HomeMy WebLinkAbout06-11-121505610143
REV-1500 Ex `°'-'°'
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code year File Number
Bureau of Individual Taxes DEPARTMENT OV REVENUE
PO 60x.280601 INHERITANCE TAX RETURN 21 12 0329
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 12 2012 O1 09 1925
Decedent's Last Name Suffix Decedent's First Name MI
ALEXIS SOPHIE
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
1. Original Return ~~ 2. Supplemental Return
4. Limited Estate [~ 4a. Future Interest Compromise
(date of death after 12-12-82)
x^ 6 Decedent Died Testate
(Attach Copy of Will)
~~ ~ Decedent Maintained a Living Trust
(Attach Copy of Trust)
9. Litigation Proceeds Received [] 1 p. Spousal PovertyY Credit (date of death
between 12-31 91 and T-1-95)
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDWARD P SEEBER 717 533 3280
ti
First line of address
SUITE C400
Second line of address
555 GETTYSBURG PIKE
City or Post Office
MECHANICSBURG
Correspondent's a-mail address: ePS@JSdC.C01Y1
State ZIP Code
PA 17055
REGISTER OF~I~S USE 01$LY
m~--, ~
~C~
~~~ `::
n
O ~' ~
~~
~ N
DATE FILED ~
~,
~;
I
~•,-,
~-
`=r:
..F.,
("`*
r-n
t~
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.
SIG RE OF PERSON RESPO I FOgFILING RETURN DATE
,,~ ~~ ~ ~--~. ~,-o Joanne Patricia Alexis _ L~~s~/ ~2
'F80 Conwa Street Carlisle PA 17013
SIGNATURE OFD ~ A R THER AN REPRESENTATIVE DATE
,i~ ~,., _.._.~__ . - -- - .. c 0 G , ,.
Edward P Seeber ~ f ,~ _
555 Gettysburg Pike, Mechanicsbura. PA 17055
Side 1
1505610143
1505610143 J
REV-1500 EX
DecedenrsName~. AIeXIS, Sophie
Decedent's Social Security Number
RECAPITULATION
1. Real Estate (Schedule A) ..................................................................................... .. 1.
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. 53 , 8 93.51
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous l~ nq Probate Property
(Schedule G) LJ Separate Billing Requested............ 7.
8. Total Gross Assets (total Lines 1-7) ................................................................... .. g. 53 , 8 93.51
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 2 6 , 3 91.42
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10. 697.75
11. Total Deductions (total Lines 9 & 10) .................................................................. . 11. 2 7 , 0 8 9.17
12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 2 6 , 804 .34
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. 2 6 , 8 04.34
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 'd4 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15. 0 . 0 0
16. Amount of Line 14 taxable
at linealrateX .045 26,804.34
1s.
1,206.20
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18. 0. 0 0
19. Tax Due ................................................................................................................. . 19. 1,206.20
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243
1505610243
1505610243
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Alexis, Sophie
STREET ADDRESS
100 Conway Street
CITY
Carlisle STATE
PA ZIP
17013
File Number 21-12-0329
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
1,145.89
(1) 1,206.20
3. Interest
60.31
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.
Total Credits (A + g) (2) 1,206.20
(3)
(4)
(5) ~.00
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 :............................................................................... ^
b. retain the right to designate who shall use the property transferred or its income :................................. ^
c. retain a reversionary interest; or ............................................................................................................... ^ ^x
d. receive the promise for life of either payments, benefits or care? ............................................................ ^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^ 0
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 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)].
. 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)]. A
sibling 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-1508 EX+t6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Alexis, So hie 21-12-0329 _
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Fidelity Money Market Account No.2BP-262803 -valued per spreadsheet dated 4/5/12 30,169.34
2 Fidelity Money Market Account No. 2BP-262803, accrued interest -valued per spreadsheet 0.13
dated 4/5/12
3 M8~T Bank Checking Account No. 2673000424 -valued per bank letter dated 4/2/12 20,547.04
4 2002 Buick Century -valued per Kelley Blue Book 3,177.00
TOTAL (Also enter on Line 5, Recapitulation) I 53,893.51
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98;
REV-1151 EX+t10-O6)
COMMNHNWE ALTHEDT~ RETURNANIA
R I~h~~ ITDENN4r DE EDENT
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Alexis, Sophie _ 21-12-0329
ITEM DESCRIPTION AMOUNT
N M R
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
18,915.85
B.
1. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zia
Year(sl Commission paid
2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 3,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Joanne Alexis
Street Address 100 Conway Street
City Carlisle State PA Zio 17013
Relationship of Claimant to Decedent Daughter
4. Probate Fees 190.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 285.07
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 26,391.42
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06;~
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Alexis, Sophie 21-12-0329
ITEM
NUMBER DESCRIPTION AMOUNT
1 Funeral Expenses
Ewing Brothers Funeral Home -funeral services
9,772.93
2 Father Kosta Petrogeorge -honorarium -funeral 150.00
3 Father Kosta Petrogeorge -honorarium - 40 day memorial 50.00
4 Father Mark Lichtenstein -honorarium -funeral 100.00
5 Father Mark Lichtenstein -honorarium - 40 day memorial 50.00
6 George's Flowers -flowers for funeral services 294.68
7 Philoptochos Society -honorarium - 40 day memorial 50.00
8 Rock Bass Grill -reception - 40 day memorial 506.00
9 Rustic Tavern -reception -funeral 2,725.24
10 Sophie Kaldes -honorarium - 40 day memorial 120.00
11 Tom Paparoidamis -funeral canter -honorarium 50.00
12 Westminster Cemetery -burial 1,826.00
13 Westminster Cemetery - gravemarker 3,221.00
H-A 18,915.85
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Alexis, Sophie 21-12-0329
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
14 James, Smith, Dietterick & Connelly, LLP -reservation for closing expenses for estate
administration
15 Lube'N Go -vehicle state inspection
16 Register of Wills, Cumberland County -filing fee for Return >3< Inventory
H-B7
200.00
55.07
30.00
285.07
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+f12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Alexis, Sophie 21-12-0329
Report debts incuned by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
tlr more space Is needetl, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08;
REV-1513 EX+ (11-08)
COMMO ~~EALTfiEOF P~N~I~$,RLVANIA
N R IDEN DE ED N N
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Hiexis, ao nie 21-12-0 329
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116 a 1.2
Dean G. Alexis Son 50% of the 13,402.17
58 Luz Del Mundo residue
Santa Fe, NM 87508
Joanne P. Alexis Daughter 50% of the 13,402.17
100 Conway Street residue
Carlisle, PA 17013
Total 26,804.34
Enter dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08;