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Home My WebLink About09-25-08 (2)i 15056051058 -'a REV-1500 ~ (U6-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosol 21 08 0430 Harrisburg, PA 171280601 RESIDENT DECEDENT ENTER DECEDENT INFORMATNaN BELOW Social Security Number Date of Death Date of Birth 133-24-1996 09/10/2007 07/10/1931 Decedent's Last Name Kosier Suffix Decedent's First Name Rose (If Appllcable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL tN APPROPRIATE OVALS BELOW ~ 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WRH THE REGISTER OF WILLS MI P MI 2. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) ~ 6. Decedent Died Testate ~ 7. Decadent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-t-95) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFI Name Julia Foley Firm Name (If Applicable) First line of address 1970 Enola Road Second line of address City or Post Office Carlisle 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) DENTU-L TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number (717) 249107 State ZIP Code PA 17013 Correspondent's e-mail address: stonehousefarm@embargmail.com REGISTE~F WILLS US~NLY c ~s C ~ ~ j " i = "_-~-~, --- C7 - Cn ~ -p r-- ,•: . ~ _.. N - - __ ~..J ,::-- ~ r ~ _- -.tT _:.~ Q~fid FILED t~ ~. ~.! Under penaltles of perjury, l declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, R is true, correct and complete. Declaration of p parer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA P'RSON R LSPONSIBL R F~ R/~ N ~~ATE / OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV 1500 EX Decedents Social Security Number ROSe P Kosier 133-24-1996 Decedent's Name: RECAPITULATION 1. Real estate (Schedule A) ............................................ . 1. 2. Stocks and Bonds (Schedule B) ...................................... . 2. 3. Closely Hekl Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................ . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Properly (Schedule E) ....... . 5. 8,000.00 6. Jointly Owned Property (Schedule F) Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property d 7 37 197 745 ....... (Schedule G) Separate Billing Requeste . . , . 8. Total Gross Assets (total Lines 1-7) ................................... . 8. 205,745.37 9. Funeral Expenses & Administrative Costs (Schedule H) .................... . 9. 31,329.60 10. Debts of Decedent, Mortgage Liabilities, ~ Liens (Schedule I) ............... . 10. 5,746.00 11. Total Deductions (total Lines 9 8 10) .................................. . 11. 37,075.60 12. Net Value of Estate (Line 8 minus Line 11) ............................. . 12. 168,669.77 13. Charitable and Governmental Bequests/Sec 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. 168,669.77 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable 168,669.77 18 25,300.46 at collateral rate X .15 . 19. TAX DUE ....................................................... .. 19. 25,300.46 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 17rar_prlpnt'c Cemnlete Address: F11e Number 21 08 0430 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Rose P Koster 133-24-1996 STREET ADDRESS 907 Derbyshire Ave. clrY Mechanicsburg srArE PA zIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 25,300.46 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 2,500.00 C. Discount Total Credits (A+ B + C) (2) 2,500.00 3. InteresUPenalty if applicable 310.36 D. Interest E. Penalty 0.00 Total InteresUPenalty (D + E) (3) 310.36 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) 22,800.46 A. Enter the interest on the tax due. (5A) 310.36 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 23,110.82 Make Check Payable fo: REGISTER OF WILLS, AGENT ~~~~~z ~~'~~ 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 :.......................................................................................... ^ b. retain 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 hank acxount 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? ........................................................................................................................ ~ ^ 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 decedents lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) p2 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)]. Asibling isdefined, 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+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Rose P. Kosier 21 08 0430 indude the proceeds of litigation and the date the proceeds were received by the estate. All properly jointlyowned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (B-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Rose P. Kosier 21 08 0430 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBE DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACHA COPY aF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET 96 OF DECD'S INTEREST EXCLUSION pFAPPLICABLE) TAXABLE VALUE ~~ Home - 907 Derbyshire Ave, Mechanicsburg, PA 17055 (Sold $197,770.26 106,088.37 100 106,088.37 less mtg payoff and dosing costs of $91,681.89) 0 2 Kosier Living Trust checking acct 51-40159286 2,057.00 100 2,057.00 3 Kosier Living Trust money market 50 03634052 36,504.00 100 36,504.00 4. Prudential Annuity E0221600 53,096.00 100 53,096.00 TOTAL (Also enter on line 7 Recapitulation) s I 197,745.37 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) SCNEp1~LE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8c INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER 21 08 0430 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Maopezzi Funeral Home 3,522.00 2 Jeffery's Flowers 301.00 s St. Joseph's Church, Mechanicsburg 200.00 a Indiantown Gap Community Center -funeral luncheon 736.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) .fUlla FOley Soaal Security Numbers}IEIN Number of Personal Representative(s) _ Street Address 1970 Enola Road c;ry Carlisle state PA rp 17013 15,840.00 Year(s) Commission Paid: 2008 2. Attorney Fees 4,800.00 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Sheet Address City State Zip Relationship of Claimant to Decedent 4, Probate Fees 381.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 300.00 7. Postage 64.00 a Foley -mileage reimbursement 2,091.00 s Foley -clean out house, prepare for sale, reimburse for refuse removal 900.00 1o Lawn mowing, edging, snow removal 645.00 11 Home repairs, garage door and electrical outlet replacement 1,308.00 12 Advertising Sentinel (166.60) Cumberland Law Journal (75) 241.60 TOTAL (Also enter on line 9, Recapitulation) ; 31,329.60 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) SCNEp1~LE 1 coMMONwEarH of PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE 1,IABILITIES, ~ l1ENS RESIDENT DECEDENT -. ESTATE OF FILE NUMBER 21 08 0430 Report debts incurred by the decederrt prior to death which remained unpaid as of the date of death, including unreimbureed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t~ Medical (Personal Care $321) Central PA Hematology ($85) Quest Labs ($62) Hospice Rx ($91) 559.00 2 2007 Final Income Taxes paid 603.00 3. PPL electric from DOD until house sold 754.00 4 United water from DOD until house sold 158.00 5. York Waste Refuse Removal ($107) + final disposition by Schilds ($250) 357.00 6 Property Taxes -Marlin Yohn, Mechanicsburg 2,395.00 7 Upper Allen Township Sewer Asssement 651.00 8 Comcast final bill 50.00 9 Citicard final bill 70.00 10 Erie Homeowners Insurance ($373 paid - $224 refund when house sold) 149.00 TOTAL (Also enter on line 10, Recapitulation) ; I 5,746.00 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) J SCHEDULE COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trusteets) OF ESTATE I TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)1 Kosier Living Trust, (Dated 02l02I05) Sean Kosier and Shannon Kosier 115573.77 Pervamik Trustees. Shannon Pevamik, 719 Allenview Drive Mechanicsburg, PA 17055 (annt~ collateral 26548.00 Sean Kosier, PO Box 135, Lewisberry PA 17339 (annuity beneficiary) collateral 26548.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THRO UGH 18, AS APPROPRIATE, ON RE V-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ( s (If more space is needed, insert additional sheets of the same size)