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Home My WebLink About10-18-05 .,.,------ ~ if. If)o <J: .01 I- ~ . M ~8~::r-:M6M a...a:VlO_~~ .a...~~I-OI'- ~ :E: ~~- ::J ~ - :I: Vl('Y1 I- CJ:! 5c::J ~-E:A <J: ~~n~ ...is . H ~ ~8 -~ ~ 'If (p-.. ........ 0-- o V) p ~ 'c/- ; -"IL~ L#i , i'" I (1 j ( t.) r. \ ~ ~M ;::I...... .$ 0" ~ ~rJ:i~ ~~< ~g~ ""' ..c:~ ~~ 2 Vi r:n ._ .- 0] ~UU ~...... REV.l500 EX 16-00) '* COMMONWEALTH OF PENNSYLVANIA .' DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT [)C} L~_ NU BER I- Z W C W (.) W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Neidig, Louise E DATE OF DEATH (MM-DD-YEAR) 05/06/2005 FILE NUMBER c2 L -Q...5 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 174-20-7963 DATE OF BIRTH (MM-DD-YEAR) 01/17/1925 THIS RETURN MUST BE FILED IN DU L1CATE WITH THE REGISTER OF W LLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- ~:$1Il ull:~ wll.U :1:00 ull:...J Il.lD Il. <( ~ 1. Original Return =:J 4. Lirnited Estate =:J 6. Decedent Died Testate (Attach copy of Wil) =:J g. Litigation Proceeds Received =:J 2. Supplemental Return =:J 4a. Future Interest Compromise (dale of dealh after 12-12-82) =:J 7. Decedent Maintained a Living Trust (Attach copy oITrust) =:J 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) =:J 3. Remainder Return (dale of deal prior to 12-13-82) =:J 5. Federal Estate Tax Return R quired 8. Total Number of Safe Depos Boxes o 11. Election to tax under See. 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) =:J 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) 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) NAME John S Kostukovich FIRM NAME (If Applicable) John S Kostukovich CPA TELEPHONE NUMBER (717) 730-0820 z o ~ ..J ::;) l- ii: ~ (.) w a:: 14. Net Value Subject to Tax (Line 12 minus Line 13) COMPLETE MAILING ADDRESS 1104 Femwood Avenue Suite 302 Camp Hill, PA 17011 (1) (2) (3) (4) (5) 29,456.00 (6) (7) (8) 29,456.00 (9) (10) (11) (12) (13) 29,456.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 29,456.00 z o ~ r; ::;) Q. :e o (.) ~ 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 20. =:J x .0_ (15) x .0_ (16) 29,456.00 x .12 (17) 3,534.72 x .15 (18) (19) 3,534.72 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 824 Lisburn Road CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,534.72 Total Credits ( A + B + C ) (2) 3. InteresUPenalty 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. This is the TAX DUE. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) 3,534.72 A. Enter the interest on the tax due. 3,534.72 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BlO KS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... :=J ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ :=J ~ c. retain a reversionary interest; or.......................................................................................................................... :=J ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... :=J ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. :=J ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. :=J ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which IF THE ANSWER ~~t:~~a ;n;:c;:;~:~a~:;~~;~~~..;~..~.~~:.~~~.~.~~~..~~~~~~~~.~~~~.~.~~~..~.~~~.~.;~E ~ AS PAR~OF kHE RETURN. Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. I Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. JURE 1 ADDRESS Andrea DesRoches, 40 Popps Ford Road, York Haven, PA 17370 SIGNATURE OF P PARER N REPRESENTATIVE 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 [72 P.S. 99116 (a) (1.1) (i)J. 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. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are 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, jln adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. , I 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. 99116(1.2) [72 P.S. ~9116(a)(1)]. ihe tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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. 10 DATE ,- REV-1508 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Louise E Neidig I cI d th SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY d fiT f d th d t th d FILE NUMB R . db n u e e procee SOl Iga Ion an e a e e procee s were receive y the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE A DATE NUMBER DESCRIPTION OF DE ATH 1 Sovereign Bank, Checking account #1661209556 29,456.00 I TOTAL (Also enter on line 5, Recapitulation) $ 29,456.00 (If more space is needed, insert additional sheets of the same size) REV.1511 EX+ (12'99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Louise E Neidig SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedu Ie I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOU NT A. FUNERAL EXPENSES: 1. None - prepaid i 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. I I I , TOTAL (Also enter on line 9, Recapitulation) $ I 0.00 (If more space is needed, insert additional sheets of the same size) 1 . REV-1513 EX. (9-00) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Louise E Neidig FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR 5HARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTA E I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Andrea DesRoches niece 100.00 40 Popps Ford Road York Haven, PA 17370 I I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHE T II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I I I I 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ I I (If more space is needed, insert additional sheets of the same size) II COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE 8UREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 0051904 DESROCHES ANDREA K I 40 POPPS FORD RD YORK HAVEN, PA 17370 ACN AMOU~T ASSESSMENT CONTROL I I NUMBER I ! ..... ----~--- fold ---------- I -------- 101 I $3,534. 172 ESTATE INFORMATION: SSN: 174-20-7963 I I 2105-0919 I I FILE NUMBER: I I DECEDENT NAME: NEIDIG LOUISE E I I I ! DATE OF PAYMENT: 10/18/2005 I I I I POSTMARK DATE: 10/17/2005 I COUNTY: CUMBERLAND I I I I DATE OF DEATH: 05/06/2005 I I I TOTAL AMOUNT PAID: $3,534 72 _. REMARKS: CHECK# 102 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBA~Q..H REGISTER OF WILLS REGISTER OF WILLS