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HomeMy WebLinkAbout03-0157REV-1500 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Faison, Thomas S. DATE OF DEATH (MM-DD-YEAR) DAT~ 0~ BI~TH (MM-DD-YEAR) ,9, ; 01/21/2002 06/18/1937 '~ (IF APPLICABL~) ~URVlVIN~ ~Pou~'S NAME i LASTi ~IR~ AND MIDDLE ~NITIAL) Faison, Martha E [] 1 Original Return [] 21 supplementai R;tU;n ~ ~ [] 4. Limited Estate [] 4a Future interest Compromise (date of death after ~ ~' 12-12-82) ~OO ,,, .J [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach ~. co of Will) copy of Trust) "~ [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (da!.5 of death between INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2oo 1 5'9 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 243-50-3736 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 3. R~m~inder ~tu-rn (date of death prior to 12-15-82) ' [] 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) : :TH[SSECTION Must BE COMPLETED; ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Paul J. Tomczuk FiRM NAME (If appli~;bl;) McQuaide Blasko TELEPHONE NUMBER 814/238-4926 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 811 University Drive State College, PA 16801 (1) None;. (2) None (3) None (4) None (5) None (6) None (7) 7,183.35 (9) (8) 7, 183.35 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1 I. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 7, I 8 3.3 5 x .00 or transfers under Sec. 9116(a)(1.2) (12) (13) (14) (15) 7,183.35 7,183.35 0.00 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [] Copyright 2000 form software only The Lackner Group, Inc. x .045 x .12 x .15 (16) (17) (18) (19) 0.00 Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 17 Nottingham Road ~ITY .... Camp Hill STATE PA ZiP 17011-7919 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) 0.00 Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty (D + E) 0.00 (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page I Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) 0.0 0 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 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 cons derat on? ................................................................................................................. [] [] 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 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. 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 preparer other than the personal representative is based on all information of which prepar_er has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS -, · - ~ - DATE Marth'' g Bison pqottlngnam t~oao ~JG~ATuhE OF P~RSON RESI5OI~S'I~-LE F~OR FILING RETURN ADDR~g~ SIGNAT[ Paul J ! OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE University Drive tate College, PA 16801 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 3% [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 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes 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 0% [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%, 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% [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. ,~ SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY .ES,DEN~- OECE~ENT ESTATE OF FILE NUMBER Faison, Thomas S. 21 - 2002 - ITEM DESCRIPTION OF PROPERTY , % OF Include the name of the transferee, their relationship to decedent and the date of transfer DATE OF DEATH NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S EXCLUSION (IF APPLICABLE) INTEREST 1 Thompson Learning Corporation 7,183.35 IRA #- 935761-01 Beneficiary: Martha E. Faison, spouse See attached statement. This schedule must be completed and filed if the answer t° any of questions I through 4 on parle2 is )/es. TAXABLE VALUE TOTAL (Also enter on line 7, Recapitulation) ?,183.35 THOMAS S FAISON 17 NOTTINGHAM ROAD CAMP HILL PA 17011 PARTICIPANT ID: 1805620 THOMPSON LEARNING CORPORATION ACCOUNT STATEMENT January 01, 2002 through March 31, 2002 GROUP ACCOUNT NUMBER: 935761-01 Your Individual Rate of Return for this quarter is -3.54% Personalized l?erformance information is provided as an approximation of the overall performance of vour account. It is based on a formula which estimates the quarterly rate of return using the opening balance, transaction activity and dosing balance. Pas~ performance is not a guarantee or prediction of future results. Please see the .Annualized Fund ' Performance on the preceding page(s). ITOTAL ACCOUNT BALANCE March 31. 2002 $7.183.35 EMPLOYEE BEFORE TAX BEGI%ND,(; TIL\ ", q F E RS, IxYESTMENT ENDING BA~ N{:E CONTRIBUTIONS DISBLRSEMEN IS REINVESTMENTS ~XRNIN(;S BA~NCE ~ ,n~ 2,90~ 96 0.00 0,00 0.00 '1 ~4.56 2,823 ?rt.m~r lc, hnoh,~) ~r,~ih A 1,600.92 O. O0 0.00 0.00 -6~.20 Moderately ,Xggr~ss~e Pr.t~lr Il 1,S38.'6 0.00 0.0U 0.00 15.56 1,854.32 SI BTOTAL S6.437.64 S0.00 S0.00 S0.00 -S225.20 S6212.41 EMPLOYER MATCH SUBTOTAL BEI;INNIN(; TR,\ NSFERS~ I'n V ESI MENT ENDING BA LA Ng'E C()NTRIBU FIONS I)I~BURSEMEN rS REINVES I MENTS ~XRNIh(;S BA~ NCE 90.41 0.00 0.00 0.00 -~.'0 93.62 49.21 0.00 0.00 OMO -2.03 4~.18 66.~1 0.00 0.00 0.00 0.56 6~.07 S215.13 $0.00 S0.00 SI}.(II) -57.26 S207.87 Page 1 3'~3633386'/'87020a2002 Great-West LIFE & ANNUITY INSURANCE COMPANY THOMAS S FAISON 17 NOTTINGHAM ROAD CAMP HILL PA 17011 PARTICIP~,NT ID: 1805620 THOMPSON LEARNING CORPORATION ACCOUNT STATEMENT January 01, 2002 through March 31, 2002 GROUP ACCOUNT NUMBER: 935761-01 EMPLOYER PROFIT SHARING ~ tJ BTOT-.X L BEG I % N I NC; !'R.\ '~SFFRF ! ", ', ES F\I ENT EN DI ~(; [~A ~ Nt'E ~'~NTRIBUTION$ DISBL RSEMEN'FS REIN~ESFMEN :~ ~XR~I~(;~ 385.46 0.00 0.00 0.00 -22.44 363.02 242.23 0.00 0.00 0.00 - 10.02 232.21 166.40 L00 0.00 0.00 1.41 167.~1 57~4.09 '.~h00 S0.00 Sl}.011 -- ~1.05 S763.0 I TOff ~L 2,482.83 0.00 q.00 ;00 -202.'0 3,280.04 TOT.__ '~L__ $7.4a6.Sr~ S0.011 $0.00 S0.110 -$263.51 q:.183.35 53§.104900 9.02686q ~.331343 6.095539 END OF' :ST ~,TE.",IENT Page 2 C re t-West LIFE & ANNUITY INSURANCE COMPANY REV-1513 EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Faison, Thomas S. SCHEDULE J BENEFICIARIES NUMBER I. 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Martha E. Faison 17 Nottingham Road Camp Hill, PA 17011 , FILE NUMBER 21 - 2002 - RELATIONSHIP TO AMOUNT OR SHARE DECEDENT OF ESTATE Do NoLListJlustee{s) Spouse 7,183.35 Enter dollar amounts for distributions shown above on lines 15 through 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET FI¸ McQUAIDE BLASKO ATT() R N I!YS AT LAW 811 University Drive, State College, Pennsylvania 16801-6699 MAIL CUMBERLAND COUNTY REGISTER OF Wl l. US OFFICE CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE CARLISLE, PA 17013-3387 BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX D/VISION DEPT. zBn601 HARRISBURG, PA 171ZB-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-I$4? EX AFP (01-0S) PAUL J TOHCZUK HCQUAIDE BLASKO 811 UNIVERSITY DR STATE COLLEGE PA 16801: DATE 04-14-2005 ESTATE OF FAISON DATE OF DEATH 01-21-2002 FILE NUHBER 21 03-0157 ~COUNTY CUHBERLAND ACN 101 Amount Remitted THOHAS S HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I1~ RETAIN LONER PORTION FOR YOUR RECORDS *,~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF FAISON THOHAS S FILE NO. 21 03-0157 ACN 101 DATE 04-14-2003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 1. Real Estate (Schedule A) 2. 5. 4. $. 6. 7. 8. ORIGINAL RETURN (1) Stocks and Bonds (Schedule B) (2) Closely Held Stock/Partnership Interest (Schedule C) ($) Mortgages/Notes Receivable (Schedule D) (4) Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5) Jointly Owned Property (Schedule F) (6) Transfers (Schedule 6) (7) Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) lO. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Tote1 Deductions 12. Nat Value of Tax Return 15. 14. (9) (10) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax O0 O0 O0 7z183.35 (8) .00 00 NOTE: To insure proper O0 credit to your account, O0 submit the upper portion of this form with your tax payment. .00 NOTE: 7,183.35 (it) (la) 7,183.35 (13) .00 (14) 7,183.35 If an assessment Nas issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. 18 and 19 will ASSESSHENT OF TAX: 15. Amount of Line 14 st Spousal rats 16. Amount of Line 14 taxable at Lineal/Class A rats 17. Amount of Line 14 et Sibling rata 18. Amount of Line 14 taxable at Collateral/Class B rats 19. Principal Tax Due TAX CREDITS: PAYNENT RECETpT DTSCOUNT DATE NUMBER INTEREST/PEN PAID (- IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (is) 7,183.35 x O0 = .00 (16) .00 x 045 = .00 (17) . O0 x 12 = . O0 (18) .00 x 15 = .00 (19)= . O0 AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUEI .00 INTEREST AND PEN. .00 TOTAL DUE . O0 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) RESERVATION: Estates of decedents dying on or before December 12, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decadent after tho expiration of any estate for life or far years, the CoeeonNealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collataral) rate an any such future interest. PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of logo. (7Z P.S. Section 9140). Detach the top port[on of this Notice and submit eith your payment to the Register of Nills printed on the reverse side. --Hake check or money order payable to: RBGXSTER OF HILLS, AGENT A refund of a tax credit, ehich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications era available at the Office of the Register of Nills, any of the 13 Revenue District Offices, ar by calling the special Z4-hour ansearing service for forms ordering: 1-800-362-2050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only), Any party in interest not satisfied with the appraisement, alloaance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oapt. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6305. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (EX) discount of the tax paid is allowed, The lex tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period es you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z3 percent par annum calculated at a daily rate of .000164. AIl taxes which became delinquent on and after January 1, 1981 will bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOS ars: /nterest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1981 ZOZ .000548 1987 91 .000247 1999 7Z .000192 1983 16X .000438 1988-1991 111 .000301 ZOO0 8Z .000119 1984 11Z .000501 1991 91 .000147 2001 9Z .000147 1985 13Z .000356 1993-1994 71 .O00lgz ZOOZ 6Z .000164 1986 I0Z .000274 1995-1998 91 .000147 2003 52 .0001~7 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAID X NUNBER OF DAYS DEL1NQUENT X DALLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.