HomeMy WebLinkAbout04-06-15 ii i v , i
� 150561�140
REV-1500 �` �°,_,°>
PA Department of Revenue OFFiCIAL USE ONLY
Bureau of Individual Taxes Cuunty Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 9 9 2
HaRisburg,PA 17128-0601 RESIDENT DECEDENT .
ENTER DECEDENT INFORMATION BELOW
Social Security Number • Date of Death MMDDYYYY Date of Birth INMDDYYYY
0 8 2 3 2 0 1 4 0 6 2 6 1 9 3 6
DecedenYs Last Name Suffix Decedent's First Narne MI
F I S C H E R R 0 B E R T H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
F I S C H E R E M M A G
Spouse's Social Security Number
1 4 8 3 0 1 9 7 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Return � 2.Supplemental Return � 3.Remainder Return(date of death
prior to 12-13-82)
� 4.Limited Estate � 4a.Future Interest Compromise(date of � 5.Federal Estate Tax Return Required
death after 12-12-82)
� 6.Decedent Died Testate � 7.Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
� 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(date of death � 1�I.Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
M A R C U S A . M c K N I G H T , I I I '� 1 7 2 4 9 2 3 5 3
REGISTER OF WILLS USE ONLY
�v
C"� o
First line of address C Q � rn
I R W I N 8 M c K N I G H T , P . C • � � � � �
Second line of address �'��' � t`"" r"�
_ �i �7 :�
6 0 W E S T P 0 M F R E T S T R E E T �� fs' �
r'r.� dCqT �tLED"D <7
City or Post O�ce State ZIP Code — ��
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�� ��.: -� �
C A R L I S L E P A 1 7 0 1 3 i =i ►-� �--- rn
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CorrespondenYs e-mail address:
Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is Vue,correct and complete.Declaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE ERSON E PONSIBLE FOR,�ILING RETURN DATE
_�.���a-�\__� �-�.
ADDRESS --
853 DOUBLING AP R D NEWVILLE PA 17241
SIGNATURE OF PREP R N R RESENTATIVE DATE
ADDRESS
60 WEST PO FRET ET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 150561�140 15�5610140 J
ii i a . i
J 1505610240
REV-1500 EX DecedenYs Social Security Number
DecedenYs Name: R 0 B E R T H • F I S C H E R
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. 4 1 9 8 1 . � 0
6. Jointiy Owned Property(Schedule F) ❑ Separate Billing Requested .. . . . . . 6. •
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested .. .. .. . 7. .
8. Total Gross Assets(total Lines 1 through 7) ... . . . .. . . .. ... . . . . . . . . . . . . 8. 4 1 9 8 1 , 0 D
9. Funeral Expenses and Administrative Costs(Schedule H) . . . .. . . .. . . . . . . . . . 9� 7+ 6 2 5 . 5 0
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . ... .. . . . . . 10. 1 5 6 7 3 . 6 8
11. Total Deductions(total Lines 9 and 10) ... .. . .. . . .. . . . . .. . . . . . . . . . . . . . 11. 1 7 2 9 9 . 1 8
12. Net Value of Estate(Line 8 minus Line 11) ...... .. .. . ... .. . . . . . .. . . . . . 12. 2 4 6 8 1 . 8 2
13. Charitable and Govemmental 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. 2 4 6 8 1 . 8 2
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(�z)x.o _ 2 4 6 8 1 . 8 2 t5. 0 . D 0
16. Amount of Line 14 taxable
at lineal rate X.0_ 0 . 0 0 �6. 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate X.12 � . ❑ 0 17. � . 0 0
18. Amount of Line 14 taxable
at coliateral rate X.15 � • � � 1g. 0 . 0 0
19. TAX DUE . . . . . . . . . .. . . . . . . .. . . . .. . . .. . .. . . .. . . . .. .. .. . . . . . . .. . . 19. � • � 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
L 150561D24� 1505610240 �
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REV-1500 EX Page 3 File Number
Decedent's Complete Address: 2� 14 0992
DECEDENTS NAME
ROBERT H. FISCHER ____
STREETADDRESS
853 DOUBLING GAP ROAD ___
CITY STATE ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1• Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A•+-�) (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 1,Line 20 to request a refund. (4) 0.00
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;or ................................................................................................ ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occuRed after December 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 payabie-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?.................................................................................................. ❑ 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, 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 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 ftom tax,and the stalutory 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)].
• 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(12)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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.
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REV-1508 EX+(OS-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
ROBERT H. FISCHER 21 14 0992
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.
ITEM � VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1989 BASSTRACKER BOAT 3,800.00
2. 2015 CHEVROLET SILVERADO 38,181.00
TOTAL(Also enter on Line 5,Recapitulation) $ 41 981.00
If more space is needed, use additional sheets of paper of the same size.
11III'.II I Illlll.i. . 1
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT H. FISCHER 21 14 0992
DecedenYs debts must be repoRed on 5chedule[.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
StreetAddress
City State ZIP
Year(s)Commission Paid:
2, AttomeyFees: IRWIN & MCKNIGHT, P.C. 1,500.00
3. Family Exemption:(If decedenPs add�ess is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. ProbateFees: REGISTER OF WILLS 125.50
5 Accountant Fees:
6. Tax Retum Preparer Fees:
7.
TOTAL(Also enter on Line 9,Recapitulation) $ 1 625.50
If more space is needed,use additionai sheets of paper of the same size.
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REV-1512 EX+(12-12)
pennsyivania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES 8 LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT H. FISCHER 21 14 0992
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
1. ALLY BANK AUTO FINANCING-2015 CHEVROLET SILVERADO 15,673.68
ACCOUNT#611919984826
TOTAL(Also enter on Line 10,Recapitulation) $ 15 673.68
If more space is needed,insert additional sheets of the same sixe.
11 III.II I 11111.■ . �
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ROBERT H. FISCHER 21 14 0992
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
� TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. EMMA G. FISCHER Spousal 24,681.82
853 DOUBLING GAP ROAD REMAINDER
NE�M/ILLE, PA 17241
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 ll-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.
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I, ROBERT H. FISCHER, of Lower Mifflin Township, Cumberland County,
Pennsylvania, declaze this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
ONE: I direct my Executrix to pay all of my debts, funeral and administrative expenses
as soon as may be done conveniently after my decease.
TWO: I give, devise, and bequeath all of my estate of every nature and wherever situate
to my wife, EMMA G.FISCHER,provided she survives me by thiriy(30)days or more.
THREE: If my wife, EMMA G. FISCHER, has predeceased me or failed to survive
me by thirty (30) days or more, then I give, devise and bequeath all of my estate of every nature
and wherever situate to the following beneficiaries:
a. To LAURA J.FISCHER. . . . . . . . . . . . . . . . . . . . . . . 60%
a. To GVVStNNDOLYN L.FISCHER. . . . . . . . . . . . . . . . 20%
b. To ALEXANDER S.FISCHER . . . . . . . . . . . . . . . . . . 20%
If any of my beneficiaries have predece�ed me, then said share will be equally
distributed to the living issue of said deceased beneficiary. If one aF my beneficiaries has died
without living issue, said shaze will be equally divided by my benificiaries then living.
� �
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FOUR: If my grandchildren, GVVYNNllOLYN L. FISCHER and ALEXANDER S.
FISCHER have not yet attained the age of Twenty-Five (25) years of age, then I give, devise,
and bequeath their shares of my estate in Trust to LAURA J. FISCHER, Trustee for the benefit
of my grandchildren. If she is unable to serve as Trustee, I appoint MARCUS A. McKNIGHT,
III,to serve as Tnzstee in her place. This T�ust is subject to the following provisions.
A. This Trust will be for the sole benefit of my grandchildren as provided herein.
B. The net income of the Trust shall be applied at the sole and absolute discretion of the
Trustee to the support, maintenance, education and general welfare of my grandchildren, in such
manner as the Trustee deems proper, without regard to any other funds wiuch may be availabie
for the Trust purposes,or may be accumulated in Trust.
C. I further authorize the Trustee to apply not only the incorrte, but also so much of the
principal as the Trustee �'eems necessary, :n, for, or toward the maint�nance, support, education
and general welfare of my said grandchildren, in such manner as she shall deem proper.
D. When each of my grandchildren attains the age of Twenty-Five (25} yeazs, the
Trustee will distribute the balance of any Trust principal and accumula.ted income from the Trust
share to said grandchild. If one of my grandchildren has predeceased me without living issue,
then said share will be equally distributed to my grandchild then living.
E. The Trustee shall have the following powers, in addition to those vested in her by law,
for my property held for the benefit of my beneficiaries, whether income or principal,exercisable
without court approval and effective until the distribution of all property under the terms of this
Trust; the Trustee, at her discretion, may compromise claims, borrow money, or retain property
for such length of time as she may deem proper, sell, lease, pledge,martgage,transfer, exchange,
convert or otherwise dispose of or grant options of all or any portian of Trust property for such
prices, on such terms in public or private transactions as she may deem proper; and invest Trust
property and income without restriction to legal investments.
2
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FIVE: I appoint my wife, EMMA G. FISCHER,to serve as Executrix of this my Last
Will. If she is unable to serve, or if she ceases to serve as Executrix, I name LAURA J.
FISCHER to serve as Substitute Executrix in her place.
SIX: My Executrix may, at her disc:e'aon, compromise claiins, borrow money, retain
property for such length of time as she may deem proper; lease and sell properiy for such prices,
on such terms, at public or private sales, as she may deem proper; and invest estate property and
income without restriction to legal investments.
SEVEN: No Ezecutrig, Substitute-Egecutriz, or Trustee acting hereunder sha11 be
required to post bond or enter security in this or any jurisdiction.
�
IN WITNESS WHEREOF, I have hereunto set my hand and seal this � day of
March 2009
`�������,r.� (SEAL)
ROBERT H.FISCHER
Signed, sealed, published and declared by ROBERT H. FISCHER, the above named
Testator, as and for his Last Will and Testament,in the presence of us, who, at lus request and in
his presence and in the presence of each other have subscribed our names as witnesses hereto.
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11 III'II I 111111.� . 1
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ACKNOWLEDGMENT AND AFFIDAVIT
WE, ROBERT H. FISCHER, KAREN S. NOEL and CHEKYL L. CLELAND, the
testator and witnesses respectively, whose names aze signed to the fnregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority tlxat the testa.tor signed and
executed the instrument as his last will and that he had signed willingly, and that he executed it
as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the testator, signed the will as a witness and that to the best of their
laiowledge the testator was, at that time, eighteen years of age or older, of sound mind and under
no constraint or undue influence.
�G"�--�' I /�J � �!/.t-��
ROBE�I'H.F C
N N EL
�
CHERYL .CLELAND
COMMONWEALTH OF PENNSYLVArTIA .
: SS:
COUNTY OF CUMBERLAND .
Subscribed, sworn to and acknowledged before me by ROBERT H. FISCHER the
testator herein, and subscribed and sworn to before me by KAREN S. NOEL and CHERYL L.
CLELAND,witnesses,this Ja�day of March 2009
COMMONWEALTH OF PENNSYLVANIA
Notadel Seal
Marth�L.Noel,Notary Public 0 1'y PU i1C
CadisM�oro,Cumber�nd CauMy
My Commission Expirea Sept 18,2071
Member,Pennsylvania Asaociation of Notaries
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DATE INVOICE NO.
05/12/14 �� 1AD99734286
VEHICLE IDENTIFICATION N���'�''I;�I yEAp ���°'�,jl� MAKE ;li�"I, S,
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, ; I,the undersigned authorizedf!!`���p-resentative of the company,':fit�or corporation named belQ�iu;�hereby cer-
tify that the new vehicle des u�'ik��d above 'is`ttie properry ofi��� said company, firm or cor�} tion and is
transferred on the above,.date and under the lnvoice N �nber indicated to the following,;, istributor or dealer.
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NAME OF DISTRIBUTOR,DEA,j;ER,EfC. I�I
iI�"W � H I���EVROLET�II����f��ADILL�I�,�� �,�I��,�I�, 1��,�,Z56 RRTR�QI,B �';
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S��7PPENS�BURG I"''' PA 17257-00'I98 `�' '
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It i�further certified that this;�'�"��' the first transfer of such�;�°,''�vehicle in ordinary trade a���:.�ommerce.
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. **********���*** GE�,��RAL _�IOTORS LLCII;I
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Pricing
Invoice MSRP
Base Price �38,181 $41,055
Destination $1,095 $1,095
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Total Base Price $39,276 �42,150
OptlOflS chan e
Price with Options $39,276 �42,150
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