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Home My WebLink About06-05-08 (2)J 15056051058 REV-~ SOO Ex (06-05) OFFICIAL USE ONLY PA DepaMlerlt of Revenue Bureau of Individual Taxes County Code Year File Number Po BDx 280801 INHERITANCE TAX RETURN ~S ~~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ 1 4 ~ b ENTER DECEDENT INFORMATN)N BELOW Social Security Number Date of Deatfi Date ~ Birth 187-44-8192 11 /09/2007 12/14/1961 Decedent's Last Name Suffix Decedent's First Name MI Gobantes Richardo ~ (H Appllpble) Eller Survhrin® Spouse's Informatlon Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE YVITFI THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum 2. Supplemental Retum 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Pmoeeds Received 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. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name DayOme Telephone Number Tonia M. Richardson (717) 346-1078 Firm Name (tf Applicable) N/A REGISTER OF WILLS USE Ok C~ First line of address ~ ~ [J ~' ~ 327 W. North Street ~ ~ m oo m Second line of address 7 ~ ~ ~ ~ ~ ~00 p~O~~n Criy Or POSt Office Stat@ ZIP Code DATE FILED ~ ~ ~ ~y Carlisle PA 17013 '' ~ ~ correspondents a-mall address: T-Jrichardson~comcast.net Under penalt~s of perjury, 1 dedere that 1 have examined this return, Including accompanying schedules and statements, and to the best of my knowledge era belief it is true, coned and complete. Dedaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIE OF PERS ~ NSI LE FOR FILING RETURN /uc_~// DATE iir2~.~.~ ~_..~--------.. 06/05/08 327 W. North Street, Carlisle, PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE AUUKlSS PLEA8E UsE ORNNNAL FORM ONLY Side 1 15056051058 15056051058 REV-1500 EX Page 3 Decedent's Complete Address: Flk Number DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Richardo J Gobantes 187-44-8192 STREETADDRESS 459 John Mitchell Road CITY Youngsville STATE NC ZIP 27596 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 4,743.00 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + g + C) (2) 0.00 3. InteresUPenalty ff applicable D. Interest E. Penalty Total IMerestlPenalty (D + E) (3) 0.00 4. If line 2 is greater than Line 1 + Line 3, enter the drfference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Uri 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,743.00 A. Enter the interest on the tart due. (5A) [3. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 4,743.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did deoederrt make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shall use fire property transferred or its income : ........................................... ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the pronrise for life of either paymerds, benefits or care? ...................................................................... ^ 2. ff 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" ~ payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an In~vidual Retirement Account, annuity, or other non-probate properly which contains a berraficiary desi9rration? ......................................................................................•................................. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FlLE R AS PART OF THE RETURN. For dates of death on ar after July 1,1994 and before January 1,1995, the tax rate imposed on if>e net value of transfers bo ar for the use of the surviving spouse is three (3) percent p2 P.S. §9116 (a) (1.1) (i)]. Far dates of death on ar after January 1, 1995, the tax rate imposed on the rret vahre of transfers b ar for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does rat exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stiff applicable even if the surviving spouse is the ary benefiaary. For dates of death on ar after July 1,21x10: The tax rate imposed on the net value of transfers from a deceased chid tvreniy-are years of age or younger at death to ar far the use of a natural parent, an adoptive parent, ar a stepparent of the drill is zero (0) percent [72 P.S. §9116(a)(1.2)j. The tax raise imposed on Ute net vahae of trarlsfers b ar for the use of the decedent's firreal benefiaaries is tour and are-half (4.5) percent, except as rated in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to ar for the use of the decedent's siblings is twelve (12) peroent [72 P.S. §9116(a)(1.3)j. A sit>firtg is defined, under Section 9102, as an individual who tras at least one parent in conxrron with the decedent, whettrar by blood ar adoption. 15056052059 REV-1500 EX Decedents Social Security Number Decedents Name: Richardo J Gobantes 187-448192 RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits ~ Miscellaneous Personal Property (Schedule E) ........ 5. 6. Jointy Owned Property (Schedule F) Separate Billing Requested ....... 6. 35,132.00 7. Inter-Vrvos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. 35,132.00 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ................ 10. 11. Total Deductions (total Lines 9 8 10) ................................... 11. 0.00 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 35,132.00 13. Charitable and Governmental Bequests/Sec 9113 Tnists for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 35,132.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, ar transfers under Sec. 9116 (ax1.2) X .0 0 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 16. 0.00 17. Amount of Line 14 taxable at sibling rate X .12 17,566.00 17. 2,108.00 18. Amount of line 14 taxable 17,566.00 at collateral rate X .15 18. 2,635.00 19. TAX DUE ......................................................... 19. 4,743.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDt~LE F JOINTLY OWNED PROPERTY ESTATE OF FlLE NUIIABEft M an duet was made joint wiWn one yur of the decedent's date of desth, k must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A• Tonia M Richardson 327 W. North Street, Carlisle, PA 17013 Sister B' Carla E Gobantes C. JOINTLY-OWNED PROPERTY: 7308 N. 21st Street, Philadelphia, PA 19138 Cousin ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BArM(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 DECEDENTS INTEREST t • A• 12/31/84 Joint Survivorship interest in 327 W. North Street, Carlisle, Pa 17013 105,396.00 ~(~~¢ 17,566.00 2 B 12/31/84 Joint Survivorship interest in 327 W. North Street, Carlisle, Pa 17013 105,396.00 ~~ -(~`~ 17,566.00 TOTAL (Also enter on line 6, Recapitulation) I = 35,132.00 (If more space ~ needed, insert add~ional sheets of the same site)