HomeMy WebLinkAbout07-11-14 J 1505610105
REV-1500 EX(02-,1)(R)Iff
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
°`^°TM°^'°'^ ^°° C Code Year File Number
Bureau Individual Taxes County
PO BOX 28o6ot INHERITANCE TAX RETURN �� ' �� .i
Harrisburg.PA 17128-06ot RESIDENT DECEDENT a"�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12/20/2013 04/12/1926
Decedent's Last Name Suffix Decedent's First Name MI
FABER -..,__.
ELIZABETH C
(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
t ...
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)
OD 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust S. 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 D. KILLIAN, ESQUIRE !(717)232-1851
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REGISTER OMOWILLS USE d1i 'Zl
First Line of Address _ _ M=( r
218 PINE STREET n
u „
...... r:.>C'
Second Line of Address
City or POSI Office DA{ T FR!ED State ZIP Code
HARRISBURG PA 17101
Correspondent's e-mail address:'killian killian a hart.com
Underpenalties of perjury,I declare the have a mined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declar tion of pre aver other than the pensonal representative is based on all information of which preparer has any firowledge.
SIGNATURE-OF P O R SPON IBLE FO FILING RETURN DATE
ly l
ADDRE
471 N012TH G4EN ROA RISBURG, PA 17110-3237
SIGNA RE I PR E THER EP tVZATIVE DATE
ADDRESS
218 PINE TREET, HARRIS URG, PA 17101
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: ELIZABETH C. FABER I
RECAPITULATION
1. Real Estate(Schedule A). .............................. ..... ......... 1. i 0.00
2. Stocks and Bonds(Schedule B) ....................................... 2.! 387,77617
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 :
4. Mortgages and Notes Receivable(Schedule D)........................... 4,ii 0.00
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5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)..... . 5. 21,572.09
6. Jointly Owned Property(Schedule F) C3 Separate Billing Requested ....... 6. i 0.00
7, inter-Vivos Transfers&Miscellaneous Nan-Probate Property
(Schedule G) O Separate Billing Requested. .. 7. OAO -
8. Total Gross Assets(total Lines 1 through 7), ....... ...... .. 8.( 409,348.36
9. Funeral Expenses and Administrative Costs(Schedule H),......... ........ 9. i 15,256.02
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10.i 5,884.60 j
11. Total Deductions(total Lines 9 and 10).- ....... . . ....... ........... 11. j 21,140.62
12. Net Value of Estate(Line 6 minus Line 11).............................. 12. 388,207.74
13. Charitable and Governmental Bequestst5ec 9113 Trusts for which
an election to tax has not been made(Schedule J) ........................ 11 38,820.77
14, Net Value Subject to Tax(Line 12 minus Line 13) . . 1a. 349,366.97 1
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 f--... ._._-_., ..,...- _.... --_.._ ......_. ............ ..... . .-
(a)(1.2)X.0_ 1 15. 0.00
16. Amount of Line 14 taxable
at lineal rate X.045 349,386.97 16, ,� 15,722.41 I
17. Amount of Line 14 taxable
at sibling rate x.12 -_.�..._,..._..___ 17. 4.00
16. Amount of Line 14 taxable I 0.00 '
at collateral rate X.15 16.
19. TAX DUE......................._..............._............... 19. 15,722.41
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Oa
Side 2
1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
ELIZABETH C. FABER
STREETADDRESS
5225 WILSON LANE
_STATE
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 15,722.41
1 CreditslPayments
A.Prior Payments 16,000.00
B.Discount 842.08
Total Credits(A+B) (2) 16,842.08
3, Interest
{3) 0.00
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
FIII in oval on Page 2,Line 20 to request a refund. (4) 1,119.67
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
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...........................................__.......................................,. ❑
b. retain the right to designate who shall use the property transferred or its income........................................
..,. ❑
c. retain a reversionary interest...............................................................................-..................___..............__ ❑ 0
d. receive the promise for life of either payments,benefits or care?....-................................................................ ❑ E
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
wfthout receiving adequate consideration?_......-...........................................................................___........
....._.. ❑
3. Did decedent own an"in trust for'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? ..._..._......................__................................._..._.......-...........
_..........._.._..... � ❑
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)(11)(it)}.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[72 P.S.§9116(a)(1.2)1.
• The tax rate imposed on the netvalue of transfers to orfor the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(i)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent i72 P.S.§9116(a}{1.3}}.A sibling is defined,
under Section 9102,as an individual who has at least one parent in common wfth the decedent,whether by blood or adoption.
REV-go;EX.(9.=)
pennsyivania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH C. FABER 2014-00024
All property jointly owned wkh right of survivorship must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
i' MERRILL LYNCH ACCOUNT#872-56470 114,692.48
2 MERRILL LYNCH ACCOUNT#872-74021 (IRA) 273,083.79
TOTAL(Also enter on tine 2,Recapitulation) $ 387177627
If more space is needed,Insert additional sheets of the same size
REV•iSog EX+(o841)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERrrMCE TAX RETURN - PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELIZABETH C. FABER 2014-00024
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. 1ASBURY COMMUNITIES CREDIT FOR OVERPAYMENT 21766.56
2 iHiGHMARK BLUE SHIELD REFUND 60.50
3„ IRA CLOSE OUT TRANSFER — 234.551
q,; IRA CLOSE OUT TRANSFER 4.9811
5,i PA TAX REFUND 423.00!£
8,; FEDERAL TAX REFUND 21334.00.1
j 7,1 ASBURY COMMUNITIES REFUND '! 3,000.00
,
8, BANK DEPOSIT-MERRILL LYNCH(872-56470) 12,748.50
!
, I 5
( II_
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TOTAL(Also enter on Line 5, Recapitulation) $ 21,572.09
If more space Is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08.13)
pennsylvania SCHEDULE H
Iy�
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE Of FILE NUMBER
ELIZABETH C. FABER 2014-00024
Decedent's debts must be reported on Schedule I.
ITEM f
NUMBER DESCRIPTION AMOUNT
A, FUNERALEXPENSES:
1' CNeil Funeral Home8 655 741,
El F-
❑ _ �+•-— }
r.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: O
Name(s)of Personal Representative(s) W. RUSSELL FABER
Street Address 4717 NORTH GALEN ROAD
City HARRISBURG state PA zIP 17110
Year(s)Commission Paid:
5,00�0
2. Attorney Fees:
3. family Exemption:(If decedent's address is not the same as claimant's,attach Explanation.)
0.00
claimant
Street Address
City State_ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 463.00
5. Accountant Fees: O.Oo
6. Tax Return Preparer Fees: A 850.00
7• Legal Advertisements 11•.••x•.•.[ 28�6 7
Cl __ ❑ .
TOTAL(Also enter on Line 9, Recapitulation) 15,256.02�f
If more space is needed,use additional sheets of paper of the same size.
REV-1512 Ex+(12-12)
92 ppennsytvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,_
INHERITANCE TAX RETURN MORTGAGE LIABILITIES&LIENS
RESIDENT DEaDENT
ESTATE OF FILE NUMBER
ELIZABETH C.FABER 2014-00024
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
F-1. Checks in transit at time of death �89O 40
L 2.I Pinnacle Health System — 40.00
i 3. 4mnicare 39.58
L. . �- ----
4. McKesson Medical 65,68
5. McKessonMedical --- — - - x y „109.48
6. Bank Service Charga 4.96
7, iLoss on Liquidation of assets 734.50
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TOTAL(Also enter on Line 10,Recapitulation)
If more space Is needed,Insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsytvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELIZABETH C.FABER 2014-00024
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. F.SAMUEL FABER, P.O.Box 126639,Harrisburg,PA 17112-6639 Son 215%
❑2 PATRICIA F.VERNON, 4875 South Monoco Street Denver CO 80237 Daughter I 22.5%
FJAMES R.FABER,200 Oakland Place,North Wales,PA 19454 Son i� 22.5%
W.RUSSELL FABER,4717 North Galen Road,Harrisburg,PA 17110 Son J I 22.5%
I
❑ -
F-1 -- -- - - - ❑. -_.__ ..
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:
yy
1
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
11(eystone Area Council,Boy Scouts of America,I Baden Powell Lane,Mechanicsburg,PA 17050
El L C:777-7
El
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. F 100%
If more space is needed,use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
ELIZABETH C. FABER
I, ELIZABETH C. FABER, declare this to be my Last Will and
Testament and hereby revoke all prior wills and codicils made by
me .
FIRST: My Executor shall pay from the residue of my estate
all my debts, funeral and administration expenses and all estate,
inheritance, succession and transfer taxes imposed by the United
States or any state, territory or possession which shall become
payable by reason of my death. It shall not be necessary to file
any claims therefor, nor to have them allowed by any court.
SECOND: I give and bequeath my diamond rings to my daughter,
PATRICIA F. VERNON, if she survives me. In the event that my
daughter, PATRICIA F. VERNON, does not survive me, I bequeath said
diamond rings to my granddaughter, SARAH K. VERNON.
THIRD: I give all tangible personal property which I own and
insurance thereon, to my surviving children, to be divided between
them as they may select in as nearly equal shares as is practical .
If there is any disagreement as to distribution, I direct my
Executor to make such distribution. The decision of my Executor
shall be final and binding. I direct my Executor to sell, or
otherwise dispose of in his discretion, any such property not
LAST WILL AND TESTAMENT
OF
ELIZABETH C. FABER
selected and to add the net proceeds from their sale to the residue
of my estate.
FOURTH: I give and devise the residue of my estate, real,
personal and mixed, of whatever kind and nature, and wherever
situate at the time of my death, including any property over which
I now have or hereafter acquire a power of appointment, as follows:
(a) ten (10%) percent to KEYSTONE AREA COUNCIL, BOY SCOUTS OF
AMERICA, ENDOWMENT FUND; and (b) ninety (90%) percent to my
children, F. SAMUEL FABER, PATRICIA F. VERNON, JAMES R. FABER, and
W. RUSSELL FABER, in equal shares, per stirpes. In the event my
son, W. RUSSELL FABER, predeceases me and is married at the time
of his death to ANDREA H. FABER, the said ANDREA H. FABER shall
receive the share intended for W. RUSSELL FABER, per stirpes.
FIFTH: I nominate, constitute and appoint my son, W. RUSSELL
FABER, Executor of this my Last Will and Testament, to serve
without bond or security, and to make distribution of my estate in
cash or in kind, or partly in cash and partly in kind, and in such
manner as he may determine. I authorize, empower and direct him
to sell and convey, by good and sufficient deed, in fee simple
estate, any and all of my real estate, at public or private sale,
2
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LAST WILL AND TESTAMENT
OF
ELIZABETH C. FABER
for such price or prices, upon such terms and conditions, as in his
judgment is best for my estate, and to that end to sign, seal,
execute, acknowledge and deliver all deeds or other instruments
necessary therefor, as effectively as I could do if I were
personally present..
In the event such person does not survive me, or refuses to
act as Executor, or does not complete the duties of Executor, then
I nominate, constitute and appoint my son, F. SAMUEL FABER, as the
alternate Executor, to serve without bond or security. My
alternate Executor shall have all of the powers, privileges, duties
and immunities granted to my Executor as provided herein.
IN WITNESS WHEREOF, I, ELIZABETH C. FABER, the Testatrix, have
to this my Last Will and Testament, set my hand and seal this
2S"' day of June, 2005.
F _ (SEAL)
C. FABE
ET
1
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3
f
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LAST WILL AND TESTAMENT
OF
ELIZABETH C. FABER
Signed, sealed, published and declared by the above named
Testatrix, as and for her Last Will and Testament, in the presence
of us, who have hereunto subscribed our names at her request, as
witnesses hereto, in the presence of the said Testatrix, and of
each other. The preceding document consists of this and three (3)
o�F ,,r consecutively numbered typewritten pages .
residing at
siding at
4
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
: ss . :
COUNTY OF DAUPHIN
The Testatrix and the witnesses whose names are subscribed to
the foregoing instrument, being first duly. sworn and qualified
according to law, do hereby acknowledge and declare to the
undersigned authority that the Testatrix signed and executed the
instrument as her last Will in the presence of the witnesses, that
she signed willingly or willingly directed another to sign for her,
that she executed it as her free and voluntary act for the purposes
therein expressed, 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.
estatrix
Tq fitness
Witne s
Sworn to, subscribed and acknowledW, before me by the above
named Testatrix and witnesses this Z� day of June, 2005.
(SEAL)
Notary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Rhonda L.Lang,Notary Public
Cityty of Harrisburgg.Dauphin Counntyty
My Commission Expires Aug.9.2008