Loading...
HomeMy WebLinkAbout07-08-15 (3) 1505607121 REV-1500 EX (©6.05) OFFICIAL USE ONLY PA Department of Revenue 0601 County Cads Year File Number PO BOX 28 Bureau 280601 INHERITANCE INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT 2 1 1 5 0 5 6 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 5 0 4 2 0 1 5 0 7 2 9 1 9 1 5 Decedent's Last Name Suffix Decedent's First Name Mi F R E Y M A R Y S (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 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 0 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 ® 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Son.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CON'FIDENTIA'L TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number H A R 0 L D S I R W I N I I I 7 1 7 3 1 9 5 6 0 Firm Name(if Applicable) cry �r REGIST§R 6PwILLS U;~ONLfn I R I N L A W O F F I C ECn ` c7 First line of address -7) :I� CO 6 4 S P I T T S T Second line of address —�6A-fE FILED r— City or Post Office State ZIP Cade - C A R 'L I S L E P A 1 7 0 1 3 Correspondent's e-mail address:irwiftlawOffice0_Clmail.COrn Under penalties of perjury,t declare that t 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 n the personal representative is based on all information of which preparer has any knowledge. SIGNAT�RRESPQVnISIME FURN DATE 3410ASPRING ROAD CARLISLE PA 17013 S E F PREPARER OTHE I�lE DAT DRE 64 SOUTH PITT ST -EET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 1505607221 REV-1500 EX Decedent's Social Security Number Decedents Name: M A R Y S • F R E Y RECAPITULATION 1. Real estate(Schedule A) 1. 1 5 3 9 0 0 . 0 0 2. Stocks and Bonds(Schedule B) . . ... . . .. .. 2. 0 . 0 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0 . 0 0 4. Mortgages&Notes Receivable(Schedule D) . . . . . . .. .. . . . . . .. . . I . . . . 4. 0 . 0 0 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E) . . . . . . . 5. 1 5 1 6 4 . 9 5 6. Jointly Owned Property(Schedule F) El Separate Billing Requested . . . . .. . 6. 0 . 0 a 7, Inter-Vivos Transfers&Miscellaneous N Probate Property (Schedule G) 5 Separate Billing Requested .. . . 7, 0 . 0 0 8.Total Gross Assets(total Lines 1-7) 8. 1 6 9 0 6 4 9 5 9. Funeral Expenses&Administrative Costs(Schedule H) . . . . . . . . .. . 9. 2 0 2 2 1 4 4 10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1) . . . . . . .. . .. . 10. 5 6 1 4 8 11. Total Deductions(total Lines 9&10) .. . . I. . ........ . . ... .. . .. . 11. 2 0 7 8 2 9 2 12.Net Value of Estate(Line 8 minus Line 11) ...I I. . . . . ...... .... 12. 1 4 8 2 8 2 0 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) I I . . . . . . . . . . . . . .. . 13. 14.Net Value Subject to Tax(Line 12 minus Line 13) .. . . . . . . . . . .. I . . . . 14. 1 4 8 2 8 2 0 3 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under See.9116 (a)(1.2)x.045 1 4 8 2 8 2 . 0 3 15. 6 6 7 2 . 6 9 16. Amount of Line 14 taxable at lineal rate X.0- 0 . 0 0 16. 0 . 11 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19.Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . 19. 6 6 7 2 . 6 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 15 0569 DECEDENT'S NAME MARY S. FREY STREET ADDRESS 3058 SPRING ROAD CITY STATE ZIP CARLISLE I PA 117013 Tax Payments and Credits: I. Tax Due(Page 2 Line 19) (1) 6,672.69 2. Credits/Payments A.Spousal Poverty Credit B.Prior Payments C.Discount 333.63 Total Credits(A+B+C) (2) 333.63 3. Interest/Penalty if applicable D.Interest E.Penalty Total Interest/Penalty(D+E) (3) 0.00 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 6,339.06 A.Enter the interest on the tax due. (5A) B.Enter the total of Line 5+SA.This is the BALANCE DUE. (513) 6,339.06 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; ...................................................................... El0 b. retain the right to designate who shall use the property transferred or its income; ............................... c. retain a reversionary interest;or ............................................................................... ................ ❑ d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑X 2. If death occurred after December 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? ......... ❑ ❑X 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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three(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 zero(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 twenty-one 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 zero(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 four and one-half(4.5)percent,except as noted in 72 P.S.§9116(1.2)[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 twelve(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-1502 EX+(&98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL. ESTATE INHERITANCE TAX RETURN RESIDENT.DECEDENT ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 All real property owned solely or as a tenant In common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. _ Real proeewhich is _ln_tt -owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. HOUSE AND LOT OF GROUND AT 3058 SPRING RD, CARLISLE, PA 17,013 153,900.00 Parcel No. 21 - 13-0966-020 Value based on assessedd value TOTAL(Also enter online 1,Recapitulation)1 $ 153 900.00 (If more space Is needed,insert additional sheets of the same size) REV-1503 EX+(6-93) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY S. FREY _ 21 15 0569 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE 0.00 TOTAL(Also enter on line 2,Recapitulation) $ 0,00 (If more space is needed,insert additional sheets of the same size) REV-1504 EX+(6-98) SCHEDULE C CLOSELY-HELD CORPORATION, COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP OR INHERITANCERESIDENT DECEDENT RETURN SOLE-PROPRIETORSHIP ESTATE OF _ FILE NUMBER MARY S. FREY 21 15 0569 Schedule C-1 or C-2(including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent,other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE 0.00 TOTAL Also enter on line 3,Recapitulation) $ 0.00 (11 more space is needed,Insert additional sheets of the same size) REV-1507 ER a(6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES ES INHERITANCE TAX RETURN RESIDENT DECEDENT RECEIVABLE ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 All property jotntiy-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 7. NONE 0.00 TOTAL Also enter online 4,Recapitulation $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1508 EX-(6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & misc. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 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 I. MISCELLANEOUS PERSONAL PROPERTY 500.00 2, TRANSAMERICA ENDOWMENT POLICY 500.00 Final Payment 3. FOOT LOCKER, INC. 108.98 Final Pension Payment 4. MEMBERS 1ST FEDERAL CREDIT UNION 2,667.63 Checking Account No. XXXXXXX602 Value based on attached Exhibit"B" 6. M &T BANK 11,388.34 Checking Account No. 695777 Value based on attached Exhibit"C" TOTAL(Also enter on fine 5,Recapitulation) $ 15,164.9 (if more space is needed,insert additional sheets of the same size) REV-1509 EX+(8-98) r7CHE��++�r�. �+. ©'VLE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 If an asset was made jointwithin one year of the decedents date of death,it midst be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. B C JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECDS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. NONE 0.00 0.00 TOTAL(Also enter on line 6,Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1510 EX+(6-98) SCHEDULE G INTER•VIVOS TRANSFERS& COMMONWEALTHINHERITANCE EO TAX RETURNANIA MISC. NONPROBATE PROPERTY RESIDENT DECEDENT_ ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 This schedule must be completed and filed If the answer to any of questions 1 through 4 on.the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM MMUUEDIE NOEOFTHETFW/SFEREE.THEM AaA ONSWTODECEDEMAND DATE OF DEATH %OFDECUS EXCLUSION TAXABLE NUMBER THE DATE OFTRAWM ATTACHACOPVOFTHE DEED FOR RE&ESTATE. VALUE OF ASSET INTEREST OFAPAJCMW VALUE 1. NONE 0.00 0.00 TOTAL Also enter on line 7 Recapitulation $ 0.00 (If more space Is needed,insert additional sheets of the same size) REV-1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES& INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. NICKEL FUNERAL HOME - Funeral and Burial 10,414.94 2. PASTOR AND ORGANIST- Funeral Expenses 300.00 3. FUNERAL DINNER 566.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid: 2. AttomeyFees IRWIN LAW OFFICE 8,500.00 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 CUMBERLAND COUNTY REGISTER OF WILLS 360.50 5 Accountant's Fees 6. Tax Return Preparer's Fees 7. RECORDER OF DEEDS - Deed Transfer 80.00 TOTAL(Also enter on line 9,Recapitulation) $ 20 221.44 (If more space is needed,insert additional sheets of the same size) REV-1512 EX+(12-03) ab SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCERESIDENT TAX DECEDENT— TURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT � ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CENTURY LINK 278.82 Utility Bill 2. PHILLIPS LIFELINE 41.12 Outstanding Bill 3. PP&L 131.96 Utility Bill 4. Direct TV 86.90 Utility Bill 5. APRIA PHARMACY NETWORK- FOLVROFT 22.68 Medical Bill TOTAL(Also enter on line 10,Recapitulation) $ 561.48 (If more space is needed,insert additional sheets of the same size) REV-1513 EIC.(9-Do) v74HEDVLE COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY S. FREY 21 15 0569 _ 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 (Inaude outri ht spousal distributions,and transfers under Sec.9116(all(1.2)1 1. FRANK M. FREY, III Lineal 3410 Spring Road 100'% Residue Carlislern PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE'S 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET I . NON-TAXABLE DISTRIBUTIONS; A,SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1, TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (if more space Is needed,insert additional sheets of the same size) MEMBERS IST FEDERAL CREDIT UNION-P.O.BOX 40•MECHANICSBURG,PENNSYLVANIA 17055 No. 0QQ 1 026093 r Acct : XXXXXXX602 Teller: 2008 Date: 05/29/15Time: 5 :47pm ---------------------------------------------------------- -------- See receipt for reference ------------------------------------------------------------------ Check Number: 00 0001026093 Purpose : SHARE WITHDRAWAL Amount : $2, 667 .63 Pay to : THE ESTATE OF MARY S FREY T , M INQUIRIES CALL: (800)724-2440 I 1 AC OUNT TYP ' h CLASSIC CHECKING 00 0 04319M NM 117 ACJ0OUNT`fi1i,9MSER STATEI sto-pEAIODl- P 6951 MAY.08,2016 000001268 FIDS154IG70105081505 03 010000 B1r12iNN1NC BALANCE $10,326»40 MARY S PREY � 54.1.4S& REDITS1,319.84 3058 SPRING RD 2S!'.9i1 CARLISLE PA 17013-8713 0.00 $11,388.34 WEREST EARNED FOR STATEMENT PERIOD $0.00 HIGH STREET-CARLISLE ACCOUNT SUMMARY I3I=GI NING Or-POSITS,&OTHER CURRENT' ENI71Nd B NCE AE11 CHECKS PAID OTHER DEBITS(-) 1*R B CE N N AMO NT $10,326.40 2 $1319.84 3 $257.90 0 . $0.00 $0.00 $11,388.34 ACCOUNT AC71WTY POSTINti TRANSACTION DESCRIPTION DEPOSITS&OTHER WffRDRAWALS& DAILY' DATE C3 R A' E 04110!2015 ISEGINNINGBALANCf $10,326.40 04/10i201S CHECK NUMBER 4285 $142.67 10,183.73 04/13/2015 CHECK NUMBER 4286 40.23 10,143.50 0412012015 CHECK NUMBER 4287 '75.00 10,068.50 0412=15 BALTIMORE LIFE DISBURSE $555.84 10,624.34 05/0112015 SSA TREAS 310 XXSOC SEC 764.00 11,388.34 ENDING BALANCE 11 .34E CHECKS PAID SUMMARY CHECK NO. 'DATE AMOUNT CHECK NO. DATE AMOUNT CHECK NO, DATE AMOUNT 4285 04110115 142.67 4286 04/13/15 40.23 4287 04/20/15 75.00 . HOMEOWNERSHIP IS IMPORTANT.WERE HERE TO HELP FIRST-TIME HOMEBUYERS NAVIGATE THE MORTGAGE PROCESS AND MAKE BUYING A HOME AFFORDABLE.TO FIND OUT MORE ABOUT M&T'S AFFORDABLE MORTGAGE PROGRAMS CALL 1-888-816-7942 OR VISIT MTB.COM/MORTGAGE. M&T IS AN EOUA'L HOUSING LENDER.THIS IS NOT A COMMITMENT TO MAKEA MORTGAGE LOAN.2015 M&T BANK.MEMBER FDIC.NMLS#381076, PAGE 1 OF 2