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Home My WebLink About09-06-05 RE\ij50GO:lfi-Cln\ '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 . . HARRISBURG, PA 17128.0601 I' REV-1500 FILE NUMBER 21 05 INHERITANCE TAX RETURN RESIDENT DECEDENT COUNTY CODE YEAR NUMBER 00334 t- Z W C W (.) W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) FREY, DARLlEN M. SOCIAL SECURITY NUMBER 195-32-1305 DATE OF DEATH (MM.DD-YEAR) 03/15/2005 DATE OF BIRTH (MM-DD-YEAR) 08/17/1941 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF ""ILLS SOCiAl SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w 1IC1-1 III (,.) 1IC ~ g (,.) iil ~ ~ 1. Original Return o 4. limited Estate o 6. Decedent Died Testate (Attach copy of Willi o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of ct..th aftar 12.12.82\ 07. Decedent Maintained a Living Trust (Anach copy 01 Trusl) o 10. Spousal Poverty Credit Ictal. 01 O8;lth belw.an 12.31.91 ano f.1.95) o 3. Remainder Return (dat. al4..th pHOf to 12.13.821 o 5. Federal Estate Tax Relur~ Required I o 8. TOlal Number 01 Safe Dedasi! Boxes o 11. Election to tax under sIIq. 9113(A) (AIt.ch Soh 01 DIRECTED TO: !z ~ = ~ (,.) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD NAME COMPLETE MAILING ADDRESS Shaun E. O'Toole, Esquire 2813 North Second Street FIRM NAME (1IAppl'cabla) Harrisburg, Pennsylvania 17110 TELEPHONE NUMBER (717) 213-6653 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole.Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscelleneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Translers & Miscellaneous Non.Probate Property (Schedule G or L) 8. Totsl Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts 01 Decedent. Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (tolal Lines 9 & 10) 12. Net Value of Estate (line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts lor which an election to lax has not been made (Schedule J) z o ~ ;:) t- o:: ct (.) w 0:: 14. Net Value SubJect to Tax (Line 12 minus Line 13) (1) (2) (3) (4) (5) 0.00 0.00 0.00 0.00 5,383.87 -) ~n "1.:; I !..t' [..~." r .) I :', i-';. ..'r.., li,--.M ~'--': f'~"-~' (--) ~-3 iTl '::::::J ,-:-) . .'J C) lTl C:.) ,--I ~) (6) 0.00 ~'\'") ~ ,,~ (7) 17,000.00 UJ -,. , C!,) "-l- (9) (8) 6,064.00 1 ,014.83 (11) (12) (13) 22,383.87 (10) 7,078.83 15,305.09 0.00 (14) 15,303.09 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 688.73 z o ~ ..... ;:) a.. :IE o (.) ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ~ ~_____ 15,:30~.09 x .0 ~~ (15) x .0 ~_ (16) 16. Amount 01 line 14 taxable at lineal rate 17. Amount 01 line 14 taxable al siblin9 rale 18. Amount of line 14 taxable at collateral rate 19. Tax Due x .12 (17) x .15 (18) (19) 688.73 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 200 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < II D'8cedent's Complete Address: STREET ADDRESS 401 Front Street CITY H . b I STATEpA I ZIP 17025 arns urg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Cre<litsJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 688.73 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnteresllPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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) A. Enter the interest on the tax due. (5A) 0.00 0.00 688.73 0.00 688.73 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. I \ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BL~CKS 1. Old decedent make a transfer and: Yes No I a. retain the use or income of the property transferred;...... .. ......... .. ......... ................ .... ............ 0 [iJ I b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [iJ c. retain a reversionary interest; or........................................................................................................................ 0 1iI d. receive the promise for life of either payments. benefits or care? ................................................................. 0 1iI 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? .............. 0 [iJ 4. Old decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneflciary designation? ........... .......................................... ........ .............. .......................... ..........,..,.... 0 (58) Make Check Payable to: REGISTER OF WILLS, AGENT [iJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF HE RETURN. 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 true, correct and complete. Declaration of preparer other than the personal representative is ba$ed on aU information of which preparer has any knowledge. ~:::E OF PERS N RESPONSIBLE FOR FILING RETURN _____ _ . _ ___ _ _ wO.O ioh 6-\. \Dest- Fcl.'j rUlet.0 SIGNAT E F P~RER O~HAN REPRESENTATIVE t,. lV,,)~ DATE I q- Oa..-f'$ ______,__________. _._,,__........ u_.__ __.._"_____.____....________.___...., _.~.-......- ,_ I r"JOa-S PA DATE " 0'1/oz/oo1 I I I "1- __u 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 3% [72 PS. ~9116 (a) (1.1) (I)). 1 For dates of death on or after January 1, 1995, the tax rale Imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~~116 (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 I applicable even if the surviving spouse is the only beneficiary. I I For dates of death on or after July 1, 2000: I The tax rate imposed on the net value of transfers from a decease<l child twenty-one years of age or younger at death to or for the use of a natural parent, a~ adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(12)J. : i The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~~116(a)(1)). The tax rate Imposed on the net value of transfers to or for the use of the decedent's siblings Is 12% [72 PS. ~9116(a)(1 ,3)]. A sibling Is defined, under Sebtion 9102, as an it1dlvidual who has at least one parent In common with the decedent, whether by blood or adoption. RESS 2813 NorthSElcp~~_S!r~e!.}_1~rrJ~~u!~.J'Elfln~y~~~~_E~JO II \ REV-1508 EX+ (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULI I CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FREY, DARLlEN M. FILE NUMaER 21-05-0334 ITEM VALU~ AT DATE NUMBER DESCRIPTION OF DEATH 1. Members 1 st Federal Credit Union; Checking Account #112777 -11 1,642.39 2. Members 1st Federal Credit Union; Savings Account #112777-00 25.45 3. Members 1st Federal Credit Union; Money management #112777-05 3.716,03 i TOTAL (Also enter on line 5. Recapitulation) $ ~,383,87 ., Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F (If more space IS needed, Insert additional sheets of the same sIZe) Send Inquires to: 1 5000 Louise Drive PO Box 40 Mechanlcsburg. PA 17055 _.membenl1Bt.org Main SwItchboard: (717) 697-1161 or (BOO) 283-2328 EZ CaD: (717) 697-4372 or (BOO) 283-4372 TOO: (717) 697-5312 or (BOO) 283-2328 exl5312 ToIeBranGh: (717) 7ll1HlO40 or (800) 237-7288 Account Number: Statement of Accounts II Mar 01, 2005 thru Mar 31, 2005 MEMBERS 1st FEDERAL CREDIT UNION DARLIEN M FREY 401 FRONT ST ENOLA PA 17025-3220 Account Balances at a Checking: Savings: Certificates: Loans: Money Management: 112777 GI~nce: 1~629.40 25.45 0.00 0.00 3,1719.94 i 1 lof 2 i I I Page: We have partnered with Carlisle Events to provide you with the opportunity to attend one of their events free of charger See the enclosed insert for more information. CHECKING ACCOUNTS 11- CHECKING Date Mar 01 Mar 01 Mar 01 Mar 01 Mar 02 Mar 02 Mar 11 Mar 16 Mar 31 Transaction Descri tion Balance FoIWard Deposit Transfer From Share 00 Check 001771 Tracer 0301005457 Check 001775 Tracer 0301015248 Check 001774 Tracer 0302006766 Check 001773 Tracer 0302019360 Deposit Transfer From Share 00 Withdrawal ACH PEOPLES LIFE INS TYPE: INS- PREM ID: 1520670766 Ending Balance Additions Subtractions 70.76 47.7.... 161.94- 29. 72- 41 . 81- 248.29 12.~ CHECK SUMMARY Check # Amount Date 001771 47.74 Mar 01 001773* 41.81 Mar 02 * AsteriSk next to number indicates skip in number sequence ., Checks Cleared for 281. 21 Date Mar 16 Date Mar 01 . Check # 001774 001775 Amount 29.72 161.94 WITHDRAWALS AND OTHER CHARGES Amount Description 12.99 Withdrawal ACH Date Amount Description Balance ,604.55 ,675.31 ,627.57 ,465.63 ,435.91 ,394.10 ,642.39 ,629.40 ,629.40 Date M r02 M r01 DEPOSITS AND OTHER CREDITS Amount Description 70.76 Deposit Transfer 2 Deposits and Other Credits for 319. 05 Amount Description 248.29 Deposit Transfer Date Mar 11 - - - Continued on following page - - - ~1. ~-t Mar 01, 2005 thru Mar 31, 2005 Account Number: 112777 Page: 2 of 2 SAVINGS ACCOUNTS 00. REGULAR SAVINGS Date Mar 01 Mar 01 Mar 01 Mar 11 Transaction Description Salance Forward Deposit ACH CIVIL SERV 10: 3121736156 Withdrawal Transfer To Share 11 Deposit ACH COMPASS GROUP TYPE: PAYROLL 10: 1561874931 DATA: CANTEEN CORP12-11082 Withdrawal Transfer To Share 11 Ending Balance Additions Subtractions Balance 25.45 70.76 96.21 70. 76- 25.45 248. 29 273.74 248.29- 25.45 25.45 Additions Subtractions --~Baiance--- i 3,716.03 3.91 13,719.94 i3,719.94 Mar 11 Mar 31 05. MONEY MANAGEMENT Date Transaction DescrIption Mar 01 Balance Forward Mar 31 Deposit Dividend 1.240% Annual Percentage Yield Earned 1. 250% from 03101/2005 throUgh 03131/2005 Mar 31 Ending Balance YTD SUMMARIES TOTAL DIVIDENDS PAlO 00 REGULAR SAVINGS 05 MONEY MANAGEMENT 11 CHECKING 1.36 43.53 0.58 Total Year To Date Dividends Paid NOTE: Total includes closed shares 45.47 I' REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FREY, DARLlEN M. FILE NUMBER 21-0510334 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. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH \ TAXABLE INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND % OF DECO'S EXCLUSION NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABlE) I VALUE 1. Transfer of $17,000 cash to Decedenfs daughter, Brenda Hess, on February 17,000.00 100 0.00 17,000.00 24,2005 I TOTAL (Also enter on line 7 Recapitulation) $ 117,000.00 .. (If more space IS needed, IOsert additional sheets of the same size) II REV-1511 EX+ (12-99. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FREY, DARLlEN M. ALE NUMBER 21-05-0334 Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AM 1. FUNERAL EXPENSES: Michael J. Shalonis Funeral Home 4,513.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representalive(s) Sociel Security Number(s)/EIN Number of Personal Representative(s) Street Address City ,StBle Zip Year(s) Commission PBid: 2. Attorney Fees 1,400.00 3. Family Exemption: (If decedent's address is nol the same as claimant's. attach explanation) Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 91.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) !,6,064.00 II REV-1512 EX+ (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FREY, DARLlEN M. FILE NUM~ER 21-05-0334, Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical ex~. ITEM VALUE AT DATE NUMBER DESCRIPTION OF EATH 1. Dell Financial Services 1,014.83 ! ! TOTAL (Also enter on line 10. Recapitulation) $ 11,014.83 ! .. (If more space IS needed. Insert additional sheets of the same Size) II REV-1513 EX+ 19-001 '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)\ A. John McConnell, 401 Front St., West Faiview, PA 17025 FILE NUMBER 21-05-0334 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ES ATE ESTATE OF FREY, DARLlEN M. B. Linda Schonemann, 2316 NortheastThird St., Boynton Beach, Fla. 33345 Son 0,20 1),,-...~" .\.c.r 0.20 1>o.y.~",~ 0.20 4$""" 0.20 t>6."~~~ 0.20 C. Brenda Hess, 244 West Dauphin St., Enola, PA 17025 D. Jay Max McConnell, 401 Front St., West Fairview, PA 17025 E. Tracy Hoffman, 620 High Street, West Fairview, PA 17025 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHElOT II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) 0.00 Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Darlien M. Frev No. 00334 of 2005 also known as Date of Death March 15. 2005 , Deceased Social Security No. 195-32-1305 Personal Representatlve(s) of the above Estate, deceased, verify that the Items appearing in the following inventory inclu all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedenfs death, a d that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memoran um at the end of this inventory. lIWe verify that the statements made in this Inventory are true and correct lIWe understand the false statements herein are made subject to the penalties of 18 Pa. C.S. SectIon 4904 relating to unsworn falsification to auth9rities. Personal Representative: Name of Attorney: Shaun E. O'Toole 1.0. No.: 44797 Address: 2813 North Second Street Dated Harrisbura, PA 17110 Telephone: (717) 213-6653 Description Value (1) Members 1 st Federal Credit Union Checking Account $ 1,642.39 (2) Members 1 st Federal Credit Union Savings Account $ 25.45 (3) Members 1 st Federal Credit Union Money Management Account $ 3,716.03 ", t~') ;1; tl:.r~'1 Cv) n'l ....., '"' -"~J "'1:-1 ~::s ::-:-.J ::.'0 I :';:~i~~ t::-J :~3 . .:") n. ,..-) -~\: .1 , (~') ...-., -I ':,-..) .. Cf..) .,.- (Attach Additional Sheets if necessary) Total: $ 5,383.87 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each Item, but such figures should not be extended Into the total of the Inventory. Form RW-7 (Douphin County - Rev.lIII2)