HomeMy WebLinkAbout07-16-13 (2) � 1505611185
REV-1500 EX(02-11)(FI) pFflL1ALU5EONLY
PAOepartmentofRevenue �ountyCoda Vear filaNumber
8ureauollneNWUeITe<es INHERITANCETAXRETURN 21 13 �050
PO BO%280601
Hattisburp,PA 7712B-OSat RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYVW Date of Birth MMDOrrrr
09262012 08011985
Decedenfs Last Name Suffiz DecedenYs First Name M I
SARCONE JOHN J
(If Applicable) Enter Surviving Spouse's Infortnation Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Securiry Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
� 1. Original Retum � 2. Supplemental Refum � 3. Remainder Retum(Date of Death
Pnor to 12-13-82)
❑ 4. Limited Estate ❑ 4a. Future Inte2st Compromise(date M ❑ 5. Federal Estate Taz Retum Required
death after 12-12-82)
� 6. Decedent Dietl Testate � 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wilp (Attach Copy of Trust.)
❑ 9. Litigation Praceeds Received ❑ 10.Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A)
Between 1231-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SEC710N MUSTBE COMPLETED.ALL CORRESPONDENCE AND CONFIOENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daylime Telephone Number
DONNA M • MULLIN, CPA 717-761-7210
� REGISTER OF 1MLLS USE ONLY
�� �
n w � m
Firsl Line W Address � � C � Q
BOYER 8 RITTER CPAS m = � • � p
Second Line of Address 7� n r ~ �n m
r Z TT1 �j � O
211 HOUSE AVENUE z v_' � o 0
o cva tF -n -n
City or Post Office � State 7JP Code n � � � �
CAMP HILL PA 17�11 •°.� � � R'
'9 N � O
D �,,� ?1
correspondenese-mat�aedress: DMULLINaCPABR . COM
UnEer penelties of pefury, I declere that I heve exeminetl tNS retum,intlu0ing eccompanyin8��ules anE stetements,enE tothe best of my knaMMge and Celiel,
it is trve,carrect enE complere.Declaretlon of preperer ot�er than Ne pereon p�eswteth.e is baseO on ell informatlon of which preperer hes eny knvMedge.
SIGNAlURE OF PFRSON RESPONSIBLE FOR FILING RERIRN I DATE
DAVID M SARCONE � �✓ a��6 ��i
ADDRESS
55 SOUTH PIN OAK DRIVE BOILING SPRINGS, PA 170�7
SIGNATUREOFPRFPARFR07HFR'fHANREPRESE�111VE —�^_ �%� r//n' �� �///�
DONNA M MULLIN CPA ��, �-�'/�
ADORESS
BOYER & RITTER CPAS, 211 HOUSE AVE • CAMP HILL, PA 17�11
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505611185 1505611185 �
OMaBa]3.000 J/� ^
�/Y II 1
' W\il
_% l�
J 15�5611285
REV-1500 EX(FI) -
DecedenYs Social Securiry Number
o edenrsNam SARCONE JOHN J
RECAPtTUtATtON
t. RealEstate(Schedu�en) . . . . . . . . . . . . . . . . . . . . . . . . . . . . � 0 .00
Z. Stocks and Bonds(Schedute B). . . . . . . . . . . . . . . . . . . . . . . . . y. �. OQ
3. Closely Held Corporation,Partnership or Sol�Proprietwship(Schedule C), , , , , 3, ❑. ��
� 4. Mortgages and Notes Receivable(Schedufe D) , , , , , , , , , , , , , , , , , 4. ❑• ��
5. Cash, Bank Deposits antl Miscellaneous Personal Property(SChedule E) , , , , , 5. 8�Q 9], • 0�
6. Jointly Owned Property(Schedule� � Separate Biliing Requested , , , , g. ❑.��Q
7. Inter-Vivos Transfere 8 Miscellaneous Non-Probate Property �
(Schedule G) � Separate 8illing Requested . . . . 7. ❑- p Q
8. Total Gross Asets(tofal Lines 7 throuqh 7) . . . . . . . . . . . . . . . . . . 8. B�Q 91. 00
g. Funeral E�enses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. 4 ,54�• 0�
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , , , , �0. 1 S 4 • 0�
11. ToWI Deductions(total Lines 9 and YO), , , , , , , , , , , , , , , , , , , , , ��. 4,6 9 4 • 0 0
12. Net Value of Estate(Line 8 minus Line 1 t) , , , , , , , , , , , , , , , , , , , �2, 3�3 97• 0�
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an e�ection to tax has not been made(SchedWe d), , , , , , , , , , , , , , , , 13. 0. 0 0
14. Net Value Subject to Tarz(Line 12 minus Line 13) , , 14. 3,a 9� . o a
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES -
15.. Amount of Line 14 ta�oble
at the spousal taxrate,or -
� transfers un�er Sec.9116
(a)(tz)x.o_ p-p0 ts. 0.00
tfi. Amount of Line 14 �mble
atlinea�ratex.o4� 3�398.0� is. 153. 00
17. Amount of L.ine 14 ta�ble
atsiblingrateX.12 � ,�� �� 0. �0
18. Amount of Line 14 tarable
atcollaterelrateX.15 � •�� 18. o. oa
is. raxoue . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . �s. 153-00
20. FILL IN THE BOX IF YOU ARE REQUES7iNG A REFUND OF AN OVERPAYM19ENT � ❑
Side 2
� 1505611285 1505611285 �
OM4648 3.000 .
REV-1500 E%(Fp Page 3 File Number
Decedent's Complete Address: 21 13 0050
OECEDEM'S NAME
SA CONE JOHN J
STREEf ADDRESS
CUMB AND
cro srare ziP
BOILING SPRINGS PA 17007-
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) t�) 15 3•�0
2. Credits/Payments �
A.Prior Payments � •��
B. Discount � -��
Total Credits(A+g) (2) � •��
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
5. If Line 1 + �ine 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 15 3 •0 0
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X"IN THE APPROPRIATE BLOCKS
1. Ditl decedent make a transfer and: Yes No
a. retain the use or income of the property transferretl . . . . . . . . . . . . . . . . . . . . . . . . � �
b. retain the right to designate who shall use ihe property transferted or its income . . . . . . . . . . ❑ �
c. retain a revereionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : � �
d. receive the promise for IHe of either payments,benefRS or care? . . . . . . . . . . . . . . . . .
2. If tleath occurred after Dec. 12, 1982,did decedent trensfer property within one year N 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? . ❑ ❑X
4. Did decedent own an intlividual retirement account, annuity,or other norrprobate properry,which � ❑
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF iHE ANSWER 70 ANY OF THE ABOVE �UESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TiE RETURN.
_.�-c - s..s? wr; - ..�.r� -- _ z�S ..:.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 lo or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)]. �
Fm dates of death on or after Jan. 1, 1995, the tax rate imposed on the net vaWe oT transfers to or for the use of fhe 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 lhe statutory requirements for disclosure of assets and
filing a taz retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July i,2000:
• 7he tax rete imposetl on the net value of transfers from a tleceased chiltl 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)(12)].
• The tax rate imposed on the nef value of transfers to or for the use of the decedenPS lineal benefciaries is 4.5 percent,esept as noted in[72 P.S.§9716(a)(1)j.
• The tau rate imposed on Ihe net value of transfers to or for the use of the decedenCs siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined.
under Section 9102,as an indivitlual who has at least one parent in common with Ihe decedent,whether by blood or adoption.
oMae�i a.000
REV4508 E%.(Ob12) .
pennsylvania SCHEDULE E
°E'°""'�'roF�"'� CASH, BANK DEPOSITS 8 MISC.
��M'" PERSONALPROPERTY
ESTATE OF: FILE NUMBER:
John J. Sarcone 21 13 0050
IncWEe t�e pmceeOS M Iitlgetbn anA Ne tlate the proceeES�ere receM1eO Ey the eslate.
� All ro e ointl owned with ri ht of survivorshf must be disclosed on ScheOule F.
�M VALUE AT DATE
NUMBFR DESCRIPIION OF DEATH
7. Personal property (computer, TV, apartment furniture,
etc.) valued by Adminiatrator's estimate 1,550
2 Checking account �**9217 at Woodforest National Bank, PO
Box 7889, The Woodlands, TX 77387-7889, valued as close
out proceeds (copy of check attached) , which includea
date of death balance and final pay deposited via direct
EIDployer deposit. 1,372
3 2000 Nissan Maxima SE Sedan, 61,000 miles, good
condition, Kelly Blue Book valuation attached. 6,726
4 Refund o£ Federal Income Tazes 443
TOTAL(Also enter on line 5.Recapil'ulation) S B,091
]wa9AD 2.000 It more space is neetletl.use etltldional slleets o1 papM otthe same ske.
REV4570 EX+(OB-09) �
pennsylvania SCHEDULE G
OEPARTMEMOF REVENUE INTER-VIVOS TRANSFERS AND
INHERRANCE TAX RETURN MISC.NON-PROBATE PROPERTY
RESIDEMOECEDEM
ES7ATE OF FILE NUMBER
John J. Sarcone 21 13 0050
This schedule must he completed antl filed if the answer to any of questions 1 Nrough 4 on page three of the REV-1500 is yes.
DESCRIPIION OF PROPERiY
IiEM nnine�uv.�or�mwxrw�.�wR�unoraNCrooccmeurnw DATEOFDEATH %OF�ECD'S IXCLUSION TAXABLE
NUMBE 11E¢9lEOFlWVSHiAlTiD1TWWOFT£D�FORRFALESTFTE. VALUEOFASSET IMEREST FPPPI�CABLE VALUE
�� Pennsylvania Psychiatric
Institute Retirement Plan
account #TT069277 00001 paid to
decedent's parents, named as -
death beneficiaries on the
account. This employment
benefit is excluded from
taxation because the decedent
was 27 years o£ age and did not
have the right to plan benefits
at the time of his death. A
copy of the retirement account .
summary for October 1, 2012
through December 31, 2012 is
attached. 0 100.0000 0 0
TOTAL(Also enter on line 7,Recapitulation)$
0
- If more space is needetl,use adtlitional sheets of pape�of ihe same size.
9 WJ6AF 2 000
REV45fl E%.lt(Fp.�
pennsyivania SCHEDULE H
c�arn�xroF�� FUNERAL IXPENSES AND
ea�suwc�T,uc�n,RN ADMINISTRATIVE COSTS
f�BdfR�OEM
ESTATE OF FILE NUMBER
John J. Sarcone 21 13 0050
Decedent's debts must be reported on Schedule I.
fTEM
NUMBER DESCRIPf10N � AMOUNT
A. FUNERALEXPENSES:
�. Hoffman—Roth Fwneral Home 3,881
B. ADMINISIRATNE COSiS:
1. Personal Representffiive Commissions:
Name(s)of Personal Representative(s)
Street Atltlress
City Slate ZIP
Year(s)Commission PaiC:
2. Atlomey Fees:
3. Family Exemplion:(If decedent's address is not the same as daimanYs,attach e�lanation.)
. � Claimant
Street Address
City State LP �
Relationship of Claimant to Decedent
4. Probate Fees: 109
5. AcwuntantFees: .
6. 7axRetumPreparerFees: � 550
7.
None
70TAL(Also enter on Line 9,Recapitulation) S 4 540
gwesnG z.000 � ��more space is needed, use additional sheets of paper of ihe same size.
REV.154 EX�(12-08)
pennsylvania SCHEDULE I
°�c"m"g'"roF a�"`� DEBTS OF DECEDENT,
°'"�"'�r'ix"E""'" MORTGAGE LIABILITIES&LIENS
fE510ENf0.ZEDEM
ESTATE OF FILE NUMBER
John J. Sarcone � 21 13 0050
RepoR debts Incurred by lhe decetlent prior to death that remaineE unpaid at the tlate d death,Including unreim6ursetl mediwl expenses.
�M VALUE AT DATE
MIMBER DESCRIPf10N OF DEATH
�� Cumberland County Tax Bureau - final earned income tax
return balance due . � 154
TOTAL Also enter on Line 10,Reca itulation S 154
ewasnn z.000 If more space is nee0etl,inseA atltlitional sheets of the same size. �
REV-0513FX�(0740) SCHEDULE J
pennsylvania
°�"�"`�"`°F`�""E BENEFICIARIES
INHERRANCETA%RETURN
RESIDEMDECEDEM
ESTATE OF: FlLE NUMBER:
John J. Sarcone 21 13 0050
RFIATONSHIPTODECEDENT AMOUNTORSHARE .
NUMBER NAMEANDADDRESS OF PERSON(S)RECEMNG PROPERN Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS�InGuEe wtright spousel EislrlEutbns entl transfe�s unCer
Sec.9116(a)(1.2).]
�. David M. Sarcone
55 Sovth Pin Oake Drive
Hoiling Springs, PA 17007
08 of Residue: 1,699 Father 1,699
2 Linda D. Sarcone
55 South Pin .Oak Drive
Boiling Springs, PA 17007
50B of Residue: 1,699 Mother 1,699
ENfER DOLLAR AMOUIdIS FOR DISIRIBUf10NS SHOWN ABOVE ON LINES 15 THROUGH iB OF REV-7500 COVER SHEET,AS APPROPRIATE.
�� NON�TAXABLE OISTRIBUTIONS
0.SPOUSAL DISTRIBUilONS UNDFR SECiION 9113 FOR NMICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS:
7.
TO7A�OF PART 11•ENiER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 5 0
gwasni z.aao �It more space is neetletl,use additional sheeis of paper ot Ihe same size.
WOODFOREST� `'�yo�6�84
N A T I O N A L B A N K 332 Carfisle Walmart(332)
P.O.BOx�8B9 M�m6vFOfC ICRomanoskie
The Waadlanas,SX n389-'lB89 35-846
�, Purchaser: JOHN JOSEPH SARCONE ' (an)sseassz
a Memo: Estate of account"'9217 � : � �3O
V P'4Y One Thousand Three Hundred Seventy-One dollars and Eighty-One cents "*""""""""`"`"""""
�
a To rHe '$1,371.81'
W ORDER OF Estate of John Joseph Sarcone, Deceased
U
� DATE THRU
CASHIER'S CHECK NOTVALIDOVER'S1E3]BiH�N900AYS F�R MEMO * NOTNEGOTIABLE
Kelley Blue Book Page 1 of 2
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>�`. ' "" ,. Kelley Blue Book meT��S«e a���re ;
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NISSAN �
Innovetion that excites^' ���� � rssnn �
1 SNOPNOW )
Ys%Gow�N'vaanmm �
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Your Blue Book�Value , •
�� 2000 Nissan Maxima
SryAe:SE SNan 9D
Mileage:63000
! �
�
Private Party Value
Excellent Vehide Highlights
$5,101
Very Good MPG:Ciry 19/Hwy 25 Max Seating:5
$4,826
Doors:4 Engine:V6.3.0 Liter
Gootl
s'4,'726 Drivetrain:FVJD Transmission:ManuaL 5-Sptl
Fair EPA Class:Midsize Cars Body Style:Sedan
54,151 Country of Ori9in:Japan Country ot Assembly:Japan
Your Configured Options
. .our me-mk�4a w�,wsea a,Npb�eqWV�n rw mm o..
JOptlms Mat you aEhtl wM�e canllgurtrq M�IS ar.
Engirre ComtortemlCOnv¢nimce Fzterior
V6,3A tJOer Nr ConOitlwtlnp Mat Spolltt
Trensmiszfon Pwler Windows Wheels amI Tires
/ Manual,SSpC �r��s Alby Whetls
Drhe4aln �^'���0^�
FWD Steerinp
Brekin8 anA Tracdan Power Sfcertng
RBS(4Wheep Pn Wh¢¢I
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RH/FM SlerN
U55ette
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Glossary of Terms
� Kelley Blue Book�Trade-in Value-Tliis is the amount you wn ezpect to mcerve when yau Vade in
. your car ro a dealer.This value is Getermined basetl on the sryle,conGitlon,mileage and optlons
indiptetl. i
� Kelley Blue BookB Private Party Value-This Is Ne startlng point for nego[iation of a usetl-or sale
Getween a private buyer anA seller.This is an"as is"value that tices iwt irKluGe any warrantles.The final
- pnce Gepeiks on ihe oYS actual<oMNOn antl lacal marke[faccors.
�� � Ezcellent Contlitlon:3%of all wrs we value meet Mis cri�na.This rar looks new aM is in«cellent �
� mechanical mndition.[t has�ver hatl paint or bodywwk antl has an interior antl body free of wear antl I
, visible defects.The car is rust-free anC tloes not need remnGi[ionir�g.[LS tlean e�ine mmpartment is I
' tree of Huitl leaks.It alw has a clean dtle histary,has wmplete antl verifiaMe service mcords arM will �
pass saFely anA srtag inspection. ,
Very Good ContliEOn:2?%of a0 cars we value mee[this aiteria.This or has minor wear or vlsible !
defects on Me boAy antl intenor but is in evicellent mxhanical mnditlon,requinng onry minimal �
� recontlitloning.It ha5litUe to�ro paint an0 boGywork and is free of ms[.Its dean engine mmpartment is ,
'�. free of Fluid leaks.The tires mak�antl have 75°h or more of treatl.[t also has a dean tltle hisrory,wiM ,
� most service remrds available,antl will pass safery and smog inspecUOn.
� � Good Contlitian:59%of all cars we value meet ihis cntena.This car Is hee of major mechanical -
: pmblems but may neeC some rewntliUOning.Its paint and botlywork may mquire minor tou<Rups,with '
' repaiable msmetic defects,arM its engine wmpartmenc may have miiwr leaks.There are minor botly '
sc2hhes or tlings aM minor interior blemishes,but no rust.The Hres ma[ch and have 50%or rtwre of
tread.It alw has a tlean tltle history,with mme service mcords available,and will pass safety antl smog ��
• inspectlon. '
. Fair Contlition:18%of ail wrs vre vaiue meet Ni5 aiMna.This mr has some mechaniol or rosmetic
- dMec[s aM neetls servitlrg,but is stlll in wfe running condition antl has a tlean title history.me painp � ,
'�. botly anA/or in�nor may nee0 professiowl servidng.The tires may neetl repacing and Nere may be .
wme repaimble rust damage. i
; . . . . .._.___-_' _ _. .
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[O fhi5 partit'ula�vel�i[lp Or fh¢hanuRion o�t�e pu2e5 N lhe 4dnsacfmn.This Rpart i5/nf¢nOetlloi Me lndrvitludlYS¢0/[M1e person g¢n¢rDNng(Ns
'� report only antl sliall nof Oe sdC or[ransmittetl lo anoMerpatty Kelley Blue Book assumes M resPo^46iliry/or erNrs o/omissinns.(v.130J1)
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