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HomeMy WebLinkAbout02-05-15 REV-1500 EX(01-10) fill 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60x.280601 INHERITANCE TAX RETURN 21 14 0502 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 03 26 2014 04 23 1984 Decedent's Last Name Suffix Decedent's First Name MI DEMARCO CHRISTOPHER R (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 0 1. Original Return FJ 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) 8 Decedent Died Testate 7• cedentMaintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) Copy of Trust) 9. Litigation Proceeds Received 1D,Spousal Povert Creditl(date of death 11,Election to tax under Sec.9113(A) between 12-311 and -1-95) (Attach Sch.0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRADLEY L GRIFFIE 717 243 5551 REGISTE@F WILLS UMONL;Yj o _ r-1-) zl_ 47) First line of address (.Z r_1 111 f j tX C,7 200 N HANOVER STREET .� --- —a . ,' Cr7 r ' 70 Second line of address r.., CD _ t City or Post Office State ZIP Code �DATF FILEDrh �..,i I. CARLI SLE PA 17 013 C� Correspondent's e-mail address: bgriffie@griffielaw.com Under enalties 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 ,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT OF P R ON RES IBLE FOR FILING RETURN DATE Beth A. DeMarco L ADDRESS 87 South Side Drive, Newville, PA 17241 SIGU PREPARER OTHER THAN REPRESENTATIVE DATE Bradley L. Griffie —a7-,90/J RES 20 orth Hanover St., Carlisle, PA Side 1 1505610143 1505610143 'W"1 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: DeMarCo, Christopher R. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 31 , 634 . 73 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(Schedule E)............... 5. 3 , 879. 12 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Iraq Probate Property (Schedule G) u Separate Billing Requested............ 7, 8. Total Gross Assets(total Lines 1-7)..................................................................... 8. 35 , 513 . 85 9. Funeral Expenses&Administrative Costs(Schedule H)....................................... 9. 33 , 003 . 94 10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1).............................. 10. 2 , 884 00 11. Total Deductions(total Lines 9&10)................................................................... 11. 35 , 887 94 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -374 . 09 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. -374 . 09 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. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 0 . 00 16. 0 . 00 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. Tax Due.................................................................................................................. 19. 0 . 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-14-0502 Decedent's Complete Address: DECEDENT'S NAME DeMarco, Christopher R. STREET ADDRESS 220 Creekwood Drive CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 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. (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) 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;............................................................................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;.................................. .❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ 0 d. receive the promise for life of either payments,benefits or care?.........:.................................................. ❑ ❑x 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?................................................................................... ............................... ❑ ❑x 3. Did decedent own an"intrust 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?...............:..................................................:............................................... ❑ Eil 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 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 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. i Rev-1503 EX+(6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DeMarco, Christopher R. 21-14-0502 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 TD Ameritrade - 31,634.73 Account No. Ending 7719 (See attached statement) TOTAL(Also enter on Line 2, Recapitulation) 31,634.73 (If more space is needed,additional pages of the same size) Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.6-98) Rev-1508 EX+(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF [FILE NUMBER DeMarco, Christopher R. 21-14-0502 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Horizon Blue Cross Refund 679.12 2 Personal Property 3,200.00 TOTAL(Also enter on Line 5, Recapitulation) 3,879.12 (If more space is needed,additional pages of the same size) Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.6-98) REV-1151 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INRESIDENTD CE TAX ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER DeMarco, Christopher R. 21-14-0502 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 19,353.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Beth A. DeMarco Street Address 87 South Side Drive City Newville State PA zio 17241 Year(s)Commission paid 2015 1,000.00 2. Attorney's Fees Griffie &Associates, P.C. 3,000.00 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 288.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 9,362.44 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 33,003.94 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER DeMarco,Christopher R. 21-14-0502 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Funeral Expenses 14,285.00 2 Memorial Service and Wake 4,800.00 3 Memorial in New York 268.00 H-A 19,353.00 Other Administrative Costs 4 The Sentinel (Advertising) \ 169.30 5 Cumberland Law Journal(Advertising) 75.00 6 Moving and packing personal property from New York City to Camp Hill,'PA 3,187.00 7 Storage of personal property 3,248.00 8 Expenses to Retrieve Son's Body from Colorado 2,183.14 9 Reserves 500.00 H-B7 9,362.44 Copyright(c)2002 form software only The Lackner Group, Inc: Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DeMarco, Christopher R. 21-14-0502 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 State and Federal Tax Return for 2013 534.00 2 April Rent for New York City Apartment 2,350.00 TOTAL(Also enter on Line 10, Recapitulation) 2,884.00 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+111-08) *M SCHEDULE J COMMONWEALTHT PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DeMarco, Christopher R. 21-14-0502 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT Do Not List Trustees (Words) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Beth A. DeMarco Mother Fifty percent of 87 South Side Drive net distributable Newville, PA 17241 estate John P. DeMarco,Jr. Father Fifty percent of 220 Creekwood Drive net distributable Camp Hill, PA 17011 estate. Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as CIPPI o riate. NON-TAXABLE DISTRIBUTIONS: II. 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 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 11-08) Attachment to Schedule "B Ameritrade June 3, 2014 Bradley L Griffie Griffie&Associates 200 North Hanover Street Carlisle, NY 17013 Re:Your Request for an Account Valuation Dear Bradley L Griffie, Please accept my sincere sympathies on your loss.We are here to help in any way we can, so please don't hesitate to let us know if there is anything we can do. Here is the account valuation you requested.As of March 26,2014,the valuation for the TD Ameritrade account ending in 7719 was$31,634.73.We've enclosed a spreadsheet listing the value of the different positions in the account. Please keep this letter and the spreadsheet for your records. If we can be of any further assistance,please let us know.Just log in to your account and go to the Message.Center to write us.You can also call Client Services at 800-669-3900.We're available 24 hours a day,seven days a week. Sincerely, Alan Davidson Resource Specialist TD Ameritrade This information is furnished as part of a general information service and TD Ameritrade shall not be liable for any damages arising out of any inaccuracy in the information.Because this information may differ from your TD Ameritrade monthly statement,you should rely only on the TD Ameritrade monthly statement as the official record of your TD Ameritrade account. Market volatility,volume,and system availability may delay account access and trade executions. TD Ameritrade,Inc.,member FINRA/SIPC/NFA(mmWinra.org,www.sioc.oro,www.nfa.futures.oral*TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company,Inc.and The Toronto-Dominion Bank.©2013 TD Ameritrade IP Company,Inc.All rights reserved.Used with permission. TDA 1727 L 09/13 200 South 1 Oe Ave, Omaha,NE 68154 WWW.tdamerltrade.COm t DATE OF DEATH VALUATION for:Chris Ryan Demarco Account Number(last 4 digits): 7719 Account Title: Chris Ryan Demarco Date of Death: 3/26/2014 Business Day Used: 3/26/2014 Date of Death Date of Death Date of Death Quantity Security Name Symbol High Price Low Price Average Value ASI (20,815.77) Cash $0.00 $0.00 ($20,815.77) TOTAL CASH&CASH EQUIVALENTS ($20,815.77) 1FUNDS 10000 TaxuCardium Pharmaceuticals Group Inc. CRXM $0.66 $0.62 $6,400.00 5,000 Claude Resources,Inc. CLGRF $0.19 $0.18 $925.00 1,000 Doral Financial Corporation DRL $10.40 $9.24 $9,820.00 2,000 Empresa Distribuidora y Comercializadora Norte S.A. EDN $6.57 $6.33 $12,900.00 6,000 LDK Solar Co.,Ltd. LDKSY $1.01 $1.01 $6,060.00 100 Lockheed Martin Corporation LMT $162.09 $159.62 $16,085.50 2,000 Viscount Systems Inc. VSYS $0.14 $0.12 $260.00 **no quote available-used statement TOTAL STOCKS $52,450.50 FIXED INCOiNIE $0.00 $0.00 $0.00 TOTAL FIXED INCOME SECURITIES $0.00 TOTAL DATE OF DEATH VALUE : $31,634.73 This information is furnished as part of a general information service and TD Ameritrade shall not be liable for any damages arising out of any inaccuracy in the information. Because this information may differ from your TD Ameritrade monthly statement,you should rely on the TD Ameritrade monthly statement as the official record of your TD Ameritrade account.