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Home My WebLink About04-02-15 . ,� , , . � pennsy�vania 15 0 5 61814 8 DEPARTMENT OF REVENUE EX(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox zeoso� INHERITANCE TAX RETURN r'"� Harrisburg,PA 17128-0601 RESIDENT DECEDENT �L;� � 'S I � ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 206- 08122�14 12311948 DecedenYs Last Name Suffix Decedent's First Name MI PANTALONI DONNA (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI PANTALONI NAZARETH THIS RETURN MUST BE FILED IN DUPLICATE WiTH THE REGISTER OF WILLS FILL�N APPROPRIATE BOXES BELOW Q 1. Original Return Q 2. Supplemental Return Q 3� Remainder Return(date of death priorto 12-13-82) Q 4. Agriculture Exemption(date of Q 5. Future Interest Compromise(date of 0 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) Q 7. Decedent Died Testate Q B. Decedent Maintained a Living Trust � 9. Total Number of Safe Deposit Boxes (Attach copy of wili) (Attach copy of trust.) Q 10. Litigation Proceeds Received Q 11. Non-Probate Transferee Return � 12. Deferral/E�ection of Spousal Trusts (Schedule F and G Assets Only) Q 13. Business Assets XQ 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONPIDENTIAL YF�X INFORMATION SHOULD BE DIRECTED TO: Name I�aytime Telephone Number ROBERT G. FREY 717-243-5838 First Line of Address 5 SOUTH HANOVER STREET Second Line of Address City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent's email address: R F R E Y a�F R E Y T I L E Y .C 0 M �, � �� REGISTER 6L,,F WJ�,LLS USE��' rry s � .-.�,�. � O REGISTER OF WILLS USE ONLY � -�} � {,f) � DATE FILED MMDDWYY �� "'� � ^� y.. � N r�1 i�,. .�� -v°3 „ C� ..;. �-� . ,, , `� ,� � .� «`� � iC:� -T3 "'� :C DATE F�LHD:STAMP -✓i �. . „,i ...J � � � . � PLEASE USE ORIGINAL FORM ONLY Side 1 ��I��(�� 1505618148 1505618148 � � J 1505618155 REV-1500 EX DecedenYs Social Security Number DecedenYsName: DONNA PANTALONI RECAPITULATION 1. RealEstate(Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. �. �0 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . .. . . . .. . . . . . . . . . .. . . . . . . . . .. 2. 0. �� 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). .. . .. . 3. Q. �Q 4. Mortgages and Notes Receivable(Schedule D). . . . ... .. .. . . . . .. . ... . . . . . . . 4. Q . Q Q 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . .. .. 5. Q. Q Q 6. Jointly Owned Property(Schedule F) 0 Separate Billing Requested. . . . . . . . 0. O O 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) �Separate Billing Requested. . . . . . . . 7. �. 00 8. Total Gross Assets(total Lines 1 through 7). .. . . . ... .. . . .. . . . . . . .. . .. . . . . 8. �. �0 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . ... . . . . . . . . g. 93� . 5� 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). .. . . ... . .. . . . . . �p. �. 0� 11. Total Deductions(total Lines 9 and 10).... . . . . . . . . . . . . . .. . . . .. . . . . . .. . ..11. 9 3�. 5 Q 12. Net Value of Estate(Line 8 minus Line 11). ... . .. . ... . .. . . .. . . . . . .. . .. . . . 12. -9 3 0. 5� 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . ... . . . . . . . . . . . .. . . .. . . ..13. �. �Q 14. Net Value Subject to Tax(Line 12 minus Line 13). . .. . . .. . . ... . .... .. . .. . . 14. -9 3�. 5 0 TAX CALCULATION-SEE�NSTRUCTIONS 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 16.Amount of Line 14 taxabie �5• �. �0 at lineal rate X.0 4 5 17• Amount of Line 14 - 16• 0 . 00 taxable at sibling rate X . 12 17. 0. �� 18. Amount of Line 14 taxable at collateral rate X . 15 1g. 0. 00 19. TAX DUE. . .. . . . . . . .. .. . . .. . . . . . . . .. . .... . ...... . . . . . . . . .. . . .. . .. . . 19. O . O O 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Under penalties of perjury,I declare 1 have examined this return,inGuding 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 person responsible for filing the return is based on all information of which preparer has an know�ed e SIGNATU E PERSON RE PON FI G RETU DATE ADDRESS � 03/27/15 5 SOU H HANOVER STREET CARLIS PA 17013 SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FO FILING THE RETURN DATE ADDRESS L �� Side 2 1505618155 1505618155 J ��:IlIII,. Ilili � Ktv-iouu cn rage a File Number 206-38-8049 Decedent's Complete Address: 21-15-0174 DECEDENT'S NAME DONNA PANTALONI STREET ADDRESS 410 NORTH MARKET STREET 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 (See instructions.) 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) 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................................................... ........................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income................................. ❑ QX c. retain a reversionary interest.................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?.......................................................... ❑ QX 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 containsa 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 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 step-parent 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 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 biood or adoption. _. REV-1511 EX+(OB-13) pennsylvania SCHEDULE H DEPARTMENTOF REVENUE FUNERAL EXPENSES AND RESIDENTDEC D NETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Donna and Nazareth Pantaloni 21-15-0174 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 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: 750.00 3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Claimant SVeet Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 105.50 5. Accountant Fees: 6. Tax Retum Preparer Fees: 7. Advertising in Cumberland Law Journal 75.00 TOTAL(Also enter on Line 9, Recapitulation) $ 930.50 If more space is needed, use additional sheets of paper of the same size. . . . 11IlII;".I IIIIIII. � I REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENTOFREVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Donna and Nazareth Pantaloni 21-15-0174 ___ RELATIONSHIPTO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE � TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(12).] � Nazareth Pantaloni spouse Entire estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LiNES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT 7AKcN: 1. ' B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ O.00 If more space is needed,use additional sheets of paper of the same size.