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Home My WebLink About07-15-09~ REV-1500 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box.28osoi INHERITANCE TAX RETURN 2 1 0 9 0 3 0 2 Harrisburg, PA 17128-0601 y - RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 438201841 03252006 09201924 Decedent's Last Name Suffix Decedent's First Name MI GIORGIO JR. CARMELO B (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 ® 1. Original Retum ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (dale of death after 12-12-t32) 0 ® g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes - ^ 9. Litigation Proceeds Received ^ 1p. Spousal Poverty Credit (date of death 11,Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) ^ (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number CRAIG A. DIEHL, ESQUIRE, CPA 7177637613 Firm Name (If Applicable) LAW OFFICES OF CRAIG A. DIEHL First line of address 3464 TRINDLE ROAD Second line of address City or Post Office CAMP HILL State ZIP Code REGISTER WILLS US~NLY i - a r,. rn _.._ t- ~' ':z7 Ul - ~ } - v~7: C . . nC~<7 -i7 ~ _t ~ _..~~ ~ ~ ~7 N DA'L FHLED °~ - ~~ -k? r`1 .~ =~,-? ,~. C..J C. -- `1+ ~'~ e::> -r• r PA 17011-4436 Correspondent'se-mail address: cdiehl@Cadl'ehllaW.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, corr and complete. Decl ration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE PERSON RESPON FOR F I G RET RN UATE ~~,~ _ ~~, Suzanne G. Bonhage ~ - ~~ ~ f 1020 Tiverton Road, Mechanicsburg, PA 17050 SIGNATURE OF PREPARER ER N RE ESENTATIVE DATE Craig A. Diehl, Esquire, CPA ADDRESS 3464 Trindle Road, Camp Hill, PA 17011-4436 Side 1 1505607120 1505607120 J J 1505607220 REV-1500 EX Decedent's Social Security Number oB~eaer,rs Name G I O R G I O, C A R M E L O B. J R. 4 3 8 2 0 18 4 1 RE CAPITULATION 1. Real Estate (Schedule A) ......................................................................................... . 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 15,121.85 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 38,466.43 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 6 1 4 7 4 (Schedule G) ^ Separate Billing Requested ............. 7, . 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 5 4, 2 0 3 0 2 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 5,359.74 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 14,436.86 11. Total Deductions (total Lines 9& 10) ...................................................................... 11. 1 9. 7 9 6. 6 0 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 3 4 , 4 0 6 . 4 2 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. 3 4 , 4 0 6 4 2 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 .00 15. 16. Amount of Line 14 taxable 3 4, 4 0 6 4 2 at lineal rate X .045 16. 1, 5 4 8 2 9 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..................................................................................................................... 19. 1, 5 4 8 2 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 0302 DE D NT' M Giorgio, Carmelo B. Jr. STREET ADDRESS 1020 Tiverton Road CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 1 ,548.29 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Total Credits (A + B + C) InteresUPenalty if applicable (2) 0.0 0 p, Interest E. Penalty Total InteresUPenalty (D + E) (3) 0.0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 1 , 548.2 9 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~ , 5 4 8.2 9 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 :.................................................................................. ^ b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. ^ 0 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? ....................................................................................................................... ^ I X 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? ...................................................................................................................... ^ 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 exemot 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)j. 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS FILE NUMBER ESTATE OF GlOrglO, Carmelo B. Jr. 21 - 09 - 0302 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1 ~ Citigroup Global Markets -Investment Account UNIT VALUE VALUE AT DATE OF DEATH 15121.85 15,121.85 TOTAL (Also enter on line 2, Recapitulation) ~ 15,121.85 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF GlOrglO, Carmelo B. Jr. 21 - 09 - 0302 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 BellSouth -Spousal Benefit 32,025.96 2 Prudential Financial -Investment Account 3,400.00 3 Cendant -Class Action Settlement 2,048.91 4 Cendant -Class Action Settlement 991.56 TOTAL (Also enter on Line 5, Recapitulation) I 38,466.43 COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Giorgio, Carmelo B. Jr. FILE NUMBER 21 - 09 - 0302 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY Include the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed for real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 i ~ ~ i I PNC Checking Account I 614.74 ~ 100% ~ I I i 614.74 i TOTAL (Also enter on line 7, Recapitulation) ~ 614.74 SCHml1LE H FUNERAL EXPOVSES & COMMONWEALTH OF PENNSYLVANIA '~+ ~/~ n /~ /'-/'~~+~+ INHERITANCE TAx RETURN ~Nh7~ IY1T'IYG l!W 1 J RESIDENT DECEDENT ESTATE OF Giorgio, Carmelo B. Jr. FILE NUMBER 21 - 09 - 0302 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT -~---_ - A. 1 2 3 4 5 B. 1. 2. 3. Kimmel Funeral Home -Funeral Expenses Times Picayune Obituary -Obituary Costs Impestato's Restaurant -Memorial Dinner ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Law Offices of Craig A. Diehl Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 982.00 221.76 1,400.00 2, 000.00 Street Address City State Zip Relationship of Claimant to Decedent a. Probate Fees Register of Wills, Cumberland County 177.00 i 5. ! Accountant's Fees I I 6. ~ Tax Return Preparer's Fees 7, Other Administrative Costs 1 Law Offices of Craig A. Diehl -Reimbursement of certified mail coast for PA DPW i 5.32 letter I TOTAL (Also enter on line 9 Reca itulation P ) 5,359.74 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H Funeral F~enses & /~,,~,,,,,~ /+~,,~,~ ,,,.,,~~,„ fWl l Nn ~+lJpp (+VI ~W ~~ FILE NUMBER ESTATE OF Giorgio, Carmelo B. Jr. 21 - 09 - 0302 2 Cumberland Law Journal -Estate Advertisement 75.00 3 Fenstermacher & Associates -Attorney Fees 265.50 4 The Sentinel -Estate Advertisement 198.16 5 Register of Wills, Cumberland County -Filing Fee for Pennsylvania Inheritance Tax 15.00 Return 6 Register of Wllls, Cumberland County -Filing Fee for Family Settlement Agreement 20.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN f RESIDENT DECEDENT FILE NUMBER ESTATE OF GlOrglO, Carmelo B. Jr. 21 - 09 - 0302 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Andrews & Patel -Physician Bill 16.66 2 East Jefferson Hospital -Medical Bill 200.00 3 Dr. Angelo Russo -Physician Bill 2,126.97 4 Infectious Disease Associates -Medical Bill 154.62 5 Ochsner Clinic LLC -Physician Bifl 49.24 6 Radiology & Interventional -Medical Bill 8.24 7 AARP Credit Card Services -Credit Card Bill 2,335.55 8 Cardiovascular Specialists -Physician Bill 29.58 9 US Treasury - 2005 Federal Income Tax Liability 553.00 10 US Treasury - 2006 Federal Income Tax Liability 3,963.00 11 Robert Bonhage -Payment of Personal Loan 5,000.00 I TOTAL (Also enter on Line 10, Recapitulation) ~ 14,436.86 REV-1513 EX+ (9-00) ~ ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Giorgio; Carmelo B. Jr. FILE NUMBER 21 - 09 - 0302 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not List Trusteels) I, TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1 Suzanne G. Bonhage Daughter 1/3 of Residue 1020 Tiverton Road Mechanicsburg, PA 17050 2 ~ Saundra G. Pearson Daughter 1/3 of Residue 1176 St. Anthony Street Slidell, LA 70460 3 Wayne B. Giorgio Son 1/3 of Residue 149 Portland Ave., Apt. 105 Dover, NH 03820 Enter dollar amounts for distributions shown above on lines 1 5 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 i I I I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00