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HomeMy WebLinkAbout05-01-13 � �snsb�olas �EV-f���!0°`�'.,,���,^t"� enns t �FFICtAL US€QNLY PA Qepart.menY oF Aever�e p Y`�+aMa ��V� �� F��j� 6ureau af frict"svidual Ta�9 � �'�. _ . . . . . aosaxaeo6ox �����r7ANCE7A:3( RE7UI2N Harns6urc1Ph�71�4G0; RESCL}EN7 DECEDENT���- �..� ENTER LIEGEOENT ENF9RM19A71QN BELOW r�=�y.�r Saciai 5xurib�Numtrer �ate of baatfs itiF.lGxYYYYY Oaiz af Eirth �hUGOY"1t'r �' � Oi131l20t3 �� ' 23' �92� ' DecedeM's La;i�Jaers Sutftt IDacedanCs First 4ame� OAI Brussese Jr Nick Qif Applicable)Enter Survfvkng Spousa s inFormatian Below . . ... .. .. ... . . . . . . ... . .. .... . .. ...... .. Sp�use"s tast�Fame Sutfiz Spouse�rirst.t�lama Ail Spnuse's Sooiai�zcuriry alumber ?HIS kETl1RN AlUST 66 FkLED IN pUPi.ICATE WfTF!THE Ft�GtS"f�R t3� W1LLS FtL1 IH APPROPRIATE OVALS H£LOW �. __ C'p �.O+i3irvae Re�urn �i� 2.Supphemental ReG�m LJ 5 Rerna.+ni�r Retwn(�vte af C3eath� ..... Prwr 6a 32-13-82} � a_Limi�e�i Essale p ds.t�ut�e IMerast Gort�womase�de;e of � 3. Feaferal Estate Taac ReBUm Ftequired �' .... _..� deaihsi�ri3:-f2-�) €'fS 6.lA?�ae�at Died Testate p T.CpecMenl Y.taintained a Ltving Fiust 0 g. TWaI Num.b�+r of�e CwmsiC Bozes� �a;�,c�y w�u� � Ran�n eoPy w r��t1 "`J 4.Liaga�wn Aacw 7s Recerv�d q t6.SRai%2�Povcrty Credit(T?aea af t5eath � 11. Ele�tian tn Taa under Sec.�f 13(A) ... ,.._ Beh�an i'2-aiAf zroi f-9-l15} �__. ff+�ac�Scfwtlule O} CORRESPONO€NT- lH7S SECT30X:IAU5T�BE S9NAI.£7E0.AL!C4RRESPOMAIENCE A!�CON#WENTtAL tA%IMFORMATIQN.SHd1LD 9E OIRECTE6 7tl� Name GayLime Tel._.phane Wumtnet 1Caren A�1. 631aban (7t7}232=3708 �_' � R STER OF NleLL-'S�JSE � � � G7 Q � First Lirx3 ofAd�reas � -- �% { .--t � :n �:� r sr� m PO Soz 821 !�- � r`� F-' .�. � y, � . Sewrd line c1AdQress - - • �c C'� C> .L' i � .l '"'T > � —� ��� ��� y:: C) � City o�Past flf5ce Skose ZIP Code <:'� ��:.:,:DATEFEL�D'` '." r."1 , � N d }iarrisburg PA ��1710$ ;;� u� �1 CorraspondenYs e-mail address:KOr�B81r3IS8f1 BalabanLLC� IJrrclerp�alilesalPM�+"f.ICeNaeV�al11u1vees3ud�eAlhisleGYn.V%:kvli �aeCm irr; � src'gLnee:v_ntistv]lo@rebevtdml3nov�lerYgea�hr_1i�1, c�iY trve.eurec�mr.:�am(�eC oer9sraGnn�M pt�er oe�v.w tlf�t tl'u per� 1. e ix secE on ee ntnmatian d wn�m prepmv nen arry Yeiuw�ed�c. SIG74A7URE OF�PERSCIN flE5�PON31E4€F1JR 6RSt3G RE'TiFWJ Qa fE/J The pA�ePsrtment ot Reu�+we rlaea�t accapt elect �f 'ZS' 3 �ooRE��2� �ox GN , NRIzQI �vu�b , PAZ, 17�12• 31CdVATUREOFP�C€F'AREROfFiERTNNlREPRESEM7ATk`tE �w�,L-a-r� s�� /hr�.�-`�,.,,--� CtiiE 3'he PA Ifupartment af E2ev�nue dads N07 attept atec{ronie siqna{uras,Pfeas�stgn your retsim. �/,iS'/3 AODRES, Karen M. Balaban LLC P.O. Box 821 Harrisburg, PA 17108-0821 ? ,,,� �s�s��a��� ftEV-45G�J EX(FI} � ��A������ . t EiaaiEsta'e(ScheduieA}. ........................................... .. t. 1�4,{'11��1.� : �S ?.. st+rtcsa,a�arr�s;sir9du3as) ..................... ............. ... .. z. � 57,2Et.80� ��. ; 3. Ctos-aty Hetd Cor�rat4on,Parhmrship cir SaSe-:Proprisawsfiip(Sch�3z::te C} ..... 3. 4.�� O' e. P;for[gagsa arM NoEes Re�.a4vaCie(Sc#redule�)...................... ...... d. �.0�0� � 5. Cash.Bxdc Csprn�iis and hiiscet3�neaiss Persanel�Pro�ertY i^a�..hesEUte E}....... 5..- +#7,.'��J3.2f ��� � H. Jointly O^xmed Sjr¢perty(SchedWe F) �.7 Se�ar�ate Bil6ing Reqtxstsd ....... n". . . . . .. ..�.� �� .�.. 7. inser-b4uns Tean�s€�s 4 hAisce�ar�us Nan-F'rabata Property . . . . . . .. . . . � {Scfras3ufe Y.i} �Saparate BiBing Requas2ad........_. 7. Q:(}d , � s. To�,E cross nsset�(�oeAr�;ne� a ��yn�>...... .......... ... ... ..... s. ?72�8i 8.01 � 9. =unerai Expenses anQ AGmin�sVatit�w Co,FS#Seheehde N}................... �3. . . 1�.�#2_7{} ia. oettsorcacadeM.ASarEgage,Eiacailtes�rxfuens{stl,edulz�p. .. ..... .. .... to . ... _ . �.. ..1J,379.tU' � ai, totatDedUC3innsStat�9linzs9and9fl}.................... ........... ..... it. 27,922.84' 12. Net Value qf Hstate(larie 8 minus tirae 11}....... ..... ..... ..... i2. . 244�„fi96.21 � ��. ... . 13. C!?aritaWe aral Gavemmeartai 8equsst;75ec 9t13 Tivs s ar which . . . � an eeee3F�n b tax has aoC 6aen m,adz(Sehsdc+ta Jj . .._ -..__. €3.- 4-QD .s i4. Met Va4ue Subject to 7ar[qL"reie 12 mirrus L�e 19j . .._.... ................ :A. . ... .244,896�21 7A%�ALCULATkON-3EE lNSTRt}G310HS F6R APPt.tGABtE RA7E& 15. Rrtqunt af Line i 1+a�qt�ie a4 the spwrsal Paz rate,a . „r.�:nrf�reurro�er5ec.41i6 � � � (a}�12}X.q,..._ �. f5. Q.��-�.. ifi. Amount ef lirre #A fa*sbie - . . . . . � � . at 5ne�raea x.a�t5 2�,69$.21 � ps. 1 t,f)1 t.33�� 7L ,�.maurrt of Line lA 1a�aDle . . . . . .. . . . ... . . .. . ..... e�.s�tasngra`e x.az �T. O:QO � 78�. Amaun{a(t�eu? 14 Saxe7�le . . ... . . . . _ . . .. . . .. .. ... . . . .. a�ca9atera�rate x.+s ;b. 6:00 �9. f�.xoue..... —_.,.....__..,.. — ....__ _--- ..._.._ s�. 11,011.33 € 20_ �3LL IN TME�.LtHAL iF YOLI ARE RECyL1E571NG q REFUM�qF AN�VE)YS+AYMENT r� Nb%i Paq� � Side 2 7 REY-!5a9�JI:t�Cli +�?°3 fitlo-Numbw [Jtr�ed�ret's G[�mp@aeta Arldrass: �cEe€.vr�s x,ur� ^` "� hdack Bruss�e.lr .5'f,��'TA �1�55. . . . . . . . . . sra�t$gd��� c,n s�as* � Camp F�all RA 1�011 Tax Payrn��rks ans! Grodits: _. E3uCtte e�e�.l�e°1?J t,t! �".1.5�'11.33 2 CYCx�kl�N}'�1LW .. . ..... . . . _ . . . ;..t�a�jrr�is p-� a.O�m�ra d:60 � Trs�Caeclla{A3:6 E ;2! 0_04 ]. IffYPik5t . . .. . . .. dat �-� a. �r u�r a#s�grca�r man Lisa� .u�a;3,mter�Eacwencri. tns a.0�auERw.avar€Hr F�Fn av�et�Pa�t P�Lirtir i�10 tcqtrt3t a 3efut�9 {b� 0_�fl u. ir��r� .�3v��rv�s��wntm2.�r�csnw�.ar;semeTnxsruE esp t1.�D11_33 Make ch�ck pay�b�e ko: F.�GIS7E�2 t}F 1NI�LS,,�GEtdT. PLEASE AN�WER THE Ft3LLt3Wl?#G QUf5TlL}tiS BY Pl.AC1A�G AN"SC" EM TPI�A3�PRbFR€A'P� Bl:t}�KS �. �a a,_�nt�nsr�z a�an�r sr� xes r�c, ; 3 r9L9at Ehe u4e ot tnerilne of ihe�c�([Y Itsnst�trEti . ....... ._. _............_ _ . � � � a aeisin�r dg�t ta a��e�ro snan�ttre pru�,��tl�a�s�rra�t«�ts aucrre........_,. � � c, rv+!�s rrreosaimry WererL__. ......._. .._....�_. . _ . _ .. .... .._. . ..__..._....� � �. rca�h�a�Krcrahe?a�at�p�yttxnls,6EO�m�care?............_.._.........._��.......... .. . [� � 2 �tkeiri ntnm'M e�E OeG 12,1�!?,cltl�cCe�lett!Irert3l��P��p-°G�y''p�in w19..y8ar otd�lr.. I�, viilxwl ttio�'riiiig st�Rquakr Can5i�tafkks?........�._.........----.__...---.....____..........._.._.__.................__....!I..J; � v ti 3. EFe aa�nt r�in�m•n!ri�[rar tx�rt�er+-Qeam banA�w�tl�r�xartiy�ffi rba a t�r�de�r�----._.._ (�! ■ = d. Cid�ti�±nt wtin�le'rn�3�i3u�selY�EmPrY 3�;[ssnl an�Ay m affer r�^++�;a++ntyr��t?�P"�'M.wA(cli �—t � rrrtgns s�S6ay desiyne5at7 .._ . ...__._.............__..............._._........_ ` . _........ . .. ..__°u! � tF TME ANSIHER�D ANY OF�,RBbYE'l�41ESYlONS P5 YES,Y(tiU t�UST COMP�.ETE 9Ct�@ULE G ANtI FtLE t7 AS f�i OF THE fR£StldtM. for dates ai dsath s�ar�r Js�1. t4�t„�r�1 befw�Jan. �.#9r�5,I���ut r�ta impose�5 on ths nzt�✓�af iracsC�!�ou Er;€tl^a use of tr�e sun�ai€rB�P�� is 3 pas�nt�7E P.5.F9li�r�a)[LF)�i]. �or dao� oC,�h m a aker 1an. t. 1995, �he itx r� imprasEd rn thaa rst ua)ue t�t��rs 5� cc�r fl�rs usa af#�e rsvr�ing �¢rae is 0 parcerat [7c P.S.�J1 t�a[a)(t.aj firi�j ll»stai�s�es rmt exsrr4x 3 trar�r�r m a swvivig spouse tcm tar.�d iF.e�hctcey n�7uire€nar�s tr�r aacl�,�re of asseis arrJ filrg a�z rarum ere e41 a�fi�ea�rt�ifie stimarxe��e fa'#�e er�y banHSaar�: For daSa_5+�f�atfi n�[s��er��Fjt l,J)�4 . The t�rs� m{�ed cr,�xz nel ual�a�(?r�s3��s from a dece��chBi 2 t yaars�:(�ar y+�ura�r at�ath ka�r fcr the ese rf a c�mr�gar?n,en ait3ptrwe par�t cr a srpG��i�#�e chh�is 4 c"+�ce�t[T2 P:S.;91 t fi(aX t�)). . Th�tax.ra.?irt�.ecis�'Pie�r�tv�a13^mrrf�srocrkxt�err-.adi7adeo�3eaE's6�aaltaxef�ci�i�s�s4.5pero-�t,ex��r,akxi"ur[T2�S.g�t3+i�a}�fYj. . The�r�a im�cssd an the r�A v�k�e af tr�rtst=_rs tn ar`at tha i�e aP�the c���vt's�.�irgs is 12 p�mac2[72 P.3.§9 tti�f,aj47�.3��.k^�ifrli�x�is�2firtr_-d.. �n�=_r.Sectina 9a�CQ,a�a�.intlnid.�l�wsn R�s at ka-�[one pa+�nt uc Farnmon�a�Eh tf�e decedcrt.xd�2th���ar adc�un. COMMONWEALTH OF PENNSYLVANIA SCHEDULE A INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER 2012 � OO��f Nick Brussese Jr. All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defned as the price at which property would be exchanged belween a willing buyer and a willing seller, neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. 810 Meadow Lane, Hampden Township, Cumberland County $174,000.00 Deed description and appraisal attached. TOTAL $174.000.00 iYN.s�Exi i9,ix! ( N;,If�°� ' p�nn5ytv�n3a '�rCHypE��►t/1��Ey�yyy 1� f�.v�YAlii'9hCa�tl.tS1� ���,A� �. �'Y��� � :hi1+�'ft[TA'�tLE iAX RE"fi,tRH {'{�;'S�f�tNF uEi:ELtiCNS � E57ATE.�OP. . . . . . .. . . . . ._. .... . . . .. FILE HUM9ER .�.. . .. � . ��. ��� Nick E3russ�r�?a.ir Zat2— 00� 11 ! ..w.� ..,._ �._.._..__,........_._... ..�,..�.......,�m �.....��..... ..........._., __� __.._�_ M.____..._n.,�..�...._ pl I P��+P�+2Y 1oMetNy awned wiUr rlghd of w'rvlvorshfp nwttst be AVSC1[MSed ofl 5chedute F. � il'JA 'drlLitF AY bAF`c�. ; ?dUMPER �S[RF'[F6N OF�E�"�i :' _.._—�--"�"— US�ave�s 9�sai 5i0.000{XiGQ87i4EE�•Issuet�31f711987 17.�1'2.� � US$a4'i2+$s9�S10.�[X21T3t�#9EE�-i�,suecftt2?Ji�32 13,�}SS6.{K3 ; 3 US 3a�•h�s Bc�'510.OQU(X2173041 EE)�tasuaE�#Y17I1892 13,95S.i?�D � t3�Savk��s E��s St.C+Q��64Etb48548�EEj-is�Z 0$f200s 627.�a0 5 US Samv:;s Ear�fs 5t,00Q (►+IB04�S"nEE},issa�ed fYd!20Ud 62?.6i] ' j b 11SSatkr��u^t3sSf.IX}D�h18tl4HS�S86EE)•lssste+�D7124�5 628.G�Q i � US Saa���s f3�"r:,S t,�(M�t35282QEE��is�r�3 06IiA04 628.tQ ; t s g US Sat�k�,s��St.�7P��td�36T57EE�.is�ed�3t2El9» 634:80 ' g US Sav�s E?�31,Q60(1�T7771774EE)•ls�b"t2064 fi35.60 ' d fi0 US Savin+;s��51:�iM77771773EE}-issna�[�1t2�fld &35.80 � �� U5 Savk�s 8an.",3 S1.ODd(M'7765g358EEy•fssuc�i 11120Q3 638.8U � � 32 �5 Savk;s�,�FS Si.C�(Aft?»67608EE)•ts�'I Of�03 643.24 13 U8 Sav�gs 8�rtds Si,�GIa77R87fiU9EE).issrrexi 1CUN�3 693.2� ' 3 3 � � � � � s 3 � � � � � . . . . . . . . . . 7CYTAk.(.0.1?ts c*it�r an �.ine 2, �clapit�latran} I.� 51.2Fr3.$fl ? _ REV-15Q$EX+(g.gg} COMMONWEAI.TH OF PENN5YLVANIA SCHEDULE E INHERITANCETAXRETURN CASH, BANK DEPOSITS, c� MISC. aESro�r�-r aECeoErrr PERSONAL PR4PERTY ESTATE OF FILE NUMBER Nick Brussese Jr. 2���_ ��,� � � � 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 an Schedule F. 4TEM DESCRIPTION VALUE AT DATE NUMBER OF pEATH 1. M&T Bank Premium Checking Acca�rnt#98498673&8 14,091.73 3805 Trindle Rd Camp Hill, PA 17011 2. Choice Plus Checking Account#18380018 5,921.48 3. 2008 Ford Mustang 11,240 miles, goad condition 13,400.00 4. 1956 Ford Thunderbird 8.929 miles, fair condition 15,OOO.pO 5. Tools end lawn #ractor 20+ years, fair condition 100.00 8. Househald furnishing, clothing, furniture, perspnai effect, and appliances 540.00 30 ta 50 year oid items FdTAL �4T.353.2'i COMMONWEALTH OF PENNSYLVANIA SCHEDULE H INHERITANCE TAX RETURN FUNERAL EXPENSES & RESIDENTDECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Nick Brussese Jr. 20�2 " ��C� � � ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES Malpezzi Funeral Home 11,046.87 8 Market Plaza Way, Mechanicsburg, PA 17055 B. ADMINISTRATIVE EXPENSES 1. Personal Representative Commissions 2. Attorney Fees: Karen M. Balaban LLC PO Box 821 Harrisburg, PA 17108-0821 1,000.00 3. Probate Fees 373.50 4. Nick M. Brussese Post-Funeral meal 122.33 TOTAL $ 12.542.70 REV-1512 EX+(�2-03) COMMONWEALTH OF PENNSYLVANiA SCNEDULE 1 INHERITANCE TAX RETURN DEBTS OF CIECEDENT, RESIDEN7DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE Of FILE NUMBER Nick Brussese Jr. ZO{Z'QQ9 � � Report debts incurred hy the decedent prior to tleath which remained unpaid as of the date of death,including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. AI{State lnsurance Aug. home and auto manth4y ins premium 214.18 2. Andrews & Patei Associates, P.C. Medical treatment 45.6p 3. Birch Telecom telephone 41.43 4. Michael Lengan real estate taxes 1,907.24 5_ Sunoco gasoVine credit card 1325 B. AliState Insurance Sep. home and auto mon#hiy ins premium 27G.1g 7. Publishers Clearing House unpaid invoice 55.90 8. Holy Spirit Hospital hospital bill 12.75 9. PPL Sept.e4ectric 76.17 14. M&T Banlc pay off laan 721.A4 11. AiiStake insurance dct. home and auto monthiy ins premium 214.i$ 12. PPL Oct. electric 25.09 13. Hampden Township quarterly sewer &trash 155.p5 14. West Share EM8 ambuiance service �,064.9D 15. AIIState insurance Nov. home and auta manthly ins premium 214.18 16. PPL Nov. eiectric �7,gg 17. Birch 7elecom Dec. telephone 13.95 18. A14State Insurance Dec. home and euto monthly Ins premium 214.18 19. PP� Dec. e4eciric 23,gg 20. AIIState Jan. home a�d auto monthly ins premium 214.1$ Su6-total this page only $ 5,458.98 REV-t5t2 EX+(�2-03} COMMONWEAI.TH OF PENNSYLVANIA SCHEDUL.E I INHERlTANCE TAX RETURN DEBTS (7F DECEDENT� RESI6ENT DECEDENT MQRTGAGE ZIABILITIES, t� �IENS ESTATE OF FILE NUMBER Nick Srussese Jr. 2ot2- c�o� t1 Report debts inCUrred by the decedent pnor to death which remained unpaid as of the dete of death.including unreimbursed medical expenses. ITEM NUMBER DESCFtIPTION AMQUNT 21. PPL Jan. electric 26.34 22. Hampden Tp. Sewer and trash 114.25 23. A8G Fusi Oii Heating oii 985.04 24. AIIState Feb. home and auto monthfy ins premium 214.18 2S. PPL Feb. eiectric 28.44 26. AIIState Mar. home and auto monthly ins premium 131.22 27. PPl Mar. electric 2$.87 28. Mark Heckman Real estate appraisal 3$5.00 29. ABC Fuel OfI Neating oi! 786.40 30. M8T Bank check no. 9408 post-death cleared check 2p0.00 31. Sociai Security reverse direct deppsit 1,2$4.00 32. AIIState insurance{auto) 13122 33. AIIState insurance (home) 72.97 34. PPL electric 24.54 35. Hampden Tp. Sewer & trash 114.25 36, Cumberland County reel estate tax 647.72 Reserves until real estate is sold et auctian (3 months) 37. PPL eleciric 95.00 38. AiCState insuranca 398.00 39. Yard maintenance 300.00 40. Estimated real estate auction fee (3% x $174,000) 5,220.00 41. Goodwill do�atian of clath3ng&personai efFects 950.Q0 Sub-total this page oniy $ 4,182.74 Sub-totalpac�e 1 $ t1,216.40 TOTAL $15.379,10 . . _ .. _ . ... _ .- . _ . . .. . _. . _ . _. . _. . . _. . . COMMONWEALTH OF PENNSYI.YANIA INHERITANCE TAX RETURN SCHEDULE .J �ESroENr aecEaer�s BENEFICIARIES ESTATE t}F � F1LE NUMBEF2 � Nick Brussese Jru�� � ��ix, �� �! � � � NUM6ER NAME AND ADDRESS OF PERSON(Sj RECEIVING PROPERTY ftELATIONSHIP TO DECEDENT AMOUN7 t7R SHARE OF ESTATE 7AXABLE DiSTRI8UTIONS: l. Nick M. Srussese, 421 Fax Lane, Harrisburg, PA 17112 son one third 2. Staven A. Brussase, 852 Moares Mauntain Rd, I,ewisberry, PA ]�339 son one#hird 3. I�eth A. Palmer, 204 S. 16"' St., Camp T�iill, PA 17011 da�ughter one third