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Home My WebLink About04-15-13 1505610105 REV-1 500 EX(02-11)(F I) OFFICIAL USE ONLY PA Department of Revenue permsylvania DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN Harrisourg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 07152012 02171930 Decedent's Last Name Suffix Decedent's First Name MI SHATTO JOHN L (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW F71 1 Original Return 0 2, Supplemental Return 3. Remainder Return(Date of Death Prior to 12-13-82) 4 Limited Estate 4a. Future interest Compromise(date of 0 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8, Tot.]Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9, Litigation Proceeds Received 10, Spousal Poverty Credit(Date of Death 11, Election to Tax uncer Sec 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 7 DAVID B. SHATTO 717-g80-118W C� - EigNTER OF MILS UU Y M First Line of Address 133 OAKLEA RD 1Z C) Second Line of Address City or Post Office State ZIP Code :> DATa-F-WED HARRISBURG PA 17110 Correspondent's e-mail address: DAVIDSHATTO@COMCAST . NET 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 pre parer other than the personal representative is based on all information of which pre parer has any knowledge. SIGNATURE 0 P N RESZQULJaLQ4-QR FILING RETURN DATE D4/15/13 ADDRESS 133 OAKLEA RD . , HARRISBURG, PA 17110 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side I 1505610105 1505610105 J1505610205 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name. JOHN L SHATTO RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 170000 . 00 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. NONE 3 Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . 3. NONE 4. Mortgages and Notes Receivable(Schedule D). . . . . . . . . . . . . . . . . . . . . . 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . 5. 33082 . 00 6. Jointly Owned Property(Schedule F) =Separate Billing Requested . . . . . . . 6. NONE 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) =Separate Billing Requested . . . . . . . 7. 38989 . 00 8. Total Gross Assets(total Lines 1 through 7). . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 242071 . 00 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . 9. 2305 . 00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). . . . . . . . . . . .10. 3609 . OD 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . 11 5914 00 12, Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 2 3 615 7 . 00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for 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. 236157 . 00 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 0 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X 45 236157 . 00 16. 10627 . 07 17. Amount of Line 14 taxable at sibling rate X . 12 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X . 15 18. 0 . 00 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . _ . . . 19. 10627 . 07 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 J REV-1500 EX(Fl) Page 3 File Number 200-22-5050 Decedent's Complete Address: DECEDENT'S NAME JOHN L SHATTO STREETADDRESS 1139 SECOND STREET CITY STATE ZIP WEST FAIRVIEW PA 17025 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 10627.07 2. Credits/Payments A. Prior Payments B. Discount _ Total Credits(A+ B) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 10627.07 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............................................ El c. retain a reversionary interest............................................................................................................... ............. ❑ ❑ d. receive the promise for life of either payments, benefits or care?....................................................... ............. E] X❑ 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?..................................................................__...... .................._...... .... ❑ 0 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ............. E] X❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,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. For 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 for the use of the surviving spouse is 3 percent[72 P.S. §9116(a)(1.1)(i)]. 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 0 percent [72 P.S.§9116(a)(1.1)(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 1,2000: • 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.§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 percent,except as noted in[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 percent[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. REV-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: John L Shatto All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1139 Second Street, West Fairview, PA 17025 15,000 2. 1132 Second Street, West Fairview, PA 17025 90,000 3. 415 Fairview Street, West Fairview, PA 17025 65,000 TOTAL(Also enter on Line 1, Recapitulation) $ 170,000 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT TAX RETURN PROPERTY INHERITANCE TAX RETURN RN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: John L Shatto 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Metro Bank, Checking Account, 0536947336, Harrisburg, PA 3,336 2 Wells Fargo Checking Account, 1000294476083, Harrisburg, PA 7,207 3 PNC Bank, Checking Account, 51-4011-2445, Harrisburg, PA 1,593 4 PNC Bank, Certificate of Deposit, 31700270289, Harrisburg, PA 2,540 5 PNC Bank, Certificate of Deposit, 31900271474, Harrisburg, PA 5,710 6 Personal Property 200 7 1969 Cheverolet Truck 100 8 1989 Dodge Grand Carivan 100 9 Burial lot, decedent 300 10 Burial lot, non-decedent 300 11 Wells Fargo, Certificate of Deposit, 247412053432552, Harrisburg, PA 9,172 12 Rents Receivable-July 1-15, 2012 992 13 Federal Income Tax Refund 1,532 I i i TOTAL(Also enter on line 5, Recapitulation) $ 33,082 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(0g-Og) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER John L Shatto This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of t')e REV-1500 s yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST "F aaa"CAa`E' VALUE 1. Wells Fargo, IRA, 257410093643099 24,151 100.00% 24,151 Merrill Edge, IRA, 2AR-23D75 14,838 100.00% 14,838 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL Also enter on Line 7, Reca itulation $ 38,989 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND RESIDENT DECEDENT ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER John L Shatto Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Sullivan Funeral Home-cremation and death certificates 2,005 Burial lot-decedent(also on schedule E) 300 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)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 Fees 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ 2,305 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE INHERITANCE TAX RETURN DEBTS OF DECEDENT, RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER John L Shatto Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Real Estate Taxes, 1139 Second St, West Fairview, PA 747 2. Real Estate Taxes, 415 Fairview Ave, West Fairview, PA 1,166 3. Real Estate Taxes, 1132 Second St, West Fairview, PA 1,592 4 West Shore EMS 42 5. Holgate Podiatry 9 6. Perll Diagnostics 40 7. SusquehannalMed 13 TOTAL(Also enter on Line 10, Recapitulation) $ 3,609 If more space is needed,insert additional sheets of the same size