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HomeMy WebLinkAbout09-04-12 (2)~ REV-1500 Ex(°'-'°''~` PA Department of Revenue pannsylvania Bureau of Individual Taxes °°"""'"F1TOP R"1°"" Po Box.zeosot INH Harrisburg, PA 77128-0601 F 1505610143 OFFICIAL USE ONLY County Cotla Vear File Number TAX RETURN 21 12 0132 )ECEDENT Date of Birth 02 03 1952 Decedent's First Name MI JAMES P ENTER DECEDENT INFORMATION tstLOw Social Security Number Date of Death Decedent's Last Name Suffix STRAHOSKY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI FILL IN APPROPRIATE OVALS BELOW 1. Original Return ^ 2. Supplemental Return ^ 3. poor to d2rt 3eB2' (date of death 4. Limited Estate ^ ^ Future Interest Comppromise 4a' (oats or tlealh after 12-02-82) ^ 5. Federal Estate Tax Return Requiretl a Decadent Dietl Testate ^ 7. lA~~ ~opy o~4ruas j Living Trost O a. Total Number of Safe Deposit Boxes (Attach Copy orlMll) ^ 9. Litigation Proceeds Received ^ 10~b~iweenP~v~i ~i~en~{aetgeSM tleath ^ tt, Election to tax untler Sec. 8113(A) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL'rAXlNFORMATION SHOULD BE DIRECTED T0: Name Daytime Tale hone Numtl~at, EDMUND G MYERS (717 )1 4 ~0 -r, T a~ ~' =~.i First line of address C~?G S ~, ~ r= 301 MARKET STREET O Second Ilne of address y ~ o ~`D flJ PO BOX 109 DATE FILED City or Post Office State ZIP Code LEMOYNE PA 17043 Correspondent's a-mail address: egm~assw.wm Under penalties of perjury, I declare that. I have examined this return, including accompanying schedules and statements, and to the best of my knowletlBe and belief it is true, correct antl wmplete. Declaration of preparer other than the personal representative is based on all Infonnatlon of which preparer has any knowledge. SIGNATURE OF PERS E FOR FILING RETURN DATE Jason T Strahosky ~~Z ~~Z RESS 152 outh 2nd Street Dillsbur PA 17019 SIGN E OF PREPARE3OTHER THAN REPRESENTATIVE DAT / /~.~L ~ ~ia_~ EDMUND G. MYERS ~' L4 / /'7/ 301 MARKET STREET Lemoyne PA Side 1 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number oa~aam~aNamo: Strahosky, James P 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 8 Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 10 , 218.00 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8 Miscellaneous t~oq Probate Property (Schedule G) ~J Separate Billing Requested............ 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 10 , 218.00 9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... 9. 1 , 299.60 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 8 10) ................................................................... 11. 1 , 2 9 9.60 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. - 8 , 918.4 0 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. 8 , 918.40 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0.00 (a)(1.2) X .00 16. Amount of Line i4 taxable $ 918.40 ~ 16. 401.33 at lineal rate X .045 17. Amount of Line 14 taxable 0.00 17. 0.00 al sibling rate X .12 18. Amount of Line 14 taxable 0.00 18. 0 • 00 at collateral rate X .15 1s 401.33 1s. Tax Due ................................................................................................................. . . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 15056117243 J REV-1500 EX Page 3 n..aednn++~ Cmm~lw}w Addrwss• Flle Number 21-12-0132 ... ...r...__ ..__. ___. DECEDENT'S NAME Strahosky, James P STREET ADDRESS 905 Eric Avenue CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Cheek box on Page 2 Llne 20 to request a refund 401.33 0.00 5.89 (4) 1. Did decedent make a transfer and: Yes No a. retain the use or inwme of the property transferred :............................................................................... ^ 0 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? ............................................................ ~ x 2. If death occurretl after December 12, 1982, did decedent transfer property within one year of death without ^ ^ receiving adequate consideration? .................................................................................................................... x For dates of death on or after July 1, 1994 and before Jan. 7, 1995, the tax rate imposed on the net value o~f transfers to or for the use o e survmng spouse is 3 percent [72 P.S. §9176 (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 thie 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 they statutory requirements for disclosure of assets and fling 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. §9176 (a) (7.2)]. . 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. §9176 1.2) [72 P.S. §9716 (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)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the cecedent, whether by blood or adoption. (1) Total Credits (A + B) (2) (3) Rev-7608G7(~IB-98) gCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONNEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OELEOENi ESTATE OF FILE NUMBER Strahosky, James P 21-12-0132 molvtla me proceeds or la.gsoon antl me dale me proceatle were received Dv ma a=Isle. All property IolnayovmetlwlM the fight of survivorship moat Da tlbcloaetlon achatluls F. ITEM VALUE A7 UA I t NUMBER DESCRIPTION OF DEATH 1 Settlement proceeds - -James P. Strahosky, Administrator of the Estate of ttfe Cory James 5.000.00 Strahosky, Plaintiff v. Preston Evans, Defendant Dauphin County, No. 2011 CV 3158 CV 2 1993 Chevrolet Camaro -Valued in Good Condition using Kelly Blue Book. A. copy of the 2,278.00 valuation is attached to this Retum 3 1997 Chevrolet Blazer -Valued in Good Condition using Kelly Blue Book. A r:opy of the 1,955.00 Valuation is attached to this Return 4 U.S. Treasury - ReimbursemenURefund 985.00 TOTAL (Also enter on Line 5, Re<:apitulation) I 10,218.00 (If more space is neetleq 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-1767 Ex~ fl0-O8) COMr~~~r~ANIA SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COST: ESTATE OF FILE NUMBER Strahosky, James P 21-12-0132 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Sheet Address Ciry State Zio _ Yearfsl Commission paid 2. Attorney's Fees JOHNSON DUFFIE 750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Stale Zio _ Relationship of Claimant to Decedent 4. Probate Fees 89.50 5. Accountant's Fees 6. Tax Return PrepareYs Fees 7. Other Administrative Costs 460.10 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 7,299.60 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE I~OSTS continued ESTATE OF FILE NUMBER Strahosky James P 21-12-0132 ITEM DESCRIPTION AMOUNT NUMBER 1 Other Administrative Costs Cumberland County Registerof Wills Office -Filing Fees for Inheritance Tax Return and 30.00 Inventory 2 Reserves -Additional costs and miscellaneous administrative expenses 200.00 3 The Cumberland Law Journal -Notice of Estate Administration 75.00 4 The Patriot News Company -Notice of Estate Administration 155.10 H_g7 460.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE J ~oMr~~~yANIA BENEFICIARIES ESTATE OF FILE NUMBER Strahosk , James P 21-12A732 NAME AND ADDRESS OF RELATIONSHIP TO SHAFIE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S1 RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116 a 1.2 Jason T Strahosky Son EntilB Estate 152 South 2nd Street Dillsburg, PA 17019 Total Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO l"AX IS NOT TAKEN 6. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-t 5UU c:OVtR ~ntt i I Copyright (c) 2009 form software only The Lackner Group, Inc. Forth PA-1500 Schedule J (Rev. 11-08) ESTATE OF JAMES P. STRAHOSKY 4('HEDULE OF EXHIBITS EXHIBIT A Kelly Blue Book for valuation of 1997 Chevro!'et Blazer EXHIBIT B Kelly Blue Book for valuation of 1993 Chevroi!et Camaro sizasz Kelley Blue Book ' ° Kelley Blue Book The Trusted ResDUrce° .:~.yN,y:~ 2©92 Corvette amenaement .A '~~: Your Blue Booka Value ~,.,,.~; 1~99711Chevrolet Blazer Mikape: 200000 Private Party Value Excellent $2,255 Very Good. __..... $2,055 Good $1,955 FaU.___..____... $1,455 Vehicle Highlights Page 1 of 2 MPG: City 15/HVry 20 Doors: 4 Drlvetraln: 4WD EPA Class: Sport U[Illty Vehicles Country of Origin: United States Max Seating: 6 Engine: V6, High Outpu4 4.3L Transmission: Automatic Body Style: Sport Utlllry Country of Assembly: United States Your Configured Options Our pre-seleRed optlons, based an rypkal equipment far NIS car. JOpbons Nat you added whsle conFlgudng this mr. Engine Braking onO TmNOn V6, High Output 4.3L A05 (9-Wheel) Tmnsmladon Comfort antl COnvenlence Automalk Alr COndi[bning Drivetrain Steering 4WD Power steering Glossary of Terms Kelley Blue Book® Trade-in Value -This Is the amount you wn expect N receive when you trade in your or to a dealer. Tnls value is determined basetl on the style, condkion, mileage antl optlons Intlkated. Entertainmen! and InsW mentatlon AM/FM $IY20 Wheels aM Tlras Steel Wheels Kelley Blue Book® Private Party Value -This Is Ne startirg polo[ for negotlatlon of a usetlrar wle between a private buyer and seller. This is an "as Is" value Nat does not Include any wamandes. The Mal price depends on the oIS actual contlltbn and local market factors. J Excellent Contlltlon: a% of all ors we value meet Nis criteda. This Wr looks new antl Is in excNlent q ~ ,1 ~' L ~~ mec6aniral oMalon. I[ has never had paint or bodywork antl has an Interior and hotly free of wear antl '. ~ ~~/JU}-~. D visible defects. The car H. rust-free and does rat need reondldoning. Its clean engine compartment Is F a http://www.kbb.corn/chevrolet/blazer/ 1997-Chevrolet-blazer/sport-utility-4d/?vehicleid=745... 8/9/2012 Kelley Blue Book .~°~~ L ` ~(Q~~Q~( BLU2 B~0{C The Trusted Resource' ,..~,;:f 2012 CnutDrO CDUpB /~ .my aesr eaverusement Your Blue Boob Value 1993 Chevrolet Camara Style: Coupe 2D Mileage: 165000 fk ...,. e. a... Private Party Value Excellent $2,578 Very Good $2,378 Good $2,278 Fair $1,753 vohicle Hiahliahts Page 1 of 2 MPG: CRy 17/Hwy 26 1 Max Seating: 4 Doors: 2 Engine: V6, 3.4 Liter Drlvetraln: RWD Transmission: Automatic EPA Class: Sub Compact Cars Body Style: Carpe Country of Origin: United States Country of Assembly: Canada M~ Your Con£gured Options Our pre-selected options, based on typical equipment for this wr. J Optlons that you added while mntlguring this car. Comfort Ond COnvanlence Engine V6, 3.4 Liter qtr Condltloning Transmisalon Power Windows Power Door larks Au[omatk Cruise Control Drivetmin SteeHn9 RWD Power Steering Tlt Wheel Enterbinment and InsGUmentaNon AM/FM Stereo Cassette New Cars You Might Like ~~.;b.:~~~;~~~~~~~ ~~ 2013 Chevrolet Camara "~. 2013 Fob Mustang Safety antl Security Dual Alr Bags W hash and Tires Steel Wlxels http://www.kbb.com/chevroleUcamazo/ 1993-Chevrolet-camazo/coupe-~