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Home My WebLink About06-11-15 � 1505610140 REV-1500 EX �°,_,°> OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2eoso� INHERITANCE TAX RETURN 2 1 1 5 0 4 7 1 Harrisbur4 PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 6 0 7 2 0 0 0 0 1 3 0 1 9 4 6 DecedenYs Last Name Suffix DecedenYs First Name MI L e t u n i c Wi I I i a m J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI L e t u n i c Y u C h e n M Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Return � 2.Supplemental Return � 3. Remainder Return(date of death prior to 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise(date of � 5. Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) � 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(date of death � 11. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number S c o t t W . Mo r r i s o n , E s q 7 1 7 5 8 2 2 3 0 0 REGISTER OF WILLS USE ONLY J S"_) � n i�'1 ..7 �7� First line of address c= �., � �� c� _ --, (_ � <'� 6 W e s t M a i n S t r e e t -,> > �� Second line of address _ � �' '� _;. ;,_, �._., , P . O . B o x 2 3 2 _ > DATE FIlED- �-°-� � 7 City or Post Office State ZIP Code -"" '�� _.,. _ __ : C� N e w B I o o mf i e I d P A 1 7 0 6 8 , ' ` � r . r� . � � c..a �;� c� � -n CorrespondenYs e-mail address: St1'10fTIS01118W centurvlink.net 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 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 P�(RSON RESP IB ETURN DATE 4•_-C��--- (��. �L�� AD ESS 27 Siri Co rt West Melbourne FL 32904 SIGNATU R OTHER T PI-R ESENTATIVE DATE ��o df rJf AD ESS 6 e a' Street New Bloomfield PA 17068 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610140 1505610140 � �� 1505610240 REV-1500 EX Decedent's Social Security Number DecedenYs Name: William J. Letunic 1 6 2 3 6 3 6 6 0 RECAPITULATION 1. Real Estate(Schedule A) �• � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2• ' 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. ' 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. ' 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. ' 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 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. • 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9 9 � 2 • 9 � 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. ' 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 9 � 2 • 9 � 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Z� - 9 � 2 . 9 � 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . �3 • 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. - 9 � 2 • 9 � 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 _ � . � O 15. O . � � 16. Amount of Line 14 taxable � . 0 Q at lineal rate X.0_ � • � � 16. 17. Amount of Line 14 taxable Q . � Q 17. � • 0 � at sibling rate X.12 18. Amount of Line 14 taxable O . 0 O �g � . Q � at collateral rate X.15 19. TAX DUE O • O O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FtLL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 � 1505610240 1505610240 � REV-1500 EX Page 3 File Number Decedent's Complete Address: 2� 15 0471 DECEDENT'S NAME William J. Letunic ----- STREET ADDRESS 154 Vir inia Avenue ---- CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: �� o.00 1. Tax Due(Page 2,Line 19) 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 oval 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 . . . ,. . 3 . ^�'�. � , . , :°'� .. .. ,.� r . . . , ,r,' . . � . . . . . 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: ...................................................................... O � b. retain the right to designate who shall use the property transferred or its income; ............................... X c. retain a reversionary interest;or ................................................................................................ O � 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 receiving adequate consideration? ....................................................................................... ❑ � 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. ' , d _ _. . �� . . _ ._ , . _ 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 i: 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(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,undei Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER William J. Letunic 21 15 0471 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 Attomey Fees: SCOtt W. MOPPISOf1 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: Lisa M. Grayson, Esq 115.50 5 Accountant Fees: 6, Tax Retum Preparer Fees: 7. Cumberland Law Journal -estate advertising 75.00 8. The Sentinel -estate advertising 222.40 TOTAL(Also enter on Line 9,Recapitulation) $ g12.90 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William J. Letunic 21 15 0471 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Yu Chen Mary Letunic Spousal 275 Sirius Ct. 100% West Melbourne, FL 32904 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE, Ij, NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. ''� pennsylvania DEPARTMENT OF HUMAN SERVICES May 1, 2015 SCOTT W. MORRSION, ESQUIRE 6 WEST MAIN STREET P.O. BOX 232 NEW BLOOMFIELD PA 17068 Re: William J Letunic, Jr SSN: ###-##-3660 Dear Attorney Morrison,: Pursuant to your letter dated April 30, 2015, the Department of Human Services (DHS), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that DHS will only pursue the recovery of PROBATE ESTATE claims when the individual was fifty-five years of age or older at the time that assistance was received. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If you have any questions, please feel free to contact me. Sincerely, �� r--? � r�� Vince A. Porter Recovery Section Manager (717)772-6604 Bureau of Program Integrity � Division of Third Party Liability � Rerovery Section PO Box 8486 � Harrisburg, Pennsylvania 17105-84Ho A235-10 LAST WILL AND TESTAMENT R235-04 BE IT KNOWN,that I, �<<-Z�� J, ��'��`� of /S'� 1%��'�/�L'/A AvE , C/�'LlSC� ,Counry of G �.J/y 13C.%[:/lti°I� , in the State of ��N�YC v hN"�'�"' _being of sound mind,do make and declare this to be my Last Will and Testament expressly revoking all my prior�Vitls and Codicils at any time made. I. PERSONAL REPRESENTATIVE: I appoint 1 U CH�/Va M11�Y �C�i,��1iL of /S4 V';/'G,nl l� /�Yc`- L��C1SL� ,as Personal Representative of this my Last Will and Testament and provide if this Personal Representative is unable or unwilling to serve then I appoint l�<`ISl��L" LC��'r'/< 4"—QS-S of Z2� ADr��+N r�., C./�/��<�f}L�`� Y��' , as altemate Personal Representative. My Personal Representative shall be authorized to carry out alI provisions of this Wil!and pay my just debts,obli�ations and funeral expenses.I further provide my Personal Representative,shall not be required to post surery bond in this or any other jurisdiction,and direct that no expert appraisal be made of my estate unless cequired by law. II. GUARDIAN: In the event I shall die as the sole parent of minor children,then I appoint .(/G/!/TJ� I �i��-I'rJ-J ,as Guardian of said minor children.If this named Guardian is unabie or unwilling to serve,then I appoint W 1 Lu�f�"� J /_f_ T'u�.`I�- �- as alternate Guardian. III. BEQUESTS: I direct that after payment of all my just debts,my}�iroperty be bequeathed in the manner follo�ving: � �'.�v"v �� M Y P��c��Y �.� �'�Y w;�'c` Y� Cti'tiv ��+�y i L[`i v�;�r�' . � Testato Initials Execute and attest before a notar,y. Caution: Louisiana residents should consult an attorney before preparing a will. cRe�6�9e� �E-Z Legal Forms.Before you use Ihis fonn,read it,fill in all blanks,and make whatever changes are necessary m your pxrticulu �ransactioa Consult a lawyer if you doubt the form's fitness for pour purpose and use.E-Z Legal Forms and the retailer make no O 53926 20028 3 �epresenta�on or wazranty,express or impliW,wi�h mspe<t w Ne werchantability of this form foc an intended�se or pu�pose. ZAHF IN WITNESS WHEREOF,I have hereunto set my hand[his a`r day of I��'� 2�C'v, (yeaz),to this my Last Will and Testament. T�atur Slgnature IV. WITNESSED: The testator has signed this will at the end and on each other sepazate page,and has declared or signified in our presence that it is his/her last will and testament,and in the presence of the testator and each other we have hereun o subscribed our names this a( day of /n/�.2 C <-( ,�Z�'�' (yeaz). 7_.z� A�R.��i�f L�r GA�'�Ofk�` t�/� Witness ture Adciress �___`�'�(� y,/�J ) n (�"' � �`L� CL�� C�l�S_/✓.(.�a,w �i� �- �%1/0- Witness Signamre � Address �� '� 2l'c. ! �-��'�P_�f rJ T ��4,"��t�F:L`L � �'I-1� �ness Signat � Address State of ��✓��"S`-l�n,✓i""'�- ) County of l7�•.'P�'�'`�'� �r�-E<,na as �„ CJ D!7?c�.�J✓� We, S'�P�EN A. �R/�•`�S __ (�✓cc..t_i/�.-rt �< �-4=�'vNi L ,and ��,�;�i� L�T�nN.C. C'��,CSS , the testator and the witnesses,respectively,whose names are signed to the attached and foregoing instrument,were sworn and declared to the undersigned that the testator signed the instrument as his/her Last Will and that each of the witnesses,in the�res tes or apd each other,signed the will s a witness. Testaror: �1�'� J \ Witness Wimess �� WitnesS;1� .�---- On ,�-/ /�'iM�-C.�-t Zvc,t� before me, �Yr-;«r:r /t-�'-- ��`-�.�4 �% , appeared S'i-Fn�Gr�sr.C,c,rSS, T�'<<T^nJ �-i. b.9ik�,•.�5, 4,-<r��nr„J'.<-£.i�,n,r�� /.�h6,��-ti�1"3/�c�� personally known to me(or proved to me on the basis of satisfactory evidence)to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that heJshe/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signamre(s)on thc instrument the person(s),or the enticy upon behalf of which the person(s)acted,executed the instrument. WITNESS my and and officiai seal. Signamre �//J - , Sig�amre of Notary Af£iant Known Produced ID Type of ID (Seal) �E-Z Legal Forms.Betore you use this fortn,read ic,fill in all blanks,and make wharever changes aze necessary to your particulaz¢ansnction.Consult a lawyer if you doubi�he foan's fimess foi your purpose and use.E-Z L.egal Forms and the re�ailer ninke.no rcpmsentacion or wazranry,express or implied,with respect to che merchantability of[his form for an inrended use or puryose. .-;,.�.n.n�-,_r.ir-m- k , _,� _ � � _ f w' " �; �;� � t �� j`� . � � \�.. e�' ..�4 ' � � ��i' `�. i+ ��y��r," ^„ � t e �� .. ..�,,. �. : t t ;. . ,�._� �� r.- cJ G C^ L'� l.d..�l ___ e--d }— ��... C,_� .' r--{ . . � _. � f _ � C:._ ... L '1 �--i � ` • .: T, � :� � ,{ .. . � c , : e—y ; . y�� u_ c:; ._,,, �:� ;:� . _ 'F' —' � O c�, __. .._ _- c,� �'� �. �` � c..� �� =� � c_:� ' — (� � r:- �n � �� 3 � _ ..__, � .�„ �' � � � � � � � � _+ °- � �, ; _ � � � � � � � � � r� � � V � `� U 0 � � � _. � � ^ � ��n nri-�...�..�r�ni.. s