Loading...
HomeMy WebLinkAbout11-14-121,50561,D1,D1, REV-1!~a0 tx~~~-~~; OFFICIAL USE ONLY f'A Department of Revenue Pennsylvania Bureau of Individual Taxes `~ , . , Count}1 Cade Year PO BOX 28o6oi INHERITANCE TAX RETURN Harrisburg, PA 17128-06oi RESIDENT DECEDENT ,, / I ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death h.1h~f rJDI'}'YY" Date of girth PV"h:1DJl'YYY 269-48-6499 09/08/2011 12/21 /1948 Decedent's Lasi Name Suffix Decedent's First Name Mazias Evangelic (If Appticable} Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mazias Thomas Spouse's Social Security Number THIS RETURN MUST BE FILED I DUPLICATE WITH THE 195-32-0241 f~ECISTER C3F WILLS FILL IN APPROPRIATE OVALS BELOW File Numbsr n~ MI MI C!3 1. Ong~nal Return ® 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82j Q 4. Limited Estate Q 4a. Future Interest Compromise (date of Q 5, Fsderal Estate Tax Return Required death after 12-12-82} Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Capy of b'4'ilij (Attach Copy of Trustj Q 9. L€tigatian Proceeds Received Q 10. Spousal Poverty Credit (date of death ® 11. Election to tax under Sec. Q113(Al betaveen 12-31-91 and 1-1-95} (Attach Sch. O} CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number James W. Kollas. (717) 731-1600 .,~ ~' ~-~ REGISTER` i]VILLS USE +}1NLY ~' -- Fww~ 1-=, ~- ,, .._ First line of address :_ _ ; `~~ """ ,. - ; , ,~ „~- _, Kollas and Kennedy ~~~ ,. ~ Second fine of address _ `," ., .._ ... r ~.) - ~ ' ; ,-' 1104 Fernwood Avenue ;> ~ ~, f f City or Rost Office State .........ZIP Code DATE FILED ~~ -~~ Camp HIII PA 17011 Correspondent's a-mail address: fames@kollasandkennedy.com 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 persanai representative is based on all information of 4vhich preparer has any knowledge. SIG E OF PERSO 'RESPONSIBLE FOR FILING RETURN DATE DRESS 524 D Street, Carlisle, PA 17013 SIGNATU -UF P ARER OT ER THAN REPRESENTATIVE DATE ADDRESS 1104 Fernwood, Avenue, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 150561,OI,01, 1,5056101,01, J /, J 150561,01,05 REV-15(10 EX Decedents Social Security Number Decedents Name: Evangelic Mazias .269-48-6499 RECAPITULATION 1. Real Estate {Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds {Schedule B) ..................................... .. 2. 32,064.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule D} ......................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property {Schedule E}..... .. 5. 175.00 6. Jointly Qwned Property (Schedule Fj O Separate Bluing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property (Schedule Gi C7 Separate Billing Requested...... .. 7. 0.00 8. Total Gross Assets {total Lines 1 through 7} ........................... .. 8. 32,239.00 9. Funeral Expenses and Administrative Costs {Schedule H) ............. ...... 9. 18,353.50 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I i ........ ..... . 10. 0.00 11. Total Deductions (total Lines ~ and 10} ........................... ...... 11. 18,353.50 12. Net Value of Estate (Line 8 minus Line 11 } ........................ ...... 12. 13,885.50 13. Charitable and Governmental Bequests/Sec 0113 Trusts far 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. 13,885.50 TAX CALCULATION -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 00 13,885.50 15. 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 collateral rate X .15 18. 19. TAX DUE ....................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 0.00 O ~If~@ 2 15O561O1D5 1,50561,01,05 REV-1500 EX Page 3 Fife Number Qecedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits;Payments A. Prior Payments ----_---- B. Discount 3. interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Fill in oval an 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 ©UE. Total Credits ~ A + B j (2) (3j ~~~ (g) 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 transferred :.................................................................................... ...... ^ 0 b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ 0 c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ ^X 2. If death occurred after Dec. 12, 19&2, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 0 3. Did decedent o~vn an "intrust for'" or payable-upon-death bank account or seourity at his or her death? ........ ...... ^ 0 4. Did deoedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiar}~ designation? .................................................................................................................. ...... ^ IF THE ANSWER TQ ANY OF THE ABQVE QUESTIONS IS YES, YQU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Far 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 far the use of the surviving spouse is 3 percent [72 P.S. §9116 (aj (1.1) ~~}]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is G percent [72 P.S. §9116 (a) i1.1 i {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, 2GOG: • The tax rate imposed an 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 G percent [72 P.S. ~9116(aj(1.2j]. The tax rate imposed on the net value of transfers to or far the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. X9116(1.2} [72 P.S. §9116(aj(1 j]. 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)(1.3j]. Asibling is defined, under Section 91G2, as an individual who has at least one parent in common with the decedent; whether by blood or adoption. REV-15G3 EX+ (6-8£?1 ~~ C0t~1f490Nb°v'EALTH OF PENNSYLVANIA STOCKS & BONDS 1NHER(TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Evangelic Mazias 21-12-1034 All property jointlyowned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-158 EX+ {6-98) ~~o _,.~~ COMP~10N4~4'ERLTH OF PENNSYI_VF~NIF~ 1NHERfTANCE TAX RETURN RESIDENT DECEDENT ~~ CASH, BANK DEPOSITS, & MISC. PERSONAL PRC>PERTY ESTATE OF FILE NUMBER Evangelic Mazias 21-12-1034 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) ~T W' 1 9 7~~" Y '~ '~:.i i Pennsylvania UFPARrh1EN? OF REVtNU!- IPHERIT.ANcE TAX RETURN RESIDEPvT DEcECE~JT ESTATE OF __ FILE NUMBER Evangelic Mazias 21-12-1034 Decedent`s debts must be reported on Schedule I. ITEM NUf>76ER CESCRIPTIQN AMOUNT A. FUNERAL EXPENSES. ~~ Ewing Brothers Funeral Home, Inc (domestic funeral services) 12,735.00 2. Transportation of body and casket to Greece for burial 2,000.00 E. 1 ADMINISTRATII,%E COSTS; Personal Representative Commissions: Names, of Personal Represer:.tative(s Thomas Mazias State PA ZIp 17013 0.00 ~. Attorney Fees. 0.00 ~. Family Exemption: ;If decedent`s address is not the same as claimant's, attach explanation., 3,500.00 Claimant Thomas Mazias street address 524 D Street City Carlisle State PA ~Ip 17013 Relationship of Claimant to Decedent Surviving Spouse 4, Probate Fees: 118.50 s, Accountant Fees: 0.00 b, Tax Return Preparer Fees: 0.00 7. Street Address 524 D Street City Carlisle Year(si Commission Paid: n/a SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE CASTS TOTAL (Also enter on Line 9, Recapitulation) I $ 18,353.50 If more space is needed, use additional sheets of paper of the same size. RE's-151."s EX+ (Q1-10) Pennsylvania SCHEDULE ) r~FC>aNZr~t-Nr of r~FV~rvuF INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Evangelic Mazias 21-12-1034 RELATIONSHIP TO DECEDENT AMOUNT 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• Thomas Mazias, 524 D Street, Carlisle, PA 17013 Surviving Spouse 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size.