HomeMy WebLinkAbout09-26-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
FRANKOVICH LEONARD T
4410 CHESTNUT ST
CAMP HILL, PA 17011
__nun fold
ESTATE INFORMATION: SSN: 174-24-2440
FILE NUMBER: 2105-0745
DECEDENT NAME: FRANKOVICH MILDRED G
DATE OF PAYMENT: 09/26/2005
POSTMARK DATE: 09/26/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/16/2005
NO. CD 005839
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $442.96
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 0096
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
$442.96
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV.1500 EX 16-00'
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL)
Ff<.~Nt<c)V\'eH- M~L.t>~cb
DATE OF DEATH (MM-DD-YEAR)
08 - { 6 - 2(<)0 0..;:-
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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~ 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Willi
D 9 Litigation Proceeds Received
G.
DATE OF BIRTH (MM-DD-YEAR)
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D 2. Supplemental Return
D 4a. Future Interest Compromise (cate of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
FILE NUMBER
;)l_-O~
COUNTY CODE YEAR
/'
.1)Q.2-~~
NUMBER
SOCI~7SECURITY NUMBER
(1 '-t - :2 --:l L\- c.t 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of deafh prior 1012-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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nu$..ECTtOl\l'~....'QQII~."iq."'CO""'POHl)EMCE.,,"D'~~e~tM:'
NAME I LI ~ r-~ _ I COMPLETE MAILING ADDRESS
t--- E.O!\Jrt"'-(L't/ '\-1'<-A"....H.<...<J0 \~ \""'t LLU LO C+-\ESTt-lJ"l ST.
FIRM NAME (If ApplICable) \" 1:
CrtmP -t+\-L.. '-l VA. lrC ( (
TELEPHONE NUMBER
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages. & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D 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)
(1)
(2)
(3)
(4)
(5)
II, '?-:J.. \. \ 9
(6)
(7)
(9)
(10)
It 4 S' ". ~~
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
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)
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14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
IOl~~(' t..:.c.f-
x.O _ (15)
XO'+S;--(16)
x .12 (17)
x .15 (18)
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(8)
((, ~ 2.(. ( '1
114. <;l - ---
(11) ~6
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(12) 10 I "6 ~ { .
(13)
(14) (0\ ~ ~ (. ~t{
Lf-G Co. ~ 7.
(19)
LU~~ t 2 7
Decedent's Complete Address:
STREET ADDRESS J::1 '" C'
NO(L.".,.. I.. L-
Wr"tL..N ~
JLL \, & L E. \? p..-
CITY
R-d.
~d\TdvY\
(JOl
STATPA- _
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount ~ ~ I ~ I
(1 )
Total Credits (A + B + C ) (2)
~s . ~ {
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( 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)
ZIP
V1Qt
Lf-<o~. L 7
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5) 4lt 'd.. \ c:r ~
A. Enter the interest on the tax due.
(5A)
4*"2-. ., ~
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
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
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
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
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
SIGNATURE 0
ADDRESS
H~LL.
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Ct\(Y\f>
DATE cr-( ~C, 0:;-
ltG' (
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 39116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 39116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, nnd the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 39116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 39116(1.2) [72 P.S. 39116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1511 EX+ (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
tr\H....\>RE:'D 5-~ kA""KO"~(C:H
FILE NUMBER
ITEM
NUMBER
A.
B
Debts of decedent must be reported on Schedule I.
DESCRIPTION
1.
FUNERAL EXPENSES:
f'r\.ll ~ ~ E L fY'IR ,,' ,\="" 1"1\ € ~ -Pt '- .~ "1 L
'3 ~ ~ ~,",ffl Y'Y\ ~ '- A" €.. ,
~EYY\ c-( ~ f: ?A . \to,,", ~ _
E:""'l. ~e:NS~S NOI lN~L.-..i~€:..\) '^r fRt- Af':Rf'tNCE>Y\€N. \
p... r-\.e:..~A,- ~c~ ~R..p,~ T
;;to
C€(/i<;:'''Tfo.-2., '( (YIA\~ ~€({..
l~. Gp..~NT\,a>w ~\.~ \. 'rY\JMv'/rl€.~\s. .1:"'Nc::.
L <a w c:"S\ E;~'b ~.;:) ~D -''1 N th,..r~ J\)
UJ~L.<gc;.-~f\~R(.. ?F\. 1<a"O<"
ADMINISTRATIVE COSTS:
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'3 . c:,~C.O r-
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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
2. Attorney Fees
Year(s) Commission Paid:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
4.
5.
Claimant
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
Probate Fees r.. (; G \ S. ~ S ~ 0 l= w \ L..~ b
r-- ,. i- U~ \:r- ,:' E t..
Accountant's Fees
-"q.c:l()
\ s.. 0 0
6. Tax Return Preparer's Fees
7.
AMOUNT
lIOiC.S-S:-
.-
q:l. CO
"?.o 0 .." 0
cr't.O'O
TOTAL (Also enter on line g, Recapitulation) S \ ~ ~ ~ . <; S-
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00) .
'*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
FilE NUMBER
ESTATE OF
(\\L.'D R. CD E;. RAN \<0,", l~H
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)] SCl'.' ~ /'1.
1. L€.c~ ~~D F';z..p.~}5c "Jl~ 14-
4"'t l Co c tt t:sI rHJ I S I .
C-fh'YlY t-fiL..L., f'~. .,0" 'D~u~TE:.n "/1
J.'~ '8SlZ.t-i \e~ eA-~~,...L
10 \ c;l....I) 'M:l~ ~IV't.-
eArn? ttll..l..., PA.. "0' l
3. RA't iY"C1'1 'D ~;: 1'\ 't<:..c v \ Co t+ ~C;N \/1
:)..l 6 u ~ I", ~ So. l-
'?Lft-I N S ?A ~ I~ .as.
'-+, (Y\ \ c: H r't E: t. 'i='"t2- ~ l'o\ ~" ~ Co \+ 6 RAH. \':) 50 r-..l \ [1
I 2..5"' T~c ~A-~dE. R d~
\)'LL-.~Gu"G-\ i;'H. llCJlcl (;.RRtV'D -
5, K~E.rl l<;AuFFmAr-1 _ ~ (1-
3q\~ ~,i:>~i...AND .a\_:-JD.. . ~ A\J (;t-+ n'~
ff\ e:~ ~ A-I'.h ~s ~""'RC:r ?A-, \,055
, - \
\3~ \ G...... G-~~Mt> s~r-J \./1.
l...,. Ch~\-sIb"T\e:lt... '~ '
e t'l. Cl t... t> Fe. l\ '\:) d...?- \.., Cl C
N.E..- ' C\J(Y\6~R\...A-M v, !A<
I........ _ G~ANl> -
l .~. . . c: A G~~r--l \ ~ 1'1
,)'t..~S\. 'Fb~'O bR.lv'C \::> A U G-ti\1:.:. g,.
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ENTER DOLLAR AMOUNTS F~R DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S
(If more spac~ is needed, insert additional sheets of the same size)
-'~"'''m '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE fAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
f'nIL\)R-E:D G.. ~~AK.(<C."lCH
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
c..rtt~'t( 11'\ G-ACCch..i0tI- 6S:3..~C~ (.q1cl8
Cc VV\ 1Y\ E.~ <eo. ~ ~ ~N ,"'-
<... AAI.... \~\"-''L. ~ \~'C.. _
Y'f\ 'L~ ~'A-r-t \ ~':;> Slj R G-, ?A, llO ~s..
VALUE AT DATE
OF DEATH
8 5ao~ y-v
I
"J. .
\-.i. e. R ~A-1\.\d L. C ~R ~
\ZE:~\'Vt..t-l\5 ~C::R.S6N.AL.- \~v~T
CA~\.'I,.S\"'e:. FAe.\.I.-\.\"'1 .~~\~
CA-R\...U;\..t\.. ~~ .
\=,....J i'J p
?:l ~ -:"'5 . "1<t
'v
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$lll'l 8~. . l Cf
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