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HomeMy WebLinkAbout06-06-1225®56201,05 E -15 ~x;cz_ ~; c-t; enns lvania OFFICIAL USE ONLY PA Department of Revenue P _ Y p ,. -.. Bureau of Individual Taxes ~ County Cod., Year rFile Number_ Po BOxz8o6oi INHERITANCE TAX RETURN r Harrisburg, PA zy~28-0607 RESIDENT DECEDENT ~ ~ I ~ ~~ ENTER DECEDENT INFORMATION BELOW ~- Social Security Number Date of Death iv1he1DDYYYY Date of Birth '`,9iv1DDYYYY 174-03-9089 04/02/2011 04/05/1918 Decedents Last Name Suffix Decedent's First Name MI Hock ' ' Larue C (If Applicable} Enier Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILE D IN DUPLICATE WITH THE TER QF ILLS FELL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date ofi 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 O 7. Decedern Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will} {Attach Copy of Trust.} O 9. Litigation Proceeds Received O 1 Q. Spousal Poverty Credit {Date of Death O ':1. Election to Tax under Sec. 9113{A} Between 12-31-91 and 1-1-95} (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Te€ephone N ber ~, . ~ Jered L Hock (717) 243-0471 ~Q •v ~ ~ ~ 7 REC,ISTER OF Vfa@ + E ONLI~. =~.~ ~~~ <}' w , ~ First Line of Address CC`` - f, ~ ~~ ~ 1334 Kiner Blvd. C- ~ ~ ., _. `~ Second Line of Address. •~._~ ~ W ~`~ Cj L~ `~- City or Post Office State ZIP Code DATE FILED Carlisle PA 17015 Correspondent's a-mail address: Under penaaies of penury, I decare that I have examined this return, Including accompanying schedules and statements; and to the best of my krowledge and belief, it correct and complete. Declaation of preparer other than the personal representat!ve is based on ail information of •,vhich areparer has any ''knowledge. I AT OF PERSON RE PON$IBLE FOR F ING RETURry, DATE Lt,., _.__ /'~ ~ v ~, i 06/06/2011 ADDRESS 1334 Kiner Blvd., Carlisle PA 17015-9769 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 2505620205 2505620205 ~~ ll -~~ 1,5C1561,a2(75 REV-1500 EX (Fi} Decedent's Social Security Number ~e~eaer,r5 Name: Larne C. Hock 174-03-9089 RECAPITULATION 1. Real Estate {Schedule A} ........ .................................. .. 1. 0.00 2. Stocks and Bands {Schedule Bj ..................................... .. 2 339,699.59 3. Closely Held Corporation, Partnership or Safe-Proprietorship (Schedule C} ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule t3} ......................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Persona! Property tSchedule E}..... .. 5. ', 85,755.89 6. Jointly Owned Property (Schedule Fj O Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 42 690 86 (Schedule G} O Separate Billing Requested...... .. 7. , . 8. Total Gross Assets (total Lines 1 through 7} .. . ........................ .. 8. 468,146.34 9. Funeral Expenses and Administrative Casts {Schedule H} ................. .. 9. ' 17,847.86 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule [} ............. .. 10. 25,458.29 11. Total Deductions {tota3 Lines 9 and 1©} . . . . . . . .. . .............. . ...... .. 11. 43,306.15 12. Net Value of Estate {Line 8 minus Line 11} ............................ .. 12. 424,840.19 13. Charitable and Governmental BequestslSec 9113 Trusts for 4vhich an election to tax has not been made (Schedule J} ... . .................. .. 13. 2,000.00 14. Net Value Subject to Tax {Line 12 minus Line 13j ...................... .. 14. ' 422,840.19 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATE5 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 00 . {aj(12} X .0 __ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 422,840.19 16. 19,027.81 17. Amount of Line 14 taxable at sibling rate X .12 000 17. 18. Amount of Line 14 taxable 0 00 . at collateral rate X .15 18 19. TAx ouE ....................................................... .. 19. 19,027.81 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 ],5fl561~02®5 ],5®561,025 J REV-1500 EX [FI} Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Larue C. Hock STREET ADDRESS Green Ridge Village, 210 Big Spring Rd CITY 'STATE ZIP Newville PA 17241 Tax Payments and Credits: t Tax Due (Page 2, Line 19) (1} 2. CreditsPayments A. Prior Payments _ 17,680.00 __ --- B. Discount 847.91 3. Interest Tota! Credits (A + B j (2} 19,027.81 18,574.71 5.83 458.94 (3j 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 2t} to request a refund. (4) 5. If Line 1 + Line 3 is greater #han Line 2, enter the difference. This is the TAX DUE. (5} Make check payable to: REGISTER 4F 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 ............................................ J c. retain a reversionary interest .............................................................................................................................. ~ ~ 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 o:~dn an "intrust for" or payable-upon-death bank acccunt or security at his or her death? .............. 4. Did decedent o:vn an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ....................... 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 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 ar after July 1, 2000: o 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 chiid is 0 percent [72 P.S. §9116fa)(1.2)]. The tax rate imposed on the net valuue 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(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 sibiing 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-1503 EX+,?-i;) I I I t a pennsylvania g DEPATM [Ni OF PE4'PtJUE /'~ INHERITANCE TAX RETURN TVA & B RESIDENT DECEDENT I j ESTATE OF FILE NUMBER Larue C. Hock 2111-0474 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUl~1BER DESCRIPTION Or" DEATH 1' PP&L - 2000 shares, common, DOD value, $25.76 per share 51,520.00 2 Public Service Electric and Gas (trade symbol PEG) - 1400 shares, DOD value $31.70 per share 44, 380.00 3 Ameriprise, Columbia Diversified Bond Fund, Class A, DOD value per information received from Ameriprise, agent Michael Dwyer, Northumberland PA, (570) 473-8254 9,653.01 4 Eaton Vance, High Income Opportunity - A, 6661 shares, DOD value $4.47 per share 29,774.67 5 Morgan Stanley: CAIBX, 474.23 shares, DOD value $51.37 per share 24,361.20 FKINX, 5734.12 shares, DOD value $2.26 per share 12,959.11 g United States Savings Bonds: 7 "I" Bonds, January, 2006, $1,000 face, DOD value $1216.80 per bond 8,517.60 6 "EE" Bonds, October, 1992, $5,000 face, DOD value $6,576 per bond 39,456.00 6 "EE" Bonds, September, 1992, $5,000 face, DOD value $6,576 per bond 39,456.00 5 "EE" Bonds, January, 1993, $5,000 face, DOD value $6,446 per bond 34,230.00 3 "EE" Bonds, February, 1993, $5,000 face, DOD value, $6,446 per bond 19,338.00 3 "EE" Bonds, September, 1993, $5,000 face, DOD value, $5,018 per bond 15,054.00 3 "EE" Bonds, October 1993, $5,000 face, DOD value, $5,000 per bond 15,000.00 TOTAL {Also enter on Line 2, Recapitulation} $ 339,699.59 it more space is needed; insert additi;,nal sheets of the same size REV->5o8 EX+ (i~-1o) i Pennsylvania ~+u( S LE DEPARTMEPiT CF REJENUE CAS[~7, BANK DEPOSITS & MISC. INHERITANCE TA?( ftETUFPd PERSONAL PROPERTY RESIDENT CECECENT ESTATE OF: FILE NUMBER: Larue C. Hock 2111-0474 Include the proceeds of litigation and the date the proceeds •~°dere received by the estate. All property jointly owned with right oP survivorship must be disclosed on Schedule F. ITEf~1 VALUE AT DATE NUMBER DESCRIPTI03J OF DEATH 1. ~ Members First Federal Credit Union, Account 321194-00 (Note: Joint Owner Spouse Wanda A. Hock ~ predeceased Decedent on Sept. 10, 2009, all assets being Jt. or "T by E" with Decedent) 2. Members First Federal Credit Union, Account 321194-47 (including accrued interest) 3. PNC Checking Account , Account 9260006733 (including accrued interest) 4. PNC Savings Account, Account 9285049457 (including accrued interest) 5. Adams County National Bank (Newville PA), Account 2263769 (including accrued interest) g. ~ First Columbia Bank & Trust Co. (Bloomsburg PA), Account 062943 (including accrued interest) 7. ~ 4 burial plots, Elan Memorial Park, Lime Ridge (Bloomsburg), Columbia County PA g. j Blue Cross insurance premium refund (unused premium) (Note: Decedent lived in nursing home for several years and had no tangible personal property except used valueless clothing, which was donated to charity or discarded as worthless after his death). 11.24 44,287.25 21,981.24 2,183.64 2,052.39 14,603.04 400.00 237.09 TOTAL (Aiso enter on Line 5, Recapitulation) $ 85,755.89 If more space is needed, use additional sheets of paper of the same size. REV-i5o9 EX+ (oi-io) -~~ pennsylvan~a DE PARTM EPvT OF RE`JE~~;vUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Larue C. Hock 2111-0474 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE ]DINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYWG NUMBER. ATTACH DEED FOR )OWTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 08/09/10 Graystone Bank -Reported on Sch. G "Less than 1 year" 0.00 0 0.00 2. A. 01102/11 ELCA Mission Inv. Fd -Reported on Sch. G "Less than 1 year" 0.00 0 0.00 TOTAL (Also enter on Line 6, Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. 0.00 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. RcV _:. ~ .. -u°j ~ pennsylvania SCHEDULE G ~' o=..=aR-wiF~dT of zeverd,~- INCTt/ER-VIVO~fS T®R~AANSFryERSt~ ANDY SNHER;TANCE TAX RcP.JRR ~ .rs NO -PR®BTE OPET i RESIGENT DECEDEPJT ESTATE OF FILE NUMBER Larue C. Hock 2111-0474 This schedule must be corrpieted and fired if the ansU~er to any of c:uesticns 1 through 4 or, page three of the REV-1500 is yes. iTEh1 NUMBER GESCRIF n, OF FROP'ER Y N~~~~oE ~r ~ ,Frye _,t-, ~ te,_~,.~to ,. ~o~ECFO -grit, ~ 'H~r.~- . rc:se=,, aTa.-~.a~~f !, T+r r,=~o „a ~. =sTr,T=. ! DATE flF DEATH '!ALUEOF,ASSET °/a OF CECD'S IPTEREST EXCLUSION IF - TAXABLE VALUE .. ELCA Mission Invest. Fund, Trans. to Jered L. Hock, Son, on 01/02/11 15,196.03 50 3,000.00 12,196.03 2 Graystone Bank, Trans. to Jered L. Hock, Son, on 08/09/10 ~ 15,403.77 50 0.00 15,403.77 3 PNC IRA account 75100004602, Decedent's Estate beneficiary 9,407.28 100 ''I 0.00 9,407.28 PNC IRA account, 75900004589, Jered L. Hock, Son, beneficiary 78 5 683 100 0 00 683 78 5 4 , . 3 I i I E i . I ~~ . ; Tt~TAL (Also enter cn Line 7, Recapitulation) $ 42,690,86 It more space is needed, use add!tonal sheets r,` paper of the same sze. Ra ~ 5..E -~c'; pennsylvan~a OE~A *.TMENT OF REUEMUE INHERiT,4NCE TAX REPJRN RESIGEN DECEDENT 5CHEDULE FUNERAL EXPE SS N® ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Larue C. Hock 2111-0474 pecedent`s debts must be reported on Schedule I. ITEP1 NUPIBER DESCRIFTDPi AMOUNT A. FUNERAL EXPENSES: 1' Allen Funeral Home, Bloomsburg PA 13,085.00 2. Bon Ton (clothing for deceased for viewing) 81.81 3. Folk Florist, Bloomsburg PA (flowers for coffin/funeral) 318.00 a. Pine Barn Inn, Danville PA (funeral reception) 1,932.50 s. The Rev. Charles Brophy, Carlisle PA (ministerial services for funeral) 200.00 s. The Sentinel, Carlisle PA (obituary notice) 60.00 B. ADMINISTRATIVE COSTS; 1. Personal Representative Ccm,missior:s: Name(s) of Personal Representatives; Jered L. Hock street Address 1334 Kiner Blvd. City Carlisle ware PA zIF 17015 years; Commission Paid: No commission paid. These are mileage expenses only 2. Attorney fees: 3. Fam y Exemption: (I` cecedent`s address .s not the same as claimant's, attach explanation. i Claimant Street Address City State ZI? Re!aticnship of Cla mans to Decedent 4. P°ohate Fees: 5. Accountant =ees: 6. Tax Return Prepaer Fees: %• Carlisle Sentinel, Estate Notice a. Cumberland Law Journal, Estate Notice s. Postage and necessary Express Shipping ~o. Fax, photocopy (Office Max) ~ ~ . Register of Wills, Account, Releases, Extra Short Certificates ~ 2. Reserve for closing costs 40.00 0.00 0.00 535.00 600.00 340.00 145.06 75.00 30.19 30.30 355.00 20.00 T©TAL fAlsr~ entFr nn Line 4. Recar~itulationl 5 17,847.86 It more space is needed, use additional sheets ct paper of the same size. REV-51Z E~~, 'i<'-ORj ~ pennsytvania SCHEDULE I ~' o=-AR?MENT ~F ~E•~E~,;~_ DEBTS OF DECEDENT, INHERITANCE TAa RETURN MORTGAGE LIABILITIES LIENS RESICENT. DECECEPJT ESTATE OF FILE NUMBER Larue C. Hock 2111-0474 Report debts incurred by the decedent prier to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM V~:LUE AT DATE hiJf~18ER ~ DESCRIPTIO(~J OF DE.4TN r Green Ridge Village, Newville PA -nursing home bill of decedent 10,197.00 2. Millenium Pharmacy -Drug bill of decedent 728.29 3. United States Treasury -Income tax owed by decedent (NOTE: This bill is all for taxes owed on income before the date of decedent's death. None of it is for post-death taxes. The taxes were calculated by Susquehanna Financial Advisors, attn: Ed Gormley, Mechanicsburg PA) and have been paid to U.S. Treasury 4. PA Department of Revenue - Income tax owed by decedent (NOTE: This bill is all for taxes owed on income before the date of decedent's death. None of it is for post-death taxes. The taxes were calculated by Susquehanna Financial Advisors, attn: Etl Gormley, Mechanicsburg PA) and have been paid to PA Dept. of Revenue TOTAL (A.Is4 enter on L ine 10, Recapitulation ~ I $ if more space is ^?ed?tl, inner` adcikiona sheets of the came size. 14,466.00 67.00 25.458.29 REV-1513 EX+ !Q1-10) i Pennsylvania SCHEDULE J o,.=ar?riENTOr ~Ev~riu INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Larue C. Hock 2111-0474 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE 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. 9116 (a) (1.2).] 1. I 2. 3. II Jered L. Hock, 1334 Kiner Blvd, Carlisle PA 17015 Stephen G. B. Hock, 1503 St. Denis Ave, Norfolk VA 23509 Joel M. B. Hock, 40 W. 77th St., New York, NY 10024 (Note: Foregoing percentages reflect estate after $2,000 gift/tleduction for Christ Lutheran Church, set forth below. After this $2,000 gift all of clear value of Decedent's estate is taxable at 4.5%, as being transferred by will or beneficiary form to son and grandsons). Son Grandson Grandson ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE, NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1~ None (Spouse, Wanda A. Hock, pre-deceased Decedent) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. Christ Lutheran Church (Buckhorn), Schoolhouse Rd., Bloomsburg PA 17815 2,000.00 ~..~.~ ..~ n•nr w rn~rrn TnTni ninni Tnvnni ~ ni[`TnTDIITin nlc nnl ~ TnIC 17 nC ^C\/_1 rnn fn\/CD CurrT I~ 80% 10% 10% If more space is needed, use additional sheets of paper of the same size.