HomeMy WebLinkAbout05-21-12J 1505610105
REV-1500 Ex (D2-11)(FI)
enns lvarda OFFICIAL USE ONLY
PA Department of Revenue P ... E Y
Bureau of Individual Taxes County Code Year File Number
PO BOX zso6ot INHERITANCE TAX RETURN ~ `
Harrisburg, PA 1'Ji28-D6ot RESIDENT DECEDENT ~,,~ I ~-`
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of peach MMDDYYYY Date of Birth MMDDYYYY
01I04l2010 02/17!1921
Decedent's Last Name Suffix Decedent's First Name MI
FARAGO FLORENCE D_
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffrx Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED 1N DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
Op 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limi[etl Estate O 4a. Future Interest Compromise (tlate of O 5. Federal Estate Tax Return Required
death aker 12-12-82)
® 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 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-3t-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT- THIS SECTION MUST eE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECT~D T0:
Name Daytime Teleph6r'r2 Number `_;
JAMES D. CAMERON, ESQ. >_ ~ rys
(717) 236-3~? =~~ m
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REGISTE~QE_'M4C3 USE`ONLY --
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First Line of Address J { ~ i. ~ ~-
1325 NORTH FRONT STREET ~
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Second Line of Address G;i
City or Post OKCe State ZIP Code GATE FILED
HARRISBURG PA '17102
Correspondent's a-mall address
Untler penalties of perjury I declare that I have examined this return, including accompanying schedules and statements and to [he best of my knowledge and belief,
it is true, correct and complete. Dedaretion of preparer other than the personal representative is based on all intormaticn of which preparer has any knowledge.
SIG liRE,OF~ERSON RES ONSIBr,4E ROB ~ Ifs ~RETUQR ~ ~ ~ DF'ATF,,~ 1~
20 Rivervie rive, E PA 17025
SIGNAT PA R O7 THAN REPRESENTATIVE DATE
AD ES
1 orth Front Street, Harrisburg, PA 17102
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX (FI) Decedent's Social Security Number
Decedent's Name: FLORENCE D. FARAGO, DECEASED :187-16-6348
RECAPITULATION _ _
1. Real Estate (Schedule A) ........................................... .. 1. 0.00
2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00
3. Closely Held Gorporetion, Partnership or Sole-Proprietorship (Schedule G) ... .. 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. 31,587.48
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vvos Transfers & Miscellaneous Non-Probate Property
'
0
00
(Schedule G) O Separate Billing Requested...... .. 7. .
8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 31,587.48
9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 4, 952.95
10. Dabts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. 2,403.78
11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 7,356.73
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 24,230.75
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. 24,230.75
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under S
(a)(t.2) X .0_ 16. 0.00
16. Amount of Line 14 taxable -
at lineal rate X .0 45 24,230.75 ,
1g, _..
1,090.38
17. Amount of Line 14 taxable - - .........
0
00
at sibling rate X .12 17. .
18. Amount of Line 14 taxable
0
00
at collateral rate X .16
_. 18. .
_. _.
19. TAX DUE ....................................................... .. 19. 1,090.38
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15D5610205 1505610205
REV-1500 EX (FI) Page 3
Decedent's Comulete Address:
File Number
DECEDENT'S NAME
FLORENCE D. FARAGO
STREETADDRESS
20 RIVERVIEW DRIVE
CITY
ENOLA STATE ZIP
PA 17025
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments ._ 1,000.00
B. Discount 50.00
(i)
38
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 TO to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Total Credits (A+B) (2) 1,050.00
(3) 0.00
(4)
(5) 40.38
Make check payable to: REGISTER tJF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOGKS
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 ........................................................................................................................ ...... ^ I•
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 properly, which
contains a benefciary designaiion? .................................................................................................................. ...... ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE {T 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
(!2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from fax, 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 perrcent, except as noted in (/2 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.
REV-i5o8 EX+ (uao)
~ pennsylvania SCHEDULE E
DevARTMENT of REVENUE CASHr BANK DEPOSITS & MISC.
iNnER~TnNCE rnx REruaN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
FLORENCE D. FARAGO, DECEASED 21-12-0053
Include the proceeds of litigation and [he date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed nn Schedule F.
u more space is neeeeD, use atltlihonal sheets of paper of the same s:e.
REV-1511 Ex+ (10-09)
:~~ ~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TA% RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
FLORENCE D. FARAGO, DECEASED 21-12-0053
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t' Gingrich Memorials (gravemarker) 1,090.00
6. ADMINISTRATIVE COSTS:
1. Personal Representative Commisslons•.
Name(s) of Personal Representative(s) ___i___
Street Address _. _. _
City ___ State ZIP
Year(s) Commission Paid: _.
3,500.00
2. Attorney Fees:
3. Family Exemption. (If decedent's address is not the same as daimant's, attach explanation.)
Claimant
Street Address
City _ State _ ZIP
Relationship of Claimant to Decedent
4, Probate Feer 141.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
~• Cumberland Law Journal (legal adverbs+ng) 75.00
s. The Patriot-News Company (legal advertising) 116.45
s. Register of Wills of Cumberland County (fling fees--Inventory and Inheritance Tax) 30.00
TOTAL (Also enter on Line 9, Recapitulation) $ 4,952.95
It more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (1J-OS)
_~ ~~~'~pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TA% RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
FLORENCE D. FARAGO, DECEASED 21-12-0053
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
1 St. Patrick's Catheral (check written prior to death which cleared after death) 30.00
2. Community Life Team EMS (medical expense not covered by insurance) 57.00
3. PSERS (overpayment on pension) 8 86
4. The Jewish Home of Greater Harrisburg (medical expense not covered by insurance) 2,285,27
5. Continuing Care RX (prescription expense not covered by insurance) 22.65
TOTAL (Also enter on Line 10, Recapitulation) I; 2,403.78
[f more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (Ol-10J
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES IS THROUGH IB OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
~ pennsytvania SCHEDULE 7
DEaARTmeNT of REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDEM DECEDENT
ESTATE OF: FILE NUMBER:
FLORENCE D. FARAGO, DECEASED 21-12-0053
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) (1.2j.]
1. Stephen P. Farago, 1032 Teakwood Lane, Enola, PA 17025 child 50% residue
2. Pauletta A. Alexiev, 20 Riverview Drive, Enola, PA 17025 child 50% residue
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
II
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, use additional sheets of paper of the same size.
WzLi..
FLARENCE D. FARAGO
I, FLORENCE D. FARAGO, of the Borough of Lemoyne, Ciunberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my dust debts and funeral expenses, including my
gravemarker and all expenses of my last illness, and any and all taxes and assessments
imposed by any governmental body as a result of my death;, whether on property passing
under this will or otherwise, shall be paid from my residuary estate as soon as
practicable after my decease as a part of the expense of the administration of my
,~ ` estate.
'~~~ ITSM II. I give and bequeath all of my household goods, automobiles, jewelry, and
all other articles of household and personal use, equipment and ornament, together with
all insurance thereon and relating thereto, to such of my children who survive my death
by sixty (60) days, in equal shares.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
r; possessions and estate of every nature and wherever situate to such of my children who
survive my death by sixty (60) days in equal shares. Should none of my children
survive my death by sixty (60) days, I give, devise, and bequeath all the rest,
residue, and remainder of my possessions and estate of every nature and wherever
1
situate among those of the following of my nieces and nephews who survive my death by
sixty (60) days:
ROSINA PROVAZZO of Carlisle, Pennsylvania;
VINCENT PROVAZZO of Carlisle, Pennsylvania;
MARY URICH of Carlisle, Pennsylvania;
FRANCES MALAFARA of Harrisburg, Pennsylvania;
ANTOINETTE PETRUCCI of New Cumberland, 'Pennsylvania;
ANTHONY D'AGOSTINO of Harrisburg, Pennsylvania; and
ROSEANN NORHOLD of Harrisburg, Pennsylv~snia.
ITEM IV. I appoint my daughter, PAULETTA A. ALEXIEV, of Enola, Pennsylvania,
executrix of this my last will. Should my said daughter predecease me or otherwise fail
to qualify or cease to serve as executrix of this my last; will, I appoint my son,
STEPHEN P. FARAGO, of Enola, Pennsylvania, executor of this my last will.
ITEM 0. I direct that my personal representatives ;shall not be required to give
bond for the faithful performance of their duties in any ,jurisdiction,/.~ ._,
IN BITNESS WIffiREOF, I have hereunto set my hand and seal this (~/ % day
of 1985.
D. FARAGO:
2
The preceding instrument, consisting of this and TWO other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published,
and declared by FLORENCE D. FARAGO, the testatrix therein named, as and for her last
will, in the presence of us, who at her request, in her presence, and in the presence
of each other, have subscribed our names as witnesses hereto.
~%
l
~~
3
COMMONWEALTH OF PENNSYLVANIA )
( SS..
COUNTY OF CUMBERLAND )
The undersigned, being the testatrix whose name is ;signed to the attached or
foregoing instrument, having been duly qualified according to law, does hereby acknow-
ledge that I signed and executed the foregoing instrument; as my last will, that I
signed it willingly; and that I signed it as my free and voluntary act for the purposes
therein expressed.
R_J'~ ~~
Sworn pL^,a€fixmeii to and acknowledged
befor Rie.by~the, testatrix named above
thig~tiay of ~c f~.e~, 1985.
- `f"' _ i~
Notdry Public iiNDn C. LONG, NoT ~~`•
~lemoyne, Cu d ~~~
n~y.COmmission Expires Nov. 28, 19Ef
COMMONWEALTH OF PENNSYLVANIA )
( SS..
COUNTY OF CUMBERLAND )
WE, GEORGE A. VAUGHN, III, and MICHAEL L. BANGS, the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw the testatrix sign and execute the
instrument as her last will; that she signed it willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that each of us in the
hearing and sight of the testatrix signed the will as witnesses; and that to the best
of our knowledge, the testatrix was at that time 18 or more years of age, of sound
mind, and under no constraint or undue influence.
prn-gr affirm~d_to and
tl2daed bemire me this
.,
of_ ~~ 1985.
~. l
LINDA C. LONG,.$6tary Publfe
Lemoyne, Cumberland Co., P6.
My Commission Expires Nov. 28,19[0
p ~s~
499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
James Duryea Cameron
1325 North Front Street
Harrisburg, PA 17102
ss"°""'^_''"'""" "'"""` °' ""`."" Phone B88-502-0349
".'""'"o„'°",.~'°~°,,.~°'..""`"°."°"m` Faz (302)934-2955
January 23, 2012
Re: Estate of Florence D Farago
Social Sectuit~ 187-16-6348
_.
`" - - _ Date of Deaths Tanuary 4.2012
Deaz Sir or Madam:
Per your inquiry on 3anuary 13, 2012, 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 Accouns
Account Number 32225105
Ownership (Names ofl Florence D Farago
Paulette Aleziev (POA)
Opening Date 1228/67
Balance on Date of Death $31,441.67
Accrued Interest $ .00
Total $31,441.67
For any additional informatlon on the above accounts, induding ownership and any changes, dosures and/or rdmbursement or funds,
please raa the West Shore Plaza Office at #717-731.1730.
We were unable to locate any safe deposit box for the above-mentloned decedent
This triter does not indude any eorounts in whidi the dcre~d mey have been listed as Power of Attorney, Gtistodian o[ Uniform Tnuader;
liepreseotatlve Payee, or Trustee under a Written Age~ent
Sincerely,
fir" /~~
Tammy Spencer
Adjustment Services