HomeMy WebLinkAbout03-27-15 J 1505610143
REV-1500 Ex`°2,,, a�
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
County Code Year File Number
Bureau of Individual Taxes DEVARTMENrOFREVENUE
Po eox.zsoso� INHERITANCE TAX RETURN 21 14 0229
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW Date of Birth
Social Security Number Date of Death
171 03 03 2014 10 10 1937
Suffix DecedenYs First Name MI
DecedenYs Last Name M
BERTOLETTE EDNA
(If Applicable)Enter Surviving Spouse's Information Below Suffix Spouse's First Name MI
Spouse's Last Name
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW ❑ 2 Supplemental Return � 3. Remainder Return(Date of Death
� �. Original Return Priorto 12-13-82)
Future Interest Compromise � 5. Federal Estate Tax Return Required
� 4. Limited Estate ❑ 4a'(date of death aRer 12-12-82)
Decedent Maintained a Living Trust _ g, Total Number of Safe Deposit Boxes
Decedent Died Testate � 7• (Attach Copy of Trust)
❑ 6� (Attach Copy of Will)
Spousal Povert Credit(Date of Death � �1.Election to tax under Sec.9113(A)
� g. Litigation Proceeds Received � �� between 12-31�1 and T-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUS7 BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIADayt me Telepho e N mbe BE DIRECTED TO:
Name 717 730 7310
MICHAEL L BANGS �, -
v-+ s'�t
RE(�T�6t OF WILJ.�_. US�b�Y
C� -,�Tj � i r3 i�J
�"r^1 ..�* C"7 ..,...� C;".;7
First Line of Address { �" r' N � Q r�
� "� —J , G:J
429 SOUTH 18TH STREET ":` ; - � ''•=a
� �i -T�
, , �.,, � _�.�
Second Line of Address t -> -T� '""
�, :.: C7
'�:' ATE FIL►E� c-- �
City or Post Office State ZIP Code rt N -s�
CAMP HILL PA 17011
CorrespondenYs e-maii aadress: m�kebangs@verizon.net
it s trueecorrect andecomplete CDecleration of preparer o�th�er than the pe�rsonalaepresentative Ss based on a�ll nformation�of whlchhpreparerfhas any knowledge.belief,
DATE'
SIG OF PERS N RE PONSIBLE FO FILING RETURN �/,� (�
Jack I. Bertolette <<� �
ADDR
1600 Hemlock Lane Dau hin . 17018 � � �
SIGNATURE OF PREPARER OTHER TH Ej>RES TATIVE
�;n` � �� � �� Michael L. Bangs
,L,.
ADDRESS�� �
429 South 18th Street, Cam Hill, PA 17011
Side 1 �
� 15D5610143 1505610143
�
� 1505610243
REV-1500 EX DecedenYs Social Security Number
DecedenYs Name: BeC�OI@�@� Edna M. 171 2 8 512 6
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................
� � . 0�
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(Schedule E)............... 5.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous�on;Probate Property
(Schedule G) U Separate Billing Requested............ 7.
g, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 0 . �0
. . 500 . 00
9. Funeral Expenses and Admmistrative Costs(Schedule H).................................... 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ ��. 500 . 00
. -500 . 00
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)...............................................
13.
• ........................ 14. -500 . 00
14. Net Value Subject to Tax(Line 12 minus Line 13).......................
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 0 . 0 0 15. 0 . 0 0
(a)(1.2)X.00
16. Amount of Line 14 taxable �6 O . 0 0
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 0 0 17. � . 0 0
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 0 0 18. 0 . 0 0
at collateral rate X.15
19 0 . 00
19. TAX DUE................................................................................................................
20. FILL IN THE OVAL IF YOU ARE RE4UESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2 �
� 1505610243 1505610243
REV-1500 EX Page 3 File Number 21-14-0229
Decedent's Complete Address:
DECEDENT'S NAME
Bertolette, Edna M. -
STREET ADDRESS
1601 Carlisle Road -
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
Total Credits(A +B) (2) _
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) �.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:............................................................................... � �
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?............................................................ ❑ LJ
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?..................................................................................................................
';THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ir�,... �'�"^�... .� ..��' ..,r,.,:�ii��:. � ..".",�- ��_ �; `..�.�..�F'` y...�"....'#�.: ,. :'°5�.�' `:;,.... ..?�' �. r.."r"�'�-,,_ .=-. . ^..; . . .i�.s.; ,� ."�",„:; ,� .,.s���.:. `'� .x".: � ..w:": .
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)].
�or 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)l•
. 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.
Rev7502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN
�� RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Bertolette, Edna M. 21-14-0229
All real property owned soiely 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 lhe relevant facts.
Real propeRy that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the propeRy has been sold
Include a copy of the deed showing decedenYs interest if owned as tenant in common.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 Real Estate-1603 Carlisle Road, Lower Allen Township. Tax Parcel No. 13-23-0547-503. 0.00
This asset was suspended on the previous return filed. The mortgage far exceeded the sale
price of the residence. On the previous return(Schedule I, No. 1)the estate picked up
$52,943.48 of the excess mortgage payment due over the value to be received for the real
estate.
The actual amount needed to be paid by the estate to take care of the mortgage was
$53,460.63. The asset then had no value and the house was upside down as reported on the
previous return.
TOTAL(Also enter on Line 1, Recapitulation) 0.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc.
Form PA-1500 Schedule A(Rev.01-10)
REV-1511 EX+�10-09) SCHEDULE H
pennsylvania FUNERAL EXPENSES AND
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF 21-14-0229
Bertolette, Edna M.
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
�q FUNERAL EXPENSES:
g, ADMINISTRATIVE COSTS:
�. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
State Zio
Year(s)Commission Paid
500.00
2. Attornev's Fees Michael L. Bangs
g. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
State Z�p
City
Relationship of Claimant to Decedent
4. Probate Fees
5, AccountanYs Fees
g, Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL(Also enter on line 9, Recapitulation)
500.00
Form PA-1500 Schedule H(Rev. 10-09)
Copyright(c)2009 form software only The Lackner Group, Inc.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE .!
DEPARTMENT OF REVENUE gENEFiCIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT FILE NUMBER
ESTATE OF 21-14-0229
Bertolette, Ed118 M. RELATIONSHIP TO
SHARE OF ESTATE AMOUNT OF ESTATE
NAME AND ADDRESS OF DECEDENT (Words) �$$$�
NUMBER PERSON(Sl RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS d�sV butionsr�ahnd tansfers
I' under Sec.9116 a 1•2 one-half of estate
Jack I. Bertolette
Son
1600 Hemlock Lane
Dauphin, PA 17018
Tammy C.Cobaugh
Daughter one-haif of estate
52 Sunset Drive
Sheiton,CT 06484
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKE
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 F�EP 1500 Schedule J(Rev.01-10)
Copyright(c)2010 form software only The Lackner Group,Inc.
OMB NO.2502-0265 ���
�_ ., g. TYPE OF LOAN.
• " � 1. FHA 2 QFmHA 3 QCONV UNINS 4.QVA 5.QCONV,INS.
6.❑F�LE NUMBER: 7. LOAN NUMBER.
'ARTMENT OF HOUSING 8 URBAN DEVELOPMENT
- P.15-002
SETTLEMENT STATEMENT g. MORTGAGE INS CASE NUMBER.
C. NOTE: 7his form is furnished to g'rve yvu a statement of adual settlement costs. Amounts paid to and by the settlemenf agent are shown.
�Items marked"�POC]"were paid oufside the dosing;they are shown here for informetional purposes�a�nd,alr�e noH�dEd e�PFtD�t�toa�ls,Z
D NAME AND ADDRESS OF BUYER:
E. NAME AND ADDRESS OF SEILER. F. NAME AND ADDRESS OF LEt�AER'.
Deborah S.Hoover Estate of Jack E.Bertoletle and
Estate of Edna M.Bertolette
G. PROPERTY�OCATION: H. SETTLEMENT AGENT: 23-2402316
I SETTLEMENT DATE
1603 Carl'�sle Road PURITYA&STRACT COMPANY March 13,2015
Camp Hill,PA 17011
Lowe�Ailen Twp,Cumberland Co�nty PLACE OP SETTLEMENT
Century 21 Reafty Services
3315 Market St,Camp Hill,PA 17011
J.SUMMARY OF BUYER'S TRANSACTION K.SUMMARY OF SELLER'S TRPNSACTI ON
400. GROSS AMOUNT DUE TO SELI.ER: g7,500.00
100. GROSS AMOUNT DUE FROM BUYER: g7,500.00 401. Contrad Sales Price
101. Contrad Sales Price qpy, Personal Pro e
102. Personal Pro �
103. Serilement Char es to Bu er Line 1400
�.g4g,pp 403.
104. 2015 CO/TWP TAX to BONNIE MILLER,TREASURER 9n� 405.
105. Ad'ustmenfs For Items Paid 8 Seiler in advance
Ad'ustments For Items Paid B Seller in advance qpg. Coun !Tw Taxes tO
106. Coun /Tw Taxes tO �0
�0 407. C' Tax 591.Oa
107. C Tax B9�.pq 408. SchoolTax 03/13/15 to 07101/15 i
108. School Tax 03/13/t 5 to 07/01/15 409.
109. 410. �
110. 411.
111. 412.
112. 98.09L04
120. GROSS AMOUNT DUE FROM BUYER 101,016.10 420. GROSS AMOUN7 DUE 70 SELLER
500. REOUCTIONS IN AMOUNT DUE TO SELLER
200. AMOUNTS PND BY OR IN BEHALF OF BUYER: 5�� 501. Excess De osrt See Instrudans t�,361.6t
201. De osit or earnest mone 5pZ, gettlement Char es to Se�ler Line ta00
2p2. Prin' alAmount of New Loan s 503. Existin ban s taken sub' d to
203. Existin ban s taken sub d to gp4, Payoff of first Mortgage ro BAYV�EW LOAN SERVICING 140,000 00
204 505. Pa oft of second Mort a e
205. 506.
206. 507. De sil disb.as roceeds
207. $08.
208. 509.
209. AdLstments For Items Un aid 8 ���� i 190.06
Ad'ustments For/tems Un aid B SeNer 01l01/15 to 03/13/15
tgp.pF> 510. Coun /T Taxes ro
210. Coun /Tw Taxes 01/01l15 to 03/t3/15 5��, C' Tax
211. C Tax 10 to
�0 512. SdioolTax
212. SchoolTax 513.
213. 514.
214. 515.
215. 516.
216. 517.
217. 518.
218. � 519.
Z�9 151,551.67
220. 70TAL PAID BY/FOR BUYER 5,190.06 520. TOTAL REDUC7/0N AMOIANT DUE SELLER
300. CASH AT SETT�EMEHT FROMITO BUYER: 800. CASH AT SETTLEMENT TO/FROM SELLER: 98 091�
301. GrossAmount Due From B er Line 120 101,016.10 601. GrossAmount Due 7o SaNer Line 420 ( �51.551.6
302. LessAmount Paid B/For B er(Line 220) ( 5,190.06) 6�2. Less Redud'ans Due Seller(Line 520) � 53,460.63
303. CASH(X FROM)( TO)BUYE I
95,826.04 603. CASH( TO)(X FROM)SELLER
The undersgn hereby a owled r ceQt ot a completed copY of pages 1&2 of this statement&any attachments referred to herein.
Seller ' � ' ^ ` G+�(N f j�
Buyer a�}c L Bertolette,Administrator of the Estate of Jack E. ��
a S. o r 8ertoletle and the Estate of Edna M.Bertolette
Paga 2
l.SETTLEMENT CHARGES �„o�ROM �,�o FROM
700.TOTAL COMMISSION Based on Price $ 97,500.00 6.0000% 5.850.00 euveas sEUERS
D'nnsion of Commissbn line 700 as Folbws: FunoS�T Fu"°s"?
701.$5,850.00 to CENTURY 21 REALTY SERVICES s�-��Er,��,r seTT��en+eN1
��z $ �a 5,850.00
703.Commission Paid at Settlement 295.00
704.ADD'L COMMISSION to CENTURY 21 REALTY SERVICES
500.ITEMS PAYABLE IN CONNECTION WITH LOAN
801.Loan Or' inatbn Fee % to
802.Loan Dismunt % to
803.Appraisal Fee to
804. Credit Reporl t0
805. Lender's Inspedion Fee to
806. Flood Cert Fee to
807.Tax Servlce Fee to
808. Doament Prep Fee
809.
810.
811.
900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE /daY � days �)
901.Inlerest From to @ g
902. Mort a e Insurance Premium for months to
903.Hazard Insurance Premium for ars to
904.
905.
1000.RESERVES DEP0.SITED WITH LENDER $ r
1001.Hazardlnsurance $ �
1002.Mort a e Insurance $ �
1003. Coun ffw Taxes $ �
1004.C Tax � $ ��
1005. School Tax $ �
1006. r 0.00
1007. g r
1008. AGGREGATE ADJUSTMENT
1100.TITLE CHARGES
1101. Setllement or Cbsin Fee �O
11p2. Abstrad or Title Search to
1103. Title Examinatbn to
1104. Tflle losurance Binder ��
1105. Doament Pre aratbn t� 5.00 10.00
1106. Nota Fees to NOTARY CLERK
1107. AttorneysFees �0
indudes abow item numbers: 889.00
1108. Title Insurance to PURITY ABSTRACT COMPANY
indudes abo�a item numbers: $
1109.Lender's Coverage $ 97�� 12.00
1110.Owner's Coverage �o PURITY ABSTRACT COMPANY 20.00
1111. Payofi outgoing wire fee
1112. Taxcertfee to PURITYABSTRACTCOMPANY
1113.
�ypp,GOVERNMENT RECORDING AND TRANSFER CHARGES 79.00
79.00:MoRgage $ ; Releases $ 975.00
1201.Recording Fees: Deed S 975.pp Mort a e 975.00
1202.C 1Coun TaxlStam s: Deed 975.00;Mort a e
1203.State TarJStam s: Revenue Stam s RECORDER OF OEEDS
12�' RECORDER OF DEEDS
1205.
1300.ADDITIONAL SETT LEMENf CHARGES
1301. Surve �a 983 46
1302. Pest Ins d'an 2,216 15
1303.OUTSTANDING SEWER/FZEFUSE to CUMBERL.AND COUNTY TAX CLAIM BUREAU 1,000 00
1304. 2014 SCHOOL TAX ESCROW
1305.ESTATEINHERITANCETAX to PURITYABSTRACT t,948.00 1?,361.6�
1400.TOTAL SETTI.EMENT CHARGES Enter on Lfnes 103,Sectfo2 J�a��2��a�K �
BY si9^�9 va9a t d mis st�emeK tle siq�alvies eckraMed9B rxeq al a wmpUetl wPi OaAa
�
I qg$TRACT COMPANY
IementAgent
Certfied to be a true copy
(P1SOQ2/P16002It2)
$�NC�.S I.�Yl�O�IC�, LLC
429 SOUTH 18T" �TREET PHONE: 717-730-7310
FAX: 717-730-7374
CAMP HILL, PA► 17011
E-mail: mikebanQs�"a�verizon.net
MICHAEL L. BANGS,Attorney-at-Law WILLIAM E.MILLER,JR.
Of Counsel
WENDY K. STRAUB,Paralegal
March 26, ?O 15
Lisa M. Gray�son, Register of`J�'ills
Cumberland County Courth��use
One Courthouse Square
Carlisle,PA i 7013 "'
e�'a � �
� u� � t'�1
RF,: Estate �f Edna M. Bertolette = � � uu'_ �
�� -v � v�� �
File Ivo. 21-14-0229 �� -rY � --� ��
;�:3 �„ r� N ,-� r�
� �� � �
Dear Ms. Urayso►.: � ` "�'
.- �-7 r.� '� '� -i
, � _t9 � � __..
Enclosed you will find the followin�: � ; C'
,�� h.�., �M rn
__a
l. "rhe originai and ane copy of a su�plemzntal inheritance tax return. . = � U� �
2. E�n inventory.
3. �0 check in t:ie arrRo�nt of$30.00 to pay the filing fee.
4. A letter of explanation to the Department of Revenue which should be filed along
with the returns.
Kind!y file the supp:emental retuni ac,cardingly an� send me a receipt in the enc.losed, stamped,
pre-addressed envel�pe.
If�ou require anything fut�ther, plea�e contact rr�e directly.
;
Ver��truly y�urs,
.����•v�L�
�
Niichael L. Bangs
wks
Enclosures
cc: Mr. Jack I. Bertolztte
$�NC.S I.��O�IC�, LLC
429 SOUTH 18T"STRE�T PHONE: 717-730-7310
CAMP HILL,PA 17011 FAX: 717-730-7374
E-mail: mikebangs�verizon.net
MICHAEL L.BANGS,Attorney-at-Law WILLIAM E. MILLER,JR.
WENDY K. STRAUB,Paralegal Of Counsel
March 26, 2015
PA Department of Revenue
Bureau of Individual Taxes
Post Office Box 280601
Harrisburg, PA 17128-0601
RE: Estate of Edna M. Bertolette
Supplemental Inheritance Tax Return
File No. 21-14-0229
To Whom It Mav Concern:
On November 25, 2014, we filed ihe initial inheritance tax return in the above-captioned estate. 1
included with that a letter of explanation dated November 25, 2014 as this was a companion
inheritance tax reiurn for the Estate af Jack E. Bertolette filzd under No. 21-14-0228. This
supplemental return picks up the real estate that was pending an Agreement of Sale that was owned by
the decedents. This suppleme�tal tax return should be read in conjunction with both of the other tax
returns I filed.
Should you have any questions, please contact me.
Very truly yours,
, �
w � :�� ���
��
Michael L. Bangs
wks
,�
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