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Home My WebLink About10-23-09~ REV-'~ Jr' ~0 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Vear File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 /', Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 (~ 9'v`- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 07162008 03011919 Decedent's Last Name Suffix Decedent's First Name MI GREENE ANGELES F (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 12-122) ^ 6 Decedent Died Testate ^ ~• Ad~acdh Copy of T ~)a Living Truat 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) ( ^ 9. Litigation Proceeds Received ^ 10, Spousal Poverty Credit (date of death ^ 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 INFORMATtO SHOULD BE DIRECTED TO: Name Daytirne TelepFlwrrie Number TERRENCE J. KERWIN 7173623215 Firm Name (If Applicable) KERWIN AND KERWIN First line of address 4245 ROUTE 209 Second line of address City or Post Office State ZIP Code ELIZABETHVILLE PA 17023 REGISTER WILLS U~7NLY -- .,~ r c~ p ~ ` A. -" ~ ~ ~.. __ C ? --1 Cl - - syr W .: ,,.. C __ ._~ .. - j `-.-~ DATF~.ED •• ~ - _. ;t:~ ,~ r_--~ C :~ -"'C7 L__ ) t' N'3 !` J 0'1 ':, . ;•t. I yr Correspondent's e-mail address: Under penalties of perjury. I declare that I have examined this return, inGuding 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE Elliott Chotas 175 Stiles Drive, Marysville, PA 17053 IIGNA7~RE OF PREP OTf~7H REPRESENTATIVE Terrence J. Kerwin ~~, Q ADDRESS ' 4245 Ro a 209, Elizabethville, PA 17023 Side 1 1505607120 1505607120 J REV-1500 EX 15a5so722o oecedanYsName: GREENE, ANGELES FERNANDEZ RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ^ 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. Decedent's Social Security Number 166,000.00 66,584.89 232,584.89 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ......................................................................11. 12. Net Value of Estate (Line 8 minus Line 11) .............................................................12. 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. 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 at lineal rate X .045 3 7, 0 5 0. 9 7 16. 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 41,112.58 154,421.34 195,533.92 37,050.97 37,050.97 1,667.29 1,667.29 Side 2 1505607220 1505607220 J REV-1500 EX Page 3 File Number 21 Decedent's Complete Address: Greene, Angeles Fernandez STREET ADDRESS 8 Round H[II Drive CITY Camp Hill STATE I ZIP PA ~ 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + 6 + C) 3. Interest/Penalty if applicable p. Interest 44.2 2 E. Penalty Total InteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. q. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT w _ (1) 1,667.29 __ __ (2) 0.00 (3) 44.22 (4) (5) 1,711.51 (5A) (56) 1, 711.51 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 :................................................................................ ~._ ', I x ', ,___ _._ b. retain the right to designate who shall use the property transferred or its income :.................................... ~; '~ x c. retain a reversionary interest; or ...............................................................................................................{.J i x~ d. receive the promise for life of either payments, benefits or care? ............................................................. ', i x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without -- receiving adequate consideration? .....................................................................................................................F. '! x I 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ', ; x 4. Did decedent own arylndiv9 ual Retirement Account, annuity, or other non-probate property which __ i contains a beneficia desi nation? ...................... ~ x ' IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR .~ .. ,_ r l 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)J. 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)]. 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 A REAL ESTATE ESTATE OF Greene, Angeles Fernandez All real property owned solely or as a tenant in common must be reported at fair market valueEair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither bein compelled to buy or sell, both having reasonable knowledge of the relevant factsAeal property which is jointly-owned with right o~ survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Real estate located at 8 Round Hill Drive, East Pennsboro Township, Camp Hill, Cumberland 166,000.00 County, Tax Parcel #09-20-1850-138. Property sold on August 7, 2009 for a purchase price of $166,000.00. See attached HUD-1. FILE NUMBER 21 TOTAL (Also enter on Line 7, Recapitulation) 166,000.00 COMMONWEALTH OF PENNSVLYANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Greene, Angeles Fernandez Include the proceeds of litigation and the date the proceeds were received by the estateR~ll property jointly-owned with the right of survivorship must be disclosed on schedule F. ------- ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Checking Account #38317214 - M & T Bank 63,918.44 2 Income Tax Refund 462.00 3 Refund -Homeowner's Insurance 2,204.45 TOTAL (Also enter on Line 5, Recapitulation) 66,584.89 FILE NUMBER 21 SC~-EDUI..E H FUNE3ZAL. EXPE7V.SES & COMMONWEALTH OF PENNSYLVANIA wry~,^M p~T INHERITANCE TAX RETURN F,I.~IrAl~ l Iw l ~ ~~ RESIDENT DECEDENT __ _- ---- ----------- --1--- -------- ----- ESTATE OF Greene, Angeles Fernandez FILE NUMBER 21 +~' AMOUNT 8,903.00 Debts of decedent must be reported on Schedule I. ITEM-----__- - NUMBER FUNERAL EXPENSES: DESCRIPTION A. 1 ~ Myers-Harner Funeral Home B. ', ADMINISTRATIVE COSTS: 1. ~ Personal Representative's Commissions I, Social Security Number(s) / EIN Number of Personal Representative(s): -- Street Address 2. 3. City State Zip Year(s) Commission paid Attorney's Fees Kerwin and Kerwin -- Terrence J. Kerwin Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant a. 5. s. 7. 1 Street Address City State Zip Relationship of Claimant to Decedent Probate Fees j i Accountant's Fees Tax Return Preparer's Fees A to Z Tax Service Other Administrative Costs The Paxton Herald -Estate Notice '~ TOTAL (Also enter on line 9, Recapitulation) 3,500.00 342.00 120.51 38.00 41,112.58 Sched~,ie H COMMONWEALTH OF PENNSYLVANIA 1"~ 1~~ ~ """' INHERITANCE TAX RETURN ~ ~~ RESIDENT DECEDENT ESTATE OF Greene, Angeles Fernandez 2 ~ Cumberland Law Journal -Estate Notice 3 Bring Down Title Search 4 PA Dept. of Revenue - 2008 income taxes i 5 Reimbursement of VA Retirement for overpayment 6 Reimbursement to State Employees Retirement System for overpayment 7 East Pennsboro Township -municipal bills 8 ~ PPL Electric -electric bills i 9 .Manor Care, Carlisle 10 IPA American Water -water bills 11 ~L Chapman Fuel Oil Service -fuel oil bills 12 ~ Poppe Plumbing -repairs 13 ~ Verizon 14 Comcast Cable 15 I USAA Home Insurance i 16 2008 School taxes 17 I, M & Z Carpet 18 ~~ Lowes 19 Home Depot i 20 ';~ U.S. Postmaster -stamps '- --- -- FILE NUMBER '21 I 75.00 35.00 11,69 5,649.27 981.96 471.50 497.83 12.00 414.74 1,005.69 347.50 233.38 169.62 381.56 2,121.99 370.00 122.07 105.50 43.01 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Sched~i~ H /~~,~,~,Funeral Exper>ses & ESTATE OF vreene, Angeles rernanaez --~ 21 Reimbursement to Elliott Chotas for estate expenses 22 ~ Lisa Bruaw -part of sewer fees 23 j GE Money Bank 24 ~ Consignment Gallery 25 ~ Yard maintenance and snow removal 26 ~~ Register of Wills -Releases 27 ~i Register of Wills -filing fee for return and inventory 28 Recorder of Deeds - 1 % transfer tax on sale of 8 Round Hill Drive 29 ~ Notary fee 30 Ii, Century 21 Piscioneri Realty, Inc. -commission on sale of real estate 31 32 33 FILE NUMBER 21 Deborah Lupold, Tax Collector -prorated portion of County/Township taxes paid outside of closing Prorated portion of school taxes paid from closing Closing costs, e.g. postage, copies, 2009 income tax __ 173.65. 46.25 2,100.00 95.00 450.00 15.00 30.00 1,660.00 5.00 9,960.00 359.07 195.79 70.00 Page 3 of Schedule H COMMONWEALTH OF PENNSYl4AN1A INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Greene, Angeles Fernandez Include unreimbursed medical expenses. FILE NUMBER 21 ITEM DESCRIPTION AMOUNT NUMBER 1 Mortgage to Financial Freedom Senior Funding Corp. (originally M & T Mortgage Corp) dated 154,421.34 9/13/06 in the face amount of $280,500. Paid off at settlement on 8/7/09, with payoff figure of $154,421.34. SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS TOTAL (Also enter on Line 10, Recapitulation) 154,421.34 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Greene, Angeles Fernandez NUMBER ~ NAME AND ADDRESS OF PERSON(S) j RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS]include outright spousal distributions and transfers I under Sec. X116 (a) (1.2)] 1 I Elliott Chotas 175 Stiles Drive ' Marysville, PA 17053 2 , Chrysanthe de Los Angeles Chotas Baker 4683 Basque Drive Santa Maria, CA 93455 3 I~I Angefa Michelle Greene j 232 Joya Circle Harrisburg, PA 17112 (only child of Decedent's deceased son, Michael Patrick Greene) RELATIONSHIP TO DECEDENT Do Not Llst Trustasta) Son Daughter Granddaughter FILE NUMBER j 21 SHARE OF ESTATE I AMOUNT OF ESTATE (Words) - - ($$$) 1/3 1/3 1/3 i I Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet III iNON-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 0.00