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Home My WebLink About08-28-14 J REV-1500 1505610143 EX��2-,,, �"t PA De artment of Revenue � OFFICIAL USE ONLY P pennsylvania cou�ry coao vear File Number Bureau of Individuai Taxes OEPAATMENTOfREVEHt1E � PO BOX.280601 INHERITANCE TAX RETURN �( I� O v O Harrisburg,PA 1712s-o6o1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth O1 O1 2014 06 07 1947 DecedenYs Last Name Suffix DecedenYs First Name MI EVANS MARGARET P (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Su�x Spouse's First Name MI BERMAN ARNOLD J 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 (dale of death after 12-12•82) � g, Decedenl Dled Testete � 7. oecedent Meintalned a Llvinp Trust �___ 8. Total Number of Safe Deposit Boxes (Attech Copy of WIII) (Attach Copy of Trust) � 9. Litigation Proceeds Received ❑ ��'between P2-31 91�ndti Da95j f Death ❑ ��'�Att ch Sch dule O)Sec.9113(A) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORIIAATION SHOULD BE DIRECTED TO: Name Daytime Tele ,�ione Number�,� HAMILTON C DAVIS ESQUIRE 717 5��5713.,.''--'�� REGISTEf�k'�'�AlIG�6 U3E7DNLY�` � �� N ,� First Line of Address '° �'? '�' � :.�� 20 EAST BURD STREET SUI �� ;� 7 � =� .: �:_.. ,�.. Second Line of Address �.:� � � rn PO BOX 4O f.3DATEFILE�—+ � � `�1 City or Post Office State ZIp Code SHIPPENSBURG PA 17257 Correspondent'se-mailaddress: hdavis@zullinger-davis.COm Under pen ties of erjury,I declare that xg examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is tru rrect an complete.De au-efpreparer other than the personal representative is based on all information of which preparer has any knowledge. SIG TURE OF ER N RESPO BLE R FILING RETURN DA — rnold J. Berman ti � ADDRESS 202 East King Street, Shippensburg, PA 17257 SIGNAT F PREPARER OTHER THAN R PRESENTATIVE DATE • � Hamilton C Davis Esquire 2 '7 t ADDRES Zullinger-Davis, P.C. 20 East Burd Street, Suite 6, Shippensburg, PA 17257 Side 1 � 150561�143 1505610143 J � _ _ _ � 15�5610243 REV-1500 EX DecedenYs Social Security Number oe�ae�rsNema: EVANS, MARGARET P 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. MoRgages&Notes Receivabie(Schedule D).......................................................... 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 0 . 0 0 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested............. 7. 2 7 7 , 6 7 8 . 9 8 8. Total Gross Assets(total Lines 1 through 7).......................................................... g. 2 7 7 , 6 7 8 . 9 8 9. Funerai Expenses and Administrative Costs(Schedule H)..................................... 9. 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 11. Total Deductions(total Lines 9 and 10).................................................................. ��, 0 . 0 0 12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 2 7 7 , 6 7 8 . 9 8 13. Charitabie 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. 2 � � r 6� 8 • 9 8 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 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X ,12 2 7 7 , 6 7 8 . 9 8 �� 3 3 , 3 2 1 . 4 8 18. Amount of Line 14 taxable at collateral rate X .15 �8• 19. TAXDUE................................................................................................................... 19. 33 � 321 . 4$ 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 Decedent's Complete Address: Evans, Margaret P STREET ADDRESS 202 East King Street --- _ - - - - - CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,l.ine 19) (1) 33,321.48 2. Credits/Payments A• Prior Payments B. Discount Total Credits(A +B) (2) 0.00 3. Interest (3) 0.00 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) 3 3,3 21 .4 8 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 properry transferred or its income:.................................... � � c. retain a reversionary interest;or.................................................................................................................. ❑ ❑ 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?...................................................................................................................... ❑x ❑ 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 refurn 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)j. •The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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•1609 EX+(Ot-10) `�f,�� penn$yOVanEC�E SCHEDULE F INHERITANCETAXRETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF Evans, Margaret P FILE NUMBER If an asset was made joint within one year of the decedenYs date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT Arnold J. Berman 202 East King Street Husband q Shippensburg, PA 17257 JOINTLY OWNED PROPERTY: LETTER DATE � ��SCRlPTlO�C�F PRO�ERTY �%OF DATE OF DEATH ITEM FOR JOINT MADE Include name o mancial ins i u ion an bank account numbe DATE OF DEATH VALUE OF NUMBER� TENANT JOINT ;or similar identifying number.Attach deed forjointly-held real VALUE OF ASSET �INT REST DECEDENT'S INTEREST estate. 1 A various Decedent and her spouse, Arnold J. Berman, o.o0 50% 0.00 owned their home (situated at the above address) and resided together therein, as tenants by the entirety. The contents of the home; various tangible and intangible personal property; various financial assets were held by the spouses as tenants by the entirities or by beneficiary designation or the like and all of those but for those listed on Schedule G, passed at the Decedents death to her said spouse and are non-taxable and non-reportable but are listed here for purposes of explanation and/or documentation. TOTAL(Also enter on line 6, Recapitulation) 0.00 REV•1610 EX+(08�09) �] ]?�� pennsylvania ��\�r DEPARTMENTOFREVENUE SCHEDULE G �'�� INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN RESIDENTDECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Evans, Margaret P FILE NUMBER - _ - --- - -- -- -- - -- _- This schedule must be completed and flled if the answer to any of questfons 1 through 4 on page 2 is yes. ITEM DESCRIPTION OP PROPERTY DATE OF DEATH %�F EXCWSION TAXABLE VALUE NUMBER InGude the name of lhe trensfaree,fheir ralationship to decedent • VALUE OF ASSET � DECD'S �IF APPLICABLE) and tha date of trensfer. Attach e copy of lhe deed for real estete. INTEREST -- — ------- -- -- ------------ ---- ---- ----- ----- --- — --- --- - -- - 1 ', Decedent had, by Beneficiary Designation, arranged 277.678�98 '� 277,678.98 ' for the passage at her death of the assets shown on ! ! the attachment. ; � , i � �, i I ! I I�, I I ; � � i � TOTAL(Also enter on line 7, Recapitulation) 277,678.98 _ _ _ _ _ REV-161J EX+(01-10) � pennsylvania SCHEDULE J �� DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Evans, Margaret P FILE NUMBER RELATIONSHIP TO i SHARE OF ESTATE 'AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT ' (Words) (5$$) RECEIVING PROPERTY �o Not ust 7rustae(s) � -- - -- -� - - - -- ------- ---- - � -- _ _—-- i - - ---- - - - - - - I� �TAXABLE DISTRIBUTIONS[include outright spousal I i distributions and transfers � under Sec.�116(a)(1.2)] � 1 Eileen Patsos Taylor Sister ' 297 Botcher Road � Newark, NY 14513 � i � i 2 Christine Patsos i Sister 133 Westbrook Hills Drive i Syracuse, NY 13214 i 3 Nancy Patso$ i Sister 179 E. 3rd St., Apt. 5 � New York, NY 10009 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II� NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DiSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 _ _ _ _ _ _ _ _ REV•1613 EX+(01•10) �`�.� pe nnsyl�vanEa E SCHEDULE J INHERITANCETAXRETURN BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF Evans, Margaret P FILE NUMBER - , - - RELATIONSHIP TO i SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT ; (Words) (�$$) RECEIVING PROPER?Y oo Not ust Trustee(s) + - � -------- - - - - - -- . -- - -- I� �TAXABLE DISTRIBUTIONS[include outright spousal � distributions and transfers ; I under Sec.�116(a)(1.2)] i 4 i� Catherine Patsos Sister i ' 105 Bennett Avenue 12B ', New York, NY 10033 ' � � � � ; 5 James Patsos � Brother 214 NYS Rt. 414 � New York, NY 13165 6 Stephen Patsos I Brother 57 Stevenson St. #15 ! Seneca Falls, NY 13148 7 Daniel Patsos Brother 17 Fitch Street Walton, NY 13856 8 Mark Patsos Brother 3934 11th Ave. North St. Petersburg, FL 33713 9 Henrietta Griffiths Niece (daughter of 1575 Overhill Street deceased sister) Yorktown Heights, NY 10598 I i � Page 2 of Schedule J _ _ _ _ . _ _ _ Estate of Evans, Margaret P. File Number Attachment to Schedule G Assets Passed by Beneficiary Designation Beneficiary SSN# Address Taxable Value Eileen Patsos Taylor(sister) xxx-xx-6104 297 Botcher Rd Newark NY 14513 $30,853.22 Christine Patsos(sister) xxx-xx-2938 133 Westbrook Hilis Dr.Syracuse NY 13215 $30,853.22 Nancy Patsos(sister) xxx-xx-6293 179 E. 3`d St.Apt.5 New York, NY 1009 $30,853.22 Catherine Patsos(sister) xxx-xx-5545 105 Bennett Ave. 12B New York, NY 10033 $30,853.22 James Patsos(brother) xxx-xx-6016 214 NYS Rt.414 New York, NY 13165 $30,853.22 Stephen Patsos(brother) xxx-xx-6020 57 Stevenson St.#15 Seneca Falls, NY 13148 $30,853.22 Daniel Patsos(brother) xxx-xx-6339 17 Fitch St.Walton, NY 13856 $30,853.22 Mark Patsos(brother) xxx-xx-9832 3934 11`h Ave. N.St. Petersburg, FL 33713 $30,853.22 Henrietta Griffiths xxx-xx-2363 1575 Overhill St.Yorktown Heights NY 10598 $30,853.22 (Niece)(Daughter of deceased sister Carolyn Patsos Griffiths) Total $277,678.98