HomeMy WebLinkAbout07-12-12
1505610105
~ REV-15001x1°'-",(F°~'
OFFICU\L USE ONLY
PA Department of Revenue Pennsylvania Counfy I;ode Year File Number
Bureau of Individual Taxes ~ ,.,.E.., -
POBOX2806of INHERITANCE TAX RETURN ~ _ 21 1 2 0346
Harrisburg PA 17128-0601 RESIDENT DECEDENT '
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
03/13/2102 .11/04/1924
Decedent's Last Name Suffix Decedent's First Name MI
Bock Helen R
(If Applicable) 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 INAPPROPRIATE OVALS BELOW
OD 1. Original Return 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)
OD 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total 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. 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 8E DIRECTED TO:
Name Daytime Telephone Number
. ___
_- __ i
Richard L. Placey, Esq. ~ (717) 236-9577
First Line of Address
Placey & Wright
Second Line of Address
3621 North Front St.
City or Post Office
Harrisburg
~~~ _ ~~ State ZIPCode
--
PA ,17110
REGISTER OF WILLS USE ONLY
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Correspondent's a-mail address: pWeW@eplX.net
Under penalties of perjury, I tleclare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correcyandpomplete. Declaration of preparer other than the personal representative is based on all intormatior of which preparpf has any knowledge.
Philip L. Bock, III, Executor.,.c(o Placey & Wright, 3621 North Front Street, Harrisburg, PA 17110
SIGNATURE OF P$ AR O HER TH R PRESENTATIVE _ J
1 North Front Street, Harrisburg, PA 17110
IE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
J
150561025
REV-1500 EX (FI)
Dec;edent's Social Security Number
Decedent's Name: Helen R. Bock 146-14-2063
RECAPITULATION
1. Real Estate (Schedule A) . ......................................... .. 1. 0.00
2. Stocks and Bonds (Schedule B) ............ .. .. .. ..... ............. .. 2. 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 4,084.50
6. Jointly Owned Property (Schedule Fj O Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
0
00
(Schedule G) O Separate Billing Requested...... .. 7. .
8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 4,084.50
9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 5,830.02
10. Debts of Decedent, Mortgage Liabilities and Liens (Schetlule I) ............. .. 10. 0.00
-..
11. Total Deductions (total Lines 9 and 10) ............................... .. 11.
.-. 5,830.02
__._ _
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 0.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...................... .. 13. 0.00
--.-.__
14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 0.00
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 141axable
at the spousal tax rate, or
transfers under Sec. 9116 -
0.00 '.
0
00
(a)(t2) x .0_ 15. .
16. Amount of Line 14 taxable ~ ~ ~ '
at lineal rate X .0 45, 0.00. ~
16. i,
~
0.00
17. Amount of Line 14 taxable
0
00 ~
'
Q00
.
at sibling rate X .12 17.
.
18. Amount o/ Line 14 taxable
0
00 '.
'
0
00 '~
.
.
at collateral rate X .15 ,
16 .
..
------
19. TAX DUE............ ..... .... .............. .. 19. '~. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1525610205 J
21-12-0346
REV-1500 EX (Fl) Page 3 File Number
Decedent's Complete Address
DECEDENTS NAME
Helen R. Bock __
STREET ADDRESS
46 Erford Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1)
2 Credits/Payments
A. Prior Payments _ 0.00
B. Discount 0.00
Total Credits (A+ B j (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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
o.oo
0.00
0.00
(4) 0.00
(5)
0.00
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 ........................................................................................................................ ...... ^
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 own an "in trust fol" orpayable-upon-death bank account or security at his or her death? ........ ...... ^ ~
4. Did decedent own an individual retirement account, annuity or other non-probate properly, 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)].
Far 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) (li)]. 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 fhe use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(L2)].
The tax rate imposed on the net value of transfers to or far 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)]. Asibling 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-i5o8 EX+ (uno)
i ` Pennsylvania SCHEDULE E
t~ oevnRTneNT or ReveNUe CASHx BANK DEPOSITS & MISC.
mr+ERITnNCE rnx RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
HELEN R. BOCK 21-12-0346
Include the proceeds of litigation and the date the proceeds were received by the estate.
nil orooerly iointly owned with rfaht of survivorship must be disclosed on Schedule F.
[f more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
0.ESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
__. ___.
ESTATE OF FILE NUMBER
HELEN R. BOCK 21-12-0346
Decedent's debts must be reported on Schedule I.
ITEM
A. FUNERAL EXPENSES:
1' Musselman Funeral Home, Inc. 3,240.07
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City _ _ _______- State ZIP____.,,.,__.
Year(s) Commission Paid: ___ ,. __ _
500.00
2. Attorney Fees:
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: 85.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7 PA Department of Public Welfare-claim 1,004.45
B. Reserve for future costs, taxes and expenses 1,000.00
TOTAL (Also enter on Line 9, Recapitulation) $ 5,830.02
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EX+ (01-1D)
~ ' pennsylvania SCHEDULE J
oEeARTnENTOEREVSUUS BENEFICIARIES
INHERRANCE TAX RETURN
RESIDEM DECEDENT
ESTATE OF: FILE NUMBER:
HELEN R. BOCK 21-12-0346
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OP PERSON(S) RECEIVING PROPERTY Da Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Cynthia Nagy, 5510 Vanderbilt Road, Old Hickory, TN 37138 .Daughter One-Third Residue
2. Philip L. Bock, III, 2265 Paonia Street, Loveland, CO 80538 Son One-Third Residue
3. Earl D. Bock, 20 Dannah Drive, Carlisle, PA 17015 Son One-Third Residue
II
1.
it 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:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 00.00
If more space is needed, use additional sheets of paper of the same size.
. , . , ~ ~.
„~,;,~~ ~ ; ~' ";E OF
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LAST WILL AND TESTAME14fFR{( QF
ORPHAN'S COUR?
OF CUI~FFR! ANi ,, r,, ; . PA.
HELEN R. BOCK
I, HELEN R. BOCK, now of Camp Hill, Cumberland County, Pennsylvania, do
hereby declaze this to be my Last Will and Testament and hereby revoke all prior Wills and
Codicils made by me.
1TEM I. 1 direct that all of my just debts and funerai expenses, including the cost
of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my
decease as a part of the administrative expenses of my estate.
ITEM II. I give and devise all ofmy estate of every nature and wherever situate
in equal shares #o my children, CYNTHIA NAGY, PHILIP L. BOCK, III and EARL D. BOCK,
or their respective issue, per stirpes. Should any of them predecease-me and die without issue,
such beneficiary's share shall be paid to the surviving beneficiazies, or their issue, per stirpes, as
the case may be.
ITEM III. ]f any income or principal shall be payable to any person who shall
be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal
representative, as trustee, shall such income and principal for such beneficiary until the age of
twenty-five (25) or during incapacity (whichever event occurs first) aztd shall be entitled to
apply such income and principal to the health, maintenance, support and educarion of such
person after considering other resources available to such person for those needs without the
appointment of any gtiazdian or committee or arty authority of court, and shall be entitled to
make direct application hereunder or to make application by payment thereof to the parent or
other person in charge of such person, or to his or her guardian or to a custodian under the
Uniform Transfers to 1\4inors Act. Any remaining income and principal to which such person
shall be entitled shall be paid and distributed to such person upon attaining the age of twenty-five
(25) or upon the tenmination of incapacity.
Helen R. Bock
IVldf IJ IL VO.WfJ LUlli]IIIC DUUi~
ITEM IV, I appoint my son, PHILIP L. BOCK, III, E~:ecutor of this my Lasl
VY'il[ and Testament. No bond shall be required by my personal representative in any
jurisdiction.
ITEM V. In addition to the powers given by law to my personal representative(s)
and trustee(s) (hereinafter fiduciaries] in the administration of my estate and of any trust(s)
created herein, they shall have the following discretionary powers applicable to all real and
persona[ property held by them, including property held for minors, effective without court order
until actual distribution.
A. To retain any property owned by me at my death and to invest auy funds held
by them in any stocks, bonds, notes or other securities or property, real or personal, including
common trust funds, mutual funds and money market deposit accounts operated or offered by
my corporate trustee, if any, or any affiliate of it.
B. To sell or otherwise dispose of any property, real or personal, at any time
fornvng a part of my estate or the trust estate, for cash or upon credit, in such manner and on
such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the
application of any monies paid
C. To manage, operate, repair, improve, mortgage or lease for any teen [even if
beyond the duration of the trust{s)] any real estate at any time held or owned by them as
fiduciaries
D. To hold investments in the name of a nominee and exercise and dispose of
warrants.
E. To engage in litigation and compromise, arbitrate or abandon claims and
property.
F. To conduct any business in which I am ea~gaged or in which I have an interest
at the time of my death for such period as the fiduciaries deem advisable, with the power to
~~ ' _1~
He en R. Bock
borrow money and to pledge the assets of the business and to do all other acts which I, in my
lifetime, could have done, or to delegate such powers to a partner, manager or employee without
liability for any loss occurring therein.
G. To allocate items of receipt or disbursement between principal and income as
the fiduciaries deem equitable regardless of the character given such items by law; to distribute
in cash or kind or partly in each at valuations fixed by the fiduciaries.
H. To borrow money, including the right to borrow from any corporate trustee, if
any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee.
I. To join in any merger, reorganization, voting mist plan or other concerted
action of security holders, and to delegate discretionary duties with respect. thereto.
J. Should the principal of any trust herein provided for be or become too small in
ttustee's opinion so as to make establishment or continuance of the trust inadvisable, my
u~ustee(s) may make immediate distribution of the then remaining principal and any accumulated
or undistributed income outright to the person or persons and in the proportion they are then
entitled to income. Upon such termination, the rights of all beneficiary-(ies) who might otherwise
have an interest as succeeding income beneficiary(ies) or in remainder shall cease.
K. In general, to exercise all powers in the management of the assets of my estate
or the trust estate which any individual could exercise in the management of similar property
owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to
execute and deliver all instruments and to do alt acts which the fiduciaries may deem necessary
or proper to carry out the purposes of this will or any trust(s) created herein.
L. To apply income or principal to which any beneficiary is entitled, directly for
his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary
incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the
same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a
complete acquittance therefore without the intervention of any guardian.
Helen IZ Bock
M. To assume continuance of the status of any beneficiary with reference to
death, marriage, divorce, illness, incapacity or other change in the absence of information
deemed reliable without liability for disbursements made on such assumptions.
~l. all principal and income shall, until actual distribution I:o any beneficiary, be
free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may
not be liable for any levy, attachment, execution or sequestration while in the hands of any bene-
ficiazy, and the same may not be liable for any levy, attachment, execution or sequestration while
in the hands of any fiduciaries.
i~
~., ~ IN WITNESS WHEREOF, I have hereunto set my hand and seal t)s>~ ~dtay
of J L~ ~ ~~ ,2006.
~? - /..7--Plt~
Helen R. Bock.
The preceding instrument, consisting of this and three other pages, identified by the signature of
the testatrix, was on the day and date thereof signed, published and declared by Helen R Bock,
the testatrix therein named, as and for her last V1ri11, in the presence of us, who, at her request, in
her presence, and in the presence of each other, subscribed our names as witnesses hereto.
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN
], HEtEN R BOCK, testatrix whose Dame is signed to the ahached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that i signed and
executed the instrument as my ]ast tiNill, that I signed it willingly, and that I signed it as my free and
voluntary act for the purposes therein expressed.
9 ~-G~/~
Helen R. Bock
S~vom or affirmed to and acknowledged before me, by Helen R. Bock, testatrix, this
~~^O day of ~ , 2006.
WEALTH OF pENNSYLVANiA
Nolirr®I Seal
Melva M. Wafs. N61aty Public
suaquahamaT'wa..O>a+P~ Cary
MyConManbn Fjpinu Os113.2D07
MemOar, Panmylven~a Association Of Nolartes
COMMONWEALTH OF PENNSYLVANIA
Notary Public
My Commission Expires:
AFFIDAVIT
SS.
COUNTY OF DA[JPH1N
the witnesses whose names are signed to the ttached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw testatrix sign and execute the
instrument as her last Will; that she signed willingly and that she executed it as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
testatrix signed the Will as witnesses; and that to the best of our knowledge the testatrix was at that
time 18 or more years of age, of sound mind and under no constraint or.dridu~'m'fluence.)
F /~r
~............_. _1,`~
1 OvOLJ~r~.t (,p
Swom to and subscribed before me this ,~.a "`~ day ofd .u , 2006.
COMMONWEALTH DF PENNSYLVANIA -~
NWrel Seal ~~
-}?1 -~--• ~ --.
Meisa M. LUCes. rJOmry Publc Notary, Public
suxtuenanna Twp.. neuphln Crony
My Cmeffbsia~ E>mires 0213, 20(Tr
Member. Pennsylvania Association Of Notaries My Commission Expires:
PLACEY g WRIGHT
RICHARD L. PLACEY
WILLIAM K. WRIGHT
(I 9 43- 1 9991
ATTORNEYS AT LAW
362 I NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 1 7 1 10-1 533
(71 7) 236-9577 FAX (71 7> 236-0843
July 10, 2012
Register of Wills
CUMBERLAND COUNTY COURTHOUSE
One Courthouse Squaze
Carlisle, PA 17013
RE: Estate of Helen R. Bock
Estate No. 21-12-0346
Dear Madam/Sir:
OF COUNSEL
CHARLES J. DENARY, III
STANLEY J.A. LASKOWSKI
We enclose herewith for filing, in duplicate, Pennsylvania Inheritance Tax Return for the
captioned decedent, together with check in the amount of $15.00 to cover the filing fee.
Please return your receipt for the same to the undersigned in the enclosed, stamped,
addressed envelope, together with aclocked-in copy of the additional first page enclosed.
Thank you.
Very truly yours,
RLP:hsk
Enclosures
PLACEY W G~
' and L. P acey T
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