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HomeMy WebLinkAbout05-15-07 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes ~ Po sox zsosol INHERITANCE TAX RETURN 21 06 0664 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 178-24-5527 05/25/2006 05/06/1932 Decedent's Last Name Suffix Decedent's First Name MI Cook George R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Cook Kathryn M Spouse's Social Security Number 170-26-7620 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 1. Original Return 2. Supplemental Return 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required death after 12-12-82) • 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 6. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 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. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Richard L. Placey (717) 236-9577 Firm Name (If Applicable) ~~ ~---~ REGISTER OET 1~,LS USE OMtY Placey & Wright ~ _} First line of address -.. 3631 North Front Street - ~ ~~' Second line of address --' `" - - _-~ ~ _ City or Post Office State ZIP Code DATE FILED -- -C Harrisburg PA 17110-1533 Correspondent's a-mail address: PWIBW@epix.ent Under penalties of pery'ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best 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. SIGNPTURE OF PERSON RESPONSIBLE FOF;FILING RETURN DATE Kathryn-J~A.°Cook, Executrix, Wright, 3631 North Front Street, urg, PA 17110-1533 L. Placey, Esqul~e, 15056051058 3631 North Front Street, Harr E USE ORIGINAL FORM ONLY Side 1 ~~ DAT 1 PA 17110-1533 15056051058 ~~, 15056052059 REV-1500 EX Decedent's Social Security Number George R Cook ' 178-24-5527 decedent s Name: RECAPITULATION 1. Real estate (Schedule A). ......... ................................... 1. 0.00 2. Stocks and Bands (Schedule B) ....................................... 2. 15,866.50 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 0.00 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~::u:~:: Separate Billing Requested........ 7. 0.00 8. Total Gross Assets (total Lines 1-7) .................................... 8. 15,866.50 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 18,351.24 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................ 10. 0.00 11. Total Deductions (total Lines 9 8 10) ................................... 11. 18,351.24 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 0.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 0.00 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_ 0.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 _ 0.00 1 g, 0.00 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 0.00 18. Amount of Line 14 taxable 0 00 0 00 . at collateral rate X .15 18 . 19. TAX DUE ......................................................... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ,.r .,. 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21 06 0664 DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER George R Cook 178-24-5527 STREET ADDRESS 128 South 31st Street CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 0.00 2. Cn:dits/Payments 0.00 A. Spousal Poverty Credit B. Prior Payments 0.00 C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable 0 00 . D. Interest E. Penalty c 0.00 Total InteresUPenalty (D + E) (3) 0.00 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.00 Make Check Payable fo: 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 properly transferred :.......................................................................................... ^ ^x b. retain the right to designate who shall use the property transferred or its income :............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 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 p2 P.S. §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.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 twelve (12) percent [72 P.S. §9116(a)(1.3)). Asibling 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-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER GEORGE R. COOK 21-06-0664 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~~ 5 shares common stock Avaya 57.90 2. 198 shares common stock Bell Atlantic (Verizon) 6,167.70 3. 88 shares common stock BellSouth (AT&T) 2,261.60 4. 31 shares common stock Comcast 987.66 5. 68 shares common stock Lucent 912.56 6. 34 shares common stock Qwest 231.88 7. 131 shares common stock SBC (AT*T) 3,366.70 8. 30 shares common stock Southwestern Bell (AT&T) 771.00 9. 50 shares common stock Vodafone 1,109.50 (See holdings and valuation statement attached from Ameriprise Financial Services, Inc.) TOTAL (Also enter on line 2, Recapitulation) I E (If more space is needed, insert additional sheets of the same size) 15,866.50 A.T:CTIp[~3L' T'InfC1GIR1 ~CrvI:CS, )RC. 34"• 7AT Hsu'hw Grivc, 577~:l: 5"LS rcr: ~ Fax: ~-~~ -~3 ~ .. ~~' ~ 3 From: ~,(.,~j,~ 7~ Qt'J Date: _ a'~ ~_-r~- ~ W Re: (~..Q,~l l Pages:- ~ ------------- CC: ~ Urgent CI For R~vi~rl ^ Please Comment G Please Rep~y ^ Please Recycle ,~~~~ Geor e Cook Sock I{ol s 5125/06 Stock Ticker Closing Price Individual Shares Joint Sli.ares Avaya AV $11.58 5 15 Bell Atlantic VZ $~ ] .15 1.9s 3~Y (Verizon) BellSautb T $25.74 88 23~ (.AT&.T) Comcasi CMCSr~ 531.86 3 < 8' Lucent ALU X13-~2 68 l~!? c~~~~, Q SBC T X25.70 :31 754 (A"1'dzT 5outlzwestMrn Bell X25.70 34 $`~ (AT&T j Vodafone VC~D $2.19 54 ? ~.`' REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER GEORGE R. COOL 21-06-0664 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Myers-Hamer Funeral Home, Inc. 8,822.00 2. Catholic Cemeteries 775.00 3. Post-funeral luncheon 75.00 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 Year(s) Commission Paid: 2. Attorney Fees 3. family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Kathryn M. Cook Street Address 128 South 31st Street City Camp Hill State PA .Zip 17011 Relationship of Claimant to Decedent Spouse 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Pinnacle Health - debt of decedent s. Citibank USA NA (Sears Roebuck & Co) -debt of decedent TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) Zip 2,000.00 3,500.00 75.00 952.00 2,152.24 18,351.24 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER GEORGE R. COOK 21-06-0664 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)I 1 • Kathryn M. Cook, 128 South 31st Street, Camp Hill, PA 17011 Spouse Entire Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16, 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S 0.00 (If more space is needed, insert additional sheets of the same size) ,~ r LAST WILL AND TESTAMENT OF GEORGE R. COOK I, GEORGE R. COOK, now of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate unto my wife, KATHRYN M. COOK, provided she survives me by thirty (30) days. ITEM III. If my wife, KATHRYN M. COOK, shall predecease me or die on or before the thirtieth (30th) day following my death, I then give and devise all of my estate of every nature and wherever situate, in equal shares, unto my children, or their issue, per stirpes. ITEM IV. I appoint my wife, KATHRYN M. COOK, as Executrix of this my Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I then appoint my sons, STEVEN P. COOK and JEFFREY R. COOK, as Contingent Co-Executors of this my Last Will and Testament. No bond shall be required of my personal representative(s) in any jurisdiction. ITEM V. In addition to the powers given to my Personal Representative(s) by operation of law, the following powers are herein given to him to be exercised by him at his sole discretion. (The words "he" and "him" as used herein shall be deemed to include the words "she", "it", "they", "them", "his", and "her" as appropriate.) A. To retain any property received and to invest any funds held by him during the term of my Personal Representative's service in any stocks, bonds, notes or other securities or property, real or personal, within the limitations of the law. ~-~1 George Cook B. To continue the operation of any business in which I am engaged or in which I have an interest at the time of my death for the term of his service as he deems advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without, liability for any loss occurring therein. C. To hold investments in the name of a nominee, exercise and dispose of warrants. D. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate, during the term of his service, for cash, property or credit, in such manner and on such terms as my Personal Representative deems advisable within the limitations of the law. E. To manage, operate, repair, improve, mortgage or lease for any term any real estate at any time held or owned by my Personal Representative. F. In general, to exercise all powers in the management and settlement of my estate which any individual could exercise in the management of similar property owned in his own right upon such terms and conditions as my Personal Representative deems best, and to execute and deliver all instruments and to do all acts which he may deem necessary or proper to carry out the functions of a Personal Representative. G. To engage in litigation and compromise, arbitrate or abandon claims and property. H. No interest of any beneficiary of my estate shall be subject to anticipation or to pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his or her interest, nor shall the interest of any beneficiary be liable or subject in any manner while in the possession of the Personal Representative George Cook - 2 - hereunder for the liability of such beneficiary, whether such liability arises from his or her debts, contracts., torts or other agreements of any type. IN WITNFiSS WHEREOF, I have hereunto set my hand and ~~ ~.,T- seal this ~~'~ day of ___k„,C+v~~ ''7 , 1988. Geo ge Cook The preceding instrument, consisting of this and two other typewritten pages, identified by the signature of the testator, was on the day and date thereof signed, published and declared by George R. Cook, the testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence cif ea h other, subscribed our names as witnesses hereto. ,f ,--~ 1. ~ r ~ ~~ t f ._ ~_~ .. ~~ - 3 - ~• ~ r ACKNOWLEDGMENT COT~lMONWEALTH OF PENNSYLVANIA SS: COUPJTY OF DAUPHIN I, GEORGE R. COOK , testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. George R Cook Sworn or affirmed to and acknowledged befor me, by George R. Cook , testat or , this ~~~ day of Jc~nu~ f~ ~ti/ 19 8 8 ~L ~ ~ ~-~~ Nota y Public My Commission Expires: AFFIDAVIT COTM~'iONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN Gn c~ h-c~n ~ CL the witnesses whole names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testat or sign and execute the instrument as his last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testat or signed the Will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~.~ ., ~~,.. r~/v ~~, ,. l,- f ~ 'C E _ . ~_- /" We, ~ iC `1Gx.ac~ ,~ . ~ ~~ Sworn to and subscribed before me this ~ 9 ~ day of .~ cam/ N ary Public- My Commission Expires: RICHARD L. PLACEY .~ '.~? ! - h, PLACEY g WRIGHT ATTORNEYS AT LAW 363 I NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1533 (717> 236-9577 FAX (717) 236-0843 May 14, 2007 Register of Wills CUMBERLAND COUNTY COURTHOUSE One Courthouse Square Carlisle, PA 17013 RE: Estate of George R. Cook Estate No. 21-06-0664 Dear Madam/Sir: WILLIAM K. WRIGHT (1943-1999) We enclose herewith for filing, in duplicate, Pennsylvania Inheritance Tax Return for the captioned decedent, together with check in the amount of $15.00 to cover the cost of the filing fee. Please send your receipt for the filing of the same to the undersigned in the enclosed, stamped, addressed envelope. Thank you. Very truly yours, PLACEY &WRIGHT ~~~ Richard L. 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