HomeMy WebLinkAbout04-29-13 (2) � 1505610143
REV-'1�Oq EX{02-11} }u��
OFFICIAL USE ONLY
PA Department af Revenue pennsylvania co�n�y coae Year Fite Number
Bureau c�f Individual Taxes �P�TMENTOFREVENUE
Pa gox.2sosol INHERITANCE TAX RETURN �1 p? 0 0 5 7?
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INF4RMATION BE�C}W
Sociaf Secu�ity Number Date of Death Date of Birth
08 02 2t303 C15 05 1927
Decedent's�ast Name Suffix Decedent's Firs#Name MI
HQRVATH BERNITA E
{If Applicable}Enter Surviving Spouse's Infarmation Below
Spouse's Las#Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLI�ATE WITH THE
REGISTER OF WI�LS
FiI.L IN APPRaPR1ATE t�VALS BELQW
o 1. Original Retum � 2. Supplemental Return � 3. Remainder Retum(Da#e of Death
Prior to 12-13-82)
� 4. Limi#ed Esta#e � 4a.Future Interest Campromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
g Decedent Died Testake 7 Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes
❑ (Attach Copy af Will) ❑ (Attach Copy of Trust)
� 9. Litiga#ion Proceeds Received � 10.bet�vveenl2 31 9�a d't�(Da95�f Death � ��.Election to tax under Sec.9113(A)
{Attach Schedule Q}
CORRESPONDENT-THIS SECTIQN MUST BE COMPLETED.ALI.CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE�IRECTED TO:
Name Daytime Telephone Number
WAYNE M P'EC�iT ESQ ?1? 691 98Q$
r�.,,,;
REGIS�R t3F WILLS�E C1�.11�7
� �
� � � � c`�
First Line of Address � "�s � �,� �
12 U 5 MANC3R DRIZTE � � rn � �'� `�
� � �"�"4 �,""1
Secand Line of Address �" �: � � �
SUI TE Z o a �� � � � � �
'��' � TE FILED ""`° "'�"'
City or Post Office State ZIP Code � � t-r�
MECHANICaBURG PA 17055 ;� cr� c:� c�
� �
Correspandent's e-mail address: wp►ech��pech�law.COt11
Under penalties of perjury,I decfare that!have e�mined this return,including accampanying schedules and statements,and to the best af my knowledge and beEief,
it is tnae,correct and plete.Declaration of preparer ather than the personal representative is based an all information of which preparer has any knowledge.
SIGN RE OF PERSQN 0 IBLE FOR FILING RETURN DATE
i �t � ., , -�
Bernita E Nye o�� ������
A DRESS
3613 Albe venue ec anicsbur PA 17050
SIGNA URE OF REPA OTH TMAN PRESENTATIVE DATE
�
� %�� Wayne M Pech#Esq. ���-�"1�;�
ADDRESS
1205 Manor Drive, Mechanicsburg, PA �17055
Side 1
�, 1505610143 15056]�0143 �
%'��
PA Inheri�ance Tax Return
Signa#ure of Additional Fiduciaries
ESTATE OF FILE NUMBER
Horvath, Bernita E. 2�1-07-00577
Under penalties afi perjury,1 declare that 1 have examined this return,including accompanying schedules and statements,and to the best af
my knowledge and belief,it is true,correct and complete.Declaration of preparer other than the personal representative is based on all
infonnation o#which pre arer has y knowle e.
i
Signature#2 1
Name Melanie R Harvath
Address�l ��15 Wingert Qrive
Address2
Clty,S#at�,ZI� Mechanicsburg,PA 17050
Date
�-.��'-�".�
Si nature#3 f �—t'��
�
Name Corinne R Brandt
Addressl 513 Penn Ayr Road
Address2
Clty,St1'��,ZI}� Gamp Hill,PA 17p71
Date `� Z--`� �_..�
� 1505610243
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 94 ,5 0 0 . 0 0
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. .
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits 8�Miscellaneous Personal Property(Schedule E)............... 5. 9, 7 3 7 . 2 6
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8�Miscellaneous I�n-Probate Property
(Schedule G) U Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ g. l O 4 ,2 3 7 .2 6
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 14, 7 0 4 . �0
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 3�,584 . 33
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 4 S,2 8 8 . 3 3
12. Net Vatue of Estate(Line 8 minus Line 11).......................................................... �2. SS, 948 . 93
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. $S, 948 . 93
TAX COMPUTATION-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.00 15. � . 0 0
16. Amount of Line 14 taxable 58 948 . 93 �s. 2 652 . 70
at lineal rate X .045 � �
17. Amount of Line 14 taxable
at sibling rate X.12 � . �� 17. � . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 0 0
19. TAX DUE................................................................................................................ 19. 2 , 652 . 7�
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 150561�243 1505610243 �
REV-1500 EX Page 3 File Number 21-07-00577
Decedent's Complete Address:
DECEDENT'S NAME
Horvath, Bernita E.
STREET ADDRESS
633 Silver Spring Road
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 2,652.70
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +g) (2) 0.00
3. Interest �3�
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �4�
Check box on 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 DUE. (5) 2,652.70
Make Check Pa able 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:.................................. ❑ �x
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, 1982, did decedent transfer property within one year of death without ❑ ❑
receivingadequate consideration?.................................................................................................................... x
3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑ 0
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 January 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�ling 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 decedenYs 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+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horvath, Bernita E. 21-07-00577
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
Include a copy of the deed showing decedenYs interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate situate at 633 Silver Spring Road,Mechanicsburg, PA 94,500.00
TOTAL(Also enter on Line 1, Recapitulation) 94,500.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horvath, Bernita E. 21-07-00577
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Fidelity Mutual Distributing Trust-10/19/2009 25.26
2 Fidelity Mutual Distributing Trust-12/18/2012 8.59
3 Fidelity Mutual Distributing Trust-3/11/2008 436.71
4 PNC Bank-Checking Account#51-4003-0386 6,674.47
5 PPL Electric Utilities-Refund 49.08
6 Proceeds from American General Life and Accident payable to Estate of Bernita Horvath- 500.00
Check No.640077226
7 Proceeds from American General Life and Accident payable to Estate of Bernita Horvath - 500.00
Check No. 640077227
8 Proceeds from sale of tangible personal property 1,543.15
TOTAL(Also enter on Line 5, Recapitulation) 9,737.26
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horvath, Bernita E. 21-07-00577
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 9,264.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attornev's Fees PeCht&ASSOCiates, PC 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zi�
Relationshiq of Claimant to Decedent
4. Probate Fees 365.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 75.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 14,704.00
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
"lAl
scHECru�E H
FUNERAL EXPENSES AND ADMINlSTRATIVE COSTS
cantinued
ESTATE OF FILE NUMBER
Horvath, Bernita E. 21-Q7-Q�577
ITEM
NUMBER DESCRIPTION AMOUNT
Funerat Exoenses
1 Minister-Shippensburg, PA 200•00
2 Neil Funeral Home,Camp H111-Funeral Expenses 8.�6�•��
�3 Olde Towne Florists-Funeral Flowers 608.40
H-A 9,264.00
Other Admir�istrative Costs
4 Cumberland Law Journa!-Estate Legal Advertisement 75•00
H-B? 75.00
Copyright(c}2042 form software oniy The Lackner Group,fnc. Form PA-1500 Schedule H{Rev.6-98}
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horvath, Bernita E. 21-07-00577
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Bernita Nye-Reimbursement for 2006 Real Estate Taxes-633 Silver Spring Road 1,649.64
2 Bernita Nye-Reimbursement for 2010 Real Estate Taxes-633 Silver Spring Road 2,280.46
3 Bernita Nye -two requests to Debra Weist Tax Collector for copies-3/15/2012; 10/9/2012 20.00
4 Bernita Nye-Reimbursement for legal fees paid to Martson Law Offices 1.135.00
: 5 Bernita Nye-Reimbursement for miscellaneous expenses incurred 382.30
6 Black's Tree Service 600.00
7 Capital City Oil -Heating Oil 12/08/2003 and 1/20/2005 472.20
8 Cropf Brothers -Winterize 168.00
9 Cumberland County Bar Association-Referral Fee 25.00
10 Dirty Dog Hauling-Hauling refuse from 633 Silver Spring Road 940.00
11 Dugan Appraisal Services-Appraisal -633 Silver Spring Road 300.00
12 Duty's Locksmith 123.12
13 Hornungs-Chainsaw;Turbo Dryer; Pump 83.00
14 Liberly Mutual-Property Insurance-06/2004-06/2006 1,113.00
15 McClure -Heating Oil-108/2003 and 02/23/2004 493.89
16 Melanie Horvath - Reimbursement for PPL Service for 633 Silver Spring Road 9/2003-2/2013 3.208.00
17 Melanie Horvath -Reimbursement for 2004 Real Estate and School Taxes 1,502.75
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 10, Recapitulation) 30,584.33
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
Rev-1512 EX+{12-08)
S+CHEDULE i
pennsylvania DEBTS GF DECEQENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEQENT
continued
ESTATE C1F FIL-E NUMBER
Horvath, Bernita E. 21-Q7-OU577
iTEM VALUE AT DATE
NUMBER DESCRIPTION pF QEATH
18 Melanie Horvath -Reimbursement for 20Q3 Rea!Estate and School taxes 1,283,59
19 Melanie Hanrath -Reimbursement for 2Q05 Real Estate and Schaot Taxes 1.fi35.47
�{} Melanie Horvath-Reimbursemen#for 2011 Real Estate and SchoalTaxes 2,294.17
21 Melanie Horvath -Reimburse for trash cotlectian services to Penn Waste M�nagemen#- 1,280.00
09/03-12/2Q11
22 Melanie Norvath-Reimbursement for final payrnent for Comcast services 203.?8
23 New Beginnings Restaratian-Mold tnspection and Remidiation 1,273.t14
24 Prudential Financial-06/2333-06/2004 Properly Insurance ���•a�1
25 Roto-Rooter-Repair-Pipe leak 151.61
2fi Sears-�awnmawer and various parts and o#her toois 657.26
27 Shughart-Field mowing-�7/16/2889 '���•��
28 Sparik Roofing,Inc.-fi33 Silver Spring Raad 6,730.00
29 Verizon-telephone service-11/2003-7/2004 291.09
TOTAL fAlso enter an Line 10,Recapituiation) 30,584.33
Gopyright�c}2048 form software only The�ackner Group,Inc. Form PA-1500 Schedule 1{Rev. 12-08}