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HomeMy WebLinkAbout06-04-12r J 1505610105 REV-1500 E" `O2-""~' PA Department of Revenue pennsylvanta OFFICIAL USE ONLY Bureau of Individual Taxes o.M~~.*o..E.E,~E County Code Year File Number INHERITANCE TAX RETURN PO 80X z8o6o1 ~' / ~ JS ~ ~ (~ Harrisburg, PA 17tz8-06oi RESIDENT DECEDENT lJ `[ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 008-28-5255 04/10/2012 06/06!1928 Decedent's Last Name Suffix Decedent's First Name MI TUREK ' 'MICHELE C (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 Retum O 2. Supplemental Retum O 3. Remainder Retum (Date of Death Prior to 12-13-82} O 4. Limited Estate O 4a. Future Interest Compromise (date of O 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 10. Spousal Poverty Credit (Date of Death O 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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number r~ CAROLINE TUREK ANTONELLI .... ..m (717) 932-93 ^O _ _ ~ REGISTER SE n 1 rr'? C%) ~ F .73 C.a First Line of Address ~ ? -p ~z 601 50UTHRIDGE DRIVE _ 8 ,_ Second Line of Address - N ~~ ~ Clts r ,,.. Cit or Post Office .. State 21P Code DATE'FILED y MECHANICSBURG PA ;17055 Correspondent's e-mail address: Under penattles of per}ury. I declare that I have examined this return, including accompanying schedules and statements, and to the bit of my knowledge and belief, ii is true, correct and complete. DeUaretion of preparer other than the personal representative is based on ali information of which preparer hes eny knowledge. SIGNAT QF PERSOMIRESPONSI LE FOR FILING , ~ DATE 601 SOUTHRIDGE DRIVE MECHANIt;`SBURG PA 17055 31GttItaTURE OF PREPARER OjHEit T RESENTATIVE ADDRESS ' / 430 N ENOLA DRIVE OLA PA 17025 PLEASE USE ORIGINAL FORM ONLY Side 1 150561D105 15D5610105 J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number _. __ _.. Decedent's Name: MICHELE C TUREK 008-28-5255 RECAPITULATION 1. Real Estate (Schedule A) ............................................. L I 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ' ', 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. ' 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 42,099.77 ti. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. ', 7. Inter-Vivos Trensfers ~ Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 111,391.01 ', 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 153,490.78 9. Funeral Expenses and Administratlve Costs (Schedule H) ................. .. 9. 6,233.50 70. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. ' 4,257.41 11. Total Deductions (total Lines 9 and 10) ............................... .. 11. ' 10,490.91 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ', 142,999.87 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. 142,999.87 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. I 15. 16. Amount of Line 14 taxable ~ ~~~~ ~~~ " ~ " ~~ '~°"" "' "" at lineal rate x .0 4~` 6,435.00 ' 1 s. ' 6,435.00 17. Amount of Line l4 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collaterel rate X .15 18. 19. TAX DUE ....................................................... .. 19.' 6,435.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 REV-1500 EX (FI) Paga 3 Decedent's Complete Address: File Number DECEDENTS NAME MICHELE C TUREK STREET ADDRESS 601 SOUTHRIDGE DRIVE CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 321.75 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 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 6,435.00 Total Credits (A+ B) (2) 321.75 (3) (4) (5) 6,113.25 Make check payable to: REGISTER OF WILLS, AGENT. t,. ~°~ ,, k nai~I~i,~,~i~~I~y;IPt~tI~1~`~~ ~- `~. ~;; ~~~~,~~~,~, ~e 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 .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occuned 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? ........................................................................................................................ ~ ^ 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. §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 [l2 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 [T2 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-15o8 EX+ (11-io) ~~ pennsylvania DEPARTMENT OF REVENUE INNERTTANCE TAX RETURN RESIDENT DECEDENT SCNEpULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE Of: FILE NUMBER: MICHELE C TUREK 21 Include the proceeds of Iltigation and the date the proceeds were received by the estate. All property iolntly owned wkh right of survivorship must be disclosed on Schedule F. tr more space is needed, use additional sheets of paper of the same size. Susquehanna May 3,.2012 To whom it may concern: Michele Turek had a .checking.account with our financial institution. As of OG/10/2012, her hate of death, the balance in her checking account was $45,099.77. Please fleet free to contact me with any q ~ ions or concerns. r~` 'Sheri Melnick Financia' Scrvtc€~ Re~ressrr;arivt, aetlysbura Koari 'Jfrlce PJ(NLS Ir'! 8496€i~: Susquehanna Sank ^~'++ GettVSbury Ft~ad. CamF; Hilt, Wr i7C9^ t~taicca8= 1Br Te 4hPr w9etni.k~a^~susguehanna.nn; VVeb wwu~.suscauehanna.net Connect with us; Farebaok ftrlner ~ 'Foul ubf E31ag REVd510 EX+ (08-09) ~~ ~ i~ pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENr DECEDENT ESTATE OF FILE NUMBER MICHELE C TUREK 21- This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCUroE THE Na~1E OFTNE TRANS~,TREIR R9ATIaNSfm TO DE09)e1r AND INEOAIEOFTRaKSFaiaTracNACaPrarTNEO®FOrtREraarATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION FnAPU TAXABLE VALUE 1. WESTERN NATIONAL LIFE INSURANCE CO -ANNUITY 111,391.01 CAROLINE TUREK ANTONELLI 601 SOUTHRIDGE DR MECHANICSBURG 37,130.34 33 37,t30.3< PA 17055 CHRISTIAN TUREK 40 FAIRFIELD STREET MONTCLAIR NJ 07042 37,130.34 33 37,130.3r MARIE-HELENE POLLOCK 506 RIDGE AVENUE UNIT B WILMETT IL 37,130.33 33 37 130.3; 60091 , TOTAL (Also enter on Line 7, Recapitulation) ~ I 111,391.01 If more space is needed, use additional sheets of paper of the same size. Gi5f 22f 2012 11 : ~'? ~~63A'~'F~966 WP•IL tii~sLIr: F'tiGE ~f f 02 ~t~NESTERN ..:~ NATIONAI. i_i rc, Ins.~~ n~~:_ ~ .; ,,rr,~c~n~~ ~'l. i...... ;~ i '. Bf1ii'I;'~i q~,xR~ 11~ay 22, 2012 CAROLIN$ ANTONELLI FAX: 77 7-932-1630 Re: Contract #: FXUOI 330 Deceased: Michele Turek Dear Ms. Antonelli: Thank you for your recent inquiry regarding the referenced annuity contract. It is our pleasure to be Of SCrVIGe t0 yoU- The value of the above referenced contract on Aprii 10, 20x.2 was $1.11,391..01. Should you have any questions ar require further assistance, please contact rntr Client Care Center by using our toll free number of 1-$00-424-4990. Sincerely, a ~,~ Carolyn Smith Annuity Claims Dept. R REV-1511 EX+ (lU-U9) ~ ' Pennsylvania DEPARTMENT OF REVENUE [NHERIfANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MICHELE C TUREK 21 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' MALPEZZI FUNERAL HOME 4,414.35 2 A-1 RENT-ALL -PROJECTOR RENTAL 222.60 a FLOWERS 150.00 a FUNERAL LUNCH 696.55 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: 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: 5. Accountant Fees: 6• Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) I ~ If more space is needed, use additional sheets of paper of the same size. 300.00 450.00 6,233.50 MalpezZi Funeral Home _ ~ a. 8 Market Plaza Way ~~ Mechanicsburg, PA ] 7055 vµv, Jeremy J. Michael J. Malpezzi, Owner, FD (717)697-4696 uneralHome.com ----~ Kyle C. Knipe, FD May 3, 2012 Caroline A. Antonelli 601 Southridge Drive Mechanicsburg, PA 17055 This is the final statement for the funeral services of Michele C. Turek We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way. PROFESSIONAL SERVICES: Anatomical Donation $2,350.00 FUNERAL HOME SERVICE CHARGES $2,350.00 THE COST OF OUR SERVICES, EQUH'MENT, AND MERCHANDISE THAT YOU HAVE SELECTED $2,350.00 CASH ADVANCES: At the time funeral arrangements were made, we advanced certain payments to others as an accomodation. The following is an accounting of those charges. Certified Death Certificates $90.00 Newspaper Notices -Patriot $1,146.88 Newspaper Notices -Sentinel $361.95 Newspaper Notices -Main Line Times $465.52 TOTAL CASH ADVANCES AND SPECIAL CHARGES $2,064.35 CONTRACT PRICE $4,414.35 TOTAL AMOUNT DUE $4,414.35 If you have any questions or concerns regarding this bill, please call our office at (717) 697-4696. R .~ ~ld-~v Live-Jn Care caf Penrtsylvartia, inc. Client Name: Client Signature: Caregiver Name:' `~ Caregiver Signature: Date Caregiver Live-In Care 1 ~ 1 1 2 1 ! Id:S 7r ~ /2 C / l ~~ Total Mail White Copy with Live-In Care fee to: Live-In Care of Pennsylvania, tnc. 1655 Manheim Pike, Ste. D4, Lancaster, PA 17601 www.}iveinca reofpa.cot~t White: Live-In Care Yellow: Client Pink: Caregiver Gt l/ t.ive-In Gare ©f per>Ensylvania, lnc. Client `Nam®: £lient Signature:. Caregiver Name: i t `~ "_ ~•- f, ``~ yr Caregiver Signatur :~ ;, Date Car fiver Live-In Care - ._. i { ._ ( ! =' .. ~ !~ . -. , ~: ~, u •~, __ ! - i a ~ J awl Total ` Mail Whita Copy writh five-ln Care fee 10: Live-}n Care of Pennsyiania, Ino. 1655 Manheim Pike, Ste. D4, Lancaster, PA 47ti01 www.liveincareofpa.com White: Uve-In Caze Yellow: Client Pink:. Careoivet Pd' Live-ln Care of Pe~n~ylvar>lia, lnc. Glient Name: Cliern Signature: Caregiver. Name: ~_ ; `, .. -, ,, , , , - ~ ; Garegiver Signatures>.-,=-'--; Mail Whita Dopy with Live-In Care fee to: Uve-in Care of Pennsylvania, #nc: 1655 Manheim Rlke, Ste. D4, Lancaster, P/117641. wtivw liveincareofpa.com White: Live-In Care Yellow: Client Pink: Caregiver v Live-trt Care ~# Pertrtsylvania, Inc. Client Name: Client Signature: Caregiver Name: Caregiver Signature: Date Caregiver Live-In Care ~~ _1 i S- aa~ -~ -! rf d~ _ ~ - oD - oa . ~ - t~'d _2 ._i •~t Total Mail White Copy with Live-In Care fee to: Live-In Care of Pennsylvania, Inc. 1655 Manheim Pike, Ste. D4, Lancaster, PA 17601 ,rvwvsr.live'sncareofpa.com William L. Adler, Esquire 4949 Devonshire Road Harrisburg, PA 17109 Phone: 717-652-8989 Invoice submitted to: Michelle Turek Estate May 11, 2012 Invoice #11098 Professional Services 5/2/2012 Conference _ Review assets, fax to Valic. - 5/3/2012 Preparation - Susq Correspondence review 5/4/2012 Preparation 5/9!2012 Preparation Inheritance Tax notice, email 5/112012 Preparation Email, Valic Preparation Follow up For professional services rendered Hrs/Rate Amount ~g 0.80 160.00 200.00/hr 0.10 20.00 b 200.00/hr 0.20 40.00 ~~' 2oo.oomr 0.20 40.00 ~~' 2oo.oomr - _ -- 0.1Q 20.00 200.00/hr 0.10 20.00 ~~ 200.OOfir 1.50 $300.00 MARTIN J. FLANNERY & ASSOCIATES, LLP ACCOUNTANTS 430 N ENOLA DRIVE ENOI.A, PA 17025 (717)732-2331 Estate of Michele Turek C/O Caroline Antonelli 601 Southridge Drive Mechanicsburg PA 17055 As of May 29, 2012 For the yeaz ended December 31, 2012 Prepare Inheritance Tax Return ('~~ $ 450.00 U~ I ~ z/ ~Z`~ PLEASE RETURN TOP PORTION WffH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS ~l ~~ Bethany Village 325 Wesley Drive Mechanicsburg, PA 17055 Michele C Turek 465 Bethany Drive Mechanicsburg, PA 17055 Turek, Michele C STATEMENT Page: 1 of 1 ^ x ~~~~.a Tt~lt ~. , 6F0~.. ~ ~~~~ ~~t. I~ ~~ ,~ d~IC3 ~ i>~ "7 s ;~ {fir ~ : 3 ~ I ~ ~ / ~,~ -.,. . . • SIONMTURE. Ndedine the damage N9iver, as provioecl 9re TINBtSe sloe fF DECLINED THiS'IS YOUR CONTRACT, READ BOTH 31DES BEFORE SIONIN6 - ee fo pay the above described additional dimes therefor PLEASE INITIAL ~ r,• to ,c•.. r nt ~:~ <a Ar:pr+ . REV-1512 EX+ (I2-U8) ~ ~ ` Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER MICHELE C TUREK 21 Report debts incurred try the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE 1• HOME HEALTH AIDE 2 BETHANY VILLAGE 3 PP&L -ELECTRIC 4 WEST SHORE ENERGY 5 HAMPDEN TOWNSHIP AMBULANCE 6 PA AMERICAN WATER 7 COMCAST 8 JACK PANAS INSURANCE 9 DR COHEN 10 DR KANTOR 11 PINNACLE HEALTH 12 CHASE CARD 13 QUANTUM 14 APRIA HEALTH CARE TOTAL (Also enter on Line 10, Recapitulation) I; If more space is needed, insert additional sheets of the same size. 1,925.00 1,318.87 230.40 61.63 75.00 67.75 30.39 125.75 42.80 13.68 23.36 160.77 34.70 147.31 4,257.41 ~ ~ = o W ii d ~ T tV OOi~I(1 •7 a...,~ ooh pp ~ rln '_ ll N T = 7 , ~ ~ W L M x ~ ~ n -- r.- '~'~ o k~ o N ~ y -. .~. ~:.. .~.. ~~' ^~ -~ ~~ ~~ w OC W G. W J>N x a M U M Z W~~ W~y V] Qi O - Z J ow 7 Q W ZO o a~ w °cw ~ Z N NM x a w~Ha ~ ~H ~- ~ W Q~ w w~~~ Q P4 U •~ V C A ,