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Home My WebLink About04-09-09i . 1505607120 REV-1500 PA Department of Revenue EX (06-05) OFFICIAL USE ONLY Bureau of Individual Taxes county coda vaar File Number PO Box.2sosot INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 10 2 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10 O1 2008 02 08 1927 Decedent's Last Name Suffix Decedent's First Name MI COCKLIN MAUDE (If Appllcablej Enter Surviving Spouse's Information Below Spouse's Last Name Suffix 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 X^ 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of deaCr after 12-12-82) x g. Decedent Died Testate (Attach Copy of wii) ^ Decedent Maintained a Livin Trust ~' (Attach copy of Trust) 9 0 B. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 D, Spousal Poverty Credd (date of death 11. Election to tax under Sec. 9113 A between 121-91 and 1-1-95) ^ ( ) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JENNIFER B. HIPP 717 737 8761 Firm Name (If Applicable) BOGAR AND HIPP LAW OFFICES First line of address 1 WEST MAIN STREET Second line of address City or Post Office SHIREMANSTOWN Correspondent's e-mail address: State 21P Code PA 17011 REGISTER OFFS USE h3NL.Y 1 -,~ °~- ~ ~ :~ ~ r ~ Pt t j ~. < _, ~ DAT~ILED .._ „~ rn _'~.7 4 "~ f .,~ ~. _. • =j Iii L Under penalties of perjury, I deGare 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. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA RE OF PERSON ESPONSIBLE FOR FILING RETURN DATE l~ ~ ~.~~_ _,P Eric H. Cocklin ~ - "~] _ pR ADDRESS 39 Ashburg Drive, Suite 2, Mechanicsburg, PA 17050 SIGNA E OF PREPARER OTHER THAN REPRESENTATIVE DATE ~ •~~ Jennifer B. Hipp U _ -Z _ ,~, p 1 West Main Street, Shiremanstown, PA 17011 Side 1 1505607120 1505607120 1505607220 REV-1500 EX Decedent's Social 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. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1 9 3 , 4 4 0 . 6 3 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. 1 9 3, 4 4 0. 6 3 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 0 , 0 1 8 . 8 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 1 0 , 0 1 8 . 8 9 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 18 3 , 4 21.7 4 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. 1 8 3 , 4 2 1 . 7 4 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 .00 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X •045 0. 0 0 16• 0, 0 0 17. Amount of Line 14 taxable at sibling rate x .12 18 3 , 4 21.7 4 17• 2 2 , 010.61 18. Amount of Line 14 taxable at collateral rate X .15 0, 0 0 18• 0. 0 0 1 s. Tax Due ..................................................................................................................:.. 19. 2 2 , 010.61 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 I,~, 150560722D 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-1029 DECEDENTS NAME Maude Cocklin STREET ADDRESS 39 Ashburg Drive, Suite 2 CITY STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 20,923.77 1,100.53 Total Credits (A + B + C) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. q, Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) (2) (3) (4) (5) (5A) (56) 22,010.61 22,024.30 13.69 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 In~I contains a beneficiary designation? ...................................................................................................................... ^ 6cJ 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 t1, 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)]. 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)]. 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. Rsv-laoe Ex+ Is-98- SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY CONwIONWEALTH OF PENNSYLVANW RJHERRANCE TAX RETURN RES~FNT DECEDENT ESTATE OF FILE NUMBER Cocklin, Maude 21-08-1029 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jolMlyownsd wltlr the AgM of survlvarshlp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash 83.00 2 Citizen's Bank -Checking Account No. 6100702332; date of death balance 3,230.56 X3,230.56. This account was non-interest bearing. 3 Citizen's Bank -Checking Account No.6200241574; date of death balance 190,027.07 5190,027.07; accrued interest X0.00 4 Personal Property -sold at private sale 100.00 TOTAL (Also enter on Line 5, Recapitulation) I 193,440.63 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) +~tizens ~ank~ November 6, 2008 JENNIFER B HIPP Esq 1 W MAIN 5T SHIItEMANSTOWN PA 17011 Estate of MAUDE COCKLIN Date of Death: October O 1, 2008 SSN: 200-24-2183 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of her date of death. The decedent had 2 active accounts at the time of her death and she had no Safe Deposit Box. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, Phillip Lynch Operations Services y ~itiz~r~s B~n~C° Account Number- 6100702332 Account Title MAUDE COCKLIN Date O ened 6/7/1976 Account T e Checlcin Princi al Balance as of DOD $3,230.56 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $3,230.56 Y'TD Interest to DOD $ .00 Citizens B~nkTM Account Number 6200241574 Account Title MAUDE COCKLIN Date O ened 8/5/2002 Account T e Checlcin Princi al Balance as of DOD $190,027.07 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $190,027.07 YTD Interest to DOD $1,156.70 REV-1151 Ex+ (12-89) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Cocklin, Maude 21-08-1029 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER AMOUNT A FUNERAL EXPENSES: See continuation schedule(s) attached I 2,154.67 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Soaal Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorneys Fees Bogar and Hipp Law Offices 6,150.00 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 302.00 5. Accountant's Fees 6. Tax Return Preparers Fees 75.00 7. Other Administrative Costs 1,337.22 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 10,018.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Cocklin, Maude 21-08-1029 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Cocklin Funeral Home -funeral bill 2,154.67 H-A Sutrtotal 2.154.67 Other Administrative Costs 2 Camp Hiil Emergency Physicians -medical bill 33.46 3 Darryl K. Guistwite, D.O., Inc. -medical bill 82.83 4 Darryl K. Guistwite, D.O., Inc. -medical bill 33.78 5 Darryl K. Guistwite, D.O., Inc. -medical bill 45.12 6 Heritage Medical Group, LLP -medical bill 13.68 7 Metro Med Services -medical bill 70.35 8 Quantum Imaging ~ Therapeutic Associates -medical bill 50.26 9 Quantum Imaging & Therapeutic Associates -medical bill 69.48 10 RESERVES: -Costs to conclude administration of Estate, including filing PA 800.00 Inheritance Tax Return and Inventory and Fiduciary Income Tax Returns 11 Spirit Physician Services -medical bill 120.36 12 West Shore Pathology -medical bill 17.90 H-B7 subtotal 1,337.22 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-ts~a EX« (moo) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cocklin, Maude 21-08-1029 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Ltst Trustes(s I TAXABLE DISTRIBUTIONS [include outright spousal ' distributions, and transfers under Sec. 9116(a)(1.2)] Eric H. Cocklin Brother One Hundred 39 Ashburg Drive, Suite 2 Percent of Mechanicsburg, PA 17050 Rest, Residue and Remainder Total 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF MAUDE COCKLIN I, MAUDE COCKLIN, of Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and devise any and all interest of whatever nature that I may have in the Henry S. Cocklin family farm located in Monaghan Township, York County, Pennsylvania, to my brother, ERIC H. COCKLIN. Should ERIC H. COCKLIN predecease me, I give and devise any and all interest of whatever nature that I may have in the Henry S. Cocklin family farm to my sister, RUTH COCKLIN. Should both ERIC H. COCKLIN and RUTH COCKLIN predecease me, I give and devise my interest in the Henry S. Cocklin family farm to my brother, JAMES H. COCKLIN. If JAMES H. COCKLIN should predecease me, then his share shall be and become a part of my residual estate to be distributed as set forth hereinbelow. SECOND: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon to ERIC H. COCKLIN. Should ERIC H. COCKLIN predecease me, I give and bequeath his share to my sister, RUTH COCKLIN. Should RUTH COCKLIN predecease me, I devise and bequeath her share, in equal shares, to my nephews, ERIC JOSE COCKLIN, JOHN SAMUEL COCKLIN and PAUL ROBERTO COCKLIN. Should any of my above specifically named nephews predecease me, I give and bequeath such deceased nephew's share, in equal parts, unto my surviving specifically named nephews. THIRD: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. 2 (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FOURTH: I direct that all inheritance, estate, trans- fer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Wi11, shall be paid out of the principal of my residuary estate. FIFTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of-any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. SIXTH: I nominate and appoint ERIC H. COCKLIN, Execu- tor of this, my Last. Will and Testament. In the event of the death, resignation or inability to serve for any reason whatso- ever of the said ERIC H. COCKLIN, I nominate and appoint my sister, RUTH COCKLIN, Executrix of this, my Last Will and Testa- ment. In the event of the death, resignation or inability to serve for any reason whatsoever of the said ERIC H. COCKLIN and RUTH COCKLIN, I nominate and appoint JAMES D. BOGAR, ESQUIRE, Executor of this, my Last Will and Testament. I direct that my Executor or Executrix, as the case may be, and their successors, 3 shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this a?~st day of sl Trl'~ ~-.~ hr r 2 0 0 4. !<~~s.•~- ~ ( SEAL ) MAUDE COCKLIN Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address ~3'd~ °"~ 4