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Home My WebLink About11-06-14 (2) —� REV-1500 Ex(02-11) . 1505610143 PA Department of Revenue OFFICIAL USE ONLY p pe MENTOF ania SUPPLEMENTAL County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po BOx.280601 INHERITANCE TAX RETURN 21 05 0930 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 03 13 2005 11 22 1930 Decedent's Last Name Suffix Decedent's First Name MI COSTELLO JOANNE C (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 ❑ 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) ❑ g Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ® 9. Litigation Proceeds Received ❑ 1 o.Spousal Poverty Credit(Date of Death ❑ 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 U DIRECTED TO: Name Daytime Tele@_Ione NumbeE DONALD L REIHART 717 7527997 rxi Co 'C) G'3 CJ REGISTEf2-OF WILLS USE ONLY t t 4 I CJS r-rl 7 Cn r7 C7 First Line of Address °~ q 3015 EASTERN BOULEVARD Second Line of Address __i rV r�- I--� Gn tV City or Post Office State ZIP Code DATE FILED YORK PA 17402 Correspondent's e-mail address: ef'nail@reihartlaw.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 informatio f which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE 4950 Janelle Dr _, Harrisburg, PA, ,-William Costello /) -3 haul ADDRESS 2352 State Street, Harrisburg, PA 17103 Kathleen Fouse' SIG iz�z PARER OTHER THAN PRES TATIVE DATE r " Donald L Reihart f 3 fo ADDRESS Law Office of Donald L Reihart 3015 Eastern Boulevard,York, PA 17402 Side 1 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: COSTELLO, JOANNE C. 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 3 , 500 . 00 p p rty(Schedule E)................ 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 3 , 500 . 00 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 817 . 50 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 11. Total Deductions(total Lines 9 and 10).................................................................. 11. 817 . 50 12. Net Value of Estate(Line 8 minus Line 11).............................................................. 12. 2 , 682 . 50 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. 2 , 682 . 50 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 2 , 682 . 50 16. 120 . 71 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE................................................................................................................... 19. 120 . 71 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 1505610243 1505610243 J ti REV-1500 EX Page 3 File Number 21 - 05 - 0930 Decedent's Complete Address: DECEDENT'S NAME Costello, Joanne C. STREET ADDRESS 3015 Eastern Blvd. CITY STATE ZIP York PA 17402 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 120.71 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) 120.71 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;................................................................................ ransferred:................................................................................ H x b. retain the right to designate who shall use the property transferred or its income:.................................... x c. retain a reversionary interest;or.................................................................................................................. x d. receive the promise for life of either payments,benefits or care?.............................................................. ❑x 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?......... ❑ Qx 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,w§ether by bloo�or adoption. pennsylvania SCHEDULE E DEPARTMENT OFCASH BANK DEPOSITS AND MISC. INHERITANCE TAXAXRETURN � RESIDENT DECEDENT PERSONAL PROPERTY Y FILE NUMBER ESTATE OF Costello, Joanne C. 21 -05-0930 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Proceeds from Settlement Facility- DCT, received September 2014 2,500.00 2 Proceeds from Settlement Facility- DCT, received September 2014 1,000.00 TOTAL(Also enter on Line 5, Recapitulation) 3,500.00 REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE MNUZALE PES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS S ESTATE OF Costello, Joanne C. FILE NUMBER21 -05-0930 Decedent's debts must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Donald L. Reihart, Esquire, Attorney fee ($225 on 787.50 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's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 8 Register of Wills, fee for filing Inventory 15.00 See attached 15.00 TOTAL(Also enter on line 9, Recapitulation) 817.50 Schedule H COMMONWEALTH OF PENNSYLVANIA Funeral Expenses& INHERITANCE TAX RETURN AdminiistraM Costs continued RESIDENT DECEDENT ESTATE OF Costello, Joanne C. FILE NUMBER 21 -05-0930 9 Register of Wills, fee for filing inheritance tax return 15.00 Page 2 of Schedule H REV-1513 EX*(01-10) t j pennsylvaniSCHEDULE J �{ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Costello, Joanne C. FILE NUMBER 21 -05-0930 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)) 1 William Costello Stepchild 1/7 of remainder 4950 Janelle Drive Harrisburg, PA 17112 2 Kathleen Fouse Daughter 1/7 of remainder 2352 State Street Harrisburg, PA 17103 3 Josephine Salinger Stepchild 1/7 of remainder 3803 Crooked Hill Road Harrisburg, PA 17112 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV-1613 EX+(01-10) I-Ipennsylvania 7 DEPARTMENT OF REVENUE SCHEDULE INHERITANCE TAX RETURN BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF Costello, Joanne C. FILE NUMBER 1 21 -05-0930 RELATIONSHIP TO SHARE OF ESFA-TE ' AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) RECEIVING PROPERTY Do Not List Trustees) ($$$) TAXABLE DISTRIBUTIONS distributions, outright spousal and transfers under See.9116(a)(1.2)] 4 Joseph Costello, Jr. Stepchild 1/7 of remainder 7616 Patterson Drive Harrisburg, PA 17112 5 Scott J. Fisher Son 1/7 of remainder 2295 Rosstown Road Wellsville, PA 17365 6 Randy Fisher Son 1/7 of remainder 2995 Rosstown Road Wellsville, PA 17365 7 Floyd Costello Stepchild 1/7 of remainder 1023 Walnut St. Lemoyne, PA 17043 Page 2 of Schedule J