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Home My WebLink About06-20-14 J 1505610143 REV-1500 EX(02-11) Iff PA Department of Revenue OFFICIAL USE ONLY P Pennsylvania County Code Year File Number Bureau of Individual Taxes amv1aWra.e.as,aWE PO BOx.280601 INHERITANCE TAX RETURN 21 14 0169 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 12 08 2013 08 09 1963 Decedent's Last Name - Suffix Decedent's First Name MI FAHNESTOCK JULIENNE (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI FAHNESTOCK LARRY Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ❑ 2. Supplemental Return 3. Remainder r3etturn(Date of Death o 4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) 5 Decedent Died Testate T Decadent Main fined a Living Trust 0 8. Total Number Of Sale De (Attach Copy of Will) (Attach Copy rust) posit Boxes 9. Litigation Proceeds Received ❑ 10.5 ousal PovertYYCredrtrDate a Death 11.Election to tax under Sec.9113(A) between 12-31-91 and i-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone NurM!pr EDWARD P SEEBER 717 933° 3264 m M ° c-d REGIS Eft OF WILLS�diE ON4Yo N+ M M First Line of Address . : ° SUITE C400 o :3 :Try Second Line of Address ` 4 c9 D ~ 1' M V 555 GETTYSBURG PIKE w OC ° City r Post Office DATE FILE H State ZIP Code MECHANICSBURG PA 17055 Correspondent's e-mail address: eps(rDlscic.com Under penalties of perjury,I declapffhat I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and com ete.D6,01kration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATU RE 'F R FILING RETURN DATE r ( Larry Fahnestock C9 14j1(/ ADD 12 Broa oo Drive ElMechanicisbung LPA 17055 SIGNATURE PREP ER OTHER THAN REPRESEN IYE— DATE Edward P Seeber ADOR S Suite C-40OL1555 Gettysburg Pikei7NechanicsburgLPA 17055 Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Fahnestock, Julienne 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&Notes Receivable(Schedule D).. . .. .. .................................... 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 35, 360 . 65 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous I(oq Probate Property (Schedule G) u Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 35 , 360 . 65 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 24, 889 . 50 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 24 , 889. 50 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 10 , 471 . 15 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. 10 , 471 . 15 TAX COMPUTATION-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.00 10, 471 . 15 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 0 . 00 16. 0 . 00 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 0 . 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El Side 2 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-14-0168 Decedent's Complete Address: DECEDENT'S NAME Fahnestock,Julienne STREETADDRESS 12 Broadmoor Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: I Tax Due(Page 2,Line 19) (1} 0.00 2. Credits7Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2CLine 20 to request a refund 5, if Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00 Make Check Pa able to: REGISTER OF WILLSE AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS i, Did decedent make a transfer and: - Yes No a. retain the use or income of the property transferred;.......__.........................................-......................... ❑ Q b. retain the right to designate who shall use the property transferred or its income;.--- ......... I x c. retain a reversionary interest;or..................................................................-.........._....._........................ x d. receive the promise for life of either payments,benefits or care?............................................................ 1 If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.........-..........._.-......................................................___.........................---- ❑ ❑x 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 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 YESCYOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Y 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)(i)]. For dates of death on or after January 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 PS,§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 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 p2 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-1508 EX.(11-10) SCHEDULE E pennsylvania DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Fahnestock Julienne FILE NUMBER 21-14-0169 Include the Proceeds of litigation and the date the Proceeds were received by the estate. All property JoinByowned with the right of survlvon:hip must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 American Diabetes Association -account refund 34.61 2 Genworth Life Insurance Company-premium refund 4,333.07 3 Lincoln National Life Insurance Company-premium refund 600.00 4 Prudential-Pinnacle Health 457(b)Deferred Compensation -beneficiary is the Estate;valued 30,392.97 per letter dated 3/24/14 TOTAL(Also enter on Line 5, Recapitulation) 35,360.65 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) REV-tilt F-X+(10R9) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE IE CEDENT R" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 'FahnestockoJulianne 21-14-0169 Decedent's debts must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: Funeral expenses -funeral servicesCgrave openingCand marker 181816.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 1 Attorney's Fees JSDC Law Offices 2[400.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 31500.00 Claimant Larry Fahnestock Street Address 12 Broadmoor Drive City Mechanicsburg State PA Zio 17055 Relationshio of Claimant to Decedent Spouse 4. Probate Fees 173.50 5. Accountant's Fees 6. Tax Return Preparer's Fees T Other Administrative Costs TOTAL(Also enter on line 9CRecapitulation) 241889.50 Copyright(c)2009 forth software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.10-09) REV.IW EX+101.10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Fahnestock,Julienne 21-14-0168 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) no Not List IrmstawAl I TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a) 1.2 Larry Fahnestock Spouse 100%of the 10,471.15 12 Broadmoor Drive residue of the Mechanicsburg,PA 17055 Estate Total 10,471.15 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet,as a ro nets. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE Copyright(c)2010 farm software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) aobtsod sn N N N r ow o 831SVH i w 0 x x x O U C � 0 CY 0 wQ � d W� � OQ wU - U - 1 F � a U � � w �W Ooo � V dUE• d I