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HomeMy WebLinkAbout95-0374 6U:~~'` 3w 2EV-1500 EX+ (7-94) ~, INHERITANCE TAX RETURN FOR DAIlJ yr YCAEn wrE cLC F aw ~ ~~ ~ a.nca.n ncsc IF A SPOUSAL ^ POVERTY CREDIT IS CLAIMED RESIDENT DECEDENT FILE NUMBER COMMONWEALTH Of PENNSYLVANIA (TO BE FILED IN DUPLICATE 21-95~~ ~3~ 7 DEPARTMENT OF REVENUE DEPT. 280601 WITH REGISTER OF WILLS) COUNTY CODE YEAR NUMBER HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MI LE NITIAI) DECEDENT'S COMPLETE ADDRESS Beleski Anthon B. Lea der Nursing & RE~habilitation Center W SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH a l nut Bottom Road , Car 1 i s le , PA 0 "' 199-09-2651 10/29/95 7/25 12 co°n Cumberland p ( IF APPIIGBLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTION51 Anna Beleski 189-03-5919 170 699.97 L++ c [~ 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (for dares of death prior to 12-13-82) Y rn cc Limited Estate ^ 4 ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required = . Wll] n0t d b t (for dates of death after 12-12-82) v a m . a e pr o ~] 6. Decedent Died TAstate. ^ 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes a (Attach copy of Will) (Attach copy of Trust) _ y~ y z NAME COMPLETE MAILING ADDRESS sZ Ronald E. Johnson Andrews & Johnson Vp~. TELEPHONE NUMBER 78 West Pomfret Street 1 7T7 1 ~i,~_nT~~ __ _. 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2 ) 3. Closely Held StocklPartnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 ) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 8, 699.97 (Schedule E) z g 6. Jointly Owned Property (Schedule F) (6 ) 7. Transfers (Schedule G) (Schedule L) (7 ) 8 699.97 a 8. Total Gross Assets (total Lines 1-7j 3 955.00 , (B ) 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 8 10) (11) _~T~.~~., nn 12. Net Value of Estate (Line 8 minus Line 11) (12) _ 4, 744.97 13. Charitable and Governmental Bequests (Schedule J) (13) - -~ 14. Net Value Subject to Tax (Line 12 minus Line 13) s- ~1>i fYA9.s (14) _ 4, 744.97 z 0 a o. 0 v x a 15. Spousal Transfers (for dates of death after 6-30-94) See Instructions for Applicable Percentage on Reverse Side. (Include values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at 6% rate (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rate (Include values from Schedule K or Schedule M.) 18. Principal tax due (Add tax from Lines 15, 16 and 17.) 19. Credits Spousal Poverty Credit Prior Payments i ~ - i (~ `--~ ` ~ o cnn n, (16) x .06 = (17) x .15 = Discount Interest + + - 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. A. Enter the interest on the balance due on line 21A. B. Enter the total of Line 21 and 21 A on line 21 B. This is the BALANCE DUE. Make Check Payable to: Register of Wills, Agent Under penalties of perjury, I declare that I have examined this return, including accompanying it is true, correct and complete. I declare that all real estate has been reported at true market based on all information of which preparer has any knowledge. 4DDRE55 4L / N . Hanover St . , Carlisle, PA 17013 ADDRESS 78 W. Pomfret St. (18) _ 0.00 (19) (20) (2t) _ 0.00 (21 A) _ (21 e) _ 0 00 Iles and statements, and to the best of my knowledge and belief, Declaration of preparer other than the personal representative is P t , - DATE ~~ ~L / DATE Uzi ~~ v REV-1508 EX+ (2.871 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MfSCELLANEOUS PERSONAL PROPERTY Anthony B. Beleski (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION NUMBER 1. Guardianship Checking Account -York Federal Savings & Loan Assoc. This was established as a result of Court proceedings and a Court Order wherein the decedent was adjudged an incapacita ed person on June 22, 1995. The Court appointed guardians have filed a First and Final Account and Schedule of Proposed Distribution showing the distribution of the balance in the account being distributed to Anna Beleski, the decedent's widow. VALUE AT DATE OF DEATH 8,699.97 Please Print or .E NUMBER 21-95-374 TOTAL (Also enter on line 5, Recapitulation) ~ $ 8 , 699.97 (Attach additional 815" x 11" sheets if more space is needed.) REV•ISfl EX+ n.aa, SCHEDULE H FUNERAL EXPENSES, COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES RESIDENT DECEDENT Please Print or Type ESTATE OF 'FILE NUMBER Anthony B. Beleski 21-95-374 ITEM DESCRIPTION AMOUNT NUMBER A. 1. FuneraLExpenses: B. ~ Administrative Costs: 1. Personal Representative Commissions _ _ Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees to Andrews & Johnson 350.00 3. Family Exemption Claimant Anna Beleski Relationship wife 3, 500.00 Address of Claimant at decedent's death Street Address 427 N. Hanover St. , Apt. 1 City Carlisle State ~_ Zip Code 17013 4. Probate Fees C. Miscellaneous Expenses: 1. Register of Wills - filing fee for guardianship accounting & schedule of distribution 95.00 2. Register of Wills :Inheritance Tax Return filing fee 10.00 3. 4. 5. b. 7. ~ 8. ~ TOTAL (Also enter on line 9, Recapitulation) I $ 3955.00 (If more space is needed, insert additional sheets of same size.) REV-1649 EX+(8/95) SCHEDULE O TRANSFERS TO SURVIVING SPOUSE COA9.{pNWFL1i,TEi or PQdJ3YLVANIA Ra~RITANCE TAR REnntN RHSmII~71'DECFDO~If ESTATE OF ruetrumuer Anthony B. Beleski 21-95-374 PART A: Enter the description and value of all interests, both taxable and non-taacable, regardless of location, (net of deductions) which pass to the decedent's surviving spouse by will, intestacy, operation of Iaw, or otherwise. Description of items Amount 1 Balance in guardianship checking account from Schedule E ts,byy.yr 2. Jointly owned savings accounts at PNC Bank. (approximate value) 59,000.00 3. Jointly owned checking account at PNC Bank (approx. valu ) 3,000.0() 4. Jointly owned certificates of deposit at PNC Bank (approximate v~t~u~) 30,000.00 5. Jointly owned certificates of deposit at First Fidelit Merchants Bank. (approximate value) 50,000.00 6. U. S. Series E. Savings Bonds. (approximate value ) 20,000.00 Part A Total: Enter the amount shown on the recapitulation sheet in the Decedent Information Section. 17 0 , 6 9 9 . 9 7 Election To Subject Property To Taz Under Section 2113(A) As A Taxable Transfer By This Decedent. If a taut or similar arrangement mats the requirements of Section 2113(A), and: a. The trust or similar arrangement is listed on Schedule O, and b. The value of the trust or similar atrangemrnt is rntered in whole or in part as an asset on Schedule O, then the transferor's personal repn~setrtative may spec~cally identify the trust (all or a fractional poRion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule O, the personal representative shall be considered to have made the clection only as to a fraction of the trust or similar arrangement. The numerator of this fraetion is equal to the amount of the trust or similar arrazrgement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangemrnt. ELECTION: Do you elect carder Sectlon 2113(A) to treat as a tuable transfer in this estate all or a portion of a trust or similar arrangement created for the sok use of this decedent's surviving spouse during the surviving spouse's entire lifetime? YES ~ NO ~ Signature Date Note: If the election applies to more than one trust or similar arrangement, then a separate form must be signed and tiled. Part $: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, (net of deductions) which pass to the decedent's surviving spouse for which a Section 2113 (A) election is being made. Description of items _ Amount Total LAST WILL AND TESTAMENT of. •. ANTHONY BELESKI I, ANTHONY BELESKI, of 780 West Main Street, Plymouth, Luzerne County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all previous Wills and Codicils heretofore made by me. ITEM I: I direct that all my just debts, including funeral expenses,be paid as soon after my decease as is possible. ITEM II: I give, devise and bequeath my entire estate, real, personal and mixed, of every nature and wheresaever situate, to my wife, Anna Beleski. ITEM III: Zn the event that my wife, Anna Beleski, predeceases me, then in that event, I give, devise and bequeath my entire estate, real, personal and mixed, of every nature and wheresoever situate, .._. ,;.,,•• to my four grandchildren, namely, Michelle Beleski, Robert Beleski, Brenda Beleski and Anita Beleski,. share and share alike. In the event that one or more of my aforesaid grandchildren should be under the age of 18 years and in the event that my wife predeceases me, then in that event, I nominate, constitute and appoint Raymond • Radomski and Rosemary Radomski to serve as the guardian of the estate of such minor children for the health, education and general welfare of such minor children. ITEM IV: I hereby nominate, constitute and appoint my wife, Anna Beleski, to serve as the Executrix of this, my Last Will and Testament. In the event that my wife predeceases me or is unable to serve as my said Executrix, then in that event, I nominate, constitute and appoint Raymond Radomski and Rosemary Radomski to serve as the joint personal representatives of this, my Last Will and Testament. I further direct that my said personal - 1 - representatives ahall not be required to post bond in any jurisdiction in which they might serve., IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of April, 1982. X C~~~1'L« ~ ' (SEAL ) Anthony. Beles SIGNED, SEALED,PIJBLZSHED and DECLARED by the above=naiDed Te$tatoz as 'and 'for hi,'s Last WS,11 and .Teataipent, in the pxesence of us, who ~t his xeq.uest, in hi,~s pxe&ence, and in the pxesence of each othez, Kaye hereunto ~sub.s'crib.ed our names as witnesses the~eto.~ x'esi~di,ng _~t.. ~~~~j,~'~f ~~ /I'/l~L~~4~~ ('a !/CL~.i/1~ res~l,ding at // ~~ ~`~/~/ ,~? ~f/ /4'. _ 2 ...