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Home My WebLink About04-17-07 15056051047 .J REV.1500 EX (06-05) PA Department of Revenue * Bureau of Individual Taxes PO BOX 2B0601 HarrisbUrg, PA 1712B-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN ""1J'. I RESIDENT DECEDENT t:?""" File Number 06 tJ fr /f Date of Birth 20& MI Suffix Decedent's First Name c Decedent's Last Name !In. If I.C;:: .//./J- e-L- MI (If APplicable) Enter surviving Spouse's Information BelOW Spouse's Last Name SuffiX Spouse's First Name "';."_,".,W"')""" '" Spouse's Social Security Number ..,,:0_,""' THIS RETURN MUST BE FILED IN DUPLlCA.TE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW <=:) 1. Original Retum .. 2. Supplemental Return <=:) 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required <=:) <=:) 4a. Future Interest Compromise (date of death after 12-12-82) <=:) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) <=:) 10. spousal poverty Credit (date of death <=:) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESpONDENT _ "'IS SECTION MUST BE COMPIElEI' AU. CORRfSPOIlIlEKCE AND CDN- TAXIMFORMA11OII SIIOULD BE DIftEClED TO' Name Daytime T~_ ",mbe< <=:) <=:) 4. Limited Estate pI 8. Total Number of Safe Deposit Boxes <=:) 6. Decedent Died Testate (Attach COpy of Will) 9. Litigation Proceeds Received r:.~5 REGISTER OF WILLS USE ONLY Firm Name (If Applicable) ~-'-) r":":'I 37 if Q '::::SS ;~} t-" 1': (.: ~f~ c::; --.J First line of address ::::-,,. -'~:I -.l Oil --1'-.. City or Post Office ---- j::" ,Iv 0 ?.l7 ;;:'4- f-':> o Correspondent's e-mail address: UodM_- d po<j'~ ,_ "" I h"" """"'""' ",~Illm. """"'" """"_ -.... _..... to'" """dmy ...........od-. .. lNO. """'" a lata. Dada ." d ,_,.... '" ,"",",,0 _~ .,,,,,, "" .u -" d whi'" -'" h.. "" -... SIGNATURE . ILlNG RETURN ADDRESS grzJd /:r/i~ Iv ~./J DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L- Side 1 15056051047 15056051047 ..J -l 15056052048 REV-1500 EX .41/ LIfrn:2- ~ ;/;}?-) 0 L. hF!MJ Decedent's Name: RECAPITULATION 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 2. Decedent's Social Security Number ~ t) r':: .6:6 .......~ (/ CJ . 3. Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C) . . . ., 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 4. 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . ., 5. 6. Jointly Owned Property (Schedule F) <:::) Separate Billing Requested . . . . . ., 6. 7. Inter-Vivos Transfers & MiscellaneouS Non-Probate Property (Schedule G) <:::) Separate Billing Requested.. . . . . ., 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 8. 9. Funeral Expenses & Administrative Costs (Schedule H)..................... 9. 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 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. TAX COMPUTATION. 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_ 16. Amount of Line 14 taxable at lineal rate X.o!t..2 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT <:::) Side 2 L. 15056052048 15056052048 .....I REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENTS NAME /t/J c I. STREET ADDRESS '$'2--0 tJo~Y ,~I-/ 6~ k,Jk C E-_ /~ STATE Y?fJ- ZIP/'-L- TtlZQ CllY ~ l-P-- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 137,;). ''/,/ Total Credits (A + B + C ) (2) ---- 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E ) (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) 8YZ. '1<7 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. 35& ' 'if 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 rn b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 [!I 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 I2D 4. ~~:~e:~~~i:~I~:~:~;:o~~ti~~.~.~.~.~~;;~~.~~17~~~.~.~~~~~....................... 0 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-1508 EX+ (6-98) . '* COMMONV\IEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Michael Santiago c. Espino Include the proceeds c11it1gation and the date the proceecIs were received by the estate. All property jolntly-owned with right of lurvlvol'lhlp must be dllcloled on Schedule F. FILE NUMBER 2006-00574 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 02 Feder~ Incare Tax Reftmd $6000 .00 $2332.00 01 Release of EscrOM Aaca.mt Liberty Land Settlement Services :4 TOTAL (Also enter on line 5, Recapitulation) $ -8332.00- (If morespac:e is needed, insert additional sheets cI the same size) REV-1511 EX+ (12-99>* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Michael Santiago C. Espino FILE NUMBER 2006-00574 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Henry Edward Ostman Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 394 Sample Bridge City Enola 500.00 State PA Zip 17025 Year(s) Commission Paid: 2007 2. Attorney Fees 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. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 500.00 U.S. DEPARTMENT OF HOUSING and URBAN DEVELOPMENT . . .. .. SETTlEMENT STATEMENT. . ' L..1E3ERTY.LANDISETTLE~ENJ: ....... SERVIC~~,IN~. . .':.:. .=.~=.:;:.:~,:::..i:itPE~Ft~~~~W~;12{;;!~~':,,-,:.':: . 4660 Trlndle Road....Sulte 103 . c:..:._ l;'[]FHA'-' \1i'.OJI~;,;lir~.lIIoo ':;~'[:!'C?~~,~I.~!1. Camp HIII,IPA 1701~ .. 4. r IVA--.--...-----:-s71TcoNifiN's.::> :c', ,',<,. ,,':! .' "''''. .;' q,' I 0 6.FILENUMBEFf-""~~ I 7. LOAN NUMBER:..2".'.:Lr,:::.:.:,. ,'.' o crt) If .' 50826--""-'''''''''''. .....,.,.. 1 ./7 . . ... . /'. it~) .. 6.~~RT.~~S.~~ENO~:.__ ..- - ---.";..., ''''i C. NOTI;: This form is furnished to give yoJ a statement of actual settlement costs. AmoUnts llaicHci andllyi'lle selllement agent erll!shown. lIems marked '(p.o.c.)' were paid outsidelhe Closing; they ere shown here for Informational purposes end ere tiOrlriclUdeCllii'the lot8ts. . . D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADORESS OF SELLER:. . _. . ..--... 'F. NAME'AND'AlJDRESS OF LENDER: LINDA R. GARSKOF MICHAEL SANTIAGO C ESPINO CASH"...--....--.----.... ESTATE .'- -. ''''0'''' ...,.. .---..-...-...--.-..--......... LIBERTY LAND SETTLEMENT SERVICESINC'~:'~:~' I PLACEOFSEffiEMENT: ",,"'-'" .........-- C-21 WALAK, CEDAR AVE. i CAMP HI,~E!~~!~;:;!~i0 .~~~>r,. 0.">< .. .....-... ..~,. J. SU....ARYOf BORROWER'S;TRANSACTION:' K:'SUMMAIlY OF SELLER'S TRANSACTION: ',' '.' ....... 100. ORosaAMOUNT DUE FROM BORROWER I,' . 400. GROSS AMOUNT DUE TO ULCER ,." . .... ,,'...' .' tOl. Contract salas price i 89000.00 401.ContraclsaiisDrlce" '! ~ .. 89000.00 102. Personal proDertv . r . . .. . . 402.PersoOallirOD8rlV ".. " .. ',,' .. .:. .. 103. SeUlement cheraes to borrower (line 1400) : 1858 ; 98 403." , !' . : W '''',. 104; '.' ... i . 404.'" ...... 106. '..... , " I' .. 405. ",,; :',' , ... Adjustments for items paid by seUer in advance ' n"",. ~. Adjustm.ht.'for items Daid bv seUer In advance~ -';';;,1 -'-' , . l06.Cilyrrownlax \0 I.' 406.Cilyrrownlax 10 (,J." """,e,",:, :,.:u.:,.. 107.Countvlax 08/21/0&012/31/06 72.44 407.Countvl8X 08/21/061012/31/06"0.'..,-- '72.44: lOS. A...samenls 10 , . ... . 4os.AsMSsinenls -- '. 10 ,,{ 0', ill i\" ", '.. "" .' tOll. 08/21/061006/30/07 638.94 40l1.' 08/21/06\006130107: "638.94 ltO. SEWER 8/21- 9/3010 50.00 410. SEWER 8/21;' 9/3010" """-~50';OO .' 111. I. .. I ..... .., .. 411.." ..- "::"':;'i\"O~-'" ., ,.:. ','" ;, t12. i. 412. ..- ,'.. 120. GROSS AMOUNT DUE fROM BORROWER I' ,- 91620 .36 420. o ROSSAMOUNT DUnO SELLER' ,I\{" 8 97 6Li8 :. .. $OO.REDUCTIONaiNAMOUNT DUE TO SELLER . ,'''' . ':"., , 501.Exce6s deposif(see lristructloos) "1 "" ,.. 502.Setllen1enfcharQesto seller'(line 1400) .' '. 6885.19 503.Exisllnaloanfsltaken subiectto.. . ..' 504.Payoff of RrSt Morl~~ge.!fal)."""":..._..__~. ___..", . -. . 'CITIMORTGAGE . 43726.53 505.Payoff'ofSeconclMortgage Loert'~Ei.Le.:!':.':':.:!' '.!:.~'!__.,. '.. INHERT ;'TAJC'ESCItOW . "Ti:.Lss)' 1~E>~(]. ,600a; 00 506....-. \H'~ C .Of! J3 ;t~, H;JLi '~';,:";';};".~. ;_.r~.:,'_~;:~.:J":.-.._ S07." ',1: :"l ~) {;! ~ .: r:li~jll ___.'. .~' \ "_'.." '.',' ': 50S. __ ',,' .-' ....--.-. 5011. ,,,. .;.. ...'i. c"''- ,-,,,..,' Adju6tmenls for items iJnoaid bv s.lIer .. :'. to c',,, ':..' , .'. to ., '.c.... A.. G. PROPERTY LOCATION: WESTWOOD 820 CHARLOTTE WAY ENOLA; PA 17025 CUMBERLAND couNTY, H. SEmEMENT AGENT: PAc 200. AMOUNTS PAlD BY OR IN BEHALF OF BORF OWER 201. Deposit or earnest money: ..., 202. Princloal amount of new loanCs) 203. Existina loanCsltaken subiect to 3000.00 . . ... .... 204. , . 205. i 206. . ~ . 207. . 201. 2011. ..... ... . . .. ..... .' .' 62.32 Adiustments for items unpaid bv seller 210. Cltvrrown lax \0 211, County lax \0 212. ASMssments \0 ~~ \0 214. ASSOC.DUES 8/1-8/21 215.: . ,. . 216. 217. 216. 2te. I 3062.32 220. TOTAL PAID BY/FOR BORROWER 300. CASH AT SETTLEMENT FROM OR TO BORROWER 301. Gro&S amount due from borrower fline 1201 r 302. Less &mount Dald bvlfor borrower f1ine 220). r. 91620.36 3062.32 88558.04 303, CASH <IX] FROM) ([ ] TO) BORROWER -Wb- ~ !jJ.df Buyer or Borrower', 'gnatur. I :;C .., ;",..;ii .i.," '. ....:.__. ),' ~.'.':5':~. :~~ ~~!~::!!,::::\i0~';~~~:~;;:~,~;;;::'-C'j~=).'- .., ........5.... i ,,,,,; .. .. _._-....._.,;:.,:;:.;-;,'7;;.:,,(j.~;;;-:;-~ r . ..- .,. :c: -."",.-'". ,.. ~._,.,~.._~-.."._~..~-::'.. 'I',i~;' I. SETILEMENTDATE: 610,Cltvrrown lax 611.County lax 512.A,aesamen" . 613. "'.. 514. ASSOC . DUES 515.. . 516. 517. 5t6. 61e. " .... .. .' .. 10 .' '.. .. \0 ",., , ....c.' .. 8/1-8/21.____ "':',",62.32 . . .,-.,'::',~..\.;']:<~'~ ") l~',:,I:;,' I ~;,~ ,J, . '. . ..,.. ,'" . . . ,. .. '., '. ,. .' .. '. ..' . ,. 56674.04 ""co' .'i ..:..'.. ... 520.TOTAL REDUCTION AMOUNT DUE SELLER soo.CASH AT SETTLEMENT TO OR FROM SELLER"" 601.Gross &mOunt due 10 seller lline 42OV". ' .. S02. Less reduction amount due s.ller f1lne 5201 8976L38 56674.04 33087.34 603.CASH [00 TO) ([ ] FROM) SELLER ~iii. JM-,,",,(.~tL Selle,', Sign 'iii' .".. .' . . HUD.l Rev. 5/86 WALAK WALTZ ",,' ~ ~ .,",1 ,. ,,;.l. ,'.' ;'1)'" ,." ..~', i' ~ 'I . ._~';...IVI'" ;. "n ~w: \ ~ r :~.'r~'\.. ~.;'_'l.'_"_':_i ,: f H ;"1:', .- ~'l:' ..~~ ~U1../'t ~ 'f:':~".~..'d';.n....) c:~( \ J. AS . y'rnlF .) :'W';: ,<1 ~', ''';''',:; j1.\ , : '.;'.'~".,i.-"";~:-:;. . ,'~:",~~~~'~'''''-r r' r..,:-j.'1t' LIBERTY. LAND:SETT.SERV. CASH 100.00 10.00 ~ --..-.. ..- -'~.--~ ." ~., ,', - 1iiiliiiiiimnI~ I d (. . t.: ~~j j., (~ LIBERTY LAND .SETT.SERV-.-:.. .-..---,,.. 38-;50 "--890';00 890.00 CONDO ASSOCi"':" 275 POC BIECHLER & TILL WESTWOOD VILL . CONDO ASSO DEBBIE LUPOLD T.C. WESTWOOD CONDO ASSOC. '92~0() 1858.98 ...:,:....'.....). ~..ti: ...~: Buyer or eorrower"a $lgnalura ... - , , ' -"" .': Buy.,', Addr... &; Phone: ' . _:.: ",' ' I.,' 1 '~:~j, >~- -:!~;,1Jiff~~;~ :,l:;\;.;,~:t;:;;~. ;:- At wh~ I hew prepared Ia a IN. ~nd .c;cur.I..~ur:'1 01 t~"I'.n"OUon. I hv. " 1~' I '''-. L,\ \~- Of willoa_lho 1._ ... be _In occOtdoneo wilb Ihla "o\orylonl. J.) J ~ ::~f';;."- :... .. - Oal. . crine to knowinolv make I.... elailemanls 10 Ih. Unilad Slat.. on Ihla or an)' am"-, lorm. Pandie. upon conviction c.n include. fin. .nd Im~t. For del.ilI... a: u.s. C_SocllOn 1001 ondSoctlon 1010. HUD-I Roy. 5/86