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Home My WebLink About05-20-14 �,. � ..,_ ��,.�.._��,�.��. �,� x�.. , . � 1505610105 REV-1500 EX�o�_��,�Ft,.�: OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes °`"p'`"�`p`�`��` County Code Year File Number Po Box zso6oi INHERITANCE TAX RETURN 2 p1�7 � Harrisburg PA i'7i28-o6oi RESIDENT DECEDENT � I J L ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ' 05/08/2013 06/13/1925 DecedenYs Last Name Suffix DecedenYs First Name MI SCALIA ROBERT (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Su�x 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 O 1. Original Return � 2.Supplemental Return O 3. Remainder Return(Date of Death Priorto 12-13-82) p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 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 � ��> Edmund G. Myers c-� `�-�=' -� � �.� � _.:� � �'t REGISTE�F�IyILLS USET�LY t, � � � �Y"]� —� �") �'C ..�:1 . . First Line of Address ?"� � r�? � t ('T `;; � > � � �:w 301 Market Street - - � .�� ,,. �., t�� ., � �_, _..,..� Second Line of Address C� C> -r� � '�`t C� C: . ._.. PO Box 109 ` �-� N r- rn "IDATE FILED � City or Post Office State ZIP Code , � Qa `*1 Lemoyne PA 17043 CorrespondenYs e-mail address:egm a�jdSw.COm _ 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 OF PERSON RESPONSIBLE FOR FILING RETUR�� /�� 1�u�� DAT��/`�/p, /G'�JC J < < 6 j� ADDRESS 16 Patricia Drive, Enola, Pennsylvania 17025 SIGNATURE OF PREPARER OTHER THAN REPRESENT E �/��,/' DATE� /• �C/ // ADDRESS 301 Market Street, l.emoyne, Pennsylvania 17043 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 J _,, � �� ,�,�,.,�� ,,��.�. . , .G�..�w.�.a..�„�.�..,,,�.��.�.��,...�..��. _�,.�,�-�.�s. r, .�_..,�., .,. � 15D5610205 REV-1500 EX(FI) DecedenYs Social Security Number DecedenYs Name: ROb@ft SCaIlB 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 and Notes Receivable(Schedule D)........................... 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 838.00 6. Jointly Owned Property(Schedule F) O Separate Biiling Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets total Lines 1 throu h 7 ......... 8. 838.00 � 9 ).................... 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 65.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. 11. Total Deductions(total Lines 9 and 10)................................. 11. 65.00 12. Net Value of Estate(Line 8 minus Line 11) ................... ........... 12. 773.00 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. 773.00 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_ ' 15. ' .... .__.._.._. _....,...._ _ . _.�.... ...... . . ..... 16. Amount of Line 14 taxable at lineal rate x.0 45 773.00 �6. : 34.79 ,... _.._ _. �...... .. ., _ 17. Amount of Line 14 taxable at sibling rate X.12 ��• ' ,.._. _ .. ....._ _... 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE .................... ..................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1505610205 15�5610205 � v . . T _. �_ �.<w_ �.� �,r ,��.�R.�.,.�..� .,�� ,��„�..�,�.�.,��-�,�.,�.,��.� ,�,�. �.�,.�.�. � _ � ..� REV-1500 EX(FI) Page 3 Flle Number Decedent's Complete Address: DECEDENT'S NAME Robert Scalia _ __ _ _ __ _ _ _ ___ _ _ _ _ _ -_ _ _ __ _ STREET ADDRESS 16 Patricia Drive _ __--_ _. --___ _ I -- -- CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 34.79 2. CreditslPayments A.Prior Payments B.Discount Total Credits(A+B) (2) 3. Interest (3) 0.26 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill 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) 35.05 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.............................................................................................................................. ❑ � 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,annuiry or other non-probate properry,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 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 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 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 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. , wr.�. ,.� ,�.��,��..�: -. .� �.�.,�,�.� ,�H.. Personal Income Tax e-Services Center Page 1 of 1 Penalty and Interest Calculations CALCULATION DATES- 2/8/2014 TO 5/12/2014 TAX DEFICIENCY $ 34.79 CALCULATED INTEREST $ 0.26 BALANCE AS OF 5/12/2014 $ 35.05 Start Over https://www.doreservices.state.pa.us/pitservices/Default.aspx 5/7/2014 _ . �ri _�., �,.� ��.�, .� . .�t . T�.��..n��.�.�,�, �. ,,.� ti _, . � � .� . REV-15o8 EX+(o8-iz) � pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX REfURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert Scalia 21-13-0627 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 �, Cash received from Robert Pierce&Associates P.C, re:Armstrong World Wide Industries Supplemental Payment on Settlement Proceeds 838.00 TOTAL(Also enter on Line 5, Recapitulation) $ 838.00 If more space is needed,use additional sheets of paper of the same size. ..�..�:� ,�..�� -, . .. . ,,��,�.��,�� .�.��..� �.�..z�„�.,.� ��'� E�1�'�� .��l�t��` � � A 1 T O R N L Y S A T L A ��T 2�00 Gulf To��er e 707 Grant Street a Pittsburgh,PA 15219-1913� Telephone: (412)281-7229 • Faz: (412)281-4229 • Toll Free:1=800-543-9g5�� www.peircelew.com March 10, 2014 Robert Scalia 16 Patricia Drive Enola, PA 17025-1932 Re: Armstrong Worid Industries Trust Supplemental Payment Dear Mr. Scalia: We are plea��d �o �dvise that the Armstrong Trust is in a financial position to make an additional payment to peopl.e who previously received an Armstrong settlement payment: You qualify for an increased payment of $1455. We have deducted our fee of$582 and the unpaid costs that we have advanced which consist of either medical costs, filing fees, or services related to compliance with federal government � Medicare resolution. These costs total $35. We are pleased to enclose our check payable to you in the amount of$838. There are a number of bankruptcy trusts in the process of being created, so it probably will be at least several years before all of the potential claims are processed. Robert Peirce & Associates, P.C. does not provide tax advice. 0ur legal representation is limited to claims related to expo�ure to asbestos. Very Truly Yours, � � �ind�sey � �agzvell Lindsey K. Bagwell /Ib . Enclosure .„ �_� ,..� ,,,. �... ,�,�;� . s��,�:....,�r�. .,�� . .��.��,.�,�..�...3.�,�,�..o�,;,�,� ,� _.. . . . __.___'___.,_�.__.___________'._ _________________ '___._'�__'_._ ' "'— M _ _ , — 3762.91--, PNC Bank, N.A. ` ROBERT PEIRCE & ASSOCIATES� P,C. Pittsburgh, PA TRUS7'ACCOUNT CHECK NO. CHECK DATE 2500 GULETOWER 8-9-430 70Z GRANT STREET . : - . —, PITTSBURGH,PA 1 521 9-7 91 8 � � . . . . . �RWeNM aBUSNm . . .. .. � . a . ' 376291 ' 03/07/2014 0 FAX : CHECKAMOUNT - � _ o Eight huridred thirty-eight and NO/l OQ - _ $838.00 , B oR ER ROBERT:SCALIA ` � m OF _ _. � _ ;r .,_. , ' � �-� . ._ . . � . . _ .. -� .. . .i _i � �. �. , l �. r.- ._. . . .� r� �. ::.- .., . . . . � . . . . . � � . � _r .! � _;. . . . - - f .: ,�. �.: � . . . .. . . . . _. .. _ 7 ,' .. . . ._. � .. . . . . . . .� � � � - � � - . � - � -"� . . _ �AUTHORIZEDSIGNATURE � � � _.------------._-------'--'-----------'-------------'--�-----------`------------------ �� 3 76 29 1ii� 0a04 3000096oa 10 �0 1 5 5609ii° N �. � �,�. ��.�.� ,�, . . .�,��,� REV-1511 EX+ (08-13) � pennsylvania SCHEDULE H DEPARTMENTOfREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. e, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions; Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid; 50.00 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 Return Preparer Fees: 7, Cumberland County Register of Wills-Filing Fees 15.00 TOTAL(Also enter on Line 9, Recapitulation) $ 65.00 If more space is needed,use additional sheets of paper of the same size.