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Home My WebLink About08-21-06 (2) REV-, 500 EX + (6-00) * OFFICIAL USE ONL V COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER II 2006 COUNTY CODE YEAR SOCIAL SECURITY NUMBER NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U W C FISCHER, MARY LOUISE 410 196-28-7122 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [!]1 Original Return 0 2. Supplemental Return 0 3. Remainder Return (date of death prior to 12-13-82) w .... 04 0 0 >0::$", Limited Estate 4a. Future Interest Compromise (date of death after 5. Federal Estate Tax Return Required oa:>o: 12-12-82) wo..o J:oo 06 Decedent Died Testate (Aftach 0 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes oa:-' o..m copy of Will) copy of Trust) 0.. <C , 09 Litigation Proceeds Received 0 1 0 S~ousal Povert~ Credit (date of death between 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0) . 1 -31-91 and 1-1- 5) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 04-23-2006 07-15-1937 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) .... z w c z o 0.. '" W a: a: o o NAME LEONARD TINTNER, ESQUIRE FIRM NAME (It applicable) BOSWELL, TINTNER, PICCOLA TELEPHONE NUMBER 717-236-9377 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) z o i= ~ ...J ::::l l- ii: ~ u w cr:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6.Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) COMPLETE MAILING ADDRESS 315 N. FRONT STREET/PO BOX 741 HARRISBURG, PA 17108-0741 (1 ) None (2) None (3) None (4) None (5) 42,308.06 (6) None (7) None (9) 10,625.44 (10) None OFFICIAL USE ONLY '-, t,,'-:' (8) 42,308.06 (11 ) 10,625.44 31,682.62 (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) None (14) 31,682.62 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 20. D 0.00 0.00 0.00 0.00 0.00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2002 form software only The Lackner Group, Inc. 15. Amount of Line 14 taxable at the spousal tax rate, 31,682.62 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 i= 16. Amount of Line 14 taxable at lineal rate 0.00 x .045 (16) ~ I- ::::l D. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) :!: 0 u 18. Amount of Line 14 taxable at collateral rate 0.00 (18) >< x .15 ~ I- 19. Tax Due (19) Form REV-1500 EX (Rev. 6-00: Decedent's Complete Address: STREET ADDRESS 3604 FRANKLIN AVENUE CITY Mechanicsburg STATE P A ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 0.00 (5A) (5B) 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;.................................................................................. 0 [!] b. retain the right to designate who shall use the property transferred or its income;.................................... 0 [!] c. retain a reversionary interest; or.................................................................................................................. 0 [!] d. receive the promise for life of either payments, benefits or care?.............................................................. 0 [!] 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 [!] 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. Under penalties of perjury, 1 declare that 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 personal representative is based on all Information of which preparer has anY..I<"".wledge. .________.. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS JACOB R. FISCHER ADDRESS DATE 3604 FRANKLIN AVE1N7UOE50 \/ 1/1-/-11 1 Mechanicsburg, PA t11~ ~ V .0 . _~iF-ICfo ADDRESS DATE 315 N. FRONT STREET/PO BOX 741 HARRISBURG, PA 17108-0741 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 P.S. g9116 (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 0% [72 P.S. g9116 (a) (1.1) (ii)]. The statute does not exemot 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 0% [72 P.S. g9116 (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%, except as noted in 72 P.S. g9116 1.2) [72 P.S. g9116 (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 P.S. g9116 (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-~ 508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FISCHER, MARY LOUISE FILE NUMBER 21-2006-410 Include the proceeds of litigation and the date fhe proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 CERTIFICATE OF DEPOSIT - MEMBERS 1ST FEDERAL CREDIT UNION 10,151.20 2 MONEY MARKET ACCOUNT - MEMBERS 1 ST FEDERAL CREDIT UNION 29.565.22 3 SAVINGS ACCOUNT - MEMBERS 1ST FEDERAL CREDIT UNION #35234-00 25.00 4 IRA - MEMBERS 1 ST FEDERAL CREDIT UNION 2.566.64 TOTAL (Also enter on Line 5, Recapitulation) 42,308.06 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REVi1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FISCHER, MARY LOUISE FILE NUMBER 21-2006-410 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 7,845.59 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions WAIVED Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip - Year(s} Commission paid 2. Attorney's Fees BOSWELL, TINTNER, PICCOLA 2,100.00 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 367.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Adrninistrative Costs 312.85 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 10,625.44 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev,1502 EX+ (6-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FISCHER, MARY LOUISE FILE NUMBER 21-2006-410 ITEM NUMBER DESCRIPTION AMOUNT 1 ADVERTISE - CUMBERLAND LAW JOURNAL 75.00 2 ADVERTISE - THE SENTINEL-LEGAL 187.85 3 BOSWELL, TINTNER, PICCOLA & ALFORD - REIMBURSEMENT TRAVEL EXPENSE, POSTAGE, PHOTOCOPIES, ECT. 50.00 Subtotal 312.85 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REIt-1513 EX+ (9-00) ESTATE OF NUMBER I. 1 SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FISCHER, MARY LOUISE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal aistributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-2006-410 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) JACOB R. FISCHER 3604 FRANKLIN AVENUE Mechanicsburg, PA 17050 Husband ENTIRE ESTATE Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet 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 Copyright (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Form PA-1500 Schedule J (Rev. 6-98) 0.00 39,528.21 39,528.21 tv 1st MEMBERS 1st FEDERAL CREDIT UNION SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner MONEY MANAGEMENT ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Rate Name of Joint Owner IRA CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Rate Name of Beneficiary CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest I nterest Rate Name of Joint Owner 35234 -00 10/13/1983 $25.00 $.00 $25.00 None 35234 -05 12/14/2005 $29,531.31 $33.91 $29,565.22 1.98% None 35234 -16 04/14/2005 $2,560.50 $6.14 $2,566.64 3.98% None 35234 -45 12/14/2005 $10,125.45 $25.75 $10,151.20 4.22% None ~B,ERS 1ST FEDERAL CREDIT UNION AliJltde d/04 Denise A. Wolfe -; - Insurance Services Supervisor June 27,2006 Estate of: MARY L. FISCHER Date of Death: 04/23/2006 Social Security Number: 196-28-7122 5000 Louise Drive. Po. Box 40 · Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org