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Home My WebLink About03-25-15 -� REV-1500 �"�01�10� , 1505610143 PA Department of Revenue � OFFICIAL USE ONLY pennsylvania County Code Year File Number Bureau of Individual Taxes DEPFRTMENfOFREVENUE Po eox.28oso� INHERITANCE TAX RETURN 2 1 13 0 0 5 7 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth Suffix DecedenYs First Name MI SENTIWANY ROGER E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� SENTIWANY MARGE K Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Retum ❑ 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 Retum Required (date of death aker 12-12-82) � g, Decedent Died Testate � Decedent Maintained a Living Trust (nttach Copy of wiil) � (Attach Copy of Trust) 8• Total Number of Safe Deposit Boxes ❑ 9. Litigation Proceeds Received � �p.Spousal Poverty Credit(date of death ��.Election to tax under Sec.9113 A between 1231-91 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 ROBERT G RADEBACH 717 896 2666.> � _-, .�.. �.� :.__, T REGIST��Q�+WILLS l�&ONLY J-� __. , w� __., , __ --, . First line of address �� r� 912 NORTH RIVER ROAD ._.� Second line of address -�� ' rv : I City or Post Office DATE FILED . State ZIP Code `' +::,J .,.y HALIFAX PA 17032 Correspondent'se-mailaddress: missySwartz51ca8ol.Com Under penalties of peryury,I declare that I have examined this retum,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. SIGNATURE OF PERS PONSIBLE FOR FILING RETURN DATE Marge Kaye Sentiwany ADDRESS i 207 o�r A e, m ne, PA 17043 SIGNAT E F PR P O R HA REPRESENTATIVE DAT I Robert G Radebach �5' ADDR SS 912 North River Road, Halifax, PA 17032 Side 1 L 1505610143 15�5610143 J � J 1505610243 REV-1500 EX DecedenYs Social Security Number oe�ee�eSName: SENTIWANY� ROGER E. 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 8�Notes Receivable(Schedule D).......................................................... 4. 5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 3 , 3 0 1 . 0 � 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 1-7)....................................................................... 8. 3 , 3 0 1 . 0 0 9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 2 , 2 9 1 . 4 0 10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule I)................................ 10. 1 0 0 . 0 0 11. Total Deductions(total Lines 9&10)...................................................................... ��. 2 , 3 9 1 . 4 0 12• Net Value of Estate(Line 8 minus Line 11)............................................................. �p. 9 O 9 . 6 0 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. 9 0 9 . 6 0 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(�.2)x.o0 9 0 9 . 6 0 15• O . 0 0 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .�2 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 � REV-1500 EX Page 3 Fi1e Number 21 - 13 - 0 0 57 Decedent's Complete Address: D ED N ' NAM Sentiwany, Roger E. STREET ADDRESS 1051 Allendale Road, Apt. L CITY STATE ZIP Mechanicsburg PA 17055 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) 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) 0.�� Make Check Payable to: REGISTER OF WILLS, AGENT. _ x , � 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.................................................................................................................. X 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 receivingadequate consideration?....................................................................................................................... ❑ 0 3. Did decedent own an"in trust for" or payable upon death bank account or security at hxs or her death?......... � 0 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. :� `:�<_. .� ' " ". �, �;� �:. : ��._..";. �.p:: > .. �;: . �, � �:,,,. ��x°.� ,; '�� '"�;�: For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate im osed 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 retum 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 decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)1. A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTHOFPENNSYLVANIA PERSONAL PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sentiwany, ROg21' E. FILE NUMBER 21 - 13-0057 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 2004 Honda Accord 2,500.00 2 Verizon Refund 1.00 3 Refund from Apartment 200.00 4 Members 1st Federal Credit Union Bank Accounts 600.00 TOTAL(Also enter on Line 5, Recapitulation) 3,301.00 SCHEDU�H COMMONWEALTH OF PENNSYIVANIA �"'�—" —�+� INHERRANCE TAX RETURN /�nA/��Tp A�� RESIDENT DECEDENT ��ann �a�rw ESTATE OF Sentiwany, Roger E. FILE NUMBER 21 - 13-0057 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A• 1 Parthemore Funeral Home 1,367.12 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 Robert G. Radebach, Esquire 500.00 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Fee to Open Estate- Register of Wills 118.50 Oath Fee- Register of Wills 20.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Advertising Fee-The Sentinel 210.78 TOTAL(Also enter on line 9, Recapitulation) 2,291.40 SchedWe H COMMONWEALTH OF PENNSYLVANIA ��-�""""`^ INHERITANCE TAX RETURN �ri��,�� RESIDENT DECEDENT ESTATE OF Sentiwany, Roger E. FILE NUMBER 21 - 13-0057 2 Advertising Fee-Cumberland Law Journel 75.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTHOFPENNSYLVANIA LIABILITIES, & LIENS INHERfTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sentiwany, ROg@C E. FILE NUMBER 21 - 13-0057 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Cleaning Supplies 100.00 TOTAL(Also enter on Line 70, Recapitulation) 100.00 REV•1513 EX+(17-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA B E N E FI C IARI E S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Sentiwany, Roger E. I 21 - 13-0057 NAME AND ADDRESS OF PERSON S) RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER RECEIVING PROPERTY � DECEDENT (Words) �$$$� Do Not List Trustee(s) I, TAXABLE DISTRIBUTIONS[include outright s�ousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Marge Kaye Sentiwany Wife 207 Bosler Avenue Lemoyne, PA 17043 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 II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00