HomeMy WebLinkAbout11-12-101505610101
"~ REV-1500 IX (oi-io) ~ OFFICIAL USE ONLY
PA Department of Revenue Pennsylvarria County Code Year File Number
UEMNTMENT OF~I~NHERITANCE TAX RETURN
Bureau of Individual Taxes
PO BOX 280601 RESIDENT DECEDENT
8 601
712 -o
Harnsburg PA 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY
Decedent's Last Name Suffix
~
~
~s
(If Applicable) Enter Surviving Spouse's Information Below
e's Last Name
S Suffix
pous
'
Date of Birth MMDDYYYY
/ / / 7 1 ~
Decedent's First Name MI
~- TTY-1-T"T'T~l
Spouse's First Name MI
~"I'T~-1-'I-T'T1'"TTT~ ^
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Original Return
~ 1
O
2. Supplemental Return
O 3. Remainder Return (date of death
82
. )
prior to 12-13-
p 4. Limited Estate O 4a: Future Interest Compromise (date of
death after 12-12-82) O 5. Federal Estate Tax Return Required
p 6. Decedent Died Testate
(Attach Copy of Will)
O 9. Litigation Proceeds Received O
O 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95) 8. Total Number of Safe Deposit Boxes
O 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
An1D t~ 0 _ ~ ~ '7 ~ 7 ~~9 4~'3
REGISTEi~F YYILLS U$rc.6lILY
C Q ~
First line of address '~ ~ ~_ _ ~
~~ i
~v ~ N ~_ ' ~, t.7
Q ~( N U L t_ U L~ ~ cis ~
~~~ f_ :, r,,f3
Second line of address ~f,`7 -T't 3
ILED
City or Post Office State ZlP Code ~i
e A ~ s i ~. Q I
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
't' true correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
L 1505610101
Side 1
1505610101
i is ,
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
x
J
1505610105
REV-1500 EX Decedent's Social Security Number
~ ~+ ~
Decedent's Name:
RECAPITULATION ~ -~ ~~ °» '°'''~
~d =
1. Real Estate (Schedule A) ............................................. 1. < .. ~ h..~~ ; ,. ~s-~ y,. •., `
•~ F d t
2.
2. Stocks and Bonds (Schedule B) ...................................... .
~•, ~.~ ~.,a~. ;.ate ~-v'
a ~ ~ t p
~ U
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ;; r~~~~ g ~ _
> ~ U
4. Mortgages and Notes Receivable (Schedule D) .......................... .
~'
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... 5. ~ ~ ~ # • oZ ~ ~ ~ ~
r
6. Jointly Owned Property (Schedule F) p Separate Billing Requested ....... 6. ,~ g ~ n
. s.,;- ,
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~ ~ 4 ~
O Separate Billing Requested........ 7. ~ a
,..;
(Schedule G) ~ ,ter n ~.~ f. ~ ,..~ ~_•::~.
8. ~ '$ Z O
..............
8. Total Gross Assets (total Lines 1 through .............. .
9. Funeral Expenses and Administrative Costs (Schedule H) .. • • • • • • • • • • • • • • • • • 9. ° ~ ~ 1 `~ , 7 ~ 3:
.~
.............. 10.-
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I)
11. Total Deductions (total Lines 9 and 10) ................................. 11.
..............................12.
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental BequestsJSec 9113 Trusts for which , 13. i
an election to tax has not been made (Schedule J) ....... ;
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14.
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or _ ~ ~,
transfers under Sec. 9116 °'- ~ +~i. ,
~ ~ 15.
(a)(1.2) X .0_ ~ ..v war ~ -
16. Amount of Line 14 taxable ~ ~ ! ~ 16.
at lineal rate X .0 ~ ~- ~~- ~ ~ ~ ~ ~ Z 3
17. Amount of Line 14 taxable r K ~ ~ ~ ~ 17.
at sibling rate X .12 ~ ~ '_
18. Amount of Line 14 taxable ~ ~ ~ ~ ~ 18
at collateral rate X .15 ~ ~ . , ~, ~~•
19. TAX DUE .........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 1505610105
Side 2
~.2~2~9
1505610105
O
J
REV-1508 EX. (t-97)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHRESIDENT DECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
A ~ -~ ~ tM L ~. au~s
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
SAVI~Co S J~CGT , mEgiZb ~~-~K
` ~ ~*NW'-3v-6 s O Co 2 ~3 y 6 3 `~ S ~ o, ~ 7~. 3 g
c NEC-1~--w3 C'o ~ C c-T - ~n ~rft-o (3,a<<,.~K-
50 PWS - 053~q~ -Z(a5 151.C51p
l~e~e~ ~ruwt'~t^~ clrze,~)Ac-D ~-~c~~ ~ Q ~ 3. I s
~- ~ N VS ~ D Po 2~1 cSuJ 0 ~ ~~
~ -~J291to -20 -
TOTAL (Also enter on line 5, Recapitulation) I $ a ~ g' ~o tJ
f
(If more space Is needed, Insert additional sheets of the same size)
REV-1511 EX+ (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCI~IEDIJLE M
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
o na n F-u N fXz ,~- I-I-awt t~ P,~~
~~~ ~~-~~
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address _
City State
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
~~~ . 3 8'
185. ~
Zip
4.
5.
s.
7.
City State
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
IOG. 00
`15. C70
TOTAL (Also enter on line 9, Recapitulation) I $ '~ -~ (, 7j
(If more space is needed, insert additional sheets of the same size)
Zip
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCFIEDIJLE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed mPdiral aYnancnc
~n more space is neeaea, insert adamonal sneers of the same size)
REV-1513 EX+ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
t~lAlt Ut
FILE NUMBER
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not List Trustee(s) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
1.
A "rte ~ ~ -~ -'~ o I"FE?~ ~
a ~
~
x ~) ~ ~,,, L,,, , ~ ~ ~~ ~ 2 ~o ~
Ca~v-~ ~ s l.~ , P~ ~ z a r ~s ~
A «~ ~ W. L~ ~~~ s
5 O (A 't ~S W'~~~ ~ ~ cJ 6T1 S d ( a
~ t LI,-.1~ Sp G S 1'A
~ Z a 0 7
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE G
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ~
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ G
(It more space is needed, insert additional sheets of the same size)
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
DECEDENTS NAME
/9wn/19 ,~y~
/~i~E ~.A~U~/S
STREET ADDRESS
~~ ~
c~ 5 i~ r ~ .~~
CITY
~oa~l
~ 5 STATE
~ ZIP
f7oD7
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
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.
(1) I Q 34 .~Co (c
Total Credits (A + B) (2)
(3) 1 Z . Co 3
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) , o ~{ 7 . Z
Make check payable to: REGISTER OF WILLS, AGENT.
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 Dec. 12, 1982, did decedent transfer properly within one year of death
without receiving adequate consideration? .............................................................................................................. ^ ^
3. Did decedent own an "intrust for" or payable-upon-death bank acxount 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 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 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.
'METRO
BANK
>02267 6067794 001 092140
ANNA M LANDIS
2 FOX HOLLOW LN
CARLISLE PA 17015
Metro Bank
3801 Paxton Street
Harrisburg PA 17111-1418
1-888-937-0004
We're here 7 days a week, 24 hours a day at 1-888-937-0004.
Statement BafanGe as of 10!13!09
P(ua -_~_~~~pQ$tts and pth®r CnepFts;
{
Less _3 Checks and Qher Depfta
Ptua Interest Pald
Statement Balance tis of 11/12/09
Transactions By Date
50 PLUS CHECKING 0536981269
. < ~ ~~
5320.7& ~'
Date Descri lion
p
Debit
Cre
dlt Balance
10116/08:` CHECK ~ 3342-. ;30.Op ,
~224rsit}
~~ A'~ ?~
10/19/09 CUSTOMER DEPO iT .
55,300.00 58
524
98
10N9/Q9 _ CHECK # 3361.. /
/
~
~ ;7.78 '. ,
.
?~i~ 58,51,x.2 ;`
~
10/26/09 CHECK # 3363
V ~Ai i~ ~;~
) 0 ~~
3~ I ~ 58,366.14 5151.06 ~/
~
10!30109 PA TREASURY DEPT ANNUITANT , Y
;188.39
532Q
45
ANNA M LANDIS .
',~ .
11/12/09 INTEREST PAYMENT 50.33 5320.78
Check Transactions
Number Date Amount Number Date Amount Number Date Amount
33131 ;; :.. .._,, °1011 '+: ~;7,78 `" ~ 3362 10/16 530.00 33tt3 ` " '~0 tT-~',S~ 14 -~. "°y:;
Items denoted with an "E" are electronic entries and will not have a check image. Items denoted with an "'" indicate processed checks out of sequence
Interest Summary
Beginning Interest Rate ,~
~ ,~.
Numt~er of t)ay& in thl$ Statement Period - ~ ' ~ ~ ,;~~. +~ : ~ ~~~~~ ~~
Interest Earned thia'Statement Period ~ - r ,^ .. ~ ,, ~ ~ <<. ~ 54,33,.,,
Anpual Percentage Yleid Earned this Statement Period (APY) < , .x r: i0•'ls°ti'r
Interest Paid Year tS? Date - '+ `- ~ _ , ,
A Metro Bank Visa® Gift Card makes the perfect holiday gift.
Purchase without a fee at your nearest Metro Bank store today/
~' ~ C[~ 3 3 (~ 3
Palo t~ --i- to c.~ ~ ~.~ l~U'2.s f -.~ ~, ~~n ~ crhJ I v (a 3 ~ I
12 Cvcle PAtlQ 1 of d
'METRO
BANK
>l]1510 6145143 0~1 X92140
ANNA M LANDIS
2 FOX HOLLOW LN
CARLISLE PA 17015
Metro Bank
3801 Paxton Street
Harrisburg PA 17111-1418
1-888-937-0004
_ We ne here 7 days a week, 24 hours a day at 1-888-937-0004.
~~
- PERS STATEMENT SAVINGS 0626546345
~~-StBta~nt 6ala~c~ ~,ot St91391Q9 _ ;, ~ ~ a ~ ~ a ~,
~ Y ~' S, '~` ~ s. 'Nt~E ,Z,.C Si r 3Fi, i. 7
Plus `1~,epQaits and Other Grgt, ~ ~~,~ R "~,;~~ =, ~.>, ~~ :``;~
~ i~. ~~ 'Jrt: ,~r~~e v)w .anal Ott~gr ~~~ ,. `` s~ ~ x ft »1 r ~~:~'~kt Ya.'
~Plua f~,ntt~a~ro4~P~ia ~ ~~ ~ K,-~ ~ ~~ ~~.,~ ~~~'
ac:nr+":~~~.~3` r ~~ +6~.. Y ..? ~ ...` K{ .., , v . ~ t . ., ' ~ i ~`' r.Cz~r •t~'~'~"~ N
Transactions By Date
Data ---------Descriptifln- -.-- _ __ _ Qebit.__ - .~.___ Credit .~.Balanas.
10/31/09 INTEREST PAYMENT y S5 02 S2t1,581 40
- _
,~. ,,
~...,.... xW...~. __,
Interest Summary
Beginning Interest E~{e ~ ~~ ~ ~ ~ - a '
N4unl~er of,[~ays ip tfali ,StaZembnt Period ~ ' ; a~
lntkir~t Ea~nad thtp S~itgrtieni Period ~ ~ 'r' ~ '~ru~1~~ °^~~>
AnhualP.prcenta~ ,Yle~d 1^grngd this &tatement RPrlAd;f~APY~` *' s ~ ~ _ # .~• '+ ~ ~ ; ~`
.~~!~~.~~~[ 3~r%~.~ISI"i.1a~ ' ~SAi~~w..`,..$:'r.~`•7 ~ ~ arY~t {~;~N t,~ .rY ~7
.W rs..-a...L C M `t:.:. ...-~ mni 4 ~ ~~~ III. ~ jr ~'3..A ~~..5
Good News for Savings and Money Market Account Customers)
The number of transfers and/or withdrawals you can make per statement cycle has
Increased to 6 from 3, including check, debit card and online bill pay transactions.
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'METRO
BANK
3801 Paxton Street
Harrisburg • PA • 17111
mymetrobank.com
888.937.0004
November 5, 2010
To Whom It May Concern:
Anna Landis owned two accounts with us at Metro Bank prior to her death on October 24, 2009. One
was a Savings Account, which her daughter, Andrea Moretti was Power of Attorney on. The amount in
her account at time of her death was $20,576.38. On November 3, 2009 this account was closed with a
balance of $20,581.40 ($5.02 interest had accrued). This amount was transferred over to an Estate
Account for Anna Landis with Andrea Moretti and Allen Landis as signers. This account was opened on
November 3, 2009, same date as the closing of the Savings Account.
Concerning her Checking Account, Andrea Moretti was also Power of Attorney. Prior to October 24,
2009, the balance on the account was $320.78. Upon closing the account, the balance was $20.85. The
$300.00 was transferred on January 5, 2010 and deposited directly into the Estate Account.
On November 4, 2009 both Andrea and Allen withdrew $2000.00 (totaling $4000.00) for personal
expenses. After all final expenses were paid the balance in the Estate Account was $19,000 even which
Andrea and Allen each received $9,500.00 on January 5, 2010 and the account was closed at that time.
Sincerely,
~~ G~
Mary Wheeler
Customer Service Representative
Metro Bank -Carlisle
(717) 240-2665