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Home My WebLink About04-17-07 (3) . . --.J 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY County Code Year File Number PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisbu PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT Olo Date of Birth 181-50-6776 11162006 02281915 Decedent's First Name MI Decedent's Last Name Suffix MCCOY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix GRACE I 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 DLI 1. Original Return o 4. Limited Estate DLI o 2. Supplemental Retum D o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o D D D 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 between 12-31-91 and 1-1-95) 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JOHN W MCCOY Firm Name (If Applicable) 717-776-6546 REGISTER OF WILLS USE ONLY 574 MIDDLE ROAD First line of address City or Post Office State ZIP Code 'Q .;:~g '-- --. o '-' 0 : .'~' ,...." . ;1] .' , ,{3':T~ I'~-,) (,."".') c:S -.... I. --, , '! -) Second line of address J::'t. v -~ NEWVILLE PA 17241 -.J -0 ~.- - ~ Correspondent's e-mail address: :~7::3 N, <.')' Under penalties of pe~ury, I declare thai I have examined this return, including accompanying schedules and statements, and to the besfuf my knowledgeend belief,. ills',' J true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledg" ~ -.) .SJG.....~~..!JB. .0. F......r.E:.R.~Qt<lRs~.ONSl~hUORF.JL1NG8..EJU. RN.~. .....~...... . . .............. D.A. TE -~.-,,>. ....~-~;:~,."".~. .... "'c.,..... """4:;;'~'01 ADDR S 574 MIDDLE ROAD NEWVILLE PA. 17241 ~ BLoc- DATE HIGH ST NEWVILLE PA. 17241 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 15056041114 --.J --.J 15056042115 REV-1500 EX Decedent's Name: GRACE I MCCOY RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly OWned Property (Schedule F) DSeparate Billing Requested . . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181-50-6776 Decedent's Social Security Number 1. NONE 2. 3. NONE 4. NONE 5. 6. NONE 7. NONE 8. 9. 871. 00 483119.00 483990.00 8629.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . . 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 Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . .. 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a)(1.2) X.O ~ 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 15. 473729.00 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042115 15056042115 1566.00 10195.00 473795.00 0.00 473795.00 0.00 21318.00 0.00 0.00 21318.00 D --.J , . REV-1500EX Page 3 181-50-6776 Decedenfs Complete Address: File Number 2006-01048 DECEDENrs NAME DECEDENrs SOCIAL SECURITY NUMBER GRACE I MCCOY 181-50-6776 STREET ADDRESS 574 MIDDLE ROAD CITY 1 STATE I ZIP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 21318.00 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. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 21318.00 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 21318.00 Make Check Payable to: REGISTER OF WILLS, AGENT IIlI _ J'~ ~ 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 0 b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. 0 0 c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 0 d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. 0 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 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. 11 1 , ,', ftw"?~"oh:re'cfmoooraTIefJlfryT:~anti tie,u. c'Januaryl, 'i~:meIaXTale lmposeo onti'iefief'vcffi:reOf lra. ,:>.1:1. :o'loorior~"'" the use of the surviving spouse is three (3) percent [72 P .5. ~9116 (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. ~9116 (a) (1.1) (ii)]. The statute does not exempt 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. ~9116(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 four and one-half (4.5) percent, except as noted in 72 P .5. ~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 twelve (12) percent [72 P.S. ~9116{a){1.3)]. A sibling is defined, under Section 9102, as an individual who has at le~st one parent in common with the decedent, whether by blood or adoption. \ . 217 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Grace I McCoy Estate ITEM NUMBER 1. FILE NUMBER 2006-01048 All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. Prudential Financial 10 shares DESCRIPTION TOTAL Also enter on line 2 Reca (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 871 871 217 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grace I McCoy Estate ITEM NUMBER 162547 160499 160460 1953815: 0209220 0209255 0010537 0010537 0010537 ~002348 1002726 404083: 10317711 Include the proceeds of litigation and the date the proceeds were received by the estate. All ro olntl -owned with rl ht of survlvorshl must be disclosed on Schedule F. Cert. of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit Cert of Deposit DESCRIPTION Adams County Nat Bank Adams County Nat Bank Adams County Nat Bank Sovereign Bank Wachovia Bank Wachovia Bank PNC Bank PNC Bank PNC Bank PNC Bank PNC Bank PNC Bank PNC Bank TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) FILE NUMBER 2006-01048 VALUE AT DATE OF DEATH 15,000 32,382 21,000 75,000 110,391 25,684 40,000 44,000 14,000 19,852 30,000 33,748 22,062 483,119 > . 217 REV-1511 EX+(12-99) COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Grace I McCoy Estate FILE NUMBER 2006-01048 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. 3,858 2. Law Journal and Newspaper 190 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City Year(s) Commission Paid: State Zip 2. 3. Attomey Fees Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant John McCoy Street Address 574 Middle Rd City Newville State Pa Zip 17241 Relationship of Claimant to Decedent Son 3,500 4. Probate Fees 456 5. Accountant's Fees 6. Tax Return Preparer's Fees 625 7. TOTAL Also enter on line 9 Reca (If more space is needed, insert additional sheets of the same size) 8629 .. . REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN I NT T SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Grace I McCoy Estate 2006-01048 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. unreimbursed medical expenses 1,566 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,566 REGISTER OF WILLS CUMBERLAND County, Pennsylvania No. 2006-01048 PA No. 21-06- 1048 Estate Of: GRACE I MCCOY fAlst, Middle, Lastl Late Of: UPPER MIFFLIN TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 181-50-6776 ----~-wHEREAS, on the 29th day of November 2006 an instrument dated October 18th 1983 was admitted to probate as the last will of GRACE/.MCCOY fFusr. Middle. Lastl late of UPPER MIFFLIN TOWNSHIP, CUMBERLAND County, who died on the 16th day of November 2006 and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: JOHN W MCCOY who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set' my hand and affixed the seal of my office on the 29th day of November 2006. _u_ .. ~ i . d * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ",",VIVILJl-/Il-r""1/V,-, '-',"-,VI V, I Deceased Social Security No: 181-50-6776 WHEREAS, on the 29th day of November 2D06 an instrument dated October 18th 1983 was admitteq to probate as the last will of GRA eE I MeeD y (FifSt, Middle, Lastl late of UPPER MIFFLIN TOWNSHIP, CUMBERLAND County, who died on the 16th day of November 2006 and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: JOHN W MCCOY who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 29th day of November 2006. j a.. Vl~ .pp.Depury d * *NOTE* * ALL NAMES ABOVE APPEAR (FIR,ST, MIDDLE, LAST) above named, as and for her last will and testament, j.n t:ne presence U.L Ul:>, wuv a'fheTrequest .~.'.'1:fi~i'ref'PfaeUeean<i"~u ~fieFi7~~~'';;~'~~~~~~=<!;:'~;c .~..~-ih"'..-1. our names as witnesses hereto. .~ t'2~~ ~~g.~~ /I-J I~ d :#~~ rR 0 <f 'P6~3)~ .lJewv,lle I PIJ /id.l./) , LAST WILL AND TESTAMENT I, GRACE I McCOY, of Lower Mifflin Township, Cumberland County, Pennsylvania, being of sound mind and memory do hereby make, publish and declare this to be my last will and testament, hereby r~oking any wills or codicils previously made by me. Item 1. I direct that all my just debts and funeral expenses be fully paid as soon as may be conven~ently accomplished after my decease. Item 2. I devise and bequeath all of my estate of every nature and wherever situate to my husband, JOHN F. McCOY, providing he shall survive me by sixty days. Item 3. Should the gift in Paragraph No. 2 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my son, JOHN W. McCOY. Should JOHN W. McCOY not survive me as provided above, I devise and bequeath all of my estate of every nature and wherever situate to any children of JOHN W. MCCOY, then living, born of hlhs marriage to NANCY STRAYER McCOY, share and share alike. Item 4. I nominate and appoint JOHN F. MCCOY to be the executor of this my last will and testament, he is to serve as such without bond. Should he die before my death, renounce or refuse to serve for any reason, or die leaving "C~)': ()Kl,llY~~h~J::;~ .lJ!l~c;1!1!;i;g;!.~J.:~~c~g"" 1 nominaEe~ag .~I>],~,~~,J9]!g.,,~...~c;.S91 substitute executors; also to serve as such without bond, with the same powers I as are given herein to my executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal this IrA day of Otl::nbe r /qf3 ~~ J~-,' ~lf GRACE I McCOY ~;O"Tl"'r'l. !':p::Ilpi!. nnhltshed and da:iared bv GRACE I McCOY. the testatrix Item 1. I direct that all my just debts and funeral expenses be fully paid as soon as may be conveniently accomplished after my decease. Item 2. I devise and bequeath all of my estate of every nature and wherever situate to my husband, JOHN F. McCOY, providing he shall survive me by sixty days. Item 3. Should the gift in Paragraph No. 2 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my son, JOHN W. McCOY. Should JOHN W. McCOY not survive me as provided above, I devise and bequeath all of my estate of every nature and wherever situate to any children of JOHN W. MCCOY, then living, born of his marriage to NANCY STRAYER McCOY, share and share alike. Item 4. I nominate and appoint JOHN F. MCCOY to be the executor of this my last will and testament, he is to serve as such without bond. Should he die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint J9HN W. McCOY as substitute executors; also to serve as such without bond, with the same powers as are given herein to my executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal this IrA day of OebJDe r /qf'3 ~~~ J.~J. ~f GRACE I McCOY . Signed, sealed, published and da:iared by GRACE I McCOY, the testatrix above named, as and for her last will and testament, in the presence of us, who atherCrequest,' l.u1:l:1!r"p"te'S'etI'ce ana' :tn.'i:~y,l; c-o,;;u;....-c . ~~~;:.fi.~~~~==~ =-~..Ae.~~C"... ~ our names as witnesses hereto. I .k~-~~ ~~t3.~~ /1.-0 j~ d YJ?~ rR 0 '/ 136 -.L. 3)~ ./Je.wv.1 / e I I'll 17 J..'-I ) , \ 'I'''' KCKNOWLEDGMENTAND AFFIDAVIT COMMONWEALTH OF PENNSYLVAAIA 55. COUNTY OF CUMBERLAND We, GRACE 1. McCOY,. J-eS$( !-Ie/i't1 73, Shu~llhl~' -g. Shoemak-rr and the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare 'to the undersigned authority that the Testatrix signed .and executed the instrument as her last will and that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witness and that to the best of his knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 0~ a.... f:1. c7 . . . ~ /5 /~eal) Subscribed, sworn to and acknowledged before me by GRACE I. McCOY, the Testatrix, and subscribed and sworn to before me by .Jca.~:sr' l -:J:.~U'/lte:1k~r ,___.1.J,,,,-;,J._..~___ _..; ~".. _ rJ I 1 ' . ..- AJ. ' ~ ~: atld1rlTi'n . -fl.' o~~r;;;lflrfff'rc" ;'wttnessc~s;l:llfs'~ day of 6t'!- --bob't'r 1983. I ~.ci!- ~ ~(Seal) ~~~ ,(seal) ?~;,'" q C~ (SEAL) ;~~:~COOIC/(. HOfAitv PUSlIC MV COMilISSIO"C~W::::r:: ~OUNTY M<Aml:Jer. Pennsvlva '.1._ . /l...1I 2, 1987 . "'ll ....Soclation of HClfarie$