERTTANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Clarice E. Flesher 21-12-1033 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 Sec.9116(a)(1.2).1 I. Scott E.Flesher lineal 100% 31 E Winding Hill Road, Mechanicsburg,PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. fI NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: i. TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed,use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF CLARICE E. FLESHER n a x� I, CLARICE E. FLESHER, of Mechanicsburg, Pennslilia declare this to be my Last Will and Testament, and cy and all Wills and Codicils made by me. o L7 ITEM I: I direct that all my just debts and funeral expenses, including my grave marker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease, as a part of the expense of the administration of my estate. ITEM II: I give, devise and bequeath the rest, residue and remainder of my estate of every nature and wheresoever situate outright to my spouse, THOMAS J. FLESHER, on condition that my spouse survive me by thirty (30) days. ITEM III: In the event my spouse, THOMAS J. FLESHER, predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath the rest, residue and remainder of my estate of every nature and wheresoever situate to my son, SCOTT E. FLESHER, or his issue, per stirnes. ITEM IV: All Federal, state and other death taxes payable because of my death with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the, administration of my estate and shall be paid out of the residue of my estate, without apportionment or right of reimbursement. ITEM V: I direct that no executor serving hereunder be required to post bond or enter security in any jurisdiction. ITEM VI: I appoint my spouse, THOMAS J. FLESHER, Executor of this my Last Will. Should my said spouse, THOMAS J. FLESHER, fail to qualify or cease to act as Executor, I appoint my son, SCOTT E. FLESHER, Executor of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this :2 "6 day of Jt "x , 1993. (SEAL) CLARICE E. FLESHER The preceding instrument, consisting of this and one other typewritten page, was, on the date thereof signed, published and declared by CLARICE E. FLESHER, the Testatrix therein named, as and for her Last Will., in the presence of use who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. residing at Gztit /bCll residing at JcGrt-I's bCA217 J PA - � . F 2 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN /WE, CLAAR�ICE E. FLESHER, ( �n�� � and 11T4 lu// ( � LnmLtf(,L , the Testatrix and the witnesses, respectively, whose names are signed to the attached or 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 that she had signed willingly and that she executed it 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 that time eighteen years of age or older, of sound mind and under no constraint or undue influence. p CLAt RIC/E E. FLESHERo L- �_ Cc Yl _ - wi-tnoso V Subscribed, sworn to and acknowledged before me by CLARICE E. FLESHEtt��R, the Testatrix, and subscribed and sworn to before me by 6d� ,i f Na �� and _ �r.�A 1� ��rro�QtUc. witnesses, this _ day of �ffC , 1993. Notary Public r�l L.�iSA,Mti�rY Pik F�n'is��,Q$nphin Ca