HomeMy WebLinkAbout03-24-14 1505610105
�J REV-1500EX(02at)(FI)ryrt
Pennsylvania
OFFICIAL USE ONLY
PA Department of Revenue P enn5 Y
Bureau of Individual Taxes `""""`.. County Code Year file Number
PO BOX 28o6o1 INHERITANCE TAX RETURN C�
Harrisburg,PA 17128-0601 RESIDENT DECEDENT a I 13 0 q /7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
06/23/2013 12/03/1928
Decedent's Last Name Suffix Decedent's First Name MI
FRAIN JAMES J
(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
Op 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-62)
O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
OID 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 0)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number o
JEFFREY S COHICK EA (717) 249-5321 � 0 3
REGISTER OF WILLS USE ONLY (33 n 9
�1vM N
rzm ,s
First Line of Address N
390 ALEXANDER SPRING RD n ° ° (300
Second Line of Address :p0 s .Qj J
D
n
M = C7 W
City or Post Office State ZIP Code DATEF Dr O
D 7D O:. .
CARLISLE PA 17015 o 0
O C7 p
n O -n g TI
O C
Correspondent's e-mail address:icohick@cohickassoc.com CJ !— rn
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the bes my knowledge aO belief(/ O
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which pre rer has anykno e. 'TI
SIG _ RE OFPERso S NSIBLE F FILING RETURN DATE"
A.f G r�� ) 77 do
ADDRESS
23169 PA LLEY R , DOYLESB P 17219
SI RE OF PR R OTHE P E TA DATE
SS
390 ALEXANDE SPRING ROAD, CARLISLE, PA 17015
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
_J 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: JAMES J FRAIN
RECAPITULATION
1. Real Estate(Schedule A). . ... . ... .. . ... ...... ... ... .. ... ... ... ... ... . 1.
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. 106,337.89
6. Jointly Owned Property(Schedule F) l7 Separate Billing Requested . .. .... 6,
7, Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. .. ... . 7. 33,038.51
S. Total Gross Assets(total Lines 1 through 7).. .. . ... .. . .. ... ... ... ... .. . . 8. 139,376.40
9. Funeral Expenses and Administrative Costs(Schedule H). . ... . . ... .. . ... . 9. 10,149.98
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1).. .. . ... .. . ... . 10. 3,551.59
11. Total Deductions(total Lines 9 and 10)....... .. ... ... ... .. . ..... . ... ... 11. 13,701.57
12. Net Value of Estate(Line 8 minus Line 11) .. ... ... ... ... ... .. . ... .. . .. . . 12. 125,674.83
13. Charitable and Governmental Bequests/Sec 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. 125,674.83
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal lax rate,or
transfers under Sec.9116
(a)(1.2)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.
17. Amount of Line 14 taxable
at sibling rate x.12 125,674.83 17. 15,080.98
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE . . .. . .. . .. . . . . .. . . 19. 15,080.98
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (39)
Side 2
1505610205 1505610205
REV-1500 Ex(Fl) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
JAMES J FRAIN
STREETADDRESS
GREEN RIDGE VILLAGE
210 BIG SPRING ROAD
CITY STATE ZIP
NEVVVILLE PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 15,080.98
2. Credits/Payments
A.Prior Payments 17,000.00
B.Discount 754.05
Total Credits(A+B) (2) 17,754.05
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) 2,673.07
5. If Line 1 +Line 3 is greater than Line 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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ........................................... ❑ 0
c. retain a reversionary interest ............................................................................................................................. ❑ 0
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?.............................................................................................................. ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? .........................................................................................___........................ ❑
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)),
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)(it)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
fling 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 noted in[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.
REV-i5o8 E%+(o8-12)
7 pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INNERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
JAMES J FRAIN 2113-0847
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.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532601 28,748.22
2. NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532604 5,659.23
3, NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532607 13,135.49
4, NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532608 3,145.19
5. NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532609 2,063.10
6. NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532610 11,549.72
7. NAVY FEDERAL CREDIT UNION CERT DEPOSIT ACCOUNT#68000146532611 9,558.87
8, ADAMS COUNTY NATIONAL BANK CHECKING ACCOUNT#2244934 333.80
9. VANGUARD 500 INDEX FUND INVESTOR SHARES FUND#40 ACCOUNT#9903997266 4,163.89
10,; VANGUARD PRIME MONEY MARKET FUND#30 ACCOUNT#9903997266 1,450.97
11. NAVY FEDERAL CREDIT UNION FLAGSHIP SAVINGS ACCOUNT#1539482008 5.63
12. NAVY FEDERAL CREDIT UNION FLAGSHIP CHECKING ACCOUNT#1539482701 22,716.08
13. MINIMAL PERSONAL PROPERTY 250.00
14, 2013 IRS INCOME TAX REFUND 3,173.00
15. RENTER'S INSURANCE REFUND ERIE INSURANCE CO 5.00
16. MEDICARE REFUND 31430
17, BLUE CROSS REFUND 65.00
TOTAL(Also enter on Line 5, Recapitulation) $ 106,337.89
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
�-� SCHEDULE G
;-&-, pennsylvania
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JAMES J FRAIN 2113-0847
This schedule must be completed and filed if the answer to any of questions t through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCWDE THE NAME or THE TRANSFEREE,THEIR ADATIDNsHIP TD DIaDon M DATE OF DEATH % DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF OER. ATTACH A OW or THE DIED FOR REAL EST ATE. VALUE OF ASSET INTEREST r APPacmRn VALUE
I. VANGUARD 500 INDEX&MONEY MARKET IRA FUND ACCT#990399266 5,577.16.. 100 5,577.16
2 'VANGUARD 500 INDEX FUND ADMIRAL SHARES IRA FUND#540 27,461.35; 100 27,461.35
:ACCOUNT#9983965917
JAMES J FRAIN'S SISTER,JUNE F BUZBEE IS 100%BENEFICIARY OF
BOTH OF THE IRAs
i
i'
I I
i'
TOTAL(Also enter on Line 7, Recapitulation) $ 33,038.51
If more space Is needed,use additional sheets of paper of the same size.
' REV-1511 EX+ (08-13)
Upennsytvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JAMES J FRAIN 2113-0847
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
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:
6,600.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
4. Probate Fees: 313.50
5. Accountant Fees:
6. Tax Return Preparer Fees: _ 2,850.00
7. LEGAL NOTICE-CUMBERLAND LAW JOURNAL 75.00
8. LEGAL NOTICE-CARLISLE SENTINEL 210.78
9. MOVING&STORAGE COSTS FOR FILES 100.70
TOTAL(Also enter on Line 9, Recapitulation) $ 10,149.98
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
JAMES J FRAIN 2113-0847
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medial expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• GREEN RIDGE VILLAGE-SWAIM HEALTH CENTER 3,275.93
2. MILLENIUM PHARMACY-PRESCRIPTION 275.66
TOTAL(Also enter on Line 10, Recapitulation) ; 3,551.59
If more space Is needed,Insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RENRN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
JAMES J FRAIN 2113-0847
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).]
I. JUNE F BUZBEE,22035 ERRYBANE LANE,ROBERTSDALE,GA36567 SISTER 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON 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 DISTRIBUTIONS:
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.
East Mill Unb Gentnment of
James J. Frain
I, James J. Frain, of 116 Green Ridge Road, Newville, Cumberland County,
Pennsylvania, being of lawful age, sound mind and memory, and under no restraint, do
publish this, my Last Will, revoking all others previously made by me.
First: All expenses, fees, costs, and taxes related to this estate shall be paid from
the probate estate assets, and all gifts and bequests shall be paid from the net distributable
estate.
Second: I bequeath those articles of my personal effects and personal property as
set forth in a separate memorandum, which I shall.place with my will, to the persons therein
designated.
Third: I give, devise, and bequeath my entire estate, real, personal, or mixed, of
every kind and nature, and wherever situated, which I may own, or hereafter acquire, or
have a right to dispose of at my death, to my sister, June Buzbee with a current address
and telephone number of 22035 Errybane. lane, Robertsdale, Alabama 36567, telephone
(251) 955-6588.
Fourth: In the event that my sister does not survive me, then I give, devise, and
bequeath my entire estate, real and personal, to my brother-in-law, Frank Buzbee with a
current address and telephone number of 22035 Errybane Lane, Robertsdale, Alabama
36567, telephone (251) 955-6588.
Fourth: I nominate and appoint my friend, Anita Rayburn, with a current address
and telephone number of 23169 Path Valley Road, Doylesburg, Pennsylvania 17219,
telephone number (717) 349-2298, to be the Executrix of my Last Will, granting to her
authority to sell and convey any or all of my estate, real and personal, or mixed, upon such
terms and prices as she shall deem proper, without obtaining any prior order of the court
therefor. I also grant her full power and authority in the settlement of my estate, to compro-
mise, adjust, and settle any and all debts and liabilities due to or from my estate, for such
sums, and upon such terms and conditions as she shall deem best. In the event that she
shall for any reason decline to serve, or fail to qualify for any reason, or having qualified
and been appointed, fail to complete the administration of my estate, then I nominate
Attorney Edgar R. Luhn III, with a current office address and telephone number of 480
Doubling Gap Road, Newville, Pennsylvania 17241, telephone (717) 448-1204, to be the
Page One of Three
Alternate or Successor Executor. I direct that no bond or surety shall be required of any
administrator or fiduciary named herein.
IN WITNESS WHEREOF, I have hereunto subscribed my name, and acknowledge
and publish this instrument as my Last Will in the presence of the undersigned witnesses,
on March 8, 2007.
Jades J. Frain
Witness
Witness
Page two of Three
Signed, sealed, published and declared by James J. Frain, Testator, as and for his Will,
in the presence of us, who at his request, in his presence, and in the presence of-each
other, have hereunto subscribed our names as witnesses hereto.
c= L / residing at
residing at
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
We, James J. Frain, and C.?
_ Ldw 7-
the Testator and the witnesses whose names are subscribed to the attached Will, being
duty qualified according to law, do depose and say that we were present and saw the
Testator sign and execute the instrument as his Last Will; that he signed it willingly and that
he executed it as his free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of James J. Frain signed the Will as witnesses; and that to
the best of our knowledge he was at that time 18 or more years of age, of sound mind and
under no constraint or undue influence.
V7Witnesses
Testator:
a &4�
Sworn and subscribed to before me, this day of 44� 2007.
NOTAK4 SEAT,
EDGM R LMN,0
NONNymft iKo-tary Public
LOW"MFM 101RCUMALAND:D COUNTY
MY CO"Wift;0"BON Apr 24.2008
Page three of Three
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