HomeMy WebLinkAbout11-19-07
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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
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 7
File Number
1057
Date of Birth
038058235
02192007
01221916
Decedent's Last Name
Suffix
Decedent's First Name
MI
ZIFCAlt
MICHAEL
J
(If Applicable) Enter Surviving Spouse's Infonnatlon Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
ZIFCAlt
MARY
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[!J 1. Original Return 0 2. Supplemental Return 0 3. Remainder Retum (date of death
prior to 12-13-82)
0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
lKJ 6. Decedent Died Testate 00 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and 1-1-95) (Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number....,
EDWARD P. SEEBER 71753~280 g
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REGISTER~~~@S USI!CONLY~-;".
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Finn Name (If Applicable)
SUITE
204,
5020
RITTER ROAD
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JAMES,
SMITH,
DIETTERIClt
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First line of address
Second line of address
DATE FILED
City or Post OffIce
MECHANICSBURG
State
PA
ZIP Code
17055
Correspondent's e-mail address:eps@jsdc.com
Under penalties of perjury, I 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 knowledge.
SIG-JfT~RE OF E IBL NG RETURN DATE
, '-"\. Mark A. Zifcak
ADDRESS
260 st. John
Camp PA 17011
51 URE DATE
Edward P. Seeber
Suite 204, 5020 Ritter Road, Mechanicsburg, PA 17055
Side 1
L
15056041147
15056041147
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ESTATE OF
Zlfcak, Michael J.
PA Inheritance Tax Return
Signature of Additional Fiduciaries
FILE NUMBER
21-07-
Under penalties of pe~ury, I 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 knowledge.
Signature #2
Name
Address1
Address2
City, State, Zip
Date
Providence, RI 02906
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15056042148
REV-1500 EX
Decedent's Name: Michael J. Zlfcak
Decedent's Social Security Number
038058235
RECAPITULATION
1. Real Estate (Schedule A)......... ........... ................. ............. ............. ................ ...........
2. Stocks and Bonds (Schedule B)...............................................................................
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)..........
4. Mortgages & Notes Receivable (Schedule D)..........................................................
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested.............
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested.............
8. Total Gross Assets (total Lines 1-7).......................................................................
1.
2.
3.
4.
5.
6.
7. 979,506.77
8. 979,506.77
9. 32,178.09
10. 1,614.18
11. 33,792.27
12. 945,714.50
13. 671,688.90
14. 274,025.60
'9. Funeral Expenses & Administrative Costs (Schedule H).........................................
1 D. 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. Charitable 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
transfers under Sec. 9116
(a)(1.2) X .00 2 7 4 , 0 2 5 . 6 0
16. Amount of Line 14 taxable
at lineal rate X .045 0 . 0 0
17. Amount of Line 14 taxable
atsiblingrateX.12 0.00
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0
19. Tax Due..................................................................................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
15.
0.00
16.
0.00
17.
0.00
18.
0.00
0.00
D
15056042148
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07-
DECEDENT'S NAME
Michael J. Zlfcak
STREET ADDRESS
260 St. Johns Drive
CITY I STATE 1ZIP
Camp Hili PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
0.00
TotallnteresUPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 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.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(58) 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.
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.1610 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Zifcak, Michael J.
FILE NUMBER
21-07-
ESTATE OF
This schedule must be completed and filed W the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM DESCRIPTION-oFl'RoPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Auer Memorial Home & Cremation Services, Inc. 935.00 100.000 0.00 935.00
- prepaid funeral account
2 Commerce Bank Account No. 536054067 - titled 4,702.11 100.000 0.00 4,702.11
In the Michael J. Zifcak and Mary Zifcak Living
Trust dated 8/211994; valued per letter dated
3/6/07; one-half of total value reported
3 Commerce Bank Account No. 536054067, 0.46 100.000 0.00 0.46
accrued Interest - titled In the Michael J. Zlfcak
and Mary Zlfcak Living Trust dated 8/211994;
valued per letter dated 3/6/07; one-half of total
value reported
4 Janney Montgomery Scott Account No. HB66 617,108.64 100.000 0.00 617,108.64
8952-4826 - titled In the Michael J. Zifcak and
Mary Zlfcak Living Trust dated 8/211994; valued
per letter dated 3/9/07; one-half of total value
reported
5 Janney Montgomery Scott Account No. HB66 3,070.12 100.000 0.00 3,070.12
8952-4826, accrued Interest - titled In the Michael
J. Zlfcak and Mary Zlfcak Living Trust dated
8/211994; valued per letter dated 3/9/07; one-half
of total value reported
6 Miscellaneous personal property - titled In the 2,500.00 100.000 0.00 2,500.00
Michael J. Zlfcak and Mary Zlfcak Living Trust
dated 8/211994; valued per Trustees; one-half of
total value reported
Total of Continuation Schedule ee attached page
TOTAL (Also enter on Line 7, Recapitulation) 979,506.77
(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 G (Rev. 6-98)
Rev-1510 EX+ (6"6)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
continued
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zlfcak, Michael J.
FILE NUMBER
21-07 -
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
7 Real estate located at 260 St. Johns Drive, Camp 89,529.90 100.000 0.00 89,529.90
Hili Borough, Cumberland County, PA - titled In
the Michael J. Zlfcak and Mary Zlfcak Living
Trust dated 8/211994; valued per tax assessment
* common level ratio (157,070 * 1.14 =
179,059.80); one-half of total value reported
8 USAA Federal Savings Bank Account No. 261,478.58 100.000 0.00 261,478.58
055-7724-1 - titled In the Michael J. Zlfcak and
Mary Zlfcak Living Trust dated 8/211994; valued
per letter dated 4/13/07; total value reported due
to Disclaimer and Renunciation
9 USAA Federal Savings Bank Account No. 181.96 100.000 0.00 181.96
055-7724-1, accrued Interest - titled In the
Michael J. Zlfcak and Mary Zlfcak Living Trust
dated 8/211994; valued per letter dated 4/13/07;
total value reported due to Disclaimer and
Renunciation
TOTAL (Also enter on Line 7, Recapitulation) 979,506.77
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule G (Rev. 6-98)
REV.1151 EX+ (12-88'
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zlfcak, Michael J.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 9,995.01
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees 20,510.00
See continuation schedule(s) attached
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. Other Administrative Costs 1,673.08
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 32,178.09
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (8-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TN< RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21-07-
Zlfcak, Michael J.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Always & Forever - flowers for Arllngon, VA services 575.00
2 Anthony Curccl - honorarium for organist 100.00
3 Auer Memorial Home & Cremation Services, Inc. - funeral services 1.608.25
4 Globe Advertising - obituary 413.50
5 Good Shepherd - funeral reception 200.00
6 Karen Appel - honorarium for soloist 75.00
7 Mattox Photograpy - funeral services video 495.00
8 The Enchanted - flowers for Arllngon, VA services 174.50
9 The Patriot News - obituary 283.02
10 Travel & hotel expenses for Trustees to attend funeral 6.070.74
Subtotal
9.995.01
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1102 EX+ (8-98)
*'
SCHEDULE H-82
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zlfcak, Michael J.
FILE NUMBER
21..07-
ITEM
NUMBER
1
DESCRIPTION
James, Smith, Oletterlck & Connelly, LLP - attorney fees for trust administration
AMOUNT
6,000.00
2
Pecht & Associates, PC - attorney fees for trust administration
14,510.00
Subtotal
20,510.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev. 6-98)
Rev-1602 EX+ (6-96)
*'
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Zlfcak, Michael J.
FILE NUMBER
21.07-
ESTATE OF
ITEM
NUMBER
1
DESCRIPTION
Commonwealth of Pennsylvania - title transfer fee
AMOUNT
28.50
2
James, Smith, Dletterlck & Connelly, LLP - reservation for trust administration
closing costs
250.00
3
Postage, phone calls & supplies for Mark Zifcak, Co-Trustee
1,164.78
4
Register of Wills, Cumberland County - filing fee for Return
15.00
5
Travel expenses for Michael Zifcak, Co-Trustee
196.80
6
Vital Records - death certificates
18.00
Subtotal
1,673.08
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
R.v-11112 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zlfcak, Michael J.
FILE NUMBER
21-07-
Includ. unrelmbursecl m.dlc.1 .xpens...
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 BILo 011 Company - 011 delivery to residence (1/2 of Invoice) 130.94
2 Comcast - cable service for residence (1/2 of Invoice) 24.83
3 Fox Chimney - repairs to residence (1/2 of Invoice) 44.50
4 H&R Block - 2006 Individual Income tax return preparation (1/2 of Invoice) 223.50
5 Hampden Township Sewer Authority - sewer service to residence (1/2 of invoice) 64.27
6 Marie Huber, Tax Collector - 2007 county/borough real estate taxes (1/2 of Invoice) 213.37
7 PA Department of Revenue - 2006 Individual Income tax liability (1/2 of amount due) 207.50
8 PAWC - water service for residence (1/2 of Invoice) 31.20
9 PPL - electric service for residence (1/2 of Invoice) 31.88
10 USAA Mastercard - credit card account (1/2 of value) 633.62
11 Verizon - telephone service for residence (1/2 of Invoice) 8.57
TOTAL (Also enter on Line 10, Recapitulation)
1,614.18
(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 I (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Zlfcak, Michael J.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
oistributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-07 -
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not Ust Trustee/a'
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
See attached schedule
Total 274,025.60
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
See continuation schedule(s) attached
671,688.90
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
671,688.90
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Michael J. Zifcak 038..05-8235 02119/2007
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Mary Zlfcak
260 St Johns Drive
Camp Hili, PA 17011
Spouse
Commerce Bank;
part of the Janney
Montgomery Scott
brokerage account;
real estate
274,025.60
Total 274,025.60
1
Rev-1H2 EX+ (1-18'
*'
SCHEDULE J-IIA
SPOUSAL DISTRIBUTIONS UNDER
SECTION 9113 FOR WHICH AN
ELECTION TO TAX IS NOT BEING MADE
continued
CO'-'MONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Zlfcak, Michael J.
FILE NUMBER
21-07-
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Janney Montgomery Scott Account No. HB66 8952-4826 - amount disclaimed by
spouse used to fund the Family Trust
443.820.63
2
Less: Schedules H & I
-33.792.27
3
USAA Federal Savings Bank Account No. 055-7724-1
261.478.58
4
USAA Federal Savings Bank Account No. 055-7724-1, accured Interest
181.96
Subtotal
671.688.90
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule J-IIA (Rev. 6-98)
J\\II...\lllll()llllll<llk~(()..dll\111. I III (llllll' J'~')'C
November 15,2007
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013-3387
Re: Michael J. Zifcak, deceased
Dear Ms. Strasbaugh:
Enclosed are an original and two (2) copies of the Pennsylvania Inheritance Tax
Return and an original and one (1) copy ofthe Estate Information Sheet to be filed for
the above-referenced decedent, along with a check for Fifteen Dollars ($15.00)
representing the filing fee. Please time-stamp the extra copies and return them to me
in the enclosed self-addressed, stamped envelope.
If you have any questions, please feel free to contact me.
Sincerely,
JAMES, SMITH, DIETTERlCK & CONNELLY, LLP
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Enclosures
cc: Mark Zifcak, Co-Trustee
Michael Zifcak, Co-Trustee
Reply to:
Suite 1M
5020 Ritter Road
Mecbanicsburg, P A 17055
Direct Dial: 717-298-2094
TI-IE
ESTATE
SECURITY
FOR~11Jl_A
Cheryl L. Baker, CP
Certified Paralegal
717-298-2094
clb@jsdc.com
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134 SIPE AVENUE
HUMMELSTOWN, PA 17036
MAILING ADDRESS
PO BOX 650
HERSHEY, PA \7033
lOLL ~REE '\.800.942.3660
'TEL 7"\ 7 S33 .3280
fAX. 7"'\7.533.777\
www.jsdc.cOlTl
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