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Home My WebLink About01-09-07 (2) REV-1500 EX (6-00) I COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER ~L COUNlY CODE -9L 0371___ YEAR NUMBER I- Z w C w t) w C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) F Helen DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 4/22/2006 11/6/1909 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I SOCIAL SECURITY NUMBER 179-30-4167 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ [X] 1. Original Retum :.:::!;U) D ~ g:~ 4. Limited Estate :%: 00 r:;;r (J 11:::....1 LAJ 6. Decedent Died Testate (Attach copy of \Mil) c..1Xl ~ D 9. Litigation Proceeds Received D 2. Supplemental Retum D 3. Remainder Retum (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required o 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe DeposH Boxes D 10. Spousal Poverty Credit (dBt. of d"th b.tw"n 12-31-91 BOO 1-1-95) D 11. Election to tax under Sec. 9113(A)(AItBChSChO) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOOLD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z W o Z o c.. en w a:: a:: o (,) Richard e. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman, p.e. TELEPHONE NUMBER 717-697-8528 44 West Main Street Mechanicsburg, PA 17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 0.00 68,453.47 0.00 4,200.00 251,433.27 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5 Cash, !'ank DeposHs & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested j:: :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ;:) (Schedule G or L) l- n: 8. Total Gross Assets (total Lines 1-7) <( t) W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0:: 10. Debts of Decedent, Mortgage Liabililies, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 0.00 OFFICIAL USE ONLY f"-..~ Q g --.J ,- ::-:~ -.-:JP' ...".,...... I \D 5: a (8) 30,282.13 11 , 878 . 81 (11) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (12) (13) 324,086.74 42,160.94 281,925.80 0.00 281,925.80 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0.00 x.O L(15) z rate, or transfers under Sec. 9116 (a)(1.2) 0 i= 16. Amount of Line 14 taxable at lineal rate 281,925.80 x .0 45 (16) < I- ::l 0.00 II. 17. Amount of Line 14 taxable at sibling rate x .12 (17) :E 0 0.00 C,) 18. Amount of Line 14 taxable at collateral rate x .15 (18) X < 19. Tax Due I- (19) 0.00 12,686.66 0.00 20. [K] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 12,686.66 > > BE SURE TO ANSWER ALLQUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W46451.000 Decedent's Complete Address: S1REET ADDRESS 161 R e ate Road Monroe T Cumberland Count CITY Mechanicsbur STAlE PA ZIP 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 12,686.66 0.00 11,000.00 550.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 11,550.00 0.00 0.00 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. Check box on Page 1 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) 1,136.66 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Pa able to: REGISTER OF WILLS, AGENT (5B) 1,136.66 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . 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? . . . . . . . . . 2. If death occurred after December 12. 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . " D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ 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, I declara 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 representatl.... is based on all information of which prepa,", has any knowledge. SIGNATUREOFPERSONi)=V=IL~RE~ J. +- ADDRESS I ~~ f-/~ Yes No D D D D Qg Qg ~ ~ ~ []g DATE 1/5/tJl 161 Ryegate Road, Mechanicsburg, ADDRESS Richard C. Snelbaker, Esquire 44 W, Main Street, Mechanicsburg, PA 17055 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. 139916 (a) (1.1) (i)J. 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. 139116 (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 0% [72 P.S. 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%, except as noted in 72 P.S. S 9116(1.2) [72 P.S. 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% (72 P.S. 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. 3W4646 1.000 REV-1503 EX + (&-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Helen I. Fry 21 06 0371 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Cumberland Valley Co-op 4 shares of stock valued at $10.00 per share 40.00 2 Duquesne Light Holdings, Inc. 150 shares of common stock valued at $16.85 per share 2,527.50 3 Firs t Energy Corp 174 shares of common stock valued at $50.19 per share 8,733.06 4 Methacton School District Authority school revenue bond, series of 1978 with a maturity date of 4/1/2007 5,062.00 5 Pepco Holdings, Inc. 254 shares of common stock valued at $23.22 per share 5,897.88 6 PNC Financial Corporation 228 shares of common stock valued at $69.61 per share 15,871.08 7 PPL Corp 440 shares of common stock valued at $29.33 per share 12,905.20 8 Public Service Enterprise Group, Inc, 75 shares of common stock valued at $64.09 per share 4,806.75 9 Sprint Nextel Corp 500 shares of common stock valued at $25.22 per share 12,610.00 3W4696 1.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 68,453.47 R,EV-1507 EX ~ (6-98) COMMONWEALTH OF PENNSYL V ANJA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen I. Fry SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21 06 0371 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Ronald D. and Lori A. Trace Loan receivable dated July 10, 1996 ($4,000.00 principal and $200.00 interest) 4,200.00 TOTAL (Also enter on line 4, Recapitulation) $ 4,200.00 3W46AC 1000 (If more space is needed, insert additional sheets of same size) RI'V-1508 EX +.(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Helen I. Fry FILE NUMBER 21 06 0371 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 146,723.26 Citizens Bank checking account, account number 6101189612 2 Citizens Bank certificate of deposit, account #6140848695 10,622.51 3 Citizens Bank checking account, account number 6100705536 34,780.32 4 PNC Bank, N.A. certificate of deposit, account number 31400213715 5,010.34 5 PNC Bank, N.A. certificate of deposit, acccount number 31800222899 25,955.90 6 PNC Bank, N.A. certificate of deposit, account number 31200271938 6,423.11 7 PNC Bank, N.A. certificate of deposit, account number 31400276129 12,995.63 8 PNC Bank, N.A. checking account, account number 5070096899 8,922.20 3W46AD 1.000 TOTAL (Also enter on line 5 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 251,433.27 REV-1511 EX + (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen I. Fry ITEM NUMBER A. B. 2 3W46AG 1.000 Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: Gingrich Memorials inscription on grave marker Total from continuation schedules 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Donald E. Whi tman Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 161 Ryeqa te Road City Mechanicsburg State PA Zip 17055 Year(s) Commission Paid: 2. Attorney Fees Snelbaker & Brenneman, P.C. 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal Advertising Executor's Notice Patriot News advertising Executor's Notice Total from continuation schedules FILE NUMBER 21 06 0371 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 125.00 63.27 16,200.00 12,352.17 310.00 75.00 129.69 1,027.00 30,282.13 Estate of: Helen I. Fry 179-30-4167 Schedule H Part 1 (Page 2) Item No. Description Amount 2 Trindle Spring Lutheran Church funeral luncheon 63.27 Total (Carry forward to main schedule) 63.27 Estate of: Helen I. Fry 179-30-4167 Schedule H Part 7 (Page 2) 3 Register of Wills filing fee for Inheritance Tax Return 15.00 4 Register of Wills short certificates 12.00 5 Reserve for filing fees, accounting fees and other miscellaneous costs associated with the administration of Decedent's estate 1,000.00 Total (Carry forward to main schedule) 1,02;.00 RE,V-1512 EX +.(12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen I. Fry SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 06 0371 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Cindy Thrush beautician services 20.00 2 Pinnacle Health Hospitals medical expenses 4,594.24 3 Albert J. Zagretti, D.O. P.C. medical expenses 94.22 4 Pinnacle Health Hospitals medical expenses 7,170.35 3W46AH 2000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 11.878.81 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen I. Frv 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Ru th E. Whi tman 161 Ryegate Road Mechanicsburg, PA 17055 FILE NUMBER 21 06 0371- RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I One Third of Residue: 93,975.27 Daughter 93,975.27 2 James M. Fry 524 Silver Spring Mechanicsburg, PA Road 17050 One Third of Residue: 93,975.27 Son 93,975.27 3 Judy A. Fry 1 West Sherwood Drive Mechanicsburg, PA 17055 Mechanicsburg, PA 17055: 46,987.63 Granddaughter 46,987.63 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 3W46AI 1.000 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 Estate of: Helen I. Fry 179-30-4167 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 4 Lori A. Trace 20 West Simpson Street Mechanicsburg, PA 17055 Mechanicsburg, PA 17055: 46,987.63 Granddaughter 46,987.63 LAW OFFICES SNELBAKER. BRENNEMAN 8: SPARE LAST WILL AND TESTAMENT I, HELEN 1. FRY, of the Township of Silver Spring, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at anytime heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executor or Executrix, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my three (3) children, namely, JOHN E. FRY, JAMES M. FRY and RUTH E. WHITMAN, share and share alike, absolutely and in fee simple. If any of my said children should predecease me, I order and direct that the foregoing share of my residuary estate attributed to such deceased child shall be distributed unto the issue of such deceased child per stirpes, by representation and not per capita. LASTLY. I nominate, constitute and appoint my son-in-law, namely, DONALD E. WHITMAN, to be the Executor of this, my Last Will and Testament, but if for any reason he should fail to qualify as such Executor or cease so to serve, then and in that event, I nominate, constitute and appoint my daughter, namely, RUTH E. vVHITMAN, to be the Executrix hereof, each and both to serve without bond or other security as a condition of qualification hereunder. IN WITNESS WHEREOF, I, HELEN 1. FRY, have hereunto set my hand and LAW OFFICES SNELBAKER. BRENNEMAN Be SPARE seal to this my Last Will and Testament, which consists of two (2) typewritten pages to each of which I have affIxed my signature this ..2. S- tI... day of October, A.D. Two Thousand (2000). j~E~.~~ (SEAL) The preceding instrument, consisting of this and one (1) other typewritten page, each identifIed by the signature of the Testatrix, was on the date thereof signed, sealed, published and declared by HELEN 1. FRY, the Testatrix therein named, 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, have subscribed our names as witnesses hereto. ~~.~ -2- COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. ) We, HELEN 1. FRY, RICHARD C. SNELBAKER and JANE J. COONEY, the Testatrix and the witnesses, respectively, whose names are .signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his or her knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. )~x9-~Mj ness h2e~~ Subscribed, sworn to and acknowledged before me by HELEN I. FRY, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J. COONEY, the witnesses, this .:25th day of October, 2000. NotarIal Seal Sandra K. Showers, Notary PublIc Mechanlcsbum Bora, Cumberland pounty My CommissIon Expires Nov. 22, 2003 Memw, Pqr,Il$V!I/Ilnl", A~fjfiQn of ~tar!~5> ~~~~ Notary Public LAW OFFICES SNELBAKER. BRENNEMAN 8: SPARE