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Home My WebLink About09-08-15 pennsytvania 1505614105 DEPARTMENT OF REVENUE 1 EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN I � i ��"" -"__ , Harrisburg , PA 17128-0601 RESIDENT DECEDENT i , l i � ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY - � i 1106222015 12281923 - N Decedent's Last Name Suffix Decedent's First Name MI Slderis i Constantine LT (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 CD 1.Original Return O 2. Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) O 7. Decedent Died Testate O 8. Decedent Maintained a Living Trust 1 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 TO: Name Daytime Telephone Number (James C. Sideris (extr) I (717) 732-6020 First Line of Address 1012 Wansford Road Second Line of Address — , I , City or Post OfficeState ZIP Code Mechanicsburg' , I PA 117050 Correspondent's email address: Jimsideris@verizon.net c� IM REGISTE"FWLLS US LY n F 1 •- C J -b C''3 REGISTER OF WILLS USE ONLY - DATE FILED MMDDYYYY C� 15 r t r, DATE FILED STAMP) I"rl O GO a N 'T1 PLEASE USE ORIGINAL FORM ONLY Side 1 L 111111111111111111111till[11q1111,1111 11111111111111111 5 1505614105 1505614205 REV-1500 EX(FI) Decedent's Social Security Number Decedents Name: Constantine T. Sideris RECAPITULATION 1. Real Estate(Schedule A). . ..... .. . .... ...... .... ............. .... .. .. 1. 0.00 2. Stocks and Bonds(Schedule B) ..... ....... .... .. . .... .. .. .. .. .. . .. ... 2. 0.00 i 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .... . 3. 0.00 j 4. Mortgages and Notes Receivable(Schedule D).. .. .. ....... .. .. .. .. .. .... 4. 0.00 5.- Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). ...... 5. 132,146.61 j 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. .. . .. 6. 25,818.03 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property = (Schedule G) O T Separate Billing Requested.. . .... . 7. 0.00 8. Total Gross Assets(total Lines 1 through 7). . .. .... . .... .... ... .... .. .. . 8._1 157,964.63 i 9. Funeral Expenses and Administrative Costs(Schedule H).... .. .. .. .. . .. ... . 9. i 762.63 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). .......... .. .. 10. ry 2,699.39 11. Total Deductions(total Lines 9 and 10) . ... ... ...... .. .. ..... ...... .... . 11. 3,462.02 I I 12. Net Value of Estate(Line 8 minus Line 11) .. .... .... .... . .. .. .. ..... .. .. 12. 154,502.61 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which •� -�� an election to tax has not been made(Schedule J) . .. ........ .... .. .. .. ... 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) . .... .. .. .. . .. ..... .. .. . 14. 154,502.61 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 r-- __�. -,_-------- - --------_ _- 4 --....---__�-.-- ----- __�-----� (a)(1.2)X.0_ i 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 ; 154,502.61 16• 6,952.62 17. Amount of Line 14 taxable -� at sibling rate X.12 17. ; 18. Amount of Line 14 taxable at collateral rate X.15 L 18. y 19. TAX DUE . ... ... . ... ... ... .. . .. . ... ....... .. ... .... . .... .... .. .... 19.' 6,952.6 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 accompanyingschedules.and statements,:and to the!'best sof xn, !knowledge Band ibelief, P p l rX 9 Y g it is true, correct and comp te. Declaration of preparer other than the iperson responsible for filing the return its ibased on a l information of whish ppreparer has any knowledge. 11 SIGNATURE OF PERS N ESPONSIBLE FDR FILIN R URN, !DATE 08/26/2015 ADDRESS 1012 Wansfor Road, Mechanicsburg, PA 17050 SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBL'E'FOR'.FILING THE RETURN IDAT'E ADDRESS i��i�i�i�i�i�oiii Side 2 1505614205 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Constantine T. Sideris STREETADDRESS 60 Lee Ann Court CITY STATE JiFP Enola PA 17050 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,952.62 2. Credits/Payments A.Prior Payments 0.00 B.Discount 347.63 (See instructions.) Total Credits(A+B) (2) 347.63 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) 0.00 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) 6,604.99 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 ............................................ ❑ N c. retain a reversionary interest .............................................................................................................................. ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ N 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? ........................................................................................................................ ❑ 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 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-1508 EX+ (02-15) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Constantine T. Sideris 2015-00733 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• PNC Bank Account Number 50-0627-6596 130,230.05 2 2003 Ford Focus 1.,833.00 3 Cash on Hand 83.56 TOTAL(Also enter on Line 5, Recapitulation) $ 132,146.61 If more space is needed,use additional sheets of paper of the same size. REV-1509 EX+(02-15) pennsylvania SCHEDULE F DEPARTMENT REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAXAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Constantine T. Sideris 2015-00733 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, Nancy A. Miller 29 South Arlene Street Daughter Harrisburg, PA 17112 B.Thomas C. Sideris 5178 Calle Asilo Son Santa Barbara, CA 93117 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 DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 03/28/05 PNC Bank Account 50-0435-3666 40,179.22 50% 20,089.61 2 A 09/28/08 Citizens Bank Account 6253744012 3,353.83 50% 1,676.92 3 B 09/01/65 PNC Bank Account 51-4005-8362 8,102.99 50% 4;051:50 TOTAL(Also enter on Line 6, Recapitulation) $ 25,818.03 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (02-15) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Constantine T. Sideris 2015-00733 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' TBD B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) TBD Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 362.13 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: 400.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TBD TOTAL(Also enter on Line 9, Recapitulation) $ 762.63 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(02-15) Jpennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Constantine T. Sideris 2015-00733 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 1. Utilities 232.23 2 Auto Insurance 141-01 3 Rent 2;220.00 4 Other Estate Expenses 1106.15 TOTAL(Also enter on Line 10, Recapitulation) $ 2;699.39 If more space is needed,insert additional sheets of the same size.