Loading...
HomeMy WebLinkAbout07-15-10J 1505610101 REV-1500 Ex ~O1_1°' ' PA Department of Revenue Pennsylvania OFFICIAL USE ONLX Bureau of Individual Taxes OEPARTMENTOFREVENUE County Code Year File Number PO Box 280601 INHERITANCE TAX RETURN Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT ~ ~ ~ U G' : c~ C9 ~ ,~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY f ~ 3 ~5 3~~3~ ~1 ©~~o t o d5" ~'1 t `~ t '7 Decedent's Last Name Suffix Decedent's First Name MI ~oM~ J~. Jo~N `~ J. (If Applicable) Enter Surviving Spouse's Information Below Spouse'siLast Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ,~ 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate (Attach Copy of Will) O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes , (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) • between 12-31-91 and 1-1-95) (Attach Sch. O) ,.CORRESRONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0 Name : Da y time Te leph on e: Number ` `` `` n ~ } / ~ First line of address Second line of address City or Post Office c ~--,~ ~, Correspondent's a-mail address: State ZIP Code ~ 1 ~ a ~ t ~ _, ' _ REGIS~;~ F WILLS E ONLY .~ ,-p k"` ~ r--.. a Ir i°TI ~ .... ', .. -.-; .~ _~~{~ 4 ' " ; r _ y, -~~ ~ U DATE: FILEIT"~ Under ties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is tru , co ct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA RE F PE RESP LE FOR FILING RETURN "' - DATE _ ~~~ f~L t dot ( __ _ SIGN RE F PREPARER OTHE HAN REPRESENTATIVE -DATE ~i PLEASE USE ORIGINAL FORM ONLY ~ -~-•-_._~...__ , Side 1 1505610101 15056101 01 t '~j ~~` e% 1505610105 REV-1500 EX~ ~~N ~. ~n • Decedent's Social Security Number tM I~ ~ ~ 3 ~ ~ 3 ~ 3 ~ Decedent's Name: 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. G ~ 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. ~* 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. ~ J' ©d• C~ v 6. Jointly Owned Property (Schedule F} (,~ Separate Billing Requested .... ... 6. ~(~ ~ ~' ~ • ~ ~~ 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) Q Separate Billing Requested..... ... 7. w 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. .~.- ~ ~ ~ 3 ~ • r ~~}~ 9. Funeral Expenses and Administrative Costs (Schedule N) ................... 9. ~ ,~ ~' ~ . ~j a 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. l ~ ~ j ~ a,. •~s ~ (J 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ~3 ~ ~ ~ , v Q 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. ~ ( ~ L ~r 8 5 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. ~. TAX CALCULATION -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 at lineal rate X .0 __ . 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. • 18. Amount of Line 14 taxable ~ ~~ • ~ ~ t at collateral rate X .15 + 18. • 19. TAX DUE ..................................................... .... 19. (.~° ~- 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 1505610105 1505610105 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDE T~NAME STREET DRESS ~1 _1~~~55lrin_ - s/_t ~i~ - - ------ j cry / - I EC~ftM/ CGS ~7/'~ _._ _ - - S AT ~ ~ ZI~ ~~~,,,, Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) ~" ~ r 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 3. Interest (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) ---~ b ~` 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 Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ ~" 3. Did decedent awn 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? ........................................................................................................................ ^ Q~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 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 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. REV•75Q8 EX + tt•97) COMMONWEALTH OF PENNSYLVANIA INHEft4TANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Miscellaneous Personal Property ~ 1,500.00 • 1.,5~J0.00... • TOTAL (Also enter on line 5, Recapitulation) $ (lf mnrc~ enonn is neerlGrl incorl ar)rlifirlllal CFtl~PfC Il{ tM0 CafY1P CI7P.~ -- SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOfNTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE flLE NUMBER !fan asset was made joint within one ye r of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NA"AE A. John J. Comey !3. C James H. Comey JOINTLY-OWNED PROPERTY: 801 Mandy Lane, Camp Hill, PA 17011 107 Treaty Road, Drexel Hill, PA 19026 RELATIONSHIP TO DECEDENT son son ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE SOiNT UESCRIPT)ON OF PRGPERTY tnclu;ie name of fina~7cial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH `JALUE OF ASSET °/ OF DECD'S INTEREST DATE GF DEATH VALUE OF DECEDEI~1T a> IN1'ERE~ ~. A. PNC Investment 2,373.57 50 1,186.79 2.' ~ A ~ PNC CD ~ 22,333.78 50 ~ ' 11;166:89 3. A PNC Bank Checking Account 75,315.72 50 37,657.86 4. A/B Bank of America 2,757.61 50 919.20 TOTAL (Also enter on line 6, Recapitulation} $ 50,930.95 !tf mnra cnarp is n~ariPri. insert adciitinnai sheets 0f the same size) REV-i5ii EX+ (i0-06) ,~ .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE 7AX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE F FILE NUMBER - Debts of decedent must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~~ j~ Cremation 1,550.00 Death Notice (newspaper) Memorial Engraving B ~i~ l~i~t~~,tl$~~Tc~e - Register of Wills 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City ----- ----____------- - ------- State -------Zip - Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is plot the same as claimant's, attach explanation} Claimant Street Address _ __ _ - - __ City ___- -~~ ____._-__--- State -----__--- Zi - ---- --------- P Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 420.00 433.00 141.50 TOTAL Also enter on line 9, Recapitulation)~$ 2,544.50 (If more space is needed, insert additional sheets of the same size) REV-i512 EX+ (12-031 ,~~.~,~~~ SCHEDULE 1 ~~.~ I c~~,n~©~,~;~Ea~T~-~ o~ ~c~~~;vsYwar,,a DEBTS ~f DECEDENT, ~~NF~~~~{~~c~ ~a:"~F'~~~ 1VIORTGAGE LIABILITIES, & LIENS ~zES;oEw~r oEC~~Eti ESTATE OF FILE NUMBER R,.;p,~rt ciek:~ts inr:ur~red lay the dr~~e~lent E~rior t eath ~vt7ic;h remained un~aici as of the date of death, including unrPimbursed nl~adical expen~~.s.. ... .. ___ __ _ _.____ NU~4E3E:F: ! ___ l)CSt'FZ~F~TiC~iv ____.-_ ~C7FC)EAl"H _.__._._-- 2 3 4. Medical Expenses 568.30 Outstanding Checks Written in 2009 for Holiday Gifts/Distributions ! 26,150.00 (checks written but not cleared by date of death) ~ 2009 Federal Taxes 2009 PA Lncome Taxes 24,446.00 18.00 i ~.,~Ta'~L. (~~r, ~,~~.~~ nn =;~,E; ~;~3. f~;~ta,.~~itts4; i~>~:) i } ~; ~ 1,1$2.30 } ~ 'I( '')<3'„ !1; c G`I^i~ ir_ ,!t ~t(C`It~t~rid~ ..I!~:('.i O.` t''., ~ ~.'f l~? Si%P,~ REV-1513 EX+ (9-00) ~~ COMMONWEALTH OF PENNSKI-VANlA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEi:iC1ARIES ESTATE OF 11 t FILE NUMBER ~ RELATIONSHIP TO DECEDENT AMOUNT OR 5HARE 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. 91 i 6 (aj (1.2jj 1. John J. Comey, 801 Mandy Lane, Camp Hill, Pa 17011 son 50% James H. Comey, 107 Treaty Road, Drexel Hill, PA 19 26 son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWAi ABOVE ON LINES 15 TH ! ROUGH 18, AS APPROPRIATE, ON fiEV-1500 COVER SHEET jT NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA .fr ~.. ~~= ~~ ~~., ~. :~~~ _ ; ~ /'~ .yam.. '1. ~~ No . 20 ~ 0- 00083 CERTIFICATE OF GRANT OF LETTERS PA No . ~? ~ - 10- 0083 Estate Of : JOHN JOSEPH COMFY JR (First, Middle, Lastl Late Of : HAMPDEN TOWNSH/P CUMBERLAND COUNTY Deceased Social Securi ty No : ~ 73-05-3738 WHEREAS, on the 26th day of January 2 010 an instrument dated April 25th 2002 was admitted to probate as the Last will of JOHN JOSEPH COMFY JR (First, Middle, Last/ late of HAMPDEN TOWNSH/P, CUMBERLAND County, who died on the 7th day of January 2010 and, WHEREAS, a true copy of the will as probated i s annexed hereto . THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi1.Zs in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: JOHN J COMFY 111 who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, all of which f u11 y appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE, CA RL lSL E, PENNS YL VA NlA . IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 26th day of January 2070. i' ~~~ *~- Register of Vl/ills ~ ~, .., . ~ `s ,, Deputy * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL & TESTAMENT of JOHN J. COMFY, Jr. 1, John J. Comet', Jr., of Martin County, Florida, being of sound and disposing mind and memory, declare this document to be my Last Wil(& Testament, and hereby revoke all prior wills and codicils. ARTICLE I. For information purposes, at the time of the execution of this will, my family status is as follows. ! am single, and I l~iave children. My children's naiYie are John Comet', 111, James Comet' and David Comet'. ARTICLE II. l direct that all my legally enforceable debts, funeral expenses, ar~d adminis- tration expenses be paid in the order and in the manner prescribed by law. ARTICLE III. I direct that my personal representative pay out of my residuary estate, without apportionment, all estate, inheritance, succession and other taxes, Except any generation skipping tax, imposed on any property of which I am considered to be or deemed transferor {together with any penalty thereon), assessed by re<~son of my death, imposed by the government of the United States or any state or territory thereof, or by any foreign government or political subdivision thereof, in r~;spect to all property required to be included in my gross estate for estate or like death tax purposes by any such governments, whether the property passes under this will or otherwise, without confiribution by any recipient of any such property. ARTICLE tV. devise all of my furniture, furnishings, clothing, jewelry, household goods, personal effects, automobiles and other vehicles, boats, and all other tangilale personal property, not otherwise specifically devised {except cash on hand or ~on deposit, property used in a trade or business, and any property held for the production of incomes, toy my two sons, John Comet', Ill and James Comey. I Direct that said property be divided between these two sons as they may determine, or should they be unable to agree, as my Persona! Representative shall decide. Last Will & Testament Of John J. Comet', Jr. Page 1 ARTICLE V. 1 may leave a written statement disposing of certain items of rrly tangible personal property not otherwise specifically disposed of in this wil{. Any such statement in existence at the time of my death, dated and signed by me, shall be determinative with respect to all items devised therein. if such a written statement is not found and identified by my personal representative within thirty days after Letters Of Administration are issued, it shall be conclusively presumed that there is not such a written statement, and any subsequently found written statement shall be ignored. ARTICLE VI. I devise the rest, residue, and remainder of my estate, of every kind, mature, and description, which I now own, or hereafter acquire, or have the right to dispose of at the time of my death, to my two sons, John Comey, 111 and James Comey, per stirpes. I have deliberately made no provision in this Last Will and Testament for my son David Comey since he has received a loan in the amount of $196,922 from mE;, which he has not repaid. ARTICLE VII. { appoint my son, John Comey, lll, as the personal representative of my estate. If my designated personal representative predeceases me, or is unable to serve as my persona( representative, I appoint my son James Comey, as the persona( representative of my estate. I direct that no bond be required of the personal representatives designated herein. In addition to, and without in any way limiting the powers conferred upon my personal representative by law, I vest my personal representative with full power and authority to sell, transfer, or convey any property, real or personal, which I own at the time of my death, at such time, and upon such terms (including credit), as my personal representative may -determine, and to do every other act and thing nf;cessary or appropriate for the complete administration of my estate, including pursuing all debts owed to me or my estate and offsetting any beneficiaries share against said debts. ARTICLE VIII. In addition to the powers conferred upon personal representatives by law, my persona( representative shall have full power, without any court order or proceeding, to lease, or fio sell, pursuant to any contract, option, or otherwise, at publiic or private sale, and upon such terms as my personal representative deems best, any real or personal property belonging to my estate, without regard to the necessity of such sale for the purpose of paying debts, taxes, or devises; or to retain any or all of such property not so required, without liability for any depreciation thereof; to make distribution in kind; to assign or transfer certificates of stock, bonds, or other Last Will & Testament Of John J. Comey, Jr. Page 2 securities; to adjust, compromise, and settle all matters of business and claiims in favor of or against my estate; to continue any unincorporated business for the period of administration, or to incorporate any business in which (may be engaged at the time of my death and to continue that administration; and to do any and all things necessary or proper to complete the administration of my estate, a!I as fully as I could do myself. On ; / ~'" ;ZE%~~;L in Martin County, Florida, in the presence of the un ersigned witnesses, l hereby sign my name to this document, and I hereby declare it to be my Last Will & Testament. ~~_.. _ ., U John J. y, J . On the date indicated above, in our presence, John J. Comet', Jr. signed this document, and he declared it to be his Last Will & Testament. At the request of John J. Comet', Jr., and in his presence, and in the presence of each other, we hereby sign our names as attesting witnesses, in Martin County, Florida. 'tness .---, ~,~ Witness SELF PROOF OF WILL State C?f Florida County Of Martin 1, John J. Comet', Jr., the testator, who signed the foregoing document, affirm that I, in the presence of each of the witnesses, signed the said document and declared it to be my Last Wiil & Testament, and I affirm that each of the witnesses, in my presence, and in the presence of each other, signed the said document as witnesses. We, the witnesses, who signed the foregoing document, affirm that John J. Comet', Jr., in our presence, signed the said document and declared it to Ise his Last Will & Testament, and we affirm that each of us, in the presence of John J. Comet', Last Will & Testament Of John J. Comet', Jr. Page 3 Jr., and in the presence of each other, signed the said document as witnesses. Johr . Co y, Jr. 1lVit ess --~~ ~.. Witness Affirmed and signed before me, on -1.r~~' ~ ~-~, Z., on~4-- by each of the following individuals: --~- John J. Comey, Jr.: [ /I who is personally known to me, or [ ] who produced the following identification: (Witness -Printed Or Typed Name} [ ~ l who is personally known to me, or [ 1 who produced the following identification: (Witness -Printed Or Typed Name) who is personally known to me, or f l who produced the following identification: .John J. Comey, Jr., and each of the witnesses, personally appeared before me at the time of notarization, and, after being given the oath, acknowledged signing the foregoing document in the presence of each other. `~-'" '~ ~ Notary Public .SPRY pV~ Thomgs F. Weiksnar ~° ~Comrnission ~ CG 737241 ~ o' Expires Mey 31, 2002 (Notary Public -Printed Or Typed Name) ~'aFa~AT,ANeON~o,~cco.,~Nc Commission Number & Commission Expiration Date: (SEAL) last Wi{1 & Testament Of John J. Convey, Jr. Page 4 I(~ ~~