HomeMy WebLinkAbout06-07-07
REV-1500 EX + (8-00) .
.' COMMONWEALTH OF
, . .
PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPT. 280601
. HARRISBURG, PA 1712B-ll601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICiAl USE ONLY
FILE NUMBER
2 1 -0 6 6 9 7
""CoUNTYCciiiE" ----y"EAR- - - NuMBER- -
I-
Z
W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Coffe Jo ce L.
DATE OF DEATH (MM-DD-Year)
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
2 06- 3 2 - 1 264
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
05/08/2006 03/17/1940
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Coffe Donald L.
SOCIAL SECURITY NUMBER
w
!;(
ll:-II)
U O:ll:
wll.U
J:oo
U 0:...
8:lD
c(
!Xl 1. Original Retum
D 4. Limited Estate
!Xl 6. Decedent Died Testate (Allach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy ofTrusQ
D 10. Spousal Poverty Cred~ (dale of death between 12-31-91 and 1-1-95)
D 3. Remainder Retum (date of death priorlD 12-13-82)
D 5. Federal Estate Tax Retum Required
.Q.. 8. Total Number of Safe Depos~ Boxes
D 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
. THIS SECnON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAl. TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Joel R. Zullin er 14 North Main Street, Suite 200
FIRM NAME (If Applicable)
Zullin er Davis P.C.
TELEPHONE NUMBER
717264-6029 Chambersbur PA 17201
I-
Z
W
C
Z
o
II.
II)
W
0:
0:
o
U
z
o
j::
:5
::)
l-
ii:
c(
o
w
~
z
o
j::
~
::)
a..
:Ii
o
o
><
c(
I-
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Depos~ & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly ONned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
OFFICIf.LUSE ONLY
.,
9,357.43 ..
.-..J
(8)
9,357.43
(11)
(12)
(13)
9,357.43
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
9.357.43
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
9,357.43 X 0.00 (15)
0.00 X _(16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
0.00
0.00
0.00
0.00
0.00
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
.~
.>:>' BEgURE TOANgWERAll QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Dl"'cedent's amp ete ress:
STREET ADDRESS
. 123 Cleversbura Road
CITY I STATE I ZIP
Shippensburg PA 17257
C Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
0, 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. (5)
A. Enter the interest on the tax due, (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check AGENT
0.00
0.00
0.00
0.00
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 !XI
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 !XI
c. retain a reversionary interest; or ...................................................................................................... 0 !XI
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 !XI
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................... 0 !XI
3. Did decedent own an 'in trustfor' or payable upon death bank account or security at his or her death? ................. 0 !XI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ..................... .................................................................................. 0 !XI
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,1 declare that I have examined this retum, includinQ 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.
SI ATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
5--3-07
PA 17257
DATE
~-
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) (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 0% [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 retum 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 0% [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 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 at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX + (6-98)
'W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Coffey Joyce L
FILE NUMBER
21 06
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
697
ITEM
NUMBER
1.
DESCRIPTION
Vanguard Account #09866033021, consisting of 292.237 shares of Wellington Fund
@32.02 per share
VALUE AT DATE
OF DEATH
9,357.43
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9.357.43
'EV-""~'_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
r'nffQ\I .1, lVr.A I ?1 On AA7
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Donald L. Coffey Spousal
123 Cleversburg Road entire estate
Shippensburg, PA 17257
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
ll. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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)
. Vanguard'
March 1, 2007
P.O. Box 2600
Valley Forge. PA 19482-2600
www.vanguard.com
JOEL R ZULLlNGER ESQ
14 N MAIN ST SUITE 200
CHAMBERSBURG, PA 17201
Wellington Fund Inv
09866033021
Dear Mr. Zullinger:
We are responding to your letter notifying us of the death of Joyce L. Coffey, and
requesting a valuation of the above account. First, please accept our condolences
for your loss.
As of May 8, 2006, the number of shares, the price per share, the value of the fund,
and the accrued dividends (if applicable) were as follows:
Fund
Shares
Price
Value
Accrued
Dividends
$0.00
Wellington Fund Inv
292.237
$32.02
$9,357.43
If you have any questions or need further assistance, please contact a member
of our Transition Specialist Team at 1-888-237-9045. We are available Monday
through Friday from 8 a.m. to 8 p.m., Eastern time.
Sincerely,
Transition Specialist Team
pgd
50812868
Vanguard Marketing Corporation, Distributor.
~
~
k
~
JRZ- '5.1 -coffey.2
January 1.6, 2004
LAST WILL AND TESTAMENT
I)
C;o
;.~ :'IJ
:': J ..:~::?
~;.~. ;.; in
")
~
'-":.')
-..
....,
.....,
1~:.J
~~.~-' ~ ji
..: . :-. .~'
. -'.
en ~.=} t~
" ::..3 Q :Q .; ~':;
...... '_ -L- j'
I, Joyce L. Coffey, of 1.23 Cleversburg Road,_~oappensburgr~5
. . .~ .." :.: ,r ~~:; ;~:~
Cumberland County, pennsylvania, being of sound and di6posi~mind; ,:'
memory and understanding, do hereby declare this to be -my will~
hereby revoking any and all former wills and codicils thereto by me
heretofore made.
1:.
I direct that all my just debts and funeral expenses,
including all expenses of my last illness, shall be paid from my
estate as soon as practicable after my decease as a part of the
expense of the administration of my estate.
. II. _
I give, devise and bequeath the residue of my estate of.every
nature and wherever situate to my husband, Donald E. Coffey,
providing he shall survive me by thirty days.
III.
Should my husband predecease me or die on or before the
thirtieth day following my death I give, devise and bequeath the
Received Time Jun. 5. 8:55AM
-<
J
~
~
residue of my estate of every nature and wherever situate to my
children, namely Stephanie L. Coffey and Jennifer c. Amigh, in
equal shares, provided that the share of any child who predeceases
me or dies on or before the thirtieth day following my death shall
be distributed to said beneficiary's issue, per stirpes, living on
the thirty-first day following my death, and in default of any such
then-living issue, such share shall be added to the share or shares
of my other child.
IV.
In the event my husband, Donald E. Coffey, and both of my
children, and all of their 'issue predecease me or die on or before
the thirtieth day following my death, I give and devise the residue,
of my estate of every nature and wherever situate as follows:
A. Fifty percent thereof to my husband's sister, Bonnie
Purcell, provided, however, should my said sister-in-law
predecease me or die on or' before the thirty-first day
.
, following my death, her share shall be distributed to her
issue, per stirpes, living on the thirty-first day
following my death;
B. Fifty percent thereof to be divided into six shares, with
one equal share to my sister, Sylvania Negley, one equal
share to my 'sister, Gloria Rueger, one equal share to my
sister, Gladys Kammer, one equal share to my brother,
Emory Shughart, one equal share to my brother, Nelson
Page 2
R e c e i ve d Tim e J un. 5. 8: 55 AM
K
Shughart, and one equal share to the issue per stirpes of
my deceased brother, Gabriel Shughart.
v.
In the event that anyone entitled to a share of my estate
shall be under the age of twenty-three years at the time for
distribution to such beneficiary, I constitute and appoint Orrstown
Bank, with principal offices' in Shippe~sburg, Pennsylvania" as
trustee of any property which passes either under this will or
otherwis~ to said,beneficiary. Said trustee shall in the trustee's
sole discretion 'and without order of court, use principal as well
as income from time to time as may appear to be necessary for the
beneficiary's welfare, comfort, medical care, recreation" support
and education, without responsibility to the beneficiary or to any
person taking care of the beneficiary; and ,the remaining balance in
the hands of said trustee shall be distributed to said beneficiary
when the beneficiary attains the age of twenty-tbree,years. If
such ben~ficiary dies prior to attaining the age of twenty-three
years, said trustee is authorized in the trustee's discretion to
pay part or all of the beneficiary's funeral expenses and the
remaining balance in the hands of said trustee shall be distributed
to the beneficiary'S personal representative. In the event the
funds held by the 'trustee for any benefici'ary become in the opinion
of the trustee too small for proper and efficient administration,
the trustee, in the trustee's sole discretion, may deposit such
Page 3
Received Time Jun. 5. 8:55AM
K
funds in a savings account in the name of the beneficiary.
VI.
Any fiduciary under this will shall have the following powers
in addition to those vested in them by law and by other provisions
of my will applicable to all property whether principal or income,
including property held for minors, exercisable without Court
approval, and effective until actual distribution of all property:
. A. To retain any and all of the asset.s of my estate, real or
personal,. without regard to any principle of
diversification of risk.
B. To invest in all forms of property including stock,
common trust funds and mortgage investment funds without
restriction to investments authorized for pennsylvania
fiduciaries as they deem proper, without regard to.any
principle of diversification of risk.
C. To sell .at public or private sale, to exchange or to
lease for any period of ti~e any real or personal
. property and to give options for sales, exchanges or
leases, for such prices and upon such. terms or conditions
as they deem proper.
D. To allocate receipts and expenses to principal or income
or partly to each as they from time to time think proper.
E. TO comprom1se any claim or controversy.
F. To distribute 1n cash or in kind or partly in each.
Page 4:
Received Time Jun. 5. 8:55AM
~
~
~
~
~
G. To hold property in their names without designation of
any fiduciary capacity or in the name of a nominee or
unregistered.
VII.
I direct that all taxes that may be assessed in consequence of
my death of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a~art of the expense of
the administration of my estate.
VIIJ:.
I appoint Stephanie L. Coffey and Jennifer C. Amigh, as ,co-
executors of this my will. Should my children predecease me, fail
to qualify or cease to act, I appoint Orrstown Bank with principal
officas in Shippensburg, Pennsylvania, as executor of this my will.
'Ix.
No bond shall be required of any fiduciary hereunder in any
jurisdict.ion.
IN WITNESS WHEREOF I I hereunto set my hand and seal to this my
last will and testament, consisting of seven typewritten pages, the
first five 'of which bear my signature in the margin fer the p:urpose
Page 5
, Received Time Jun. 5. 8:55AM
of identification this ..a..3 ~ay of
9""p",~
, 2 ()(Sr
~-'o ~
.....,:?
A
- '\
~_ _ (SEAL]
r!
Signed, sealed, published and declared by the above-named
testatrix as and for her last will and testament in our presence,
who in her presence, at her request and in the presence of each
other have hereunto set our hands as attesting witnesses.
-L'L~' t' dj"''''- ~I ~~l4.
j1:fJ Inrisly hI 41 ~
We, Joyce L. Coffey,
-r~/~ the
respectively, whose names are signed to the
...,...--;---." .
, ~.../
-//"~
<'/
.....;.,...
.....
..,./ . ..I'~
,,,," ,./'/.~' ..,..,,/ d
" ,.,~".'./ ,.. " .n,"';;-,' '''.1 an
, )
y
the witnesses
testatrix
and
attached or 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 testament 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
said testatrix, signed the will as witnesses and to the best of
their knowledge, said signer was at that time eighteen years of age
Page 6
Received Time Jun. 5. 8:55AM
or older, of sound mind and under no constraint or undue influence.
subscribed, sworn to and acknowledged
before me by the above-named signer and
subscribed and sworn to before me by the
above-named witnesses this ~~day of
/J;d~Y · ~ .
~ ,,/.---.., , /~- ,-
/~ ~M'~
.~ Notary,/Public
I~' =.:!~::;?:;~~, ~";;;: -I
~~~::-.. ~",,,,,,,,,,,,~~s., l...w,C'. ."':':I.~[:n Co~rH. ;
:.::2- C ~IM'I!;SlCn Ex~'tce t~E:V ~... ""t!~ ~
, ~-.....' . .. . . ~-:-~ ~\,.- '-::I
Page '7
Received Time Jun. 5. 8:55AM
LAW OFFICES OF
ZULLINGER - DAVIS
PROFESSIONAL CORPORA nON
JOEL R. ZULLINGER
14 North Main Street
Suite 200
Chambersburg, P A 17201
717-264-6029
Fax: 717-264-1884
JoelZullinger@zullingerlaw.com
Dale F. Shughart, Jr.
of counsel
HAMILTON c. DAVIS
20 East Burd Street, Suite 6
P.O. Box 40
Shippensburg, P A 17257
717-532-5713
Fax: 717-530-5222
hamiltondavislaw@comcast.net
June 4, 2007
Register of Wills
Cumberland County Courthouse
Carlisle, P A 17013
Dear Register:
RE: Estate of Joyce L. Coffey
File No. 21-06-6697
Enclosed for filing in your office is an original and one copy of the P A Inheritance Tax
Return along with check in the amount of $15.00 for filing fee for the above estate. Thank you.
~ZR~~ :
(!t R ZullingttJ ~ U
Encls.
" \
~ :
\ -~
f
'l\i~~S (
· "LOW
ij ; c; ~ g ~~(\1 J
, It 0 :::l ~ !.. -"
ll. -;_
It~'~~!
~ ~} ~~::!
~ ~ NO<
II
'--....
o
0....
NO
Q)N
~r-
~....
00<.
~a..
... (j) -
Q)c:2l
0)._ ~
C:CO.Q
3~~
N~Q)
t.Q
liOE
-Z~
(lJ ~ f_
E. - .~
0\
0\ \
v -'
_ ""f-
\ :
G)
g
1
u
~~
(/) So 0
- r-
:-::lu_
~~<
....CclP-<
0..... ~
"'" .8 G)
G) 'ril
tiEl~
.6b ~ ~
~uu
.~~
-
u
~.......,
~
~
-
. -
""'::
~
-
;-.
~
~=
~
~
~
.".
."-,..
"
......
f!o.l
...\
~o.
it
.~~
t'l
~
,,~
~
'-.
~~