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Home My WebLink About03-09-12 (2)-~ REV-1500 Ex(01-10) 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes OEPFRTMENTOFREVENUE County Code Year File Number Po Box.2aoso~ INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 11 0 0 0 9 8 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 167 40 0642 11 16 2010 10 17 1954 Decedent's Last Name Suffix Decedent's First Name LIPPI M- KATHY A (If Applicable) Enter Surviving Spouse's Information Below 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 ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death ^ 4. Limited Estate ^ prior to 12-13-82) qa Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required ® g Decedent Died Testate (Attach Copy of Will) ^ 7, Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 1 p. Spousal Poverty Credit (date of death between 12-31-91 and 1-i-95) ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE Name COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA TION SHOULD BE DIRECTED TO: ROBERT P K L I N E Daytime Telephone Number 717 770 2540 First line of address 714 BRIDGE STREET Second line of address PO BOX 461 City or Post Ofifice NEW CUMBERLAND Correspondent's a-mail address: _ Under penalties of perjury, I declare that I have it is true, correct and complete. Decl~ticfl-oY[ ADDRESS REGISTER OF,..1~1/ILLS USE ONLY .__. ~ ;~~ -r, ... '~ ~ ,Yy •- fir- C7 r+? ~:I'~- -~ a ? ' ~'3 ~ f"1`7 t _' Gn ~ 1~~ i -- :, . State DA~ QED r•`" _.F -' r-*i , ZIP Code ,; PA 17070 ~~ ~' including accompanying schedules and statements, and to the best of my knowledge and belief, personal representative is based on atl information of which preparer has any knowledge. Robert J. D'Angelo 501 Woodcrest Drive, Mechanicsburg, PA 17050 ~IGNATUR PREPARE OTFikT1TR1l~J REPRESENTATIVE 1~~- '~ /~„~{r/ Robert P Kline ADDRESS 714 Bridge Street, New Cumberland, PA 17070 Side 1 L 1505610143 ~~~~ DATE 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number °e~edanes "ame: _ L I P P I, K A T H Y A ----------- 1 6 7 4 0 0 6 4 2 CAPITULATION _ _ 1. Real Estate (Schedule A) ................................................................................ .......... 1. 2 1 9, 9 0 0. 0 0 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. 1 8 3 , 0 7 7 . 6 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ......... ... 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property . . (Schedule G) ^ Separate Billing Requested ......... .... 7• 2 9 , 4 31.31 8. Total Gross Assets (total Lines 1-7) ................. ....... ........................................ ....... 8. 4 3 2, 4 0 8. 9 4 Funeral Expenses & Administrative Costs (Schedule H) ................................... ...... 9. -- 4 3, 8 5 5. 9 4 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .......................... ...... 10. 8 0 , 7 9 4 . 5 4 11. Total Deductions (total Lines 9 & 10) ..... .......................................................... .......11. 124,650.48 12. Net Value of Estate (Line 8 minus Line 11) .. .................................................... 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .......12. 3 0 7, 7 5 8 4 6 an election to tax has not been made (Schedule J) ..... ....................................... ..... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... . ..................... TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES .....1a. 307, 758.46 __ __- - _- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate x .045 2 9 3 , 811.8 2 17. Amount of Line 14 taxable 16. 13 , 2 21.5 3 at sibling rate X .12 13 , 9 4 6. 6 4 18. Amount of Line 14 taxable 17. 1, 6 7 3. 6 0 at collateral rate X .15 18 19. Tax Due .............................................................................................................. .....19. 14,895.13 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: Lippi,_Kathy A STREET ADDRESS 5224 Meadowbrook Drive __--_-- CITY Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + g) (2) 12,744.76 (3) 24.16 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. Make Check Payable to: REGISTER OF WILLS, AGENT. (4) (5> 2,174.53 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: es o a. retain the use or income of the property transferred :............... - - ..................................................................I. I x ~ -- b. retain the right to designate who shall use the property transferred or its income :....................................! ~x c. retain a reveprsionary interest; or......p .y ....................................~............................................................. . ~ _X d. receive the romise for life of either a ments, benefits or care ....................... . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without _ receiving adequate consideration?.......... ....................................I _x .................................................................... x ' .. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... I~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?........... xJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,~YOU MUST COMPLETE SCHEDULE G AND FILE IT AS _~ -- PART OF THE RETUR 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)]. 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)]. • sibfng is definedounder Sectiont9102eas am indiv dual who has ateea thoneepardentt n common wi hPhe decede n, wh§ethe6 by)lilooif or adoption. 12,000.00 744.76 File Number 21 - 11 - 00098 --- - - I STATE ZIP PA 17050 (1) 14,895.13 COMMONWEALTH OF PENNSYLVANIA INHERI SCHEDULE A REAL ESTATE TANCE TAX RETURN RESIDENT DECEDENT --__- _. - -_ ESTATE OF ~ippi, Kathy A i FILE NUMBER ---- -- 21 - 11 - 00098 All real roe - -- - - -------- ~ -.-_- -_- _ _ _ p p rty owned solely or as a tenant in common must be reAorted 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 facts. Real property which 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 sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. -- - -- ITEM -- - NUMBER DESCRIPTION VALUE AT DATE OF -- - ---- -- - - -DEATH ------ - ---- -- 5224 Meadowbrook Drive, Mechanicsburg, PA 17050; Hampden Twp, Cumberland Co.; Parcel #10-18-1319-129 (see attached HUD-1) 219,900.00 -- - -- TOTAL (Also enter on Line 1, Recapitulation) 219,900.00 ~ SCHEDULE E j CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA ~ PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT --_-_. --_ ---. _ z-:_ -_z.-_- _ ___ ____ ESTATE OF Lippi, Kathy A ~ FILE NUMBER --- --- ~ 21 - 11 - 00098 - - -- -- ---- - -- _~_-- 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. - -. _ ___ _ ITEM NUMBER 1 Belco FCU 621730-S4 2 Belco FCU 621730-S1 3 ~ Belco FCU 621730-S2 4 ~ M&T Bank #3741406080 5 ~ 1999 Toyota 2T1 CG22P8XC254750 6 ~ Fidelity Investments 7 ~ Escrow Refund from M&T Bank --_ -_ - - - DESCRIPTION VALUE AT DATE OF - DEATH - -9,222.83 59,048.18 290.60 1,386.59 4,000.00 106,717.27 2,412.16 ------ TOTAL (Also enter on Line 5, Recapitulation) 183 077.63 COMMONWEALTH OF PENNSYLVANIA IN 1 ER_VIVOSD RANSFERS & INHERITANCE TAX RETURN - RESIDENT DECEDENT I MISC. NON-PROBATE PROPERTY ~ -- -- _ -_ - _ - --- ----- ---- -- -~ - _ _ - - TE OF Lippi, Kathy A __ __ FILE NUMBER _ -- ----- -_ .-_ _ -- -- 21 - 11 - 00098 - _ --- - -i his schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. _. - _ _ ----- _ - - _ _ ITEM DESCRIPTION OF PROPERTY DATE OF DEATH NUMBER Include the name of the transferee, their relationship to decedent TAXAB ~ --~ DECD S EXCLUSION ~ _ _ _ - and the date of transfer. Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE) I, I - _ 1 Lincoln Financial #97-5749637 t_- - -^ _-i - _ - ~ - - - - 10,599.91 100% I _ LE VALUE - - 10,599.91 2 Lincoln Financial #96-5643125 s,a95.55 100% j 6, 895.55 3 ,Lincoln Financial #97-5643084 7,051.09 I 100% 7,051.09 4 Met Life Annuity #8828284 4 884.76 ' ~ ~ I I o 100 /o I I 4,884.76 I - ~- ---_- -- I -- ---- I --- --. .1 - - __ -L- __ __- TOTAL (Also enter on line 7, Recapitulation) , 29,431.31 ^- p, SCHEDULE H COMMONWEALTH OF PENNSYLVANIA _' '~ ""' ° r ~ INHERITANCE TAX RETURN /~ry~A~wp~-•r~A~ T ^^~ RESIDENT DECEDENT /'1L/Ir11~\h7 ~ IW "vC ~.-~7' J ~ __ _- _ _ - -- ESTATE OF Lippi, Kathy A FILE NUMBER - -- I 21 - 11 - 00098 __ - - Debts of decedent must be reported on Schedule I. - ITEM --- __ __ NUMBER FUNERAL EXPENSES: DESCRIPTION I AMOUNT ~----- - __ A. 1 Parthemore Funeral Home & Cremation Services, Inc., New Cumberland, PA 6, 784.46 2 ~! Funeral Luncheon Expenses to Janet D'Angelo & Gail D'Angelo j 1,090.16 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 'I Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Kline Law Office 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 4 Probate Fees Register of Wills 5. ! Accountant's Fees 6. Tax Return Preparer's Fees 5,000.00 408.50 7. ! Other Administrative Costs 1 Expenses related to sale of home (Hud-1 attached) (settlement costs and seller' 24,071.33 assistance reduced by credit for pro-rated taxes) I - __ ~- -- ___ - ____- TOTAL (Also enter on line 9, Recapitulation) 43,855.94 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _~_ ESTATE OF Lippi, Kathy A 2 ~ M&T Bank -mortgage payments 3 ~ Comcast 4 Gene Shulman 5 I Armando Chilmaza 6 I Amerigas Schedule H Funeral E~enses & Ac~ninistrative Costs continued __ -- -_ _. __ - -____ FILE NUMBER - - 21 - 11 - 00098 -- - -- -- ---- --- 5,607.92 168.95 303.16 132.00 289.46 Page 2 of Schedule H SCHEDULEI ~ DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT i - ~ ---- =_ pp , y ------T -_ - - -_ - - ESTATE OF LI i Kath A I FILE NUMBER - - -- 21 - 11 - 00098 - _- _-- __ __ - Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. -- _- _ -. --- -. TEM - - _ NUMBER DESCRIPTION 1 M&T Mortgage Loan #010448132 (payoff at sale per attached HUD-1) 2 US Treasury AMOUNT -- 80, 041.54 753.00 - - - --_ _ TOTAL (Also enter on Line 10, Recapitulation) 80 794.54 REV-157 3 EX+ (~ ~ -OS) ' ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BEN INHERITANCE TAX RETURN EFICIARIES ~' RESIDENT DECEDENT ~'~ -. TATE OF _ __ _ -_ _ _ _- __- Llppl, Kathy A I FILE NUMBER --- --_ i -- i -- _ 21 - 11 - 00098 - -- ___ j RELATIONSHIP TO ~ NUMBER '~ NAME AND ADDRESS OF PERSON(S) DECEDENT SHARE OF ESTATE ~ AMOUNT OF ESTATE RECEIVING PROPERTY Do Not List Trustee(s) (Words) ' ($$$) a - --_ __ I,TAXABLE DISTRIBUTIONS[include outright spousal - '- distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Michelle Minter Daughter 338 Big Spring Avenue Etters, PA 17319 II. 2 P.J. Lippi i Son 1470 Timber Brook Drive i Mechanicsburg, PA 17050 3 James D'Angelo i Brother 615 Moores Mountain Road Mechanicsburg, PA 17055 II one-half remainder ~ I i one-half remainder i Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as a ro ria ~r ~ tt?. 13, 946.64 rvvrv- I ~HtsLt UIS I KIt3UTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN I I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ~ rOTAL OF PART II -ENTER-TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE~T 0.00 LAST WILL AND TESTAMENT OF KATHY A. LIPPI I, KATHY A. LIPPI, of Hampden Township, Cumberland County, Pennsylvania, being ~ of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my personal representative hereinafter named to pay all of my just debts, funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my personal representative need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. Page 1 of 5 Pages