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Home My WebLink About09-03-15 ; pennsylvania 15D56184�3 � OEPARTMENTOFREVENU �X(03-14) RE�,'--1500 OFFICIAL USE ONLY County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 5 � `f ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 05 18 2015 � 8 29 192 � DecedenYs Last Name Suffix DecedenYs First Name MI MOTISKA DOROTHY G (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 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, Agricultural Exemption(date of � 5, Future Interest Compromise(date oi death on or after 7-1-2012) death after 12-12-82) � 6. Federal Estate Tax Return Required ❑ 7. Decedent Died Testate ❑ 8. Decedent hlaintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) ❑ 10. Litigation Proceeda f2eceived ❑ �� Non-Probate Transferee Return ❑ 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) ❑ 13. Business Assets ❑ 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDEM-TWS SECi10N MUST BE COMPLEfED,ALL.CORRESPONDFSJCE AND CONFlDENi1AL TAX WFORMAT1pN SHpULD BE DIRECTF�TO: Name Daytime Telephone Number ELIZABETH H FEATHER 717 232 7661 First Line of Address 3631 NORTH FRONT STREET Second Line of Address City or Post Office State ZIP Code HARRISBURG PA 17110 , .,� c� �-; � CorrespondenYs email address: Efeather@cklegal.net � � -�7 r't -- -.� � ;� , REGIST �O�MNI,�.,�S U9fLpNl.Y,-;-, ^;7 _::.� �.. ,.7 REGISTER OF WILLS USE ONLY ". " �.�.��. ,'�.� DATE FI ED MMDDYYYY - F W -' -:'> ..-. ",`� �,� -�r-q � "'1 V—� ---- �'> fv .,._ i"1_I DATE FILED STAMP�-- �j p Side 1 � �'� �� I�I��I�I I��I�� ( ��II��'�I II �� \,� 1,505618403 150567,84�3 J `� \ \ � 15�5618411 REV-1500 EX Decedent's Social Security Number oe�eeen�'sName: MOTISKA� DOROTHY G. RECAPITULATION 1. Real Estaie (Schedule A).......................................................................................... 1. 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. 1 , 0 0 0 • � 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 1 3 2 , 7 0 1 • 9 3 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 1 3 3 , 7� 1 • 9 3 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... g, 1 0 , 5 7 4 • 9 9 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. ��• 2 , 5 5 3 • 4 2 �� Total Deductions(total Lines 9 and 10).................................................................. 11. 1 3 , 12 8 • 4 1 12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 2 O , 5 7 3 • 5 2 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. 1 2 O , 5 7 3 • 5 2 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax ra;�,or transfers under Sec. 9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 2 0 , 5 7 3 • 5 2 16. 5 , 4 2 5 • 8 1 �7 Amount of Line 14 taxable at sibling rate X,12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAXDUE................................................................................................................... 19. 5 , 425 • 81 2�• FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Under penalties of perjury,I declare I have examined this return,including accompanying schedules and siatements,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 any knowiedge. SIGNATURE OF�PERS�N R PON 18�L�s FO FILING RETURN John W. Motiska DAT� �5- L(A Qi � A 255 Sassafras Street, Harrisburg, PA 17102-3153 SIGN URE OF PRE R OT ER THAN REPRESENTATIVE Elizabeth H Feather DATE �_.�.,�.�;��. �'�.�.�.., �1;��>> ADDRESS Caldwell & Kearns P.C. 3631 North Front Street, Harrisburg, PA 17110 �I�� '�I��I'�� I�� I�I� �I��I �� I'� Side 2 I,_. 1505618411 15�56184],1 � REV-1500 EX Page 3 File Number 21 - 1 5 DecedenYs Complete Address: DECEDENT'S NAME Motiska, Dorothy G. STREET ADDRESS 1447 Hillcrest Court, Apt. 312 CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 5,4 2 5.81 2. Credits/Payments A• Prior Payments B. Discount 2 71.,2 9 -. Total Credits(A +B) (2) 2 71.2 9 3. tnterest (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) 5,15 4.rJ 2 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:.................................... � � c. retain a reversionary interest;or....:............................................................................................................. ❑ � d. rec�;✓e the promise for life of either payments,benefits or care?.............................................................. � ❑x 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?...................................................................................................................... ❑ ❑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. � , , �� . 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 spo 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 r72 P.S.§9116(a)(1.1)(ii)]. The slafute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets iiling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or afier July 1,2000: •The tax rate imposed on the net value of transfers from a deceased child 21 ears of age or younger at death to or for the use of a natura�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 percenf,except as noted in[72 P.S.§9116(a)(' •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. -� pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN f RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Motiska, Dorothy G. 2� - �5 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointiy-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 1998 Toyota - net proceeds 1,000.00 TOTAL (Also enter on Line 5, Recapitulation) 1,000.00 REV•1509 EX+(0'I•10) --�: pennsylvania �� DEPARTMENTOPREVENUE SGHEDULE F INHERITANCETAXRETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Motiska, Dorothy G. 21 - 15 If an asset was made joint within one year of the decedenYs date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT John W. Motiska 255 Sassafras Street Son A Harrisburg, PA 17102-3153 JOINTLY OWNED PROPERTY: ITEM LETTER DATE Include name of fina cial in�titullo nanpd bank account numbe DATE OF DEATH %OF DATE OF DEATH NUMBER FOR JOINT MADE or similar identi in number.Attach deed for ointl -held real VALUE OF ASSET DECD'S VALUE OF TENANT JOINT � 9 � y INTEREST DECEDENT'S INTEREST estate. 1 A 01/11/1988 PSECU Savings A��ount No. 75078771 �so,zio.o3 50% 65,105.02 2 A 01/11/1988 Citizens Bank Checking Account No. 397-6 50,106.41 50% 25,053.21 3 A 01/11/1988 Citizens Bank Savings Account No. 018-3 a5,087.39 50°/o 42,543.70 TOTAL(Also enter on line 6, Recapitulation) 132,701.93 REV-1511 E%+(OB•1J) :� pennsylvania SCHEDULEH DEPARTMENT OF REVENUE M FUNERAL EXPENSES AND RESIDENT DECEDENT URN ^�AIA'�Tpw��.^�.� M�JIYI IY 1 fV1 I�JJ FILE NUMBER ESTATE OF Motiska, Dorothy G. 21 - 15 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Neill Funerai Home 8,039.99 B. ADMINISTRATIVE COSTS: �, Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Caldwell& Kearns P.C.-- Elizabeth H Feather 2,500.00 3, Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent a. Probate Fees Register of Wills - Filing fee 35.00 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7, Other Administrative Costs 1 TOTAL(Also enter on line 9, Recapitulation) 10,574.99 �-� pennsylvania SCHEDULE I � DEPARTMENTOFREVENUE DEBTS OF DECEDENT MORTGAGE INHERITANCE TAX RETURN � RESIDENTDECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF Motiska, Dorothy G. 21 - 15 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medicai expenses. ITEM E�ESCRIPTION AMOUNT NUMBER 1 Holy Spirit EMS 63.03 2 Kantor and Tkatch Assoc 15.00 3 Travelers Insurance 374.00 4 Country Walk Apartments - Rent 1,830.00 5 Holy Spirit EMS 100.00 6 PPL Electric 61.00 7 Verizon 28.10 8 Comcast 82.29 TOTAL(Also enter on Line 10, Recapitulation) 2,553.42 REV-1513 EX+(01-10) �� pennsylvania SCHEDULE J � OEPARTMENT OFREVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Motiska, Dorothy G. 21 - 15 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not Llst Trustee�s) I, TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a) (1.2)] 1 John W. Motiska Son 100% of Estate 255 Sassafras Street Harrisburg, PA 17102 Enter doilar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II. NON-TAXABLE DISTRIBUT�ONS: 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 O.00 CALDWELL & KEARNS JAMES R.CLIPPINGER JAMES L.GOIDSMITH A PROFESSIONAL CORPORATION OF COUNSEL STANLEY J.A.U15KOWSKI DOUGLAS K.MARSICO ATfORNEYS AT LAW JAMES D.CAMPBELL,IR. CHARLES J.DEHART,III BRE7T M.WOODBURN MICHAEL D.REED MICHAEL A.FARRELI THOMAS D.CALDWELL,JR. THOMAS M.FRATICELLI 3631 NORTH FRONT STREET (1928-2001) PETER M.GOOD HARRISBURG, PENNSYLVANIA 17110-1533 ELIZABETH H.FEATHER CARL G.WA55 DAVID A.WION (1937-2010) JEAN D.$EIBERT 717-232-7661 THOMAS S.LEE FAX:717-232-2766 RICHARD L.KEARNS JESSICA E.MERCY RETIRED CASEY L.SIPE � CRAIG A.SCHROLL THEFIRM@CKLEGAL.NET August 31, 2015 Lisa M. Grayson, Esquire, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Att: Heidi Warner Re: Dorothy G. Motiska, Deceased Dear Heidi: Thank you for your recent phone call. Enclosed please find a check payable to your office in the amount of$15. This check represents the filing fee for the Inheritance Tax Return we previously sent to your office. I have also enclosed a self-addressed, stamped envelope for you to return to me the $35 check we previously submitted. Thank you for your assistance with this matter. Very truly yours, `� ..� � c, u-+ _...,, c� ��SC� fv �� c� :J3 <:� � l " i 7 =�, ,�, `� `�ti n�' .,� � C.: , �5....:.� Elizabeth H. Feather . � - r�' � ' `:�'' ._. , .-� CALDWELL & KEARNS, P.C. . _.� � t efeather@cklegal.net ==3 -�, =; EHF:nb '_' - i" �.�, � /Enclosures �;.� '�' � 15275-001/FL*42295 �"' 2 D � � N � � ' D � W � � r � o O o � � � � m Z 2 Z o r � m Z �, � , r < O � r /�,, n X� y � D o Z N '� � � � r' ° Rl � m � � � O �' z � � W W ,..:. ;�; v '�� n o n r �' ;_� �� :z= ;'� a' ,'� � r � � i:; �' � ,� � • � ;J') r77 C> �' �, f7 a"' r-r'1 G� C> �:..i x � � � �' r; _ �L� r.'J ;') �... � 'b � � rn :. , _ ,' .� C ) F..:} i1. � �" � � C,J ; ` I.::! V � n� � t..;. � � y � p ; <. .� ..J . � (�,� fn � � � _ cD � .t] '� y l--+ --- c� '� W � `�.r� �> ��' r,; pp � 0 �, ; _•- u�� c:� C �p h--� "•I r::,• p c'� � � � �. ^� �•• O ,�-'"'^..'�.: �" � �� }-� z• y �:... � � �.. �.� � •��„{ � L• +... ff7;/�nMf; . f R�. �`.: D a� u�vrr� ''" r o �' Il7 l� -.. Sj. `.: p � � � �� 7 �f " m �N cn -�' O �"' ��1 � v �: ro�,EA �ay� � �� .. C�� ov ooDi m, 0 �, ;o� o � o N ��