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Home My WebLink About02-17-11 (2)J REV-1500 Exlol.tol ~ 1505610143 ti OFFICIAL USE ONLY PA Department of Revenue Pennsylvania cwnty cotl. v.x Fib NuMx Bureau of Individual Taxes oc~eeTMeer or ecv¢xue Po eox.2sosot INHERITANCE TAX RETURN 21 10 0 0 6 6 2 Harrisburg, PA 17128-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Data of Death Date of Birth 197 26 0801 05 30 2010 10 O1 1934 Decedent's Laat Name Suffix Decedent's First Name SZUKALSKI EUGENE (If Applicable) Enter Surviving Spouse's InformatJon Below Spouse's Last Name Suffix Spouse's First Name MI MI Spouae'a Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® t. Original Retum ^ 2. Supplemental Return ^ 3. Remainder Return (date o1 death prior to 12-13-82) ^ 4 Limited Estate ^ 4a. Future irtterast Compromise ~ 5. Federal Estate Tax. Return Required feet. a d.mn mw +z•t z-ezl ~ ® 6. DstlWNx DiM Tsstala ^ T Dagdsnt Maintanetl a Living Trust (Attach Copy of Trustl e. Total Number of Sate Deposit Boxes (AUSCn Copy of wltl) ^ 9. Li4gatbn Proceetla Received ^ 10.~~1?Z"MYg~ dn~ea gsa aeatn ^ 11.Elettion to lax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Hams Daytime Telephone Number RICHARD E CONNELL ESQ 717 232 8731 First line of address 2303 MARKET STREET Second line of address City or Post Office CAMP HILL REGISTER O~IIILLS USE Oa WY ~ C _~ r-~ ` r'TT '. % 'a. Z ~ t1~ X ~ . -~ ~ r"t ~ ce f ;:~ p J O 1'i A DAT~ILED ' `r_i r1 State ZIP Code • - `~ r- r~l PA 17011 ~ ~'~~ Correspondent'sa-manaddresa: connell~bmc-law.net 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. ration Of parer other than the personal representative to based on all information of which preparar has any knowledge. at Of PER E TURN ATE Gary Szukalski o~ ( ~/ 21703 DATE Richard E Connell Eeq 2303 Market Street, Camp Hill, PA 17011 Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX oaceeein~s Namr. S Z U K A L S K I, EUGENE Decedent's Social Security Number 19 7 2 6 0 8 01 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... ... 1. 2. Stocks and Bonds (Schedule B) ............................................................................ ... 2. 4 4, 6 2 6. 8 6 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)....... ... 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... ... 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .............. .. 5. 1 , 7 0 3 . 0 1 6. Jointly Owned Properly (Schedule F) ^ Separate Billing Requested ........... .. 6. 0 . 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ........... .. 7, 4 4 9 , 811.0 9 8. Total Gross Assets (total Lines 1-7) ..................................................................... .. 8. 4 9 6, 1 4 0. 9 6 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... .. 9. 3 , 4 0 9 . 3 3 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10. 11. Total Deductions (total Lines 9 & 10) .................................................................... .. 11, 3 , 4 0 9 . 3 3 12• Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 4 9 2 , 7 31.6 3 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... .. 13. 14. Net Valua Subjeet to Tax (Line 12 minus Line 13) ............................................... .. 14. 4 9 2 , 7 3 1 . 6 3 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 4 9 2, 7 31.6 3 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 REQUE8TING A REFUND OF AN OVERPAYMENT. 22,172.92 22,172.92 Side 2 L 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: Szukalski, Eugene 500 Lamp Post Lane File Number 21 - 10 - 00682 ~ Camp H[II I srArl=_ zIP PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 22,172.92 A• Prior Payments 1,785.00 B. Discount 93.95 Total Credits (A + B) (2) 1,878.95 3. Interest (3) 0.00 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 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2 ~ , 2 9 3.9 7 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: a. retain the use or income of the ro Yes No P party transferred :.................................... ^ ^ b. retain the right to designate who shall use the property transferred or its income :.................................... c. retain a reversionary interest; or .................................................................................................................. ^ x d. receive the promise for life of either payments, benefits or care? ......................... ..................................... ^ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................. ^ ^ ................................................ .......................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly 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 JuIY 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 p2 P.S. §9116 (a) (1.1) (i)]. t 2 P S s91 dsaah ~ ; r((afte The staryute does~riot exempt a iranstef to ehsurviving spouse ff om tax and the statutoryhequi ementsf or dlscloslerofnt 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 yyears 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)]. • siberigXS defined under Secetiont9102 as ten indiwtltual who has at least one pareelit Insrlroblmrnon withphe detcedentswfiettier by blood~oAadoption. SCHEDULE B caurnoNwEUrNOCVENNSYwnNw STOCKS Si BONDS WNERRANCE TA%RETURN REBDENT OECEOENT ESTATE OF Szukalski, Eugene FILE NUMBER 21 -10 - 00662 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 Charles Schwab Account No. 86729665 Exhibit Attached 24,508.86 2 Series EE $10,000 Savings Bond Serial No. X2115984ee 13,412.00 Issue Date: 6/1991; Final Maturity 6/2021 (Issue Price $5,000; Interest $8,412) 3 Series EE $5,000 Savings Bond Serial No. V2253463EE 6,706.00 Issue Date: 6/1991; Final Maturity 612021 (Issue Price $2,500; Interest $4206) TOTAL (Also enter on line 2, Recapitulation) 44 626.86 SCHEDULE E CASH, BANK DEPOSITS, & MISC. `"`TM°`~~Y"'^"" PERSONAL PROPERTY 4MERRANDE TN(RETURN RE&DEM DECEDENT ESTATE OF FILE NUMBER Szukalski, Eugene 21 - 10 - 00662 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Genworth Life Insurance Company, Long-Term Care Refund 1,487.01 2 Genworth In-Home Care Reimbursement 216.00 ~ TOTAL (Also enter on Line 5, Recapitulation) I 1,703.01 SCHEDULEF COMMNHERw rnNCE TTAX RETURN ANIA JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Szukalski, Eugene 21 - 10 - 00662 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Karen L. Szukalski 500 Lamp Post Lane Wife A Camp Hill, PA 17011 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT ~ RtPT.lO~ F PR f ER~Y InGude name o Inanclal Ins u Ion anu ban account number or similar identifying number. Attach deed forjointy-held real estate. DATE OF DEATH VALUE OF ASSET °h OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A Wells Fargo Securities 45,962.24 0% 0.00 Account No. 8243-1029 (Jointly owned with wife, therefore not taxable) TOTAL (Also enter on line 6, Recapitulation) ~ 0.00 COMMONWEALTH OFPENNSVLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Szukalski, Eugene FILE NUMBER 21 - 10 - 00662 t ms scneaule must tte completed and filed if the gnawer to any of questions 1 through 4 on naee 2 i,Q wee ITEM NUMBER DESCRIPTION OF PROPERTY DATE OF DEATH I~o°B °ia °8°1° °~ ~° tronsf°ro°, their relatbnahip t° °ece°ent VALVE OF ASSET en° the °ata of tranater. Attach a copy of iM tlee° for real estate. % OF DecD's INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Roth IRA Wells Fargo Financial Advisors 41,200.73 100% 41 200.73 0 00 Account No. 8243-1926 , . Beneficiary: Spouse -Karen L. Szukalski 2 Wells Fargo Financial Advisors (formerly Wachovia 341,875.60 100% 157,262.7 184 612 82 Securities) Regular IRA Account No. 8243-1924 , . Beneficiaries: 46% to spouse, Karen L. Szukalski 27% to son, Gary Szukalski 27% to daughter, Donnajean Szukalski 3 Wells Fargo Financial Advisors (formerly Wachovia 491,107.94 100% 225,909.6 265 198 27 Securities) Regular IRA Account No. 2843-1930 , . Beneficiaries: 46% to spouse, Karen L. Szukalski 27% to son, Gary Szukalski 27% to daughter, Donnajean Szukalski TOTAL (Also enter on line 7, Recapitulation) 449,811.08 cDnwarrvuEwrH of PEnr~erwu~w N'1MERRMICE TW(RETURN RE6IDEM DECEDEM Std-®III.E H ~~'y~~R~A~L~D~FN~SyE~S. ~ r+v~~s1R7 ~ 1W~ W~7~ ESTATE OF Szukalski, Eugene Debts of decedent must be NUMBER A. DESCRIPTION on Schedule I. -10- AMOUNT B• ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Gary Szukalski 0.00 Street Address 5310 St. Mawes Court city Frederick State MD zip 21703 Year(s) Commission paid 2. Attorneys Fees Ball, Murren $ Connell 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 2,500.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent '------ 4. Probate Fees Register of Wills 158.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Schwab Wire Transfer Charge 12.00 TOTAL (Also enter on Ilne 9, Recapitulation) 3,408.33 C Sd~edule H COMMONWEALTH OF PENNSYLVANIA Furl INHERITANCE TAX RETURN ^~ RESIDENT DECEDENT ~ ~J66 ESTATE OF Szukalski, Eugene 2 Mileage Reimbursement -Executor (250 miles ~ $.55/mile) 3 Postage 4 Purchase of Estate Checks 5 Miscellaneous Expense - Reimbursement to Executor 6 Cumberland Law Journal -Legal Advertising 7 The Sentinel -Legal Advertising 8 Wells Fargo Advisors -Date of Death Valuation 9 Reimbursement to Ball, Murren & Connell for costs advanced FILE NUMBER 21 - 10 - 00662 Page 2 of Schedule H 137.50 15.90 12.00 41.45 75.00 166.30 262.50 28.18 REV•1615 EXt (77-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT c~71NIC Vr Szukalski, Eugene FILE NUMBER 21 - 10 - 00662 NUMBER ~ NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY () RELATIONSHIP TO DECEDENT Do Not LJSt Tnutse(s) SHARE OF ESTATE (Words) I, TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X116 (a) (1.2)) 1 Mrs. Karen L. Szukalski Wife Residue and 500 Lamp Post Lane Camp Hill, PA 17011 personal property 2 Ms. Donnajean C. Szukalski Daughter Investments and 39 West Keller Street securities Mechanicsburg, PA 17055 3 Mr. Gary Szukalski Son Investments and 5310 Saint Mawes Court Frederick, MD 21703 securities Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. II, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS AMOUNT OF ESTATE ($$$) TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00