HomeMy WebLinkAbout06-29-11J 7,51]561~1Q5
REV-1500 EX (o2-ii) (FI} '.
OFFICIAL USE ONLY
PA Department of Revenue pennsytvania County Code Year File Number
Bureau of Individual Taxes ~pINHERlTANCE TAX RETURN ,.
PO BOX z8o6o1 RESIDENT DECEDENT `
Harrisburg, PA 1~1z8-o6oi
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MPvtDDYYYY Date of Birth MMDDYYYY
196-05-1899 01 /22/2011 08/19/1917
Decedent's Last Name
Suffix
Decedent's First Name MI
Joseph P
Sza~ek
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suftix
Spouse's Social Securty Number
FILL IN APPROPRIATE OVALS BELOW
~ 1, Original Retum O
Spouse's First Name M1
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Retum O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O E. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(Aj
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Joel Szaiek (717) 982-6307
First Line of Address
1014 Southfield Court
Second Line of Address
City or Post Office State ZIP Code
Harrisburg PA 17~~~
Correspondent's e-retail address: PAPOIIaCk@hOtmalLCOm
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REGIS WILLS I~SE ONL~j=, ;
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GATE FILED '•
Under penaltles of per , I de a that I have exami this return, including accompanying schedules and statements, and to the trest of my knowledge and belief,
it is true. co ct and o plet claraGon of prep er ther than the personal representative is based on all information of which preparer has any knowledge.
S!GNATUR OF PE ON NSI EFO ILWG RETURN DAT ,.
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ADDRES~ ~!i~l~`~ c.J~\W~11 \~~~ ~~ ~1.'` ~ ~~IJ ~.1'~It'~I ~a.~l ~~~ ~,
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE 4 DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 15056,0105
J
15~561~2175
REV-1500 EX (FI) Decedent's S:~cial Security Number
196-OS-1899
Decedent's Narne:
RECAPITULATION
1. Real Estate (Schedule A) ........................................... .. 1.
2. Stocks and Bands (Schedule B) ..................................... .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship {Schedule C) ... .. 3.
4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4.
5 Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5.
6 Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7,907.51
7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property
12
562
00
(Schedule G) O Separate Billing Requested..... ... 7. .
,
8
( g ) ................
Total Gross Assets total Lines 1 throu h 7 . ... 8. 20,469.51
9
p ( ) ................
Funeral Ex enses and Administrative Costs Schedule H 9.
... 1 ,626.50
10. debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10.
11. Total Deductions (total tines 9 and 10) .. . ........................... ... 11. 1,626.50
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 18,843.01
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. 18,843.01
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
1 `~. Amount of line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ 15.
1 Ei. Amount of Line 14 taxable
at lineal rate X .0 45
16.
847.94
1 ' . Amount of Line 14 taxable
at sibling rate X .12 1 ~
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
Side 2
1505610205 15~56102lJ5
847.94
O
J
REV-1500 EX (FI) Paoe 3
Decedent's Complete Address:
Joseph P. Szajek
-------- ---
- -
STREET ADDRESS
1100 Crandon Way
_ _ __-_
__ __
CITY
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (°age 2. Line 19)
2. CreditslPayments
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.
5. Pf Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
File Number
__ _ _
STATE -
ZIP
PA 17055
(1) 847.94
Tota! Credits (A + B) (2)
(3)
(4)
(5) 847.94
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 ....................................................................................................................... ...... ^
d. receive the promise for life of either payments, benefits or care? ............................................................... ...... ^ ^
2. If death occurred after Dec. 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 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(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}]. 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.
REV-i5og EXi (oi-io)
~~i, Pennsylvania
DE?ARTh1EMi OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHED~ILE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
Joseph P. Szajek 2011-00355
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A Joel Szajek
1014 Southfield Court
Harrisburg, PA 17111
Son
B.
C.
]OINTLY OWNED PROPERTY:
;TEM
NUMBER LETTER
FOR 70INT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET i of
DECEDENT'S
INTEREST DATE of DEATH
VALUE OF
DECEDENT'S INTEREST
1. A.
Sovereign Bank 0971119325 6,637.00 100 6.637.00
Sovereign Bank 098109389 1, 270.00 100 1, 270.51
TOTAL (Also enter on Line 6, Recapitulation) $ '•907.51
If more space is needed, use additional sheets of paper of the same size.
-_.-_.. o ~x . ~:~ .<<3
~ `pennsylvania SCHEDULE G
oE~narr+ervT of aEVEri+~E INTER-VIVOS TRANSFERS AND
ESTATE OF
FILE NUMBER
Joseph P. Szajek 2011-00355
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
ihc.~oerH~~ar~=oF-He?w,ns~aaee,r~=~eae~nomsn»Toc.c=_oe,ravo
rna Dare of -s~NS~R. Ar'~ach A ccvr of rs+e oeee Foa Raa~ =sra~.
DATE OF DEATH
VALUE OF ASSET
°InOFDECD'S EXCLUSION
INTEREST pr aoaucnaLa)
TAXABLE
VALUE
1. Sovereign Bank 8122029884 -Trust Account -paid out to Rose Szajek I
I
i 12,562.00
I
~
I 100 i X2,562.00
i
~~
i
~
i
i
i
i
i
i
!,
i
~~
i
I
i 0.00
TOTAL {Also enter on Line 7, Recapitulation) $
IF more space is needed, use additional sheets of paper of the same size.
0.00
Pennsylvania
GEFAH7MENT OF HEVEPJIIF
INHERITANCE TAY RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Joseph P. Szajek 2011-00355
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES;
~ Hoover Funeral Home -Cremation
~ 1,493.00
B. ADMINISTRATIVE COSTS:
I. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City _ --
Years} Commission Paid:
State
ZIP __
2• ~ Attorney Fees;
3. ( Family Exemption; {If decedent's address is not the same as claimant's, attach explanation.}
Claimant
Street Address
City -- _ - ----- ---------____--- State ZIP
Relationship of Claimant to Decedent
?~ Probate Fees:
~• Accountant Fees:
6• Tax Return Preparer Fees:
7.
TOTAL (Also enter on Line 9, Recapitulation) $
if more space is needed, use additional sheets of paper of the same size.
133.50
1,626.50