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HomeMy WebLinkAbout12-02-13 (2) s 1 1505610105 �1 REV-1500IXf0r12)(M OFFICIAL USE ONLY PA Department of Revenue �nsyls Bureau of Individua(Taxes INHERITANCE TAX RETURN County Cade Year/? File Number PO BOX rg,PA 1 I /-t Harrisburg.PA 1gu8-o60t RESIDENT DECEDENT { -J t l ENTER DECEDENT INFORMATION BELOW 10/07/2013 01/12/1921 Decedent's Last Name _ Suffix Decedent's First Name MI DeLone Jr. Charles A (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 OVALS BELOW O1D 1.Original Return C7 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12.13-52) C1 4.Limited Estate O 4a,Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) DID 8.Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) Ct 9.Litigation Proceeds Received C) 10.Spousal Poverty Credit(Date of Death (= 11, Election to Tax under Sec.9113(A) Between 12.31-91 and 1.1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST DE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Charles A. DeLone,ill (610)269-1822 REGISTER OF WILLS U3E ONLY i = M First Line of Address _ _ _ C-73 G�-a 19 Downing Circle M c'} C fn :X3 ... . ... r— --i C� Second Una of Address T'n Ry M Ti �7 City or Post Office State ZIP Code CZ)o FR Downingtown PA .19335 ::o �_ m Cn ca co Correspondent's e-mail address:CAD3 @COMCAST.NET Under penalties of perjury,i declare that I have examined this Mum,including accompanying schedules and statements,and to the best of my knowledge and belief, tt is true,correct and compete_Declaration of preparer other than ate personal representative is based on aft information of which preparer has"knowledge. SIG TUR OF N R PONSIBLE FOR flLl N �) DATE 3 A REDsUR EOP s U- SIGNATURE OF REPARER I OTHER THAN R t6ENIA1IVLv DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side A 1505610105 1505610105 1505610205 REV-1500 EX(Fl) RECAPITULATION 1, Real Estate(Schedule A). ....... ................... ......... 157,500.00 2. Stocks and Bonds(Schedule B) .. ................... ......... 2. 305,498.00 3. Closely Hold Corporation,Partnership or Sole-Proprietorship(Schedule C) 3, 4. Mortgages and Wes Receivable(Schedule D).......... ...... 4, 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 6, Jointly Owned Property(Schedule F) =) Separate Billing Requested ..... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C=D Separate Billing Requested........ 7. 862,221.00 a, Total Gross Assets(total Lines 1 through 7)............................. 1,325,219.00 9. Funeral Expenses and Administrative Costs(Schedule H)............ 9, 15,763.00 % Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).... 110. 11, Total Deductions(total Lines 9 and 10)................................. 11, 15,763.00 12, Net Value of Estate(Line 8 minus Line 11). .............. 12 1,309,456,00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ................... 13, 14, Not Value Subject to Tax(Lim 12 minus Line 13) ................. 14, 1,309,456.00 TAX CALCULATION-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.0— 16. Amount of Line 14 taxable at lineal rate X-0 45 1,309,456.00 16, 58,925.00 17, Amount of Lim 14 taxable at sibling rate X.12 IT 18, Amount of Line 14 taxable at collateral fate X-15 18. 19. TAX DUE............................. 19. 68,925.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C= Side 2 1505610205 1505610205 REV4500 FXC FI Page a t 9 Rte Number Decedent's Complete Address: DECEDENT'S NAME Chartas A. Del-one, Jr. STREETADDRESS 511 Brentwater Rd. CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 56,925.00 2, Credits/Payments A.Prior Payments B.Discount 2,946.00 Total Credits(A+B) (2) 2,94600 1 Interest (3) 4. if line 2 Is greater than Une t+Una 3,enter the difference. This is the OVERPAYMENT: F91 in oval on Page 2,Line 24 to request a refund. (4) S. If Una 1+Line 3 is greater than Una 2,enter the difference.This is the TAX DUE. (5) 55,979.00 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........................................................................................_ ❑ b. retain the right to designate who shall use the property transferred or its income............................................ ❑ c. retain a reversionary interest......_.............................................................»._...._......._...._......_............_......... ❑ E d. receive the promise for lice of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after Dec.12,1962,did decedent transfer properly within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 3. Did decedent own an in trust for'or payabta-upon-death bank account or security at his or her death?,............. ❑ 4. Did decedent own an individual retirement account,annuity or other nonigrobate 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. 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 172 P.S.§9116(a)(1.1)(t}j. 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 V2 P.S.§9116(a)(1.1)(it)j.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 sfill 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 F2 P.S.§9116(aj(1.2ij. • The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5 percent,except as noted in(72 P.S.§9116(a)(1)j. • The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12 percent(72 P.S.§9116(a)(1.3)1.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+(12-12) pennsytvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Charles A. DeLone,Jr. 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}airy-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 DESCRIPTION OF DEATH 1• 511 Brentwater Road,Camp Hill,PA -per attached estimate from Jack Gaughen 175,000.00 Less:Estimated Costs to sell (@ 10%of selling price per Zilksw.corn&Lendingtree.com) -17,500.00 TOTAL(Also enter on Line 1, Recapitulation.) $ 157,500.00 If more space is needed,use additional sheets of paper of the same size. J A C K G A U G H E N REALTOR ® ERA ® Real Estate Services Proposal Prepared Especially for: Estate Of Charles A Del-one Jr 511 Brentwater Rd Camp Hill, Pa., 17011 For Marketing the Property Located at: 511 Brentwater Rd Date: November 18, 2013 This analysis has not been performed in accordance with the Uniform Standards of Professional Appraisal Practice which require valuers to act as unbiased,disinterested third parties with impartiality, objectivity and independence and without accommodation of personal interest. It is not to be construed as an appraisal and may not be used as such for any purpose. JACK GAUGHEN ■ REALTOR E Rik ar J A C K G A U G H E N ' REALTOR11 ERA ® Comparative Market Analysis Summary Currently On The Market Addrass Munk Style At& Ebuh htmh Abv Gr Sold Prim List erlu 903 Valley Rd East Pennsboro Split Level 3 2 1 1663 $169,900 Average of 1 Properties:$169,900 Min:$169,900 Max:$169,900 Median:$169,900 Recently Sold Address Mums Style 22ds Ebsth Hbath AbyGr Sold ListCrJu 1463 Clover Road East Pennsboro Ranch 3 2 1 2164 $115,000 $129,900 64 Westwood Ct East Pennsboro Townhouse 3 2 1 1548 $120,000 $145,000 1010 Teakvrood Lane East Pennsboro Traditional 3 2 1 1800 S195,000 $219,900 47 Victoria Way East Pennsboro Split Level 3 2 1 1796 $203,000 $209,900 8 Round Hill Rd East Pennsboro Cape Cod 4 2 1 1739 $207,500 1208,000 1112 Kent Drive East Pennsboro Traditional 3 2 1 1784 $209,900 $209,900 709 Veronica lane East Pennsboro Traditional 4 2 1 2100 $210,000 $205,OD0 10 Windsor Way East Pennsboro Traditional 3 2 1 1764 $214,000 $229,900 532 Joyce Road East Pennsboro Ranch 3 2 1 1333 $225,000 $239,900 1052 Hemlock Ln East Pennsboro Traditional 4 2 1 2016 $225,000 $229,900 5 Cypress Hollow Rd East Pennsboro Split Level 4 2 1 2084 $229,000 $229,000 Average of 11 Properties:$195,945 Min:5115,000 Max: $229,000 Median:$209,900 This can not be construed as an appraisal and is only my opinion of fair market value. The subject property, 511 Brentwater Rd, has 3100 SF of living space of which 1750 SF is indoor pool area. The pool area is in need of repair. In my opinion the fair market value is approximately $175,000.00. Bob Hughes JACK Office:(717)761-4800 GAU G H E N 606225 ` Direct Dial:017)612-5133 .REALTOR ERA • Home Phone:(717)737-0604•Cell Phone:017)215-2285 V -_ - A �� T:.L15151,r1+31.1:Iji'ir n+• (Loh 4 u?�i1pr;.Urv;4�yv]tN�irUX]alk ltCl}Yttrth's!l4 S1tirllf IIrF14 r REV-150}EX+(8-u) pennsytvanta SCHEDULE B INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Chades A.Del-one,Jr. All property Jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH I' Mentll Lynch Account 872-11242(Date of Death Statement Attached) 266,083.00 2 Merrill Lynch Account 87248457(Date of Death Statement Attached) 39,415.00 TOTAL(Also enter on Line 2, Recapttutation) ; 305,498.00 If more space M needed,Insert addittonal sheets of the same size wealth MenagemaM MM al RrroMp wp'rt Historical Date of Death Valuation Charles D'Lone DOD 872.11242 Values supplied by Evaluation Services Inc We of Death 10/07/2013 Estate of DE LONE,CHARLES 'aluation Date 10/07/2013 Report Type Date Of Death 'recessing Date 11118f2013 Number of Account(s) 1 Account,872.11242 Number of Security(s):3 Shares,Security High tAsk Low Bid Mean and/or Div and lnt Security or Ps r'• .Description .Adjustments Accruals Value CITIGROUP INC(172967358) , FIXED-FLTG SER J NON-CUM ' 7.1251 PFD STK PERPETUAL 2) I 9,637 ML BANK DEPOSIT PROGRAM(990266916) - ,I Merrill Lynch "" ! 3) 1 0 CASH ..33 256,446.00 Total Value $266,08100 Total Accrual $4 - Total - . $266,083.00 Total Security Value: $266,083.00 Total Accruals: $0 Total Combined Value: $266,083.00 t he information herein has been churned from a source we believe to be reliable,but we do nal guarantee its accuracy or completeness.Memh Lynch does not provide tax,accounting or legal advice.Any tax atements contained herein were not intended or written to be used,and cannot be used for the purpose of avoiding U.S.,federal,slate or local tax penalties.Please consult your advisor as to any tax,accounting legal statements made herein. isciasures: There is NO Fee assessed to the Branch Office or Client for this service at this time. Alternative Date of Death valuations is rot available In this application.Please consult your tax adviser for assistance in obtaining this report. Report may Include trades that are not settled as of valuation date. All security poshlons are based on trade date. Money funds,money market anchor tgMftaid Income mutual funds may or may not include chwdendsanterast accruals prior to month and payment. For amounts with Credit andlor Debit carols),the cash poselon may hot reflect reduction for purchases of goods W services which are paid for by automatic debit on the Wednesday before the last Friday of each pmh. Cash balance may not reflect outstanding checks written prior to valuation date or Unsettled cash as of valuation date. Ad herbs flagged'!"ants highlighted in red reflect manually adjusted transactions{for price,share$,market value a security name)or positions with rm available price. Asset positions provided to Bank of America I Merrill Lynch from an outside tinanclal Institution(i.e.Annuities),may require the Securities Description line to be manually updated, Fee accruals we not captured in TMA accounts. All mortgage backed securities have the paydown factor t amortization factor automatically applied. If the account you are valuing is a 9DO series amount(ntemaronal),the values that you receive hack will net be In USD,but rather in me currency that the amount holds.Please also note that If this account is )usehoided with USD accounts and they we valued together,you well not waive an accurate housahWd value.Please run these amounts separately tram me rest of the household. Aormatan contained in this report Is supplied by Evaluation Services Inc.Evaluation Services Inc la rout atfillated with Merrill Lynch and Merrill Lynch Is not responsible for the information presented.We bellwe this formation Is accurate,but accuracy and conoeteness are tout guaranteed, rvestmem prsMucts provided are Merrill Lynch Ple ce,Fenner&Smith Incorporated: Ire Nw FDIC Insured Are Not sank or State Guaranteed May Loseffeiut, j lerrlll Lynch,pierce,Fenner&Smith Incorporated Is a wholly owned subsidiary of Bank of Amarloa Corporation,and a registered broker dealer and member of FINRA and SIPC. lentil Lynch,Pierce,Femrer&Smith Incorporated Is not a tax a legal adviser.Clients should consuh a personal tax or legal advisor before making tax or legal related Imnestmam decisions. othing discussed or suggested in these materials should be construed as permission to supersede or circumvent any sank of America m Merrill Lynch,Pierce,Fenner&Smith Incorporated cliches,procedures,rules,and guidelines. 2 ern t• Mem'It'Cynch Wealtk Manegenrofd sak a"rice corwavoa Historical Date of Death Valuation Charles Delone DOD 872.48457 Values supplied by Evaluation Services Inc late of Death 10/072013 Estate of DE LONE,CHARLES 'aluation Date 101072013 Report Type Date Oi Death vocessing Date 11/182013 Number of Aocount(s) 1 Account•872-48457 Number of Security(s):2 Shares Security High/Ask Low/Bid Mean and/or Div and Int Security or Par Description Adjustments Accruals Value 1) 1 39,414 ML BANK DEPOSIT PROGRAM(990286916) Merrill Lynch 39,414.00 2)-1--- - `0 CASH — 0.61 Total Value $39'414'61 Total Accrual $0 Total $39,414.61 Total Security Value: $39,414.61 Total Accruals: - ' $0 Total Combined Value: $39'414'61 he Information herein has been obtained from a source vre believe to be reliable,but m do not guarantee as accuracy or completeness.Merrill Lynch does not promde tax,accounting or legal advice.Any tax atements contained herein were not intended or valnen to be used,and cannot be used for tiro purpose of swilling U.S.,federal,state or Ideal tax penalties.Phase xnsuh your advisor as to any M.acocundng legal statements made herein. 11 e issbsures: Thermis NO Fee assessed to the Branch Office w Client for this service at this time. Alternative Date of Death valuations Is not available In this application.Please consua your tax adviser for assistance in obtaining this report. Report may include fettles that are not settled as of valuation date AO secury positions are based on trade date. Money funds,money market and/or bondA iced Income mutual funds may or may not Include dlvldendsMterest accruals prior to month end payment. For accounts with Credit andfor Debit cam(s),Me cash position may not reflect reduction for purchases of goods or services which are paid for by automatic debit on the Wednesday before me last Friday of each month. Cash balance may not reflect outstanding checks written prior to valuation date or unsettled cash as of valuation date. All items flagged"F and higMighted In red reflect manually adjusted transactions(for price,shares,market value or security Cents)or posftk=with no available pans. Asset positions PlOvIded b Bank of America f Metals Lynch from an outside financial institution the.Annuities),may require the Securities Description line to be manually updated. Fee accruals are not captured In TMA accounts. All mortgage backed securities have the paydown factor I amortization factor automatically applied. If the account you are Wising is a 906 series account Qrcemationai),the values that you receive tack will not be in USD,but tether in the currency that the account holds.Please also note that k Mrs account is mseholded with USD accounts and they are valued together,you will not receive an accurate household value.Please run these accounts separately from the rest of the household. dormation contained In this report Is supplied by Fvaluatron Services Inc.Evaluation Services Inc is not affiliated with Merrill Lynch and Men#i Lynch is not responsible for the mformolion presented.We befiWeihis formation is accurate.but accuracy and completeness are not guaranteed, wastmard products provided are Merrill Lynch,Pierce,Fenner&Smith Incorporated: Ire Not FDICC ln¢wed Are Not Bank or State Guaranteed May Loae Value lentil Lynch,Pierce,Fenner&Smith Incorporated is a wholly owned subsidiary or Bank of Americo Corpmeilon,and a registered brokw dealer and member of FINRA and SIPC. leMU Lynch,Pleme,Fenner,&Smith Incorporated is not a to w legal advisor.Camara should consult a personal tax w legal advisor before making tax or legal mimed Investment decisions, othing discussed or suggested In these materials should be construed as permission to supersede or cicumvem any Bank of America w Merrill Lynch,pierce,Fenner&Smith Incorporated ofkies,procedure&miss,and guidelines. 2 REV-1510 EX+(08.09) pennsytvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVBS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE IN MBER Charles A. DeLone, Jr. This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH `%OF DEWS EXCLUSION TAXABLE iNQWETAT NOME Of M.ATTACH AE,TN O REtE DEM. U ENi ANe NUMBER "E DATE OF TIUNSfei.ATTACHACDP(gf 1HEDEED fOR REAL ESTATE. VALUE OF ASSET INTEREST UFAPPIMLE1 VALUE 1. Cash distributed Nov/Dec 2012 to Linda Hughes,Daughter 85000AO 3,000.00 62,000.00 2 Cash distributed Nov/Dec 2012 to Charles DeLone,Son 85,000.00 3,000.00 82,000.00 3 Cash distributed Nov/Dec 2012 to Diane Andes,Daughter 85,000,00 3,000.00 82,000.00 4 Cash distributed Nov/Dec 2012 to J.Bart DeLone,Son 85,000.00 3,000.00 82,000.00 5 Cash distributed Nov/Dec 2012 to Bret DeLone,Son 85,000.00 3,000.00 82,000,00 6 Cash distributed Nov/Dec 2012 to Peter DeLone,Son 85,000.00 3,000.00 82,000.00 Decedents IRA with each of six children as equal beneficiarie r attached 370,221.00 100 370,221.00 statement from Merrill Lynch account 872-73564) TOTAL(Also enter on Line 7,Recapitulation) $ 862,221.00 If more space is needed,use additional sheets of paper of the same sue. IMerriii gc r ett!) weals,Managn„em Historical bate of Death Valuation Charles DeLbne 87273564 Values supplied by Evaluation Services Inc late of Death 10107/2013 Estate of DE LONE,CHARLES 'aluation Date 10/072013 - Report Type Date Of Death 'rocessing Date 11/182013 Number of Account(s) 1 Account:872-73584 Number of Securlty(s):3 Shares Security High/Ask Low l Bid Mean and/or Div and Int Seburlty or Par Description Adjustments Accruals Value 1) 1 124,198.5300 ML BANK&TRUST FS8 RASP(55499T918) Merrill Lynch 124,198.53 _2) 1!246,022.0100 ML BANK USA RASP(55499U915) Merrill Lynch 24602201.: 3) 1 0 CASH 0.84 Total Value $370,221.38 Total Aocrual $0 Total $370,221.38 Total Security Value: $370,221.36 Total Accruals: $0 Total Combined Value: $370,221.38 t •t� a he information herein has been obtained from a source we believe to be reliable,but we do not guarantee its accuracy or completeness.Merrill Lynch doss not provide tax,accounting or legal advice,Any tax atements contained herein were not intended or written to be used,and cannot be used or the purpose of avoiding U.S.,federal,state or local tax penalties.Please consult your adviser safe any tax,accounting legal statements made herein. isciosures,: There is NO Fee assessed to the Branch Office or Client or this service at this time. Alternative Date of Death valuations Is not available in this application.Please consult your tax adviser for assistance in obtaining this report, Report may include trades that are not settled as of valuation date. An security poshions are based on trade date. Money funds,money market and/or bondRixed Income mutual Mods may or may not Include dividendsAnterest accruals prior to month end payment. Far accounts with Credit and/ar Debit carols),the cash position may not reflect reduction for purchases of goods or services which are paid for by automatic debit on the Wednesday before me last Friday of each omh. Cash balance may ner raged ou[tEarairg checks written poor o vaoafjon date or unsealed cash as of valuation date. All hems flagged"F and highugmed in red regect manually adjusted transactions(tor price,shares,market value or security name)or positions with no available price. Asset positions provided to Bank of America I Merrill Lynch from an outside financial Insulation(i.e.Annuities),may require the Securities Description line to be manually updated. Fee accruals are not captured In TINA accounts. AN mortgage backed securities have the paydown factor/affu0no kin factor automatically applied. If the account you are valuing Is a 906 series account drimmat onal),the values that you recerce back will not be in USD,but rather in the currency that Rte account holds.Please also note that Mrs account is Mseholded with USD accounts and they are valued together,you will not receive an accurate household value.Please run these accounts separately from me rest of the household. ,formation contained In this meant is supplied by Evaluation Services Inc.Evaluation Services Inc Is not aRillated with Merrill Lynch and Merrill Lynch Is not responsible or the information presented,We believe this formation is accurate,but accuracy and completeness are not guaranteed. westmem products provided are Merrill Lynch,Pierce,Fenner&Smith Incorporated: Ire Not FDIC Insured lAre Not Bank or State Guaranteed Msy Los9 Value small Lynch,Pleme,Ferrer&Seen Incorporated Is a wholly owned subsidiary of Bank of Aneric r Corporation,and a registered broker dealer and member of FINRA and SHOO. lentil Lynch,Pierce,Fenner&Smith Incorporated Is not a but or legal advisor.Clients should consuR a personal tax or legal advisor before making tax or Mgat related inveremerd decisions. othing discussed or suggested In these materials should be construed as permission to supersede or circumvent any Ben%of America or Merrill Lynch,Pierce,Fenner&Smith Incorporated *holes,procedures,rules,and guldelines. 2 • REV-1511£X+ (e8-13) Q7pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Charles A. DeLone, Jr. Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Parthemore Funeral Nome 6,51800 2 Reception for Decedent 9,245.00 B. ADMINISTRATIVE COSTS: t. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State_ZIP Year(s)Commission Paid: Z. Attorney Fees: 31 Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City--- ZIP Relationship of Claimant to Decedent 4. Probate fees: S. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9,Recapitulation) $ 15,763.00 If more space is needed,use additional sheets of paper of the same size.