The URL can be used to link to this page

Home My WebLink About10-03-11 (2) 1505611185 1500 EX (02-11) (FI) REV - OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 21 11 0172 Po Box zsosot Harrisburg, PA 17126-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 104-24-8459 01072011 07021930 Decedent's Last Name Suffix Decedent's First Name M I TAYLOR VIVIAN E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I 640~ERFORD ROAD CA L PA 1701,1 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE T METTE, EVANS & WOODSIDE // ADDRESS 3401 N• FRONT STREET, PO BOX 5950 HARRISBURG, PA 17110-0950 PLEASE USE ORIGINAL FORM ONLY Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death Prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death ^ 11. Election to Tax under Sec. 9113(A) 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 TO: Name Daytime Telephone Number JEFFREY A • ERNICO, ESQ • 717-232-x5,000 m. ' x? REGISTERQF~.LS USE LY _ ',~T"1 I ~ First Line of Address F',- J t_s C'am' c7 '"`' ' ~', 3401 NORTH FRONT STREET 7~`~ _ _ -; Second Line of Address !~ ~ -`; -- '.,., --+ ° -~ PO BOX 5950 c.°~ City or Post Office State ZIP Code DATE FILED HARRISBURG PA 1711DD95D Correspondent's a-mail address: J A E R N I C O a~ M E T T E• C O M 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 of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE DEBORAH E • SGRIGNOLI ~ /,~Q~LI ~ ~~~- / / 1505611185 Side 1 OM4647 3.000 1505611185 1505611285 REV-1500 EX (FI) Decedent's Social Security Number 104-24-8459 Decedents Name T A Y L O R V I V I A N E RECAPITULATION 1. Real Estate (Schedule A) 1. 10 8 , 0 0 0 • 0 0 2. Stocks and Bonds (Schedule B) . 2. 0 . 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3. Q . Q Q 4. Mortgages and Notes Receivable (Schedule D) 4, 0 - 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 1, 8 2 5.0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g. 6 4 5 • 8 8 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested 7. 0 • 0 0 8. Total Gross Assets (total Lines 1 through 7) g, ], ], 0 , 4 7 0 . 8 8 9. Funeral Expenses and Administrative Costs (Schedule H). g. 8 , 3 0 7 . 3 9 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10, 14 , 2 2 9.3 5 11. Total Deductions (total Lines 9 and 10) , 11. 2 2 , 5 3 6.7 4 12. Net Value of Estate (Line 8 minus Line 11) 12, 87, 934 •14 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , . 13. Q . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 8 7 , 9 3 4 •14 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 16. Amount of Line 1 4~xable at linealratex.o- 87,934.16 16. 3,957.04 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. Q' Q Q 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 1 g Q• 0 0 19. TAX DUE 19. 3 , 9 5 7.0 4 ^ 20. FILL IN THE BOX tF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX (FI) Page 3 n.. ...L...t~c f`..mnlntn erlrlrocc• File Number _~___. _.-_ _ _ ____r___ _ _--_ - - - DECEDENTS NAME TAYLOR VIVIAN STREET ADDRESS CUMBERLAND COUNTY CITY CAMP HILL STATE PA ZIP 17011- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments ~ • ~ ~ B. Discount ~ (1) 3,957.04 Total Credits (A + B) (2) ~• (3) ~ • 0 0 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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) 3 , 9 5 7 - 0 4 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 ^X a. retain the use or income of the property transferred i i ^ ncome ts b. retain the right to designate who shall use the property transferred or 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? . " " ^ or payable-upon-death bank account or security at his or her death? in trust for 3. Did decedent own an Did decedent own an individual retirement account, annuity, or other non-probate property, which 4 . ^ 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. §91 16 (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)]. 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. OM4671 2.000 REV-1502 EX+ (01-10) Pennsylvania DEPARTMENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: Vivian E Taylor 21.11 0172 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet 'If the property has been solo. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Real estate situate in East Pennsboro Township, Cumberland County, Pennsylvania, known as 640 Erford Road; Tax Parcel Number 09-16-1050-260 Valuation is based upon tax assessed value of $108,000 at applicable Common Level Ratio factor of 1.0. TOTAL (Also enter on Line 1, Recapitulation.) $ swasss z.ooo If more space is needed, use additional sheets of paper of the same size. 108,000.00 108.000.00 REV-1506 EX+ (11-10) Pennsylvania SCHEDULE E DEPARTMENTOF REVENUE CASH, BANK DEPOSITS, ~ MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: ' '~~ """"'"~' Vivian E Taylor __ 21 it 0172 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1989 Pontiac Grand Prix, 80,000 miles, poor condition 500.00 2 Household goods and furnishings and miscellaneous personal effects 1,000.00 3 Diamond engagement ring 325.00 NOTE: The other two pieces of jewelry referred to in Item Third of decedent's Will were given away more than one year prior to death TOTAL (Also enter on line 5, Recapitulation) $ ~ 1 , 825.00 owaeAO 2.000 If more space is needed, use add'Aional sheets of paper of the same size. REJ-1509 EX+ (•71-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER: Vivian E. Ta for 21 11 0172 ff an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURV NING JOINT TETyANT(S) MANE{ S) ADDRESS REIATIONSHIP TO DECEDENT A Sgrignoli, Deborah E 1640 Erford Road, Camp Hill, PA 17011 Daughter JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENPNT QATE MADE I JOINT DESCPoPTION OF PROPERTY NCLUDE NAAE OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUM3ER Ofi SIMLAR IDENTIFYINGNUM3ER.ATTACHDEEDFORJgNTLYHELDREALESTATE. ~'~ OF DEATH VALUE OF ASSET °~ OF DECEDENT'S INTB~EST DATE OF DEATH VALLIE OF DECEDENT'S INTEREST 1 A 9/25/200 Members 1st F.C.U. Holiday Club Account #254373-02 45.01 50.0100 22.51 2 A 11/16/200 4 Members 1st F.C.U. Checkin Account #254373-11 1,138.03 50.0000 569.01 3 A 11/16/200 4 Members 1st F.C.U. Regular Savings Account #254373-00 108.71 50.0000 54.36 TOTAL (Also enter on Line 6, Recapitulation) E 645.88 swasAE z o0o If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10.09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Vivian E. Ta for 21 11 0172 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Auer Cremation Services of PA (Balance of funeral was prepaid) 49.00 Total from continuation schedules . B. 1 2. 3. 4. 5. 6. 7. 1 2 9W46AG 2.000 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Deborah E Sgrignoli Street Address 640 Erford Road City Camp Hill State PA ZIP 17011 Relationship of Claimant to Decedent DAUGHTER Probate Fees: Accountant Fees: Tax Return Preparer Fees: Cumberland Law Journal Legal advertisement The Sentinel Legal advertisement State ZIP TOTAL (Also enter on Line 9, Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. 160.97 4,000.00 3,500.00 345.50 75.00 176.92 8,307.39 Estate of: Vivian E. Taylor Schedule H Part 1 (Page 2) Item No. Description 2 Patriot News Obituary 21 11 0172 Amount 160.97 Total (Carry forward to main schedule) 160.97 REV-1512 EX+(12-OS) SCHEDULE Pennsylvania DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES H~ LIENS OFCIr1FAiT f1Fl:Fr1FNT ESTATE OF FILE NUMBER Vivian E. Ta for 21 11 0172 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH 1. American Home Patient Medical bill 20.58 2 Bank of America Account #4888930082727691 - credit card 4,624.00 3 Citibank - credit card 2,734.64 4 Discover - credit card 2,971.98 5 GE Consumer Finance - Lowe's consumer credit account 853.36 6 Members 1st F.C.U. Account #254373-04 - unsecured loan 1,378.06 7 Pennsylvania Gastroenterology Consultants Medical bill 180.00 8 Quantum Imaging Medical bill 242'77 9 Systems and Services Technologies, Inc. - unsecured loan 730.77 10 Travelers Insurance Homeowners insurance 66.50 11 West Shore EMS Medical bill 100.00 12 Woman Within - credit card 326.69 TOTAL (Also enter on Line 10 Recapitulation) ~ $ 14 , 229.35 awasAH z.ooo If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) Pennsylvania DEPARIMENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: v: _ FILE NUMBER: y"l 21 1 1 0172 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Deborah E. Sgrignoli 640 Erford Road Camp Hill, PA 17011 Diamond engagement ring Inventory Value: 325.00 Members 1st F.C.U. Checking Account #254373-11 Inventory Value: 569.01 Members 1st F.C.U. Holiday Club Account #254373-02 Inventory Value: 22.51 Members 1st F.C.U. Regular Savings Account #254373-00 Inventory Value: 54.36 25$ of Residue: 21,740.82 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. I NONTAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBU110NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00 SCHEDULE J BENEFICIARIES 9W46AI 2.000 """ c ~Nacc io i iccucu, ~~c euuni~nai sneers or paper or me same size. Estate of: Vivian E. Taylor Schedule J Part 1 (Page 2) Item No. Description 1 Daughter 2 Barbara E. Spencer 107 Sholly Drive Mechanicsburg, PA 17055 One Quarter of Residue: 21,740.82 3 Joan M. Naugle 124 West Portland Street #45 Mechanicsburg, PA 17055 25$ of Residue: 21,740.82 4 Paul L. Taylor 11 Hematite Road Cornwall, PA 17016 One Quarter of Residue: 21,740.82 Relation Daughter Daughter Daughter Son 21 11 0172 Amount 22,711.70 21,740.82 21,740.82 21,740.82