HomeMy WebLinkAbout11-25-09 _
'--! REV-1500 Excos-o5)
PA Department of Revenue
' Bureau of Individual Taxes
PO BOX 280601
Harrisburg. PA 17128-0601
15056051047
OFFICIAL USE ONLY
Countv Code Year File Numt~er
INHERITANCE TAX RETURN
RESIDENT-DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth I
~~~~~~~~~~~~~~~ II Irl - rrr I~1 II ~~~+~~~~*y~
1 0 9 2 4 9 4 4 e15 ~ ~ ®~ ~ ~ ~ ~ ~ ~ ~ ~ ~ M%J
Decedent's Last Name Suffix Decedent's First~Nam~"e~ Mt
~ ~~~ R~-b +e i r 1 t i~-~ J
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Spouse's First Name MI
Suffix ~
T~
O' C o n n o r D i a n e
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICIYTE'VIIITH THE
REGISTER OF WILL'S
FILL IN APPROPRIATE OVALS BELOW
i 1.Original Return O 2. Supplemental Return O 3. RemaGnder Return (date of death
priortq 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-62)
r 6. Decedent Diad Testate O 7. Decedent Maintained a Living Trust ~ ~oinT~tel Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation. Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Eleictioh to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attlach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Tile hone Number
A n t h o n L D e L u E 7 1 2 5$ 6 8 4 4
Firm Name (If Applicable) REt313TER OF WILLS USE ONLY
N
:'t_3
First line of address ~ ~:> :;''
G~
C~ t'r~ f
P O B o x 3 ~~ ,,,~ ~-
r.- N t t_r.
Second line of address ,~~rn ~
1 1 3 F r o n t S t r e e t ~''~ ~ FIL .~ ~J~
City or Post Office State ZIP Code ~_r.- '~
I run rlul ~ ~. ....._ ~""t"i
B o i l i n 5 r i n s P A 1 7 0 0 7r~ ' r '-~'~ ~ ~~
r
Cor'espondent's e-mail address:
Under penalties of perjury, I dedare that I have examined this return, including accompanying schedules and statements, and to'the Ibest of my knowledge and belief,
it is true correct and complete. Declaration of preparer other than the personal representative is based on afl information of which reparer has any knowledge.
SIG RE OF PERS~ES ~I~SI(i'QE FOR FILIN RETURN ~ t~ / r v 1~ ~r
.14 ..i ! 1 / ilAe~t ~ ~/tJI ~.
Side 1
1505.6051047 1S051aD51D47
J
REV-1500 EX
Decedents Name:
Decedent's Social Security Number
'
1. Real estate (Schedule A) . . ........................ . ................. . 1. IIMI ~I AY71 ~ NC M 6PYa
0 IYNA'
0
0
2. Stocks and Bonds (Schedule B) ....................................... 2. 1 5 5 1 5 7 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . ; ... 3. 0 0 0
4. Mort a es 8 Notes Receivable Schedule D
9 9 ( ) ............................. 4. 0 0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . , ...... 5. 3 0 8 4 0 2
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 0 0 0 ,
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) C~ Separate Billing Requested.. , ..... 7.
0
0
0
8. Total Gross Assets (total Lines 1-7) .................................... 8. 1 5 4 1 0 2
9. Funeral Expenses ~ Administrative Costs (Schedule H) .. . .................. 9. 7 6 1 5 2 1
10. Debts of Decedent, Mortgage Liabil(ties, & Liens (Schedule I) ................ 10. 1 1 9 2
11. Total Deductions (total Lines 9& 10) ................................... 11. 1 r 9 0 8 9 1 3
-.: .
12. Net~Value of Estate (Line 8 minus Line 11) .............................. 12.
1
6
6
5
.1
$
9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ........................ 13.
0
0
0
14. Net Value Subject to lax (Line 12 minus Line 13) ........................ 14. 1 ~ 6 5 5 1 8 9
iM vvmrv ~h~ wn - .7CC 119.7 ! RUI. I IVIVJ tVtt AYYUGAtSLC KAI t5
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .OQ..
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.
16.
17.
18.
19. TAX DUE .... ....................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTIfW~ A'R1)`UN~! OF AN`OVERPAYNIENT
15056052048
O
Side 2
15056052048 1.505bg15~048
REV-1511 EX+ (70-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF F{LE NUMBER
Robert J. O'Connor 21-09-0746
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: $ 2 , 8 0 6.21
1~ Hoffman-Roth Funeral Home
219 N. Hanover Street
Carlisle, PA 17013
B.
1
2.
3.
a.
5.
s.
~.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State Zip
AttomeyFees Anthony L. DeLuca, Esquire 4, 000.00
Family Exemption: ({f decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees 2 7 9. 0 0
Accountants Fees
500.00
Tax Return Preparer's Fees
Filing fees for Inheritance Tax Return and Tnventory 30.00
TOTAL (Also enter on line 9, Recapitulation) I $ 7 , 61 5.21
(If more space is needed, insert additional sheets of the same size}
REV-1512 EX+ (12A3)
COMMONYYEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & IIENS
ESTATE OF FILE NUMBER
Robert J. O'Connor 21-09-0746
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ROBERT J. O'CONNOR
FILE
21-09-0746
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ ~ Do Not Llst'tfustse(A) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9118 (a) (1.2))
1. Diane F. O'Connor Wife 100
659 Spring Lane
Boiling Springs, PA 17007
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATff, O N REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE i3 OF REV-1500 COVER SHEET ', $ - 0 -
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
ROBERT J. O'CONNOR
I, Robert J. O'Connor, a legal resident of South Middleton Township, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do
hereby make, publish, and declaze this as and for my Last Will and Testament, hereby revoking
all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my grave
marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: 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
apart of the expense of the administration of my estate.
THIRD: I bequeath those articles of my household furnishings, personal effects,
,end personal property as set forth in a sepazate memorandum, which I intend to sign and keep
with my copy of this Will, to the persons named in that memorandum.
FOURTH: I devise and bequeath the residue of my estate, of every nature and
wherever situate, to my wife, Diane F. O'Connor, provided she shall survive me by thirty (3U)
days. Should my wife, Diane F. O'Connor, predecease me or die on or before the thirtieth day
following my death, I devise and bequeath the residue of my estate, of every nature and wherever
situate, to my children, equally, 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 his or her 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 shazes for my other children.
FIFTH: I nominate, constitute and appoint my wife, Diane F. O'Connor,
Executrix, of this, my Last Will and Testament. In the event of the renunciation, death,
resignation, or inability to act for any reason whatsoever of the said Diane F. O'Connor, I
nominate, constitute, and appoint Edward L. Schorpp, Esquire, Executor, of this, my Last Will.
and Testament. I hereby relieve my Executrix or her successor from the necessity of posting
security in connection with their duties as such in any jurisdiction in which they may be called
upon to act, insofar as I am able by law so to do.
~~ c
itials
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IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Wij~~
and Test nt, consist' of two typewritten pages, each of which bears my initials, this / ff
day of , 1998.
' J
(SEAL)
Ro J. O' onnor, Testator
Signed, sealed, published, and declared by the above-named Testator, Robert J.
O'Connor, as and for his Last Will and Testament, in the presence of us, who,.. at his request, in
his sight and presence, and in the sight and presence of each other, have hereunto subscribed our
names as witnesses.
~a ~~~
--~-
ACKNOWLEDGMEPIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, Robert J. O'Connor, Testator, whose name is signed to the attached or foregoYng
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.
~n or affirm to and ac owledged before me by Robert J. O'Connor, the Testator,
this ~ day of ~--; 1998.
T tator, R rt J. O'Connor
Notary Public
Notarial Seal
8ucen K. Guyer, Notary Public
Caruslm Boro, Cumberland Counttyy
My Commis9ian Expires Sept. 4, 1899
em er, annsy an a u~t on o otar ea
~A.. ~.
~~:,:~. , w ,.,~;,
AI~FID~VTF
COMMONWEALTH+OF PENNSYLVANIA
SS.
COCJNTY OF CUMBE$LAND )
We, Edward L. Schorpp and ~. the
witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw Testator sign and execute the
instrument as his Last Will; that Robert J. O'Connor signed willingly and that he executed it as
his free-and voluntary act for the purpose therein expressed; that each of us in tie hearing and-
sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the
Testator was at that time eighteen or more years of age, of sound mind, and under no constraint
or undue influence. .
/~ S rn r ed and subscribed to re me by azd L. S • orpp an
lJr-
witnesses, this ~L~~~y of 1!998.
EAL)
Witness, Edwazd L. Schorpp
~~~ ~ = h~ ~ (SEAL)
Witness
C~ `~ (SEAL)
Notary Public
Natarlel Seal
Susan K. Quyer, Notary Publio
Carlisle Boro, Cumberland Countt+
My Commlaafon Expires Sept.. 4,1899
em or; onncylvan a a on o ota a
LAST WILL AND TESTAMENT
OF
ROBERT J. O'CONNOR
I, ROBERT J. O'eONNOR, of Boiling Springs, Cumberland County, Pennsylvania, do
make,-publish and declaze this to be the first Codicil to the Last Will- and Testament executed by
me on December 17, 1998, in the presence of Edward L. Schorpp, Esquire and Linda A. Rohm.
FIRST: I revoke and annul the FIFTH item of my Last Will and Testament executed by
me on December 17, 1998; and, in lieu and substitution thereof, I direct that the FIFTH item of
my Last Will and Testament executed by me on December 17, 199$ be as follows:
FIFTH: I nominate, constitute and appoint my wife, Diane F. O'Connor,
Executrix, of this, my Last Will and Testament. In the event of the renunciation, death,
resignation, or inability to act for any reason whatsoever of the said Diane F. O'Connor, I
nominate, constitute, and appoint Anthony L. DeLuca, Esquire, Executor, of this, my Last Will
and Testament. I hereby relieve my Executrix or her successor from the necessity of posting
security in connection with their duties as such in any jurisdiction in which .they maybe called
upon to act, insofaz as I am able by law so to do.
In all other respects I ratify and confirm all of the provisions of my said Will dated
December 17,199$.
~~ ~ ~
~~'""
RO ERT J. 'CONNOR
~~ r. _
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k ,cy.rg„ ,.
}
LAST WILL :AND 'TESTANT
OF
ROBERT J. O'CONNOR
IN WITNESS WHEREOF, I, ROBERT J. O'CONNOR, subscribe my name, this ~--
day of ~ P. ~ r ~/ , 2005.
,.
H
ROB J.O'CONNOR
The foregoing instrument, consisting of this and one preceding typewritten page was signed,
published and declared by ROBERT J. O'CONNOR, the Testator, to be the first. Codicil to his Last
Will and Testament in our presence, and we at his request and in his presence and in the presence of
each other have hereunto subscribed our names as Witnesses this ~~~ day of October, 2005.
xesiding at ~'ar ~,~ T /,,~ir~.l' ~i~ l~B d ~ l
residing at oQ'~