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Home My WebLink About05-29-13 (2) _ . _ _ ��r - � � � 15�5610105 REV-1500 EX(oz-u)(FI) PA Department of Reve�ue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes °`"p,"`" `"`�`"°` County Code Year File Number Po BOx zso6oi INHERITANCE TAX RETURN Harrisbur9,PA 1�128-o6oi RESIDENT DECEDENT ' 02 ' , (� �-1� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY : 03/05/2013 ' 09/11/1925 DecedenYs Last Name Suffix DecedenYs First Name MI Pankiewicz ' Rosemary p (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 OVAL5 BELOW � 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death Priorto 12-13-82) O 4.Limited Estate p 4a. Future Interest Compromise(date of p 5. Federai Estate Tax Return Required death after 12-12-82) �1 6. Decedent Died Testate O 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 SHOULD BE DIRECTED T0: Name Daytime Telephone Number � David B. Proko � : P (631) 82�.1�4 =-� . � �y _ �.r, - `, ��? �-� REG fE�t�F�lIy1LLS�ON�.�l; - �:w � t�,� � ' :. 'Pk L.`� First Line of Address '': � 131 Route 25A `-=` . � �� " � _, � . _ , __, . . , _� .. -� Second Line of Address , - ;`" - '�.� . , �.. y�:..� ,.._. , , - ..• ° . t�.� u; �7 City or Post Office State ZIP Code � DATE FIL� '�7 Rocky Point ' NY '11778 CorrespondenYs e-mail address: Under penalties of perjury,i declare that I have exami this ur including accompanying schedules and statements,and to the best oi my knowledge and belief, it is true,correct and complete.Declaration of prepa r her t n e personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FO FI IN RE DATE 5 'Zv ADDRESS ' 131 Route 25A, Rocky Point, NY 11778 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 J �i;, __ _ . _ __ _ .�� , . � 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number oecedenYs Name: ', RECAPITULATION 1. Real Estate(Schedule A). .. . .. . . . . . ... ......... ... ..... ... ...... ..... 1. 146,400.00 2. Stocks and Bonds(Schedule B) . .. . ....... ...... ...... ..... ...... ..... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . ... 3. 4. Mortgages and Notes Receivable(Schedule D)... ..... . ...... .. . .... . ... . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)..... .. 5. 500.00 ' 6. Jointly Owned PropeRy(Schedule F) O Separate Billing Requested .. .. ... 6. ' 12,827.47 ' 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested....... . 7. 8. Total Gross Assets(total Lines 1 through 7)... ..... ......... ........... . 8. ', 159,727.47 9. Funeral Expenses and Administrative Costs(Schedule H).. ... .. ........ . ... 9. ', 25,567.55 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)...... .. . .... . . 10. 24,062.56 11. Total Deductions(total Lines 9 and 10)..... . ...... ..... ...... .. . ..... .. 11. 49,630.11 12. Net Value of Estate(Line 8 minus Line 11) ..... . . .......... ... . .... . . ... 12. 110,097.36 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. 110,097.36 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxabie 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_ 16. 17. Amount of Line 14 taxable _ at sibling rate X.12 ' 17. ' 18. Amount of Line 14 taxable .. at collateral rate X.15 �g, ' 110,097.36 ' 19. TAX DUE .. ..... ... ...... ......... ... ........ ... ...... .... . ... .... 19.; 16,514.61 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 � 1505610205 1505610205 J __ _ _ _ _ . , , .�w REV-1500 EX(FI) Page 3 Pile Number Decedent's Complete Address: DECEDENT'S NAME Rosemary P. Pankiewicz - ---_— _. _. _ _ - STREETADDRESS __-- __ _.. ._ __-- — — 43 Ridgeway Drive _ __ _ __ _ _- __ . _ _ _ ____ --- — -- -- -- — ----- -- — — ------------- - CITY STATE ! ZIP Mechanicsburg ', PA 17050 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 16,514.61 2. CreditslPayments A.Prior Payments B.Discount 825.73 Total Credits(A+g) (2� 825.73 3. Interest (3) 4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. Ffll 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) 15,688.88 Make check payable to: REGISTER OF WILLS, AGENT. p '4�'h� p°� �x � . '� .0�`� ��"�z�c�"�t�� a1�a� � ��t '�z" �'.� . ,> �:d� �a�1.V�d�'t��v�'�� v", �'"3n.�,,;�.s9PJ�::��F� e�y s z?�d�u �. �i�w�a�� . � E��:-- r..�. �: �ti� .�. :-�# � , �t wafi�n��°�?�..,,Fr� :�._,w ��G , .�, ,. . �s � 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 inwme of the property transferred.......................................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ � c. retain a reversionary interest .............................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ � 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ � 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 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. t, �� ,�, � � � � �� Fa��a'��.�.�.�:�:�*��ki��6""h.�o.'.r�:�'., . �.:a ,q'�.�.: "�`-�.�r,."' "� .:?�.r�a�,. ��`��s2,a..< ,�i �.��u��'. _.3.,��:;� ��.. ._ �'�A� $1� ,,. .. �a�..��'!.�. . �' �. 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 suNiving 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 oniy 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 decedenYs 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 adop6on. __ _ _ - - - _ _ _ _ _ _ _ _ _ _ _ _ _ r��r REV-i5o8 EX+(o8-i2) j i� pennsylvania SCI�IEDULE E �� DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX REfURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Rosemary P. Pankiewicz 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. Fumishings and household goods 500.00 ' TOTAL(Also enter on Line 5, Recapitulation) $ 500.00 If more space is needed, use additional sheets of paper of the same size. _ . _ _ _ .�*� REV-isog EX+(oi-io) �� pennsylvania SCNEDULE F : DEPARTMENT UF REVENUE INHERITANCE TAX RETURN )OINTLY-OWNED PROPERTY RESIDENT DECEDEfJT ESTATE OF: FILE NUMBER: Rosemary P. Pankiewicz If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING]OINT TENANT(S)NAME(5) ADDRESS RELATIONSHIP TO DECEDENT A• David B Prokop 131 Route 25A Nephew Rocky Point, NY 11778 B. C. 70INTLY OWNED PROPERTY: �rrea DA� DESCRIPT[ON OF PROPERTY %oF onh OF DEarfi ITEM FOR]OINT MADE INCLUDE NAME OF FINANCtAI.INSTITUT[ON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR]OINTLY HELD REALESTAlE. VAIUE OF ASSET INTEREST DECEDENT"S INTEREST 1. A, 02117109 PNC Money MarketAccountAcct.#50-0516-9422 22,283.54 50% 11,141.77 03101/08 PNC Checking Account Acct.#51-4004-8324 3,371.41 50% 1,685.70 TOTAL(Also enter on Line 6, Recapitulation) $ 12,827.47 If more space is needed, use additional sheets of paper of the same size. _ . _ _ _ _ .�+.- REV-1511 EX+{10-09) � ` pennsylvania SCHEDULE H . DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosemary P. Pankiewicz Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTI�N AMOUNT A. FUNERAL EXPENSES: 1' Malpezzi Funeral Home g,27g,g2 2. Flowers 379.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 4,392.00 Name(s)of Personal Representative(s) David B. Prokop ________ street Address 131 Route 25A City _Rocky Point __ _ _ _ _ State NY ZIP 11778 _ __ __ __ __ Year(s)Commission Paid: 2013 Z• Attorney Fees: 3• Family Exemption: (If decedent's address is not the same as claimanYs,attach expianation.) Claimant _ _ _ Street Address _ _ ..__ _ _ . _ City __ ___ _ __ __ _ State ZIP Relationship of Claimant to Decedent _ _ _ _- __ 4• Probate Fees: 5. Accountant Fees: 358.50 6. Tax Retum Preparer Fees: �• Publication of Probate 200.82 s. Settlement Costs-43 Ridgeway Drive,Mechanicsburg,PA 17050 10,960.31 a.Realtor Commissions- $8,874.00 b.Deed Preparation- 105.00 c.Transfer Tax- 1,464.00 d.Sewer Bill to Silver Spring 110.62 TOTAL(Also enter on Line 9, Recapitulation) $ 25,567.55 If more space is needed,use additional sheets of paper of the same size. _ . _ u�r*� REV-1511 EX+(iD-09) � pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FU N ERAL EXPE N SES AN D INHERCfANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosemary P. Pankiewicz DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, 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 Retum Preparer Fees: �• Settlement Costs-43 Ridgeway Drive,Mechanicsburg,PA 17050 (cont.from page 1) e.2013 Counry Taxes- 496.69 TOTAL(Also enter on Line 9, Recapitulation) $ If more space is needed,use additional sheets of paper of the same size. _ _ _ _ _ _ ��,_. __ _ _ .�� REV-1512 EX+(12-12) �pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERTfANCE TAX REfURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER RosemarY P. Pankiewicz 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• Malpezzi Funeral Home 9,276.92 2. Thornwald Home 13,273.60 3. Dr.George Branscum 49.95 4. Holy Spirit Hospital 1,054.82 5. UGI 79.70 6. PPL 28.18 7. United Water 13.49 8. Boshinski Eye Ciinic 36.90 9. John Dennehy,CPA 75.00 10. Sewer-Silver Spring Township 110.62 11. Millenium Pharmaceutical 63.38 TOTAL(Also enter on Line 10, Recapitulation) $ 24,062.56 If more space is needed,insert additional sheets of the same size. - _ _ _ _ _ _ _ _ _ . nll� . ' �� }�,'/" � ��'.�� '�'�l�� . I, ROSEMARY P. PANKIF�WI�„�,�acer Spring T��shi.p��unberland County, .,�.�.,, �.F�„�.�.� .,,,... ,�,, .� ,. Pennsylvania, declare this to be my last will and revoke any will previously made by me. ' ' ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker 0 �` and all expenses of my last illness, and any and all taxes and assessments imposed by any ' � 3 governmental body as a result of my death,whether on property passing under this will or a otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. _ ITEM II. I give and bequeath the sum of FIVE THOUSAND DOLLARS ($5,000.00)to . � JANET PANKIEWICZ FISHER of Milford,Connecticut provided she survives my death by ', � thirty(30) days. Should the said Janet Pankiewicz Fisher predecease me or be deceased on the thirty-first day after my death,this specific bequest shall go in equal shares to those of her issues, , per stirpes, as survive my death by thirty (30)days. ' � ITEM III. I give, devise, and bequeath aJl the rest,re�id�e,and remai.nder. of m3� possessions and estate of every liature and wherever situate in equal shares to the following: ' A. To my niece, KATHLEEN P. DUFFY,provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty- ', first day after my death, her share shall go in equal shazes to my nephews ' JOSEPH W. PROKOP, DAVID B. PROKOP and MICHAEL C. PROKOP. 1 __ _ ,,� , - - _ _ _ _ _ . . __ __ ,�.� _ _ . _ _ , _ ,.. _ �� ' Should any one of my nephews predecease me or not survive my death by thirty (30) days,then their share shall go to their issue,per stirpes. , , B. To my nephew,JOSEPH W. PROKOP,provided he survives my death by thirty(30)days. Should he predecease me or be deceased on the thirty-first ` day after my death, his share shall go to his issue,per stirpes. \ C. To my nephew, DAVID B.PROKOP,provided he survives my death ' by� thirty �30 j days. Shoul:i he predecease me or be deceased on the thirty-first � day after my death, his shaze shall go to his issue,per stirpes. . � `� D. To my nephew, MICHAEL C. PROKOP,provided he survives my death by thirty (30) days. Should he predecease me or be deceased on the thirty- � first day after my death, his share sha11 go to his issue,per stirpes. _� ITEM IV. All of the interests of the beneficiaries hereunder sha11 not be subject to anticipation or to voluntary or involuntary alienarion nor shall they be subject to any execution or attachment. � ITEM V. I appoint my nephew DAVID B. PROKOP executor of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives b5� Pennsylvania law and by the otlier terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of a11 property: to compromise any claim or controversy; to make distribution in cash or in kind,or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them;to invest in aIl forms of property, including any stock or other securities in any corporate fiduciary 2 __ _ _ . ni w _ . . . . � ...., yMy ^x•'�nR... . .. � �.. . .� . ....... ..... ........ . . :.. ... . . . . . ...: ...,..... :: . � �� or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my � personal representatives deem proper, without regazd to any principle of risk or diversification; to retain any or all assets of my estate,real or personal, without regazd to any principle of risk or diversification; to sell at public or private sale,to exchange,or to lease for any period of time, any real or personal property and to give options for sales,exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personai representatives ''' '�" deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF,I have hereunto set my hand this .t•t� day of �� , 2007. � ROS ARY P. PANKIEWICZ 3 - _ _ - _. - - �,. _ _ __ _ _ _ e��r �n ,,. . , . : 4�. The preceding instrument, consisting of this and THREE other typewritten pages, each identified by the signature of the testatrix was on the da.te thereof signed,pubiished, and declazed ' by ROSEMARY P. PANKIEWICZ,the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence,and in the presence of each other, have subscribed our names as witnesses hereta �.. . �' . _ _ __ - - _ ;�J _ w11�f � �'�;w � . . . . . �. , �� 1�."�a;. COMM�WEA�..� .. ,.u.� - . ., : .. COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrurpent,having been duly qualafied according to law,does hereby acknowledge that I signed and executed the foregoing instrument as my last will,that I signed it willingly;and that I signed it as my free and voluntary act for the purposes therein expressed. � � R EMARY P.PANKIEWICZ : "Swoi'rr qr affirmed to and acknowledged ' .:-��.�f��ts�� 2a y the� tr x n t�e.d a.bave . :�^� thi��:' �a of� �'f ,Z407. � �`�� ` �' N VAAt+ittA '. /.>,�Y ,� ,�I� IVO�({S�.S891 - - �- ,,,. Wencfy K straub,Natary PubUc .,� f�J_r,;..r L.�vuor Rf�ett Twp.,Cta�lfsedartd Cotmty � ..,.w...r^, . My C.ornrr�on E�l r�s,M ay 10,2Q11 '�,,,,, , COMMONWEALTH OF��IVNS��i�,�°�� ) (SS: COUNTY OF CUMBERLAND ) WE, �,�,�..�,� �,C�ow�-r and ��Uk��l'S t 1��►�s1�� ,the wimesses whose names are signed to the attached'or foregoing instrument,being duly qualified according to law,do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the , purposes therein expressed;that each of us in the hearing and sight of the testatrix signed the will as witnesses;and that to the best of our knowledge,the testatrix was at that time 18 or more years of age,of ' sound mind,and under no constraint or undue influence. ' Sworn affirmed to an acknowledged ; b��o� � s 5� day of �� , 2007. . . '.1^ �.'.!.`-w--�: �� . / • ^\` !i : ^ A ��`P �TH F RENNSYLV�INIA �', �,--r ' t Seel ; _..YMdndy K Straub;No�y Public ..i,,oweraler,'�',np.,c�,ber�and(:o�xdy My Corrrrtission E�Eres May 10,20i 1 PennsylvaNa AssoGatlon of Notarles 5 __ _ - �� - _ _ _ _ _ _ __ _ __ __ _ _ . ��.�,_