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HomeMy WebLinkAbout06-03-08REV-7500 FJC ~ (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 H Z W W V W 0 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-Year) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) (IFAPPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2 1 - 0 8 ~ (~ COUNTY 000E YEAR ~- NUMBER SOCIAL SECURITY NUMBER 1 1 4- 4 6- 1 9 5 4 THIS RETURN MUST BE FILED IN DUPLICATE WRH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ ©1.Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-821 ~ a x ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date or Beam after tz-12-s21 ~ 5. Federal Estate Tax Retum Required c=i d ~ ®6. Decedent Died Testate (Attach copy or will) ~ 7. Decedent Maintained a Living Trust iAtlach copy of trust) _ 8. Total Number of Safe Deposit Boxes a a ~ 9. Litigation Proceeds Received ~ 1 O. SpOUSaI POVerfy Credlt (date of deam between 12.31-91 and 1.1-951 ~ 11. Election to tax under Sec. 9113(A) (Adach Sch of W NAME °z MARCUS A. McKNIGHT III y FIRM NAME (If Applicable) ~ IRWIN 8~ McKNiGHT ~ TELEPHONE NUMBER d v ,---~ - -- ---- COMPLETE MA{LING ADDRESS 60 WEST POMFRET STREET CARLISLE Z QH J F- a Q V W PA 1701; 1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporafion, Partnership or Sole-Proprietorship (3) 4. Mortgages 8 Notes Receivable (Schedule D) (4) o c°x~ ± `~ -x r.•: 5. Cash, Bank j eposits & Miscellaneous Personal Property (5) ~ : _I `~' ' (Schedule E ~ .. , ~_ 7 __ 6. Jointty Owned Property (Schedule F) (6) 7 087.6 ~ ~ ~..,~ ~...r Separate BiAing Requested ~ _ `t ~' --;--`, ..., 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (7) r"•"i (Schedule G or L) -p ""~ ';~`~ :~_,? ~ 8. Total Gross Assets (total Lines 1-7) (8) G 7,087.64 9. Funeral Expenses 8 Administrative Costs (Schedule H) (9) 1,200.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 73.56 11. Total Deductions (total Lines 9 & 10) (11) 1,273.56 12. Net Value of Estate (Line 8 minus Line 11) (12) 5, 814.08 13. Charitable and Governmental Bequests/Sec 9113 Trusts for wh ich an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X (15) 0.00 ~ 16. Amount of Line 14 taxable at lineal rate 5,814.08 X .045 (16) 261.63 ~ 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 0.00 V 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax oue (19) 261.63 H ^ 20. • • ~ • • » BE SURE TO°ANSWER ALL'QUESTIONS ON REVERSE SIDE AND RECHECK'MATH ;< < - (14) 5,814.08 Decedent's Complete Address: STREET ADDRESS 1069 ALLENDALE ROAD CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: t. Tax Due (Page 1 Line 19) 2. Credits~Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 13.08 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 261.63 Total Credits (A + B + C) (2) 13.08 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. (3) 0.00 (4) 0.00 (5) 248.55 (5A) Enter the total of Line 5 +SA. This is the BALANCE DUE. (5B) 248.55 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 : ........................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income : ........................................ ^ ^X c. retain a reversionary interest; or ...................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ............................................................. ^ X^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................... ^ ^X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... ^ 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 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 th the personal representati is based on all inf lion of which preparer has any knowledge. SIGNATURE O~SO RESPONSIBLE FO ILING RETU DATE ,., --~ I ~ Cam` ~ /-~}ac/ -~ .3 O O ~' ADDRESS 108 HOLLY D E MECHANI~SBURG ~ PA 17055 SIGNATURE OF P PgR~R OTHER THAN.RE~ESF,~QT~TIVE DATE ADDRESS ~0 WEST POMFRET STRE~'I`~ CARLISLE PA 17013 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. §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 0% [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 0% [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 4.5%, 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 12% [72 P.S. §9116(a)(1.3)]. Asibling 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-1509 EX + (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 1APADAT ANUICA 21 08 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ~ ADDRESS (RELATIONSHIP TO DECEDENT A. l IBERIU LAF'ADAT 108 HOLLY DRIVE MECHANICSBURG, PA 17055 13 KATARINA LAPADAT C JOINTLY-OWNED PROPERTY: 108 HOLLY DRIVE MECHANICSBURG, PA 17055 SON DAUGHTER-IN-LAW ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 07/05 MEMBERS 1ST FEDERAL CREDIT UNION 16,477.78 33.3 5,487.10 CERTIFICATE OF DEPOSIT #267376-40 2. A/B 12/06 MEMBERS 1ST FEDERAL CREDIT UNION 3,379.63 33.3 1,125.42 CERTIFICATE OF DEPOSIT #267376-41 3. B 07/05 MEMBERS 1ST FEDERAL CREDIT UNION 345.72 50. 172.86 SAVINGS ACCOUNT #267376-00 4. B 07/05 MEMBERS 1ST FEDERAL CREDIT UNION 604.51 50. 302.26 CHECKING ACCOUNT #267376-11 TOTAL (Also enter on line 6, Recapitulation) 1 $ 7 087 64 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER LAPADAT AN U I CA 21 08 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS FUNERAL HOME 260.00 B. ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: y, AttomeyFees IRWIN & McKNIGHT 3. Family Exemption: (If decedenPs address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5 Accountant's Fees PATRICIA A. ROSENDALE, CPA TAX PREPARATION 6. Tax Return Preparer's Fees 7. I REGISTER OF WILLS -FILING FEE 750.00 175.00 15.00 TOTAL (Also enter on line 9, Recapitulation) I $ 1 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (g_98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN OF SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER PP&L -ELECTRIC DESCRIPTION VALUE AT DATE OF DEATH 73.56 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (osni SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE 7AX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2]] 1. TIBERIU LAPADAT Lineal 5,814.08 108 HOLLY DRIVE JOINT ACCOUNTS & MECHANICSBURG, PA 17055 1/2 RESIDUAL -NONE 2. KATARINA LAPADAT Lineal 108 HOLLY DRIVE JOINT ACCOUNTS MECHANICSBURG, PA 17055 3. EFROZINA MATEJ Lineal 9118 W. KERRY LANE 1/2 RESIDUAL -NONE PIORIA, AZ 85382 _ I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON L1NES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 91.13 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -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) LAST WILL AND TESTAMENT I ANUICA LAPADAT, of Upper Allen Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. ONE: I direct my Executor to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. TWO: I specifically give, devise and bequeath the sum of Ten Thousand and no/100 ($10,000.00) to my daughter, EFROZINA MATEJ if she has not yet received it from the sale of my real estate located in Upper Allen Township, at 404 Mount Allen Drive, Mechanicsburg, Pennsylvania 17055. The balance of the proceeds from the sale of my real estate I specifically give, devise and bequeath to my son, TIBERIU LAPADAT, JR. THREE: All the rest, residue, and remainder of my estate of every nature and wherever situate, I give, devise, and bequeath to my son, TIBERIU LAPADAT, JR., and my daughter, EFROZINA MATEJ, in equal shares, per stirpes. ,If one of my children has predeceased me, the share of said deceased child will be distributed equally to the living issue of said child. FOUR: I appoint my husband, TIBERIU LAPADAT, JR., to be the Executor of this my Last Will. If he has predeceased me, failed to qualify, or ceased to serve as Executor, I appoint my daughter-in-law, KA.TARINA LAPADAT, Executrix of this my Last Will. 8'/~~ FIVE: My Executor may, at his discretion, compromise claims, borrow money, retain property for such length of time as he may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he may deem proper; and invest estate property and income without restriction to legal investments. SIX: No Executor, acting hereunder shall be required to post bond or enter security in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 15th day of December 2005. ~'~ ~~ 'L~i~~.~ r ~.~^~~''G~~ (SEAL) ANUICA LAPAD T Signed, sealed, published and declared by ANUICA LAPADAT, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other have subscribed our names as witnesses hereto. ~~ , ' `^' f I/. ~,,. ~ ^/' ~ !~"~ . z ~/3 ~ ACKNOWLEDGMENT AND AFFIDAVIT WE, ANUICA LAPADAT, KAREN S. NOEL and CHERYL L. CLELAND, the testatrix and witnesses respectively, whose names are signed to the 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 that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein 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 their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. :~- ANUICA LAPADA~- r , _.. _. , l r KAREN~S. NOEL ' ` ~ F~ CHERYL- .CLELAND COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS: Subscribed, sworn to and acknowledged before me by ANUICA LAPADAT, the testatrix herein, and subscribed and sworn tP before me by KAREN S. NOEL and CHERYL L. CLELAND, witnesses, this v 'day of ~,~ C~.r3r~lf~:',~, 2005. ,, ,.-, :...j COMMONVYEALTIi OF PENNSYLVANIA '~ i C..._.......~ ~~ j No~xlal Seal ~~ Marllta L. Noel. Ntxacy Ptrt~c y ~ ~'~ ' , Carlisle aao, cum>~+and Cotxtly Notay,¢ Public My Commission F,.~cpinas Sept 18. ZUf)7 ~, __ Member, Pannsyw8nia ;lssociatian pf Notaries kL3y St MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 267376-00 Date Account Established 07/05/2005 Principal Balance at Date of Death $345 58 Accrued Interest to Date of Death . $.14 Total Principal and Accrued Interest $345 72 Name of Joint Owner . Katarina Lapadat Date Joint Ownership Established 07/05/2005 CHECKING ACCOUNT: Account Number/ Suffix 267376-11 Date Account Established 07/05/2005 Principal Balance at Date of Death $604 51 Accrued Interest to Date of Death . $ 00 Total Principal and Accrued Interest . $604 51 Name of Joint Owner . Katarina Lapadat Date Joint Ownership Established 07/05/2005 CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established 267376-40 267376-41 Principal Balance at Date of Death 12/26/2006 $16 432 56 12/26/2006* Accrued Interest to Date of Death , . $45 22 $3,374.44 Total Principal and Accrued Interest . $16,477.78 $5 19 $3 379 63 Name of Joint Owner Katarina Lapadat , . Katarina Lapadat Date Joint Ownership Established Tiberiu Lapadat 12/26/2006 Tiberiu Lapadat 12/26/2006 *Purchased by transfer of funds from 267376-00. M MBERS1STF~ ERA CRED~NION ~ ~ ry~ Daniel e A~ine Insurance Services Specialist April 30, 2008 Estate of: ANUICA LAPADAT Date of Death: 04/16/2008 Social Security Number: 114-46-1954 5000 Louise Drive PCB. 130 4fl Mechanicsburg, Pennsylvania 170~~ (~3QO) ?}~3_~3~g ~~-~~-w.iiiemberslst.org