HomeMy WebLinkAbout01-15-15 1505610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
p DEPARTMENT OF REVENUE
Bureau of Individual Taxes INHERITANCE TAX RETURN ( (\
PO BOX 280601 1 l J
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12302009 04041948
Decedent's Last Name Suffix Decedent's First Name MI
HARBILAS TIMOTHY
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
HARBILAS LISA
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
QX 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Prior to 12-13-82)
Q 4. Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 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
JOHN C HARBILAS 717 238 5353
r_v
Kt9bISTER OF W(U:fi USE-,@N
O _ M C')
O
First Line of Address r^t 7-r- c7 ink
I— I'_" M
6W'M� �
33 NORTH SECOND STREE
Second Line of Address
l r
City or Post Office State ZIP Code DATE D
HARRISBURG PA 17101 rn
Correspondent's e-mail address: J H A R B I L A S a@ A O L . C O M
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 tru rrect and com fete.De ration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN U E OF PERSON ES O SIBLE FTURN DAT
A D ESS
NORTH SE OND STREET, HARRISBURG,PA 17101
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105
� t
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: TIMOTHY HARBILAS
RECAPITULATION
1. Real Estate(Schedule A) . . . . .. .. . . . . . . . . . . . .. . . . . . . . . . . .. . . . . .. . . . 1. 203457 . 00
2. Stocks and Bonds(Schedule B). . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . ... 2. 0 . 00
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). . . 3. 0 . 00
4. Mortgages and Notes Receivable(Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . 4. 0 . 00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . 5. 0 . 00
6. Jointly Owned Property(Schedule F) =Separate Billing Requested. . . .. . . 6. 0 • 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) =Separate Billing Requested . . . . . . . 7, 0 . 00
8. Total Gross Assets(total Lines 1 through 7). . . . . . . . . . . . . . . . . . . . . . . . . . 8. 203457 . 00
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . . . . . 9. 12359 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . . .. . . . . . . .10. 5366 . 0 0
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 17725 . 00
12. Net Value of Estate(Line 8 minus Line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . .12. 185732 . 00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . . . . . . . 13. 0 . 00
14. Net Value Subject to Tax(Line 12 minus Line 13). . . . . . . . . . . . . . . . . . . . . . 14. 185732 . 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 0 107866 . 00 15, 0 . 00
16. Amount of Line 14 taxable
at lineal rate X 45 77866 . 00 16. 3503 . 97
17. Amount of Line 14
taxable at sibling rate X . 12 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X . 15 18. 01. 00
19. TAX DUE. . . . . . . . . . . . .. . . . . . . . . . .. . .. . . .. . . . . . .. .. . . . . . . . . .. . . . . . 19. 3503 . 97
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
1505610205 1505610205
4
REV-1500 EX(FI) Page 3 File Number 187-44-8496
Decedent's Complete Address: 2010-00021
DECEDENT'S NAME
TIMOTHY HARBILAS
STREET ADDRESS
468 RUPLEY RD
CITY STATE ZIP
CAMP HILL PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3503.97
2. Credits/Payments
A. Prior Payments
B.Discount
Total Credits(A+B) (2) 0.00
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in box on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3503.97
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......................................................................................... ❑ Q
b. retain the right to designate who shall use the property transferred or its income............................................ ❑ X❑
c. retain a reversionary interest............................................................................................................................. ❑ X❑
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ FX
_J
If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................................ ❑ X❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............. ❑ X❑
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 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 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-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
TIMOTHY HARBILAS 2010-00021
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
1. 803 NORTH SECOND STREET, HARRISBURG 170,457.00
2. 213 FORSTER STREET, HARRISBURG, 33,000.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 203,457.00
If more space is needed,use additional sheets of paper of the same size.
y `
i � TatMaNTy�, ,.
re i OMS Approval No,2502-025521
0
r
R A. Settlement Statement (HUD-1)
4�rN deN@�
B. Type of Loan
1.Q FHA 2.[]RHS 3.QX Conv.linins. 0. File Number: 7. Loan Number: 8, Mortgage Insurance Case Number.
4.Q VA 5.Q Conv.Ins. 20731200f 1A5 4179650
C. Note: This form is hrmished to g(e you a statement of aohral settlement costs. Amounts paid to and by the settlement agent are Mown.
Nems marked llp.a.cj'ware paid outside ft closing,they are shown here for informational purposes and are not included in the totals.
D. Name and Address of Borrower. E. Name and Address of Seller: F. Name and Address of Lender.
Jahn C.HarbilasAdminIstrator Metro Bank
McClellan Development Group 3801 Paxton Street
2918 Glenwood Drive 33 North Second Street Harrisburg,PA 17111
Camp Hill,PA 17011 Harrisburg,PA 17101
G. Property Location: H. Settlement Agent: 1. Settlement Date:
803 North Second St Academy Settlements.LLC
Harrisburg,PA 17102 1104 Femwood Avenue,Suite 302 January 10,2014
Dauphin County,Pennsylvania Camp HETI,PA 17011 Ph. (717)695-9521
Place of Settlement
1104 Femwood Avenue,Suite 302
Camp Hill,PA 17011
J. Summary of Borrower's transaction K. Summary of Seller's transaction
100. Gross Amount Due from Borrower. __ 400. Gross Amount Due to Sealer:
101. Contract sales price 20Q000.00 401. Contract sales rice � � 200,000.00
02_ Personal property 402. Personal property
103. Sedement Charges to Borrower{Line 1400) 5,829.50 403.
Cd a04.
�{ 405.
Adjustments for items paid by Seiler In advance 4d ustmenis for tams paid by Sellar in advance
6. 01110/14 to 01101/15 2,602.91 4136, T11.0114 to 01/`01/15 2,602.91
'07. Ccur.tyTaxes 01110/14 to OV01115 j 948.78 407.County Taxes 01110114 to 01/01115 948.78
108. School Taxes 01710/14 to 07/01/14 1,765.57 408,School Taxes 01110/14 to 07/01/14 1,76557
109. 409.
10.
410.
411. ^__
112. _ 412
120. Gross Amount Due from Borrower 211,146.76 420.Gross Amount Due to Seller 205.317.26
200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due Seller:
201. Denosit cur earnest mons 3,000.00 501. Excess deposit see.nstruc ons
7
202. Pn:;doa:amount of rew'oan!s} 40,000.00 502. Settlement charces to Se!ler(Line 1400) 34.657.09
203. Extstin loans taken subject to r _
8_-- _.-. h__. Existing loans taxpn sutlect to
204. ._....._._. .�.. �...._
_ Pa}rott first Mortge;,e T
205' 505.Pa"off
Second Mun a e
206. 506.
208, 507. ue osit also.as rocceds} _
209.08. t 1 Rer.;for Jan 203.23 508. t 1 Rent for Jan 203.23
_
_ 3139.
Ad tLtments for items unpaid It SellerAd ustments for itoms un aid b Seller
210. _ to 510. to
211.County Taxes to 611.Coun Taxes to
212. School Taxes to 512.School Taxes to
213. 513.
214. _ 514
215. 515,
216. 516.
217. 517.
218, 518._
219. 519
220. Total Paid by/for Borrower
I 143,203.23 520. Total Reduction Amount Due Seller 34,860,32
300_Cash at Settlement fromtto Borrower 600. Cash at settlement tolfrom Setter
301. Gross amount sue trom Borrower lino 120 21?,146.76 601. Gross amount due to Seller(line 420) 205,317.26
342. Less amount paid by/for Borrower(line 220) ( 143,203.23 602. Less reductions due Seller(line 520) E( 34,860.32
303. Cash [ Pram ❑ To Borrower 67,943.53 1603, Cash ❑X To From Seller 170,456.94
'Paid outs4e of dosing by Dorm-,(a),saliar(S),tenoaf(Lj,w itcd-pamr(T)
The undersigned hereby ack wie a re�ceeit of�a completed copy of this statement&any attach me ferrel t heroin
Borrower --- soAor L�
M lellan Development Groupe John C.Ha aS."mm'soetor
TO THE BEST OF MY KNOWLEDGE,THE HUD-!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.
Academy Settlements.U.C, riement Agent
WARNING; IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION
CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S.CODE SECTION 1001&SECTION 1010.
The Public Reporting Burden for this cdtadion of Inromktion is estimated at 35 minks per mpona for coat bnp,mriaoing,and repdning the data.This agency may not copes thts infortnadon,end you are not required b
mmokte INS foon,unless t disotays a currently vaid OMB conbdi nuM>er.No=fklendality Is assured;this drsdosure is mendOxy.This is designed to provide the parties to a RESPA covered tra atoliort wM hkren"M
during the sodteMent pros
Page 1 of 3 HUD-1
(2013120011AS.PFD/2013120011ASf f 8)
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERRESIDENT
DECEAX DENT
ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
TIMOTHY HARBILAS 2010-00021
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. NEILL FUNERAL HOME 11,599.00
2. ADVERSTIZEMENT, ADMONSSTRATIVE EXPENSES 760.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
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:
5. Accountant Fees:
6. Tax Return PreparerFees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 12,359.00
If more space is needed,use additional sheets of paper of the same size.
t1
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN
RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
TIMOTHY HARBILAS 2010-00021
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.
PROPERTY TAX 5,366.00
TOTAL(Also enter on Line 10,Recapitulation) $ 5,366.00
If more space is needed,insert additional sheets of the same size.
John C Herbilas
33 North Second Streets
Harrisburg, Pa 17101
Phone: 717 238 5353
January 15, 2014
Register of Wills
Cumberland County, Pa
rz C �� ` r•�t cf f G� ��C*—V E� �Cc�—�� j�
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y
The reason for the late payment and filing is that the only assets in the Estate were Real
Estate.
The Real Estate was placed for sale right after death. The apartment building was in
disrepair and only 30% occupied.
1. Apartment building, 803 North Second Street, Harrisburg was sold in January, 2014.
It took four years for the transaction. Settlement papers are attached.
2. 213 Forster Street, Harrisburg is small parking lot. That has a net income of about
$2,000.00 per year. There were no buyers for the lot and it was decided that the
beneficiaries would keep it, And settle the Estate.
For the above reason I hope that the penalties will be forgiven.
hank you
John Herbilas