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HomeMy WebLinkAbout04-29-13 1 1505610105 J REV-1500 Ex(02_11)(Ft): : OFFICIAL USE ONLY PA Department of Revenue Pennsylvania N;.1 County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX rg,PA 1 Y/Q � Harrisburg.PA 17128-o6oi RESIDENT DECEDENT ( ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 171-38-3796 03/07/2011 08/24/1953 Decedent's Last Name Suffix Decedent's First Name MI Baksa Jr. William G (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 OVALS BELOW p 1.Original Return (W 2.Supplemental Return p 3. Remainder Return(Date of Death Prior to 12-13-82) O 4.Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate C=:) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SttMU BE DIRECTEVTO: M r�'t Name Daytime Telep�ene jlumber <D ED Aman M. Barber, III, Esqu (215)256 05� cy p REGIST9K ILLS USE NLY First Line of Address 425 Main St r` Second Line of Address Suite 200 City or Post Office State ZIP Code DATE FILED Harleysville PA 19438 Correspondent's e-mail address:abarber @fiorebarber.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 personal representative is based on all information of which preparer has any knowledge. DD 97 a ' C' , Royersford, PA 19468 SIGNAT O P R TH THAN REPRESENTATIVE DATE AD ES 425 Main St., Suite 200, Harleysville, PA 19438 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 J 1505630205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: William G Baska, Jr. 171-38-3796 RECAPITULATION 1. Real Estate(Schedule A). ... .. .. ... 1• 0.00 2. Stocks and Bonds(Schedule B) . .. ............ .................... .... 2. 0.00 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. 1,279.09 6. Jointly Owned Property(Schedule F) C:) Separate Billing Requested ....... 6. 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 0.00 (Schedule G) C=> Separate Billing Requested....... 7. 8, Total Gross Assets(total Lines 1 through 7).... .. . ........ 8. 1,279.09 9. Funeral Expenses and Administrative Costs(Schedule H)... ........ .. ...... 9. 0.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. ...... ..... 10. 0.00 11. Total Deductions(total Lines 9 and 10). .............. 11. 0.00 12. Net Value of Estate(Line 8 minus Line 11) ............. ................. 12. 0.00 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, 0.00 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 A_ 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 0.00 16. 0.00 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. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=) Side 2 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME William G Baksa Jr STREETADDRESS 1102 Yverdon Dr Apartment A-8 CITY STATE ZIP Camp Hill PA 17111 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments ........_................... B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,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 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.............................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 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?.............. ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which containsa 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-i5o8 EX+(11-1o) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William G Baksa, Jr. 21-11-0418 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. YRC Worldwide,Inc.-wages 200.44 2. YRC Worldwide,Inc.-wages 1,078.65 TOTAL(Also enter on Line 5, Recapitulation) $ 1,279.09 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+ (01-10) pennsytvania SCHEDULEJ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William G. Baksa, Jr. 21-11-0418 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. Jaclyn S.Baksa,978 Katie Cir.,Royersford,PA 19468 Daughter 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. 11 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. $ If more space is needed,use additional sheets of paper of the same size. VKC Worldwide,Inc, December 28, 2012 (tor YRC FREIGHT) 10990 Roe Avenue Overland Park,KS 66211 CIIFCK NUMBER: 20166640 AMOUNT PAID: 51,076.65 ESTATF W WILLIAM G HAKSA 978 KATIt:C'IRC I-A,' ttt W.RSI ORD.PA 19,468 hec ate: , ec 0 Check No, —1.766-0=6 C Handling Voocber ID Invoice Number Invoice Date Gross Amount Discount Available Paid Amount INT 03111986 121221 KGC11078 21,I)ee.2012 1.(178.63 0:00 1.078.63 11Ak1i SPOLItVitERG .._ —a - - V�ndar Nu. ti mber �`— -- mr - _ 'rota)Discount, t ESTATE . Cheek Number Date Total Amount Discounts Taken 1 Total Paid Amount i 20166540 28.1)ec 2012 S i 078.63 50.00 1:0",8:65 14-f_:'NF 01-'1'AC 1 fit--+ORI�t I-110S SM CI IFCK P• r Mild M1011 Y 'dlr+il+ ►ttnr. JPM*rgan Clutoo 1knk. 4.A,. 201681140 (far Vki OtOmp f~olitAbus,Olt CJvartontf tom;K�;�92t 1 Bate 28,Nc,2012 pit Atnolrnt Pay ****0Nt`tUO1jSAN1) EVEN4'Y+1014'rANO 61 r Iq DCJLLAR***- '61be ` : OTTA +PWILLIAM G AAKSA fire 71"'KATIF CIRCLE Autlaffiftil*11441100*! 0 20 166 5400 40441154434 S38 ? 21, 2010 I YRC worldwide,Inc. March 29,2012 (for YRC FREIGHT) 10990 Roe Avenue Overland Park.KS 66211 CHECK NUMBER: 20132126 AMOUNT PAID: $200.44 ESTATE OF WILLIAM G BAKSA 978 KATIE CIRCLE ROYERSFORD.PA 19468 Check Date: 29.Mar.2012 Check No. 20132126 Handlingi Voucher ID C Invoice Number Invoice Date Gross Amount Discount Available Paid Amount INT 02580409 120328KGO200 28.Mar.2012 200.44 0.00 200.44 DAti'A HIAIT Vendor Number Name Total Discounts 0001028125 ES I ATE OF WILLIAM G BAKSA Check Number Date Total Amount Discounts Taken Total Paid Amount 20132126 29.Mar.2012 $200.44 $0.00 5200.44 PLEASE DETACH BEFORE DEPOSITING CHECK ` �a Vide: lYt ,IPMorgan Chase Bank,NY A. $ CohNfibus,OH � �r.l��r61�211 Date 29.Mar 2©12 Pad+tct ri3at ,M-44**' :s Y's�y �'�'t�'*«'���H1.I�I3R2�3;t AND 4#I i00 pf}t:3»AR«r"• V(?1p;Ai~I ER:121!Tf YS° F r1RCL]f � �iitrtklurbrfi(r�='` .w...a..a.�.�..>.......u«...�......a.�n..._.r.....................x_...«...e_�. .. «._._...... ..��............�..�...._. ._.moo..»��w ..,_.....—..�.....�..4..ue....e_...„....N '2 11620 & 32 & 26116 1:044 & 154431: 8 38 7 2 4 20 111' FIORE & BARBER, LLC ATTORNEYS AT LAW AMAN M.BARBER,111 425 MAIN STREET,SUITE 200 CHRISTOPHER R FIORE abarber0fiorebarber.com HARLEYSVILLE,PA 19438 cfiorc@fiorebarber.com 215-256-0205 FAX 215-256-9205 www.fiorebarber.com C-) C:: w MA April 25, 2013 CO :77 IT co Register of Wills Cumberland County Court House 1 Courthouse Square M _n Carlisle, PA 17013 Re: Estate of William Baksa, deceased No. 21-11-0418 Dear Sir or Madam: Enclosed please find one (1) original and one (1) copy of a Supplemental Return and a check in the amount of$15.00. Please file the original and return a time-stamped copy in the self-addressed stamped envelope at your earliest convenience. Thank you. Very t ryj! "y u rp, y A a 4n . be'r, I I AMB,111/sld Enclosures cc: Jaclyn S. Baksa (w/o encl) IW. vNi 0 - OX �• o 3 C CD 12 y C cr cn N 0 � (I �N•, n O • v� � CD n — c C) cn N O C x O N 'R, C \.n :5. M C\ - o (D co w a7 rn G-) w n rn N m rn 00 m co rY1 iJ m '*1 855233.22 0 rn omCO) oy • ��SD Cif AL •• r �S)CO)m O