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HomeMy WebLinkAbout01-17-07 ....J 15056051058 REV-1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes PO BOX 280601 Harrisbtwg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number ~ ~ bG- bSC\:~ Date of Birth 199-05-7326 OS/26/2006 10/01/1922 Decedent's last Name Suffix Decedent's First Name MI Krajcsik (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name SuffIX Charles F Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW . 1. Original Retum 2. Supplemental Retum 3. Remainder Retum (date of death prior to 12.13-82) 5. Federal Estate Tax Retum Required 4a. Future Interest Compromise (date of death after 12-12.82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1.95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONADENTlAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 4. Limited Estate . 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes James W. Abraham, Esq. Finn Name (If Applicable) Abraham Law Offices (717) 763-1700 REGISTER OF WILLS USE ONLY :'-.' r -': .~~.:;L First line of address 2157 Market Street Second line of address -" City or Post Office Camp Hill State ZIP Code DATE FtLED I PA 17011 ----I " ( ,..) r".) <::) Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this retum, including acoompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN~ATU~~: ~NS'LY~G R~TURN , lATE ADDRESS ~.-\I----- p~~~ .. - ~!-"?t-7:- ~~ 6~__ _ Charl~s M. Kra'~ik, Execu~or - 231 Harding Ro~~, Scotch PI~i~s, NJ 07076 SIGNATURE OF. REP. OTHER THAN REPRESENTATIVE ~ !JZ) (,,-=-- I - ADDRESS James W. Abraham, Esq. - 2157 Market Street, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY. L 15056051058 Side 1 15056051058 --.J ~ -.J 15056052059 REV-1500 EX Decedenfs Name: RECAPITULATION Charles F Krajcsik 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested " . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10).. .. . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) .. . . . . . . . . . . . . .. . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2)X.0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 9,953.27 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 199-05-7326 Decedent's Social Security Number 8,688.00 106,409.11 21,869.42 100,277.47 237,244.00 14,214.88 1,845.28 16,060.16 221,183.84 0.00 221,183.84 0.00 9,953.27 0.00 0.00 9,953.27 15056052059 -.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Charles F Krajcsik STREET ADDRESS 1103 Apple Drive File Number DECEDENTS SOCIAL SECURITY NUMBER 199-05-7326 -- ..~ CITY Mechanicsburg I STATE PA TIIP I 17055 . .--- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,953.27 Total Credits ( A + B + C ) (2) 0.00 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. Fill in oval on Page 2, 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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 0.00 0.00 9,953.27 0.00 9,953.27 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 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 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 Win 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 ~ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 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 the use of the surviving spouse is zero (0) percent (72 P.S. 99116 (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 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 zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [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. 'i ,....,) r ~;, \,';:;, c......-, LAST WILL AND TESTAMENT KNOW ALL MEN BY THESE PRESRNTS, that I, CHARLES F. KRAJCSIK, presently residing at 306 South High Street, Mechanicsburg / Cumberland County, Pennsylvania, being in good health and of sound mind and disposing memory, do hereby make, declare and publish this as my Last Will and Testament, hereby revoking all former wills and codicils thereto heretofore made by me. FIRST: direct that all of my just debts, expenses of my last illness, and funeral expenses shall be paid by my Executrix, hereinafter named I from my estate as soon after my decease as shall be found convenient. SECOND: I give, devise and bequeath the rest, residue and remainder of my estate I whether real, personal or mixed I and of any nature whatsoever and wherever situated I unto my beloved wife, AN'XOINETTE G. KRAJCSIK. THIRD: In the event that my wife, Antoinette G. KraJcsik, should predecease me or die within thirty days following the date of my death, then I give, devise and bequeath the rest, residue and remainder of my estate unto my children I share and share alike. In \ the event that a child of mine should predecease me leaVing issue to survive me, the said child; s share shall be payable to his or her is sue, per stirpe s and not per capita. ~vz~ Page One EXHIBIT, "A" l" ) i....) I " ~. ,"; \ (" ,~- :~ \. ::J .' "j , I T"\ .-) :."\ .", f " FOURTH: In the event that my wife, ANTOINETTE G. KRAJCSIK, my children and the issue of my children shall all pre- decease me or shall all die within thirty days following the date of my death, then I give, devise and bequeath the rest, residue and remainder of my estate as follows: (a) One-half to my brother, RUDOLPH KRAJCSIK, presently of Mechanicsburg, Cumberland County, Pennsylvania; (b) One-half to my wife's sister, JANE BARTORILLO, presently of Wilkes-Barre, Luzerne County, Pennsylvania. FIFTH: I direct that all taxes that may be assessed 'in consequence of my death, of whatever nature and by whatever juris- diction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. SIXTH: I hereby nominate I constitute and appoint my wife, ANTOINETTE G. KRAJCSIK, as Executrix of this, my Last Will and Testament. My said Executrix shall not be required to post security. In the event that my said wife shall predecease me, or be unwilling or unable to act as Executrix, as aforesaid, then I nominate, constitute and appoint my son, CHARLES M. KRAJCSIK, to act as Executor of this, my Last Will and Testamen't. IN WITNESS WHEREOF I I, CHARLES J. KRAJCSIK, the ---reSfat'O'tttl-tli::rs;-rnyLast Will and Testament, typewritten on three CJ~~.~A- ~ ""(r Page Two (3) sheets of paper which I have identified at the bottom of each page by my signature, hereunto set my hand and seal the If ~ day of IV4'V"I'{~t, 1975. c.1-L 1.'1( ~ (Seal) Signed, sealed, published and declared by said Testator as and for his Last Will and Testa- ment in our presence I who, at his request, and in his presence and in the presence of each other I have hereunto subscribed our hands as attes g witnesses. Page Three REV-1503 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Charles Francis Krajcsik FILE NUMBER 2006 - 00548 All property joInt1y-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Rite Aid Stock Account, 200 shares @ $38.85 Penn Gaming Stock Account, 200 shares @ $4.59 VALUE AT DATE OF DEATH 2. 7,770.00 918.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 8,688.00 REV-1508 EX+ (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Charles Francis Krajcsik FILE NUMBER 2006 - 00548 Include the proceeds of fitigation and the date the proceeds were received by the estate. All property jointly_ed with right of sUlYivorIhip must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Members 1 st Bank Certificate of Deposit - Acct. No. 40140-46 92,463.83 2. Commerce Bank Checking - Acct. No. 19587 330.33 3. Yellow Breeches Mutual Fund 2,314.19 4. Corncast cable refund 91.06 5. Insurance Refund - Auto & Renters Insurance 109.70 6. Vehicle: 2002 Subaru Forestor 10,600.00 7. Household Items/Furnishings 500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 106,409.11 REV-1509 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Charles Francis Krajcsik 2006 - 00548 If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SCHEDULE F JOINTLY-OWNED PROPERTY SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Charles M. Krajscik 231 Harding Road, Scotch Plains, NJ 07076 Son B. 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 DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 03/01/04 Members 1st Bank Checking Acct. No. 40140-11 7,902.78 50 3,951.39 2. A. 03/01104 Members 1st Bank - Savings Acct. No. 40140-00 88.43 50 44.22 3. A. 03/01104 Members 1st Bank - Life Savings Acct. No. 40140-04 4,000.00 50 2,000.00 4. A. 03/01/04 Members 1st Bank - Money Management Acct. No. 40140-05 5,935.54 50 2,967.77 5. A. 03/01/04 New Cumberland Fed. Credo Union - Primary Checking Acct. S1 6,430.37 50 3,215.19 6. A. 03/01/04 New Cumberland Fed. Credo Union - Christmas Club Acct. S8 2,466.17 50 1,233.09 7. A. 03/01/04 New Cumberland Fed. Credo Union - Certificate of Deposit Acct C1 16,915.51 50 8,457.76 TOTAL (Also enter on line 6, Recapitulation) $ 21,869.42 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Charles Francis Krajcsik FILE NUMBER 2006 - 00548 This schedule must be completed and filed if the answer to any of questions 1 lhrough 4 on the reverse side of the REV-l500 COVER SHEET is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S ITEM INClUDE THE NAME OF THE TRANSFEREE, THEIR RELATKJNSHIP TO DECEDENT AND EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF Al'PUCA8l.E) VALUE 1, Members 1st Bank Certificate of Deposit - Acct. No. 40140-45; transferred 103,277.47 100 3,000.00 100,277.47 one-half (1/2) to Charles M. Krajscik, son, in August, 2005. TOTAL (Also enter on line 7 Recapitulation) $ 100,277.47 (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 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Charles Francis Krajcsik FILE NUMBER 2006 - 00548 Debts of dec:edent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Malpezzi Funeral Home, Mechanicsburg, PA Catholic Cemeteries - buriallfuneral expenses 9,317.00 775.00 2. 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. Allomey Fees 3,100.00 3. Family Exemption: (If decedent's address is not the same as claimant's, altach explanation) Claimant Street Address City State . Zip Relationship of Claimant to Decedent 4. Probate Fees 370.00 5. Accountant's Fees 300.00 6. Tax Return Preparer's Fees 7. Legal Advertising - Harrisburg Patriot News 217.88 8. Legal Advertising - Cumberland Law Journal 75.00 9. Express Mail Fees 60.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets 01 the same size) 14,214.88 REV-l512 EX+ (12.{)3) .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILnlES, & UENS ESTATE OF FILE NUMBER Charles Francis Krajcsik 2006 - 00548 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimblllSed medical ellpllfllleS. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PPL - electric bill 82.41 2. Rentpay~nt-June,2006 747.00 3. Keystone Oil - Fuel Oil - pay~nt plan 439.48 4. Mechanicsburg Club - reception 517.39 5. Medical Bills - Dr. Julie Shedlosky, dental bill and V A Hospital bill 59.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,845.28 REV-1513 EX+(9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Charles F. Krajcsik FilE NUMBER 2006-00 00548 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Charles M. Krajcsik - 231 Harding Road, Scotch Plains, NJ 07076 Son One-third (1/3) 2. William A.Krajcsik - 2 Glencarron Court, DiIIsburg, PA 17010 Son One-third (1/3) 3. Stephen J. Krajcsik -1516 Main Street, Lisbum, PA 17055 Son One-third (1/3) 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABlE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)