Loading...
HomeMy WebLinkAbout11-10-11I r 1505610143 REV-1500 Ex(°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsy vania county code Year File Number Bureau of Individual Taxes nErwe,wcwr~eev~ PO BOX.28~601 INHERITANCE TAX RETURN 21 11 0 683 Harrisburg, A 17128-0601 RFCInFAIT n1=eGncatr ENTER DECEDENT INFORM, TION BELOW Social Security Number Date of Deatlj Date of Birth 199 34 7644 03 07 X2011 10 12 1920 ~~ Decedent's Last Name ', Suffix Decedent's First Name MI COHICK BRUCE D (If Applicable) Enter Survivin~ Spouse's Information Be'ow Spouse's Last Name ', ' Suffix Spouse's First Name MI COHICR I LOIS R Spouse's Social Securty Numt~er ~, I, THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVAL BELOW 1. Original Return i ^ 2. Supplemental Return ^ 3. Remainder Return (date of death I prior to 12-13-82) ^ 4. Limited Estate I ^ qa. Future Interest Compromise 5. Federal Estate Tax Return Re utred (date of Beath after 12-12-82) ^ q O g. Decedent Died Testate ~ Decade t Mei rred a Living Trust 0 (Attach Copy of will) I ^ (Attach ~opy o~rusq 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds ReceiNed ^ 10. ~ P4~ 3~~e~~tt(dtet95~f death ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECI Name BRADLEY L GRI First line of address 200 NORTH E Second line of address City or Post Office CARLISLE Correspondents e-mail State ZIP Code ~ DATE FILED PA 170.13 Under penalties of perjury, I declare at I have examined this return, i chiding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Delia lion of preparer other than the rsonal representative is based on all information of which preparer has any knowledge. SIGNAT E OF PERSON R~E/SPONSIBL FOR FILING RETURN DATE o< ~ I usan L. Martin ~ ~ -CJ' -) ADDRESS I 33 Willis Newvill PA 17241 SIGNAT P AR R T REPRESENTATIVE DATE radley L. Griffie ~ ~ ~ A RESS li 200 North Hanover St., ~arlisle, PA 17013 I~~ ~„~ 1505610]43 I MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO~HOULD BE DIRECTED TO: Daytime Telephorrg-]~irj~l~er ~~_ -~~ 'IE (717) 24~~51 ~~ ~~ n ,. -- {.- - t-F, REGISTER OF ~S.fi~E O~ =.. ~ ~~ :I k7 ER ST ~`-' ':'r- ~~ M1_ -r°t Side 1 1505610143 i - -- >~ ~ 150561D243 REV-1500 EDC Decedent's Social Security Number oecedenrsName: COF}IICK, Bruce D. 199 34 764+4 RECAPITULATION 1. Real Estate (Schedule A) ........................................';............................................... 1. 2. Stocks and Bonds (Sc edule B) ..............................~,............................................... 2. 3. Closely Held Corporati n, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Re ivable (Schedule D)..........L ............................................. 4. 5• Cash., Bank Deposits Miscellaneous Personal Property (Schedule E) ............... 5. 4 , 0 O 1 . 2 4 6. Jointly Owned Propert (Schedule F) ^Separ to Billing Requested............ 6. 6 , 932 .2 6 7. Inter-Vivos Transfers & (Schedule G) Miscellaneous than; Probate J Se ar Property e Billin R t d p L g eques e ............ 7, 8. Total Gross Assets (t tal Lines 1-7) .......................I! ,............:................................ s. i0 , 933.50 9. Funeral Expenses & A ministrative Costs (Schedule H) ....................................... 9. 9 , 94 0.67 10. Debts of Decedent, Mo gage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (tota Lines 9 & 10) ................................................................... 11. 9 , 940.67 L' ~ 12 .992 - 83 13. Chartable and Govem • enta Bequests/Sec 9113 T ~usts for which an election to tax has n t been made (Schedule J)...~ ........................................... I 13. 14. Net Value Subject to T x (Line 12 minus Line 13)..!r ........................................... 14. .992.83 TAX COMPUTATION -SEE INSTRUCTIONS FOR APP (CABLE RATES 15. Amount of Line 14 taxa le at the spousal tax rate, r transfers under Sec. 91 6 (a)(1.2) X .o0 992.83 15. 16. Amount of Line 14 taxa le at lineal rate X .045 0 , 0 0 16. 17. Amount of Line 14 taxa le at sibling rate X .12 ' 0 . 0 0 17. 18. Amount of Line 14 taxa le at collateral rate X .15 ', 0 - 0 0 18. 19. Tax Due ........................ ....................................................................................... . 19. 20. FILL IN THE OVAL IF YI li I U ARE REQUESTING A R FUND OF AN OVERPAYMENT. '~ Side 2 1505610 43 1505610243 0.00 0.00 0.00 0.00 0.00 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0683 DECEDENT'S NAME COHICK, Bruce D. STREET ADDRESS 23 Willis Road CITY Newville ~ STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount (1) 0.00 0.00 0.0~ 3. Interest 0.00 4. If Line 2 is greater than Line 1 + ire 3, enter the difference. Chec box on Page 2 Line 20 to 5. If Line 1 + Line 3 is greater than ire 2, enter the difference. Check Total Credits (A + B) (2) (3) is the OVERPAYMENT. lest a refund is the TAX DUE. REGISTER OF WI (4) (5) T. PLEASE ANSWER TH~ FOLLOWING QUESI~IONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent mak a transfer and: Yes No a. retain the u or income of the property tr nsferred :............................................................................. ^ b. retain the rig t to designate who shall use .. the property transferred or its income :........................... . 0 c. retain a rave ionary interest; or ............... . ..... ...................................................................................... d. receive the p omise for life of either paym ......... nts, benefits or care? ............................................................ x ea occurre a er ecember 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration~ ....................j ........................................................................ ....................... ^ ^ x 3. Did decedent own n "in trust for" or payable u on death bank account or security at his or her death?....... ^ ^x 4. Did decedent own n Individual Retirement Acc unt, annuity, or other non-probate property which contains a benefici ry designation? .................... ............................................................................................. ^ ^ x IF THE ANSWER TO ANY OF THE BOVE 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 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 January 1, 1995, the tax rate impose 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 stat to does not exempt a transf r to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still a plicable even if the survivin spouse is the only beneficiary. For dates of death on or after July 1, 2 00: • The tax rate imposed on the net va ue of transfers from a decea ed 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 he child is 0 percent [72 P.S §9116 (a) (1.2)]. . The tax rate imposed on the net va ue of transfers to or for the u e of the decedent's lineal beneficiaries is 4.b percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net val a of transfers to or for the u e of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 91 2, as an individual who has $t least one parent in common with the decedent, whether by blood or adoption. Rev-1508 F.X+ (6-98) SCHEDULE E CASH, B~p-NK DEPOSITS, & MISC. PEF~ISONAL PROPERTY COMAAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~, '~, RESIDENT DECEDENT ''~ '. ESTATE OF ~'~ FILE NUMBER COHICK, I~ruce D. ~_ 21-11-0683 Indude the proceeds oT liti anon and the date the proceeds were received by the estate. All property jointly-owned wl the right of wrvivorahip must be disclosed on schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Certificate of Dep sit No. 9000432010fifi - ACNB Bank (see attached) 4,001.24 (TOTAL (Also enter on Line 5, Recapitulation) I 4,001.24 (If more space is needed, a ditional pages of the same size) Copyright (c) 2002 form software only~The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) it Rev-7599 F,(+ 18-981 ~ 1!! _ SFCHEDULE F COMMONWE4LTH OF PE JOINTLY-OWNED PROPERTY NNSYLVANIA INHERRANCE TA%RETURN i RESIDENT DECEDENT '~ ~I ESTATE OF ' ', FILE NUMBER COHICK, nice D. 21-11-0683 an asset was made joint wlthln o e year of the decadenPs date of desth, It must be reported on schedule G. SURVIVING JOINT TENAN (S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Lois K. Cohick 23 Will s Road Newvil e, PA 17241 B. C. JOINTLY OWNED PROPER ITEM LETTER FOR JOI DATE MADE DESCRI INCLUDE NAME OF FINANCIA TION OF PROPERTY INSTITUTION AND BANK ACCOUNT DATE OF DEATH % OF ' DATE OF DEATH VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTI ING NUMBER. ATTACH DEED FOR VALUE OF ASS DECD S INTEREST DECEDENTS INTEREST Jo1NTLY-H LD REAL EsTATE. 1 A 08/18/19 9 Checking Account o. 221899 -ACNB Bank 3,719.60 50.000% 1,859.80 (see attached) 2 A 04/11/20 5 Certificate of Depos ~t No. 165216 -ACNB 10,144.92 50.000°/a 5.072.46 , Bank (see attached), I I ~I TOTAL (Also enter n Line 6, Recapitulation) 6,932.26 (If more space is needed, ad itional pages of the same size) Copyright (c) 2002 form software only ~fhe Lackner Group, Inc. ' Form PA-1500 Schedule F (Rev. 6-98) _. REV-1151 Ex+ 00.061 SCHEDULE H coM~D~E~R~,AN,~ FUNERAL EXPENSES & EC AD INISTRATIVE COSTS ESTATE OF COHICNC, Bruce D. Debts of decede t must be reported on Schedule I. ITEM D SCRIPTION A, FUNERAL EXPEN ES: I See continu tion schedule(s) atta~hed ~~ I B. ADMINISTRATIVE COSTS: 1. Personal Represent tive's Commissions Name of Personal R oresentative(s) FILE NUMBER 21-11-0683 AMOUNT __ I Street Address City State Zio Yearfs) Commissi n paid 2. Attorney's Fees Grime ~ Associatel~ 3. Family Exemption: (f decedent's address is not t~e same as claimant's, attach explanation) Claimant Street Address Cry State Zio Relationship of laimant to Decedent 4. Probate Fees ~~~ i~ 5. Accountant's Fees ~ 6. Tax Return Preparer'~ Fees Iii i !~ 7. Other Administrative ~osts ~I 9,064.17 750.00 126.50 TOT L (Also enter on line 9, Recapitulation) 9,940.67 Copyright (c) 2009 form software only he Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) - _- I SCHEDULE H FUNERAL EXPENSIES AND ADMINISTRATIVE COSTS continued ESTATE OF D. FILE NUMBER 21-11-0683 ITEM NUMBER DESCRIPTION AMOUNT 1 Egger Funeral Ho e, Inc. ', 9,064.17 H-A 9,064.17 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) - _~ - __ ~ REV-1673 ~EX+ (~ 1-08) SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER COHICK, Bru a D. 21-11-0683 N ME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSO (S) RECEIVING PROPER DECEDENT (Words) ($$$) I~ TAXABLE DISTRI UTIONS [include outright s ousel distributions, and ransfers under Sec. 9116 1.2 Lois K. COHIC Spouse 100% of net 23 Willis Road estate Newville, PA 1 241 ~ ~ Total Enter dollar a ount for distributions shown abo a on lines 15 throw h 18 on Rev 1500 cover sheet as a ro i NON-TAXABLE DIS IBUTIONS: II. A. SPOUSAL DIST IBUTIONS UNDER SECTIO 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AN GOVERNMENTAL DISTR BUTTONS TOTAL OF PART II -ENT R TOTAL NON-TAXABLE ISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only he Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ~~x 3~i11 ~n~ ~~~t~m~n~ OF BR CE D. COHICR S I, BRIIC D. COHICR, o Newville, Cumberland, Pennsylvania, being of sou d and disposi g mind, memory and understanding, do make, publish and declare t is to be my Last Will and, Testament, hereby revoking and making oid all previous Wills and Codicils heretofore mad by me. FZRBT I order nd direct my ersonal representative hereinafter named to pay a 1 of my just ebts, funeral expenses and expenses ianvo~v~ed or on~nec~ed ~w~th tie- ad~aivn~s~trato-n -:off .my ester=tre ass soon after m death as is reasonably possible. However, my personal repr sentative ne d not accelerate and pay those unmatured obli ations which, in his, her or its opinion, it might be proper an more advanta eous to retain or .renew and pay as they become du and payable. If I do not own a burial plot or a grave marker at the time o my death, I authorize my personal representative, in his, her or its sole discretion, to purchase a burial plot an to erect a suitable grave marker at my grave, and to expend sums from my estate for this purpose. 200 NORTH HANOVE STREET CARLISLE, PA 1 013 GRiFFI~ & ASSOCIATES ATT RNEYS AT LAW PAGE 1 IOF 6 - I 14 NORTH MAIN STREET SUITE 307 CHAMBERSHURG, PA 17201 I give, devise and beq of my estat , together wi whatever nat re and where LOIB R. COH CR, providing days. Should a before the devise and be together with and wheresoev 1~iARTIN and HR' stirpes. FOIIRTB T grant y personal re resentative the followin g powers in addition to a d not in limi ation of such powers as my personal representative shall hold by law: (a) To r tain all prop rty received including the stock of any orporate fidu iary acting hereunder, provided such prop rty remains p oductive. (b) T join in any corporation, partnership, reca italization, erger, reorganization or voting trust plan; to dele ate authority with respect thereto; to eposit inves ments under agreements and pay GRIFFIE~& ASSOCIATES ATTO NEYS AT LAW SECOND ueath the rest, residue and remainder th all insurance proceeds thereon of ~oever situate to my beloved spouse, that she survives me by sixty (60) THIRD spouse, LOTS R. COHICR, predecease me or die on or ixtieth (60) ay following my death, then I give, ueath the res residue and remainder of my estate 311 insurance proceeds thereon of whatsoever nature r situate in equal shares to my children, BIISAN L. :E 8. COHICR w o survive me by sixty (60) days per 200 NORTH HANOVER STREET 14 NORTH MAIN STREET CARLISLE. PA 1 013 su1TE 307 PAGE ~ OF C) CHAMBERSBURG. PA 1720] assessments; an generally to exercise all rights of investors, including but not limited to, the voting of sha es. (c) To anage, operat repair, improve, mortgage or lease on ny terms any eal estate held or owned by my estate. (d) To perate any bu iness that I may own at my death. (e) To nvest any fun s of my estate in any stocks bonds b (f) (g) not s or other securities or property, real or per onal, witho t regard to the principle of div reification o any other statute or general rule of law in his, hero its absolute discretion, it being my int ntion to gi a my personal representative the bro dest investme t powers possible, providing such inve tments do n t unnecessarily prevent the prompt sett ement of my a tate. To ell or otherw'se dispose of any property, real or pens nal, tangible or intangible, at any time forming a part of my estate in any manner and on such terms and cond tions as my p rsonal representative shall see fit in h s, her or its absolute discretion. To borrow money or the payment of taxes or for any othe proper pur oses in the administration of my esta e, and to m rtgage or pledge estate assets as security. 200 NORTH HANOVER STREET CARLISLE, PA 1 013 GRIFFIE & ASSOCIATES ATTOf2NEYS AT LAW nnn~ ~ 1n~ c 14 NORTH MAIN STREET SUITE 307 CHAMBERSBURG. PA 17201 1 3 ,~ (h) (i) (] ) (k) To ~COmpromise clams without court approval including, buts not limited o, any controversies with the United Sta es of Americ or the Commonwealth of Pennsylvania con erning esta a and inheritance taxes on any int rests that ay pass under this my Last Will and Tes anent. To distribute in cash or in kind upon any division or dis ribution of m estate. To undertake an and all acts deemed necessary and pro er by my per oval representative for the proper, adv ntageous and rompt management of the settlement of my state. In g neral, to exe cise all powers in the management of my state which a y individual could exercise in the mina em~n't of Simi ar` proper'ty owned in his own right, upon such terms an conditions as to him, her or it may seem best and to xecute and deliver all instruments and o do all acts which he, she or it deems necessary or roper to carr out the purposes of this, my Last Will and Testament. FIFTH No inter st of any b neficiary of my estate, either in income or inl principal, shall be subject to anticipation or pledge, assign ent, sale or t ansfer in any manner, nor shall any beneficiary have the power i any manner to charge or encumber GRIFFIEBc ASSOCIATES ATTORNEYS AT LAW 200 NORTH HANOVER STREET 14 NORTH MAIN STREET CARLISLE. PA 1 013 suiTE 307 _ CHAMHERSBURG. PA 17201 -- •i -- T ~ his interest's either in income or principal, nor shall the interest of Iny beneficia be liable or subject in any manner while in th possession o my personal representative for the liability of uch beneficia y. sIZTH I nomin te, constitu a and appoint my spouse, LOIB 1C. COHICR, as Ex cutrix of thi my Last Will and Testament. In the event my sp use is deceas d, unable or unwilling to serve or shall cease t serve for an reason whatsoever, then I nominate, constitute an appoint my c ildren, BIISAN L. MARTIN and BRIICE S. COHICR, or the survivor of them, as personal representative of this my Last Will and Tes ament. I direct that my personal representative shall not be equired to give or post bond for the °fathful perf~ •ance .o~f h~ .her .a~r its ~tute~s ~in 'this o~r a~riy other jurisdic ion. SEQENTH I hereby declare it o be my expressed desire that my personal repr sentative em loy the law firm of Griffie & Associates, o Carlisle, ennsylvania, for legal advice and assistance reg rding this my Last Will and Testament, they having considerable k owledge of my affairs, views and wishes respecting any matters th t may arise a the probate of this instrument, the admin~strationl! of my estat and the execution of the powers herein mention d. 200 NORTH HANOVER STREET CARLISLE. PA 1 013 GRIFFIE & ASSOCIATES ATT012NEY5 AT LAW 14 NORTH MAIN STREET SUITE 307 ~,,w,.,r„ ~ nt, ~ CHAMBERSBURG, PA 17201 _r ~_ __ _ _ ~ - _- - - E IN WITNI Las/~t/-Will and 19 ~/ WITNESS: ASS WHEREOF, Ihave hereunto set my hand to this my Testament thi day of BRIICE D. COHICB 200 NORTH HANOVER STRF AR t L P - A 1 013 GRIFFIE & ASSOCIATES ATTOFRNEYS AT LAW n n r+z~ c nL+ c _- - ~_ 14 NORTH MAIN STREET SUITE 307 CHAMBERSBURG, PA 17201 L COMMONWEALTH F PENNSYLVANI SS COUNTY OF CUM ERLAND I, BRIICE attached or according to executed the signed it wi voluntary act D. COHICR, th Testator whose name is signed to the foregoing ins rument, having been duly qualified law, do he eby acknowledge that I signed and instrument a my Last Will and Testament; that I llringly, and that I signed it as my free and for the purpo es therein expressed. ~~ BRIICE D. COHICR Hw©rn ~or COHICR the affirmed --and Testator . 1996 •a=ckrt~owledged ~3~e~~ome me ;by -BaRjOCE =D. this ~S~l day of ~ '~'} Notarial Seal Leah A. Miller. Notary Publld. ' Carlisle Boro, Cumberland Caurrty, My Commission Expires April 17, 2000- GRIFFIE~& ASSOCIATES ATTO NEYS AT LAW 14 NORTH MAIN STREET 200 NORTH HANOVER STREET CARLISLE. PA 1 013 suiTE soy CHAMBERSBURG, PA 17207 - - - i - - ~ - ~~ ~ L I ', AFFIDAVIT COMMONWEALTH F PENNSYLVANI SS COUNTY OF ERLAND We, ~h-~~v'~ ~. "( ~~~Ihm-v. and .~ 1- i- ~ 1r~I~ , the witnesses whose names a e attached to the foregoing document, being duly qu lified accord ng to law, do depose and say that we were present and saw BR CE D. COHICK sign and .execute the instrument a his Last ill and Testament; that he signed willingly and that he execu ed it as a free and voluntary act for the purposes herein expres ed; that each subscribing witness in the hearing nd sight of t e Testator signed the Last Will and Testament as itnesses and t at to the best of our knowledge the Testator was at the time 18 or more years of age, of sound mind anri~ :u~l~l~er no c nstra~rlt ~or °u due -~~n~'~u~errc~e Sworn 1f-N of 200 NORTH HANOVE STREET CARLISLE, PA 1 013 affirmed ~ and , /' l and~j% sub/s~cribed before me by /_7 /'l. I~ 1./~/r this ~ da Y 196. ;~,; °, ) Notarial Seal Leah A. Miller, Notary Public '• GRIFFIE & ASSOCIAT 5 Carlisle eoro, Cumberland County ' aTr RNEYS AT LAW MY Commission Expires April 17;.2000 14 NORTH MAIN SUITE 307 CFiAMBERSBURG, PA 17201 to Sche}~ules E & F __ _ _ ~ - ACNB BANK June 29, 2011 Griffie & Associates Attn: Bradley L Gri: 200 N Hanover St Carlisle PA 17013 RE: Estate of Bruce Dear Mr. Grime: The following information is being provided a Acct. Type Accou t No. Balance at D.O.D. Super NOW 22189 $3,719.56 Account Certificate of 16521 $10,000.00 Deposit Certificate of 90004 201066 $4,000.00 Deposit Inquiries concerning A NB Corporation stock at 1-800-368-5948.. Ify u need any additional Sincerely, $arbara J W ACNB Ban Deposit Se II s per your request: Accrued Ownership Date Interest to Opened/Joint ~ D.O.D. $0.04 Joint w/ Lois K Cohick 8/18/89 $144.92 Joint w/ Lois K Cohick 4/11/05 $1.24 Individual 12/1/09 information should be directed to the Registrar and Transfer Company information, please contact me at (717)339-5122. acnb.com . acnbbusiness.4om { P.O. Box 3129. Gettvsb~ra. PA 17325 • Phone 717.334.3161 . Toll FI'PP 1 _RRR.334.ACNB (276?1 - -