HomeMy WebLinkAbout11-30-05
REV-15Oll EX (6<)0)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
RLE NUMBER
21 05 00371
COONTY COOE
YEAR
NIIIlER
'* COMMONWEALTliOF
, PENNSYlVANIA
DEPARTMENT OF REVENUE
DEPT. 28l1i01
.. . HARRISBURG, PA 17128-(]6()1
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DECEDENTS NAME (lAST, FIRST, AND MIDDLE INITIAL)
Magnelli Clare J.
DATE OF DEATH (MM-OD-YEAR)
04/16/05
SOOAL SECURITY NUMBER
18()"'()9-5210
THIS RETURN MUST BE RLED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return {dalllor_priorlo 12-13-62)
D 5. Federal Estate Tax Return Required
8. Toad Number of Safe Deposit Boxes
o 11. Electron 10 lax under See. 9113(A) (A!lIId\ Sd1 0)
DATE OF BIRTH (MM-DD-YEAR)
03/10120
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
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D 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (Al1adI cqJy cJ IW)
o 9. Litigation Proceeds R8<Bived
o 2. Supplemental Retum
o 4a. Future Interest Compromise (_0I_ofter12-12-82)
D 7. Decedent Maintained a Living Trust (AIl8dlcqJycJTrust)
o 10. Spousal Poverty Credit _ 01_ boM8l12-31-91 and 1-1-8S)
COMPlETE MAILING ADDRESS
13 Oak lane
Mechanicsburg,PA 17050
51,614.54
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NAME
Kathryne M. Glenn
FIRM NAME (" p,ppicalJleJ
N/A
TELEPHONE NUMBER
(717) 697-4563
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(8)
10,818.00
1,534.78
(11)
(12)
(13)
51,&14.54
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1. Real Estate (Schedule A)
2. Stocks and Bonds (SdJedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Reoaivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(SdJedule E)
6. Joi(1tly Owned Property (Schedule F)
o SeparalB Billing Requested
(1)
(2)
(3)
(4)
(5)
12,352.78
39,261.76
(14)
39,2&1.7&
(6)
(7)
7. Inter-VIVOS Transfers & Miscellaneous Non-Probate Property
(SdJedule G or L)
8. Total Gross Assets (lDtal Lines 1-7)
9. Funeral Expenses & Administrative Cos1s (SdJedule H)
10. Debts of Decedent, Mortgage Uabiliies, & Liens (Schedule I)
11. Total Deductions (tolal Lines 9 & 10)
12. Net Value of Estate (Line 8 milus Une 11)
13. Charitable and Governmental BequeslslSec 9113 Trusts for which an election to tax has not been
made (SdJedule J)
(9)
(10)
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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 See. 9116 (8)(1.2)
x .0 _ (15)
(19)
5.889.26
5,889.2&
16. Amount of Line 14 taxable at lineal rate
x .0 _ (16)
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17. Amount of Line 14 taxable at sibling rate
x .12 (17)
39,261.76
x .15 (18)
18. Amount of Line 14lBxable at col1ateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING", REFUND OF AN OVERPAvr,'EN,
Decedent's Complete Address:
STREET ADDRESS
Sara Todd Memorial Home
1000 W. South Street
CITY C rr I I STATE I ZIP
a Ise, PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
5,889.26
Total Credits (A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
0.00
0.00
5,889.26
0.00
Total Interest/Penalty ( 0 + 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. (5)
A. Enter the interest on the tax due.
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 [i]
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i]
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [!J
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 RetirementAccount, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 [i]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules ~d statemenls, and to the best of my knowledge ~d belief, rt is true, correct ~d complete.
Dedaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA UR OF PERSON RESPO S E FOR FILING RETURN DATE
11/25/05
ADDRESS
13 Oak Lane Mechanicsburg, P~17050______________~_________~_____
SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE 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. ~9116 (a) (1.1) (ill.
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. ~9116 (a) (1.1) (ii)).
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 still applicable even if
the surviving spouse is the only beneficiary.
For dales 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 nalural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The lax 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. ~9116(1.2) [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% [72 P.S. ~9116(a)(1.3)). A sibling is defined, under Section 9102, as an
individual who has af least one parent in common with the decedent, whether by blood or adoption.
REV-150B EX+ (6-98) _
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Clare J. Magnelli
FILE NUMBER
2105-00371
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
VALUE AT DATE
OF DEATH
1 Certificate of Deposit
15,375.10
2 Savings Account
15,104.29
3 Checking Account
21,082.71
52.44
4 Inlrest check from $6,000.00 Ufe Insurance Policy
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
51,614.54
REV-1511 EX+ (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Chr~J: MQ5V\e.l t i
FILE NUMBER c1/ 05 003'7/
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
AMOUNT
B.
1.
2.
3.
4.
5.
6.
7.
DESCRIPTION
1.
FUNERAL EXPENSES:
Funeral Home Costs
Grave site,opening and closing
Bronze Memorial Head Stone
Luncheon
7,500.00
1,400.00
1,495.00
295.00
2.
3.
4.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Kath ryne M. Glen n
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 13 Oak Lane
0.00
City Mechanicsburg,
Year(s) Commission Paid: Forfieted
State PA Zip 17050
Attorney Fees
0.00
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
0.00
Claimant
Street Add ress
City
State
.Zip
Relationship of Claimant to Decedent
Probate Fees
128.00
Accountant's Fees
0.00
Tax Return Pre parer's Fees
0.00
10,818.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABIUTIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Clare J. Magnelli
FILE NUMBER
2105-00371
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
EMS West Shore (stretcher van)
86.10
2.
Kunkel Surgical Group $54.24 & $2.65
56.89
3.
Iron Ridge Family Practice
40.40
4.
Andrews & Patel Assoc.
51.66
5.
Timothy A. Clark MD
27.95
6.
George Shahinian MD
3.84
7.
Nephrology Assoc.of PA
3.42
8.
Belvedere Medical Corp.
12.87
9.
Sara Todd Home (6 days room & board & laundry)
1,212.40
10.
PharMerica (medical bill after Ins.lHospice paid)
1.40
11.
All Telephone bill (Aunt Clare's prior to going to hospital)
37.85
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,534.78
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REV-1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Caire J. Magnelli
FILE NUMBER
2105-00371
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 pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)1
1. Earl Anthony Magnelli 707 S. 27th S1. Harrisburg,PA 17111 Nephew 3,708.05
2. Michael Joseph Magnelli 2336 Derry S1. Harrisburg, PA 17111 Nephew 3,708.05
3. David L. Magnelli 11025 Roessner Ave. Hagerstown, MD 21740 Nephew 3,708.05
4. Kathryne M. Glenn 13 Oak Lane Mechanicsburg, PA 17050 Niece 3,708.10
5. Faust LaTorre 3735 Brisban S1. Harrisburg, PA 17111 Nephew 3,708.05
6. Anna Marie Stranges 8470 Kensi Court Hummelstown, PA 17036 Niece 3,708.05
7. Teresa LaTorre 8470 Kensi Court Hummelstown, PA 17036 Niece 3,708.05
8. Nancy Davis 611 Charles S1. Mechanicsburg, PA 17055 Niece 8,708.05
9. Harry Arnold Jr. 4882 Silveroak Drive Dayton, OH 45424 Nephew 8,708.05
ENTER DOLLAR AMOUNTS FOR 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
0.00
0.00
0.00
0.00
0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
0.00
0.00
0.00
0.00
0.00
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
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