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HomeMy WebLinkAbout06-21-121505610105 REV-1500°`t°~~'~" ~ OFFlCtAL USE ONLY PA Department of Revenue P~ytvaMa CAUn Cade y~ Fk Number Bureau ofIndividuatTaxes INHERITANCE TAX RETURN PO BOX 28oGO1 nn ~; /} /~ FlarrisburO. PA t712Sabof RESR)ENT DECEDENT c~ ~ •.1 ~ZCCI ~ ENTER DECEDENT INFORMATION BELOW Sodal Secuprity Number Q Date of DeaM AIM)DYr1'Y Decedent's Last Name SuRx M.al paZZ~; IK Applleable) Enter SurvFing Spouse's Information Betow Spouse's Last Name Suffix Spouse s Soda) Security Number flLL IN APPROPRIATE OVALS BELOW Date of Birth IIMDDYYYY o7o~.r9a,~ Decedent's First Name MI l~ano~ J Spouse's First Name MI THIS RETURN MUST 8E FlLED IN DUPLJCATE WITH THE REGISTER OF WILLS ~ 1. Original Retum O 2. Supplemental RaWm O 3. RemaMder Rehm (Date of Death Prior to 12-1382) O 4. Lnriite0 Estate O 4a. Future Interest Conpranise (date of O 5. Federal Estate Tax Relum Required death aRer 12-12-92) O 6. Decedert Died Testate O 7. Decedent Maintained a Livirg Trust O 8. Total Number of Sale Deposd Boxes (Attach Copy d W~ (Attach Cray d Tnna.) 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 Solredule O) CORpE SP011DEM- TNIS SECTIfIN ARISE BE COIPLETED. ALL CORRESPONDENCE AND CONFOENML TAX MFORNATION SIpULD fM gRECTED TO: Name Daytime Telephone Number J os c p h A. M.a(p~zzi 717-579-/a77 Fast Lste of Address l40 ~4lGKory Rpa~ SecorW Lme of Address City Or Poet Office Carl.+'Sl~ Cornspondsrlt'a a-rrraN address: Under panaNee of parjtey,l dadara that I I k sae. caret[ end omdela. DedanW ~~19`o tFlc SIGNATURE OF PREPARER REGISTER of anus usE orur ~ *.a ~' rv rte,, ~ _ ` c ~~~ N U, _ -~ State ZIP Cade L- IPA tZotS 9 aNng sdreauules and aleternenis, and m e penonel reprmenleWe k based anal hrtarrnetiar dwh arcs !o PA /7a~'S- ~ ~ CJ tbu d my Iaraabdga and beN preparer has airy Iarasledge. DATE ~-z(-Za DATE i nv 'c~~' _.: r--+ n A7 q T } f~ tALEA/E WE OR161NAL FORM ONLY Side 1 '„~ 1505610105 1!iO56101O5 J J REV-1500 EX (FI) Decetlenre Name Decedent's Social Severity Number RECAPrtltunoN 1. Real Estate (Schedtde A) ........................................... .. 1. •-~- 2. Stacks and Balls (Schedule B) ..................................... .. 2. -~. 3. Gasety Held Corpaalion, Partnershq aSole-Proprietorship (Sfiedule C) ... .. 3. ..~-- 4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4. -~ 5. Cash, Bank Depabls arM Miscellanewe Personal Property (Schedule E)..... .. 5. / 7/ ~ ~• ~0 6. Jointly Owned Property (Schedule F) O Separate Bildrg Requested ..... .. 6. -~- 7. Inter-Vrvos Transfers 8 Miscedanaws Non-Probate Pmperty (Schedule G) O Separate Biding Requested...... .. 7. -~- 8. Tohl Gross Assets (tWal Lines 1 through 7) ........................... .. B. 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 11. Total Deduetlars (trial Lines 9 and 10) ........................... ...... 11. 12. Net Value of Estate (Line 8 minus Lme 11) ........................ ...... 12. 13. ChadlaNe and Govemrttental Bequests/Sec 9113 Tmsts for which an ekziion to tax has not been made (Schedule J) .................. ...... 13. 14. Nat Value 9uhjed to Tax (Lkte 12 mirxrs L'me 13) .................. ...... 14. J(7 ~~'~7°~-- ~w~a. le3 TAX CALCULATION -SEE MSTRUCTIONS FOR APPLICAtlLE RATES 15. Amount of line 14 faxabM a[ the spousal tax rate, err transfers urxler Sec. 9116 i6. AmouM of Liner 14 taxable al dneal rate X.01 ~p7.~,.(~3 18. 17. Amount of Line 14 taxable at sibdng rate X .12 $ 17. 18. Amount of Line 14 taxable at mdaterel rate X .15 ~' 18. 19. TAX DUE .......................... ............................. .. 19. 20. Ftll IN THE OVAL N; YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Slde 2 15D5610205 O ~g~'s7 -~ / r9s7 O 15056102D5 150561D205 J REV-1500IX (FI) Page 3 Flk Number ueceaenrs ~ompfet[e waaress: J~ Malpczzi r r ~~o .JOSC.~Oh _A'-MaI~JcZZt--- ! 9o fhuCory ,¢d ~`~ CarGSte - STATE ~^ ZIP l7pir Tax Payments and Credits: 1. Tax Due (Page 2, L'me 19) 2. CredilslPaymenls A. Prior Payments B. Discount 3. Interest 4. M Lure 2 is gremer Oran Line 1 + Lgle 3, ender the difference. This is dle OVERPAYMENT. FIff in oval on Page 2, Line 201o request a refund. l3) -6- (4) 5. ff Line 1 + Line 3 is greater than Line 2, enter th difference. This is the TAX DUE (5) ~ 8 7 ~.J `~ Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS i. ad deoedem make a booster and: Yes No a. retain the use a uxxme d Ore properly transfemed ................................................................................... ....... ^ b. retain the right b designate who shaA Ixte the property transferred a its irxane ....................................... ...... ^ c. retain a rwasiorlary interest ........................................................................................................................ ...... ^ d. receive the promise fa kre of eitlra payer, benefits a pre? ................................................................ ...... ^ 2. ff death awned after Dec. 12, 19()2, did decedent transfer property wOhin one year of death withwf receiving adequnte cansideradar? ........................................................................................................ ...... ^ ~] 3. Did decedent own an'in text far orpayable-upon-death t1aMc aawnt a severity at his ar her de~h? ........ ...... ^ 4. Did daederO own an urdividtral reUrentent aawnt, anwffy a otller nortprobate properly, which contains a berleffdary designation? .................................................................................................................. ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS LS YES, YOU iIUST COMPLETE SCHEDULE G AND flLE R AS PART OF THE RETURN. Fa dates of death an a after July 1,1994, and before Jan. 1, 1995, the fax rate imposed on the net value of transfers to a for the use of the surviving spouse is 3 peroent [/2 P.S. §9116 (a) (1.1) (i)]. Fa dales of death on or after Jan. 1, 1995, the tart rate apposed on Ole rlet value of transfers to a far the use of the surviving spouse is 0 percent [/2 P.S. §9116 (a) (1.1) n ]. The statute des not exempt a transfer to a surviving spouse from fax, and the statutory requiremerds far disclosure of assets and f0ing a tax redarl are sfR appNpble evert ff the surviving spouse is the Doty berte0riary. Fa dates nt death an or after Jury 1, 2000: • The tax rate imposed on the net value nt boosters from a deceased chill 21 years of age a younger at death to a far the use of a nature parent, an adoptive parent or a stepparent of Ore child is 0 percent [/2 P.S. §9115(a)(1.2)J. The hint tale imposed on the net value dtransfers to a for the use of the decedent's lineal beneficiaries is 4.5 percent, except as rioted in [/2 P.S. §9116(a)(1)J. • The tax rate imposed an the net value of transfers to or far the use of the decedents siWin~s is 12 percent, [/2 P.S. §9115(a)(1.3)]. A sibfirg is defined, under Section 9102, as an individual who has at least one parent in comrrlorl with the decedent, whether by bbod a adoption. m l84.b7 Tofalt(A+g) (2) -D- REVa5o8 EX+(u-w) pennsylvania SCNEpYLE E ail oernarnexraFaevexue (',A$N~ BANK DEPOSITS ~ MISC. '""~""ce T"" RE11PN PERSONAL PROPERTY arSroFM occmerr ESTATE OF: RILE NUMBER: Nancy J• Malp~zz,~ tndude the proceeds of Itigation and the date the proceeds were received by tlx: estate. 11E property jointly owned wMh right of survivorship mud he dhxioced on Sdrefirk F. ~~ I Checlun9 aCCVunt ~4~~~f5 jN,+T 'ganK ~ wes-i {-Frgh ~lrect Carb's(~ PA 1703 dL.l Pore thought - 6una1 aCeount ~' DeG/alyj/~ &win9 8ro~hers Funa-al ~fome~ 3• ~ ~t~h marK PG ~iifvSUranct) 4.I interest on M+T ~hecw'r~ aeGOUn{' `!4, 7IfS 37 o?/b•3-8 o~ TOTAL (Alm enter on Line 5, RecapitulaUOn) ; If more space is needed, use additional sheets of paper of the same sh:e. REV-1511 EX+ (10-09) pennsylvarria SCHEDULE H OEPINTMENT OF NEVENUE FUNERAL EXPENSES AND INHFRRNlQ TA%RERNIN Rrsulert oEV~r ADMINISTRATIVE COSTS ESTATE OF J ~ ~~ FILE NUMBER ~. Decedent's debts mwt ba roporkd m srAeduk I. ITEM NUMBER DESCRIPTIl1N AMWNT A. 1 FUNERAL EXPENSES: . Malpcz7.i Funcral ~lot~ - ~'unc+'al eupcnseu ' /oi la7S~•88 2. l-boss's '8ar~uct Re&kaura~••- ~Putw'a~ meat 73~.9'f 3• B0.ughrncin Y11~mon'a~ tAIO('1C9 - tieGdS~ne GneFtavriv~ /0O• DD B. ADMINISTRATIVE CDSTS: 1. Personal RepresetdaNVe Commissbns: Name(s) of Personal Representative(s) Sheet Address Cdy _._.. __..___ _-_-_ _. __.____State_ ____ZIP Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (if decedent's address is not the same as daimant's, attach explanation.) CWimard Sheet Address ~ _____-__ - - ___ - -_ __.___- State .__.. Z[P -__ __ RelatiarWlip of CWimant to Decedent 4. Probate Fees: 5. Accountard Fees: 6. Taz Return Preparer Fees: '. Fling ~'ec -1-nher~tonc~ Ta>< 2etu,-n 13' ©o TOTAL (Also erRer on Line 9, Recapitulation) ~ ~ 'I,Sot oZ • .Sad If more space is needed, use additional sheets of paper of the same size. REV-1512 E%+ (12-OS) pennsylvarria SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TA%RENRN MORTGAGE LIABILITIES & LIENS RESIDENT oE~oE>rT ESTATE OF It more space is needed, insert additional sheets of the same sire. REV-1513 EX+ (O1-10) pennsylvarria DER~RTMENT OF REVENUE INHERITANCE TA% RErIIRN RESIDENT DECEDENT SCHEDULE 7 BENEFICIARIES ESTATE OF: FILE NUMBER: Nanc J • Mal z Li NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELAIlONSHIP TO DECEDENT DO NOt List TrustOe(s) AMOUNT OR SHARE Of ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1,2),] 1• David L N~alpazzi son ot6 %s 153'1 FlGrnm~ng •DrIYG Longmont, GO $0601 Z• meanie I J • wtalpezzi son as' l to 0 8 N o i}t'n9t~prn ~rVL {-~ummel5}r~Lan Pa l?03(0 3. ~oscph sF• Malpctu son a5i i 9o H+'c~co~y Road Cart,t•S t.e PR ~ L ~o t 3' ~f• 6usan m • S{vuf•Fer• daughtu- as°/, to ffoover 12oad C0.rCt<5~ PA 170! 5 ENTER DOLIAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16 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: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBlITI0N5 ON LINE 13 OF REV-1500 CDVER SHEET. If more space is needed, use additional sheetr of paper of the same size.