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HomeMy WebLinkAbout12-18-0915056D51047 REV-1500 ~ (x•05) OFFICIAL USE ONLY PA Dapal6rler~ Ot t~Y611119 ~ ~geo1 Tmosc INHERITANCE TAX RETURN ~ code Yaer Fie timob~er Hardsbtag, PA 1712&0601 RESIDENT DECEDENT ~ ~ ~ ~ / ENTER DECEDENT NiFORYATION BEL!DW Social Sectrity Number Date of Death Date of Birth G~ ZL lr~~ ~ / a 4G 2.00 7 B~ 3~ l gP~ Decedent's Last Name Suffix Decedent's First Name MI ~pP/rR c ~~ ~o!'h~' n~'e lff APPS) ~ ~ driorrnattion iBelo~tr Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social SeatrKy Number TINS RETURN IAUST BE FN.ED 1N DUPLICATE WITH TILE REGISTER OF WILLS lF9_L ai APPROPRY-TE arALS IBELOW 1. Origurel Reiwn O 2 Suppiemen~ Rebrrn O 3. Remainder Rstttrn (date of death prior b 12-13-82) O 4. l.inwled Estate O 4a. Fubxe Interest Compnxnise (date of O 5. Federal Estate Tax Rehm Required deatFr alter 12-122) O 6. Decedent Died Testate O 7. Deoederk Mafrr~irred a Living Truce ~ 8. Total Number d Safe Depoek Boxes (AttacFr Copy of 11111) (Attach Copy of Trust) O 9, t.i6gatiort Prvoeeds Received O 10. Spousal qty Credit (dale of death O 11. Election b tax under Sec. 9113(A) between 1231-91 and 1-1-05) (/UFactr Sch. O) - TFMS 8EC'iION MUST BE tA1iPLETED. ALL AND t'AIIFDDITIAL TAX IMFOItCMATtON tt7101R,D BE OA6C11r'D TCI: Nam e Daytime Telephone Number ~as ere ~• ~ PirQ ci 7/7 7Z~ ~~0~ Frm Name ( Applicade) Fist line of address REGISTER OF WILLS USE t~Y o 0 w G1 n:" ~ ,-~ C? ~ ~ ~~ ~, ~ ~ ~'~ _ DATE ~.ED ,,") [.~ ? 2 1 J4 / h e r ,~ ~t ~-y ~ n u~ Second fine of address City or moat 171fioe n?~ cha h~ Stale 2~ Code c s 6 u ~~ ~,~ 1 1o sG Comesporrdent's e-rrmi address: ~a ~ 2 - Urwler perralies of perjury, I dsdsre that 1 trove exanrnsd ihls nlhsfn, iAduin9 DAD sdrsdulss and atalenrerMa, and to the beat d my luawbdpe and belief, d is true, aorrord and complete. Deidaration of preparer oMrer than the peraormi repraeerrtalive is based on all intamrseion of which preparer rras any krwwledpe. SIGNATURE OF ISLE FOR FILING RETURN DATE ADDRESS, // f n ~+ A w _ 11f SK,NATIME OF PREPARER DATE PLEASE USE ORKi1NAL FORM ONLY Side 1 ' 15056051047 15056051047 J J 11500 E//X~~,~, rn oeoed«,r: tom: lGl'.t'~a' ~dm/n~ C 15056052048 Deoedent~s Social Secrxity Number 1~v11~~5~"P tiECAPITULATION _ _ _ 1. Real estaea {Sd~edUle A} .................................. . . . . . . . ... 1. 2. Stocks and Bonds (Schedule B) ....................................... 2 3. Closely Held Corporation, Partnership or Soil-PrnpriatiorshiP (Schelde C) ..... 3. 4. Mor~ages & Nom Reoeiv~le (Sd~edrde D) ............................. 4. 5. Cash. Bank Deposits & Iu~oeNaneous Persrcxtei Property (Sdtedide E) ........ 5. 6. Jointly Owned Property {Sd~eduie F) O Separate Bing Requestied ....... 6. Vnros Transfers 81J~aellaneous Non-Probate Properly Q, 0 V ~. a ~ w0 d Vw Q' V • ~`~ 7. krter- (Sctred~de G) O Separable BN'ing Requested........ 7. O • /~~~) 8. Totem Graas Atieals (total t.ines ,-7) .................................... 8. ~ a 3 ~ ~w V (O 9. Funeral Expera3es ll Admirdstratnre Costs (Schadtde H) ..................... 9. OI % p w ~ 2, 10. Dews of Decedent, alor~e . ~ Lions (Sd,elde 1) ................ 10. l-'! 7 (/ 3• ~ G 11. Total Deduetlorrs (total Lines 9 d~ 10) ................................... 11. ! ! V ~ ~ •~y 12. Nst Value of Eetete (t.ine 8 mirwa Line 11) .............................. 12. Q w d Q 13. Charitable and GovermaerKal Beque~s/Sec 9113 Tttrsts for which an election b tax has not been made (Schedtde J) .......... . . . ........... 13. ~ w Q U 14. Net Value Subject to Tax (Une 12 nrrxrs Line 13) ........................ 14. ~ . ~ ~ TAX COI!lJTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amax>< of Line 14 taxable at the spousal tax rate, or trarrsfars under See. 9116 (ax12) X .0_ 15. w 16. Amamt of Line 14 taxable at Gneet rate X .0 _ • 16. • 17. Amotxrt of line 14 taxable at sibgng race X .12 . 17. • 18. Amamt of Line 14 taxable ~ ootielerairate X .15 • 18. • 19. TAX DUE ......................................................... 19. • 20. FILL Mi THE OYAL IF YOU ARE REt3tfESTiNG A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 RE1/-1500 EX. Page 3 PNt Number Decedent's Compiefie Address: ~., STATE Tax Payments and Credits: Tax Due (Page 2 Line 19) CreditslPayments a s> Parerly Credit B. Prior Payments C. Discarnt kNare~Penelly if appirwble D. Interest E. Perintly r~,; (1) Q. ~ Total Gracile (A+ B + C) (2) Q . l/y Total krlereaUPertelty (D + E ) ff Line 2 is greaser Uren Line 1 + Line 3, solar the dilfErerroe. This is >he OVERPAYMENT. FM in oval on Pape Z. Line 20 to rprtaat a n~tund. ff Line 1 + Lire 3 is greater than Line 2, enter the dilierertoe. This is the TAX DUE. a Eller the interest on the ~c due. (3) ©. D7j (4) (~. D~ (5~ G. ~ (~-~ ~ UU B. Erder the total of L'me 5 + 5A. This is the BALANCE DUE (56) Q . Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRUTE BLOCKS 1. Did deoedert rnalae a transfer and: Yes a. retain the use or hrconie of ills property trsr~sf9rr+Bd :......................................................................................... ^ b. -eta~r the right b designate who strei use >tte property transferred or iss inoane : ............................................ c. refan a reversionary interest: or .......................................................................................................................... ^ d. receive the promise for ire of ellher payments, benefits w c~e? ...................................................................... ^ 2. M deatlr aa~rrred attar Deoerriber 12,1982, did decedent transfer property wifwr one year of deair viiitlrortt receiving adequate cortstdera8on? .............................................................................................................. ^ 3. Did decedent own an ~ tout for' or payable upon death ber~c account or aedrily at his or her deatlr? .............. ^ [~ 4. Did decedent own an trrdividrral ReGnerrrent Aooourrt, army. or other rron-protrale ProPwh wlfrrir a berreliaery designatron? ........................................................................................................................ ^ iF THE ANSWER TO AN1(OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FN.E R A8 PART OF THE RETURN. Far dates d dea9- on or aRer July 1,1994 and before Jarxtary 1,1995, the tax rye Nrrposed on the rret value dtranalsers to or for the use dare stirvtvitg spouse is three (3) percent [/2 P.S. §9115 (a) (1.1) ¢)]. For dales d d~tlt on or at>er Jarrtrary 1, 1995, rte tax rate inposed an pre rtet value d Irartsters b or >nr rte use d rte surviving spouse is zero (0) perr~ertt (/2 P.S. §9116 (a) (1.1) (x~). The statue a ~artster b a strrvivutg spouse hoot tax, and Ute staibulory requiremertis br d'wdoetrne d assets and t~tg a tax return are ~ app9Cable even if the surviving spouse ~ >fte ortty benefiaary. For dates d death on or alter .hiy 1,2000: The tax rate 'unposed on >ltie net value d trarwfers from a deceased chid drgMy-rare years d ale ar yotmger at de~h to or for the use d a nadural parent, an adoptivie parent, or a stepparent d the chid is zero (O) pervertt (72 P.S. §9116(x)(12)). The tart rate imposed on the oat value d lrartsfets b ar for the rue d the decedents irri~l bertetrCiaries is four acrd ornadtaiX (4.5) percent, except as rated in 72 P,S. §9116(1.2) [T2 P.S. §9116(a)(1)j. The tart rate imposed on pre net value d trartsters tQ or for the use ti the decedent's sibCrtgs is twelve (12) percent (72 P.S. ~116(ax1.3)). A sibfrtg is defned, under Section 9102, as an irtd'nriduat who tray nt least one parent in oorrrnon wi9t the deceder~, whetter by bbod a adopGort. REV t5t~ t3c+t~~ee~ sc~ou~ N KTMOF~ ~ •e+es~E ~ ADMl~lIS11t~11VE t706iT5 ESTATE OF i#.E NUMBER Dominic Mic~tael Ceraci Qe6ts d deoednk ^isiet be reported an &he4M L IiB1 Nt~:p DIOd AIiOtMT ~-. R~iAt. DIES: t' D'iocaresf Herriabttng 9uriei Plot 1,631.00 2 S6rt~tlei Pttbit: Nt>rioe 118.72 3. C1Nebe1lBlld I~Ir .IOttrrtal NO~Ce of Admini6fraGort 75.00 B. ADAlIIS?RATNE COSTS: 1. Peieonl ReproseMefMe's Gomn~issisnc 600.00 Nnne d Pensrrel ReP(s? ~ C. Geraci soviet g~ ~ ty~ d paw ~ 526113175 ! ,,~~ 721 Alberta Avenue py- Mechanicsburg .8mle PA ~p 17050 1Reer<e~ Cas~niebn Paid 2007 2. Atlomsp Fees 500.00 3. Feni~r pF deoedest's eddssre is set the esree as oists~enCs, ett~ erptseeibn~ c~K 0.00 SMeetAddress ah Sire -aP Relydonel~ip d Chisent b t)eaedent 4, ProbeM Fees 60.00 5. AooaeiYriCs Feee 0.00 s. Tmc Rersn Pr+epsrers Fees 0.00 ~. TGiTAL (Atsa erMer on irre 9 ~+) I i 2,984.72 itE1R19Q18 EX+ (6'96) COIiMOMiYEA1.Tii OF PENNSYLM-NIA ~ i~~ $ M#SC. IIE TAX RERMtI ~~~ ~~ RESENT O~EMT ESTATE OF /A/ -- F~.E MI~BER / / \ _ ~ ..~i/ _ ~ S ® /f~ An is A • NdMnfe the p~aoeede d i~ip~'ion snd we dMe ~e proc6ed~ were ~6oeired 6y the eelaEe. A/ piopiryt Jai~.awned wllh d~ht d e9evMashlP eat be dledoeed an 3dadiM F. ~~ Be% JaM~ ~'cau~ 5,9~ 5~ 3. l~/U ~~5~ Q~~/~~ ab. P7 /,~ Q~cauu~ ~~ icia~ ~'~ 3,352.2L T~fAt. cao 61ref en ine 5,101 REV-1512 EX+ (12-OB) ~~ i~~ SCHEDULE I oars of oc~~Nr, Maw $ ~s ESTATE OF ~ FILE tIW1iER Report UarrM br Wo rooeAa~t prior bo ~odii flat raertNod at tl~o dtba d aootb, Mdwlio~ w o~oNcal Gl>kut~uorn/1venCbh a A,~ ~t 9,~r« Ci/~~nz.~'en~dira Pi~'l~ ~•r f Ivan ~2 6 m ~~~ ~~ X932. // 3, ~9~ ~G /, /~7. ~3 ~~g ~,