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Home My WebLink About06-01-1215056051058 X O6 OS ~ REV-1500 E ( - ) OFFICIAL USE ONLY PA Department of Revenue County Code Year Flle Number _ Bureau of Individual Taxes INHERITANCE TAX RETURN "~-"~~ ~~- _ _ ~ ~' PO BOX 280601 Harrisburg, PA 17123-0601 21 11 0866 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 05/20/2011 09/08/1923 _ Decedent's Last Name __ _ __ . Suffix Decedent's First Name MI Sgrignoli Martha 8 I (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Sgrignoli Sgrignoli G 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 C~J 2. Supplemental Retum O 3. Remainder Retum (date of death prior to 12.13-62) •:":~; 4. Limited Estate ::.~ 4a. Future Interest Compromise (date of C~ 5. Federal Estate Tax Retum Required death after 12-12-82) ._..~ 6. Decedent Died Testate 7. Decedent Maintained a Living Trust .__.- S. Total Number of Safe Deposit Bozes (Attach Copy of Will) (Attach Copy of Tmst) .::.:: 9. Litigation Proceeds Received C:..) 10. Spousal Poverty Credit (date of death ~::~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA710 ~ ~• ULD BE DIR$YED TD: ~~~yyy Name _._ _ Daytime Taleph tuber ~ Lisa Marie Coyne, Esq. (717) 737-0 ~? ~ ~ _ Firm Name (If Applicable) r I ~n'~ _ ___ REGISTE ~ USEOIILV a t (~ Coyne & Coyne, P.C. ~~ '9 `~~ T::; First line of address g - ~ ~ -. W 3901 Market Street ~ t --~ __. __ v Second line of address ', City or Post Office Stale ZIP Code i.. DATE FILED ' Camp Hill PA 17011 __- _ _. Correspondent's a-mail address: Under penallles of perjury, I dedare mat I have examined Nis return, Including accompanying schedules and statements, and b the best of my knowledge and belief, a is W e, mrract and complete. DeUaretbn of preparer amer man the personal representatlve Is based on all infonnatbn of which preparer has any knowledge. $jE~J(~TURE OF PEON ~SPONSIBLE FOR FILING RETURN _ - - DATE Phyllis L. Sgrignoli 2130 Lambs Gap Road, Enola, PA 17025 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 REV-1500 EX Decedent's Social Secudry Number Martha B Sgrignoli 193-18-0745 oecedanra Name: RECAPITULATION _ _.. 1. Real estate (Schedule A) ........................................... .. 1. 0.00 '.. 2. Stocks and Bonds (Schedule B) ........ .. .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mort a es 8 Notes Receivable Schedule D 4. I 0'00 _.___.. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ...... .. 5. ~ i 23,677.97 ~' 6. Jointly Owned Property (Schedule F) !~ Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ' 0 00 (Schedule G) ~ Separate Billing Requested...... .. 7. . . _. __.. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 23,877.97 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..... ... . 9.. 13 190.89 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............. .. 10. 255.44 _. __ 11. Total Deductions (total Lines 9 8 10) ................................. .. 11. ; 13,445.33 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 10,431.64 ~~', 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. '. 10,431.64 ~', TAX COMPUTATION -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.~ 10,431.64 15. O.OO i'.. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. _....._ 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at wllateral rate X .15 18. 19. TAX DUE .. ........... 19. ... 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~'°~ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Dar_ndent's Complete AddreSS: FII! Num¢s1_.._._. 21 ~„ 11 ' 0866 _.__ DECEDENTSNAME DECEDENTS SOCIAL SECURITY NUMBER Martha B Sgrignoli 193-18-0745 STREET ADDRESS 1700 Market Street CITY STATE 21P Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (i) Total Credits (A+ g + C) (2) InteresVPenalty if applicable D. Interest E. Penalty Total InterestlPenalty (D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Llne 201o request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (SA) (5B) 0.00 0.00 0.00 0.00 0.00 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 trans(erred :.................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income :...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ ^ d. receive the promise for life of efther payments, benefits or care? ................................................................ ...... 2. If death occuned after December 12, 1982, did decedent trensfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "intrust 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 propeAy which contains a beneficiary designa0on? ................................................................................................................. ....... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or far the use of the surviving spouse is three (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 zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a Uansfer 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 twenty-one 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 zero (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 four and one-half (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 forthe use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-'1506 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Martha B. Sgrignoli 21-11-0866 (If more space is needed, insert additional sheets of the same size) ~~~ ~~/ ~. - , `~~ February 21, 2012 Re: XXX-XX6960 /' Account Title: MARTHA B SGRIGNOLI Attn: Lisa Marie Coyne, Attorney for the Estate p I~[~C~pd~ FEB 2 7 2012 p ay_M'/ We understand that you need a date of death valuation for the above referenced account; the valuation provided below is calculated using closing price methodology. According to the information supplied, the date requested was May 20, 2011. Our records indicate the holdings on that date as the following: Descri lion Symbol/ Cusi Quanti Price Per Share Value PRINCIPLE INVESTORS TAX XMPT BOND CLA PTEAX 3,455.039 $6.94 $23,977.97 NET CASH POSITION - $100.00 Total: $23,877.97 Please know that we at CISC care about our clients and their concerns, and aim to provide quality customer service. Should you have any additional concerns, please do not hesitate to contact our Customer Service Center, toll free, at (800) 392-5749. Sincerely, n ti hile th' information has been obtained ftom sources we consider to be reliable, we do not ee its accuracy, and such information may be incomplete or condensed. Clients should make use of the attached statement for further information. °~ Chase Investment Services Corp. • i11-0291 •300 5. Riverside Plaza • Chicago, Illinois 60670-0291 Securities and investment advisory services are offered through Chase Investment Services Corp. (CISC). CISC, a member of FINRA and SIPC, is an affiliate ofJPMorgan Chase Bank, tJ.A. NOT FDIC INSURED • NO BANK GUARANTEE • MAY LOSE VALUE CHASE! j REV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Martha B. Sgrignoli 21-11-0866 Debts of deoedant must be reported on Sehedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Musselman Funeral Home 10,035.87 2. Reception 200.00 100.00 s. Honorarium B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City .State Vear(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, aaach explanation) Claimant Street Address City State Relationship of Claimant to Decedent q. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees T. Patriot News --legal advertisement a. Cumbedand Law Journal -legal advertisement s. Inheritance Tax Return filing fee to. Postage tt. Reserves Zip Zip TOTAL (Also enter on line 9, Recapitulation) S (If more space is needed, insert additional sheets of the same size) 1,500.00 67.50 500.00 109.52 75.00 15.00 88.00 500.00 13,190.89 REV-1512 EX+ (12-OS) ~ Pennsylvania DEPAPTMENT OF PfVENUE INHERfTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Martha B Sgrignoli 21-11-0866 [f more space Is needed, insert additional sheets of the same size. REV-1513 EX-r pl-OB) rr pennsylvania DEPARTMENT OF REVENUE iNHERITFNCE TPX RETURN RESIDENT DECEDENT SCHEDULE] BENEFICIARIES ESTATE OF FiLE nuneeN Martha B. Sgrignoli 21-11-0866 RELATIONSHIP TO DECEDENT AMOUM 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] (1.2).] 1. Michael G. Sgrignoli husband 100% of residual ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 CDVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN t B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON L[NE 13 OF REV-1500 COVER SHEET. If more space is needed, Insert additional sheets of the same size. No. 2011-00866 PA No. 21 11-0866 Estate Of: MARTHA 8 SGRIGNOL.I (First, Middle, Lastl Late Of : CAMP HILL BOROUGH CUMBERLAND COUN7"Y Deceased Social Security No WHEREAS, MARTHA B SGRIGNOLI 193-18-0745 late of CAMP HILL BOROUGH CUMBERLAND COUNTY died on the 20th day of May 2011 and, WHEREAS, the grant of .Letters of Administration is required for the administration of the estate. THEREFORE, I, GLENDA EARNER STRASBA UGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: PHYLLIS L SGRIGNOLI who has duly qualified as ADMINISTRATOR(RIX) of the estate of the above named decedent and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 11th day of August 2011. ~~ r ~~, eg/ster a~ ~Ils eputy Y **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ConvE & Con~rE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne 3901 MazketStreet 717-737-0464 Lisa Mazie Coyne Camp Hill, Pennsylvania Fax: 717-737-5161 Jaime L. High 17011-4227 www.coyneandcoyne.com May 31, 2012 w Register of Wills r? i Cumberland County Courthouse v3 ~ ,_ One Courthouse Squaze : ~ - Cazlisle, PA 17013 ' 8~ s -, ~ w r ~ Re: Estate of Martha B. Sgrignoli, Deceased 1' No. 21-11-0866 Deaz Madam: We represent the Estate of the Late Martha B. Sgrignoli. Enclosed please find an original and two copies of the Inheritance Tax Return for this Estate. Kindly docket the original and return a "clocked-in" copy with the enclosed envelope. Also enclosed is check no. 7869 in the amount of $15.00 which represents the filing fee for this Return. Please issue a receipt for payment of fee. Thank you for your assistance. If you have any questions, pleasc; contact me. Very truly yours, COYNE & COI'N:E, P.C. •- ~_ a Marie Coyn LMC/cmc Encl. Cc: Mrs. Phyllis L. Sgrignoli, Administratrix /° e,~~a~ ~.. ~ ~ ~~ -~- - _,..J~= ~ a ~8 ~,~ ., ` ~ ~ ~~ ~; ~~7 ~~ = ~ C~ ~~ N Ra CV c