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Home My WebLink About04-0990COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712&0601 REV-1500 I OFF'O'A' USE ONLY INHERITANCE TAX RETURN -- RESIDENT DECEDENT - o w DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Dilda, Olympia M. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 8-17-04 1-10-1918 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) n/a SOCIALSECURITYNUMBER 177-16-9843 THIS RE~JRN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURI~' NUMBER [] 1. Original Ratum [] 4. Limited Estate [] 6. DecedentDiedTestate(A~tachcopyofWlQ [] 9. Litigation Proceeds Received [] 2. SupplemeMalRatum ] 4a, Future Interest Compromise (~t. of ~ath aaer 12-12-82) [] 7. DecedentMaintainedaLivingTrust(Aeach¢opyofTr~mt) [] 10. Spo~sel Pover[yCredit(dateofdea~hbetwun12-31.91 andl-I-~5) [] 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [] 11. FJectioetotaxunderSec. 9113(A)p,.a~.,S~hO) NAME Roland P. Dilda FIRM NAME Of A~p~ceame) TELEPHONE NUMBER COMPLETE MAILING ADDRESS 15 Spoon Lane CorD de Caza, CA 92679 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Padnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Perse~at Properly (5) (Schedule E) 6. Joinlly Owned Property (Schedule F) (6) [] Separate Billieg Requested 7. Inter-Vivse Transfers & Miscellanecus Non-Probate Property (7) (Schedule G or L) 8. To~al Gro~s As~s (total Lines 1 - 7) 9. Funeral E)~seses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabililfse, & Liens (Schedule I) (10) I1. Total Deductions (total mines 9 & 10) 12. Ne{ Vaton of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an erection to tax has not been made (Schedule J) 14. Net %ldue Subject to Tax (Line 12 raises Line 13) 172,059.00 OFFICIAL USE ONLY (8) 172,059.00 215.00 (11) 215.00 (12) (13) 171,844.00 (14) 171,844.00 SEE INSTHUCllONS FOR APPUCABLE RAI~S 15. Amount of Line 14 taxable althe sp~sal tax rate, or transfers under Sec. 9116 (a)(12) x .0 (15) 16. AmountofLine14taxableatlinealrate 174844.00 X .0 z~5 (16) 17. Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amount of Une 14 taxable at cdlateral rate x .15 (18) 19. Tax Due (19) 7,732.98 7,732.98 STF PA42021F*1 Decedent's Complete Address: STREETADDRESS 546 Ichabod Court crTY Mechanicsburq I STATE PA I ziP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B, Prior Payments C, Discount 386.65 (1) Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. IfLinel + Line3isgreaterthanLine2, enterthedifference. This is the TAX DUE. A. Enter the interest on the tax due. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) (4) (5) (SA) (5B) 7,732.98 386.65 0.00 7,346.33 7,346.33 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedant make a transfer and: Yes No a. retain the use or inccme of the property transferred; ........................................ [] [] b. retain the dght to designate who shall use the propedy transferred or its income; ................... [] [] c, retain a reversionary interest; or ....................................................... [] [] d. receivethe premise for life of either payments, benefits or care? ............................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer preperty within one year of death without receiving adequate consideration? .................................................. [] [] 3. Did decedent own an "in trust fo~ or payable upon death bank account or secudty at his or her death? ..... [] [] 4, Did decedent own an Individual Ratirement Account, annuity, or other non.probate propaly which contains a beneficiary designation? ....................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penal~es 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 personal representative is based on all infc~malion of which preparer has any knowledge. SIGNATU~:~E~OF~JERSON~RF.~PO. NSIBLE FOR FLLING RETURN DATE ADDRESS ' " ' -- ' 15 Spoon Lane, Coto de Caza, CA 92679 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 4068 Mt:. Royal Blvd. #115, Allison Park, PA 15101 For dates of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on lhe nat value of transfers to or for the use of the sumiving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, lhe lax rate imposed on the net value of transfers to or for the use of the sumivJng spouse is 0% [72 P.S. §9116 (a) (1.1) (Ji)]. The statute does not exempt a transfer to a sun/lying spouse trom tax and the s a u ory requ rements for disclosure of assets and fil nga tax return are still applicable even if the surviving spouse is lhe only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfem 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 0% [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 4.5%, 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 for the use of the decedent's siblings is 12% [72 P.S, §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, STFPA42021F,2 REV-1510 EX + (1-97) (I} SCHEDULE G CO=MONW~LTH OF PENNSYLV^N~^ INTER-VIVOS TRANSFERS & I~HER~T^NCE T~X.ETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Dilda, Olympia M. Tl~is schedule must be completed and filed if the answer (o any of ques(ions t through 4 on (he reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ~TEM INCLUDE THE NAME OF ?~'E TRANSFEREE, THFJR RELATiONShIp TO DECEDENT At~} THE DATE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER OF TRANe:ER. AT~ACH A COPY OF T~E DEED FOR REN. ESTATE VALUE OF ASSET INTEREST (IF APPt.lCABLE) 1. $ 50,000 US Treasury Bill due 10-14-04 payable on death to Roland P. Dilda, son 50,000.00 100 50,000.0~ 2. National City Bank - money market savings account #9048047326 - in trust for Roland P. Dilda and Rose Reiger, son and daughter son's 1/2 interest is reported on this return 26,156.69 100 26,156.6! The following accounts are all in trust for Roland P. Dilda, son and 100% of their value is reported herein. 3. Commerce Bank - certificate of deposit #301631 dated 4-23-04, including interest 25,178.15 100 25,178.1.~ 4. National City Bank - certificate of deposit #9017582936 dated 8-28-04 10,000.00 100 10,000.0(: 5. National City Bank - certificate of deposit #3995003805 dated 1-29-04, including interest 15,131.06 100 15,131.0( 6. Parkvale Savings Bank - certificate of deposit #104163259 dated 12-9-03, including interest 10,091.46 100 10,091.46 7. PNC Bank - certificate of deposit #31400222085 dated 1-27-04, including interest 15,291.37 100 15,291.37 8. PNC Bank - certificate of deposit #31800237850 dated 2-21-04, including interest 20,210.27 100 20,210.27 TOTAL (Also enter on line 7, Recapilulation) 172.059.0u (If more space is needed, inser~ additional sheets of the same size) s9~: PA42021F.11 REV-1511 EX + (1-97) ([} COMMONV~cALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dilda~ Olympia FI, SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Reprananlative(s) Sodal Seondty Number(s) / EIN Number of Personal Repmsontative(s) Street Address City Stats Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip¸ Street Address City State Zip, Relationship of Claimant to Decedent Probate Fans Accountant's Foes Tax Return Preparer's Fees Register of Wills - fee to file inheritance tax return 200.00 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 215.00 (If more space is needed, insert additional sheets of the same size) STF PA4202'~F 12 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX{11-96) NO. CD O04568 DILDA ROLAND P 15 SPOON LANE COTO DE CAZA, CA 92679 fold !STATE INFORMATION: SSN: 177-16-9843 :ILE NUMBER: 2104-0990 DECEDENT NAME: DILDA OLYMPIA M DATE OF PAYMENT: 11/01/2004 POSTMARK DATE: 10/27/2004 COUNTY: CUMBERLAND )ATE OF DEATH: 08/17/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I 97,346.33 TOTAL AMOUNT PAID: 97,346.33 REMARKS: SEAL CHECK//822 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE v.,~-,,',c-~ (,,">!y (C hcCU"',U,=:; ;~"\A::lI8hcE OF INHERITANCE TAX 'M'RA~ENT, ALLOWANCE OR OISALLOIIANCE , DFDEOUCTIONS AND ASSESSHENT OF TAX BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG~ PA 17128-0601 ZOD5 JAil I 0 1\11 9: 1,7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-03-2005 DUDA 08-17-2004 21 04-0990 CUMBERLAND 101 A..oun't R8I'li tted ROLAND P DILDA 15 SPOON LN COTO DE CAZA CLERt, OF ORPHAN'S COURT CU~\G~!'I ":.., .v, n,', ~,._ ...' }, \ . " : ,'i ,....J ):_\ "1,' l...... ,","" \ CA 92679 *' REV_1547EXAFPtD9_04l OLYMPIA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... REV=iS47'-EifAFP-riiFo3Y-Niii'"icE--OF-iiiiiEififAifCE-YAx-jippRAisEiiEN'i':--"rrOWAifcE-jii----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DUDA OLYMPIA FILE NO. 21 04-0990 ACN 101 DATE 01-03-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. "ortgsges/Not.s Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) IS) (6) (7) ,00 .00 .00 ,00 .00 ,00 172,059.00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax (9) llO) 215,00 NOTE: To insure proper credit to your account} submit the upper portion of this form with your tax PRyment. 172,059.00 ?lli 00 171,844.00 .00 171,844.00 NOTE: If an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of line 14 at Spousal rate (15) 1&. Amount of line 14 taxable at lineal/Class A rat. (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class 8 rate (18) 19. Principal Tax Due .00 X 00 = .00 171,844,00 X 045 = 7,732.98 ,00 X 12 = .00 ,00 X 15 = ,00 (19)= 7,732,98 ,00 (11) (12) 113J (14) TAX CREDITS: rftHO=n, I+J Al10UIIT PAID DATE NUl1BER INTEREST/PEN PAID [-) 10-27-2004 CD004568 386.65 7,346.33 TOTAL TAX CREDIT 7,732.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 d1. IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY 8E DU~ A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~~ COMMONWEALTH OF PENNSYLVANIA 'DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RIEGER ROSE A 546 ICHABOD COURT MECHANICSBURG, PA 17050 n______ fold ESTATE INFORMATION: SSN: 177 -16-9843 FILE NUMBER: 2104-0990 DECEDENT NAME: DILDA OLYMPIA M DATE OF PAYMENT: 03/15/2005 POSTMARK DATE: 03/14/2005 COUNTY: CUMBERLAND DATE OF DEATH: 08/17/2004 NO. CD 005059 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $7,764.56 I I I I I I I I TOTAL AMOUNT PAID: $7,764.56 REMARKS: ROSE RIEGER CHECK# 253 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~~ Ii( ~~ ~ ~\ ~ OFFICIAL USE ONLY FILE NUMBER '":).. ~ - ~ ~ ~ 3...3- ~ _ COlMY CODE i'UlBER YEAR W I-: ~::!;(/l l)a:~ WQ.l) Iaa l)a:...J Q.aJ Q. <I: t- Z W C W o W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Dilda 01 m ia M. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) SOCIAL SECURITY NUMBER 177-16-9843 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Eleetion to tax under See. 9113(A) (AttachSch 0) 8-17-04 1-10-1918 (IF APPLICABLE) SURVNlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) na o 1. Original Return o 4. Limited Estate o 6. DecedentDied Testate (Attach copy of Wil) o 9. Litigation Proceeds Received [Xl 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) I- aJ NAME ~ Rose A. Rie er fr FIRM NAME (If Appicable) (/l w a: gj TELEPHONE NUMBER l) 717 763-0471 COMPLETE MAILING ADDRESS 546 Ichabod Court Mechanicsburg PA 17050 (1) (2) (3) (4) (5) z o ~ ...J :::J t:: Q. <C o w a::: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1 - 7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (6) (7) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCl10NS FOR APPLICABLE RATES z o ~ t- :::J Q. :E o o >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) X.O_ (15) 172,545.81 X.O 45 (16) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. Tax Due 20. 0 I CHECK HERE.lfYOU ARE REQuESTING A REFUND OF AN OVERPAYMENT I OFFICIAL USE ONLY '0 188,505.37 ("r"\ (8) 13,186.00 2,773.56 (11) (12) (13) 188,505.37 15,959.56 172,545.81 (14) 172,545.81 7,764.56 (17) (18) (19) 7,764.56 Decedent's Complete Address: STREET ADDRESS .546 Ichabod Court CITY Mechanicsbura I STATE PA I ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 7,764.56 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 7,764.56 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 7,764.56 PLEASE ANSVVER THE FOLLOVVlNG 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 [Xl b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . .. 0 [Xl c. retain a reversionary interest; or ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 [Xl d. receive the promise for life of either payments, benefits or care? ............................... 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 [Xl 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . .. IX] 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 [Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON R SPO LE FOR FlUNG RETURN DATE -~ AD RES 546 Ichabod Court, Mechanicsburq, PA 17050 SIGNATURE~ OTHE.R THAN REPRESENTATIVE A~VJ ADDRESS 4068 Mt. Royal Blvd. #115, Allison Park, PA 15101 DATE -3 - 7 - OS 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 for the use of the surviving spouse is 3% [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 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 0% [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 4.5%, 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 for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. STFPA42021F.2 REV-1510 EX + (1-97) (I> COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Dilda, Olympia M. FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM II'CLl.(JE TI-I: NAME OF TI-I: TRANSFEREE, TI-I:IR RELATIONSHIP TO DECEDENT A/IIJ TI-I: DATE DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (I F APPLICABLE) 1. $ 50,000 US Treasury Bill due 1-6-05 payable on death to Rose A. Rieger, daughter 50,000.00 100 50,000.00 2. National City Bank - money market savings account #9048047326 - in trust for Roland P. Dilda and Rose Reiger, son and daughter daughter's 1/2 interest is reported on this return 26,202.91 100 26,202.91 The following accounts are all in trust for Rose A. Rieger, daughter and 100% of their value is reported herein. 3. Commerce Bank - certificate of deposit #301586 dated 4-23-04, including interest 25,357.56 100 25,357.56 4. National City Bank - certificate of deposit #9024739523 16,223.92 100 16,223.92 5. Parkvale Savings Bank - certificate of deposit #104163260 10,115.83 100 10,115.83 6. PNC Bank - money market account #5004404224 ACN 04144878 - opened 1-30-04 694.72 100 694.72 7. PNC Bank - certificate of deposit #31300239472 due 9-21-05 ACN 04144881 17,194.94 100 17,194.94 8. PNC Bank - certificate of deposit #31000223285 ACN 04144883 15,253.21 100 15,253.21 9. PNC Bank - certificate of deposit #31000221232 ACN 04144879 10,119.70 100 10,119.70 10. This item was made joint 1-9-04 with daughter, Rose A. Rieger PNC Bank - checking account #5004281957 ACN 04144882 20,342.58 100 3,000 17,342.58 TOTAL (Also enter on line 7, Recapitulation) $ 188.505.37 (If more space is needed, insert additional sheets of the same size) STF PA42021 F.11 REV-1511 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Dilda, Olympia M. FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Brusco-Falvo Funeral Home - funeral expenses in Pittsburgh 3,760.00 2. Malpezzi Funeral Home - funeral expenses in Mechanicsburg 7,106.00 3. Headstone charges 790.00 4. Funeral repast 1,265.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 250.00 6. Tax Retum Preparer's Fees 7. Register of Wills - fee to file inheritance tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 13 186.00 (If more space is needed, insert additional sheets of the same size) STF PA42021 F.12 REV-1512 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Dilda, Olympia M. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. 2. 3. Medical bills not reimbursed by insurance Rent on apartment Final utilities AMOUNT 1,245.00 1,450.00 78.56 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) STF PA42021 F.13 2.773.56 BUREAU OF INDIVlDUM.Jl1AxE$T, INHERITANCE TAX DIYISION . PO BDX Z80601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX lOGS nlW 20 P1'112: 40 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-23-2005 DILDA 08-17-2004 21 04-0990 CUMBERLAND 101 A80unt R..i tteel C-" ED!t n;:: L Ill\ '-_h ORPHN~{S COURT ROSE A ~~ER~ 546 ICHABOD CT MECHANICSBURG PA 17050 *' REV-1547 EX AFP (03-05) OLYMPIA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 1'I~V-"Mc"Yf.m.m~'.'lMtm.!ft!'.IMI'tI'lTlM!'t.mr.lWl'llTftMMr~.'la:[WA:M!'t.llyt'.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DILDA OLYMPIA FILE NO. 21 04-0990 ACN 101 DATE 05-23-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. R..l Est.t. (Schedul. A) (1) 2. stocks and Bonds (Schedule BJ (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F J (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 .00 .00 .00 .00 .00 188,505.37 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expens.s/A~. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return 13. Charitab1e/Gover~ntal Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax (9) (10) 13,186.00 2.773.56 (11) 1121 (13) (14) NOTE: To insure proper credi t to your account I sub.it the upper portion of this form "ith your tax pay.ant. 188,505.37 lli.QIiQ 1i6 172,545.81 .00 344,389.81 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total gf ~ ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. A~unt of Line 14 taxable at Lineal/Class A rat. (16) 17. "ount of Line 14 at Sibling rat. (17) 18. Anount of Line 14 taxable at Col1ateral/Cless B rate (18) 19. Principal Tax Due T CR T. .00 X 00 = 344,389.81 X 045 = .00 X 12 = .00 X 15 = (19)= _BER CD004568 CD005059 INTEREST/PEN PAID I-I 386.65 .00 AMOUNT PAID 7,346.33 7,764.56 OATE 10-27-2004 03-14-2005 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 15,497.54 .00 .00 15,497.54 15,497.54 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY 8E DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)