HomeMy WebLinkAbout04-20-15 J pennsylvanfa 1505614105
DEVNRMENT OF REVBlIIE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
CountyCode Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURNM
'`—"—
Ha BOX 280601 G
Harrisburg, PA 17128-0601 RESIDENT DECEDENT � �0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
104102014 10311908
Decedent's Last Name Suffix Decedent's First Name MMI
Risser Blanche
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(gD 1.Original Return p 2.Supplemental Return p 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of C=:) 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
C=D 7.Decedent Died Testate p 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10.Litigation Proceeds Received O 11.Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13.Business Assets O 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Mark T. Silliker, Esquire (717)671-1500
First Line of Address
5922 Linglestown Road
Second Line of Address
City or Post Office State ZIP Code
Harrisburg PA 17112
Correspondent's email address: sillikerlaw@comcast.net
REGISTER OF WILLS USE ONLY
REGISTER OF WILLS USE ONLY
D TE "1'L D MMDDYYYI%
C1 car M
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rnA FICED STAMP - `
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PLEASE USE ORIGINAL FORM ONLY 'j :3
Side 1
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4 1505614105 J'
1505614205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Blanche L. Risser
RECAPITULATION
1. Real Estate(Schedule A). ................... ......................... 1.
2. Stocks and Bonds(Schedule B) . ....... ............................... 2. 238,934.65
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. 169,102.51
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7)............... .......... .... 8. 408,037.16
9. Funeral Expenses and Administrative Costs(Schedule H)....... ............ 9. 9,825.46
r-
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. I 15,674.62
11. Total Deductions(total Lines 9 and 10)............ ..................... 11. 25,500.08
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 382,537.08
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which
an election to tax has not been made(Schedule J) ..................... ... 13. 10,000.00
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 372,537.08
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 135,468.04 16.' 6,096.06
17. Amount of Line 14 taxable
at sibling rate X.12 17,
18. Amount of Line 14 taxable 237,069.07 35,560.36
at collateral rate X.15 18.
19. TAX DUE ............................ ............... .............. 19. 41,656.42
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIG S N,REPPCJ4SIBLE FOR FILING RETURN DA E
.--z La (3 K
ADDRESS
2237 Concord Circle, Harrisburg, PA 17112
SIGNATURE OF PREPAB T T N PERS'O'N RESPONSIBLE FOR FILING TH ETURN ``f,DA E
ADDRESS
5922 Linglestown Road, Harrisburg, PA 17112
Side 2
1505614205 J
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Blanche L. Risser
STREETADDRESS
100 Mt.Allen Drive
CITY STATE —7
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 41,656.42
2. Credits/Payments
A.Prior Payments
B.Discount
(See instructions.) Total Credits(A+B) (2)
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) 41,656.42
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 ............................................ ❑ E
c. retain a reversionary interest.............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without 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? ........................................................................................................................ ❑ N
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1 111111 IF ,
,.
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 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 step-parent 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-1503 EX+(8-12)
i pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Blanche L. Risser 2114-0381
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Fulton Financial Stock 171,375.38
2, PNC Stock
67,559.27
TOTAL(Also enter on Line 2, Recapitulation) $ 238,934.65'
If more space is needed,insert additional sheets of the same size
REV-i5o8 EX+(o8-i2)
Iffpennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Blanch L. Risser 2114-0381
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
UFulton Bank Checking account#362307656 21,342.27
2 Fulton Bank Certificate of Deposit j 145,946.80
Fulton Bank dividend payment
• 3• 1,197.44
i
4 United Healthcare Insurance premium refund 380.40
5 Miscellaneous personal property ("
200.00
6 Silver Script refund j
33.80
7 Caremark refund 1.806'
r
i
i
1 i
h �
TOTAL(Also enter on Line 5, Recapitulation) $ 169,102.51
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(02-15)
Iffpennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Blanche L. Risser 2114-0381
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Fackler-Wiedeman Funeral Home(burial clothes) 139.00
2. Funeral meal 245.22
L� Sunbury Monumental Works(memorial inscription) 150.00
❑
❑ �
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 6,000.00
Name(s)of Personal Representative(s) Stephen Risser, II
Street Address 2237 Concord Circle
city Harrisburg state PA ZIP 17109
Year(s)Commission Paid: 2015
2,500.00
2• 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: 358.50
5. Accountant Fees:
6. Tax Return Preparer Fees: =03.50
I�
7• Short Certificate 5.00
❑ Certified mail expense 64.90
�s Publication of estate notice 159.34
TOTAL(Also enter on Line 9, Recapitulation)Fs 9,825.46
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsyLvania SCHEDULE
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Blanche L. Risser 2114-0381
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
''Messiah Lifeways 2,832 00
[:2] Mark T.Silliker,Esquire-attorneys fees for guardianship 1,906.00ti'
E3.1 ,Messiah Lifeways 9,818.20,j
�P 65 00
4. ;Pennsylvania Department of Revenue(2013 income tax)
�
Re-payment to Social Security 1,011 Ifo
77'
Paul D.Daltrey,DPM 42
ElI
F-1- ._
a .=c...ra .G..r.+.xv-i:). `.n. ..ew.�.....e...ue ��.uu!.. . - n.aw_-. x.�. .. .,..=� �
El
El
,
TOTAL(Also enter on Line 10, Recapitulation) $ 15 674.621:
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
c
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Blanche L. Risser 2114-0381
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)(iZ).)
1. Paul D.Light,4186 Depot Road,Erie,PA 16510 Nephew 1/11 of residue
2. Daniel Morrow(sole heir of Virginia Morrow,deceased)7640 Breakeman
Road,Painesville,OH 44077 Great-nephew 1/11 of residue
3. Sandra L.Swope,218 Templeton Avenue,Girard,PA 16417 Niece 1/11 of residue
4. Helen L.Wardel,4214 Snowden Street,Clermont,FL 34711 Niece 1/11 of residue
5. Martha L.Shay,205 Gale Circle,Altoona,PA 16601 Niece 1/11 of residue
6. Mary L.McMinn, 111 Ewe Road,Mechanicsburg,PA 17055 Niece 1/11 of residue.
7. Jean L.Creighton,4103 Third Avenue,Altoona,PA 16602 Niece 1/11 of residue
B. Mary Ann Miick,118 Robson Road,Dillsburg,PA 17019 Daughter 1/11 of residue
9. Laura M.Gabbard,701 South Broad Street,Mechanicsburg,PA 17055 Daughter 1/11 of residue
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:
2.
Messiah Village Church 5,000.00
2. Salvation Army of Sunbury Pennsylvania 5,000.00
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 10,000.00
If more space is needed,use additional sheets of paper of the same size.
SCHEDULE J
BENEFICIARIES
Continued
Estate of Blanche L.Risser File No.2114-0381
Name and address of beneficiary Relationship to Share of estate
Decedent
10. James Hallman(beneficiary of Stephen L. Risser, Sr.) Grandson 1/8 of 1/11 of
P.O. Box 4035, Harrisburg, PA 17111 residue
11. Deborah Eisenacher(beneficiary of Stephen L. Risser Sr.) Granddaughter 1/8 of 1/11 of
1144 Highland Street, Harrisburg, PA 17113 residue
12. Dale Hallman (beneficiary of Stephen L. Risser, Sr.) Grandson 1/8 of 1/11 of
6130 Springford Drive, Apt. D-7, Harrisburg, PA 17111 residue
13. Rose Given(beneficiary of Stephen L. Risser, Sr.) Granddaughter 1/8 of 1/11 of
1316 Piketown Road, Harrisburg, PA 17112 residue
14. Carol Risser(beneficiary of Stephen L. Risser, Sr.) Granddaughter 1/8 of 1/11 of
802 Chambers Street, Harrisburg, PA 17113 residue
15. Stephen Risser, II, (beneficiary of Stephen L. Risser, Sr.) Grandson 1/8 of 1/11 of
2237 Concord Circle, Harrisburg, PA 17112 residue
16. Paul Risser(beneficiary of Stephen L. Risser, Sr.) Grandson 1/8 of 1/11 of
4750 Count Street, Harrisburg, PA 17109 residue
17. Paula Stuller(beneficiary of Stephen L. Risser, Sr.) Granddaughter 1/8 of 1/11 of
1210 Griffin Street, Harrisburg, PA 17112 residue
18. Daniel Leonard Grandson 1/2 of 1/11 of
4913 Gate Post Lane, Wilmington,NC 28412 residue
19. Michael Leonard Grandson 1/2 of 1/11 of
112 Mt. Road, Lewisberry, PA 17339 residue