HomeMy WebLinkAbout08-19-08 (2)15056051058
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg PA 17128-0601 RESIDENT DECEDENT 21 OS v~jCj~j
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death .Date of Birth
02/26/2008 01/21/1922
Decedent's Last Name Suffix Decedent's First Name MI
WOOD EVELYN I
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
~:~'~ 1. Original Retum
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
s 2. Supplemental Retum .~..:. 3. Remainder Return (date of death
prior to 12-13-82)
`" 4. Limited Estate 4a. Future Interest Compromise (date of :'::~'~„ 5. Federal Estate Tax Return Required
death after 12-12-82)
•:> 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8. 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
JEFFREY S COHICK EA
Firm Name (If Applicable)
COHICK & ASSOCIATES
First line of address
390 ALEXANDER SPRING RD
Second line of address
City or Post Office
CARLISLE
Correspondent's a-mail address: jCOhICk@COhICkBSSOC.COm
State ZIP Code
PA 17015-9129
(717) 249-5321
__..
REGISTER OF S6ULLS USE ON4~
C 7
-
~0 ~
~ ; '
T s
_~ J.l ~ r
t~ C
i G7
J
y f"" 1
,
. , „
~.O
_ t_..-_,
., :
~ -n
~
, _ ~
il --..: ..i
-
._..~
DATE FItEp r "'~'~
;'s:
r-
p a , _ ~
„
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my Knowledge ana oeuer,
it is true, correct and complete. DeGaretion of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIG ATURE OF PERSON RESP NSIBLE FOR FILING RETURN DATE
DD ESS
1 GRAHA ROAD, N ILLE, PA 172 -9 8~- -.~ ____ ____
______ f ~,_~- r _ - - ---
\DDRESS
390 AL XA DE SPRING ROAD, CARLISLE, PA 17015-9129
PLEA8E USE ORIGINAL FORM ONLY
15056051058
Side 1
GDAT /~~~
_a6~~ ~'~ ='-G~
15056051058
15056052059
REV-1500 EX Decedent's Social Security Number
EVELYN I WOOD
Decedent's Namec
RECAPITULATION
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.
9 9 ( ) .............................
Mort a es ?£ 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 Governmental Bequests/Sec 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.
~,,.., .__..___
. _.
_
_..~..~. _._ _._...._...._.,.._. __. ___....w ~_r.__
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 .0_ 15.
16. Amount of Line 14 taxable 201,691.10
at lineal rate X .0 45
16.
17. Amount of Line 14 taxable
at sibling rate X .12 17•
18 . Amount of Line 14 taxable
at collateral rate X .15 18.
19 . TAX DUE ........................................................ . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
8,781.00
74,259.11
124,714.74
207,754.85
5,746.90
316.85
6,063.75
201,691.10
201,691.10
9,076.10
9,076.10
15056052059
REV-1500 EX Page 3 Flle Number_ _ _ _
Decedent's Complete Address: 21 os
EVELYN I WOOD
STREETADDRESS
GREEN RIDGE VILLAGE
210 BIG SPRING ROAD
------- - - ----
CITY
NEVWILLE
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit __._
B. Prior Payments _
C. Discount
3. InteresUPenalty if applicable
D. Interest
E Penalty
DECEDENT'S SOCIAL SECURITY NUMBER
054-16-4860
STATE
PA
(1)
Total Credits (A + B + C) (2)
Total InteresUPenalty (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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
9, 076.10
9,076.10
9,076.10
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 :.......................................................................................... ^
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.
ZIP
17241
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. §9116 (a) (1.1) (i)J.
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)J. Asibling isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDIJLE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
EVELYN I WOOD 21-
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property lolntly-owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
EVELYN I WOOD 21
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. FAITH S ZARICHANSKY 21 GRAHAM ROAD DAUGHTER
NEVWILLE, PA 17241
B' HOPE I BRACKEN PO BOX 369 DAUGHTER
DILLSBURG, PA 17019
C.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY•HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1. A. 01/31190 M & T BANK, CHECKING ACCT# 445924 29,184.68 50. 14,592.34
2• A 01131190 MEMBER'S FIRST FEDERAL CREDIT UNION, SAVINGS 116,833.54 50. 58,416.77
. A(:(:T#11~4.riri-n(1 A(:N flR11R1fi4
3• B. 09/05!00 M & T BANK CD#031003911168754 2,500.00 50. 1,250.00
TOTAL (Also enter on line 6, Recapitulation) 15 74,259.11
(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 FILE NUMBER
EVELYN I WOOD __ 21-
This schedule must be comaleted and filed ii the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST EXCLUSION
(IF APPLICABLE) TAXABLE
VALUE
t~ CUNA MUTUAL GROUP ANNUITY CERT#60120156A 124,714.74 100 124,714.74
BENEFICIARY, FAITH S ZARICHANSKY, DAUGHTER .045 RATE p
TOTAL (Also enter on line 7 Recapitulation) S I 124,714.74
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
EVELYN I WOOD 21-
Debts of decedent must be reported on Schedule I.
ITEM AMOUNT
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
t' EWING BROTHERS FUNERAL HOME 4,158.24
2. WAYNE NOSS FLOWERS 223.66
3. PASTOR DIANE ELWEE 125.00
25.00
a. CLOTHING
g. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)IEIN Number of Personal Representative(s) _
Street Address
City .State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4, Probate Fees
5. Accountant's Fees 1,000.00
6, Tax Return Preparer's Fees 200.00
~. INHERITANCE TAX RETURN FILING FEE 15.00
TOTAL (Also enter on line 9, Recapitulation) I $ 5,746.90
(It more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDVLE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
ESTATE OF _
EVELYN I WOOD 21
_ _ ._~._ ,__..___~ ~...~,. ,,,..._as..~ .s,,. +„ rro~-h whhh rRmained unpaid as of the date of death, Including unreimbursed medical expenses.
(If more space is needed, insert additional sheets of the same srze)
REV-1513 EX+ (9-00)
SCHEDt~LE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
EVELYN I WOOD 21
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
~ • DAVID GEORGE WOOD SON 33.333
2• HOPE IRENE BRACKEN DAUGHTER 33.333
3. FAITH SYDNEY ZARICHANSKY DAUGHTER 33.333
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THRO UGH 18, AS APPROPRIATE, ON R EV-1500 COVER SHEET
11 NON-TAXABLE DISTRIBUTIONS:
SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
A. SPOUSAL DISTRIBUTIONS UNDER
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
EVELYN I. WOOD
I, EVELYN I. WOOD, widow, of South Middleton Township, Cumberland County,
Pennsylvania, (mailing address: 70 Mazsh Drive, Cazlisle, PA), being of sound and disposing mind,
memory, and understanding, do hereby make, publish, and declare this as and for my Last Will and
Testament, hereby revoking and making void any and all Wills by me at any time heretofore made.
1. I direct my hereinafter named Executor to pay all of my debts to which I am bound and
the expenses of my funeral, last illness, and of the administration of my estate as soon after my
death as may be found convenient to do so.
2. I declare that I am the widow of George F. Wood and that I have three (3) children,
HOPE IRENE BRACKEN, DAVID GEORGE WOOD, and FAITH SYDNEY ZARICHANSKY.
I further declare that I have no other children.
3. All the rest, residue, and remainder of my estate, real, personal, or mixed, and
wheresoever the same may be situate, I give, devise, and bequeath in equal shares to such of my
children as shall survive me by a period of ninety (90) days, the share any deceased child would
have received shall pass to his or her issue, per stirpes, and if there be no such issue, such share
shall lapse and be added to the remaining share or shares. At the present time I have three (3)
children as aforementioned.
4. I hereby nominate, constitute, and appoint my daughter, FAITHS. ZARICHANSKY as
Executrix of this my Last Will and Testament, but should she predecease me or fail to qualify, then
in such event I nominate, constitute, and appoint Manufacturers and Traders Trust Company, its
successors and assigns as Executor and I further duet[ that neither of them shall be required to post
any bond to secure the faithful performance of her, or its duties in the Commonwealth of
Pennsylvania or in any other jurisdiction.
5. In addition to the powers conferred by law, my herein named Executors and Trustees
are empowered:
a. To invest any part of the trust corpus in such securities, investments, or other
property as may be deemed advisable and proper, irrespective of whether the same are
authorized for the investment of trust funds under the laws of any governing jurisdiction.
b. With respect to any corporation, the stocks, bonds, or other securities of which
may be held, to vote in person or by proxy on any shares of stock; to consent to the merger,
consolidation or reorganization of such corporations; to consent to the leasing, mortgaging, or
sale of the property of any such corporations; to make any surrender, exchange or substitution
of such stocks, bonds, or other securities as an incident to the merger, consolidation or
reorganization of such corporations; to pay all assessments, subscriptions and other sums of
money which may be deemed wise and expedient for the protection and maintenance of the
proportionate interest of the investment in such corporations; to exercise any option or privilege
which may be conferred upon the holders of such stocks, bonds, or other securities of such
corporations either for the conversion of the same into other securities or for the purchase of
additional securities, and to make any and all necessary payments which may be required in
connection therewith; and generally to have and exercise as to all such stocks, bonds, and other
securities, the powers of an individual owner who is under trust obligation.
c. To hold the trust corpus in one or more consolidated funds in which separate
shares shall have undivided interests.
d. To sell at public or private sale for cash or upon credit, or partly for cash and
partly on credit, and upon such terms and conditions as shall be deemed proper, any part or
parts of the trust estate, and no purchaser at any such sale shall be bound to inquire into the
expediency or propriety of any such sale or to see to the application of the purchase money
arising therefrom.
e. To keep on hand and uninvested such moneys as may be deemed proper and for
such period as may be found expedient.
f. To compromise, settle, or arbitrate any claim or demand in favor of or against the
trust estate.
Page 1 of 2 pages
g. And authorized in the discharge of fiduciary duties, to employ counsel and to
determine and to pay such counsel reasonable compensation which shall be charged against the
principal or income of the trust fund, and shall further be entitled to charge against the principal
or income such other reasonable expenses and chazges as may be necessazy and proper to incur
for the proper discharge of fiduciary duties and for the proper management and administration
of the trust estate.
h. In making any division of property into shares for the purpose of any distribution
thereof directed by the provisions of the trust, to make such division or distribution, either in
cash or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in
making any division or distribution in kind may allot any specific security or property or any
undivided interest therein to any one or more of such shares, and to that end may appraise any
or all of the property so to be allotted and the judgment as to the propriety of such allotment
and as to the relative value for purposes of distribution of the securities or property so allotted
shall be final and conclusive upon all persons interested in the trust or m the division or
distribution thereof.
i. Authorized to register any shares of stock or other assets of any trust in their
own names or in the name of a nominee.
j. To retain and invest in shares of stock of my Trustee.
k. To retain any investments including mutual funds which I may own at the time
of my death and in addition to invest any part of the Trust corpus in such mutual fund or
mutual funds as may be deemed advisable or proper, irrespective of whether the same are
authorized for the investment of trust funds under the laws of any governing jurisdiction.
1. To determine from time to time whether all or some portion of realized
capital gains shall be treated as ordinary income for distribution to a beneficiary or treated as
principal to be retained as part of the corpus, and such designation need not be consistent from
one year to another.
IN WITNESS WHEREOF, I have hereunto set my~and and seal to this my Last Will and
Testament written on three (2) pages, this ~ q f~ day of o ~'c ~, ~ ~f' , 2002.
W "~...~ ~' ~" ~ (SEAL)
EVE I. WOOD
Signed, sealed, published and declared, by EVELYN I. WOOD the Testator above named,
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 subscribed our names as attesting witnesses.
~~~
Page 2 of 2 pages