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_J 1505610105
REV-1500 EX(oW-aa)(F0
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes County Code Year File Number
PO BOX28o6o1 INHERITANCE TAX RETURN 21 13 1352
Harrisburg,PA 19128-o601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09/2712013 07/29/1930
Decedent's Last Name Suffix Decedent's First Name MI
Breslin John P
(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
Op 1.Original Return I= 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12.1342)
O 4.Limited Estate O 4a.Future Interest Compromise(date of O S. Federal Estate Tax Return Required
death after 12-12-82)
Q 6.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.)
C=) 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death C=) 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
Bridget M. Whitley, Esq. i (717)233-1000__. ._
REGISTKR WILLS f 9ON 7
im C
M n Z C!1
First Lino of Address _ rn tv m
:7
17 S. 2nd St., Floor
c _ _ C�. —n 1
Second Line of Address C'7 C> -ri 'r-
'SkariatosZonarich LLC t` . r ri
City Or Post Office State ZIP Code DATE Fit ED G)
Harrisburg PA 17101
Correspondent's e-mail address:bmw @skarlatoSZOnarich.COm
Under penalties of perjury.I declare that 1 have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and bel'u5[
It is Irue,correct and complete.Declaration of preparar other than the personal representative is based on sit information of which prepamr has any knowledge.
SIGNAT R F PER ON RES IS E R FILIN RETURN 0 TE
�,�u PO� ��'1 a�tf�,
ADDRESS
Bridget T. Breslin, 300 Ramsay Place, Apt. 204, New Cumberland, PA 17070
SIGNAT RE OF PREPARER OTHER THAN REPRESENTATIVE DATE
,�,f;,(,�-
ADDRESS
Bridget M. Whitley, Esq., 17 d 2nd St., Floor 6, Harrisburg, PA 17101.2053
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX(FI) -
_Decedent's_Social Security Number
Decedent's Na,,: John peter Breslin -- -
RECAPITULATION
1. Real Estate(Schedule A). .. .. . . . . . . .... .. . .. .. . ... . ... . .
1 0.00
2. Stocks and Bonds(Schedule B)
2. 0.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . 3 -...._�_____e__.,_y,. __...-_„_,„
4. Mortgages and Notes Receivable(Schedule D) . .. . . . .. . ... . .... . .. . 0.00
a. 0.00 ,
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . 5
6. Jointly Owned Property(Schedule F Billing q - ----- --...___ _ 0.00
7. Inter-Vivos Transfers&Miscellaneous NO robate pr Property Requested ...... 6. �
(Schedule G) ;-•------..�..._,._..,__,____ _ _ 0.00 ;
O Separate Billing Requested... . . . 7
8. Total Gross Assets(total Lines 1 through 7 0.00 8.
9. Funeral Expenses and Administrative Costs(Schedule H). . ... . 0.00
9. '
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule i) w__._.--_
.. . .... . . . ... . . 10. ------ ._..__... .
11. Total Deductions(total Lines 9 and 10). . . . .... . ... . . ... . .. .. .... . .... 11 �_�""•_.-.._„_..___,-,___ „y` wF^;�
12. Net Value of Estate(Line 8 minus Line 11) . . . ... ..
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12
an election to tax has not been made(Schedule J) ... . . ... . .... . ... . . . ... . 0 00
14. Net Value Subject to Tax(Line 12 minus Line 13) .. . . .. . . 0.00
... . ... . . ... .. . . iq.
TAX CALCULATION. ' '�...-.."._._....__. ..._.._._._._.__.,..__,..,,:
SEE INSTRUCTIONS FOR A PPLICABLE 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 15 0.00
at lineal rate X.04-5- °-°--"_-----.,�___.___,_,_,,.
17. Amount of Line 14 taxable ""`'---------.._ 0.00 16
0 00
at sibling rate X.12
18. Amount of Line 14 taxable '"°'""°"""---_------..-._.,�.__. 17, 0.00
at collateral rate X.15
_. _.. _0.00 1
19. TAX DUE... .. . .. .. ... .. . ... .. . . . . .. .. . . . . . . . . .. . .... . . ... . . .. .. . .
s. 0.00
............. ...
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
O
L side 2
1505610205
1505610205
REV-1500 EX(Fl) Page 3 Fife Number 21 13 1352
Decedent's Complete Address:
DECEDENT'S NAME
John Peter Breslin
STREET ADDRESS
46 Erford Road
Cumberland County
CITY STATE T ZIP
East Pennsboro Township w PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. CreditsiPayments
A Prior Payments
B.Discount _
Total Credits(A+B) (2)
3. Interest
{3)
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)
S. 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 pmperty transferred or its income ............................................ ❑
c. retain a reversionary interest ............................................._.._.._........._.._........_........_.._.........................
....
... ❑
d. receive the promise for lire of either payments,benefits or pre?...................................................................... ❑
2. If death occurred after Dec. 12,1982.did decedent transfer property within one year of death
without receiving adequate consideration?....................._...............................................,....................................... ❑ 0
3. Did decedent own Win 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)(1)).
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)1.
• 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•i508 EX+(o8a2)
i pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE GASH, BANK DEPOSITS & MISC.
mHOUTANCE TAX REIURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
John Peter Breslin 21-13-1352
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
'ESTATE OPENED FOR LITIGATION PURPOSES-PLEASE SUSPEND 0.00]
I
i 1 t
t
f
TOTAL(Also enter on Line 5, Recapitulation) $ !
If more space is needed,use additional sheets of paper of the same size.