HomeMy WebLinkAbout07-01-05
REV-15QIj EX 16-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
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FILE NUMBER
21 05
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE YEAR
NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Miserendino, Lesley Ann
DATE OF DEATH (MM-DD-YEAR)
02/19/2005
SOCIAL SECURITY NUMBER
339-82-7216
DATE OF BIRTH (MM-DD-YEAR)
12/09/1979
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Allach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12.82)
o 7. Decedent Maintained a Living Trust (AllachcopyofTrusl)
o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1.1.95)
o 3. Remainder Return (dale of death prior to 12.13.82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SECTION MUST BECOMiPL.ETED.
NAME
John S. Lawler, Esquire
FIRM NAME (If Applicable)
Kegel Kelin Almy & Grimm LLP
TELEPHONE NUMBER
(717) 392-1100
COMPLETE MAILING ADDRESS
24 North Lime Street
Lancaster, PA 17602
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5) 7,235.92
(6)
(7)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
(8)
15,658.71
7,235.92
10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
(12)
(13)
15,658.71
-8,422.79
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
-8,422.79
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
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(15)
(16)
0.00
0.00
16. Amount of Line 14 taxable at lineal rate
x .0 .
_ x .12
(17)
(18)
(19)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
14 GinDer Drive
CITYM h . b
ee ames urg
I STATE
PA
I ZIP 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. ,his is the TAX DUE. (5)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
0.00
A. Enter the interest on the tax due.
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;........................................... 0 ~
c. retain a reversionary interest; or.......................................................................................................................... 0 ~
d. receive the promise for life of either payments, benefits or care? ................................................................... 0 ~
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [iJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 [iJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
6'(0 -I S - J- UOS
DATE /'
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For dates of dea r after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS. 99116 (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 th
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disc
the surviving spouse is the only beneficiary.
For dates :If death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger (
or a stepparent of the child is 0% [72 PS. S9116(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%, E
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S
individual who has at least one parent in common with the decedent, whether by blood or adoption.
(\APl)
99116 (a) (1.1) (ii)].
II applicable even if
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In adoptive parent,
9116(a)(1)].
!ction 9102, as an
REV-:S08 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Lesley A Miserendino
FILE NUMBER
21-05-0440
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
NUMBER
DESCRIPTION
Citizens Bank checking account #620012-454-3
VALUE AT DATE
OF DEATH
2 Citizens Bank savings account #6244-728608
5,584.95
1,650.97
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
7,235.92
REV-:511 EX+ (12-99)*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Lesley A Miserendino
FILE NUMBER
21-05-0440
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Modell Funeral Home
Resurrection Cemetary
8,908.71
6,700.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
. State
Zip
Year(s) Commission Paid:
2. Attorney Fees
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
50.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
15,658.71
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T01AL f
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c.a"t;;IIIt::1 tl lUI ClllUIIIUIIIt;:IIL
"We would 1I0t, brethren. have,Y(lu igl1orolll c(l/2.Cerning tlJose who (Jrt1 aslup. lesl you should grieve. t:1Ien as
o/her.t who have 110 hope. For Jfwe befi<:ve thar Je.~us died CJnd rose again. so with hi", GiJd will bring /htJse
also who have fallen asleep through Jesu..r. .. I Thessalonians, IV. )3-/4.
THIS AGREEMENT ma.dc this 25th day of February, 2005 by 3I1d betwcen TIrE CA THOUC BISHOP OF CHJCAGO. a corporation
sole. organi7ed and existing under a Special Act orlhe Legislature of the Slate of Illinois, through and by its duly authorized 3Stnt or aeeTtl.~.
p3l1)' of the fiM:t r;\rl (ncrciMfl.er called the "Granlor"), and
Robert Miserendino
136 C Enclave Circle
Bolingbrook IL 60440
Phone: (6"30) "783 -2909
pany of the second part (heremafter CQlled ,he "Grantee'), WITN ESSETH:
I. The GTllntQr, allhe price, upon thc ttnnS and sulljeclto the condItions nereiMflcr st!r ((lrch. does hc:reby give and gran! !o the Grantee
~r. Easemefll for Entombmenl in Resurrection Cemerery, 7201 Archer A'JeJ111C, JustIce. Illinois. 60458-1140.
rypf(S) Crypt 1240
Tier 4
Garden
INE: CRYPT 6,700. 00 CZUBIAK/in/lc
Monthly runc P:I.)'Tntllt PIILn of
BALANCE DUE
O~y of lh~ lTlOTlIh
c:aell p:lymcnl is due
Number of /Tlorlthly
payments
^mounl (If firsl monthly
"fA AMOUNT PAID DOWN 6."700. 00 pJymcnl
Amoullt o{ellch monthly
BALANCE DUE aid in F'L 11 llllynlcnt e:r.ct'pl Cirst
I FrNANCE CHARGE WILL BE IMPOSED IN CONNECllON WITH THIS TRANSACTION AND ACCORDINGLY, THE TOTAL OfTHf.
YMf,NTS SCHEDULED IN THE MONTHf. V TIME 1>A YMENT PLAN SHOWN IS EQUAL TO TIlE BALANCf. DUE OF THE PRICE. IN THF. E VrNT
. A DEFAULT BYTHE CRANTF.E WlUCH CONTINUES FOR 60 "DAYS. OR BREACH 8Y THE GRANTEE OR THEIR HEI.RS. UGAJ.
fR,ESF..NTATI\'lI:S, SUCCESSORS OR ASSIGNS, TH'F. CRANTOR MAV [XERCtSF. 1'K[ RIGJIT~ DF-SCRlBED IN I"ARAGRAPH5 14 I\!'IO IS.
The Cr~ll:" &hall hold ml! E.:lScn1ent subject 10 the following oovenanu and cOl'ldiliuns:
2. tf lhe: EasCnlC1lt is not paid for in aeeordnf\ct WIth the: tt:rm.': stipulaled in Paragraph I abovc, " sC1'Iice ch:ltge is [0 be: addea
.i. No entombment shall be: 'P~jtted uIlril an amount equal 10 payment for one crypt sh;l.1l have been made. Additional
cnlombmcnfS shall be ,governed by the samt rLlIC', the terms of acqUISItion no\'Wuhsll1nding, No enlombmeJ'1l of any person not a mcmber
of the Grantee's family shall b~ ITUIde without the prior C'~lnSC'TIt oft"e Grantor.
4. Unless othmorise specified in Paragr.lph I of this Asreemcnt, this Ea.semenl shall include entombment and appropriate Crypl
idenlifiCAtlon. sueh idenrificacion Jubjec:l to rhe Rule!: and Re8ul~tions ofrhe Gruntor now or hemnafter in force
5. The Gl"lInlOr shall not be held liable: for damage as a result of ~ ac1 of God or mal !cious mischief or for 4ny olher occurrence:
where the Grantor h:lS exercised reasonable: C'oif'C.
6 All SCT"oIiccs SbOllt the crypt or m:lU.l:ole:um requiring 13bor &hall he ('lC"rormcd only by the Gr:ln(or.
FINAL EASEMENT
No. M
11240