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Home My WebLink About01-11-121505610101 REV-1500 ext°'.1°' ennsylvanta OFFICUIL USE ONLY PA Department of Revenue P County Code Year Frle Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 i Harrisburg, PA 1']128-0601 RESIDENT pECEDENT ~ t 1 U U C..~. ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 586-54-3535 04/30/2010 07/02/1942 Decedent's Last Name Suffix Decedent's First Name MI NGUYEN BANG V (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mi NGUYEN HO-THANH T Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 586-58-4574 REGISTER 4F WILLS FILL IN APPROPRIATE OVALS BELOW OID 1. Original Retum O 2. Supplemental Return O 3. Remainder Retum {date of death priarto 12-13-82) O 4. Limited Estate O 4a. Future )merest Compromise (date of Q 5. Federal Estate Tax Return Required death after 12-12-82) O 6. 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 1 D. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between i2-31-91 and 1-1-95) (Allach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALl CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number MARYANNE NGUYEN First line of address ~~ S'~UYIZ~l[' C?~ C1 fJ X1''1 Second line of address J City or Post Office hn,c ~~, a r~ ~ c ~ lovr~ CorrespondienYs e-ma[I address: State ZIP Cj~ode 1 ~' )~ 1~1 `-- ~ J REGISTER OF WILLS USE ONLY _~~ r-:. `~ ~ i,__. _ _-r- -- ~~ ,~. --: J i ~ •, Under penalties of perjury, I declare that 1 have examiri@~ this nitum, including eccornp n 'ng schedules and statements, and to the best of my knowledge and belief, it is true, coned and wmplete. OeclareGon of preparer other than the personal represen live is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN a GATE SIGNATURE OF PREPARER OTHER yHAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L`r ;,-~,_} ._. ~ ~-. 7 Side 1 L„_ 1505610101 1505610101 ~~ 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: NGUYEN, BANG V. 586-54-3535 RECAPITULATION 1. Real Estate (Schedule A) ........................................ ..... 1. 91,100.00 2. Stocks and Bonds (Schedule B) .................................. ..... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. 9 9 ( ) .. .. .................. Mort a es and Notes Receivable Schedule D 4. ..... 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. 879.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .. ..... 6. 0.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested... ..... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) ........................ ..... 8. 91,979.00 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 15,157.78 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... ..... 10. 48,495.26 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 63,653.04 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. 28,325.96 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 28,325.96 TAX CALCULATION -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 .0 0 879.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 27,446.96 16, 1,235.11 17. Amount of Line 14 taxable 0 00 00 0 . at sibling rate x .12 1 ~. . 18. Amount of Line 14 taxable 0 00 0 00 . at collateral rate X .15 18 . 19. TAX DUE ..................................................... ....19. 1,235.11 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610],05 REV 1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME BANG V. NGUYEN STREET ADDRESS ----- --- ------ 1750 YORKSHIRE PL CITY -- ~---STATE ~ ZIP -- ENOLA PA j 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2 Credits/Payments A. Prior Payments ___ 0.00 i3. Discount 0.00 3. Interest 4. If Line 2 is greaser 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. Ii Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX OUE. (1) 0.00 Total Credits (A + B) (2) 0.00 (3) 0.00 (4 j 0.00 (5) 1,235.11 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 :............................................................ ,.... ..... ^ x^ b. retain the right to designate who shall use the property transferred or its income : ....................... ................ ..... 0 c. retain a reversionary interest: or ..................................................................................................................... ..... ^ d. receive the promise for {ife of either payments, benefits or care? ................................................................. ..... ^ Q 2. Ii 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? .................................................................................................................... .... ^ ^fc 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 lax 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 [l2 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 velum 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 Uansfers 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 lax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent, 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 percent [72 P.S. §9116(a)(1.3j]. Asibling is defined, under Section 9102, as an individual who has al least one parent in common with the decedent, whether by blood or adoption. Pennsylvania DEPARTMENT Of REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER BANG V. NGUYEN 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 wmpel(ed to buy or sell, botfi having reasonable knowledge of the relevant facts. Real property that is jointlyrowned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest iF owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 91,100.00 1 • ~ 1750 YORKSHIRE PLACE, ENC+LA, PA 17025 5096 OWNER TOTAL (Also enter on Line 1. Recaoitulation.l ~ S 91,100.00 Cuml~crland County tioald of Assesslnenf Appeals Old Courthouse, Fu'sl Floor One Courthouse Square Carlisle. PA 17013 (((I11t„111,1„tI(I(I,Ilttltlll,-I,i„hl,l„LI,II1,,,,1, t!ts>~ NCi)YEN, BANG V ~. to rt !. MI('IiAF,L T NGUYEN 1750 YONfi:ilI1HF. PLA('E h:N<)LA, I'A 170"?5 .''.795 THI 1S N T AX ~ Deadline for Scheduling an Informal Review AI~pOirltmellt: August 30, 2010 fur 111'1.111. I11u;1~.C tit;t~ lhE; 1(W(:fS(? blot' ~~-- _ . _ -----.--.,_ - -- _ ~IQTI6E'OF~CHAN~E'flF ~4SSESSMENT - _ . - .. _--- ------ _ _ _ -~ .I•.• ~ la',I,t'11•Illrl (.u1n11`• fit l.ntl ,;) /`:'r•••t1n•Iti AI,I)t•:Ils, c: Irtuvuitny yuu tvllh nr,ltc'e OI Uu~ v.auc l~n IIttS I,rn(uvly :• !• Il,unt',l .r .1 I,'•.IIII t•I Iln: t:unl!„•Il:llnl (.,IIUIIV (uuttlYwul(: Iz•;C.•,1•t r,nu•Ilf ,..nt{,Itri(:r! tlns, yr.,tr. I ltt~ ('r>urtt)nvlc)r. I .. ' n., t1I v.lln+'. 1•.Ir II 1~1„I+r'11~ ,I' I uu,•t,t !.rlt M.nlrt't l/•r1tA• ,,', ul l,u:(„tIY 1.:'1110. (•,{u,Jhruttl ,utd t•~;t;thltr,lunO .r .~ i" +Int I„• I,.,•,,' '.,, I}l,tl In<1lu•11u'• ,,+ bl <• , I :Il.a L'11•,11r'.:lnrl Iht' :.1111,• ,u tu.rl 1 ,lu A1•rrl•r•1 b•.l/ut tvtll hr t:rxttcl ltx• ~•,nlli' f ORMAL APPEAL DEADLINE: August 10, 2010 Ita 1 1 11T: 1,A'('I-': •lu l y 7, .'P 1 U tL+,., .•4 I•:A!'T 1'I.NN_;Hr,If(+ 'I'r1( 1.. •..: : 1;A:7T J 4N4:Hr ,tut bU ,, 1, .,. , Y~ 1 ~: lill~l•: 1'LAtY 1 l+:. ~ r• I tl 1 I.1.:: Ply U(•1'ti ,o.,t Lul Ill: 1+ILA 111",. U'~(lu :1• 1..,,..:, l1rt •r ..~,•Inr'7J1 !. „Illy .., ~.., , , .,••,1,..: Ir +o..,,. t..,J r.lr,,,w••,I ESTIMATED TAX IMPACT Parcel I(lenlitier: 09-14-0835-082.-U50 cola n.,~.[~ Y[;11 n5ti(~,~•r•d v.dlt~ old Assca~(•[I v;dltt~ F au M.ukt•t V.,hu' (?1110 M:ukct x 100'% 1 1200-0 MalkM} I .,nd 0 0 0 i ' Ruiltlings I 1 R2, 200 182, 2U0 157, 390 TOTAL I 1R2,200 162,?.00 157,390 1 , f 2010 Ck•:rn :uui Gruen Values I t 1 a(n1 WOT ... NOT I I NOT Rulldiuys APPLICABLE APPLICABLE APPLICABLE ~ o, AI I ~ ! (. .r;r ,un! r.n , !r ,,dn,• ,,lq~l~ !~. ,;I• ,hti, •,1 Lun' .,rnl L:1,•' E l.nuJ .uuf L, „~rm• , 'I, •, tra ' ~duv a{~„(+ ,ggd n •,ludi ,unf +I r•t~n,,l •• rn ,n.! (.'r,v, .t1,l,6ralu~rlo-' luu• 1 1,., na r•.v,•• Irr liu• /1~'a•• •d n, nl , 11+u ,: nc, Ld,•t Il,.d' '.'i {. nl ull l,t.b,l,t•t I',. 1l)Ill ThUaC I O[l•V1UlI51y ar)IItUWII) r[1( lrrP.ll] .UIU L;/r•f'rl dU IIUr IICL•d l0 rC-apply. { , :r r ,,,,n l,lr'llnun,uv ~ •.Intt,ltr• r+l , (,tntly L,x[•'. It,l 1U11 (,.lllr•I t(',1`•~,t^,:•rllrlli) 1 Illltir,uull vVlfll y(n.lr 1111U {(,ulr(ai!) ,• 1~rv 1.: •~ ~ I\ I,rl,(I r':.11r,lrltr•,I LI, t'tull:lr (+ r,ulily, Itlunlt Ilr;Il, s,.luxll (ir•Incll rs av:1,LIt11e r,nllrl(> See uul wclq,uyc. ' ><b + • I~., lu•I 1'llr ~. 1111'!t 1 li+~,l:•' ," 1nt t!I III I+,~YL'I Ilrlllt nl II(tllll` Ir,tll(, (.'urrent 2010 County mills = 2.579 Adjusted 2010 County mills - 2.074 4U6 ?0] 0 <'UUNTY Tar. BEFORE ReaGSessment . 3.1R 2(110 ('t7UNTY Tax AFTP:R lteas:;r:;smPnt. REV-iso8 EX+ (ii-io) pennsytvania ti CDEPARTMENt OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDt~LE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE 0F: FILE NUMBER: BANG V. NGUYEN Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly owned with right of survivorship mast be disclosed on schedule F. Pennsylvania SCHEDULE H DEPARTMEN70f REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER BANG V. NGUYEN Decedent's debts must be reported on Schedule I. A. I FUNERAL EXPENSES: I' FUNERAL EXPENSES e. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) __ _ StreetAddress_,__ __' _-__ _ _ - CitY - _____ ____, __-.____ State ___ ZIP Year(s) Commission Paid: 2. Attorney Fees: 3. Famiiy Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address ___ v City - -- -- ----- ---- State _ -_ ZIP - -- - -_ _ Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. AMOUNT 15,157.78 TOTAL fAlso enter on Line 9. Recaoitulationl ~ 3 15,157.78 Pennsylvania SCHEDULE I OEVAATMENT OF REVENUE DEBTS OF DECEDENT, INHE0.ITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER BANG V. NGUYEN Report debts incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses.