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HomeMy WebLinkAbout10-08-13 REV-1500 a(02-v 1505610105)(FI) T OFFICIAL USE ONLY Bu Department of Revenue Pen Sylvania County Code Year File Number Bureau 260601 INHERITANCE INHERITANCE TAX RETURN PO BOX 26o6m Harrisburg,PA 17126-0601 RESIDENT DECEDENT �yt• j L ENTER DECEDENT INFORMATION BELOW - Social Security Number Date of Death MMDDYYYY Dale of Birth MMDDYYYY j 104/10/2013 10/09/1933 Decedent's Last Name Suffix Decedent's First Name MI Padamonsky i Irene i : � ' R R ! (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI i Spouse's Social Security Number ----- --"---°"- THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I ._._.. REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Olp 1.Original Return O 2.Supplemental Return O 3•Remainder Return(Date of Death Prior to 12-13-82) O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12.12-82) COD 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O S.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 TO: 'Name - _ —_— Daytime Telephone Number`A-^ Ronald E. Johnson, Esq `(717)243-0123 �GISTER OF WILL'S USFVtU L m M yCJ c n � First Line of Address W -'� `--D -- !78 West Pomfret Street --- ^------`_--V o n r rri rn r m 00 o Second Line of Address C'2 7 <::, C> CD -r1 .r- -TI City or Post Office _ - - — State -ZIP Code O C DATE FILED =• c'� Carlisle PA :17013 "o ry rn o -.- --— ---- - - ------ — - - - '- ._ —. - --T-- -00 n Correspondent's e-mail address: rejOhnson @pa.net 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. SIGNAITUU EE•FF ERR 0 SPONSIBLE FOR FILING RETURN DATE ADDRESS C/o 78 West Pomfret Stre t, C isle,PA 17013 / ER O EPRESENTATIVE GATE �J Q X A RESS /0 78 West Pomfr k6treet, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J J 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Irene R. Padamonsky RECAPITULATION 1. Real Estate(Schedule A). ..... .... ................................... 1. 1 92,725.1 2. Stocks and Bonds Schedule B 1 ( ) ....... .....:. ........... .............. 2.I 0.00 I I 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. j 0.00 j 4. Mortgages and Notes Receivable(Schedule D)......... ............. ... .. 4. ; 0.00 j 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. : 2,514.48 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ! 0.00 --- 7. Inter-Vivos Transfers B Miscellaneous Non-Probate Property - (Schedule G) O Separate Billing Requested........ 7. 1 0.00 ; B. Total Gross Assets(total Lines 1 through 7)........... .................. 8. I 95,239.65 9. Funeral Expenses and Administrative Costs(Schedule H)..... .............. 9. 1 13,577.75 - 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). ....... ....... 10. 1,253.72 11. Total Deductions(total Lines 9 and 10). .................. ........ ...... 11. 14,831.47 12. Net Value of Estate(Line 8 minus Line 11) ........................ . ..... 12. 80,840.18 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. ................ ...... 13.j 0.00 j 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 1 80,408.18 j TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 f'_..__.-__.-__._._____-.-�_., (a)(1.2)X.0- I 15. 0.00 16. Amount of Line 14 taxable ,-__.._.,.__._..,_,.__._...._..-...._-..___J ..-V._.-._..__.__...__._..-._..._.�..___.-_. at lineal rate X.0 45 80,408.18 j 16,. 3,618.37 17. Amount of Line 14 taxable at sibling rate X.12 I 17. - 0.00 E 18. Amount of Line 14 taxable ! -.-...._.-...�_"'---'� at collateral rate X.15 I j 18. 0.00 19. TAX DUE ............. ....................................... ..... 19. 3,618.37 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=) Side 2 1505610205 1505610205 REV-1500 EX Fl) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Irene R. Padamonsky STREETADDRESS 1025 Swartmore Road CITY STATE ZIP New Cumberland PA 17070 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 3,618.37 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 3. Interest Total Credits(A+B) (2) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) 0.00 Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,618.37 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.......................................................................................... ❑ E b. retain the light to designate who shall use the property transferred or its income............................................ ❑ E c. retain a reversionary interest...................................................................................1.......................................... ❑ E 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? ........................................................................................................................ ❑ E 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)(11)(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)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. WILL OF IRENE R. PADAMONSKY I, Irene R. Padamonsky of Cumberland County, New Cumberland, Pennsylvania, declare this to be my last Will and hereby revoke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my .death. 2. 1 direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. 1 direct that my entire estate be distributed as follows: A. I direct that my entire estate be divided into equal shares between my children, Robert J. Padamonsky, Joseph M. Padamonsky and Theresa M. Padamonsky. B. Should any of my children predecease me, then I direct that their share shall lapse and go to my surviving children. 4. 1 appoint Robert J. Padamonsky, as Executor of this my last Will. If Robert J. Padamonsky should predecease me or cease to act in such capacity, I appoint Sheryl Padamonsky as alternate. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. 1 direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN�WITNESS WHW71 have h unto set my hand this Lf day of T 2006.2 LAW OFFICFS OF '\ , ��-�IX 6L,'7v�� STEPHEN J. HOGG Irene R. Padamonsky 19 S.HANOVER STREET SUITE 101 CARLISLE,PA 17013 The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by Irene R. Padamonsky 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 hereto. WITNESS WITN E$8 LAW OFFICES OF STEPHEN J. HOGG 19 S.HANOVER STREET SUITE 101 CARLISLE,PA 17013 ACKNOWLEDGMENT State of Pennsylvania ss County of Cumberland I, Irene R. Padamonsky, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. z� 1q. smi Irene R. Padamonsky Sworn to or affirmed and ack owledged e me by I ne R. Padamonsky the Testatrix, this �day of - , 2006. Nota Public/Attorn Onul�c FFi z:2 i AFFIDAVIT State of Pennsylvania h ss County of Cumberland We, Lt�AWNAK BOCKFN/andw/ao,2r�/.hN/�,z 77aa„�l>he witnesses 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 the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of dsound mind and under,no constraint or undue influence: S orn to or a m d and su rib d to before me by witnesses, this day of 2006. LAW OFFIM OF STEPHEN J. HOGG No ary Public/Attor 19 S.HANOVER STREET p A4b 0yy SUITE 101 ��©+��ooq 1mra^rcw�c CARLISLE,PA 17013 `'"' 1L561��a' ..;a'i'' REV-1502 Ea+(12-12) e+ pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Irene R. Padamonsky 21-13-0922 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. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1 ALL THAT CERTAIN tract or parcel of land situate in the Borough of New Cumberland, Pennsylvania,having thereon erected a dwelling house known and numbered as 1025 Swarthmore Road,New Cumbedand,PA 17070 See Deed Book V,Volume 21,Page 628. Joseph C.Padamonsky died August 30,1980 thus vesting full fee simple title in the decedant Net proceeds from sale 92,725.17 (see settlement sheet attached) TOTAL(Also enter on Line 1, Recapitulation.) $ 92,725.17 If more space is needed,use additional sheets of paper of the same size. ' 91912613 11:42:46 AM A. Settlement Statement U.S,Department of Housing OMB Approval No.25024265 and Urban Development r B.Type of Loan t.O FHA 2.0 FmHA 3.O Cm.Unina, 6'File Number, .Loan Number �Momgago insumnso, se Number ,OVA 5.0 ConvArs. OOther 20130716 C,Note: This fans is famished to give you a statement of actual settlement costs.Amounts paid to and by the Settlement agent are shown, 11emS marked'(POCy wren paid outside the closing;they are shown here for Informational purposes and are not Included In the totals. ' D.Name 8 Adtlrc65 Oavid Sohultx,PO Box 93,Camp Hiii,PA 8001 of eorrowar: E.Name 8 Address Th e state al kene Padamonsky,12i201ake lane Ddve,Austin, 78738 of Seller: F.Name 8 AddMSO of Lender: G.Property Location: Properly Address 1025 Sm"rhom Rd.New Cumberland.Pennsylvania 17070 PIN 26444809420 H.Semement Agent: Great Oed SetOameni Services,LL ,6 5.07th SOeaL Camp HIN, A 17017,{717)Tat-F640 Place of Settlement: 6 S.17th Street,Camp td'9,PA 17011 L Settlement Date: 9198D13 Proration Date: 91912013 Disbursement Onto: 9/98013 J.Summary of Bononmes,Transaction T': y:r ';;:.,K.Summary-of Seller's Transaction 100. Gross Amouna Pon from Be., ;:}.. ::...-;...- 400.",Gross Amomrt Dwto Sailor .•. -" _ 101. Canl2ct"as Pride Et00.000.Do 401. Cammurxhs price 310,00.0 102. Personal omen 402 Personal Property 103. Settlement charges to bonowm(tine 140) $1,990511 403. I W, 567. 165. 505. Adjust r iments for items paid by xlien ativance Adjustments for Items paid by Seller in adranx.- 106. eityR.tam 4as. Citylt mluxes 107. Camry Was 912/2013 to 12418013 5297,09 407, County tatty 9MM13 to 12131)2013 5297,09 108. Asmsmenls ads. Asma+mMs 109. ScMOi Trot 9798013 to8 ell 51,113.09409. Stlrom Tex 9191261310 Sr3OMD14 61,113.09 110, Refuse OM0013 to 9n(Ml3 $8.89 410. Refuse 9798613lo 9/30/2013 111. 411. 112 412, 120. Grass Amount Dun from emfOVwar 5103,40.66420. Gross Amauni OUe to$slier 210t,ar9.0 20. Amounts Paid by ar M Behalf al emn,'kr:< 60Li ns Red.tuo in Afn.umOtte to Seller m 201, Denal Or utmost ossy fY(SI,OpD.0501. Emnsdeposil(sxinstructiona) 202. Pdrdsol anneal Of new loans) 02. SeNemenl cherpnbseller pine 140J $15,635.10 293, F'mug loan(f}taken sub}M to 503, F*luq loan(,}taken Subject In 204. 804. Payort0f6mimo19aps Mahl M, $D5. PaInd of second mortgage ben 2w. 50. 207. 507. - 200. W. 09 50. Adiuelmentb for item,unpaid by$offer - * Adlbdhnants'for Items unp.ld by sailor" 21e CSYROwn taxes $10. C8yre htoes 211. County arm $IL- County taxes 212. Asommuch, $12 Asst hum 213. Sewer 7118013 to 9198013 656.79$13. Sewer711=13 to9192013 $58.79 214' 914, 215. 515, 216. $11, 217. 517. 216. at$. 219. $19. 22a Total Paldbffor Borrower $1,05819530. Tmol 1104.01on Amount Oua Salley S15,693.99 30, Cash it Setdemen[fromno Borrower 600. .Cobh ar SedlameOr toRrdm 6mki 301. Gros,amount due tram acorn mgore 120} x Ei03,a99-5801. Great emmmi due to xaer(tine 6205 6101,41910 312 Less amounts paid byRm bommer(arm 220) (51,058.79)02. Less reductions in amount due x9er(gne 50) (215,693,69) 303, Cash ®From OTO Borrovgr 5102,]50.7703. Cash 0Tp❑From Seller 585,72547 SUBSTITUTE FORM 1029 SELLER STATEMENT- Thp fnimmaWhaenpMxNBbtl:bE,G,H4ndlaM On Me4al(m,Ngrm end 401 (appOca µ IRS) m p 49itra,imfxkMvu19e 1pa e 1rv6es3e,M"y4o0u 4 7s,m 608.407 Returns b6feamtum.aoegepsnra Pe mtyaremmuMXi,M6 bskrouselonyoug Oea harms reeu9edm be repcmedand(he IRS oMeOme,Me,h two trot been rcpome SELLER INSTRUCTION- If tds real estate was your pdncipal residerme,9b form 2110,Sets or Exrhanpe of Prlodpal Resistance.for err,earn,with your throne,to mwm; fm oM11 VersaClam,orxnplete Me OuNe a pens of bon 4797,Forth 0252 and/or Sche l D(Form Iuse), You am movirod b(scolds the Senlahmt Agent Mt,your comet wPayer huntfimtbn numbs. If YOa on rot ProvWe tm Settenent Agent Mat yon server tmnayer Idenefueten mMmer,you ms,be"no, cho of Mmbtet Monso a. TH OF IR NE R. Or t//'cA'if _ 9m9R013 i1:aT.a6 AM File Nomber.201307t6 L Settlement Charges 700, Total Sales/Omkers Commission based on price 5100.000.00@6.000000%ar$6.000.00 Pak From Paid From OHision of Wannissloo ftlne 700)as follows: bonowefs Sellers 701. $3.000.00 to Century 21 Above d Repand Funds at Food,at 702. 53,000.00 W Straub E Associates Real Estate Group,Inc. Sewemant Settlement 7113, Commission pad at settlement$6.000.00 56,000,06 704, 500. Items Payable In Connection with Loan - SOL Loan aginatio,fee 902 Loan discount 903. Ap m laal fee 904. Credd new 905. LeMela houxuaim tee 609. Mortgage Insurance,MMScatbn fee 507. Assumption fee 506, 809. 610. Sn. 912, 513, 900. items Regubad by Lander W Be Paid in AOVanea 001, merest from 902. Nlongage Insurance premium for 903, Haead Insurance premium far 904. 905. tODO.ftescrves Deposited wilM1 fonder ,( '. - , 1001, Hazard insumrps loot. Morgage houranca Am Call property taxes face. Camay'Wed,taxes 1005, Annual assessments 1006, 1007. 1009, face, 1100,This Charges 1tol, Settlement or okas'uq fee »Da. Abstract«tits,search 110$. The,examinatlon 1104, Tide insuransa birder 1105. Document gbpamtbn 1106. Notary fees 1107. Ag lesto teas W Indptlea BWvG ifam npmbelb: 1108. Title Insurance to Great Rood Settlement Senecas,LLC $900.00 InW06s of Item num 110 , LenOefa covemge file. Q~.cawrage 5100.000.00 $900,00 1111. 1112, 1113, 1200,GOxammant Recording and Tum fnr CM1argas " ) ' 1201. Rese d g feed:Dose us.50 s55.59 1202, City/counH tax7afamaa:Deed 51.000.00 51,000.00 1203. state tex/stemps:Deed 51.000.00 31,000.09 1201, UPI Ced to Recorder of Deeda 510.00 1205. Erecomeng Fee IS RemNer Of OSeds 525.00 1206. 1300.Additional Settlement Charges 1301, Survey 1302 Past inspection 1303. Attorney Fees to Ronald JOhnSgn,EW $223.00 130x. Refuse 7f1 W OMO to New Cumberland!6awgh POCIS 1305, Sewer all to GMO to New Cumberland Saloom POCO$76.9e 1306, 2013.14 School Tax to Radn Gasperelli,Tax CaSector $1 410.f 0 1307, 20130 hx TwmsNp Tax an AM9=13 W ROWn Gaspeaio,Tax COikctor P0001959. 1309. hdedtarKe Tax Ewan to Register eVAlls,RgeM ST,OO6A0 14DD, Total Settlement Charges tenter on lines 103,Seaton J and$02,Se.lMn K) 51,990.50 $15,6$5.10 Rama meMed'POL'were"W outside the rJO¢kg b/.69nwer(POGO),Larder(POLL),Matgepe 6mxH(POCM),Other(POGO).Rest EAete Agent(POOR),a Seger(POCS). CERTIFICATION: 91912013 11:42:46 AM File Number:20130716 Jahave urefslly reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements tle on my account or by me in this haneacfon.I fo her certify that I have spaived a copy of HUO-1 Settlement Statement.The SaWement Agent does not warrant or represent no accuracy of information provided by any Party,including information concerning FOC items and information supplied by the lender,if any,in this transaction appearing o^n this HUD-1 Settlement Statement and the parties hold harmless the Settlement Agent as to any inaccuracies in such matters. David Schultz TH�� ATE OF IRENE .1ONSKY //bed Patlamonsky. To the best of m knowledge, 0- Executor Y ge, 1Sedlement Statement have preparetl is almea d accurate a..art ot�lhe funds which were receivetl and have been or will be disbursed by the untlersigne gperyoil a ;dement of this tansadion. James A.Miller,E Dam K WARNING: I a crime to know; gly make false statements to the United States on this or any other similar form.Penalties upon conviction can include a fine and imprison t.For details see:Ti a 1B:US.Corte Section 1001 and Section 1010. REV-1508 EX+(08-12) 117 pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TM TURN PERSONAL PROPERTY RESIDENT DECEDENT EDENT ESTATE OF: FILE NUMBER: Irene R. Padamonsky 21-13-0922 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. Cash 381.00 2, Checking account-PSECU 2,061.03 3. AIIState Insurance-refund on homeowners insurance 44.69 4. Verizon-refund 27.76 TOTAL(Also enter on Line 5, Recapitulation) $ 2,514.48 If more space Is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) i pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHEPJTA14CE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene R. Padamonsky 21-13-0922 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Parthemore Funeral Home 5,445.31 2. Resurrection Cemetary-opening 900.00 3. Resurrection Cemetary-headstone 2,561.90 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: 2,500.00 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: 313.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. AIIState Insurance-homeowners insurance 100.00 8. Jody Donatucci-cleaning and preparation of home for sale 500.00 9. PA American Water-5/14/13 89.94 10. PP&L-5/14/13 91.04 it. Verizon-6/19/13-8/5/13 114.98 12. Borough of New Cumberland-sewer bill 115.24 TOTAL(Also enter on Line 9, Recapitulation) $ If more space is needed,use additional sheets of paper of the same size. SCHEDULE H - continued Funeral Expenses, Administration Costs and Miscellaneous Expenses ESTATE OF FILE NUMBER Irene R. Padamonsky 21-13-0922 13. Overnight mail charges $ 85.90 14. Melissa—grass cutting at home 4/15/13-9/9/13 $200.00 15. UGI—utility bills—6/17/13-9/9/13 $49.94 16. Wire transfer fee $10.00 17. Reserve for closing and accounting $500.00 TOTAL also enter on line 9, Recapitulation) $13,577.75 REV-1512 Ex+(12-12) -Y-IML- pennsytvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene R. Padamonsky 21-13-0922 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. PA American Water Co-utility bill 30.23 2. PP&L-utility bill 46.23 3. Verizon 66.07 4. UGI 29.53 5. Borough of New Cumberland-sewer bill 115.24 6. Robin Gasperetti,Tax Collector-2013 real estate tax 956.62 7. Robin Gasperetti,Tax Collector-personal tax 9.60 TOTAL(Also enter on Line 10, Recapitulation) $ 1,253.72 If more space is needed,insert additional sheets of the same size. REV-1513 EX+ (01-10) 1-. �il?pennsylvania SCHEDULE J DEPARTMENT CF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Irene R. Padarnonsky 21-13-0922 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. Robert J. Padamonsky son 1/3 12120 Lake Stone Drive,Austin,TX 78738 2. Joseph M.Padamonsky son 1/3 534 Bosler Avenue, Lemoyne,PA 17043 3. Theresa Padamonsky daughter 1/3 221 B South Third Street,Lemoyne, PA 17043 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II 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.