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HomeMy WebLinkAbout09-29-14 (2) 15056051047 REV-1500 EX(06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Ha BOX 280601 + e' �� FoRlo (�© q{7Harrisburg,PA 17128-0601 - RESIDENT DECEDENT /_f ta[.3�_ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth L tj] W611�!987441—1 P Decedent's Last Name Suffix Decedent's First Name MI -`11 1,lL; - - [J-11 FIJI (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI �JI�+��UUU�J�����J DLJj01:100000000[0 �- - Spouse's Social Security Number li THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 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 Sch.O) CORRESPONDENT– THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name _ Daytime Telephone Number - _ _ �' - - o Irm Name I Applicable) Ilcable REGISaiR#WILLS ONI�6 C"7 G7 First line of addressi i • ` � � CU ri 1 a -� Second line of address f - -- L�'�J— L �_-J —_ J�'. 1— ' — DATE FIL Co CD City or Post Office _ _ State ZIP Code Correspondent's e-mail address: 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. SIGNATOR ON SPONSIBLE FOR QLING RETURN DATE ADDR SS 6 SIGNATURE OF PREPARER OTHER THAN REPRES TATIVE D E ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 150 '6'051047 15056051047 J 15056052048 REV-1500 EX Decedent's Social Security Number Decedent's Name: RECAPITULATION 1. Real estate(Schedule A). . . ... .. .. .... .... .. ....... ... . ..... ... .. .... 1. --J1- I�19 i J11 _'i 91 Z,I 2. Stocks and Bonds Schedule B ... .... . ... . .... ..... ... . ..... ..... .... 2. J II �_ -/•�,?.� 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . .... 3. I L J J+ � J. 4. Mortgages&Notes Receivable(Schedule D)... .. ... .. ... . ..... . .. .. ..... 4. �l JI �� - ice• 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E) ... ..... 5. 11 IDIJ•,JJ f I, 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . ..... . 6. it JjjJ �'I �;J y�L'A 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. ..... . 7• IIL ( ) .. ..... ... .. . 8. 8. Total Gross Assets total Lines 1-7 . ..... .. . .. .... ...... .. J� ��� �` .�•_�.t�� 4 9. Funeral Expenses&Administrative Costs(Schedule H)... ... .. .. .... . ..... . 9. JUL aIJ`3 .Lz CK I 10. Debts of Decedent, Mortgage Liabilities,&Liens(Schedule 1). .. .. ... .. ... . . . 10. IJ1 11. Total Deductions(total Lines 9&10).... . 12. Net Value of Estate(Line 8 minus Linp 11) .. .. ..... ..... .... ..... ... .. .. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. . ... .. .... ... .. .... ... 13. 1 11 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . .. .. . .... ... .. ..... .. 14. „ TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 --=1,-- - I ;T• '-1 (a)(1.2)X.0_ 15. f 16. Amount of Line 14 taxable I• - y - at lineal rate X.0*Y, 6 . 16. 17. Amount of Line 14 taxable at sibling rate X.12 f. r� .' 17. 18. Amount of Line 14 taxable - -at collateral rate X.15 _ ' _. �t •= "- 18. �._�h_1. _;.J �. a _,• I , 19. TAX DUE ... .. ... .... ... .. .. . ..... .... . . .. .. ..... .. .. ... ....... . .. 19. I •� i/1� 1.W-�- -- 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 15056052048 15056052048 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECED NT'S NAME �`� STREETADDRESS f1 .,Z Ll 58,,I&d Xooh CITYa�m ��'�L ^41 ��l// STATE ZIP Tax Payments and Credits: 1. Tax Due(Page 2 Line 19) (1) 2. Credits/Payments A.Spousal Poverty Credit B.Prior Payments C.Discount Total Credits(A+B+C) (2) � 3. Interest/Penalty if applicable D.Interest �•d� 6 E.Penalty Total InteresUPenalty(D+E) (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) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) A.Enter the interest on the tax due. (5A) B.Enter the total of Line 5+5A.This is the BALANCE DUE. (5B) 141-7, 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;or.......................................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration?......................................................................................................I...,... ❑ 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? ........................................................................................................................ ❑ it 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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three(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 zero (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 twenty-one 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 zero(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 four and one-half(4.5) percent, except as noted in 72 P.S.§9116(1.2)[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 twelve(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-1502 EX+(01-10) w` pennsylvania SCHEDULE A + DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: nl w C. 66-72 c�l -/'-/ -e5lt ,:;2 3 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 jointly-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 OF DEATH DESCRIPTION TOTAL(Also enter on Line 1, Recapitulation.) 1$ 35 - S r, �'2 If more space is needed,use additional sheets of paper of the same size. SETTLEMENT STATEMENT File Number C14-10382 Note.This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement Agent are shown. Items marked("P.O.0")were paid outside the closing,They are shown here for informational purposes and not included in the totals. BUYER: SELLER: FM KENNEDY HOLDINGS I LP ESTATE OF PAULINE WEBER DECEASED CASH TRANSACTION PROPERTY LOCATION: SETTLEMENT AGENT: SETTLEMENT DATE: 5 EHLE AVENUE JULY 14,2014 CORAOPOLIS,PA 15108 CLOSERS, INC.(412)249-1000 KENNEDY TOWNSHIP 101 WEST MAIN STREET,CARN_EGIE,PA 15106 DISBURSEMENT DATE: ALLEGHENY COUNTY PLACE OF SETTLEMENT: JULY 14,2014 CLOSERS,INC„101 W MAIN STREET,CARNEGIE,PA 15106 SWM,MARYIC1�BUYER,S7'RANS}�CT'ION ;;` SUMMARY.QF SE4'�R,S 7RANSAGTION,,,_ 100 GROSS AMOUNT DUE FROM BUYER 400. GROSS AMOUNT DUE TO SELLER 101, Contract sales price 45,000.00 401, Contract Sales Price 45,000.00 102. Personal property 402. Personal Property 103. Settlement charges to BUYER(line 1400) 1,432.50 403. 104. 2014115 SCHOOL TAXES P.O.C.B. 404. 105. 405. Arl�rrstmentsfortremsaaidbY:S$ilerrrradvence. ... Rt{vstmerJtsrortemspa7db;Settermadvanca MEMME 106. Local taxes 07/14/2014 to 12!3112014 99.59 406, Local Taxes 07/14/2014 to 12/3112014 99.59 107. County taxes 07/14/2014 to 12/31/2014 235,54 407. County Taxes 07/14/2014 to 12/31/2014 235.54 108. School taxes to 408. School Taxes to 109. 409, 110. 410, 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BUYER 46,767.63 420, GROSS AMOUNT DUE TO SELLER 45,335.13 24b' AMOt#1i 1S PAtD.9Y:taF{ON 09HALF{}F BUYER,... 502,.'REF}3CTiONS t3 AMOUN,T:;i7UE 201. Deposit or earnest money 500.00 501. Deposit or earnest money 500.00 202. Principal amount of new FIRST loan 502. Settlement charges to Seller(line 1400) 3,485.00 203. 1,503. 204, 504, Mortgage Payoff 205. 505. Mortgage Payoff 206. 506. 207. 507. 208, 508. INHERITANCE TAX ESCROW 2,025.00 209. 509. Adtusttiients Tor rferrt5,ilnpa7d bY'.sailer .;: ;;:; <,:�idtdsGnent&'�[ar.�terrts unpaisf by settar. :> ;;. .::: 210. Local Taxes to 510. Local Taxes to 211. County Taxes to 511. County Taxes to 212. School Taxes 07/0112014 to 0711412014 69.31 512. School Taxes 0710112014 to 0711412014 69.31 213. 513. 214. 514, 215. 515. CURRENT WATER INACTIVE 216. 516. CURRENT SEWAGE METER PULLED 217. 517, 218. 518, 219. 519, 220. TOTAL PAID BY/FOR BUYER 569.31 520. TOTAL OF SELLER'S REDUCTIONS 6,079.31 300. CASH AT SETTLEMENT FROMtTO BUYER 600. CASH AT SETTLEMENT TOtFROM SELLER 301. Gross amount due from BUYER(line 120) 46,757.63 601. Gross amount due seller(line 420) 45,335.13 302. Less amounts paid by/for BUYER(line 220) 569.31 602. Less reductions in amount due seller(line 520) 6,079.31 303. CASH FROM BUYER 46,196.32 603. CASH TO SELLER 39,255.82 To the best of my knowledge this Settlement Statement which I have prepared is a true and accurate account of the funds which were received and have been or will be disbursed by the undersigned as part of the Settlement of this transaction. Date: 07!14/2014 ✓ Settlement Agent Page 1 of 2 f; $E.T7L�MENT CFIARGES' `' y 700. Total Real Estate Broker Fees $3,050.00 PAID FROM PAID FROM Division of Commission(line 00)asfollows: BUYER'S SELLER'S 701.$1,700A0 TO LISTING AGENT RE/MAX SELECT FUNDS AT FUNDS AT 702.$1,350.00 TO SELLING AGENT 1 CHOICE REAL ESTATE SETTLEMENT SETTLEMENT 703, Commission paid at Settlement: $3,050.00 $500.00 (HM) = 2,550.00 704. 705. 60b )tarns.Pa �bte#n:Gflnr►eCt(b`t1 wrtil�.o.�n ,.. � 'h ', eo1. 802. 803, 804. 605. 806. 807, 808. 809. 810. 901. Daily interest from 07/14/2014 to 08/01/2014 $0.0000 /day x 78 902. 903. Homeowners insurance for ONE YEAR to P.O.C. (B)' 904. 905. 1001.Initial Deposit for your escrow account 1002.Homeowner's Insurance MONTHS @ PER MONTH 1003.Mortgage Insurance MONTHS @ PER MONTH 1004.County Taxes MONTHS @ PER MONTH 1oo5.Local Taxes MONTHS @ PER MONTH 1006.School Taxes MONTHS @ PER MONTH 1007. MONTHS @ PER MONTH 1006.Aggregate Ad'ustment 1f90 g . 1101.Settlement Fee to Closers,Inc. 125.00 1102.Abstract or Title Search to 1103.Attorney Fee to 1104.Processing 1 Document Preparation to Gilfillan Associates,P.C. 235.00 725.00 1105.Notary Fees to Howard T.Gi1611an 15.00 1106.Attorney Fees to 1107.Attorney Fees to 1106.Title Insurance to Closers,Inc./CTIC 597.50 1109.Lender's Coverage N/A 1110.Owner's Covera2e $45,000.00 1111.Attorney Fees to 1112. 1113. 72t)Q:,, .. sNDJRAN 1201.Recording Fees Deed $150.00 150.00 1202. 1203.Total Transfer Taxes Z00% 450.00 450.00 1204.Local/School Tax Stamps DEED(B) $225.00 DEED(S) $225.00 1205.State Tax Stamps DEED(B) $225.00 DEEDS $225.00 1300 1301.Survey DECLINED 1302.Pest Inspection DECLINED 1303.Home Warranty 1304.Municipal Lien Letter to KENNEDY TOWNSHIP 30.00 t305.Cumberland County Register of Wills 40.00 1306.Water Letter&Storm Sewer D e Test Certificate to KENNEDY TOWNSHIP 95.00 1307. 1308.Tax Certifications to ALLEGHENY COUNTY & KENNEDY TOWNSHIP 55.00 1309. �aDO TO7'At'SET7l;ESNENT.)~tiARGES :::: y .: {emerwtiite,lo3iron,iandtme`soxSepUo, 1,432.50 3485.00 CERTIFICATION I have carefulty reviewed this HUD I Settlement Statement and to the best of my knowledge and befiet,it is a true and accurate statement of all recolets and disbursements made on my account or by me in this transaction.i a9prova the same for payment and hereby authorize all disbursements hereon,i certify that ati signatures are genuine on the documents exerted in this transact• ;on and that the Consideralitm InerCtore was actual,adcauale and as slated without offset or defense.l further acknowledge receiot of a tusy executed Cagy o:this HIED I Settlement Statement. SELLER AGREES To PAY ALL FINAL WATER&SEWAGE BILLS FM KENNEDY HOLDINGS I LP (Buyer) ESTATE OF PAULINE WEBER,DECEASED (Seller) (Buyer) / (Seller) BY:1 I f - (Buyer) BY �,'! (Seller) - RUSSELL JOSEPH WEBER,AGENT {Buyer} I (Seller) Page 2 of 2 REV-1503 EX+(6-98) at SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Va-o t�1'^7�/�'L �t� -7�'Ck p► r X31 s� s He /D 7/ .-3 ?v oed-nA-L- D• �o 43033 b 29VO TOTAL(Also enter on line 2, Recapitulation) $ M J (If more space is needed,insert additional sheets of the same size) REV-15og EX+(oi-io) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE IJOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: i41 60603 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. . �ss��l LAJ c'6 LR 6L C J 9.0— v' SION E-o25 P /73// g, c r.caE-s kc)cr l Pry 15 OC C. JOINTLY OWNED PROPERTY: LEITER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. Vag C lT�2.e,v5 f�tjrc 5-0 Lfs 76 so- 7, ;�6 xa.n 10/02. CtTIZkf5 14 K, Ain /* 2`i -ZVO 0 5a 7c C67, X 2,8a- TOTAL(Also enter on Line 6, Recapitulation) $ YK. 74. If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10-09) I IN pennsytvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERrrANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER P-8 L)L-1 f 4 C- 60 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT. A. FUNERAL EXPENSES: i. AJji*fe- ifooe- 0[Z-q/34iis7 -FaL- ,PuA/M40— 7,j7 A;&vi5zairii L o m-e-a.4C In uacA - f 1,x- Pott 5&ei/i G6 JOGS, <:2 )q,j.3.9 T W eaerL I- nt",�r 3 0 rj ea,,ft- 7+cy-A ir PATI 0 Sur prcyL, AV) TO 6N L 0A I F 0/Z Fc)c)'O 012,, P—b-rPeWS Cos.7- of 6T--W-7 eno B. ADMINISTRATIVE COSTS: 1, Personal Representative Commissions: Narne(s)of Personal Representative(s) 5St--LL- W Street Address—/*6,q—. C4; belvc- city ETm t�!a S State PI—) ZIP /-73)F Year(s)Commission Paid: 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:. Curn15ee,,-Nvo e<AjN� geylsT&A cl)c Alills /7j�s-o 5. Accountant Fees: —61- 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9,Recapitulation)I$ 139�I. 92 If more space is needed,use additional sheets of paper of the same size. REV-bslz EX+(12-08) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES &LIENS RESIDENT DECEDENT ESTATE OFFILE NUMBER 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. r,V''r tt—�ZJ 1�,1 S`�:. Si✓ 11; G t �j 1 0�7.s0 Wes—i V I lr W Cita/As jL /Y. 6 0 ALS P+4 t)'z'f l cy /9 7, ?,/ 07 U u3r4 C Lr) 1' * dR•-Z J �0L-VM61 H r�S �6 Lfq to J0 TOTAL(Also enter on Line 10,Recapitulation) if more space is needed,insert additional sheets of the same size. REV-1.513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: F,P) oe>eyz RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] � � �3 Z Uj 6.3b-tZ l ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16 OF 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: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size.