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Home My WebLink About08-13-07 (2) ....J 15056041147 REV.1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 00234 Date of Birth 204012159 11162006 04221919 Decedent's Last Name Suffix Decedent's First Name MI ANTONUCCI MARGUERITE M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW IS! 1. Original Return 0 2. Supplemental Return o 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12.82) 0 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust (Allach Copy of Will) (Allach Copy of Trust) 0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death . between 12.31.91 and 1-1.95) o o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT B. POMEROY 7175799665 Firm Name (If Applicable) 413 AMHERST DRIVE REGISTER O~S USE ~ Y t>_~ -0 C ;~---:3 ;~l: P G'U) l::~;~ W C-),', ;: -) c-:) =-n :-:.) ~ ::-r::; --I DATt'FILED " --..... First line of address Second line of address N + City or Post Office State HARRISBURG PA ZIP Code 17109 Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this return, including accompanyi.ng ~chedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representattve IS based on all information of which preparer has any knoWledge. SI RE F PERSON RESPONSIBL OR FILING RETURN ATE ~ 413 Amherst Drive, Harrisburg, PA 17109 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS Side 1 \ 15056041147 15056041147 ---1 ~ ---l 15056042148 REV-1500 EX s r\j3r'lC ANTONUCCI, MARGUERITE M. RECAPITUL.ATION Reall::state (Schedule A).... 1. 2 StJeks and Bonds (Schedule B).. . 2. 3 Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C)... 3 5 Cash 13ank Deposits & Miscellaneous Personal Property (Schedule E). 4. Mortgages & Notes Receivable (Schedule D).. 4. 6 JOintly Owned Property (Schedule F) D Separate Billing Requested 7 Inter-VIvos Transfers & Miscellaneous Non-Probate Property (Seheciule G) D 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 )... . ............. 13 Chantable and Governmental Bequests/See 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).. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate of transfE,rs under See 9116 (all 1 ~)) X .00 16 Amount of Line 14 taxable at itreal rate X 045 17 Amount of Line 14 taxable at Sibling rate X .12 18 Amount of Line 14 taxable at collateral rate X .15 19 Tax Due. 2C FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Dececent's Sccial Security \lumber 204012159 5. 4,436.52 6. 7. 2,417.72 8. 6,854.24 5,778.00 9 10. 17,890.72 11. 23,668.72 12. -16,814.48 13. 14. -'16,814.48 15. 16 17. 18 19 o . 0 0 D 15056042148 ---l riEV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Antonucci, Marguerite M. STREET ADDFESS 14 South Market Street, #1 File Number 21 - 07 - 00234 CITY STATE ZIP Mechanicsburg PA' 17055 Tax Payments and Credits: Tax Due Wage 1 Line 19) 2 Credits/Payments A. Spousal Poverty Credit B F)rior Payments C Discount (1) 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 .j Line 3 is greater than Line 2, enter the difference This is the TAX DUE. (3) (41 0.00 B Eonter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) 0.00 A, E:nter the interest on tr:e tax due. 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 a. retain the use or income of the property transferred:.. . b retam 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?.. 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation?.. . x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. No x x x x x x 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 SUrVl'Jl1g spouse is three (3) percent [72 P.S S9116 (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 s~ouse is zero (01 percent [7;~ PS S9116 (al (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax. and the statutory requirements fOI dlsclosur~ of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary Fer dates of death on or after July 1. 2000: Tre 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 natura paree,! an adoptive parent. or a stepparent of the child is zero (0) percent [72 P.S. S9116 (a) (1.2)]. Tre t,lx 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 PS S9116 1.2) [72 P.S. S9116 (a) (1 )]. Tre tax rate IInposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent 72 PS. S9116 (al (1.3)). A. Slbl:n.~ IS de'lned under Section 9102, as an individual who has at least one parent in common with the decedent. whether by blood or adopron ~&~ ~~~ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY r="Er~NSYLVANIA R::::TUF'N ~(~'Dc'~- CECE8ENT ESTATE OF Antonucci, Marguerite M. FILE NUMBER 21 - 07 - 00.234 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 NU/BER DESCRIPTION VALUE AT DATE OF DEATH 3.703.39 PNC Bank. checking account #50-7009-3794 /0;7'" -)W'2, (JjcJ PNC Bank. savings account # " - L t /l / / J 663.05 2 3 Charming Shops (Fashion Bug) Final retirement pay, direct deposited into checking account, PNC. 70.08 TOTAL (Also enter on Line 5, Recapitulation) 4,436.52 Senior Checking Plan Account Statement PNC Bank For the period 11/16/2006 to 12/15/2006 Primary account number: 50-7009-3794 Page 1 of 2 Number of enclosures: 0 s MARGUERITE ANTONUCCI 413 l\.MEERST DR APT 0 HARRISBURG PA 17109-5413 Q For 24-h::>ur banking, and transaction cr interest rate Infornation. sign on to 1!' PNC Bank Online Banking at pnc.com For customer service call 1-888-PNC-13ANK between the hours of 6 AM and Midnight E r Para Sel/ICIO en espanol,1-866-HOUPNC Moving? Please contact us at 1-888-PNC-BANK i:2!Sl Write to. Customer Service PO Box 609 Pittsburgh PA 15:0'30-9738 5 Visit us at pnc.com [iJ TDD terminal 1-800-531-1648 For heanr'g Impalrec clients only IMPORTANT ACCOlTNT INFORMATION Amendment to the Consumer Schedule of Service Charges and Fees The information stated below amends certain information in our Consumer Schedule of Service Charges and Fees. All other information In the Schedule continues to apply to your account. Please review the following information and retain it with your :'ecords Effective f'ebruary 2, 2007 Other Account Charges and Services Insufficient/Unavailable Funds Fee * $31 - $36 per item based on the number of insufficient/unavailable items during the current and previous eleven service charge cycles: 1 -- 3 items S31 4 -- 6 items $34 7 or rnore $36 Continuous Overdratl Fee * $6 assessed each day your account remains overdrawn for a period greater than 4 consecutive calendar days, up to a maximum of$30. This charge is in addition to any insufficient/unavailable funds fees assessed International Services International Checks * $40 per check Senior Checking Plan Regular Checking Account Summary Account number 50-7009-3794 Marguerite AntonuccI Balance Summary Please see the Activity Detail secllo" for additional Information. Beginning balance Deposits and other additions Checks and other deductions Ending balance 3.703.39 964.58 3,319.50 1,348.47 A verage monthly balance Charges and fees 2,735.72 .00 Senior Checking Plan Account Statement 101 For 24-hour inforrnation, sign on to PNC Bank Online Banking .s on pnccorn. For the period 11/16/2006 to 12/15/2006 MARGUERITE ANTONUCCI Primary account nurnbe" 50-7009-3794 Page 2 of 2 Account number: ~)O-7009-3794 ' continued Transaction Summary Checks paid/ withdrawals Check Card pas signed transactions Check Card/Bankcard pas PIN transactions o o Total ATM transactions PNC Bank A TM transactions Other Bank A TM transactions o o o Activity Detail Deposits and Other Additions Dale ,""mount Description 12/01 B12.00 Direct Deposit - Sac Sec US Treasury 303 XXXXX2159A 12/06 B2.50 Reverse ACH Debit Effective 12-05-06 12/15 70.0B From Retirement Acct #7500011723 There were 3 Deposits and Other Additions totaling $964.58 Checks and Substitute Checks Check Date Reference tJ<:lIU number 2356 2,425.00 12/04 0257054 77 12105 Amount Descnplion -'312.00 Direct Payment - Reversal US Treasury 303 XXXXX2159.A, 8250 Direct Payment - Ad&D Ins XXXXXXXX7182 There ,S 1 check listed totaling $2,425.00 There Nere 2 Online or Electronic Banking Deductions totaling $894.50 Online and Electronic Banking Deductions Date 12101 Daily Balance DE!tail Date 11/16 12/01 Balance 3,703.39 3,703.39 Date 12/04 12/05 Balance 1,278.39 1,195.89 Date 12/06 12/15 Balance 1,278.39 1,348.47 Why not earn rewards while you shop for that special gift this holiday season? Use your PNC Bank VisaCk( Check Card the entire month or December _, the more you do, the better chance you have to earn DOUBLE Visa Extras points on randomly selected days in our M yslery Bonus Day, promotion. Visit www.pnc_com for details and to enroll in Visa Extras. GPNCBANK August 10, 2007 To whom it may concern, Pertaining to the estate of Marguerite Antonucci, savings account 5002043138 was closed on 03/14/2007, The total arnount of the proceeds amounted to $663.05. One hundred dollars of the preceeds went into the estate account. The remaining portion, $563.05, was combined with $1348.47 from the primary checking account to total $1911.52. This amount was sent to Stone and 11urrey Funeral IIonle on rv{arch 11 ~ 2007. ~re]~, Lfrr~neka PNC Bank A. memberof the PNC Financial Services Group WNW pncbank,com ~~ . .'~.~~~.,. ~Jtrt~ ';:;~~::.J.-, SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ';Of,.1tv10!\.JV'C6,Lirl OF PENNSYLVANIA l~jHEF TANCE TAX RETURN RESDEt,T DECEDENT ESTATE OF H::M ~,JM8ER Antonucci, Marguerite M. FILE NUMBER 21 - 07 - 00234 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY Irl::lude tr'c rame cf t~e transferee. their relatlonshp to decedent CJntj :re :;a~c :ra'ste~ Attach a copy of the deed for real estate DA TE OF DEATH V ALUE OF ASSET J,:> OF DECD'S INTEREST EXCLJSI :IN (IF APP IC/IBLEI TAXA5LE VALUE 2,4 17.72 2,417.72 PNC Eiank, traditional IRA #4204012159 Distributed to: Robert Pomeroy, son, on death,by beneficiary designation 2,417.72 TOTAL (Also enter on line 7, Recapitulation) PNC BANl< PNC BANK, NATIONAL ASSOCIATION RETIREMENT SERVICES P. O. BOX 3499 PITTSBURGH,PA 15230 000040 Tel 1-888-762-4727 Bank Fin 22-1146430 ROBERT B POMEROY BENE OF MARGUERITE ANTONUCCI {d 3 M1HURST DR APT 0 HARRISBURG PA 17109-5413 Statement Period 01-01-07 Thru 06-30-07 Date 07-24-07 Page 1 Plan Type: Plan Number: TRADITIONAL IRA {t204012159 Social Security IXXX-XX-7846 Principal Balance as of 01-01-07 Contributions Information Current Year (J .00 (J .00 n _" -= ~ _ '\/ _ _ _ Cf J_UI ledl o .00 o .00 o .00 Rollover Transfer In To Beneficiary Interest Credited Distribution Information Death Federal Income Tax Withheld Principal Balance as of 06-30-07 Interest Accrued, Not Yet Credited 2,417.72 (J .00 2,417.72- 2,417.72 o .00 o .00 o .00 SUMMARY OF INVESTMENTS Account Number Rate Maturity Date Interest Credited Current Value Interest Accrued Total Value 04209281846 0.00 ~ nn v .. U \.J n nn lJ..vv D.G Summary Totals 0.00 o . 0 0 0.00 o .0 NOW IS THE PERFECT TIME FOR AN IRA CHECKUP! CALL 1-888-PNC-IRAS (1-888-762-4727) AND HAVE ONE OF OUR SPECIALISTS REVIEW YOUR IRA TODAY. MEMBER FDIC. iDe5 *}~ l;.': .~ ~;~~~, . '~:' >~:-(~_I DC ~-,-i:::-r-, J::;E TAX RETUHN DECEDErJT ESTATE OF Antonucci, Marguerite M. SCHEDULE H RJNERAL EXPENSES & ADIVIINISTRA11VE COSTS FILE NUMBER 21 - 07 - 00234 Debts of decl~dent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: A. Stone & Murray Funeral Home, funeral and interment B. ADMINISTRATIVE COSTS: Personal Representative's Commissions DESCRIPTION AMOUNT Social Security Number(s) I EIN Number of Personal Representative(s): StreEct Address City Year(s) Commission paid State Zip 2. Attorney's Fees 3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zip City Fielationship of Claimant to Decedent 4 Probate Fees Register of Wills 5 Accountant's Fees 6 Tax Peturn Preparers Fees 7 Othw Administrative Costs Register of Wills. Short Certificates 5.700.00 55.00 8.00 5,778.00 TOTAL (Also enter on line 9, Recapitulation) . ~ ~~ ;~ttl~~ ,':;_'~~~Ui Schedule H Funeral Expenses & Administrative Costs continued COMrv1 :)NINE~L_ TH OF PENNSYLVANIA i~IHERITANCE TAX RETURN RESIDUn DECEDENT ESTATE OF Antonucci, Marguerite M. FILE NUMBER 21 - 07 - 00234 2 Register of Wills. filing Inheritance Tax Return 15.00 Page 2 of Schedule H ~. J~~ .~ ,l~r" ''':~;~t~'' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS :JF 1)::~'H'JSYL-\./Ar\IA '.'~::~IT.^"r"j':: ;~ETUFN =::E:=EJENT ESTATE OF Antonucci, Marguerite M. Include unreimbursed medical expenses. TEM NUVBER DESCRIPTION Checks written before death, clearing after death: #2356 Catholic Cemetaries, burial lot 2 I Claremont Nursing & Rehabilitation Center, nursing home bill I I I I FILE NUMBER 21 - 07 - 00234 AMOUf\lT 2.425.00 15.465.72 TOTAL (Also enter on Line 10, Recapitulation) 17,890.72 RcV-1513 EX+ (9-00) ~~~ \ :~~' ~~~:~_I SCHEDULE J BENEFICIARIES COWil)N\^JEA. T ~ OF PENNSYLVANIA IhHERi;A\JCE TAX RETURN RES'DE'IT DeCEDENT ESTATE OF Antonucci, Marguerite M. FILE NUMBER 21 - 07 - 00234 NUIv1BER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY T AXAEiLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE (Words) ,AMOUNT OF ESTATE (SSS) I. (.i t J<' i I Robel't B. Pomeroy 413 !\mherst Drive Harrisburg, PA 17019 son --n.: ( i< ,/ C': \.." . 2 Lawr"ElnCe W. Pomeroy 408 E:rian Court Mecnanicsburg, PA 17055 son ( ~'I'." j'-. I'.! 3 Patricia A. Smith 414 North West Street. #5 Carlisle, PA 17013 daughter Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate. on Rev 1500 cover sheet II. NON-T/\,XABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT f3t:ING MADE B CHI\RITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00