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Home My WebLink About06-30-111505610143 REV-1500 Ex(°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 0 9 Harrisburg, PA ~7~2s-oso~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 166 40 5407 11 15 2009 O1 02 1952 Decedents Last Name CARRAI (If Applicable) Enter Surviving Spouse's Information Below Suffix Decedent's First Name EDWARD MI B Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW '~ x 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) ' 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) ~~', 6 Decedent Died Testate ~ ~~ ~ t acheCoMaiof Trusd a Living Trust ~ 8. Total Number of Safe Deposit Boxes i ~~"Attach Copy of Will) Py ) Ci, 9. Liti ation Proceeds Received ~ 10. Spousal Povert Credit (date of death ~ 11. Election to tax under Sec. 9113(A) g between 12-31 ~J1 and 1-1-95 (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GEORGE F DOUGLAS III ESQ 717 249 6333 First line of address 354 ALEXANDER SPRING RO Second line of address City or Post Office State ZIP Code CARLISLE PA 17015 '1,7 .~~~-, ,~ . ', , _., -= ~~ ._; ~ Correspondent's a-mail address: gdOUglaS@SalZmannhugheS.COm Under penalties of perjury, I it is true, correct and complf ~~ ADDRESS that I mined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, on of preparer other than the personal representative is based on all information of which preparer has any knowledge. .E FOR FILIN RETURN DFlTE ~~~ ~v/1( ZS~Zd~~ Edward B. Carrai II (~-/.~%?,'~ j{ 610 25th Street South, Arlington, VA 22202 SIIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DAT Y'tc~ m ~ ~' . `~~~,=~t'2 q ~t George F Douglas, III Esq. G, j L! I I 354 Alexander Spring Road, Suite 1, Carlisle, PA 17015 Side 1 REGISTER Ol~tlILLS USE OFFLY ~~ ~ -..:. ~_ --1:=~ 7 •:Ji ~ Ca ;m> - -1--ry ^-,~ .7 `,.. DA'~~ED .~` File Number 1155 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Ciarra 1, Edward B. 166 40 5407 REC APITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 4 , 982 . O2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 551.14 7. Inter-Vivos Transfers & Miscellaneous ~on~ Probate Property (Schedule G) a Separate Billing Requested............ 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... g. 5 , 533.16 -- - 9. - - - Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 1 O , 72 9 . 2 O 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 17 , 722.32 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 28 , 451.52 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. -22 , 918.3 6 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. -22 , 918.3 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15. 0.00 (a)(1.2) X .00 16. Amount of Line 14 taxable O. O O 16. O. O O at lineal rate X .045 17. Amount of Line 14 taxable O OO 17. 0 • 00 . at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18. O_ O O ' at collateral rate X .15 19. Tax Due ................................................................................................................ .. 19. 0 . O O 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 REV-1500 EX Page 3 File Number 21-09-1155 Decedent's Complete Address: DECEDENT'S NAME Carrai, Edward B. _ STREET ADDRESS 600 Big Spring Rd. CITY Newvrlle STATE PA TZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + g) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) x,00 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 b. retain the right toldes gnatetwho shalrtuse the property transferred or its income :............................_.... U' x c. retain a reversionary interest; or .............................................................................................................. ~ ~~ d. receive the promise for life of either payments, benefits or care? ...................................................... _.._ ~ [x] 2. If deathg ccurred after December 12, 1982, did decedent transfer property within one year of death without ~ r _, receivin adequate consideration ................. ~_' 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?...... J x] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which __ contains a beneficiary designation? ............................................................................................................_.... ~~ ^x 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 January 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)j. 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)J. . 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)j. 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-1508 EX+(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Carrai. Edward B. 21-09-1155 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. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (8-98) SCHEDULE F COMMONWEALTH DE RENNSV~VAN~A JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Carrai, Edward B. 21-09-1155 -_ 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 A. Edward B. Carrai II 610 25th Street South Son Arlington, VA 22202 B. C. IOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT 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 ASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENTS NTEREST 1 A 9/111999 M&T Bank, Checking Account No. 950227161 963.18 50.000% 481.59 2 A 8/18/1993 M&T Bank, Savings Account No. 139.10 50.000% 69.55 15004208634681 TOTAL (Also enter on Line 6, Recapitulation) I 551.14 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+(10-06) COMMNHERITANCE TAX RETURN ANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Carrai, Edward B. _ 21-09-1155 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(sl Commission paid State Zio 2. Attorney's Fees Salzmann Hughes, P.C. 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 2,425.60 6,964.94 4 Probate Fees 92.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 75.00 7. Other Administrative Costs 1,171.66 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 10,729.20 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Carrai. Edward B. 21-09-1155 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expgnses 1 Hoffman Roth Funeral Home -balance due 2 Hoffman Roth Funeral Home -funeral services 62.00 2,363.60 H-A 2,425.60 Other Administrative Costs 3 Cumberland Law Journal -fee for bond Legal advertising 75.00 4 FedEx -mailing to Administrator in order to administer the estate 15.50 5 Fickel Insurance -fee for bond 128.00 6 Johns' Mobile Repair -towing and storing vehicle in order to administer the estate 640.00 7 Register of Wills -fee for filing claim 10.00 8 Register of Wills -filing fees 13.50 9 Register of Wills -filing fees 30.00 10 Salzmann Hughes, P.C. -FedEx mailings 61.50 11 The Sentinel-Legal -fee for bond Legal advertising 198.16 H-B7 1,171.66 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+t12-O8) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carrai, Edward B. 21-09-1155 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Capital Tax Collection Bureau - 2009, local income tax due 540.33 2 Credit One Bank -balance due on credit card 595.84 3 DCM Services -unpaid balance due to Chrysler Financial Services Americas LLC 4,916.42 4 First Premier Bank -balance due on credit card 316.00 5 Internal Revenue Service - 2008 and 2009, 1040 income tax due 8,473.43 6 Juniper -balance due on credit card 1,196.84 7 NTB Credit Plan -balance due on credit card 600.80 8 PA Dept. of Revenue - 2009 PA40 income tax due 1,082.66 TOTAL (Also enter on Line 10, Recapitulation) I 17,722.32 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11.08) COMMNHERITANCEDTAX RETSYRN ANIA RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Carrai, Edward B. 21-09-1155 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee s I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)1 1 Edward B. Carrai II Son 1/2 Residue 610 25th Street South Arlington, VA 22202 2 Lorraine Carrai Daughter 1/2 Residue Fountain Springs 95 Broad Street Ashland, PA 17921 Total ~ Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet, as a ro I NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-OS) ~VI~'B~:rlk 499 Alitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone(~333?~02-4349 Fax (302) 9 34--29`5 January 19,'OIU Salzmann Hughes, PC 35~ Alexander Spring Road Suite 1 Carlisle, PA Re: Estate of: Edward B Carrai Social Security: 166-40-5407 Date of Death: November 15,_2009 Dear Sir or Madam: Per your inquiry, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Accotiait Account Nurnher 950227161 Ownership (Names of) Edward B Carrai, joint-primary Edward B Carrai 11, joint-seco~ulary Opening Date ~ ~ 09/01/99 Balance on Date of Death $ 963.18 Accn~ed Interest ~ $ 0.00 __ Total $ 963.18 2. Type of Account Savings Account Account Number 15004208634681 Ownership (_Names of) Edward B Carria, joint-primary Edward B Carrai 17, joint-secondary Opening Date 08/183 Balance on Date of Death $ 139.06 Accrued Interest $ 0.04 Total .$...139.10 Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Spring Garden branch, 100 South Spring Garden Street, Carlisle, PA 17013. Office # 717-240-4525. Sincerely, . _., > ` y ~~ r , hZt~ricca .CP.;iI"C