HomeMy WebLinkAbout08-28-09
REV-1 S00 EX (aao~
_J 15056041158
emm.~ ~~ oar
PA Depelmrl d Rwanue CeunH Cove yes FNe Numbs
surer alnmwMr Twe
Po sox 2aae01 21 08 0923
INHERITANCE TAX RETURN
Hsdeeurp, PA 171Y1L0e07 RESDENT pECEDENT
NTER DEC IN ~~
Sodel 9scMXy Number DM d DeaM Dats d BiNh
193-46-3590 07312008 01061954
Deadent'a Lent Name SufPoc Decedenth FeN Name M I
CANEVARI LORI ~
(H Applicable) ErRsr Surviving SptNftN'e ItlforrYldlon Btlbw
Spouads Leg Name Suffix $poues's Fiat Name MI
CANEVARI GILBERT d
Spouae'a Sodal Sacurfiy Number THIS RETURN MUST BE FILED M DUPLICATE MATH TFBi
_ _ RECNSTER ClF WILLS
FILL IN APPROPRNTE BO%ES BELOW
1. OriginM Return ^ 2. BupplemsMd Ratum ^ 3' pRriar to 1~2- mum (dMe d deelh
^ 4. Llmlled Eatab ^ 4e. t OomwaMee (dMe d ^ 5. Federal Fatale Tex Relum Rpuirod
F
utu%
~
12
-B
~)
^ 8. Decadent Oled Tage4e ^ 7. a LiYkq TnMt ~ 8. Total Number d Safe Deposit Bo~M
ned
Decedent MeinW
(Attach Copy d WIII)
^ lA~ CoPI d Trull)
9113(A)
S
^ 11
t
d
E
10.
^ B. Litigation Proasde ReaMed ax un
er
ec.
.
lecllon to
3pouwl Poverty Cradl (WM d daeM
between 1231.01 and 1-1A5) (Attach Sch. O)
CDRRESPDNDENi• Tleet1eC710N MIIylCOMRLTlD.ALL COItllaPON0aN0e ANDCONYIOENnAL TAX INFOWJATION SNOIILD BE pRCCTEO Tn:
Nrrls Daytime Telephone Number
ELIZABETH P• MULLAUGH 717-237-5243
Firm Name (H Applicabb) lM!
MCNEES WALLACE B NURICK LLC `°
Fiaat IMe d address ~~ rte- GC7 L =~
100 PINE STREET `~-~~ aND
-~,~
Second line d addvns ~? ~) O -p ~
t~ C7 ~ 1 7G
P•0• BOX 1166 '~~
City or Pat Office 8taM 21P Code ~~ ~ f V ' ,-,
HARRISBURG PA 171D8-1166 c
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n r Ins, correct end oomplar. Dserreeon dprepssoMSMr Me Deraenel rapreeweeYre r bred an es infemraem dwhrh PrNxxs nee any xnowlea0e.
Slde 1
15056041158 eM,e,,,~ 1505604115E J
15056041158
REV-1500 EX (OB-05) OFFICIAL USE ONLY
PA DeDanment of Revenue
Bureau of IndiNduel Taws County Code Veer Flle Number
Po Box zeoeot INHERITANCE TAX RETURN 21 08 0923
Harrisburg, PA 17123-0801 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Socal Security Number Date of Death Date of Birth
193-46-3590 07312008 01061954
Decedent's Last Name Suffix Decedent's First Name MI
CANEVARI LORI J
(if Applicable) Enter Surviving Spouse's IMormation Below
Spouse's Lest Name SuNx Spouse's First Name M I
CANEVARI GILBERT J
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
^ 1. Original Return ^ 2. Supplemental Relum ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required
^ 8.
Decedent Dled Testate
^ 7. death after 12-12-82)
Decedent Maintained a Living Trust
~ 8.
Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ ~ 1. Election to tax under Sec. 9113(A)
between 12-31-91 and t-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO
Name Daytime Telephone Number
ELIZABETH P• MULLAUGH
Firm Name (If Applicable)
MCNEES WALLACE & NURICK LLC
First line of address
100 PINE STREET
Second line of address
P•0• BOX 1166
City or Post OfFlce State ZIP Code
717-237-5243
REGISTER OF WILLS USE ONLY
HARRISBURG PA 17108-1166
Correspondent's e-mail address: E M U L L A U G H a M W N• C O M
Under penellles of perjury, I declare that I have ezaminetl this return, Including accompenying schedules antl statements, antl to the beet of my knowledge end belief,
It Is true, correct antl complete. Declaration of preperer other then the personal repreaentathe is besetl on ell intormelion of which preperer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
INFORMANT:
ADDRESs
501 S• MARKET STREET MECHANICSBURG, PA 17055
SIGNATURE OF PREPARER OTHER THAN REPRESENTATVE DATE
MCNEES WALLACE 8 NURICK LLC, BY:
ADDRESS
100 P~_STREET, P•0• BOX 1166 HARRISBURG, PA 17108-1166
PLEASE USE ORIGINAL FORM ONLY
Slde 7
15056041158 6M486]3.000 15056041158
J
REV-1500 EX
15056042159
Decedent's Social Security Number
193-46-3590
Decedent's Nemec A N E V A R I LORI J
RECAPITULATION
1. Real estate (Schedule A) ............. 1. D • D D
2. Stocks and Bonds (Schedule B) .............. ... 2. 7 5 D • D D
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)..... . 3. Q • D D
4. Mortgages 8 Notes Receivable (Schedule D)..... .. 4. D • D D
5. Cash, Benk Deposits 8 Miscellaneous Personal Property (Schedule E) . 5.
D•DD
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested . 6. D • D D
7. Inter-Vlvos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested .... . 7. 0 • D D
8. Total Gross Assets (total Lines 1-7) ................ 8. 7 5 D • D D
9. Funeral Expenses 8 Administrative Costs (Schedule H) .............. . 9. D . D D
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule 1)... 10. D . D D
11. Total Deductlans (total lines 9 8 10) .... 1 t. D • D D
72. Net Value of Estate (Line 8 minus Une 11) ................... 12. 7 50 • D D
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................ 13. D • D D
14. Net Value SubJeet to Tax (Line 12 minus Line 13) .. ...... 14. 7 5 D • D D
TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
Vansfers urger Sec. 9116
(axt.z)x.o 750.00 t5. D • 00
16. Amount of Line 14 tarmble
at lineal rate X.OY.S D•DD t6. D•DD
17. Amount of Line 14 taxable
- at sibling rate X .12 D• D D 17. D• D D
1 B. Amount of Line 14 taxable
at collateral rate X .15 O. D D t 6. D• O D
,9. rAxDUE ............ ,9. D.DD
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042159 BMO808].000 15056042159
REV-1500 E% Page 3
n J Y. M~......1..~.. Ad.l..."..
FIN Number
]~. nA nga7
DECEDENT'S NAfr£
STREET ADDRESS
CITY
M H STATE ZIP
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) _ O.OO
2. CreditslPayments
A. Spousal Poverty Credit O • OO
B. Pdor Payments 0 • OO
C. Discount O • OO
Totalcredlts (A+e+c) (2) U•UU
3. InteresUPenalty if applicable
D. Interest 0 • OO
E. Penalty O.00
Total InterestlPenaky (D+E) (3) 0 • 00
4. If Llne 2 Is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
FIII In box on Page 2, Llne 20 to request a refund. (4) o . o O
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAx DUE. (5) O • O D
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA This is the BALANCE DUE. (5B)
Make Check Payable to: I~pSTER OF WILLS, AGSM
i, Y
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 : .....................
retain the right to designate who shall use the property transferred or Its income; ........
b
.
c. retain a reversbnary interest; or ................................ . ~ K
.
d. receive the promise for life of either payments, benefits a care'! ................ .
2. If death occurred attar December 12, 1982, did decedent transfer property within one year of death ^ ^
without receiving adequate consideration? ........................... .
"
"
^
or payable upon death bank acccunt a securtty al his or her death? .
3. Did decedent own an
in trust for
4. Did decedent own an Individual Retirement Acwunt, 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 I7 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 suMving spouse
is three (3) percent ]72 P.S. §9116 (a) (1.1) (i)].
Fp dates of death on or after January 1, 1995, the tax rata imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9118 (a) (1.1) (ii)]. The statute tloes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return era still applicable even Ii the suMNng spouse is the only beneficiary.
For dates of death on or after Juty 1, 2000:
The tax rate Imposed on the net value of transfers from a deceased child twenty-one years of age or younger el death to or for use of a natural parent, an
adoptive parent, or a stepparent of the child is aero (0) percent [72 P.S. §9118(ax1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiartes is four end one-half (4.5) Dercent, except as noted in
72 P.S. §9118(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of tranafers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §8116(a)(1.3)]. Asiding is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by flood a adoption.
enuen t.ooo
REV-1500 EX+IB$9)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANl4 STOCKS & BONDS
• INHERRANCE TAX RENRN
RESIDENT DECEDENT
7~ori J- Canevari 21 OB 092
All property jointlyowned with right of sundvorship must be disWwed on Schedub F.
ovr.aaa ,.uuu to more space is neeaetl, insert edtlitbnal sheets of the same size)
REV-1510EXtl&9e) SCHEDULE G
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS 8i
MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT -
Lori J. Canevari 21 08 0923
This schedule must be completed and tiled if the ansvrer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBS DESCRIPTION OF PROPERTY
n¢inal~niu.EOV~Tw,r~eRaa,*~nRawnoNeRV ro oacaoan nw
TIED~lEDF 1MISetNT10gIND]%OF TIE GEED FOfl RFP1 EaiPTE
DATE OF DEATH
VALUE OF ASSET
%OF DECD'S
INTEREST EXCLUSION
wnaFL~cnsLS TAXABLE
VALUE
~~ Vanguard IRA Account
N0073-8802936651d 0.00 100.0000 0.00 0.00
DOD Value $ 31,163.95
Lori Canevari was under 59 1/2
years of age, IRA is not
taxable.
TOTAL (Also enter on line 7, Recapitulation) $
(If more apace b needed, inaed addnlonal sneers of the same size)
3W09AF 1.000
REV-1511 EX+(10-08) SCHEDULE H
FUNERAL EXPENSES &
ANIA
~
AN EWTAL ADMINISTRATIVE COSTS
NCE TA%RENRN
I
RESIDENT DECEDENT
ESTATE OF r~~c numxrt
Canevari 21 OB 0923
Debts of decedent must ba reported on Schetlule I.
REM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
~, None
8. ADMINISTRATNE COSTS:
1. Personal Representative's Commissions
Name of Personal ReDresentative(s)
Street Address
City
Year(s) Commission Paid:
State Zip
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4.
5.
8.
7.
City State Zip _
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Relum Preparer's Fees
None
TOTAL (Also enter on line 9, Recapitulation) ~ $ 0 .
TwasAC t.ooo (If more space Is needed, insert additional sheets of the same size)
REV-1512 EX+(12-OB)
Pennsylvania SCHEDULE
[E,>IAnRddfOF FE~ENUE DEBTS OF DECEDENT,
' NBaiMlCETAXREIURN MORTGAGE IJABILITIES & LJENS
RE9pQJf pECEDEM
ESTATE ~ FILE NUMBER
Lori J. Canevari 21 OB 0923
Report tlebts Incurred by the decedent prior to death that remained unpaltl at the data of death, Including unrelmbureW medical expenses.
ewasAR T.oW If more space Is needed, insert eddhional sheets d the same sine.
RED{-1513 EXF (11-08)
pennaylvania
fBMIABar OF REVcM1E
INHERRANCE TAX RETURN
FILE NUMBER
Lori J.Canevari 21 08 0923
RELATIONSHIPTO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llat Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [Inclutle outdpM spousal distdeutuns, end transfers untler
Sec. 2116 (a) (1.2).]
1. Gilbert J. Canevari
501 S. Market Street
Mechanicsburg, PA 17055
All of Residue: 750.00 Surviving Spouse 750.00
ENTER DOLLAR AMOUNTS FOR DISTR18UIlONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE.
II NOr!-TAXABLE DISTRIBUTIONS:
A SPOUSAL DLSTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
7.
B. CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 0.00
SCHEDULE J
~~ 1 ~1 \ I ~~~SI L~1~~
awaeAl z.ooo Ir more space +s needed, InseR atltlilbnal sheets of the same s¢e.
]V>.90SMS REV-6(06
This is to certify chat This is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
• with Aa 66, P.L. .304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Calvin B. Johnson, M.D., M.P.H. Frank Yeropoli
Secretary of Health State Registraz
Military
Status
!~7 i 205
All619 200&
Dace
No.
eos~u9 BEV nmaE
rrPE/PBwtw
PFAw4NEM
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COMMONWEALTH OF PENNSYWANIA• DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions end examples on reverse) xipTE FILE NuweEn
I. xa«dBamwlie~ Aram. bd mlroJ zse• 9. snWlseotlYNmhr 4. wedowwluam, aen rAA
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/OWN
M~Nees Wallace &
Nurick LLC
attorneys at law
DAVID E. GRUVER
PARALEGAL
DIRECT DIAL: (717) 237-5362
DIRECT FAX: (717) 260.1658
E-MA1L ADDRESS: OGRUVER~MWN.COM
August 27, 2009
VIA CERTIFIED MAIL
Cumberland County Register of Wills
1 Courthouse Square
Carlisle, PA 17013
RE: Estate of Lori J. Canevari
Date of Death: 07I31I2008
SSN: 193-48-3580
File No. 2108-0923
Dear Sir or Madam:
Enclosed is the Pennsylvania Inheritance Tax Return Resident Decedent (two
originals) for the above-mentioned individual.
Please date-stamp the cover page of our file copy and return it to me. If you have
any questions, please contact me.
Ve truly urs,
v ~
Irl
?U~737C
avid E. G ver ~cio
Paralegal ~~
a~
1>
DEG
Enclosures
c: Gilbert J. Canevari
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P.O. Box 1166.1 OO PINE STREET • HARRISBURG, PA 17108-1166 • TEL: 717.232.8000 • FAX: 717.237.5300 • WW W.MWN.COM
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