HomeMy WebLinkAbout09-21-15 T
J pennsytvania 1505614105
OEPMTMENT OFR Nt EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601
INHERITANCE TAX RETURN _.__...___.... �_..._._..___.__.__ ....___..
'
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 151%
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_ .._ ...._...____..._. __..._...._......___.---------_------_.--------
; 01032015 111051912
Decedent's Last Name Suffix Decedent's First Name MI
_._.._...__._ __._....-......_......._..-,__,,... _. ...__,-_._..----- _..,......_........... .. _._.._... _. .._. .... ...._... __,.,.__..
Gedid Mrs i ? Frances V
........................._-......__...,..._._; _........
(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 p 2.Supplemental Return p 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemptiondate of O 5.Future Interest Compromise(date of p 6. Federal Estate Tax Return Required
death on or after 7-1-2812) death after 12-12-82)
M 7.Decedent Died Testate Q 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received O 11.Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets O 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
John L. Gedid (71 7) 731-9166
First Line of Address
_..,_. _ _._.-____ ._ .,,.._...._._. _.... ._.__. I
_5218 Deerfield Avenue
Second Line of Address
..._..__,._......_ _.._..........._., ___,,_._,.,....... .........�
City or Post Office State ZIP Code
_..._ _ _ _._.__...__._..._.__._.. ....._... _.,_....._.. ....................................._._...,_.......................
......_.._..
Mechanicsburg PA 117050
___.._...__...----__...____...________.._.__._._._.___.... _...._.__.__,._l ._._.___.___.._.,...__..._....................
__...._-..__._......�
71 cn
Correspondent's email address: Jighome@verizon.net c p c.)
REGISTER-OF- IL"tS USE ONLY --A
REGISTER OF WILLS USE ONLY
CIODATE FILED STAMPS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505614105
aJ-�
v
1505614205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Frances V Gedid
RECAPITULATION
....._.........._.......__..__..._._.__.._,.......__....
1. Real Estate(Schedule A). . .. .. .. . . .. .. . .. . . . . . . .. .. .. . .. .. .. .. .. . . . . . 1. 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.
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . .. .. .. 6. 9,909.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested... .. . . . 7. 11,918.00
8. Total Gross Assets(total Lines 1 through 7). .. ...... . .. .. .. .. .. .. .. . .. .. 8. �..�.... F,.....,,,,m...µ,�M...-.....n.21,827.00
9. Funeral Expenses and Administrative Costs(Schedule H). . . .. . .. .. . . .. .. .. . 9. 15,311.00
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1).. . . . . . .. .. .. . . 10. 131,405.88
11. Total Deductions(total Lines 9 and 10). .. .. .. .. . .. .. .. .. .. .. . . . .. .. .. .. 11. 146,716.90 .
12. Net Value of Estate(Line 8 minus Line 11) . . .. .. .. . .. .. .. .. . ... .. . .. .. . . 12. 0.00
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which �� - '
an election to tax has not been made(Schedule J) .. . .. .. . . .. .. .. .. . .. .. . . 13. A „� �G4Y
14. Net Value Subject to Tax(Line 12 minus Line 13) . .. .. . . . .. . . . . .. .. .. . .. . 14. 0.00
3
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 1...
(a)(1.2)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ I u�..,-.....>.,.._�.- .,.�..�.,�.�..��..>.�......,.,..,� 16.
17. Amount of Line 14 taxable
at sibling rate X.12 I 17.
18. Amount of Line 14 taxable
R
at collateral rate X.15 18.
19. TAX DUE . .. .. .. .. .. .. .. . .. .. .. .. .. .. .. . .. .. .. .. . ... .. . .. .. .. .. . . . 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Under penalties of perjury, I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE OF S N RE P NSI FOR ILIW ETURN DATE
00,L11
ADDRESS f)"
j p OK K1d i�tJ r f�
SIGNATURE OF PREPARER OTHER THAN PERS!N RESPONSIBLEFOR FILING THE RETURN DATE J
ADDRESS
Side 2
1505614205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
FRANCES V. GEDID
Y
I STREETADDRESS
I ASBURY BETHANY VILLAGE, OAKS SKILLED NURSING HOME
325 WESLEY DRIVE
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)
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)
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 ............................................ ❑ E
c. retain a reversionary interest .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ E
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑ 0
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)].
Y> 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 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.
REV-1509 EX+(02-15)
Iffpennsylvania SCHEDULE F
DEPARTMENT OF REVENUE IOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
FRANCES V.GEDID
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.JOHN L. GEDID 5218 DEERFIELD AVENUE, MECHANICSBURG PA SON
17050
RICHARD J.GEDID 1016 AVACOLL DRIVE,PITTSBURGH PA 15220 SON
B.
s
C. _. .
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 01/01/03 'PNC BANK ACCT NO.50-0449-8099 8,609.00 . 100 8,609.00
1.' 01/13/03 :PNC BANK ACCT NO.50-0449-8099 (LIFE INSURANCE PAYMT) 771.00 100; 771.00
04102/15 ` PENSION PAYMENT 529.00 1001 529.00
E
I
1
TOTAL(Also enter on Line 6, Recapitulation) $ 9.909.00
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(02-15)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER—VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON—PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDETHE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
............................ .. ......... ............_......
..__ .- ...._. -. ._.._..
1• IRREVOCABLE BURIAL TRUST,INITIAL&INSURANCE DOCUMENTS 1 11,918.00 l' 1001 11,918.00
:ATTACHED. ANNUITANT FRANCES GEDID;OWNER JOHN GEDID; ; � I p
IRREVOCABLE'ASSIGNMENT TO DEBOR FUNERAL HOME.
♦
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TOTAL(Also enter on Line 7,Recapitulation) $ ffi
, 11,918.00
If more space is needed,use additional sheets of paper of the same size,
'REIN-1511 EX+(02-15)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
__..................__. __. __. __ _._. __._....._......__.. __....__.._.__._.__._. =xsx=, .... ... .
1' :PROFESSIONAL SERVICES (INVOICE ATTACHED) { ry . 5,105 00
_... ....._........._....................._._...._..._._...__ ..._ .._.........._..... _._
E i ICASKET&VAULT4,915 00 i
L„««.i ,...«..«....,.,,..«........,«««........................,.....,.................,..«.......,,.«...,..,......«,,..x.,...«..,..,.,.,,.,..,...:.............,,..._...,....,..,...,._,.,.«�.,.,,«,,..�.,.:
new--
NEWSPAPER
I
NOTICE,CLERGY, DEATH CERTS. HAIR,MILEAGE(HBG TO PGH) 1,367 00 n.
__......_.....__........_............._......_._._._.......... _.___ .__..
_..............._ .
__. .,_._.._.. . _........ ...... .._._.. x . .....
t [ PEN GRAVE AT CALVARY CEMETERY 11,695.00%
..«...i
--------«.... .........................................—_....�..... .,...._,.---...,........,........__.,,..._...«.....r ..... .. _ ,-
f `:INSCRIBE GRAVE MARKER205.00
` ;:DINNER AFTER FUNERAL(DeBLASIO RESTAURANT, PGH) ( 1,524 OO i
„ xxxxx. x.=.. ,x.=xxx<,x,<.........x....xx==xx==x.-,, x..x r.,x>....-x..,_ . .x..r..., =xr. _.
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B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
P
Name(s)of Personal Representative(s) ” rt`.5�:;.;♦' r:r= " " �- ''"
Street Address
City State ZIP
Year(s)Commission Paid:
:a.
2. Attorney Fees:
!x
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees: '
6. Tax Return Preparer Fees: 500.00
1..
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TOTAL(Also enter on Line 9, Recapitulation) $;`{ 15,311 00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(02-15)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
«. .a».««..»................«... -.,.:___......«...............«_«-.. ..,.__.,«..-_............,,... .,..e..__«..«....,...._.........«.... ....,
1 ;PENNSYLVANIA DEPT OF HUMAN SERVICES,MEDICAL EXPENSES
.._.._.
29,:598.98I6c
..::N.NNN
... rt:..s-:...... "r
'PENNSYLVANIA DEPT OF HUMAN SERVICES,LONG TERM NURSING CARE „xr rt^rtr rr 5Y4y101,806.90}'
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TOTAL Also enter on Line 10 Recapitulation)) S i Reca i" 131,405.88
if more space is needed,insert additional sheets of the same size.