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Home My WebLink About08-05-09.. ~• 15056051058 REV-1500 Fx (os-05, FI IA U E f OF C L S O PADep~9neldoFReversle County Code Year dhdNMtrelTaxes INHERITANCE TAX RETURN il~arml RESIDENT DECEDENT n/~ /~ Ot / V Soda! 3ecuttty Number Date of [)Beth .. Date of Birth 152-12-1321 ' 10/30/2008 03/30!1921 _- DecedeM's Lent Nerve ~ ~ ~ SuNlx Decedent's First Name _. _ _._ deGomar Ruth (If Appllwbls)EnM StlrvtvMp Spouse's InFOrmaNon Below Spouse's Last Name SuSbl Spouee'e.Flret Name„ _. _ _ ,.. Spouse's Sodel Security Number THNI RETURN IMUST BE FlLED IN DUPLICATE WITH THE REGISTER OF WILLS FlLL INAPPROPRIATE OVALS aELOW ~ 1. Original Return 2. Supp'smentel Return 3. Remelnder Relum (date of d prior to 12-13A2) 4. Limked Fatale 4e. FuWre Intareat Comptomlae (dated 5. Federel Estate Tex Return R tleeth after l2-72.82) ' 8. Decedent Dlad Testate 7. Decedent Melntalned a Cluing Tiuat ..... ....._. 8. Total Number of 8afa Defoe (Attach Copy of WIII) (Attach Copy of Trust) 9. LNDaSon Proceeds Rer:elved 10. Spousal Poverty Credit (date of death 11. Elecdon to ten under Sec. 81 between 12-31.07 and 1-1-96) (Attach Sch. O) CORRESPONDENT - 1X18 SECTION IWBT BE COMPLETED. ALL fbRREBPONDENCE AND CONFlDENTIAL TA7t INFORMATION 8FWULD BE DIREf Name ' John S Kostukovk:h, CPA __. Flnn Name (If Applicable) John S Kostukovich, CPA Fist Tine of address 3900 Trind{e Road Second Ilne of address CNy or Post pNice Camp Hill DayBme Teleplwne Number (717) 730-0820 _... REOKTER OF NNLLS U8E 1 I v State ZIP Code PA 17011 n C~ r~ ' ~ 'LJ i ~C~ ?> r- Zm1 ,,~,,~,~ c~~~`~n r> C :1> MI E MI N 0 .n i-r~, ;._ ~ p. ~i"n C t~~~0 ' t Sri' i i tit ~ ~ '~ ~~. ,.~ -'p , 3 '' N ~ '=r-I Correspondent's e-mail Bddre4s: JbRtiYA(QjCnOlt~OnBmaII.COm ~.a Under penaitlw d per)ury, I dedaro that I have eulemirred Sae return, Indu~nS eccomparrylnp edredulas and stetemenb, and io the beet d my ImowledSe a ballet, tt N in10. CtnroCt end CprIp101B. DedereBOn Of properer other tlWll the personal roprowdetlue k beMd on W Infottnatlon d vdNch properer has arty FOR FlLING RETURN ~a705 lTt)n°a1+a~ C~ /~/~9-,r?,Q/~eu.c~ ~ /7//D - N SIGt1ATURE (~ PREPARER OTHER REPRE3FMATNE DATE 15056051058 Side 1 15056051058 i ~ ed~ ~ r (~r'o b . .. c~~s_ ~ ~nVplce~5'IY a~ $-5-c~9 ~. J 15056052059 REV-lsoo Ex Decedents Name: Ruth ~cnPrcuunoN E deGomar 1. Reel estate (Schedule A) ........ . .................................... 1. 2. Stocks and Gorda (Sdredule B) ....................................... 2. 3. Ckrsety Held CwPeraBOn, PeMership or Sol~Propdetoratdp (Schedule C) ... , . 3. Decedent's 3oclel 3etxxlty 152-12-1321 4. Morlpages & Notes Receivable (Schedule D) .......................... ... 4. 5. Cash, Bank Deposks $ Mbcelleneous PeBOnel Property (Schedule E) ..... ... 5. 61, 12.00 8. Jaindy Oamed Property (Schedule F) Separate BIIIing Requested .... ... 8. 7. Inter-Vivoa Trensfers 8 MlaceNeneoue NorrProbete Property (Schedule G) 3eperete Billing Requested..... ... 7. 8. Total Oross Assets (total Linea 1-7) ................................. ... B. 81, 2.00 , 9. Funeral Expenses & Adminiatretlve Costa (Schedule H) .................. ... 9. 5,4 3.00 10. Debts or oeoedem, Mtxtgage uabgroee, a Liens (scneame I) ............. ... to. 10,4 9.00 11. Total pWuetlons (total L'mes 9 8 10) ..... . .............. . .......... .... 11. 15,9 2.00 , 12. Nat Yaws of Eatap (lJne S minus Line ti) ............... . .......... .... 12.. 45,0 0.00 13. Charitable and Govemmen equ rusts for which an ekie8on to tax has rxx been made (Schedule J) .................... .... 73. , 14. Nst Valw Sub1eG to Tax (Line 12 minus Line 13) .................... .... 14. 45,0 0.00 ; TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at 8ie spousal tax rate, or _... ....... ... _ ...... _.. uandets under Sec. 9118 ...... _. (a)(tz) x .off ts. 2,0 .25 18. Anaunt of Lkre 141axable at Nneal rata X .0 _ - 18. 1T. Amount of Lkre 141exeble at sibling rata X .i2 : 17. 18. Amount of LNre 141exable '. ' at collaQeral tale X .15 18. 19. TAX DUE ................... . ................................. .... 19. 2,02 .25 20. FILL IN THE OVAL IF YOU ARE REQUE8TING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 I.. 15056052059 REV-1600 EX Pepe 3 DeCedertt's Com s Ruth $TREETADDRESS 2705 Gateway Ct Address: E deGomar Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Cred'ASIPeyments A. Spousal Poverty Credit B. Pda Payments C. Dacoum FW Number DECEOENrs socuL sECURm NubaE =_ _ _-~-152- 2-1321 STATE LP PA 1711 (1) 2,027.25 raalcred~e(A+e+c) (a) 3. IntereaUPerrelty if app{kable D. Ingest `__ E. Penalty -__.---- Total IrrMrestlPerrefty (D + E) (3) 4. If Line 2 h greater than Line 1 + Wre 3, order the diference. Thla le the OVERPAYMENT. Fllt M oval on Page Z. LJm as to roqueat a refund. (4) 5. If Line 1 + Line 3 k greater then Lkra 2, enter the difference. TMa is the TAX DUE. (5) 2,027.25 A Enter the interest on the tax due. (~) B. Enter the total of Line 5 + 5A This la the BALMICE DUE. (5B) 2,027.25 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE 1. Dld decedent rrreke a transfer and: Yee No a. retain the u~ or Inwme of the property transferred :.................................................................................. ........ ^ h. rsfdn the dght b designate who shah use the property transferred or its Income :.................................... ........ ^ c. retain a raversbnary interest w .................................................................................................................. ........ ^ d, rerehre dre promise fa gfe of efther payments, beneftta or care7 .............................................................. ........ ^ 2. If deaM ocdrrred after December 12,1982, did decedent transfer properly wkhln one year of death without receh4ng adequate coneideratbn7 ...................................................................................................... ........ ^ 3. Did decedent own an'M wet for" w payable upon death bank acwunt a aeardty at his w her d~th? ...... ........ ^ 4. Did decedent avn an Individual Retrrement Accarnt annuity, or other non-probate property which canteins a bene8cier/ desigrretkm7 ................................................................................................................ ........ ^ IF THE ANSYYER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FU.E R AS PART OF TINE RETURN. For dales of death on w after Juty 1,1994 and before January 1,1995, the tax refs imposed on the rret value of transfers to w for the use of the rvh4ng spouse is three (3) percent ]72 P.S. §9116 (a) (1.1) (I)]. For dates of death an w after Jarwary 1,1995, the lax rate imposed on the net value of transfers to w for the use of the survivirg spouse Is (0) percent ry use Iran tax, and the stahrtory requirements for disdosu d l a~ ere tl t U ~ d assets and a 8ceble even H the surviving spouse is the only benefl retru r s l ng a Fw dates of death an w after Juty 1, 2000: The tax rate imposed on the net value of trenefere from a deceased chgd twenty-one years of age w younger at death to or fw the use of a n rat parent an adopthre parent ar a stepparent of the child Is zero (0) percent (72 P.S. §9116(a)(t2)]. The tax rate Imposed an the net value of transfers to w fir the use of the derxident's lineal beneftdariea is four and one-haH (4S) peR;eM, ex as noted in 72 P.S. §9118(12) (72 P.S. §9116(e)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's sibNngs is tvreNe (12) percent [72 P.S. §9116(e)(1.3)]. Asibling is nod, under Section 9102, as an IndNidlral who has at least one parent In common with the decedent, vdudher by blood w adoption. REV-1608 FJ(+ (B_98) scNSODU ~ COMMONNIEALTH OF PENNSYLVANIA C~Hr B~K ~~5~~ & M~.~i. INHERRANCE TAX RETURN ~~~ ~0~•~ RESIDENT DECEDEM EBTATE OF FILE NU ER Ruth deGomar Indude the proceeds M tltlpetlan end the date the pmceede were recdved q' the eetete. All property )olMlyowlled with dpht of eurvlvonhlp Inwt W dpdaed on aeheduM F. f1EM NUMBER DESCRIPTION VALU OF AT DATE EATH 1 Sovereign Bank 9,081.00 2 M 8 T Bank 1,931.00 TOTAL (Also enter on line 5, Recepituletlon) S 61, 12.00 (n more space is neeikd, insert etldltlonW sheets M the same she) REY-1511 EX+(t29a) CpMMDNwEALTN OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Ruth deGomar scN~ouu x FUNERAL EXPENSES & ADMINIS1RATNE COSTS Dabb of daadsnt moat M roporbd an &hMuN L U A. FUNERALEXPE t' Auer Memodal s, ADMINISTRATIVE COSTS: 1. Personal Reprerontetlve'c CaNdaefau Name of Perediel Repreaentatlw(s) 3odel aewdty Number(s)lEIN Number of Personal Repreeenmave(ej SheetAddrese (qty . State Year(s) Camnisebn Peld: 2. Aaarey Fees 3. FemNy Exempdan: pt decedent's address U not Nre same ee delmem'a, eNech explanatlan) Clalmenl SbeetAddroee City State Relelbnahip d Gabnent U Decedent 4. Probate Fees 5. AocawtanYs Fees 6. Tax Realm Preperer's Fees T. Register of ~Ils a Cumberland LawJoumal a PatriDt News TOTAL (Also solar on Iine 8, Recapitulation) I S (N more specs le needed, ineed eddlUOnal sheets of dre same ehs) Zip LP 920.00 .00 250.00 132.00 75.00 195.00 REV4512 EX+ (12.08) Pennsylvania SCHEDULE I UEPRernENT OF eEYENUE DEBTS OF DECEDENTr n+"~T~T"X'a"'w+ MORTGAGE LIABILITIES 81 LIENS aestoeuroerEOear ESTATE OF FILE NUMBER Ruth deGomar Report debts Ineumd hY the decadaM pNor to death tlut remained unpaid at the data of deaYtli, indudlnp unrolmbwead nedkal ~ nw. 1• Country Meadows 2 US Treasury 3 M & T Bank Service Fees 4 Sovereign Bank Service fees 5 Storage Depot e Miscell~eous tees 7 Veterans Administratlan 40.00 40.00 150.00 98.00 TOTAL (Nso enter on Llne 10, Recapltulatlon) I; more space is needed, Insert additional sheets of the same sin. ' ~ ~ REV~1513 E%i (11-08) pennsytvania OE4MITMENT OF PEVlNUE aalEairuHf TAx aETww aESmEUr cerEOe+r SCHEDULE 7 BENEFICIARIES Ruth deGomar PILe RELATIONSHIP TO DECEDENT AMOUNT R SHARE NUMBER NAME AND ADDRESS OF PERSON{S} RECEIVING PROPERTY Do Not Uet Truaha(s) OF ATE I TAXABLE DLSTRiBtR[ONS [lndude outh9bt spousal distrlbutlons and transfers under Sec. 9116 (a) (1.2).j 1. Robert C dFiGomar, 2705 Gateway Ct, Hardsburg, PA 17110 Son 75°b 2 Theodore J deGornar,1304 N.E. 16 Tetr, Apt , Ft Lauderdale, FL 33304 Son 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES SS THROUG H 18 OF REV-3500 COVER SHEET, A S APPROPRIATE. II NONdAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECRON 9113 FOR WNICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON TA7fABlE DLSTRIBItRONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space Is needed, Insed additional sheets of the same size. 0 ~Ss cA s rn r~ r :a c~ Z ~~ °o ~~ ~~ ~ o ~ ~ M O J ~, ~ a e ~ ~ ~' a /!ti_ ~1 w < 2 q \~' ~js\ ~n~7 a Y ~Y ~. ~'" ~ ~ ``~ ~ -:, ~ ~ `~ ~ ~ ° 4 ~.. ~~ ~ ~' ~ ~. ~ ~ ~ ._ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~- ~~ ~