HomeMy WebLinkAbout08-19-15 J pennsytvania 1505614105
DEFARTMENT OF REVENUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 124 � 115� �' 1`'�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 04132015 09171919
Decedent's Last Name Suffix Decedent's First Name MI
Fitchuck 7 Mrs Mary
(If Applicable)Enter Surviving Spouse's Information.Below
Spouse's Last Name Suffix Spouse's First Name MI
NA D
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CMD 1. Original Return O 2. Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
O 7. Decedent Died Testate O 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 C=:) 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NameDaytime Telephone Number
Robert L. O'Brien �T (717) 249-6873
First Line of Address
19 West South Street
Second Line of Address
City or Post Office State ZIP Code
Carlisle PA 17013 rn
C= C:>
Correspondent's email address: —— �? n
REGISTEROF WIL4S-USEPNLY M rri
r-i co
REGISTER OF WILLS USE ONLY w > O
DATE FILED MMDDYYYY ''` -,n
r- f11
DATE'FFILED STAMP t-'
PLEASE USE ORIGINAL FORM ONLY
Side 1
�ii4ii�i� 1505614105 J
J 1505614205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Mary Ritchuck [
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. 80,323.31
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. 80,323.31
9. Funeral Expenses and Administrative Costs(Schedule H). . .. . . .. .. . . . . . . . .. 9. 2,459.66
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). . . . . .. . . . . . . . . 10.
11. Total Deductions(total Lines 9 and 10). . . . ... . . . . .. . . .. . .. . . . . . . .. . . . . . . 11. 2,459.66
12. Net Value of Estate(Line 8 minus Line 11) . ... .. .. .. .. .. . . . . .. . . . . . . . .. . 12. 77,863.65
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. 77,863.65
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 77,863.65 16, 3,503.86
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE . . . . .. . . . . .. . . .. . . . . . .. . ... ..... . . .. .. . . . . .. .. .. .. .. .. . .. . 19. 3,503.86
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
!!!II ER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN �DrE� ( J
ADDRESS
Side 2
4 5 1505614205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Mary Ritchuck
STREET ADDRESS
9 Alliance Drive
Jarret Bldg. # 104
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,503.86
2. Credits/Payments
A.Prior Payments 0.00
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) 3,503.86
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 ............................................ ❑ 0
c. retain a reversionary interest .............................................................................................................................. ❑ N
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?...............................................................................................I.............. ❑ E
3. Did decedent own an"in trust for"or payable-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? ........................................................................................................................ ❑
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 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 RS.§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+(02-15)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary Ritchuck 448-2015
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- M&T#4223850 closed 4/29/15 66,627.35
2 M&T#3004980 closed 4/29/15 13,515.65
3 State Farm ins.refund 130.35
4 Chapel Pointe refund 49.96
TOTAL(Also enter on Line 5, Recapitulation) $ 80,323.31
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (02-15)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary Ritchuck 448-2015
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES;
1' Ewing Brothers Funeral Home 730.71
2 Harold D. Sausser,marker inscript 98.00
B. ADMINISTRATIVE COSTS;
1, Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
Z• Attorney Fees;
1,000.00
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: 245.50
5. Accountant Fees: 300.00
6. Tax Return Preparer Fees:
7. Spring Rd Family Practice 10.00
8 Forest Park 25.00
9 Cumberland EMS 50.45
TOTAL(Also enter on Line 9, Recapitulation) $ 2,459.66
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+(02-15)
pennsylvaniaIR SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary Ritchuck 448-2015
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. Barbara Lagazza, 1007 Northfield Dr.,Carlisle PA 17013 daughter 80%
2 Jason Sternick,251 G.Street,Carlisle,PA 17013 grandson 10%
3 Jerry Sternick,2 Lily Lane,Pottsville,PA 17901 grandson 10%
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 II— 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.
LAST WILL AND TESTAMENT
O F
MARY RITCHUCK
BE IT REMEMBERED, that I , MARY RITCHUCK, of the Borough
of Hamburg, County of Berks and State of Pennsylvania, being of
sound mind, memory and understanding, do hereby make, publish and
declare this my Last Will and Testament, hereby revoking and makin
void all former wills by me at any time heretofore made.
FIRST: I order and direct the payment of the expenses o
my last illness and burial out of my estate as soon as convenient)
may be done after my death.
SECOND: I give and bequeath all of my household furni-
ture, furnishings and equipment together with any automobiles which
I may own to my husband, CHARLES RITCHUCK, absolutely, provided
that he shall be living at the expiration of thirty ( 30 ) days after
the date of my death.
THIRD: All of the rest, residue and remain-der-of my
estate, real, personal and mixed, I give, devise and bequeath to
my husband, CHARLES RITCHUCK, absolutely, provided that he shall b
living at the expiration of thirty ( 30 ) days after the date of my
death.
FOURTH: In the event that my husband, CHARLES RITCHUCK,
s_ shall predecease me, die simultaneously with me or die before the
I
expiration of thirty ( 30 ) days after the date of my death, then I
order and direct disposition of all of my estate, real, personal
1
and mixed, as follows:
A. I order and direct the payment of the burial
expenses for my husband out of my estate if this has not been takeli
care of at the time of my death.
B. All of the rest, residue and remainder of my
estate, real, personal and mixed, I give, devise and bequeath as
follows:
1 ) EIGHTY ( 800 ) PERCENT thereof to my
daughter, BARBARA ANN LAGAZA, absolutely;
2 ) TEN ( 100 ) PERCENT thereof to my grandson,
JERRY STERNICK, absolutely; and
3 ) The remaining TEN ( 100 ) PERCENT thereof to
my grandson, JASON STERNICK, absolutely.
FIFTH AND LASTLY: I nominate, constitute and appoint
my husband, CHARLES RITCHUCK, to be the Executor of this my Last
Will and Testament. In the event that he shall predecease me, die
before completing the administration of my estate or shall for any
other reason fail to qualify or cease to act as my Executor, then
nominate, constitute and appoint my daughter, BARBARA ANN LAGAZA,
to be the Executrix in his place and stead. Further, I direct tha
my personal representative, or his successor, shall not be require
to enter security in any jurisdiction.
IN WITNESS WHEREOF, I , MARY RITCHUCK, have set my hand
and seal to this my Last Will and Testament, which consists of two
( 2 ) pages this a, 4 71� day of Ale Ile/W 6 elc 1991 .
-h_..�`"3 ,tM2�w1 f� (SEAL)
MARY ROTCHUCK
2
Signed, sealed, published and declared by MARY RITCHUCK, the above
named testatrix, as and for her Last Will and Testament, in the
presence of us, who at her request, in her presence and in the
presence of each other, all being present at the same time, have
hereunto subscribed our names as witnesses.
Residen
Residence: G "z
3