HomeMy WebLinkAbout12-13-13 (2) Pennsylvania 1505610143
DEPARTMENT OF REVENUE EX(06-13)
REV-1500 OFFICIAL USE ONLY
County Code Year File Number
Bureau of Individual Taxes
PO BOX.280601 INHERITANCE TAX RETURN 21 13 0622
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 16 2013 01 22 1943
Decedent's Last Name Suffix Decedent's First Name MI
MARTINI PATRICIA A
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
MARTINI THOMAS L
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return 2. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
4. Limited Estate 4a, Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
6 Decedent Died Testate 7 Decedent Maintained Trust a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) Copy )
9. Litigation Proceeds Received 1 D. Sgou enPove1 y edit(Date f Death 11.Election to tax under Sec.9113(A)
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
DAVID W DELUCE 717 761 4540
First Line of Address
301 MARKET STREET
c > M
t� � �
Second Line of Address M C Cry
�
PO BOX 109 F—" M rn
x> (n c� °
City or Post Office State ZIP Code
LEMOY 4E PA 17043 -n C, "'
REGISTETk WILLS U$€-®NLY—= C
REGISTER OF WILLS USE ONLY "%-'I N rte--- r1
� _ DATE FILED� � C>
CIO
I Y
Correspondent's e-mail address: dwdpjdsw.com DATE FILED STAMP
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.
SIGNATURE Fr E PONSIBLE FOR RETURN DATE
Thomas L Martini
ADDRESS
—51,5-Poplar urch ad Hill PA 17011
G RE OF PR ER HA ESENTATIVE DATE
DAVID W DELUCE Z
RESS
301 Market Street, Lemoyne, PA 17043
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Martini, Patricia A
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 1 , 000 . 00
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) u Separate Billing Requested............ 7. 3 , 828 . 13
................................. s. 4 , 828 .8. Total Gross Assets(total Lines 1 through 7)....................... '
13
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 17 , 440 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 2 , 503 . 09
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 19, 943 . 09
12, Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -15 , 114 96
11 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. -15 , 114 . 96
TAX COMPUTATION-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 .00 0 . 00 15. 0 . 00
16. Amount of Line 14 taxable 0 . 00
at lineal rate X .045 0 00 16.
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18, 0 . 00
19. TAX DUE................................................................................................................ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21-13-0622
Decedent's Complete Address:
DECEDENT'S NAME
Martini, Patricia A
STREET ADDRESS
515 Poplar Church Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
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;............................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ Ox
c. retain a reversionary interest;or................................................................. ............................................. El x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ U
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.
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 January 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 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)].
• 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.
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1989 Integra --Automobile 1,000.00
TOTAL(Also enter on Line 5, Recapitulation) 1,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1510 EX+(08-09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
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 DECD'S EXCLUSION TAXABLE
NUMBER THE DATE ONAME TRANSFER SATTACt-ITA COPY OF THE DEED FOR DECEDENT
EAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Susquehanna Federal Credit Union IRA-Beneficiary: 3,828.13 3,828.13
Thomas L. Martini, Spouse
TOTAL(Also enter on Line 7, Recapitulation) 3,828.13
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN
SIDENTDECEDENTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 11,065.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees Johnson Duffie 500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4, Probate Fees 75.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 5,800.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 17,440.00
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex ep nses
1 Musselman Funeral Home&Cremation Services 11,065.00
H-A 11,065.00
Other Administrative Costs
2 Expenses re: Burial-Lot,Opening and Gravemarker 5,675.00
3 The Cumberland Law Journal -Notice of Estate Administration 75.00
4 The Guide-Notice of Estate Administration 50.00
H-67 5,800.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
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 Boscov's Credit Card 2,010.00
2 Kohl's Credit Card 493.09
TOTAL(Also enter on Line 10, Recapitulation) 2,503.09
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01-10)
pennsylvania
SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Martini, Patricia A 21-13-0622
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY o DECEDENT
e s (Words) ($$$)List
I� TAXABLE DISTRIBUTIONS (include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Thomas L Martini Spouse Entire Estate
515 Poplar Church Road
Camp Hill, PA 17011
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 01-10)