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Home My WebLink About08-26-09 (2)15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Count Code Year File Number Bureau of Individual Taxes Y PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PAi7128-0601 RESIDENT DECEDENT 21 08 1198 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth _ _. _ _. 111/16/2008 ' 12/24/1952 Decedent's Last Name Suffix Decedent's First Name MI NAZAY I TERESA S, (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number __.. FILL IN APPROPRIATE OVALS BELOW ± 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death C~3 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 CONFIDENTIAL TAX INFORMATION SHOULD 8E DIRECTED TO: Name Daytime Telephone Number _._ _ _ ___ THOMAS E. FLOWER __ (717) 737-3405 Firm Name (If Applicable) - REGISTER O ~' ~WILLS USE F ONId a SAIDIS, FLOWER, LINDSAY i <-~ ,~ ~ ' - First line of address _ _ _ _ _ ! _ ~ -: i ars• J C'.: ;, - ~ 2109 MARKET ST ' `~ . ~ ~' ~ Second line of address "~ J' ` . .. , , ,. r~ . 'U Cit or Post Office Y :. _ DATF1 ~1L~D State ZIP Code _ __ . .. .,. C..J ' _. CAMP HILL __ ~ _. PA 17011 v `' Correspondent's a-mail address: IOW@r~S~l-IaW.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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. {mac rtR50rv R~PONSIBLE FOR FILING RETURN ~ ~ _ DATE RUTHvNAZAY, 24 COLD SPRINGS ROAD, CARLISLE, PA 17015 rcrvPrr.~ t ~r rrctr R I I1AN KEPRESENTATIVE DATE \1/_1.(/1/{/1 08/18/09 ~~ SAIDIS, FLOWER & LINDSAY, 2109 MARKET ST., CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 P~'~ ~~~ ~ .~ ,~,~-- - o~ ~`'n x ~~, J 15056052059 REV-1500 EX Decedent's Social Security Number .. ............ . __ _. Decedent's Name: TERESA S NAZAY RECAPITULATION ______ _____-___w __ 1. Real estate (Schedule A) . .......................................... .. L 2. Stocks and Bonds (Schedule B) ..................................... .. 2.' 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. 9,942.00 6. Jointly Owned Property (Schedule F) C Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) {~ Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 9,942.00 9. Funeral Expenses 8 Administrative Costs (Schedule H) ................... .. 9. 2,500.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. , 2,500.00 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 7,442.00 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. '. 7,442.00 i 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 45 7,442.00 16. 334.89 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. ' 334.89 20. FILL IN THE OVAL iF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 r)pr_pdent's Complete Address: . ,,...., _- ,.:. Elle_Number ..._~_ 21 ':.~ 08 ;',.1198 DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER TERESA S NAZAY 179-44-8536 STREET ADDRESS 703 HALDEMAN BLVD CITY STATE ZIP NEW CUMBERLAND PA 17070 Tax Payments and Credits: Tax Due (Page 2 Line 19) CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits (A+ B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (56) Make Check Payable to: REGISTER OF WILLS, AGENT 334.89 334.89 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? ....................................................................................................... ....... ^ ?. Did decedent orm an "in lust far" cr payable upon death bank acccunf 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 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)]. 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 is defined, 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+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER TERESA S. NAZAY 21-08-1198 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must 6e disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) EV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER TERESA S. NAZAY 21-08-1198 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. g. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) RUTH NAZAY Social Security Number(s)IEIN Number of Personal Representative(s) Street Address 24 COLD SPRINGS RD City CARLISLE .State PA Zip 17015 Year(s) Commission Paid: 2009 (IN ADDITION TO AMOUNT PREVIOUSLY CLAIMED) 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 5treel Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 2,500.00 TOTAL (Also enter on line 9, Recapitulation) $ 2,500.00 (Ii more space is needed, insert additional sheets of the same size) LAW OFFICES SAIDIS, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET JOHN E. SLIKE CAMP HILL, PENNSYLVANIA 17011 CARLISLE OFFICE: ROBERT C. SAIDIS TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 26 WEST HIGH STREET JAMES D. FLOWER, JR EMAIL: tflower~sfl-law.com CARLISLE, PA 17013 CAROL J. LINDSAY wwwsfl-law.com TELEPHONE: (717)243-6222 JOHN B. LAMPI FACSIMILE: (717)243-6486 DANIEL L. SULLIVAN ALBERT H. MASLAND DEAN E. REYNOSA REPLY TO CAMP HILL THOMAS E. FLOWER MARYLOU MATAS JASON E. KELSO August 24, 2009 ~, n ~p ~ -,; ' - , i "- ~ ~ y. . ~ c Office of the Register of Wills ' ~n ~ Cumberland County Courthouse ; ` ~ '~' - Room 102 - ~., v -~, ...~ - -4 ~ _ One Courthouse Square ` ' ~ ~, . =, Carlisle, PA 17013 ~?^` t„~ Re: Estate of T. Sandra Nazay File No. 21-08-1198 Dear Sir or Madam: Enclosed are the original and two copies of the Inheritance Tax Return for the above- referenced decedent along with a check in the amount of $334.89. Also enclosed is a $15.00 check in payment of the filing fee. Please return atime-stamped copy to our office in the enclosed self-addressed stamped envelope. Please contact our office if you have any questions regarding this matter. Very truly yours, SAIDIS, FLOWER & LINDSAY ~~~ ~~ Karen Riccardo, Assistant to Thomas E. Flower, Esq. TEF/kar Enclosures